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[私人意外险中残疾的新评估建议,第1部分:跨学科共识方法——基础]

[New assessment recommendations for disability in private accident insurance, part 1 : An interdisciplinary consented approach-Basics].

作者信息

Klemm H-T, Ludolph E, Willauschus W, Wich M

机构信息

Fachgesellschaft Interdisziplinäre Medizinische Begutachtung e. V., Bayreuth, Deutschland.

Freies Institut für medizinische Begutachtung Bayreuth/Erlangen, Ludwigstr. 25, 95444, Bayreuth, Deutschland.

出版信息

Unfallchirurg. 2022 May;125(5):417-421. doi: 10.1007/s00113-022-01161-4. Epub 2022 Mar 28.

Abstract

The centerpiece of a private accident insurer is the benefit promise in cases of disability, which must be determined by a doctor in due time. The insurer specifies the rates of the compensation scheme for loss or inability to function and the medical expert must then fall back on generally recognized, revised or updated assessment recommendations in order to be able to apply the given framework to the specific, individual situation of the insured person. In four steps (basics, upper and lower extremities [disability within the compensation scheme] and disability outside the compensation scheme) interdisciplinary consensus benchmarks for disability assessment are presented, which should form the basis of a uniform medical assessment of accident-related functional disorders in private accident insurance compensation.

摘要

私人意外保险公司的核心是残疾情况下的保险金承诺,这必须由医生及时确定。保险公司规定了功能丧失或无法正常发挥功能的赔偿方案费率,然后医学专家必须依据普遍认可、经过修订或更新的评估建议,以便能够将给定框架应用于被保险人的具体个人情况。本文分四个步骤(基础、上肢和下肢[赔偿方案内的残疾]以及赔偿方案外的残疾)介绍了残疾评估的跨学科共识基准,这些基准应构成私人意外保险赔偿中与事故相关的功能障碍统一医学评估的基础。

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