TP HUN NGHIP V BO HIM TRCH NHIM NGH NGHIP BC S

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CNG TY BO MINH H NI

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BO HIM TNNN BC S
I. QUI NH PHP L .

y l loi hnh bo him bt buc theo Ngh nh s

102/2011/N-CP ca Chnh ph ban hnh ngy 14/11/2011. Ngh nh ny qui nh v bo him trch nhim trong khm bnh, cha bnh i vi cc c s khm bnh,

cha bnh c cp php hot ng ti Vit Nam.

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CNG TY BO MINH H NI

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BO HIM TNNN BC S

II. SN PHM BO HIM

II.1. i tng c bo him :
1. Ngi hnh ngh khm bnh, cha bnh l ngi c cp chng ch hnh ngh v thc hin khm bnh, cha bnh gm : (1) Bc s, y s; (2) iu dng vin; (3) H sinh vin; (4) K thut vin; (5) Lng y; (6) Ngi c bi thuc gia truyn hoc c phng php cha bnh gia truyn.

2. Ngi hnh ngh ti c s khm bnh, cha bnh l ngi hnh ngh trong bin ch, ngi c HL, ngi hnh ngh c c s khm bnh, cha bnh mi t c s khm bnh, cha bnh khc n h tr chuyn mn.
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BO HIM TNNN BC S
II.2 PHM VI BO HIM.

Bo Minh bi thng cho nhng ri ro, tai bin xy ra do sai st chuyn mn hoc bt cn khi thc hin dch v khm bnh, cha bnh ti c s khm bnh, cha bnh. Phm vi a l : - Ti c s khm cha bnh, bnh vin chnh. - C s iu tr ngoi tr ca bnh vin chnh - Trong xe cu thng.
CNG TY BO MINH H NI Slide 4

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BO HIM TNNN BC S
II.3 THI HN BO HIM, HI T V KHIU NI + Thi hn bo him thng l 12 thng v c ti tc hng nm. + Thi hn hi t thng l khng qu 03 thng k t lc bt u thi hn bo him.

+ Thi hn khiu ni c m rng n 36 thng k t thi im hp ng ht hiu lc hoc chm dt thi hn bo him
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BO HIM TNNN BC S
II.4 HN MC TRCH NHIM BI THNG :

1/ Hn mc trch nhim ca mi v khiu ni : i vi tt c cc v khiu ni m

- Pht sinh t mt nguyn nhn chung c th nhng dn n thng tt thn th ca nhiu hn mt bnh nhn - Nhiu hn mt Ngi c bo him c lin quan n mt v cng mt tn tht s c xem l mt v khiu ni.

- Ngy tn tht s c xem l ngy khiu ni u tin bng vn bn c gi n Ngi c bo him. .

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CNG TY BO MINH H NI

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BO HIM TNNN BC S
2.Hn mc bi thng gp :

+ Hn mc bi thng gp l hn mc bi thng cho tt c cc cc v khiu ni xy ra trong thi hn bo him: + Trch nhim ca Bo Minh i vi mi chi ph bi thng cho mi v khiu ni pht sinh trong thi hn bo him khng c vt qu hn mc gp c qui nh trong Hp ng bo him. Lu : * i vi Hn mc bi thng gp nh hn 02 triu USD th khng phi thu xp trc vi nh ti bo him. * Gi tr hn mc bi thng cho mi v khiu ni nn tnh bng 10%-20% Hn mc gp.

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CNG TY BO MINH H NI

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BO HIM TNNN BC S
II.5 PH BO HIM :

Ph BH 01 nm = 01% x Hn mc trch nhim gp + (S lng bc s, y t v.v + 200.000 /01ngi)

VD : Bnh vin a khoa tnh Ph Th c s lng cn b CNV bc s, y t, y s v.v l 619 ngi. Hn mc trch nhim gp l 4.000.000.000 VN.Tnh ph BH cho thi hn bo him 01 nm. Ph BH (01 nm) = (4.000.000.000 * 1% + 619 x 200.000) + 10% VAT = 163.800.000 + 16.380.000 = 180.180.000 ng.

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CNG TY BO MINH H NI

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BO HIM TNNN BC S
II.6 Cc im loi tr : Tham kho qui tc BH

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CNG TY BO MINH H NI

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Bo him TNNN bc s
II. 7 iu kin c bit lin quan n trch nhim ca Ngi c bo him v l iu kin tin quyt Ngi c bo him c quyn

c bo v hoc c bi thng theo Hp ng bo him ny l:

1.

2.

3.

4.

Cc thng tin v cc chi tit ghi trong Giy yu cu bo him l ng s tht. Trong sut thi hn bo him, Ngi c bo him phi thng bo ngay bng vn bn cho Bo Minh v bt k khiu ni no, bt k thng tin no bt k hnh vi no c th chng li Ngi c bo him. Ngi c bo him trong mi trng hp phi : Lu gi cc ghi chp hot ng dch v chuyn mn sn sng cung cp cho Bo Minh kim tra trong qu trnh gii quyt khiu ni. Nu khng c s chp thun bng vn bn ca Bo Minh, Ngi c bo him khng c tha nhn trch nhim hoc chp nhn gii quyt i vi bt k khiu ni no.

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CNG TY BO MINH H NI

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Bo him TNNN bc s
II.8 Khiu ni v gii quyt bi thng
Sau khi c s c, tai bin xy ra, Ngi c bo him phi thng bo ngay cho Ngi bo him v chun b b h s yu cu bi thng bao gm : Thng bo tai bin v yu cu bi thng bng vn bn. n khiu ni ca Ngi bnh hoc i din hp php ca Ngi bnh gi Ngi c bo him . Kt lun ca Hi ng chuyn mn v nguyn nhn gy tai bin v mc thng tt nh hng n Ngi bnh. Bn sao h s bnh n v cc ti liu, chng t lin quan lm cn c tr tin.

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CNG TY BO MINH H NI

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