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Knowledge of life insurance claims

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					Knowledge of life insurance claims
   Often hear people complain that "insurance claims difficult,"
No, not No, not actually. As an insurance broker, have the opportunity to understand
the full range of insurance, I want to claim knowledge about to tell you friends, for
reference.

   ?Life insurance claims procedure:
   ?Insurance claims is a small probability risks were unfortunate victims of the
incident requiring the company to honor its prior commitment. Many insurance
companies have "insurance claims easier to hard" feeling, in
fact, it is mainly a number of customers who bought life insurance for various reasons
from the insurance company's claims could not be formed
Misunderstanding. Lead to claims difficult for many reasons, remove a handful of
people maliciously Pianbao of factors, insurance companies do not understand the
claims process is also very important reasons. If the claims in the application process,
pay attention to the following points, claims, or very easy.
   ?First, it must promptly report:
   ?When insurance claims is the first part of report. According to the provisions of
the insurance contract, insurance or the subject had been damaged insured event
occurs, the insured, the insured, the beneficiary and their agent should notify the
insurance company as soon as possible, otherwise the resulting losses borne by the
beneficiaries themselves . Under normal circumstances, the insured should be in the
insurance after the accident 10 days, notify the insurance company, but as different
types of insurance claims are not the same prescription, it must be under an insurance
contract provisions reported immediately to prevent loss of their own interests were.
   ?If the insured is in the form of an oral briefing report, then have to bill the
forgotten after a formal notice of dangerous condition. Report should detail the
following issues: the informant and the basic situation of the insured, the insurance
the accident happened, where, why, after, and the results.
   ?Second, consistent with areas of responsibility:
   ?Report, the insurance company or clerk will inform the customer whether the
incident occurred within the insurance coverage. Customers can also read the
insurance terms, consult an agent or call the hotline for re-insurance company to
confirm. Insurance 只 being insured people do because of the risk of Nei
responsibility for loss caused by Pei Chang, terms of Zhong Bao Xian, except for
liability, such as Liang Nian in suicide, Fanzui and the insured and the
insured's intentional act, insurers will not provide protection.
   ?Third, get ready the necessary documents:
   ?To prevent the insurance company made unfounded or exaggerated claims, the
insured must be required to provide a specified time and explain the detailed
circumstances of the loss of evidence. Whatever the insurance, beneficiaries are
required to prepare the original insurance policy, the insured and beneficiary
identification (ID card, household military officer, Soldiers can) the original and the
most recent invoice the premium paid, if the commission procedures for handling
claims of others need complete power of attorney.
   ?Fourth, prepare medical division one:
   ?If the insured person has the basic medical insurance, social security has to
reimburse a part of, then the need to advance to the insurance company to produce
social security issued by the division for medical expenses alone, and indicate the
total amount spent on medical expenses and social security costs have been paid,
together with the A copy of the original documents along to the insurance companies,
insurance companies will be based on the materials in the amount of medical
expenses within the remaining claims.
   ?Fifth, to conduct an accident investigation:
   ?The data was collected, insurance company claims department began an
investigation. Insurance companies may require customers to meet the research, and
provide additional material and evidence. If the insured when the insured has
concealed a history of ill insured or insured has not autographed, etc., will be to claim
hinder the smooth progress of work. Finally, the insurance company will review,
calculate, determine the claim paid, and notify the customer to collect insurance
money.

   ?This shows that the claim is not difficult, as long as the facts are clear, evidence,
insurance companies will in the shortest possible time compensation in order to
maintain its good reputation.

   ?Analysis of five common conditions are not compensable:
   ?Insurance is not a security risk will also have insurance will not pay. Not all
incidents can receive compensation insurance companies. Consumers must read the
contents of the insurance company is not paid and, in a targeted manner to avoid the
risk-free guarantee. In fact, there are several elements of an effective compensation:
first, the incident must be the responsibility of the insurance contract within the scope
of incidents, over areas of responsibility of the insurance contract, the insurance
company is not liable for compensation or payment of insurance money.
Compensation insurance companies do not lose money in the end, often the insurance
period. Insurance, accident insurance contract is valid, whether the waiting period
(observation period), to claim, whether the claim is still within the limitations are
directly related with the insurance companies are losing money. If insured by the
reminders because even after the premium due is not paid, resulting in failure of the
insurance contract, or the insured violated the principles of the insurance contract
formation, resulting in the insurance contract null and void, insurance companies, of
course, liable for compensation. Compensation insurance companies do not lose
money, pay the amount of compensation with the amount of the customer. The
amount of insurance indemnity to the insured amount is limited, and if multiple
claims, the total amount of compensation can not exceed the sum insured. If an
insurance contract, the total insurance amount of 10 million, accumulated by previous
compensation 60,000 yuan, then the recurrence of insurance claims, insurance
companies, the highest claim paid only 4 million, some will be more than the insured
themselves. Reasons for exclusions in the insurance, the consumer does not accurately
account for a large proportion of this truth. There is an important principle of
insurance contract that insured to bear the "Real Facts"
obligations. When the insured is not accurately informed, they will lose the right to
future claims. Because the law recognizes only a written record of the insurance
contract in this matter. In addition, the failure to fulfill the obligation to pay insurance
premiums on time, claims the lack of necessary documents, materials, etc., will also
be exclusions. In fact, if consumers pay more attention to the details of when the
insured, a lot of exclusions can be avoided.

   ?Often hear people complain that "insurance claims difficult,"
No, not No, not actually. As an insurance broker, have the opportunity to understand
the full range of insurance, I want to claim knowledge about to tell you friends, for
reference.

   ?Life insurance claims procedure:
   ?Insurance claims is a small probability risks were unfortunate victims of the
incident requiring the company to honor its prior commitment. Many insurance
companies have "insurance claims easier to hard" feeling, in
fact, it is mainly a number of customers who bought life insurance for various reasons
from the insurance company's claims could not be formed
Misunderstanding. Lead to claims difficult for many reasons, remove a handful of
people maliciously Pianbao of factors, insurance companies do not understand the
claims process is also very important reasons. If the claims in the application process,
pay attention to the following points, claims, or very easy.
   ?First, it must promptly report:
   ?When insurance claims is the first part of report. According to the provisions of
the insurance contract, insurance or the subject had been damaged insured event
occurs, the insured, the insured, the beneficiary and their agent should notify the
insurance company as soon as possible, otherwise the resulting losses borne by the
beneficiaries themselves . Under normal circumstances, accident insurance, the
insured should notify the insurance company within 10 days, but spent all types of
insurance claims are different, they must be timely under the provisions of the
insurance contract, reported to prevent the loss of their own interests were.
   ?If the insured is in the form of an oral briefing report, then have to bill the
forgotten after a formal notice of dangerous condition. Report should detail the
following issues: the informant and the basic situation of the insured, the insurance
the accident happened, where, why, after, and the results.
   ?Second, consistent with areas of responsibility:
   ?Report, the insurance company or clerk will inform the customer whether the
incident occurred within the insurance coverage. Customers can also read the
insurance terms, consult an agent or call the hotline for re-insurance company to
confirm. Insurance company only insured people do because of the risk within the
responsibility of compensation for losses resulting from, except for liability insurance
policy in such two years, suicide, crime and the insured and the insured's
intentional act, the insurance company does not provide protection.
   ?Third, get ready the necessary documents:
   ?To prevent the insurance company made unfounded or exaggerated claims, the
insured must be required to provide a specified time and explain the detailed
circumstances of the loss of evidence. Whatever the insurance, beneficiaries are
required to prepare the original insurance policy, the insured and beneficiary
identification (ID card, household military officer, Soldiers can) the original and the
most recent invoice the premium paid, if the commission procedures for handling
claims of others need complete power of attorney.
   ?Fourth, prepare medical division one:
   ?If the insured person has the basic medical insurance, social security has to
reimburse a part of, then the need to advance to the insurance company to produce
social security issued by the division for medical expenses alone, and indicate the
total amount spent on medical expenses and social security costs have been paid,
together with the A copy of the original documents along to the insurance companies,
insurance companies will be based on the materials in the amount of medical
expenses within the remaining claims.
   ?Fifth, to conduct an accident investigation:
   ?The data was collected, insurance company claims department began an
investigation. Insurance companies may require customers to meet the research, and
provide additional material and evidence. If the insured when the insured has
concealed a history of ill insured or insured has not autographed, etc., will be to claim
hinder the smooth progress of work. Finally, the insurance company will review,
calculate, determine the claim paid, and notify the customer to collect insurance
money.

   ?This shows that the claim is not difficult, as long as the facts are clear, evidence,
insurance companies will in the shortest possible time compensation in order to
maintain its good reputation.

   ?Analysis of five common conditions are not compensable:
   ?Insurance is not a security risk will also have insurance will not pay. Not all
incidents can receive compensation insurance companies. Consumers must read the
contents of the insurance company is not paid and, in a targeted manner to avoid the
risk-free guarantee. In fact, there are several elements of an effective compensation:
first, the incident must be the responsibility of the insurance contract within the scope
of incidents, over areas of responsibility of the insurance contract, the insurance
company is not liable for compensation or payment of insurance money.
Compensation insurance companies do not lose money in the end, often the insurance
period. Insurance, accident insurance contract is valid, whether the waiting period
(observation period), to claim, whether the claim is still within the limitations are
directly related with the insurance companies are losing money. If insured by the
reminders because even after the premium due is not paid, resulting in failure of the
insurance contract, or the insured violated the principles of the insurance contract
formation, resulting in the insurance contract null and void, insurance companies, of
course, liable for compensation. Compensation insurance companies do not lose
money, pay the amount of compensation with the amount of the customer. The
amount of insurance indemnity to the insured amount is limited, and if multiple
claims, the total amount of compensation can not exceed the sum insured. If an
insurance contract, the total insurance amount of 10 million, accumulated by previous
compensation 60,000 yuan, then the recurrence of insurance claims, insurance
companies, the highest claim paid only 4 million, some will be more than the insured
themselves. Reasons for exclusions in the insurance, the consumer does not accurately
account for a large proportion of this truth. There is an important principle of
insurance contract that insured to bear the "Real Facts"
obligations. When the insured is not accurately informed, they will lose the right to
future claims. Because the law recognizes only a written record of the insurance
contract in this matter. In addition, the failure to fulfill the obligation to pay insurance
premiums on time, claims the lack of necessary documents, materials, etc., will also
be exclusions. In fact, if consumers pay more attention to the details of when the
insured, a lot of exclusions can be avoided.

   ?Exclusions for a reason: To observe the sick during the period
   ?Some compensation for medical expenses with medical insurance contract, in
order to deliberately prevent sick insurance policy holders, but also to reduce the risk
of insurance companies, including a provision that is: the insurance liability from the
waiting period (observation period) since the end of the day, if Insurance accident
waiting period (observation period) occurred within any of the insurance company
liable for compensation.
   ?Case playback:
   ?Sze on June 1 last year, bought a female critical illness insurance, the insurance
for one year observation period. July 2005, Ms. Shi suddenly felt unwell and was
diagnosed with breast cancer. She believes that the timely payment of major illness
insurance type insurance, so long as the hospital confirmed to receive full insurance.
Then, a few days later she Bianxiang insurance company claims the request. But the
insurance companies view the policy situation, the decision to make exclusions on the
grounds that: The policy is also the observation period, insurance companies do not
bear the compensation responsibility.
   ?Expert Comment:
   ?In this case, the insurance company is indeed reason to exclusions of. Under the
contract, Ms. Shi claims to the insurance company the reason is not established.
Although Ms. Shi when the insured has not knowingly conceal the truth, but because
there has been the observation period, insurance has not yet entered into force, the
compensation she also wasted.

  ?Exclusions two reasons: the responsibility does not belong to the insurance
  ?In the absence of figure out the insurance policy held by the hands of the
responsibility to the insurance claim, but in the end rejected the situation is more
common.
   ?Case playback:
   ?This year's "11" holiday, a tour of Hainan after
having a meal at a restaurant in Shanghai, gradually developed fever, diarrhea and
other symptoms. The next day, half of the tourists were taken to hospital for treatment.
Subsequently identified as food poisoning. Tourists to travel agents claim for
compensation, travel insurance company instead tried to claim, but was refused. Said
insurance companies, travel agencies, insurance liability insurance is accident
insurance, that passengers traveling in an accident, the insurance company liable to
pay compensation, such as roll-over accidents. "Food poisoning"
is not in the context of travel insurance, the insurance company is not responsible for
compensation. Visitors can consult with travel agencies or court to resolve.
   ?Expert Comment:
   ?Each has its own specific insurance, liability insurance, insurance is not a panacea,
not "100 are security risks" insurance can not be the words too
literally. As a rational consumer, can not be condemned "King
terms" the Shique vexatious. Responsible attitude of their prior
understanding clearly their own (family) bought the insurance, accident insurance,
which can take responsibility. In addition, the need to remind consumers that buy the
insurance before the insurance claims have to look at the scope of what can be lost
after that escape from danger and what can not lose.

   ?Exclusions reason four: sign on behalf of
   ?Signed on behalf of the common cause of insurance claims disputes with family
members, friends, colleagues (in the more common group insurance) on behalf of the
sign, there are insurance agents on behalf of the sign, but no matter the circumstances,
insuring the generation of signatures is absolutely undesirable , escape from danger,
the insurance company is simply not pay for.
   ?Case playback:
   ?Last year in June, Sharon's husband was a business trip to buy a term
life insurance. Because of such insurance is the death of the insured payment
conditions, requiring the consent of the insured person's permission
(written signature). Therefore, before signing the policy, Sharon asked the agent:
"My husband was traveling, could not sign the policy." Agent
replied: "Never mind, you can sign up to help him." So, Sharon
would In a column on behalf of the insured person's husband signed his
name. Shortly after the Chinese New Year, Miss Liu's husband died of
disease. Grief, Sharon thought of her husband worked to buy the insurance, they
would make claims for insurance companies. Insurance claims, the contrast was found
after the signature of the handwriting of the insured person, one column is signed by
the insured on behalf of Miss Liu, the husband, the insured did not personally sign the
policy, so the decision to make exclusions. Later, the insurance company on the
induction agent of the customer to do a serious punishment, but Miss Liu economic
losses already suffered irreparable.
   ?Expert Comment:
   ?Ms Lau is regrettable, because misled by insurance agent suffered financially and
mentally. But the law is cruel, she happened to once again remind people: when
signing the insurance contract must be personally signed. Once a contract is signed
the insurance to pay the legal effect of health, so do not please someone to sign, do
not let the insurance agent to help fill in, in order to avoid illness, the insurance
company to the contract null and void after the grounds of exclusions.

   ?Exclusions four reasons: to inform and report does not accurately
   ?Industry, currently more than 80% of the exclusions were because the case did not
"accurately inform the" cause.
   ?Case playback:
   ?December 2000, Mr. Sun in a life insurance policy purchased, of which a
significant disease risk insured 100,000 yuan, 2600 yuan in premium. February 2005,
he made claims to the insurance company, and provided in a hospital,
"chronic renal insufficiency, uremia," Diagnosis of proof,
evidence show Mr. Sun only hospital one day, history is one week. The branch sales
personnel in a multi-hospital, after careful investigation, and finally found the insured
as early as July 1997 had been diagnosed as "chronic renal insufficiency,
renal moderate atrophy." Thus, the branch to the insured intentionally
conceals a history of attempting to defraud the insurance to pay the ground, the
amount of insurance exclusions 100,000 yuan.
   ?Expert Comment:
   ?Credibility is the most basic principles of the insurance. This principle specifically
to life insurance, the insured should be required to fulfill obligations to truthfully
inform and declarations. That is, the process in the insurance contract, the insured for
the insurer raised the subject of the insurance or the insured, among other issues,
should be answered truthfully. If the insured against the principle of good faith,
intentional concealment of facts does not perform the obligations in the event of
insured accident, the insurer can not take responsibility for and can not refund the
insurance premium. "Insurance Law" has a similar provision,
"Insurance Law" Article 17 paragraph states: "the
insured intentionally conceal facts, not to perform the obligations of, or due to
negligence fails to perform the duties, which affect the insurer decide whether to
agree to cover or increase the premium, the insurer is entitled to terminate the
insurance contract. "

   ?Five reasons for exclusions: the intent to cause death of the insured
   ?At      present,     the       attempt       to     "Murder,"
"suicide" and "killing children" in order
to get high insurance cases common in newspapers, many people in order to obtain
insurance, at the expense of the lives of themselves or their families do bet. As
everyone knows, such an approach, both crimes are not the insurance company a
penny of compensation. The result can only be a gamble, "throw good
money off soldiers" can not get insurance, but also severely punished by
law.
   ?Case playback:
   ?Recently, Sichuan Meishan City Intermediate People's Court with
Murder in the first instance verdict Pianbao case. Court's investigation,
Pengshan County Ai-Ping Yang in August 2003 as his wife Zhang Yuhua Pengshan
branch in China Life Insurance Company for life insurance coverage Corning. In the
same year on December 30, Yuhua was diagnosed with cervical cancer hospital. Thus,
Ai-Ping Yang Nian insurance fraud generated. Ai-Ping Yang Yuhua several times in
the People's Insurance for the large amount of personal accident insurance
comprehensive insurance, life insurance Corning. Chang Ai-Ping Yang for himself a
small passenger car insurance to a maximum limit of compensation to 630,000 yuan.
December 2004, Ai-Ping Yang Yuhua to prepare fake traffic accident death insurance
fraud schemes tell Shuji Heng. December 12, 2004, Ai-Ping Yang arrangements Shuji
Heng driving their own cars to take Yuhua Zhang Xuancheng Pengshan, who received
his brother-home dinner. Shuji Heng accordance with the plot in advance, to turn
green within Xie road leads to economic weir, resulting in Yuhua drowning. After the
incident, Ai-Ping Yang actually claim to the insurance company, because after the
crime brought to light, unsuccessful claims.
   ?Expert Comment:
   ?China's "Insurance Law" Article 65 provides that:
"the insured, the beneficiary the insured intentionally caused the death,
injury or disability, the insurer does not assume responsibility for payment of
premiums. Favor the insured intentionally caused the death or disability attempted ,
will lose beneficial interest. "So the insurance company the right of the
above exclusions.

				
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