교통사고
자동차사고시 의료보험처리방법

by 손찾사 손해사정사님 · 6 개월전조회수 374

<p class="0"><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">자동차사고가 발생되었을 경우</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">, </span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">상황에 따라 보험처리가 안되는 경우가 있습니다</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">.</span></p><p class="0"> <!--[if !supportEmptyParas]-->&nbsp;<!--[endif]--> <o:p></o:p></p><p class="0"><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">이럴때 대부분 당황하기 마련이고</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">, </span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">아픈데도 불구하고 보험처리 문제 때문에 치료를 받지 못하고 있는 경우도 있습니다</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">. </span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">오늘은 이런 경우에 어떻게 해야 하는지 알아보도록 하겠습니다</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">.</span></p><p class="0"> <!--[if !supportEmptyParas]-->&nbsp;<span style="text-align: inherit;">&nbsp;</span></p><p class="0"><o:p></o:p></p><p class="0"><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">"</span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">급여제한여부 조회제도</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">"</span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">인데요</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">. </span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">국민건강보험법에 의거 한 급여제한여부 조회제도란 </span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">"</span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">건강보험 가입자 등이 국민건강보험법상 급여제한 사유에 해당되거나</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">, </span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">제</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">3</span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">자의 행위로 인한 보험사고 행위에 대하여 제</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">3</span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">자로 부터 손해배상을 받은 경우</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">, </span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">건강보험 적용여부에 대해 공단의 결정에 따르도록 하는 제도</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">"</span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">를 말합니다</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">. </span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">이는 요양기관이 임의로 판단하여 가입자 등의 보험급여를 제한하는 사례가 없도록 하여 가입자의 수급권을 보호하고 보험질서를 확입하기 위한 제도입니다</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">.</span></p><p class="0"> <!--[if !supportEmptyParas]-->&nbsp;<!--[endif]--> <o:p></o:p></p><p class="0"><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">그 대상은 </span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">"</span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">교통사고와 폭행사고</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">, </span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">고의사고로 인한 사고</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">, </span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">업부상 또는 공무상 재해</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">, </span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">다른법령에 의하여 보험금여를 받는 경우</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">, </span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">제</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">3</span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">자로부터 손해배상을 받은 경우</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">, </span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">제</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">3</span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">자의 고의 또는 과실행위에 따른 부상으로 진료 받을 경우</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">"</span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">입니다</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">. </span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">건강보험 처리가 안되는 경우를 살펴보면</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">, </span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">고의</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">, </span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">중과실로 사고를 낸 경우이거나 산재나 공무원연금으로부터 보상을 받는 경우이거나 제</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">3</span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">자로 부터 배상을 받은 경우입니다</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">. </span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">제</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">3</span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">자로 부터 배상을 받지 않았다면</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">, </span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">건강보험으로 선처리가 가능합니다</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">. </span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">따라서 자동차사고는 건강보험이 되지 않는다는 조항은 없습니다</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">. </span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">그러므로 병원에서 자동차사고는 건강보험이 되지 않는다고 한다면</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">, </span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">급여제한 여부조회를 해달라고 병원에 말씀하시면 됩니다</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">.</span></p><p class="0"> <!--[if !supportEmptyParas]-->&nbsp;<!--[endif]--> <o:p></o:p></p><p class="0"><span style="text-align: inherit; font-family: 함초롬바탕;">오늘은 자동차사고 발생시 건강보험처리가 되는 방법을 알아보았습니다</span><span lang="EN-US" style="text-align: inherit; letter-spacing: 0pt;">.</span></p><p class="0"><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">사고가 발생되면 판단력을 잃기가 쉽습니다</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">.</span></p><p><br></p><p class="0"><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">따라서 전문가의 도움을 받으시길 권장하며</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">, </span><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">보험사고의 전문가인 손해사정사는</span></p><p class="0"><span style="font-family:함초롬바탕;mso-fareast-font-family:함초롬바탕;">손찾사에서 찾을 수 있습니다</span><span lang="EN-US" style="mso-fareast-font-family:함초롬바탕;mso-font-width:100%;letter-spacing:0pt;mso-text-raise:0pt;">.</span></p>

    #교통사고 #급여제한 #보험처리 #손해배상 #실비보험 #의료보험

상해·사망·후유장해 /질병·암진단비
손찾사 손해사정사

목록