Case details
On September 20 19, Mr. Chen bought an insurance policy with China life insurance company for his daughter born on 1 month. The insured amount is 20,000 yuan. At the time of purchase, Mr. Chen paid the annual insurance premium 1600 yuan to the insurance company. In February of that year, Mr. Chen's daughter was diagnosed as infantile hepatitis syndrome by the hospital and was diagnosed as "congenital biliary atresia" when she was discharged from hospital.
Later, Mr. Chen's daughter died unfortunately. The cause of death written in the death diagnosis was "congenital biliary atresia". Subsequently, Mr. Chen applied to the insurance company for compensation, but the insurance company rejected Mr. Chen's claim on the grounds that the insured did not fulfill the obligation of truthful disclosure when applying for insurance, and requested to terminate the contract. Because the insurance company refused to pay, Mr. Chen took the insurance company to court.
After the court's decision, it is normal for Mr. Chen not to know about his daughter's jaundice symptoms without medical diagnosis. He rejected the reasons why the insurance company refused to pay compensation, and finally decided that the insurance company would pay Mr. Chen 20,000 yuan according to the insurance contract.
case analysis
In the above case, the reason why the insurance company refused to pay compensation was that Mr. Chen did not fulfill his obligation to tell the truth. Although the court finally ruled that the insurance company should compensate Mr. Chen, things became complicated because Mr. Chen did not fulfill his obligation of telling the truth. If the child has a physical examination and health advice when he is insured, then the insurance company has no reason to refuse to pay compensation, and the claim will be smooth.
Health notification is a problem that many people tend to ignore when taking out insurance, so what impact will it have if they fail to fulfill their obligation of truthful notification? How to give health advice?
First, the importance of insurance truthful disclosure
According to the second paragraph of Article 16 of the Insurance Law, if the insured fails to perform the obligations specified in the preceding paragraph intentionally or due to gross negligence, and the obligation of telling the truth is enough to affect the insurer's decision whether to agree to underwrite or increase the insurance premium rate, the insurer has the right to terminate the contract.
In other words, if you didn't tell the truth when you bought insurance, or you should have told it, but you forgot it because of your negligence, the high probability is the responsibility of the insured. In the next two years, the insurance company has the right to terminate the contract on this ground, so you must pay attention to health notification when buying insurance. If there is a past history before, or there are some special circumstances and abnormalities in the body during the physical examination, especially the health scope written in the contract, you must make it clear and let the insurance company verify the situation.
If there is no health notification, the subsequent claims will have many influences. First of all, the insurance company will refuse to pay compensation, resulting in the inability to obtain compensation. Secondly, it will affect the progress of claims, and insurance companies will not make claims smoothly. If you go to court with the insurance company because you don't tell the truth, not only will you not get timely compensation, but you will also delay your illness, but it will not be worth the loss.
We have seen many cases in which insurance companies refused to pay compensation, and many of them were refused compensation because the insured failed to fulfill the obligation of telling the truth. Then, how to give health information when actually applying for insurance?
Second, how to inform health?
Because everyone's situation is different, you should also choose the type of insurance that suits you. After you choose insurance, you will generally be asked about your past medical history and whether you have any physical abnormalities. If there is any abnormality, relevant cases, physical examination and review materials shall be submitted. , before you can configure the next insurance product.
Telling the truth is a technical job in itself. In China, insurance information is often obtained through inquiry. Those who ask need to be informed, and those who don't need to be informed. Because not everyone can understand the health information of insurance, we must be careful when making health information.
Generally, you can say what you ask, and you can omit what you don't ask. Of course, you have to tell the past diseases mentioned in the notice one by one, but in Chinese mainland, limited notice is implemented, and you can answer whatever you ask, without asking or answering. For example, term life insurance, ask the insured whether there is hepatitis or cirrhosis. If he is only a hepatitis B virus carrier, it goes without saying. But if you ask, you should be careful to say that the same person has insured three policies, and the underwriting results will be very different because of the different contents.
Therefore, when we buy insurance, we must do a good job of health notification, and at the same time, we must choose the insurance that suits us according to our health status. If you have any questions about buying insurance, you can search Baidu for "Baibaojun". There are many professional insurance consultants who can help you match the insurance products that suit you according to your actual situation and help you answer any questions about insurance.