The claim for critical illness insurance is actually very simple. Generally speaking, there are only two situations: compensation or no compensation. These all depend on whether the diseases acquired by the insured belong to the scope of diseases agreed in the reinsurance contract.
If the disease falls within the prescribed scope and meets the requirements, you can get insurance claims in full for a long time. If it doesn't belong, then you can't get compensation.
In recent years, in some new critical illness insurance products on the market, insurance companies have set up "secondary payment" and "small payment" mechanisms, breaking through the traditional payment method of critical illness insurance that only pays once, that is, between the original payment and no payment, you can pay an additional level, but not completely. This is of great benefit to the insured.
(1) minor illness compensation
Compared with major diseases, mild and severe diseases are more common and frequent, and they are often in the latent stage of severe diseases. Such as early breast cancer, mild stroke and other diseases.
With the progress of medical technology, through early detection and early treatment, medical measures can be taken at an early stage to improve the cure rate. However, the traditional critical illness insurance in the market often does not cover mild diseases.
Nowadays, many insurance companies have added minor illness compensation clauses to the critical illness insurance products to meet the market demand. Basically, the proportion of minor illness compensation set by most insurance companies at present is about 10%-20% of the amount of serious illness compensation.
For example, the evergreen critical illness insurance of Huaxia Life Insurance includes the responsibility of paying for minor illnesses. Take Mr. A as an example. He has taken out 300,000 evergreen serious illness insurance. If Mr. A can't suffer from the minor illness stipulated in the contract, he can get 60,000 yuan of minor illness claim insurance money from the insurance contract, and the later premium will be exempted. A few years later, if Mr. A is unfortunately ill again (a major illness as stipulated in the contract), he can also get a claim for serious illness of 300,000 yuan from the insurance company.
Because the scope and definition of minor illness compensation are drawn up by insurance companies themselves, the product differences between insurance companies may be quite large. If you plan to insure yourself or your family against serious illness, you must know clearly before buying.
(2) The second payment and the third payment.
Generally speaking, the second payment (the third payment) means that the contract will continue to be valid after the insured gets the first claim for contracted major diseases. If the insured suffers from serious illness within the agreed scope again, he can get relevant compensation again.
Under normal circumstances, the "second major disease" agreed in the insurance contract and the first major disease do not belong to the same category in medicine. Within the agreed time limit, after the first major disease is fully recovered, another disease agreed in the insurance contract can be used to make claims. Suffering from heart disease within 5 years after cancer treatment.
For example, Mr. H insured Mattel Life Insurance of Lujiazui Cathay Life Insurance with a total insured amount of 300,000 yuan. This product guarantees 70 kinds of critical illness insurance, 30 kinds of mild illness, and the maximum payment for major diseases is three times. Suppose Mr. H is unfortunately suffering from a serious illness within the scope of contract protection after insurance, then he can get 300,000 yuan of serious illness claim insurance. If Mr. H is diagnosed with another serious illness one year later (which belongs to a different category from the first serious illness), he can get a second serious illness claim of 300,000 yuan from the insurance company.
Of course, for the classification and grouping of diseases that can be claimed for multiple times, and the proportion of insurance claims that can be obtained for the first time and the second time respectively, these key claim details are different in different insurance companies, so you need to consult and check clearly before taking out insurance.
Second, you can pay multiple times by purchasing more critical illness insurance.
According to the purpose of paying insurance benefits, general insurance branches are divided into compensation insurance and payment insurance.
Compensatory insurance refers to the insurance paid by the insurer to compensate the insured for the actual losses caused by the accidents listed in the insurance scope, such as medical insurance in social security.
In contrast, payment insurance does not aim at compensating for losses, but pays the insurance premium according to the agreed amount under the condition of meeting the claim conditions. Most life insurance belongs to payment insurance. This is because the object of life insurance is human life or health, which can not be measured by price, and it is difficult to calculate and completely compensate for the losses caused by insurance accidents with money.
At present, the critical illness insurance sold in the market generally belongs to payment insurance.
Therefore, even if multiple critical illness insurances are insured by different insurance companies, as long as they meet the claims conditions of various insurance companies, they can get claims at the same time. For example, the insured has insured the critical illness insurance with the insurance amount of 65,438+10,000 yuan in two life insurance companies at the same time. As long as the insured is in danger during the guarantee period and meets the claim conditions, he can get the maximum guarantee payment of 200 thousand from two insurance companies. This doesn't need the receipt of the hospital's medical expenses as a proof of claim. This does not involve repeated insurance and foreign profits.
Various life insurance, annuity insurance, accident insurance, etc. Also consider that human life is priceless. The insured of these types of insurance can be insured in various companies. The limit of insurance amount is mainly set by the underwriting department of each insurance company according to the age, financial situation and insured amount of the insured. There is no saying that insurance companies restrict each other in the process of claim settlement in the later period of the accident.
Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.