"Does the insurance company refuse to make money?"
This is the stereotype of insurance for many consumers.
But in fact, for insurance companies, claims are normal, and most insurance companies have set up special claims departments to do this.
Judging from the claims data of various life insurance companies in the first half of this year, the industry average claim limitation is 0.58 days, and the odds are above 97%. On the whole, "payout ratio is high and the payment speed is fast".
In other words, insurance companies are willing to pay as long as they meet the payment conditions agreed in the insurance contract. The remaining 3% cases without claims are mostly because they were not truthfully informed before insurance.
The importance of telling the truth is obvious, which is directly related to whether you can get compensation for buying insurance. So, how to tell the truth when buying insurance?
A survey shows that in the past 24,449 insurance disputes, 45 16 cases were related to "not telling the health status truthfully". So, how to fill in the health notification form correctly is most beneficial to you?
You can refer to the following principles:
Whether online or offline, there will be a health notice, which lists a series of health questions, and we should answer them according to our actual situation. In health notification, the principles to be followed are: telling the truth, answering questions, and not asking or answering.
The contents explicitly asked in the health notification belong to "important facts", which will affect the underwriting conclusion of the insurance company and must be truthfully informed.
For example, the health notice asks: Have you been refused insurance, postponed, increased expenses or claimed by our company or other insurance companies?
If you have ever been refused insurance, postponed, increased expenses or claimed by an insurance company, you must tell the truth.
Similarly, we don't need to say anything that is not asked in the health notice.
It should also be noted that some questions ask whether symptoms have occurred in a specific period of time, or whether there has been a persistent state for more than a period of time. For example, the following two notices ask:
1, whether there is any abnormality in physical examination in the last year, and whether further treatment or follow-up is needed;
2. Have you taken medicine for more than 2 months or been hospitalized for illness 15 days?
If your physical examination was abnormal a year ago and you were told by the doctor to follow up, but there was no abnormality in your physical examination in the past year, or you continued to take medicine for 1.5 months or stayed in hospital for 14 days, which met the notification, you can apply for this insurance product normally.
If some items in the health notification do not meet the requirements, we can also underwrite them through intelligent underwriting. Nowadays, more and more insurance products have the function of intelligent underwriting. In the future, intelligent underwriting is the general trend, and more and more products will have the function of intelligent underwriting.
Intelligent underwriting can be operated directly online, answer the questions prompted by the system and draw the underwriting conclusion immediately.
For example, the following is a health notice for a critical illness insurance product:
Give a few examples:
For example, Article 1 asks, "Have you taken out insurance for major illness, minor illness or accidental disability?" If you have just made an accident outpatient claim or an illness hospitalization claim, it is not within the scope of this notification, and you don't need to inform.
For example, Article 2 asks "Does the insured have any abnormal health condition in the last two years …", so if the problem occurred two years ago, it does not belong to the scope of this notification and does not need to be notified. However, it should be noted that if the problems occurred two years ago belong to the situations mentioned in other articles, they also need to be informed.
For example, the third question is "tumor or mass of unknown nature", so if it has been clearly diagnosed as benign tumor or mass, it goes without saying.
For example, article 6 asks about the symptoms of a child at birth. Nowadays, many children will have jaundice at birth, but after reading this article carefully, there is no mention of this situation, that is, there is no need to tell.
Every insurance, every insurance company's health advice is different. For example, the health notification of insurance is from loose to strict: accident insurance >; Life insurance > critical illness insurance > medical insurance. There are many examples above, just to tell you that you should read the health notice carefully and check or answer the questions mentioned in the notice. Don't mention it, don't mention it.
When you often come to me for consultation, I don't know if my health indicators are all right. Why didn't I have a physical examination before I got insurance?
This is all wet! Remember not to do this!
Health notification is to inform the "confirmed" disease. If there is no hospital diagnosis, it is not informed, so there is no need to tell. It's not hiding. Because what you don't know can't be called hiding?
On the contrary, if you go to the physical examination and some indicators are abnormal, then you may need to tell, because you already know, not telling is hiding. This is equivalent to getting yourself into big trouble.
Therefore, we should correctly understand the meaning of "truth"-it is "known and diagnosed", not "what you feel or feel", and don't deliberately go for a physical examination in order to buy insurance.
Many people often ask for insurance because they find themselves in poor health after physical examination, but at this time, it is more troublesome to buy insurance.
Sometimes I think that after I got insurance, I had some diseases mentioned in the health notice. what can I do? If I don't tell you, will I not pay in the future?
Don't panic, the health notice can be supplemented after insurance to make up for forgetting to inform and missing information.
Supplementary health advice is actually the same as health advice before insurance. If you need to handle it, you can call the customer service phone of the insurance company to inquire about the handling method.
What needs to be noted here is: if you make supplementary health notification during the hesitation period and fail to pass the surrender requirements, you can get back all the premiums; If it is after the hesitation period, only the cash value can be returned.
Because the operating cost of the insurance company's policy is based on the hesitation period, after the hesitation period, all the costs will be spent. If it is refunded in full, the insurance company will lose a lot.
In addition, if you miss the notice and find that you have bought insurance for more than 2 years, then according to the Insurance Law, the insurance company may not terminate the contract and the insurance accident will be compensated normally.
Article 16 When concluding an insurance contract, if the insurer makes an inquiry about the subject matter insured or the insured, the applicant shall truthfully inform it.
If the applicant fails to fulfill the obligation of truthful disclosure stipulated in the preceding paragraph intentionally or due to gross negligence, which is enough to affect the insurer's decision to agree to underwrite or increase the premium rate, the insurer has the right to terminate the contract.
If the right to terminate the contract stipulated in the preceding paragraph is not exercised for more than 30 days from the date when the insurer knows the reason for termination, it shall be extinguished. If more than two years have passed since the establishment of the contract, the insurer shall not terminate the contract; In the event of an insured accident, the insurer shall be liable for compensation or payment of insurance benefits.
To tell the truth, this one is quite "overlord" for insurance companies. To put it simply: deliberately or forgetting to inform, the insurance company not only can't terminate the contract after the contract has been established for more than 2 years, but also has to make normal compensation.
The original intention of this clause design is actually to protect both parties, that is, insurance companies and policyholders, who can neither tell the truth nor terminate the contract at will and refuse to pay.
It should not be used to deliberately distort or conceal deception, which is undesirable. Moreover, once there is evidence to find out that it is malicious insurance fraud, even if legal procedures are taken, it will lose the case. There is a precedent for searching such court cases.
Master the above three principles of health notification, and you can easily deal with it when you are not sure about health notification in the future.
In addition, I would like to explain the problem of "insured place", which is also often mentioned by everyone:
It is often seen that a certain type of insurance has a "sales area restriction", but this is a restriction on insurance companies because it is a "sales" restriction, not a "purchase" restriction.
Moreover, there are legal provisions for insurance companies to sell across regions through the Internet. For example, in the Regulations on the Administration of Insurance Companies, it is written:
Article 41 A branch of an insurance company shall not engage in insurance business across provinces, autonomous regions and municipalities directly under the Central Government, except as provided for in Article 42 of these Provisions and as otherwise provided by the China Insurance Regulatory Commission.
Article 42 Insurance institutions participating in the insurance business of large-scale commercial insurance or master policies and underwriting business across provinces, autonomous regions and municipalities directly under the Central Government through Internet and telemarketing shall abide by the relevant provisions of the China Insurance Regulatory Commission.
So this does not belong to the category of false information. In addition, the population itself is mobile. For example, if you work in Beijing today and go back to build your hometown two months later, the insurance policy is still valid. The insurance company will not investigate where you are when you take out insurance, when you take out insurance or when you settle claims, and how to compensate if you are in danger. There will be no refusal.
First, insurance companies will continue to expand their branches, and it is only a matter of time before they arrive in your city; Second, regulators will also keep pace with the times and further revise policies that are more suitable for the development of the insurance industry. So don't worry too much about the location of insurance.
In fact, the purchase of health insurance involves nothing more than looking at three things: responsibility, premium and health notification.
Therefore, a correct understanding of "health notification" is the key factor to successfully purchase insurance. It is necessary to be "true" and not to bring unnecessary trouble to yourself, not to worry too much about some secondary information.