What should insurance companies do if they find various reasons not to compensate?
What should insurance companies do if they find various reasons not to compensate? Nowadays, in order to protect their various rights and interests, many people usually do Buy fresh ones for yourself, but many insurance companies are very shady. Let’s take a look at what insurance companies can do if they find various reasons not to compensate. What to do if the insurance company finds various reasons not to pay the claim 1
If the insurance company does not pay the claim, you can first communicate and negotiate with the insurance company to see why it refuses to pay the claim. If the insurance company cannot give a reasonable answer , if the negotiation fails, then the policyholder can complain to the local Insurance Regulatory Commission. Generally, the complaint hotline number can be found at the bottom of the homepage of the local Insurance Regulatory Commission’s official website. However, reasonable, valid, and authentic evidence must be provided to prove that the insurance company refuses to settle the claim without reason. In addition, policyholders can also go to court to safeguard their legitimate rights and interests.
The insurance terms specify the conditions for compensation.
1. First, carefully read and understand your insurance terms to see if they meet the scope of compensation;
2. If not, the insurance company will certainly not pay;
3. If it is met and the insurance company deliberately makes things difficult, then collect relevant medical lists, settlement forms, medical records, invoices, and ask the attending physician to issue a certificate proving the cause of the disease (must comply with the insurance terms and conditions), and collect information Once everything is settled, go to the insurance company to settle the claim. If it doesn't work, call the Insurance Regulatory Bureau to complain. If the claim is confirmed, you can also sue the insurance company.
Reason 1
Accidents are not within the scope of liability
Accidents that occur do not fall within the scope of liability of the contract for product purchase. Of course, the insurance company Will not pay. For example, if Aunt Wang purchased an accident insurance and was hospitalized due to a heart disease, the accident insurance would refuse to pay.
Reason 2
Failure to inform truthfully
Health disclosure is required when purchasing health insurance, such as purchasing critical illness insurance and concealing one’s previous illness history. I bought it directly after telling the truth. When the insurance company found out about the accident, I could easily be denied compensation at this time. Therefore, health information before taking out insurance is very important. It has a significant impact on whether the claim can be settled smoothly, so you must not leave it to chance.
Reason three
Liability exemption
Insurance products will have several liability exemption clauses to prevent some extreme events. For example, it involves intentional crimes, illegal activities, suicide, drugs, drunk driving, etc., disease insurance covers congenital diseases and genetic diseases, and accident insurance covers participation in dangerous activities. These are not covered by the insurance, and the insurance company does not pay compensation due to legal provisions.
Reason 4
Disease insurance is diagnosed before the observation period and other situations
For example, critical illness insurance generally has an observation period, usually 90 days or 180 days , the insurance company will not pay compensation if a critical illness is diagnosed during the observation period. It is also easy to understand, and this can prevent adverse selection from occurring to a certain extent. What to do if the insurance company finds various reasons not to compensate 2
In these 5 situations, the insurance company may not compensate you at all, and you may suffer a loss without knowing it
1. The vehicle is parked tires, reversing mirrors or lights were stolen. According to the provisions of theft insurance, when a vehicle is stolen, if not the entire vehicle is stolen but only a certain part of the vehicle is stolen, this situation is not within the scope of compensation of the auto insurance company, and the insurance company does not need to compensate at all.
2. As a result of sudden braking, the head of the car owner or co-pilot hits the windshield, causing the windshield to break or the person to be injured. Car insurance does not include liability insurance for people in the car, so even if the person is injured, it will not be compensated. There is no compensation for a broken windshield because there is no windshield breakage insurance in the car insurance.
3. The front bumper of the car was damaged when it was wading into water. The reason is simple: water flow does not fall within the collision range of the vehicle, so the car insurance company does not need to pay compensation.
Therefore, when car owners encounter natural disasters in their vehicles, please understand the situation clearly and do not blindly go to the auto insurance company for compensation.
4. The vehicle was involved in a traffic accident, and the items in the vehicle were taken away. In this case, it is more reliable for car owners to call the police in time to retrieve the lost property. In this case, the car insurance company will also not compensate.
5. Traffic accidents caused when the vehicle is borrowed by others and used for criminal activities. In these cases, the insurance company will not compensate you, so car owners must not lend out their vehicles at will. If you borrow a car, you must ask others why they borrowed the car. What to do if the insurance company finds various reasons not to pay compensation 3
There are several situations in which insurance companies will not pay compensation
1. No compensation will be paid if the tire blows out alone
When a vehicle causes a traffic accident due to a tire blowout, the insurance company will pay the claim. However, if the tire blowout does not cause an accident, the insurance company will not care.
Experts remind: Tires should not be over-inflated to avoid over-inflation. Prevent yourself from getting a tire blowout.
2. Insurance companies will not pay for damage to privately owned equipment
For various reasons and needs, some car owners will install stereos, radios, refrigerators, spoilers or other equipment on their cars. Luggage racks, etc. If an accident occurs and the above private equipment is damaged, the insurance company will refuse to compensate.
Experts remind: Car owners can insure "new equipment loss insurance" so that they don't have to worry!
3. If the vehicle is stolen or damaged in the parking lot, the insurance company will not compensate you
If the vehicle is stolen or scratched in a paid parking lot, or is damaged , the insurance company refused to compensate, and you should find a parking lot to compensate.
Experts remind: You should first take photos and leave evidence, and then make a claim.
4. If you drive illegally, the insurance company will definitely not compensate you
Explanation: There is no need to explain this. If you cause an accident, you will have to compensate others!
5. After an accident occurs, the insurance company will refuse to compensate without verifying the damage
After an accident within the scope of insurance liability occurs, the car owner should immediately report the case to the public security department, and at the same time must When reporting a crime to the insurance company, remember to do so within 48 hours. If the vehicle is repaired without verification of damage, the insurance company will deny compensation.
Experts remind: If a vehicle is in danger, the process must not be wrong. The owner must assess the damage before repairing the vehicle.