Regulations Governing the National Health Insurance Dispute Mediation Article 24
The dispositional medical expenses case requires the disposition paper stating the following matters:1. The name and code of the contracted medical care institution.2. Texts, facts, and reasons, among which the facts and reasons not concerning the arguments may not be stated.3. The organization and its leading officer.4. MM/DD/YYYYIf the same applicant applies for over two dispute mediations on the same agreement within the given time, only the disputed matters need to be stated as stipulated by Subparagraph 2 of the preceding paragraph. The same process is also applied in the case of the same type and the same mediation result.If the Insurer re-evaluates the medical expenses case in accordance with Paragraph 2, Article 8, the NHI Dispute Mediation Committee is allowed to close the case directly without the disposition paper of Paragraph 1.The disposition paper shall include a notation of the remedial measures available for those who disagree with the decision, as well as the administrative court having jurisdiction to hear such litigation.
中文原文 全民健康保險爭議事項審議辦法第24條
醫療費用案件經審定者,應載明下列事項,作成審定書:
一、保險醫事服務機構之名稱及代號。
二、主文、事實及理由。
其中事實及理由部分,為雙方所不爭執者,得不記載。
三、機關及其首長。
四、年、月、日。
前項第二款規定,於同一申請人在一定期間內本於同一特約所生二筆以上之爭議審議案件,得僅記載有爭議之部分,無須逐筆記載;其為同類型且審議結果相同者,亦同。
醫療費用案件經保險人依第八條第二項規定重新核定者,爭審會得免作成第一項之審定書,逕行結案。
審定書應附記不服審定之救濟方法及其受理訴訟管轄行政法院。
一、保險醫事服務機構之名稱及代號。
二、主文、事實及理由。
其中事實及理由部分,為雙方所不爭執者,得不記載。
三、機關及其首長。
四、年、月、日。
前項第二款規定,於同一申請人在一定期間內本於同一特約所生二筆以上之爭議審議案件,得僅記載有爭議之部分,無須逐筆記載;其為同類型且審議結果相同者,亦同。
醫療費用案件經保險人依第八條第二項規定重新核定者,爭審會得免作成第一項之審定書,逕行結案。
審定書應附記不服審定之救濟方法及其受理訴訟管轄行政法院。