Travelers Fracture Insurance Claims

Travel accident insurance (hereinafter referred to as accident insurance) as referred to in the travel accident insurance system (hereinafter referred to as the insurance system) refers to the travel agency, in order to protect the interests of tourists when organizing group tours, on behalf of the tourists to the insurance company Pay insurance premiums. Once a tourist has an accident during travel, the technical contract stipulates that the underwriting insurance company will pay the insurance premium to the tourist.

Travel agencies in China that apply for travel accident insurance must abide by the "Interim Regulations on Travel Agencies' Application of Travel Accident Insurance."

1. Compensation scope of travel accident insurance Travel agencies organizing group tours must apply for travel accident insurance for tourists. The scope of compensation of the insurance should include the following compensations caused by accidents caused by tourists during travel: (1) Compensation caused by personal injury and death from acute illness; (2) Medical expenses for injuries and acute illness treatment; (3) Death treatment Or the expenses required for the repatriation of the remains; (4) Compensation required for the loss, damage or theft of luggage and items carried by tourists; (5) Compensation caused by third-party liability.

The proportion of the above-mentioned compensation in travel accident insurance for inbound tourism, domestic tourism, and outbound tourism shall be agreed upon by the travel agency and the underwriting insurance company.

2. Insurance period and insurance amount (1) Period. The period of inbound tourism organized by a travel agency begins when the tourist participates in the travel itinerary arranged by the travel agency after entering the country, and ends when the tourist itinerary is completed and the exit procedures are completed. For domestic tourism and outbound tourism, the period starts from when the tourist boards the means of transportation arranged by the travel agency at the agreed time until the tourist leaves the means of transportation arranged by the travel agency at the end of the trip. If a tourist terminates the travel itinerary arranged by the travel agency on his own initiative, the insurance period shall be until the time of termination of the travel itinerary. If a tourist travels on his own after terminating the travel itinerary agreed upon by both parties, he will not be covered by travel insurance.

(2) Amount. The amount of travel accident insurance provided by travel agencies for tourists shall not be less than the following basic standards: ① inbound tourism: 300,000 yuan per tourist; ② outbound tourism: 300,000 yuan per tourist; ③ domestic tourism: each tourist 100,000 yuan for each tourist; ④ One-day tour (including inbound tourism, outbound tourism and domestic tourism): 30,000 yuan for each tourist. Travel agencies that carry out special tourism projects such as mountaineering, hunting, rafting, car and motorcycle rallies, etc. can agree on the insurance amount with the insurance company based on the above basic amount standards and according to the risk level of the project.

3. Insurance procedures (1) Insurance terms. When a travel agency organizes a group tour, the following insurance terms should be clarified in the contract signed with tourists: ① insurance premium; ② insurance amount; ③ compensation ratio for various travel accidents as agreed between the travel agency and the underwriting insurance company.

(2) Insurance procedures. Travel agencies must apply for accident insurance through domestic insurance companies. The insurance procedures should be handled by the organizing agency once, and the receiving agency will not apply for insurance again.

(3) Insurance procedures between travel agencies and insurance companies. The organizing agency shall sign the "Travel Accident Insurance Contract" with the underwriting insurance company in accordance with the insurance contract content stipulated in the "Insurance Law of the People's Republic of China and the People's Republic of China", and handle the insurance procedures in the following ways: ① Hole insurance for each organized travel group The company handles the insurance procedures once; ② Based on the number of tourists organized in the previous year, the company handles the insurance procedures for this year at one time with the insurance company. In addition, the travel agency and the underwriting insurance company should agree on the validity period of travel accident insurance claims in the insurance terms, which should generally be within 180 days from the date of the accident.

(4) Valid credentials. When a tourist has an accident within the scope of insurance liability during the validity period of the insurance, the travel agency shall promptly obtain valid certificates from the public security, medical, insurance company or its branches of the place where the accident occurred, and the tour operator shall handle the claim settlement together with the insurance company. matters. For compensation for tourists' small luggage and item losses, the travel agency should stipulate in the insurance terms with the underwriting insurance company; within the agreed amount, the travel agency can advance to the tourist in advance, and the travel agency can handle the matter with the underwriting insurance company based on the claim application and proof of loss. Compensation procedures.

4. Industry supervision (1) Supervision department. The tourism administrative departments of the people's governments at or above the county level shall, in accordance with the relevant provisions of the "Regulations on the Administration of Travel Agencies", supervise and inspect the handling of travel accident insurance by travel agencies, and include the application and claim settlement of travel accident insurance into the scope of annual inspections of travel agencies.

(2) Travel agency obligations. Travel agencies should apply for accident insurance for the tour guides they dispatch to provide services to tourists. The travel agency's sales price should include accident insurance, which can be listed separately. Travel agencies should properly keep various information on travel accident insurance and claim settlement, and accept inspections by the tourism administrative department; after a claim settlement case occurs, the claim settlement situation should be reported to the local tourism administrative department for record in a timely manner.

Travel agencies should choose insurance companies with good insurance business reputation, wide service network and no bad business records.

5. Penalties: If a travel agency fails to handle accident insurance in accordance with administrative regulations, the tourism administrative department will order it to make corrections within a time limit; if there are any illegal gains, the illegal gains will be confiscated; if it fails to make corrections within the time limit, it will be ordered to suspend operations for 15 to 30 days. days, a fine of not less than RMB 5,000 but not more than RMB 20,000 may be imposed; if the circumstances are serious, the travel agency business license shall be revoked.

If a travel agency fails to apply for accident insurance according to the prescribed time limit and amount, fails to agree on the validity period of claims, or fails to apply for travel accident insurance for the tour leaders it dispatches to provide services to tourists, the tourism administrative department shall order it Those who make corrections within a time limit will be given a warning; those who fail to make corrections within the time limit will be fined not less than RMB 5,000 but not more than RMB 10,000.

Travel agencies that fail to obtain valid certificates in time and do not accept industry supervision and inspection will be ordered by the tourism administrative department to make corrections within a time limit and be given a warning; if they fail to make corrections within the time limit, they will be ordered to suspend operations for 3 to 15 days for rectification, and may also be fined RMB Fines ranging from RMB 3,000 to RMB 10,000.

If a travel agency is dissatisfied with the administrative penalty imposed by the tourism administrative department, it may, within 15 days from the date of receipt of the penalty notice, lodge a complaint with the people's government at the same level or the higher level of the tourism administrative department that made the penalty decision. If the administrative department applies for reconsideration, it can also file a lawsuit directly with the People's Court; if it is still dissatisfied with the reconsideration decision of the tourism administrative department at the higher level, it can file a lawsuit with the People's Court within 15 days from the date of receiving the notice of the reconsideration decision. If no application for reconsideration, no prosecution, and no implementation of the penalty decision is made upon expiration of the time limit, the tourism administrative department that made the penalty decision shall apply to the People's Court for enforcement.

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