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Started 10 years ago by gflksoih4x

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 ■ ■ by Case With the development of China's basic medical insurance business, everyone will be entitled to a basic medical insurance inevitable. Universal basic medical insurance, making more and more victims in personal injury and perpetrators can not be provided under the medical expenses of the case, the problem can be solved by medical expenses insurance fund. However, thus it has brought a legal issue: the health insurance fund has reimbursed medical expenses, the victim can no longer require compensation? In our judicial practice,EyO0cGK3W7, long-term follow a trial practice: victims have been reimbursed part of public health, can not ask for compensation. This practice has a direct impact on the medical expenses insurance fund has reimbursed the law applicable,01RB092iJv, so that victims often can no longer be compensated for medical expenses by the health insurance fund has been reimbursed. While a citizen of Suzhou City, Jiangsu Province, this argue, so the health insurance fund has reimbursed the huge medical expenses, obtained by liability ratio of full compensation again. Originality precedent Jinchang Suzhou City, Jiangsu Province People's Court made a judgment on this, a breakthrough trial convention on the future of the judicial practice has played an exemplary role, with positive legal and social significance. Reimbursement of medical expenses of the health insurance fund has been able to ask for compensation? Jiangzhong Fan / text A friend to help accident victims rescue expenses Medicare reimbursement Yan Tao, aged 38, is an ordinary worker in Suzhou City, Jiangsu Province, a car repair service company, his extensive interest due proficient radio technology, natural to become a member of Suzhou City Amateur Radio Association. Radio Association, although from different industries, but a common love them together, it is easy to form each other good friends. Yan Tao warm, good karma, everyone called him brother. January 13, 2007 afternoon, Yan Tao ready to install a radio antenna device at home on the second floor roof, invited the , JIANG Jianjun, Cui loose trio came home to help. After construction began, Yan Tao repeatedly asked everyone to pay attention to safety, et al laugh should be: "This is not the first installation of the antenna,9eYClS1yp0, brother, you will do well." However, the unfortunate thing happened. Fengya Bin younger, agile, volunteered to climb the north Yan Tao family house on the second floor roof, just as he chose to position the antenna, suddenly slipped and fell on the roof of the body, and rolled down the ramp down from the second floor roof , the "bang", the head of the ground, fell heavily to the concrete floor, on the spot and nose bleeding, unconscious mind. Seeing this, Yan Tao, who immediately dialed "120" emergency calls, will Fengya Bin rushed to Suzhou Municipal Hospital. The hospital rescue, Fengya Bin still have no consciousness, only temporarily saved their lives. Even so, whether it is Fengya Bin relatives, or Yan Tao, have said never give up Fengya Bin, will pour their all and do their best ability revived Fengya Bin. in Suzhou City Hospital after the hospital for two months, on 14 March 2007 Go to the Second Affiliated Hospital of Soochow University, Suzhou Municipal Hospital from treatment, and on April 4 to enter the Soviet Second Affiliated Hospital of New District Hospital hyperbaric chamber treatment. April 23 the same year, Pingya Bin from the Soviet Second Affiliated Hospital of New District Hospital and then back to Soviet Second Affiliated Hospital for treatment. October 10 the same year, relatives in comprehensive consideration of the 's condition, the possibility of cure economic situation as well as the family, the hospital requests for go through the automatic discharge procedures. Fengya Bin 207 days in hospital, spent 62 million yuan for medical expenses, medical expenses up to a daily average of three thousand dollars. Such high medical bills, became Fengya Bin and Yan Tao two can not shirk. Fortunately Pingya Bin attended the basic social medical insurance, 44 million yuan in medical expenses through Fengya Bin medical insurance accounts, the social medical insurance fund the settlement. For as required by the Fengya Bin individuals to pay 18 million yuan for medical expenses, Yan Tao to find ways to actively raise, not only to make every home, only deposits, also Radio Association in fundraising activities for the Pingya Bin 13 million yuan to raise funds , except for the payment of medical expenses Fengya Bin, nursing fee, the balance of all to the Pingya Bin families. Despite consumes a lot of manpower and financial resources exhausting, but unfortunately been unable to keep Pingya Bin. October 16, 2007, discharged home after six days, leaving the young daughter, a young wife and elderly parents, forever. The amount of the claim has been reported suffered another controversial and uncompromising Pingya Bin's death, to his family, it is a heavy blow. parents Pingguo Kang, Zhu Yan of landless peasants, living on 300 yuan a month to receive only, all under the age of 60 years, is their only child. Today only begotten son first, and Pingguo Kang felt Tiantadexian couple, can not afford, both fell ill. Fengya Bin wife, Cao Lifen less than 30 years of age, is unable to accept this reality, day in tears, grief Nan Yi. He was only 6 years old daughter, Feng Yuanyuan worldly way, so the next person is grieved. Feng family is thought to help a friend mounted antenna was unexpected calamity befell that Yan Tao shall take full responsibility for this purpose, the compensation for all losses resulting therefrom. Thus, shortly after the funeral for End , Cao Lifen on behalf of the family repeatedly found Yan Tao, Tao and demanding compensation. At this time Yan Tao mood is very heavy. Yan Tao family although not well-off, but after the event, Yan Tao do their maximum capacity, given the maximum compensation. Continue to seek compensation for Cao Lifen request Yan Tao said he could not afford indeed, impossible to lose money. After several fruitless negotiations, and other decisions to safeguard their legitimate rights and interests through legal channels. November 8, 2007, Cao Lifen wife, daughter and parents Pingguo Kang, Zhu Yan and other four came together in Suzhou City Jinchang District People's Court, a lawsuit filed, the Yan Tao onto the dock. Cao Lifen, Feng Yuanyuan, Pingguo Kang, Zhu Yan alleged, January 13, 2007, Yan Tao should request help mounted antenna, during installation, Pingya Bin unfortunate fall from a height, causing head injuries immediately unconscious. into the hospital on the same day, but the treatment failed, on October 16, 2007 died. suffered personal injury in providing helper activities Yan Tao process, in accordance with the relevant legal provisions, namely Yan Tao is to help workers should bear the liability. Accordingly, Cao Lifen, Feng Yuanyuan, Pingguo Kang, Zhu Yan and other four Yan Tao, requesting the court to compensation for medical expenses,TORR0IWA31, death compensation, alimony, mental solatium of RMB 151.9 million yuan. Among them, 620,000 yuan for medical expenses, including medical insurance fund by the settlement of 440,000 yuan, accounting for more than half of the total claims. To court and seek compensation for such a huge loss, Yan Tao felt very unjust. He said: "After what happened, medical expenses paid by me, I should not ask for compensation in addition, I also paid a four plaintiff 80,000 yuan because own gross negligence, should be appropriate to relieve me. part of the responsibility. "In addition, Yan Tao of other four plaintiffs claimed lost income, care,k33r81u05S, is the amount of dependents living expenses, transportation costs,louboutin pas cher, but also raised objections, asked the court in accordance with the regulations. For compensation for death, funeral expenses, mental solatium, hospital food subsidies no objection. Since the case involves legal hot and difficult issues, coupled with the case caused by the local media reports of public concern, it attaches great importance to the people's court Jinchang, three public hearing be heard. So, medical expenses paid by the health insurance fund has been closed, other four plaintiffs can ask for compensation? Yan Tao launch raised the possibility of contributions to offset the corresponding liability? This will not only become the primary focus of the defendants argue both sides, it has become widespread attention. On court, other four plaintiffs and Yan Tao war of words, each side. Fengya Bin questions about medical expenses. Yan Tao believes medical expenses, 44 million yuan by the health insurance fund the settlement, and not the actual expenditures of individuals, not part of the actual loss have occurred, so that part of the medical expenses should be deducted, the four plaintiffs We can no longer claim compensation. To support his point, Yan Tao from the Internet to find a number of case studies and theoretical research articles, he said: China's judicial practice, for medical expenses reimbursed by the public health, are not included in the amount of actual losses victim offender re judgment compensation. In other words, the victim of medical expenses reimbursed by the public health, and can no longer demand the polluter to compensate. This has become a judicial practice. Because our country is not yet universal social health insurance, basic medical insurance fund for reimbursement of part, you can ask for compensation? Although there is no case can learn, however, publicly funded health insurance fund reimbursement of medical claims similar nature, after the health insurance fund reimbursement, the victim no actual loss, should no longer receive compensation. other four plaintiffs argued that Fengya Bin personal enjoyment social basic medical insurance, medical expenses paid by the health insurance fund balances 440,000 yuan Yan Tao is not equivalent to the sum already paid, can not therefore exempt from the payment of the sum Yan Tao responsibility. About Yan Tao raised through donations and 13 million yuan of the issue. Yan Tao advocate, fundraiser is sponsored by the purpose of donation is used to cover the cost of treatment , rather than to a living allowance family, therefore, part of the medical expenses paid for by donations, other four plaintiffs could not claim compensation . other four plaintiffs is that the contributions are good-hearted people in the community to donate to help Pingya Bin therapy,piumini woolrich, not donated to Yan Tao, Yan Tao therefore not exempt the payment of such sums. In addition, the two sides also their responsibility to raise their own ideas. Yan Tao advocates, who that day had several mounted antenna to remind each other to pay attention to safety, but themselves because they do not accidentally fell from the roof, Fengya Bin gross negligence, it should be appropriate to reduce their portion of liability. other four plaintiffs considered gross negligence does not exist, Yan Tao does not provide the necessary security measures to helmets and other places to install the antenna also has a major security risk, it can not be reduced or exempted from civil liability Yan Tao, Tao strict requirements full compensation. The final word should pay court to break the routine Jinchang District People's Court after that, in order to help others to provide unpaid labor workers, because helper activity suffered personal injury, workers should be help liable for damages. is in free fall and cause death to mounted radio antenna in the process, Yan Tao as being to help workers should bear the liability. Meanwhile, according to relevant regulations, the victim of the same damage to occur at fault, it can reduce the liability of obligation to compensate people. From the local police station after the incident interrogation transcripts reflect Tao Yan as a homeowner to install antennas to help friends have done to a certain degree of security alert obligations. Cao Lifen the four plaintiff claims a place to install the antenna there are significant security risks, but did not provide evidence, inadmissible. During the installation of antennas, Pingya Bin accidentally falls, own gross negligence, therefore, reduce the liability of the defendant Yan Tao, the defendant bear 70% of the liability. medical expenses in part by the health insurance fund of 44 million yuan the settlement is based on Pingya Bin lifetime to pay health insurance premiums and enjoy medical insurance benefits, relief to the portion of health insurance policy and can not therefore exempt from the obligation of reparation Yan Tao, Cao Lifen Yan Tao, the four plaintiffs claim compensation for the portion of medical expenses does not violate the law, to support, therefore, the Court finds that the medical expenses of 62 million yuan. Yan Tao launched to raise donations of 13 million yuan, from the point of view is the nature of the community out of love and compassion and donations for Pingya Bin treatment, not donated to Yan Tao payments, it does not belong to the sums paid by Yan Tao, can not from the amount of compensation should bear deducted. After the addition, the court in accordance with the law, on the project and the amount of compensation the four plaintiffs,lifuGf2w7u, calculate and confirm, identified losses totaling 120 million yuan. Yan Tao should bear 70% of the liability, net Yan Tao has been paid, the balance of 71 million yuan Yan Tao shall be paid promptly. October 31, 2008, Jinchang District People's Court of first instance verdict in accordance with the relevant provisions of the law, judgment Yan Tao again other four plaintiffs compensation of economic losses totaling 710,000 yuan. After the first trial, Yan Tao refused to accept the Suzhou Intermediate People's Court of Appeal. Yan Tao made the complaint: first, in this case 44 million yuan in medical expenses paid by the health insurance fund, so the loss of that part of the non-payment of the victim himself, there would be no loss. In addition, the principles of personal injury compensation is to fill the loss, that the victims be compensated for actual losses. In this case the victim's medical expenses of only 18 million yuan, I just from the loss of this part of the compensation, otherwise press of First Instance found, other four plaintiffs will receive an additional benefit of $ 44 million 70%; secondly, donations raised 13 million yuan, is designed for Fengya Bin initiated by me to raise treatment costs of private placement, and all applied to the treatment and not to the four plaintiffs Cao Lifen comfort donations, and should therefore be found victim this loss does not exist, it should be excused of liability on the part of 13 million yuan; and third, that the Court of First Instance I should bear 70% of the liability,moncler Outlet, it should bear the responsibility I should lighten. The fact of First Instance found outside, the other due to the victim Fengya Bin after treatment, the condition has stabilized and under control, just further treatment is entirely possible recovery, but others strongly demand due discharged at the hospital to discourage invalid premise, Fengya Bin discharged, delayed treatment, the subsequent death, resulting in greater losses has not shirk responsibility. Therefore, I further losses caused by the death of its complete absence of fault, and no causal link, their liability should share at 70% or less, and the specific amount of the discretion of the court. In addition, Yan Tao identification on the part of the project amount, but also raised objections. Mainly reply the four plaintiff is upheld. Suzhou Intermediate People's Court after hearing that: in this case the facts are clear, explicit nature of the dispute, the Department of as help workers help mounted radio antenna activity, due to their own negligence fall induced brain trauma, is to help workers Yan Tao shall be liable for the range It caused controversy. On liability ratio. Help workers because helper activity suffered personal injury, worker's responsibility is to help similar employer liability, because help workers with gross negligence, and can reduce the liability of the obligation of reparation. Therefore, the trial court found that Pingya Bin own gross negligence, Yan Tao alleviate 30% of the liability, in the range of reasonable discretion, Yan Tao proportionate liability on the grounds of appeal in delayed treatment and other issues related to the scope of the loss ratio rather than liability. About loss range and the health insurance fund to pay part of the expansion of losses and delays in treatment, the Court considers that the existing personal injury compensation disputes the medical insurance fund for payment of compensation obligations and coverage of the liability relations treatment using the principles of the victims have both, health insurance fund not offset compensation scope of the obligation of reparation. hospitalized due to falls to family members who discharged the past nine months, in the treatment of traumatic brain injury sustained phase, from October 10, 2007 was discharged to family members who died on October 16 for a short interval, according to the final discharge records, admission diagnosis of traumatic brain injury After surgery, hydrocephalus, skull defects,louboutin soldes pas cher, discharge diagnosis of the situation is even worse, despite the existence of rehabilitation could continue treatment, but should be considered to select Pingya Bin families also out of frustration. Yan Tao believes Pingya Bin family requested the hospital delayed treatment, final Pingya Bin death,doudoune moncler soldes, resulting in greater losses unfounded. The trial court handling and identification of dependents on raising money correctly. July 3, 2009, the Suzhou Intermediate People's Court in accordance with the law, to make "rejected the appeal and upheld the original verdict," the final decision. Judges say Together because a friend of mine died tragically unexpected calamity caused huge personal injury compensation cases, as issued a final judgment and settled. Which has aroused widespread concern, the health insurance fund has reimbursed medical expenses can no longer claim the disputed compensation, also will be at the legislative level has been determined. Decision in that case to break the traditional trial practice, play an exemplary role, with positive legal and social significance. Prior to the implementation of social health insurance, to achieve the public health mechanisms. Under public health mechanisms, public health institutions are paid enterprises, institutions, government agencies, military and other, in addition to outside enterprises, including state-owned enterprises and collective enterprises, the other for the state. Public health, and its essence is the state to provide health care,rgI6n1AMiA, the state free to give welfare of citizens. Under this system, the victims have been publicly funded medical reimbursement of medical expenses is essentially free to give the bear country, the victim has not losses, should no longer be compensated. For public health has been reimbursed medical expenses, the court will not be included in the amount of the victim's actual loss, the decision perpetrators then be compensated. Because of our country's public health system for a long time, over time, the trial court's practice became a trial practice is national courts to follow. In recent years, we continue to strengthen the social basic medical insurance system, medical security system and gradually realize the transformation from publicly funded health care system to the social basic medical insurance system. Because of the health insurance fund has reimbursed medical expenses can not ask the question of compensation, the law does not clearly defined, judicial practice regarding claims handling practices of public health has been part of the medical expenses will directly affect the health insurance fund has reimbursed the Court of The application of law, the trial could easily lead to inconsistent consequences. Legally speaking, to raise the level of basic health and social security expenses, all medical treatment from the original country into a full embrace of individuals and units share the burden, medical insurance is to protect individual citizens in accordance with the conditions and the contribution given, citizens of basic medical treatment has been part of the property rights of individual citizens. Thus, by the insurer individual accounts by the basic medical insurance fund to pay the cost of health insurance benefits based on the insurer to pay health insurance premiums and enjoyed, because the insurer if the insurer received the benefit of liability exoneration people, then constitute the insurer's actual losses have not been compensated. Therefore, the health insurance fund has reimbursed medical expenses, it shall again claim compensation. Similarly, the circumstances of the offender if the victim previously obtained full compensation for medical expenses,PmwT24LKCI, may still require social health insurance fund reimbursement of medical expenses should be reimbursed. In other words, personal injury compensation disputes, the health insurance fund to pay compensation obligations and liability, the victim may have both. 

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