20 17 how to tell health when buying insurance and the importance of telling the truth about insurance.
First, why should we inform health?
1, to avoid insurance fraud.
When applying for insurance, if the insured knows that the insured has physical problems and wants to make profits through insurance claims, the risk faced by the insurance company is too great. This kind of behavior is not insurance, but insurance fraud, suspected of fraud.
Therefore, in order to avoid being cheated, the insurance company will ask the insured to make a health notice to understand the physical condition of the insured, so as to decide whether to underwrite and how to underwrite.
2. Set up exemption from medical examination
Physical examination is a very troublesome thing. Not every insured person needs a physical examination. Health notification can help insurance companies quickly distinguish whether the insured needs a medical examination. If the health notification is in good condition, the physical examination procedure can be omitted directly, saving time and effort.
Second, the importance of telling the truth.
Health notification is one of the important factors that affect the underwriting results. Insurance companies will ask targeted questions to the insured according to different insurance products to understand the health status of the insured for underwriting.
Article 16 of the Insurance Law If an insurer makes an inquiry about the subject matter of insurance or the insured after concluding an insurance contract, the applicant shall truthfully inform him.
What will happen if you don't tell the truth about your health? There is a detailed explanation in the insurance law:
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 applicant intentionally fails to fulfill the obligation of telling the truth, the insurer shall not be liable for compensation or payment of insurance premium for the insured accident that occurred before the termination of the contract, nor shall it refund the insurance premium.
If the insured fails to fulfill the obligation of telling the truth due to gross negligence, which has a serious impact on the occurrence of the insured accident, the insurer shall not be liable for compensation or payment of insurance benefits for the insured accident that occurred before the termination of the contract, but shall refund the insurance premium.
When concluding a contract, the insurer knows that the applicant has not truthfully informed it, and may not terminate the contract; In the event of an insured accident, the insurer shall be liable for compensation or payment of insurance benefits.
Intentional behavior refers to cheating and hiding, purposeful behavior.
Gross negligence means that the insured makes false information without knowing that the insured is physically different. This is the unintentional behavior of the insured, and the insurance company will refund the premium.
If the insurance company knows that you have not truthfully told your health status and still underwrite it, then the consequences will be borne by the insurance company itself.
If the insurer fails to exercise it for more than 30 days from the date when it knows that there are reasons for rescission, the insurance law 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.
This is the "two-year indistinguishable clause". It seems to be beneficial to the insured, but in fact, for the insurance company, the risk will also increase, so in order to avoid bringing losses to the company, their requirements for underwriting will be stricter.
The purpose of buying insurance is to obtain risk protection. If false information leads to the inability to obtain claims after the risk occurs, then the significance of buying insurance does not exist. Bian Xiao thinks this is completely unnecessary. Even if the physical condition is not ideal, the fees may be increased, except for underwriting. And the integrity of being a man cannot be abandoned. Tell the truth about your health and be responsible for yourself and others.
Third, how to inform health
In fact, health advice is not so harsh. We should understand that insurance companies protect themselves in order to reduce their own risks and avoid fraudulent insurance. So how to make a reasonable health notification, Bian Xiao has several suggestions:
1, please let me know.
That is, what to ask, what to answer, don't ask and don't answer.
Insurance companies have a strict underwriting system and professional underwriting personnel, and their health problems must be closely related to the product, which will have an impact on insurance, underwriting, premiums or claims, and there are clear and targeted problems.
As for what they didn't ask, even if it is serious, we don't need to say it. Just answer their questions, you don't need to take the initiative to inform.
2. Recorded news
Physical health status shall be subject to the records left by the hospital or medical examination institution. My own guess, the guess of my family and friends, and even the diagnosis of "health experts" and "X fortune tellers" are not counted.
If you feel that you have been in a bad mood recently, and you have not gone to the medical examination or the hospital for treatment, it is not within the scope of notification to guess what disease you may have just through online search.
However, Bian Xiao reminded that if you plan to have a medical examination in the near future, you'd better wait until the insurance is successful. In case the insurance company does not require a medical examination, it is not cost-effective to go to the medical examination and affect the underwriting.
3. Physical examination cannot exempt from the obligation to tell the truth.
Article 5 of Judicial Interpretation III of Insurance Law issued on 20 15 clearly stipulates that when concluding an insurance contract, the insured shall go to the designated medical institution for medical examination according to the requirements of the insurer, and the insured shall not be exempted from the obligation of telling the truth.
The insured can't think about perfunctory health notification with the mentality of "I have a medical examination anyway, you can read the medical examination report yourself". To tell the truth is not only responsible for the insurance company, but also for yourself. Otherwise, the consequences can be found in the first part of the insurance law.
Fourth, online and offline insurance.
Online and offline insurance are consistent in form, and both are required to complete a health notice. However, the underwriting results may be different.
1. If there is no abnormality in health, there is no difference between online and offline.
2. If you know that your body is abnormal, offline insurance is more flexible.
In the case of the same truthful information, offline insurance is faced with insurance agents. Through communication with agents, insurance will be more flexible. Although many online insurance products can also be intelligently underwritten, it is more convenient to meet people face to face.
For example, A had an operation before 10, and recovered after treatment, and there was no abnormal report within 10. However, in the health notification, this indicator is required, so A can apply for exemption from liability by submitting relevant information, and the rest will be covered by the standard.
In any case, in health notification, everyone must be honest and trustworthy, not cheating, not hiding, not taking chances, being responsible for themselves and the insurance company.
Extended reading
What's the difference between medical insurance and critical illness insurance?
Both medical insurance and critical illness insurance belong to the category of health insurance, and both of them can cope with the medical expenses such as hospitalization and surgery faced by a person after illness. Medical insurance is mainly aimed at the expenses incurred by "outpatient and hospitalization". In the event of an accident, the insured can apply for compensation within the insured amount, which will be paid by the insurance company according to the terms, or directly by the hospital. In other words, how much the insurance company can compensate depends on how much you actually spend.
Critical illness insurance is aimed at "major diseases". If the insured is diagnosed as a major disease in the insurance contract by the hospital, the insurance company will pay directly according to the terms, and the amount of compensation may not be equal to the actual cost.
Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.