Unsatisfactory life insurance claims

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					Unsatisfactory life insurance claims
- Consumer Complaints

In the first phase of the "Insurance Complaints series of reports",
the reporter before the collection of a lot of information, including official
government statistics on cases of complaints of civil rights group, the portal
publishing complaints, in order of discovery: the life insurance claims and contract
dispute the issue, China Life's complaints was high. According to the
China Insurance Regulatory Commission, 1 August 2006, premium income of life
insurance companies look at the data: China Life shares to 133,722,864,800 yuan,
topped the list.

Following complaints about China Life's case, the reporter repeatedly to
the parties An Li He Shi and track progress, the cases reflect problems in the
insurance Xiao Feizhe the more common, this issue specially invited one professional
legal professionals of the cases one by one, Zuo Wei comment , would like to draw
the consumers attention.

"My father was seriously ill death

Why can not the full amount? "

Person: Zhang Yuan Yuan, F, 25 years old, working in Beijing Sohu website.

Complaint targets: China Life Insurance Company Baoding Branch

Party saying:

Zhang Junyi Zhang Yuan Yuan's father, who is Baoding, Hebei, born in
1955, Zhang Junyi on April 2, 2006 died suffering from esophageal cancer. Zhang
Junyi insurance during his lifetime, life insurance companies in China,
"Corning term insurance" and "Corning Life
Insurance", sum insured is 40,000 yuan, China Life Insurance Company,
insurance subsidiary of Baoding Xing-branch company set. Two types of insurance
for the 180-day observation period, Zhang Junyi insurance policy on time for
February 15, 2005, by the time estimated that the end of the observation period should
be in the September 10, 2005. 10 beginning in 2005, Zhang Junyi feel unwell, family
October 20, 2005 about to take him to the Third Hospital of Hebei Province, Baoding,
oncology examination, the results of late esophageal cancer. Zhang Yuan Yuan Xing
month support given to China Life Insurance Company reported that insurance. Will
support the company asked Zhang Yuan Yuan Xing provide the appropriate
documents and to extract directly to the hospital medical records, after verification,
Zhang Junyi eligible to claim, but will support the company's
compensation Hing limit is 3 million, it must be Baoding Branch to cover a premium.
However, the dangerous condition of Baoding Branch to Zhang Junyi date from the
period of observation is very close to the ground, suspected Zhang Junyi and his
family hid the true onset time, and said to be continuing. Delayed until April 9, 2006,
Zhang Yuan Yuan, Baoding Branch Claims Branch once again linked to handle the
matter of Mr Wang said: Through investigation, they check to the Cancer Hospital in
Beijing, June 29, 2005 as a registered Zhang Junyi record, and asked Zhang to
provide round the hospital at the time of medical information. According to Zhang
Yuanyuan said: "We did not go to Beijing cancer hospital, the name of the
country called Zhang Junyi is not only my father was a man, a registered record alone,
without any medical records, how can you prove that my father did at this hospital
been treated? "Zhang Yuanyuan said this question.

Zhang Yuan Yuan reporter contacted, she said that insurance agents have 10,000 yuan
in compensation to her, but the deduction of 600 yuan: "an agent said:
because the company must follow to cover a death, so buckle year premium.
"Zhang Yuan Yuan was not satisfied with the results of this
treatment:" can not follow the death to cover a, my father died because of
major diseases. buckle year premium is unreasonable, I have asked to be deducted
with an agent The 600 premium returned to me, but have not yet returned.

China Life Response:

Press this case be transferred from the China Life Insurance Co., to the time of this
writing a total of six days, China Life planning department say: has case transferred to
a branch of Baoding, Baoding Branch also has feedback, but "case and the
fact that the parties described in and out too much," but it does not disclose
where the access, because "we have to go through the
company's legal proceedings, China Life is a listed company, must be
strictly according to the system to the" about when to respond The answer
is "as soon as possible, but not exactly what time."

Expert Comment:

Burden of proof of insurance companies are not parties, if the insurance company that
insured the incidence in the observation period should be evidence in person to the
hospital, and only medical treatment that no, there should also be concerned with the
proof of esophageal cancer.

"Insurance agent to buy my policy"

Client: Lan Zheng Xia

The target of complaint: Hunan branch of China Life Insurance Company
Party saying:

Xia Zheng Lan on February 21, 2006 in the Hunan branch of China Life to buy a
value of 90,000 yuan for China Life Hong Xin, insurance, signature, insurance
salesman acquaintance several times by a promise of summer Zheng Lancheng
benefits of the policy, but did not honestly tell an important part of the policy. After 10
days of the "policy of hesitation," salesmen have not submitted
to the summer schedule policy Zheng Lan hands, but to the first 13 days will be the
policy to her. Zheng Lan after the summer to get to know the insurance policy is not
suitable for her, but also economically she could not afford. After the summer looking
for the clerk to discuss the result is not satisfactory, the summer has found the China
Life Insurance Complaint Center in Changsha area, and after-sales service.

Lan Xia Zheng told reporters that the matter has been made to resolve: "I
sell insurance agent and I secretly resolved, the agent of my own money to buy the
insurance, the premium of 3 million." When asked Hunan branch of China
Life Insurance Company agents know what the policy commitment to customers, the
summer Zheng Lan said: "We should know."

China Life Response:

Press the case and transferred to China Life Insurance Company Limited play time of
writing, a total of six days, China Life planning department say: has case transferred
to a branch in Hunan, Hunan Branch also has feedback, but not disclose the results,
why and when the answer to the same case for a return.

Expert Comment:

1. According to Insurance Law Article XVIII: important element of the insurance
contract liability exemption clause, the agent keep up clients clarify, otherwise the
contract is not effective.

2. Hesitation of the general common practice in the industry: getting the policy began
to count from the customer, rather than an algorithm to count the cases, and in the
hesitation period, customers can always withdrawals, the customer has the right to

(Case Source: 3.15 Complaints Network)

Ma Yu reporter

Experts Return Weapon
Current Issue of experts invited to the Central University of Finance and insurance,
play Su Hao, Dean, he will interpret the above cases, the consumers reflected in the
process of consumer insurance products should pay attention to. In the future,
"Insurance Complaints series of reports", the Premier Su Hao
speech will often appear on "Shopping Guide" FAQ for

1. Enter into insurance contracts to pay attention to: the restrictive provisions of the
insurance contract, that liability exemption clause (insurance companies do not pay
provisions), to see whether they sell insurance salesman said the same. In accordance
with the insurance laws and regulations, agents have a responsibility to inform
Disclaimer customers, but some clerk does not remind consumers fear that the
consumer will not buy insurance after the.

2. To understand the characteristics of insurance. Deposit insurance is not a simple
financial management tools, many of consumption of insurance is to be compensated
after the incident, to buy the insurance they had better not surrender, surrender a great
loss, so must be careful before buying.

3. Mentality normal insurance policy-holders of the insurance payment is not received
compensation, but those who do not happen in real policy-holders of the Fund for
losses is established.

4. Take full advantage of the policy of observation, also called cooling off period,
during this period is the unconditional surrender, the general observation period of 10
days also, once this period, would like to withdrawals on the passive.

5. The above points do full, there is relatively little chance of dispute, but the event of
a claim dispute, in accordance with relevant laws: provisions of the insurance
provisions are formatted, so when an explanation for differences in terms of time to
do help non-drafter The deal, consumers can make such a request to the insurance

China Life's complaints regarding the above case studies: China Life as a
50% market share company, the accident rate is a natural market phenomenon. But it
violates the interests of consumers, so the insurance company should be honest, to do
service work, such as Qi Zhong a case: insurance salesman to the insurance buying it
eventually, I think he is to do the surrender procedures, themselves losses, because the
policyholder's name can not be replaced. This practice is not lost on
customers, but the loss of the insurance company's image.

Focus - the insurance industry standard development

China Insurance Regulatory Commission on September 20, 2006 published results
show that: in January 2006 to August, China's total insurance premium
revenue of 382,095,301,800 yuan, a year earlier 335,235,471,000 yuan. Not difficult
to see from this result, China's insurance industry is moving fast on the
road. But there are thought-provoking and fear of a data: According to the China
Consumers Association, the first half 2006 results of the analysis of complaints,
"complained the biggest increase among the top six of the
service" A, the highest among financial and insurance services, first half of
2005 was 510, the first half of 2006 was 539, an increase of 5.7%; in the consumer
association results in 2005, "The top eight complaints against the service
increases," one of the insurance ranking Sixth, in 2004, 1427, 2005 1702.

In recent years, the rapid development of the insurance industry believe that many
readers have deep feeling: the establishment of insurance companies have
mushroomed, widening the ranks of insurance agents, insurance and diversified
functions, such as insurance coverage more comprehensive, but the insurance services
The problems are also exposed: an insurance policy is really to play a proactive role?
Insurance services are the same as advertised word propaganda? From the above
results show that, not at all.

View of the current insurance industry and other emerging issues related to insurance,
newspaper want insurance to provide a communication platform for consumers, so
more and more people are concerned about the insurance industry, so that more and
more standardized insurance services. Let us together build a standardized, high
quality, meet consumer desire for the insurance service system.