In social insurance,medical treatment charge pays under the third person infringement case involves a variety of compensation legal system selection and cohesion,during regulating the social insurance fund compensation,the insurance subrogation usually can be used to prevent the insured from double benefit and the third person from taking off the responsibility by the legislation of the countries. According to the value balance principle of insurance,it is the injured insured’s natural equity to get social insurance fund of medical treatment charge pays compensation. Damage compensation principle prohibits the insured get double benefit due to the infringement of a third person;insurance subrogation system is the necessity of this logic. The advance payment is one of the elements of insurance subrogation,as a necessary part of the implementation of insurance subrogation;the advance payment belongs to the insurance subrogation system. The legislation of the advance payment of medical insurance in our country characterized by a very strong sense of advance payment and complicated conditions,content is not designed in the framework of the system of insurance subrogation;the administrative legislation is over the equity protection legislation.%在社会保险中，第三人侵权情形下医疗费用支付补偿关涉多种法律制度的选择与衔接，各国立法多在规范社会保险基金补偿时，通过保险代位求偿防止被保险人双重受益和第三人脱责。根据保险的对价平衡原则，无论有无第三人侵权，伤病时获得社会保险基金对医疗费用支付的补偿是被保险人的当然权益；损害补偿原则禁止被保险人因第三人侵权而双重受益，保险代位求偿制度是此逻辑的必然。先行支付是保险代位求偿权行使的要件之一，是保险代位求偿制度实施的一个必要环节，从属于保险代位求偿制度。我国社会保险医疗费用先行支付的立法特征是垫付色彩重、条件复杂，未在保险代位求偿制度框架内进行内容设计，是管理法重于权益保障法的立法表现。
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