Sign an insurance reminder before taking out insurance.
According to the relevant requirements of the CIRC, all life insurance companies must use the Tips for Life Insurance to clearly indicate the precautions and risks of insurance. On the one hand, it is to fulfill the obligation of informing and protect consumers' rights and interests, on the other hand, it is also for insurance companies to take this as evidence from the perspective of protecting themselves, and strive to avoid the negative impact of disputes caused by vague propaganda. Accordingly, all personnel in the life insurance exhibition industry are required to show insurance tips when selling designated products, and banks (information forum products) are also required to provide insurance tips, otherwise it is illegal. Before signing the insurance application, the applicant should read this prompt carefully and sign it in person. Personal insurance (information forum product) tips mainly include insurance risks, hesitation period and precautions, and also remind consumers to confirm the legal qualifications of insurance institutions and sales personnel. Of course, the insurance in critical illness insurance is no exception.
Physical examination has become a necessary procedure for medical insurance.
In the past, when insuring critical illness insurance in health insurance, insurance companies did not have rigid requirements for physical examination, but only conducted spot checks on health examinations according to a certain proportion, and conducted health examinations for policyholders who did not meet health conditions and were over 45 years old. However, after the implementation of the Insurance Law, because the new law pays more attention to protecting the rights and interests of the insured, and the new law introduces the incontestable rule, the insurer's compensation ratio will rise, which will lead to an increase in the operating costs of insurance companies. Insurance companies will raise the threshold of critical illness insurance and require the insured to have a physical examination to prevent the moral hazard of the insured and reduce operating costs.
If the insured fails to tell the truth, the insurance company will pay compensation two years later.
Drawing lessons from international practice, the new law adds an "incontestable" clause to the insurance contract, stipulating that "the insurer shall not terminate the contract if it has been more than two years since the date of establishment of the contract". That is, two years after the establishment of the insurance contract, the insurance company shall not terminate the contract on the grounds that the applicant has not fulfilled the obligation of truthful disclosure. That is to say, if the insured deliberately conceals part of his illness before purchasing the critical illness insurance, according to the original terms, if the insured has related major diseases in the future, the insurance company can refuse to pay compensation. However, after the implementation of the new Insurance Law, if the insured's major disease does not break out within two years and then breaks out again, the insurance company will pay for it. This rule is of great significance to protect the interests of the insured under the long-term life insurance contract, fills the gap in the current insurance law, and will also bring cost increase to insurance companies.
There are many ways, such as second payment, multiple claims, and terminally ill claims.
The so-called "secondary compensation" means that if the insured is unfortunately diagnosed with one of the 35 major diseases listed in the contract for the first time within 90 days after the contract comes into effect due to an accident, he will receive the first serious illness insurance premium according to the insured amount, and the insured amount of the main contract will be reduced by the same amount, and the policy will continue to be valid; After the expiration of 365 days from the date of the first claim for major illness, if the insured is diagnosed with any major illness in two groups other than the group to which the first major illness belongs, he will receive the second critical illness insurance premium according to the insured amount, and the insurance liability will be terminated.
Secondary claims can make up for the shortcomings of traditional critical illness insurance products, such as "one-time termination of disease protection". For example, the concept of "secondary claims" promoted by Xincheng Life Insurance provides secondary claims protection for malignant tumors. No matter whether malignant tumor is diagnosed for the first time or secondary disease (including recurrence and metastasis), the highest coverage of 100% is provided each time. In the old insurance law, the insured suffered from serious illness insurance, and the contract was terminated after the insured obtained a claim for illness.
Another example is Taiping Life's "Fulu Shuangzhi", which puts forward the concept that "terminally ill patients can also claim compensation". "For example, if a customer is diagnosed in a hospital and the survival time is no more than 6 months, now the hospital can only give some basic drugs to alleviate the patient's pain and get the corresponding claims." Personal insurance salesmen who are familiar with "Fulu Shuangzhi" products said that this provision is not limited to major diseases, such as diseases caused by major car accidents, and claims can be obtained, which actually expands the scope of claims.
The coverage of critical illness insurance has been expanded.
Due to the change in the definition of high disability of critical illness insurance in the new Insurance Law, high disability is described as a specific disease, and the product coverage of critical illness insurance has been expanded. For example, the "Hua Dan" of China Life Insurance, which accounts for more than 40% of the national critical illness insurance market, will be replaced by upgraded products, and its coverage will be expanded. For example, the coverage of the newly launched "Kangning Lifelong" critical illness insurance has been increased from 2 times to 3 times, and the coverage of critical illness insurance has been increased from 10.
Claims will be smoother and faster.
In terms of claims, the new Insurance Law strengthens and improves the effective protection of the interests of the insured and the insured who are in a relatively weak position, and modifies or refines the insurer's claims procedure or time limit. Article 22 of the new "Insurance Law" stipulates that: if the insurer believes that the relevant certificates and materials are incomplete according to the contract, it shall notify the applicant, the insured or the beneficiary to supplement them "in time"; Article 23 stipulates that: after receiving the request of the insured or beneficiary for compensation or payment of insurance money, the insurer shall verify it in time, and if the situation is complicated, it shall verify it within 30 days, unless otherwise agreed in the contract; For those who do not belong to the insurance liability, the insurer is required to explain the reasons for refusing compensation.
The critical illness insurance is insured as an additional risk.
According to the person in charge of the personal insurance department of a life insurance company, due to the addition of the "non-defense clause" in the new Insurance Law, that is, after the insurance contract is established for two years, the insurance company will not be able to refuse to pay insurance benefits on the grounds that the insured violates the obligation of truthful disclosure, such as false disclosure, omission of disclosure, and concealment of certain facts. Pure critical illness insurance for insurance companies, the risk doubles. Therefore, new critical illness insurance mostly exists in the form of "main insurance+additional insurance". On the one hand, it is to prevent the moral hazard of the insured, reduce the operating cost, and at the same time cater to the market demand and the interests of the insured. If the main insurance is critical illness insurance, it is not allowed to participate in dividends according to the regulations of the China Insurance Regulatory Commission. Choose a critical illness insurance attached to the main insurance. If the main insurance can pay dividends, the insured can get benefits while getting the protection of critical illness insurance. In addition, under the same coverage and amount, the additional insurance is critical illness insurance, which is cheaper than the main insurance. Consumers have more room for independent choice.
Critical illness insurance rate will be fine-tuned
Because the newly introduced critical illness insurance has expanded the coverage, the insurance company's compensation risk has increased. At the same time, new clauses in the new Insurance Law, such as two-year incontestable clauses, claims in claims settlement and changes in limitation of action, have increased the operating costs and compensation expenses of insurance companies to some extent. After the operation of the new Insurance Law, the payout ratio of major diseases of insurance companies may increase by tens of millions of yuan, and the newly revised insurance premium rate may need to be raised. For example, if Taiping Life's "Fulu Shuangzhi" product is a 30-year-old male, the insured amount is 200,000 yuan, the original product price is about 6,060 yuan, and the new product price is about 6,340 yuan, with a price increase of about 4.60%. According to this price, if you buy a new product, you will always pay about 8400 yuan more in 30 years, which is equivalent to.
Compensation can also be obtained during the observation period.
An insurance contract established according to law shall take effect upon its establishment. The applicant and the insurer may agree on additional conditions or time limit for the contract to take effect. This means that the insurance company can't shirk its responsibility if an accident occurs during the observation period.
Mr. Li insured himself for health insurance and additional hospitalization expenses of an insurance company. On July 3, he was hospitalized for gastrointestinal diseases. After leaving the hospital, Mr. Li came to the insurance company to apply for compensation. According to the relevant provisions of the old Insurance Law, the insurance company said that because Mr. Li's onset time was within the observation period of 90 days after the policy came into effect, the insurance company would not pay compensation.
However, the relevant provisions of the new "Insurance Law" stipulate that "an insurance contract established according to law shall take effect upon its establishment." Considering that there is a necessary underwriting link between premium payment and the formal entry into force of the policy, the new Insurance Law also stipulates: "The insured and the insurer may attach conditions or deadlines to the effectiveness of the contract."
At the same time, in view of the new provisions of the new Insurance Law on the time of establishment and effective of insurance contracts, the China Insurance Association encourages life insurance companies to introduce special treatment rules of "temporary contracts". An insurance company may, according to the actual situation, provide temporary protection for consumers to protect the interests of the insured and the beneficiary during the period from the time when the insured pays the initial premium to the time when the insured agrees to underwrite, or issue a notice of refusal to insure and refund the premium.
Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.