標(biāo)準(zhǔn)解讀
《GB/T 44893-2024 人身保險傷殘評定及代碼》是一項國家標(biāo)準(zhǔn)，旨在為人身保險領(lǐng)域內(nèi)涉及的傷殘評估提供統(tǒng)一的標(biāo)準(zhǔn)和編碼體系。該標(biāo)準(zhǔn)詳細(xì)規(guī)定了不同類型的傷殘如何被分類、評估以及相應(yīng)的代碼表示方法，以便于保險公司、醫(yī)療機構(gòu)及相關(guān)方在處理與人身保險相關(guān)的傷殘賠償時能夠有一致的理解和操作依據(jù)。
標(biāo)準(zhǔn)內(nèi)容覆蓋了從輕微到嚴(yán)重的多種傷殘情況，并為每種情況定義了具體的描述和對應(yīng)的代碼。通過這種方式，不僅簡化了傷殘等級的判定過程，還增強了信息交流的一致性和準(zhǔn)確性。此外，它還包括了一些關(guān)于如何正確使用這些代碼指導(dǎo)原則，確保在實際應(yīng)用中能夠準(zhǔn)確無誤地進(jìn)行傷殘程度的認(rèn)定。
如需獲取更多詳盡信息，請直接參考下方經(jīng)官方授權(quán)發(fā)布的權(quán)威標(biāo)準(zhǔn)文檔。
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文檔簡介
ICS
03.060
CCS
A11
中華人民共和國國家標(biāo)準(zhǔn)
GB/T44893—2024
人身保險傷殘評定及代碼
Disabilityassessmentandcodeforlifeinsurance
2024-10-26發(fā)布2025-02-01實施
國家市場監(jiān)督管理總局發(fā)布
國家標(biāo)準(zhǔn)化管理委員會
GB/T44893—2024
目次
前言
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Ⅲ
1
范圍
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1
2
規(guī)范性引用文件
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1
3
術(shù)語和定義
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1
4
傷殘評定原則
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1
4.1
確定傷殘評定步驟
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1
4.2
確定傷殘評定時機
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1
4.3
確定傷殘類別
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1
4.4
評定傷殘等級
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2
4.5
匹配保險金給付比例
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2
4.6
多處傷殘的評定
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2
5
傷殘的分類、等級及代碼
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2
5.1
神經(jīng)系統(tǒng)的結(jié)構(gòu)和精神功能
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2
5.2
眼、耳和有關(guān)的結(jié)構(gòu)和功能
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3
5.3
發(fā)聲和言語的結(jié)構(gòu)和功能
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6
5.4
心血管、免疫和呼吸系統(tǒng)的結(jié)構(gòu)和功能
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7
5.5
消化、代謝和內(nèi)分泌系統(tǒng)有關(guān)的結(jié)構(gòu)和功能
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8
5.6
泌尿和生殖系統(tǒng)有關(guān)的結(jié)構(gòu)和功能
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9
5.7
神經(jīng)肌肉骨骼和運動有關(guān)的結(jié)構(gòu)和功能
························································
11
5.8
皮膚和有關(guān)的結(jié)構(gòu)和功能
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16
附錄A（規(guī)范性）條目編碼規(guī)則
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18
A.1
概述
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18
A.2
字母和數(shù)字的含義
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18
A.3
傷殘分類代碼
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18
A.4
傷殘代碼和限定值說明
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21
A.5
身體功能與身體結(jié)構(gòu)代碼的關(guān)系說明
··························································
25
A.6
身體結(jié)構(gòu)、身體功能代碼匯總
·································································
26
附錄B（規(guī)范性）傷殘等級劃分原則
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29
B.1
一級傷殘
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29
B.2
二級傷殘
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29
B.3
三級傷殘
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29
B.4
四級傷殘
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29
B.5
五級傷殘
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29
B.6
六級傷殘
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30
Ⅰ
GB/T44893—2024
B.7
七級傷殘
·······················································································
30
B.8
八級傷殘
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30
B.9
九級傷殘
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30
B.10
十級傷殘
······················································································
30
附錄C（規(guī)范性）傷殘程度分級判定基準(zhǔn)
···························································
31
C.1
護(hù)理依賴程度分級
·············································································
31
C.2
植物狀態(tài)
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31
C.3
視力損害分級
··················································································
31
C.4
外傷性白內(nèi)障
··················································································
32
C.5
眼瞼顯著缺損
··················································································
32
C.6
語言功能完全喪失
·············································································
32
C.7
咀嚼、吞咽功能喪失
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32
C.8
張口困難分級
··················································································
32
C.9
手缺失和喪失功能的計算
······································································
32
C.10
足弓結(jié)構(gòu)破壞和足趾缺失
·····································································
33
C.11
骨骺、肢體喪失功能及關(guān)節(jié)功能的喪失
······················································
33
C.12
偏癱、截癱及單肢癱
··········································································
33
C.13
肌力的分級
····················································································
33
C.14
瘢痕的計算
····················································································
33
C.15
燒傷面積和燒傷深度
··········································································
34
附錄D（規(guī)范性）傷殘等級與保險金給付比例匹配方法
············································
35
參考文獻(xiàn)
································································································
36
Ⅱ
GB/T44893—2024
前言
本文件按照GB/T1.1—2020《標(biāo)準(zhǔn)化工作導(dǎo)則第1部分：標(biāo)準(zhǔn)化文件的結(jié)構(gòu)和起草規(guī)則》的規(guī)
定起草。
請注意本文件的某些內(nèi)容可能涉及專利。本文件的發(fā)布機構(gòu)不承擔(dān)識別專利的責(zé)任。
本文件由全國金融標(biāo)準(zhǔn)化技術(shù)委員會（SAC/TC180）歸口。
本文件起草單位：中國保險行業(yè)協(xié)會、中國康復(fù)研究中心、中國人壽再保險有限責(zé)任公司、中國人
壽保險股份有限公司、太平人壽保險有限公司、中國平安人壽保險股份有限公司、中國太平洋人壽保險
股份有限公司、泰康人壽保險有限責(zé)任公司、新華人壽保險股份有限公司、富德生命人壽保險股份有限
公司、友邦人壽保險有限公司、中荷人壽保險有限公司、太平養(yǎng)老保險股份有限公司、平安養(yǎng)老保險股
份有限公司、泰康養(yǎng)老保險股份有限公司、中國人民財產(chǎn)保險股份有限公司、中國平安財產(chǎn)保險股份有
限公司、中國太平洋財產(chǎn)保險股份有限公司、慕尼黑再保險公司北京分公司、瑞士再保險股份有限公司
北京分公司、德國通用再保險股份公司上海分公司、中國政法大學(xué)。
本文件主要起草人：商敬國、方力、董向兵、魏杰、侯瑩、賈穎、楊新文、孫鋼、韓鷗、胡琴麗、
胡婷華、孫朋強、盧志軍、李恒、苗景龍、黃喜紅、艾樂、黃蔭善、李屹蘭、周聰、汪洋、鄭超、
章瑛、寧錦、邱卓英、王旭、李永良、王巖、劉曉維。
Ⅲ
GB/T44893—2024
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