The underwriters, the gatekeepers, what kind of customers need medical examination, what kind of customers need to increase the fee, what kind of customers the company simply can not pick up to be rejected directly, what kind of customers need to provide what kind of information or proof, they are all by the gatekeeper.
Claims, the plugging of leaks, which disease claims the most, which accident is the responsibility of the insurance, the claim, how much to pay, need to go to the hospital to get evidence, all by their say.
They all have a **** the same characteristics, that is, on the medical and insurance have a deep understanding of which products to buy, how to buy, know the ground must be quite a lot.
First of all, it is necessary to understand the gap between the mainland and Hong Kong's medical plans, the following will be from the definition of disease, coverage, claims, premiums, coverage, non-disputable provisions, rate of return, the level of medical care in eight aspects of the comparison:
One. Different definitions of diseases
Mainland insurance has a strict definition of major diseases, taking liver disease as an example. The diagnosis of "fulminant viral hepatitis" must meet the following criteria:
-a. Hepatic encephalopathy, with impaired consciousness;
-b. Persistent jaundice and rapid deterioration of liver function;
-c. Diffuse destruction of hepatic lobules, with only collapsed stent structures remaining. structure. In fact, if any one of a and b had been met, the patient would have been beyond saving, let alone both. c provides for a diagnosis that can only come out as a result of an autopsy. That is, there is absolutely no possibility of compensation without death.
Two. Coverage is different
Mainland insurance products protect 40 kinds of serious diseases + advance payment of 10 kinds of diseases, while Hong Kong insurance products protect 56-100 kinds of major diseases + advance payment of 18 kinds of diseases (8 kinds of special for children). In addition, Hong Kong products also have Early Stage Disease Coverage and Multi-Disease Coverage, which covers an additional 52 Early Stage Diseases and the ability to receive five claims. It is worth noting that there are many diseases that are not covered by mainland insurance, such as:
1. Aids, which is not covered by mainland insurance companies, is covered by Hong Kong policies, which can claim for Aids contracted through blood transfusions;
2. Carcinoma in situ. The mainland insurance companies do not pay out at all. Hong Kong's policy breast and uterine carcinoma in situ, testicular carcinoma in situ, systemic lupus erythematosus, etc. included in the special disease, the first 20% of the benefits. The balance will be paid out when these diseases become more serious.
3. Any terminal illness. Not available in the mainland, but available in Hong Kong. This means that if the insured dies of SARS or avian flu, the Hong Kong insurance company will pay out the same amount.
3. Claims are different
Hong Kong medical insurance claims process is relatively simple, if the disease and hospitalization, the insured person together with the postal submission of claims (can be downloaded and printed), medical expenses invoices, diagnosis of serious illnesses and other information to the insured company, the insurance company will be from Hong Kong will send a check. There is no need for the insured to travel to Hong Kong for the whole claim process. Mainland medical insurance may also stipulate that imported drugs cannot be used, but there is no similar restriction in Hong Kong insurance, and Hong Kong insurance is a global claim, no matter whether the insured person is traveling or studying in other parts of the world, and hospitalized in the event of an illness, the claim can be made. Hong Kong insurance companies adopt the business philosophy of "strict underwriting and lenient claim settlement", which makes the claim settlement work simple and has a high claim success rate. Insurance companies in Hong Kong attach great importance to claims handling, because the quality of claims handling directly affects the company's image and reputation, as well as customer confidence in the company. Hong Kong society as a whole has a high degree of integrity, insurance companies and policyholders have mutual trust, and the claims process is very simple. It is only that some insurance companies in the Mainland have spoiled the reputation of insurance, making the majority of customers feel that all insurance claims are difficult.
Four. Premiums are different
In China, the average life expectancy is 70 years, while in Hong Kong it is 85 years. Therefore, for the same age, the premiums in Hong Kong will be much lower, plus Hong Kong has a large amount of discounts and non-smokers discounts, the rate is sometimes only 1/2 to 1/3 of the mainland.
5. Different coverage
Taking children's life insurance and critical illness insurance as an example, the maximum coverage on the mainland can only buy 100,000 yuan (under the age of 40, the amount of coverage for critical illnesses exceeding 300,000 yuan or life insurance coverage exceeding 500,000 yuan are required to undergo a medical examination), and the number of types of critical illnesses is probably about 30 kinds of diseases, and if the unfortunate occurrence of a serious illness, 100,000 yuan, in many cases, is not enough to be used to treat the disease. In Hong Kong, there is no restriction in this regard. In Hong Kong, under the age of 18, the sum insured of 250,000 U.S. dollars is free of medical examination, under the age of 40, the sum insured of 450,000 U.S. dollars is free of medical examination.
6. Differences in non-disputable provisions
In terms of "non-disputable" provisions, the Hong Kong side stipulates that an insurance company cannot, for any reason, declare a life insurance policy that has been in force for more than two years to be "void". To put it simply, the insurance company has a two-year period in which to defend itself against any concealment, omission or misrepresentation on the part of the policyholder, and the insurance company cannot use this as a reason for refusing to pay compensation after two years. For example, if Mr. Lee suddenly found out that he was suffering from a certain insured disease and unfortunately passed away two years after signing the policy, and his family wanted to apply for a claim, if in the Mainland, the insurance company may refuse to settle the claim on the ground that "the insured person was concealing the disease condition at that time", but in Hong Kong, once the two-year period of disputability has expired, the "non-contestability clause" will not be applied. However, in Hong Kong, once the two-year disputable period has expired, the "non-disputable clause" can reject the insurance company's argument, thus protecting the policyholder's rights and interests.
VII. Different rates of return
In terms of rate of return, the predetermined interest rate for life insurance on the mainland is set at 2.5 percent. But with high inflation expected on the mainland, the 2.5 percent annual interest rate is actually negative. An insurance agent from the Guangzhou branch of a domestic insurance company told reporters, "In terms of rate of return, our products can't compete with offshore policies, and our expected rate of return tops out at between 3% and 5%, while Hong Kong's policy dividend interest rates are generally around 5% to 9%, and haven't been lower than 5% in the past 10 years."
Hong Kong, as one of the world's financial centers, investment products are particularly well-developed, and the choice of insurance investment products is more than the mainland, not only high protection, but also more substantial returns. Mr. Coe, an agent of a Hong Kong insurance company, said, "Most of the savings-type life insurance policies of some Hong Kong insurance companies offer a return of 10-20 percent, in addition to an additional annual cash dividend or fund balance, which depends on the company's operating conditions."
VIII. Medical level is different
Hong Kong's medical level, medical treatment environment as a whole is better than the mainland. In addition, the mainland to see the doctor to check the diagnosis of hard and simple, the whole process is very complex: registration, pricing, payment, medicine, laboratory tests, booking instrument examination, instrument examination, to get the results of the examination again to repeat a set of processes, etc.; Hong Kong to see the doctor to check the diagnosis of the amicable and careful, the details of the full embodiment of the patient's respect. Most of the other matters are handled by the nurses, and the part that needs to be handled by the patients in person is also very simple and convenient due to the reasonable design of the procedures and the people-oriented approach. Mainland doctors prescribe large quantities of medicines, many varieties of medicines and complicated checkups; Hong Kong doctors prescribe simple and prudent medicines in full accordance with the necessary needs of the patients. Therefore, the mainlanders who invested in Hong Kong's medical care also hope that they can go to Hong Kong to see a doctor when they are sick and receive a better level of medical care.
Most importantly, mainland hospitalization plans can only claim for hospitalization in mainland hospitals. Hong Kong's hospitalization plans can claim for hospital stays in hospitals all over the world.
Medical insurance plans are categorized into critical illness insurance plans and hospitalization plans. Critical illness insurance protects customers against major illnesses and pays out a lump sum for the customer's own use once diagnosed, while hospitalization plans pay out for hospital expenses.
All along, people have been aware of the dreadfulness of major illnesses, but they did not expect that it would be so powerful. In fact, the rejuvenation of serious illness is becoming more and more powerful, has reached the point of having to prevent. Received smoking, pollution, stress and many other reasons, many diseases are showing a trend of rejuvenation. It can be said that have to pay attention to, insurance also buy as early as possible!
Young people suffering from serious illness is more terrible
In a chat with the doctor, the doctor frankly said that, in fact, now the incidence of serious illnesses show more and more under-age trend, and, young people suffering from serious illnesses, than the middle-aged and elderly people more terrible, more difficult to cure.
Because young people have a faster metabolism, and for many major diseases, a faster metabolism means that it is more difficult for the cancer cells to be controlled, and even after they have been controlled, there is a greater possibility of recurrence, so more medical expenses are spent, and the results are worse.
What's the must-have insurance?
Critical illness insurance, critical illness insurance, critical illness insurance, important things to say three times! The reason is no need to ask again, people Wang Shi said, no reason, just to buy.
Tell us your understanding of critical illness insurance
In my previous career as a physician, I have seen too many cases of poverty due to illness, and many families have borrowed money and sold their family assets in order to pay for treatment, but the amount of money they have raised may only be a drop in the bucket. As a doctor, I also know that everyone is equal in the face of illness, and that everyone is susceptible to illness, but of course I didn't know what insurance was at that time.
After so many years in the insurance industry, I realized more and more that both are trying to save lives, except that doctors use their medical skills to save lives and insurance companies use their money to save families from financial difficulties. Didn't Dr. Barnard, the heart surgeon who founded critical illness insurance, say that doctors can only save a person's physical life, and insurance can only save a family's financial life?
When is the best time to buy?
My perception is that the sooner the better, for three reasons:
First, the incidence of major diseases is getting younger and younger, I just received two claims, one sudden death, one myocardial infarction, one after 70 and one after 80, both young people. I'll tell you another number, the insurance industry average claim age for major diseases is 42 years old, not 60 or 70 years old as we thought;
Second, the earlier you buy the cheaper it is, the premium for 40 years old may be 1.5 or even 2 times of 20 years old, and enjoy the protection of the years instead of shorter;
Third, the younger the younger the better the body is more likely to be through the underwriting, the 30 year old may buy 70,000 yuan of critical illnesses insurance without medical examination. The first thing you need to do is to get a good deal of money for the insurance policy, and then you'll have to pay for it.
How much is enough to buy?
This question, like buying a car, I think you can afford to buy the higher the better. Of course, that's a bit unrealistic, and if you do buy enough that budget is also a problem. Realistically, I'd say buy at least 500k. In fact, at first I bought only 200,000 to 300,000 yuan, but something happened around me touched me. A friend's wife had a benign brain tumor and stayed in the ICU of Tiantan Hospital for two months at a cost of 700,000 RMB. I heard that the family had already started to sell the house, and I didn't know when the end would come. I can't even imagine what would happen to me if this happened to me. The money for medical treatment, the mortgage on the house, the children's schooling and the family's daily expenses, and the money for the follow-up recovery, it's just a bottomless pit.
It's important to clarify the idea that critical illness insurance is not just about the cost of medical treatment, but also about the cost of rehabilitation and the loss of family income.
I have $700,000 in critical illness insurance, $300,000 in specialized cancer insurance, and I'm planning to follow that up with mid-to-high-end medical insurance. Is it much? In fact, not much at all, tell you to give the secret, there is a big name in the industry everywhere to give people the idea of critical illness insurance, his critical illness insurance coverage is 20 million, huh ......
Who should buy the most?
First of all, it's important to make the point that insurance is designed to protect against the non-financial risks that can make a family's goals seriously compromised, or even collapsed in an instant. So who and what goes wrong can cause such a devastating blow to a family? The breadwinner, of course, the person who earns the most money in the family. So what about things? There are only two things, accidents and illnesses, right? If a job doesn't go well or an investment fails, as long as the breadwinner is still there, then it won't have a devastating effect. As the saying goes, there is no fear of burning firewood.
From this, the correct order of purchasing insurance is derived:
First, it must be the first adult and then the child, the child accident, we are emotionally hurt, but on the economic impact, as long as the family breadwinner is healthy and safe, then the source of the survival of the family will not be broken, and also have the ability to continue to earn money for the child to see the doctor.
Secondly, the first protection after financial management, insurance protection function must be the first, and this risk transfer function can only be realized through the insurance, financial savings and investment, should be considered after you have purchased sufficient protection, no 1, then more than 0 are useless, this is the reason.
The more types of critical illnesses the better?
To be honest, I never pay attention to the types of critical illnesses. According to the regulations of the Insurance Industry Association, critical illness insurance must include six mandatory diseases, malignant tumors, acute myocardial infarction, after-effects of stroke, major organ transplantation, coronary artery bypass grafting, and end-stage renal disease, and malignant tumors alone cover almost 60% to 80% of all critical illness claims or even more.
Nowadays, many companies split up some of the diseases for the sake of gimmicks, or list out the breakdown of cancers, and claim to cover hundreds of cancers, which makes no sense at all. The item malignant tumor itself covers all cancers. So, when I buy critical illness insurance, I don't even pay attention to whether the types of critical illnesses are 35 or 60, and there's no point in paying more for diseases that have a very low incidence. Some of us don't even buy critical illness insurance, just specialized cancer insurance, or a combination of both.
Can I claim if I buy heavy?
Unlike expense reimbursement insurance (which means, surely, no more than what you actually spend), critical illness insurance is a fixed-payment policy. Simply put, it means that when a person is diagnosed with a contracted disease, such as a malignant tumor, the insurance company will pay a lump sum of money, which has nothing to do with how much it actually costs, but only with the amount of coverage he purchased for his critical illness insurance. Because human life and body is priceless, the insurance company gives you the amount of coverage, it should pay you how much, and the claims between the companies do not affect each other.
Let's say this person has thyroid cancer and it only cost him 100,000 dollars, but he bought 500,000 dollars of cancer insurance from company A and 300,000 dollars of critical illness insurance from company B, so he can get a total of 800,000 dollars in claims. With this money, he does not have to rush to return to work to earn money, can be well recuperated at home, and when the body is fully recovered and then re-emerge, and the family's daily expenses, which is exactly why we have been emphasizing that critical illness insurance coverage should be enough to buy the reason.
Don't take a chance that you and your family won't get a serious illness, the country's leaders were pampered by all the medical resources have not been able to escape the clutches of the disease, not to mention that we are ordinary people?
No one is poorer for buying insurance, but there are many families who have been plunged into ruin because they do not have adequate critical illness insurance, so take out a policy while the time is still young and the health is still good!
How to buy Hong Kong insurance
At present, many people (especially on the Internet) say they can sell Hong Kong insurance, but in fact the vast majority of them do not have the qualifications of legitimate Hong Kong insurance brokers, nor do they have a legitimate working relationship with insurance companies. When buying insurance through these people, there is no guarantee of the correct choice of product or long-term after-sales service. Therefore, when buying Hong Kong insurance, it is important to look for a Hong Kong insurance broker so as to ensure that the customer's own interests are protected.
AXA Medical Insurance is your first choice