GB/T 44893-2024Disability assessment and code for life insurance (English PDF)

Foreword

This document is in accordance with the provisions of GB/T 1.1-2020 "Guidelines for standardization work Part

1.Structure and drafting rules for standardization documents" Drafting is required. Please note that some of the contents of this document may involve patents. The issuing organization of this document does not assume the responsibility for identifying patents. This document is under the jurisdiction of the National Financial Standardization Technical Committee (SAC/TC 180). This document was drafted by: China Insurance Association, China Rehabilitation Research Center, China Life Reinsurance Company Limited, China Life Insurance Co., Ltd., China Taiping Life Insurance Co., Ltd., Ping An Life Insurance Co., Ltd., China Pacific Life Insurance Co., Ltd., Taikang Life Insurance Co., Ltd., Xinhua Life Insurance Co., Ltd., Fude Sino Life Insurance Co., Ltd. Company, AIA Life Insurance Company Limited, ING Life Insurance Company Limited, China Taiping Pension Insurance Company Limited, Ping An Pension Insurance Company Limited Co., Ltd., Taikang Life Insurance Co., Ltd., PICC Property and Casualty Company Limited, Ping An Property and Casualty Insurance Co., Ltd. Co., Ltd., China Pacific Property Insurance Co., Ltd., Munich Reinsurance Company Beijing Branch, Swiss Reinsurance Company Ltd. Beijing Branch, General Reinsurance AG Shanghai Branch, and China University of Political Science and Law. The main drafters of this document are. Shang Jingguo, Fang Li, Dong Xiangbing, Wei Jie, Hou Ying, Jia Ying, Yang Xinwen, Sun Gang, Han Ou, Hu Qinli, Hu Tinghua, Sun Pengqiang, Lu Zhijun, Li Heng, Miao Jinglong, Huang Xihong, Ai Le, Huang Yinshan, Li Yilan, Zhou Cong, Wang Yang, Zheng Chao, Zhang Ying, Ning Jin, Qiu Zhuoying, Wang Xu, Li Yongliang, Wang Yan, and Liu Xiaowei. Life Insurance Disability Assessment and Codes

1 Scope

GB/T 44893-2024 is the Chinese disability assessment scale and code set for life and personal accident insurance. It is the document that decides what a policyholder is paid: an accident insurance contract expresses its benefit as a percentage of the sum insured for a given degree of disability, and the schedule that maps an injury to a percentage is the substance of the contract. Before such a schedule was standardised, insurers used their own and the same injury produced different outcomes. The standard sets the principles and method of the assessment, then the disability categories by body system and function, the neurological, ocular, auditory, speech, facial, spinal, thoracic and abdominal, urogenital and limb categories, with the degrees within each and the criteria for assigning one, the corresponding percentages, and the codes; it then sets the rules for combining multiple disabilities, the timing of the assessment relative to the injury and the qualification of the assessor. It takes effect on 1 February 2025.

This document stipulates the principles for life insurance disability assessment, as well as the classification, grades and codes of disability. This document applies to accidental injury insurance products and other personal insurance products that include accidental liability. Assessment of the degree of disability caused by harmful factors.

2 Normative references

This document has no normative references.

3 Terms and Definitions

The following terms and definitions apply to this document.

3.1 disability Physical disability caused by accidental injury.

Note. Disability refers to impairment of body structure or function, limitation of activities and restrictions on participation.

3.2 body structure Anatomical part of the body.

Note. For example, organs, limbs and their parts.

3.3 body function Physiological functions of various body systems.

4 Disability Assessment Principles

4.1 Determining the Disability Assessment Steps The single disability assessment steps include determining the time for disability assessment, determining the disability category, assessing the disability level, and matching the insurance benefit payment ratio. For multiple disabilities, after completing the assessment of a single disability, the assessment shall be carried out in accordance with 4.6.

4.2 Determining the timing of disability assessment Evaluation is conducted after the treatment of the accidental injury and its complications that are definitely related to the accidental injury is completed or the clinical treatment effect is stable. If there are other provisions in the insurance contract, the provisions of the insurance contract shall prevail.

4.3 Determining the Disability Category The types of disability involved are determined based on the damage to the body's structure and functions. The International Classification of Functioning, Disability and Health (ICF) The theory and method of functional and disability classification divides disability into 8 major categories and 281 disability items. The major disability categories include.