党的十四届三中全会提出:“要建立多层次、全方位的社会保障体系”。中国人民保险公司为了配合医疗保障制度的改革,率先在国内开办了各类医疗保险。由于医疗保险牵涉面广,技术复杂,管理难度大,因而骗赔现象频频发生。这成为人保经营医疗保险自身效益不佳的主要原因,严重威协着经营的稳定性,制约着医疗保险的健康发展。 人保山西汾西、安泽两个支公司推行了医疗专家鉴定赔案的管理办法,为我们强化医疗险管理开创了一条崭新的路子,有效地堵塞了 The Third Plenary Session of the 14th Central Committee of the Party put forward the following: “To establish a multi-level and comprehensive social security system.” In order to cope with the reform of the medical insurance system, PICC pioneered all kinds of medical insurance in the country. Due to the wide coverage of medical insurance, technical complexity, and management difficulties, so cheating phenomenon occurs frequently. This has become the main reason for the ineffectiveness of medical insurance for PICC, and the stability of the synergistic operation severely restricts the healthy development of medical insurance. People’s Insurance Shanxi Fenxi, Anze two branches of the medical experts to identify the management of claims, as we strengthen the management of medical insurance to create a new way to effectively block the