Then Mr. Shao offered to send the old lady home, taking the bus to Zongguantang Station, then accompanying her to the entrance of Xinfeng Xincun. The old lady refused to let him see her all the way to her doorstep.
C
The reporter then consulted with Mr. Fei from Hangzhou's Medical Insurance Bureau. He stated that according to the "Social Insurance Law of the People's Republic of China", the following medical expenses are not covered by the basic medical insurance fund: those that should be paid from the work injury insurance fund; those that should be borne by a third party; those that should be covered by public health; and those incurred while receiving treatment abroad. For example, traffic accidents and fights need to be covered by the party responsible for the injury.
Yesterday afternoon at 12:30, I saw Ms. Zhang lying in bed in Ward No. 4 on the 4th floor of Building No. 1 at Ze Yi Second Hospital. Her left hand was bent and resting on her chest. By her bedside, her younger sister was helping her cut her nails.
Over the past few days, Ms. Zhang's arm has been in constant pain. Two bones in her arm were broken and dislocated. She told the reporter that as of yesterday, she had already spent several thousand yuan on medical expenses. "Tomorrow (Thursday) is the surgery, and the doctor said we need to prepare another 50,000 yuan," Ms. Zhang said. "I am a retired worker, and my daughter also earns a modest income. This amount of money is not small change for our family, and we simply cannot come up with it right away."
□ Times reporter Dong Jie, text and photo
Upon examination, the old lady had only suffered external injuries to her head, with slightly elevated blood pressure, but otherwise was fine.
Ms. Fang did not agree that she was responsible for Ms. Zhang's left arm fracture and refused to help Miss Tang provide proof of her inability to bear compensation, as she believed she did not need to compensate.
Medicine expense reimbursement
Unexpected injury leads to hospital refusal of medical insurance. Share to: Welcome to post comments. I want to comment.
The medical insurance department informed Ms. Zhang that this kind of injury could not be covered by medical insurance and required the elderly person to compensate. Ms. Zhang indicated that the elder lived in hardship and that the incident was an accident and thus should not require the elder to compensate. If necessary, she would fully cooperate in providing relevant certificates, hoping that relevant departments would consider her situation of being injured while doing good deeds and help mediate.
● Follow-up
Just as the elevator was ascending, the elderly person suddenly fell backwards, landing on Ms. Zhang's left arm, causing both of them to fall.
A
Times news: Yesterday, Hangzhou's 12345 Mayor's Hotline received a letter: On the morning of February 3, 63-year-old Ms. Zhang Liyi went to the People's Pharmacy on Jiefang Road to get medicine. Due to the inconvenience of an elderly person nearly ninety years old climbing the stairs, out of kindness, she helped the elderly person take the elevator. However, they accidentally fell, resulting in Ms. Zhang fracturing two hand bones in her left hand. She is currently being treated at Ze Yi Second Hospital.
Ms. Zhang is a retired worker with Hangzhou's medical insurance. After using her medical insurance to register at the emergency department, the doctor asked Ms. Zhang to first go and take an X-ray.
Finally, under the assurance from the pharmacy that the old lady would not have to pay any money, she agreed to go to Ze Yi Second Hospital for a check-up accompanied by Mr. Shao.
The involved old lady does not recognize herself as being responsible.
50,000 yuan surgery fee remains unresolved.
I looked down to the first floor and saw an old lady leaning on a cane next to the escalator, "I also want to buy medicine, can you help me?"
Miss Tang, Ms. Zhang's daughter, told the reporter: "In order to handle the medical insurance reimbursement, I have been running around for several days. The medical insurance staff told me: Now we need to process a fact situation certificate and a certificate proving the old lady's inability to bear compensation. Once these materials are collected, the staff will decide whether my mother's situation qualifies for medical insurance reimbursement based on the material."
According to Ms. Zhang's introduction, she lives near Qingtai Street. "At around 9:30 AM on the 3rd, I went to the People's Pharmacy on Jiefang Road nearby to get medicine. Since the pharmacy is on the second floor, accessible only by escalator, when I got upstairs, suddenly a voice called me: Sister, Sister!"
The old lady appeared to be in her eighties or nineties. I quickly took the escalator down to the first floor. "Let me help you up," Ms. Zhang supported her towards the escalator. "Since the pharmacy installed a small escalator, each step is only wide enough for one person. After I helped the old lady onto the escalator, I stood on the step below her and reminded her to hold the handrail beside her."
Unexpectedly, at that moment, I just happened to meet the old lady. The old lady's surname is Fang, and she is 89 years old this year.
D
Regarding that day's event, Ms. Fang gave a different account. "That day, I wasn't feeling well and wanted to buy some medicine, but didn't want to bother my children, so I came to the People's Pharmacy by bus alone." Ms. Fang said that she didn't dare to go upstairs on the first floor, so she stopped Ms. Zhang for help. "I originally intended to give her the medicine bottle and ask her to go upstairs and buy it for me, but unexpectedly, she said she would help me up. She used a lot of strength, grabbed my arm, pulled me onto the elevator, and then I fell, and she fell too."
After the incident, the staff turned off the elevator and helped them both up to the second floor.
In the store manager's office, Miss Tang took out two prepared drafts of the "External Injury Fact Certificate" and after Manager Dong verified the facts, he stamped the unit's official seal.
"Now my mother has become the most innocent person, not only getting injured but also having no way to claim medical expenses." Miss Tang said dejectedly, "If this is the case, who would still dare to do good deeds in the future?"
Mr. Fei said: "We absolutely cannot let the patient's medical expenses go unaccounted for. If the medical expenses are legally supposed to be borne by a third party, and the third party does not pay or cannot be determined, the basic medical insurance fund can make advance payments. After the basic medical insurance fund makes advance payments, it has the right to seek compensation from the third party." Weibo recommendation | Today's Weibo hot topics (Editor: SN017)
At 2 PM on the afternoon of the 3rd, Ms. Zhang's younger sister rushed to Hangzhou's Medical Insurance Center. The staff there stated that Ms. Zhang's situation belonged to accidental injury and could not use medical insurance. It needed to be compensated by the third party causing the injury. According to the description provided by Ms. Zhang's younger sister, the responsible person was the old lady, so Ms. Zhang's medical expenses should be compensated by the other party.
Regarding the cause of the injury, when the doctor reviewed the X-ray, he inquired about the reason for Ms. Zhang's injury. After hearing the story, the doctor informed her that her situation could not be reimbursed through medical insurance and that she would need to re-register as a self-paying patient.
To treat her arm first, Ms. Zhang purchased a new hospital IC card. Upon examination, two hand bones in her left hand were fractured, requiring surgery. After notifying her family, she paid and processed the admission procedures.
"The old lady said she had no medical insurance, her relationship with her children was bad, and her living conditions were quite difficult. That day, even after getting injured, she refused to go to the hospital for fear of spending money. I think this incident was an accident and shouldn't require the old lady to pay compensation." Ms. Zhang said, "If necessary, I'm willing to fully cooperate in providing relevant certificates. I hope that relevant departments can consider the fact that I was injured while helping an elderly person and help mediate, allowing me to use medical insurance for treatment."
"I don't regret helping the old lady at the time. Seeing someone in trouble, I couldn't possibly not help." Ms. Zhang said, "But now doing good deeds has instead become a burden."
Seeing the old lady bleeding from the back of her head, Ms. Zhang let the staff first deal with her wounds while she crossed the street to Ze Yi Second Hospital for treatment.