What Are Medical Expenses?

Medical expenses refer to the expenses that victims must pay for medical examinations, treatment and rehabilitation training after suffering personal injuries. Medical expenses include not only past medical expenses, such as treatment expenses, medical expenses, but also future medical expenses, such as rehabilitation expenses, cosmetic expenses, and other follow-up treatment expenses.

Medical fees

Medical expenses refer to the expenses that victims must pay for medical examinations, treatment and rehabilitation training after suffering personal injuries. Medical expenses include not only past medical expenses, such as treatment expenses, medical expenses, but also future medical expenses, such as rehabilitation expenses, cosmetic expenses, and other follow-up treatment expenses.

Chinese name

Medical fees

Nature

Medical examination, treatment and rehabilitation training

Attributes

Paid in the work injury insurance fund

Features

List of assistive device deployment agencies

Medical expenses refer to employees who suffer injuries due to work accidents or suffer from occupational diseases for treatment, rehabilitation treatment, work-injured employees who still need to be treated after the suspension of pay period, and work-injured employees

1. General Principles of Civil Law

Article 119 Whoever injures a citizen's body and causes injury shall be compensated for medical expenses, reduced income due to missing work, and living allowances for the disabled; those who cause disability shall pay funeral expenses and necessary living expenses for those who are supported by the deceased during his lifetime.

2. Regulations on Handling Medical Accidents

Article 50, Paragraph 1 Medical expenses: Calculated according to the medical expenses incurred in the treatment of personal injuries caused by medical accidents, and paid on the basis of medical expenses, but excluding the medical expenses of the original disease. If it is really necessary to continue treatment after the case is closed, it shall be paid according to the basic medical expenses.

3. " Injury Insurance Regulations"

Article 29: Employees are treated for accidents or occupational diseases as a result of their work, and enjoy medical treatment for work-related injuries.

For treatment of work-related injuries, employees should seek medical treatment at a medical institution that has signed a service agreement. In an emergency, they can go to the nearest medical institution for first aid.

The expenses required for the treatment of work-related injuries comply with the work injury insurance diagnosis and treatment project catalog, work injury insurance drug catalog, and work injury insurance hospitalization service standards, and shall be paid from the work injury insurance fund. The work injury insurance diagnosis and treatment project catalog, work injury insurance drug catalog, and work injury insurance hospitalization service standards shall be prescribed by the labor security administrative department of the State Council in conjunction with the health administrative department of the State Council, the drug supervision and administration department, and other departments.

The cost of rehabilitation treatment for an injured worker at a medical institution that has signed a service agreement shall be paid from the work injury insurance fund if it meets the requirements of the third paragraph of this article.

Article 31 Workers who have suffered a recurrence of work-related injuries who have been identified as needing treatment shall enjoy the treatment of work-related injuries as provided in Articles 29, 30 and 31 of these Regulations.

4. Opinions of the Supreme People's Court on the Implementation of the General Principles of the Civil Law of the People's Republic of China (Trial) ^[1]

Article 144 Compensation for medical treatment expenses shall generally be based on the diagnosis certificate of the local treatment hospital and the transaction documents of medical expenses and hospitalization expenses. Expenses of seeking medical treatment in another hospital without approval should be approved by the medical department, and generally no compensation will be made; for those who purchase drugs unrelated to the damage or treat other diseases without authorization, the expenses will not be compensated.

5. Interpretation of the Supreme People's Court on Several Issues concerning the Application of Law in the Trial of Cases of Compensation for Personal Damage

I. Legal basis

According to Article 19 of the Interpretation of the Supreme People's Court on Several Issues concerning the Application of Law in the Trial of Cases of Compensation for Personal Damage. Medical expenses are determined based on receipts of medical expenses and hospitalization expenses issued by medical institutions, combined with relevant evidence such as medical records and diagnostic certificates. If the obligor has objections to the necessity of treatment, he shall bear the corresponding burden of proof.

The amount of compensation for medical expenses shall be determined according to the amount actually incurred before the conclusion of the first instance court debate. Rehabilitation fees, appropriate cosmetic fees, and other follow-up treatment fees necessary for organ function recovery training may be paid separately by the right holder for compensation after the actual occurrence. However, according to the medical certificate or the conclusion of the appraisal, the expenses that must be incurred can be compensated together with the medical expenses that have already occurred.

Interpretation of Articles

1. This article determines the compensation principles, compensation standards, calculation of compensation amounts, and rules of burden of proof for medical expenses.

2. The principle of compensation is that the obligor compensates the victims for the medical expenses actually incurred when they are infringed by the law. The people's court shall determine the medical expenses according to the receipts such as medical expenses and hospitalization fees issued by the medical institution, and combine relevant medical records and diagnosis certificates Amount.

3. In the scope of compensation, not only the medical expenses already paid by the victim, but also the rehabilitation costs necessary for organ function recovery training, appropriate cosmetic costs, and follow-up treatment costs that may occur in the future.

4. Issues to be noted when applicable:

(1) "Organ function recovery training fee" does not include the cost of psychological treatment after being violated.

(2) "Follow-up treatment fee" refers to the cost of fixing the signs of the injury after treatment and leaving the remaining dysfunction that needs to be treated again or the injury has not yet recovered and requires secondary treatment.

5. Related provisions

Article 17 The victim suffered personal injury, various expenses due to medical treatment and reduced income due to lost work, including medical expenses, lost-work expenses, nursing expenses, transportation expenses, accommodation expenses, hospitalization subsidies, necessary nutrition expenses, The obligor shall pay compensation.

If the victim is disabled due to an injury, the necessary expenses incurred due to the increase in living needs and the loss of income caused by the loss of labor capacity, including disability compensation, disability assistive device costs, living care for the dependents, and continued treatment of actual occurrences Necessary rehabilitation costs, nursing costs, follow-up treatment costs, and the obligor should also pay compensation.

In the event of a victim's death, the obligor shall compensate the funeral expenses, living expenses of the dependants, death expenses, and transportation expenses of the relatives of the victim in addition to the related expenses specified in the first paragraph of this article according to the rescue treatment. , Accommodation costs, and other reasonable costs such as lost time.

Article 19 Medical expenses are determined based on receipts of medical expenses and hospitalization expenses issued by medical institutions, combined with relevant evidence such as medical records and diagnostic certificates. If the obligor has objections to the necessity and rationality of treatment, he shall bear the corresponding burden of proof.

Amount of compensation for medical expenses. It is determined based on the actual amount that occurred before the conclusion of the first instance court debate. Rehabilitation expenses necessary for organ function recovery training, appropriate cosmetic expenses, and expenses that must be determined based on medical certificates or appraisal conclusions may be compensated together with the medical expenses that have already occurred.

6. Interpretation of the Supreme People's Court on Several Issues in the Trial of Compensation Cases for Electric Shock

Article 4 (1) Medical Expenses: Refers to the fees charged by the hospital for the treatment of persons injured by electric shock. Medical expenses are determined on the basis of the diagnosis certificate, prescription, medical expenses, and hospitalization expenses of the treating hospital.