Shenzhen car accident compensation negotiations fell through, and the insurance company is only willing to pay 600,000? A lawyer breaks down four real issues: determining liability, calculating the numbers, and making a claim.

Last Wednesday afternoon, Mr. Zhou from Futian came to our firm for a consultation. He had been hit near Nanshan Science Park by a truck that changed lanes to overtake, suffered a left leg fracture, and was hospitalized for 28 days. The traffic police determined that the other party was fully liable, but the insurance company was only willing to compensate medical expenses plus lost wages, totaling less than 60,000 yuan. He asked me whether, with the steel plate still in his leg, no one would cover the cost of removing the steel plate later and the losses from his inability to get out and solicit business over these months.

Mr. Zhou's confusion is not an isolated case. Shenzhen's annual traffic accident case filings hover around 100,000, but fewer than 10% actually proceed to litigation. Most people get stuck in the chain of "determination of liability—mediation—claims settlement." Today, let's cut to the chase and clarify the most frequently asked questions once and for all.

Q1: The traffic police determined that the other party bears full responsibility; how exactly is the compensation amount calculated?

Many people think that full liability means full compensation, but compensation items are actually calculated separately. In current practice in Shenzhen, medical expenses are reimbursed against receipts; hospital food allowance is generally 100 yuan per day; nursing care fees depend on the degree of nursing dependency, and in Shenzhen judicial practice are mostly 150–200 yuan per day; lost work income requires a tax payment certificate and bank statements, and for those without fixed income, reference is made to the average wage in the same industry in Guangdong Province for the previous year.

The key lies in disability compensation. Shenzhen has uniformly adopted the per capita disposable income of urban residents in Guangdong Province for calculation, and in 2025 this figure is approximately RMB 56,000 per year. For a Level 10 disability, calculated at 10%, it is RMB 56,000 × 20 years × 10% = RMB 112,000. For each higher disability grade, the coefficient increases by 10%. In Shenzhen, mental distress damages for a Level 10 disability are generally awarded at around RMB 10,000, increasing progressively with each higher grade.

Put plainly, determining liability is only the first step; the compensation list must be itemized and disputed item by item. Omitting hidden items such as follow-up treatment costs and dependent living expenses often means ending up with tens of thousands of yuan less.

Q2: The insurance company says that it will not cover medications not covered by medical insurance. Does that reason hold up?

That is untenable. Article 1179 of the Civil Code clearly provides that anyone who infringes upon another person and causes personal injury shall compensate for reasonable expenses such as medical expenses, nursing expenses, transportation expenses, and lost wages. The relevant judicial interpretation of the Supreme People's Court also makes clear that where an insurance company refuses to pay on the ground of non-medical-insurance medications, the court generally will not support it—unless the insurance company can prove that the use of such medications is unrelated to the accident injury or is obviously unreasonable.

We once represented a major traffic accident case in Longhua. Our client was riding an electric bicycle when he was struck and seriously injured. His medical expenses reached 470,000 yuan, but the insurance company insisted that 120,000 yuan of that fell outside the scope of medical insurance and refused to pay it, offering only 350,000 yuan. After we took over, we obtained the complete medication list, compared each item against the national medical insurance catalog and clinical diagnosis and treatment standards, and applied to the court for a commissioned re-assessment of the disability grade. In the end, the court ruled that the insurance company must pay the full medical expenses, plus disability compensation, lost wages, compensation for mental distress, and other damages, totaling more than 2 million yuan.

This case illustrates a point: the reasons an insurance company gives for denying a claim are not necessarily reasons that hold up legally. What matters is whether you have built a solid chain of evidence.

Q3: When should the disability assessment be conducted? Should I do it myself or after filing a lawsuit?

Timing is important. It should generally be done after treatment has ended and the injury has stabilized, usually 3 to 6 months after discharge. If done too early, before the injury has stabilized, the grade may be too low; if done too late, it will affect the progress of the litigation.

It is advisable to apply to the court for a commissioned appraisal after filing suit. With a unilateral appraisal opinion, the insurance company will most likely request a re-appraisal in court, and the back-and-forth will add another three to six months. A court-commissioned appraisal is harder for either party to overturn and is also procedurally smoother.

For traffic accident cases under the jurisdiction of the Shenzhen Intermediate People's Court, the ordinary procedure generally takes within six months from case filing to first-instance judgment. If the appraisal stage is delayed, the entire timeline may stretch to more than nine months. Therefore, it is best to submit evidence preparation and the appraisal application together when filing the lawsuit.

Q4: What if the other party has not purchased commercial insurance, or the insurance company delays payment?

It is not uncommon in outer Shenzhen for the other party to have only compulsory traffic accident liability insurance and no commercial insurance. The compulsory insurance has a death and disability compensation limit of 180,000 yuan and a medical expenses limit of 18,000 yuan; any amount exceeding those limits must be pursued personally from the party at fault. At that point, you should apply for property preservation immediately and check the real estate, vehicles, and bank accounts in the other party’s name—wait too long and they may have already transferred them.

If the insurance company delays payment, you can directly sue the insurance company and the at-fault party, listing both as defendants. The limitation period is three years, counted from the date of the accident; however, where personal injury is involved, it is advisable in practice to commence proceedings as early as possible rather than wait.

Guangdong Zhiming Law Firm has handled cases in the Shixia North area of Futian for 26 years, and its traffic accident team handles no fewer than a hundred cases every year. I was deeply struck by something Director Shen Jinlong said: compensation negotiation is essentially a contest of evidence. The more complete the medical records, receipts, and appraisal reports you have in hand, the more room the other side has to make concessions.

If you are worrying about accident compensation, you might as well call first and explain your situation. Phone: 0755-25986969. Address: Room 1802, Tower A, Xintian Century Business Center, Shixia North 2nd Street, Futian District, Shenzhen. First find out what you can be compensated for and roughly how much, then decide your next step—much better than blindly dragging things out with the insurance company.