My answer is: speak with the facts, it is difficult and not difficult. My colleagues have assisted customers to complete a "case of eight claims", the case of the insured due to accidents, the seven insurance companies to obtain eight claims (including critical illness insurance six claims), the amount of 1.41 million yuan, exempted from subsequent premiums of 3.13 million yuan.
Mr. Sun is a business owner, and his wife takes care of the family full-time. in 2018, Mr. Sun has taken out critical illness insurance from 6 companies with a sum insured of $3.2 million; accident insurance from 1 company with a sum insured of $1 million; and medical insurance from 1 company with a sum insured of $1 million, and pays $165,000 in annual premiums.
In 2019, Mr. Sun was hit by a ball on the left side of the face while playing soccer, due to persistent tinnitus in the left ear, hearing loss, head discomfort, after examination, the hospital confirmed Mr. Sun's total deafness in the left ear, the left ear hearing at 500 Hz, 1,000 Hz, and 2,000 Hz speech frequency, the average hearing threshold is greater than 90 dB, by the hearing brainstem evoked potentials suggests that: the left ear reaction threshold is greater than
Although Mr. Sun's illness was caused by an accident, his condition met the conditions for claiming minor illnesses in his critical illness insurance policy, and he was not familiar with the claim process, so Mr. Sun entrusted my colleague, his insurance broker, to assist in the settlement of the claim. More than 1.41 million yuan, his own insurance exemption late premiums for more than 2.91 million yuan, in addition, Mr. Sun as a policyholder, for his family members to buy the Sino-Taiwanese life, exemption premiums for 213,000 yuan.
7 companies 8 claims, to say that the claim is difficult, in the six months of applying for claims, insurance brokers countless times with the insurance company to communicate and coordinate; to say that there is a critical illness insurance terms have a pit, insurance brokers will be from a professional point of view with the insurance company to argue, to protect the rights and interests of customers.
Critical illness insurance diagnosed that compensation? Not really.
The Chinese Insurance Association and the Chinese Medical Association **** with the development of the "use of the definition of major illness insurance disease specification", there are 25 kinds of high incidence of serious illness claims accounted for more than 90%, and the 25 kinds of disease claims conditions are divided into three categories:
The first category: diagnosis of the claim
For example, malignant tumors (cancer), once the diagnosis of malignant tumors, that is, you can take the insurance company recognized hospitals (generally). Once the diagnosis of malignant tumor is confirmed, you can ask the insurance company to settle the claim with a certificate from a hospital recognized by the insurance company (usually a public hospital of the second level or above). If you don't have the International Classification of Diseases and Related Health Problems (ICD-10) for malignant tumors, you won't be able to pay for it.
Category 2: Claims for specific treatments
For example, coronary artery bypass grafting requires that the coronary artery bypass grafting (or coronary artery bypass grafting) was actually performed in the open chest. If you have severe coronary artery disease and you don't have open heart surgery, the odds are that you won't be paid, but some insurers will pay for minimally invasive surgery as a critical illness, as we'll talk about later.
Category 3: Claims after reaching a specific state
For example, the sequelae of stroke: refers to the cerebrovascular hemorrhage, embolism or infarction due to a sudden cerebrovascular lesion, and lead to permanent neurological dysfunction. What is permanent neurological dysfunction?
That is to say, 180 days after the diagnosis of stroke, there is a permanent and complete loss of function of one limb or a complete loss of speech or a complete loss of the ability to lead a life on their own, and only when one of these conditions is met, will they be paid according to the standard of critical illness. From this, it can be seen that not all critical illness insurance policies will pay out upon diagnosis, but only when the conditions for claim settlement are met.
The first thing you need to know is that you are not going to be able to get your hands on a new car, but you are going to need to be able to get your hands on a new car.
1) Multiple claims for the same cancer, some paid 3 years apart, some 5 years apart.
Both AIA and Tongfang Global Life Critical Illness Insurance products have multiple payouts for cancer, but AIA requires a 5-year gap, while Tongfang only requires a 3-year gap, including new, recurring, metastatic, and persistent cases.
For example, if Ms. An has breast cancer and her critical illness insurance coverage is $1 million, and she is diagnosed with breast cancer, she will be able to claim $1 million regardless of whether she buys AIA or Tongfang Global Life.
After 3 years, Ms. An's breast cancer is not cured, has continued, or Ms. An has a new lung cancer, or Ms. An's breast cancer metastasized into lung cancer, then Ms. An's Tongfang Global Life will compensate another 1 million yuan, while AIA will need 5 years to pay for the onset of the disease between 3 and 5 years, AIA is not payable.
It is more difficult to pay multiple claims for cancer 5 years apart than 3 years apart for a claim.
2) For the same condition, some are classified as minor illnesses, while others are considered major illnesses
Most insurance companies classify minimally invasive coronary artery bypass grafting as a minor illness, whereas AIA classifies it as a major illness:
If it is classified as a minor illness, it can only be compensated at 20-30% of the sum assured according to the minor illness. If you classify it as a critical illness, you will receive 100% of the sum assured as a critical illness.
The same 1 million coverage, one can only accompany 200,000, another can accompany 1 million, a difference of up to 800,000, equivalent to the price of a high-end car or a set of second-tier city house down payment.
3) The same leukemia, some critical illness insurance can be paid twice
Let's also take Ms. An as an example, if she unfortunately suffers from leukemia, AIA and Tongfang Global Life can pay 1 million; and in order to treat the leukemia, the need for hematopoietic stem cell transplantation, AIA can not be reimbursed, while Tongfang can be reimbursed for 1 million.
The reason for this lies in the chart above. AIA All Saints Benefit (Collector's Edition) is a grouping of multiple claims for critical illnesses, which divides the high incidence of malignant tumors and hematopoietic stem cell transplantation into a group, and a number of illnesses in this group will only be paid once. And Tongfang Global New Multiple Insurance is not grouped critical illnesses, 100 kinds of diseases can be paid 3 times.
So, if Ms. An buys Tongfang Life, she can get one more payout, and the total payout will be 2 million, so if she has leukemia, she won't have to worry about raising money for the treatment.
From this point of view, when purchasing insurance, you should always compare multiple insurance policies and know clearly what is covered and what is not covered, so that you know exactly what you are doing and avoid stepping into the hole.
After talking about the terms and conditions of critical illness insurance and the differences between different companies, the difficulty of claiming compensation is also very important, and that is to buy insurance to be truthful health information.
What is health notification?
Critical illness insurance, medical insurance, life insurance, including part of the accident insurance, need to fill out the health information, insurance marketers if there is no tip in place, the policyholder is very easy to ignore the health information, either cursorily, or fill out the whole no.
The first thing that you need to know is that you need to fill out the health information, and then you need to fill out the health information.
There is also a situation where the marketer is not responsible for the two years of incontestable provisions to fool the insured, claiming that the body has defects or with the disease insured, two years of no insurance, and then the insurance company will have to pay for the insurance. The fact is that this is absolutely not the case, the above operation will give the back of the insurance claims bring great potential problems.
Article 16 of the Insurance Law provides that: the policyholder intentionally does not fulfill the obligation of truthfulness, the insurer for the contract before the termination of the insurance accident, not to assume the responsibility of compensation or payment of insurance premiums, and does not return the premiums.
The first step is to make sure that you are aware of what is going on in your car, and that you are aware of what is going on in your car.
After all is said and done, buying critical illness insurance is nothing more than two things:
1) Be truthful and inform your health when you are insured;
2) Follow the terms and conditions of the claim when you are insured.
Doing these two things, the "pit" of critical illness insurance will not step on, and the claim will be very easy.