Is death from heat stroke considered an accident Personal accident insurance

Under normal circumstances, there will be no compensation, and death from heat stroke is not an accident in accident insurance. Details are in this article《What is included in accident insurance? These common accident insurance companies do not pay

In order to apply for accident insurance and get a claim, you must meet the following four conditions:

1.External: Generally refers to the signs of damage left inside and outside the human body due to external factors.

For example, physical injuries such as collisions, falls, electric shocks, suppression, drowning, common cat scratches and dog bites, and chemical injuries caused by gas leaks, food poisoning, acids, alkalis, gas poisons, etc.

2.Sudden: Generally refers to the injury caused by a sudden invasion of the human body.

For example, injuries and deaths caused by traffic accidents, building collapses, etc., are sudden and instantaneous.

3.Unintentional: Generally refers to unforeseeable harm that is undesirable to the person.

Injury caused by force majeure accidents that are not foreseeable by the parties and not of their own will.

If the result of the injury is an accident, but the cause is not an accident, it cannot be defined as an accidental injury: for example, if the bodily injury caused by driving at a speed exceeding the speed limit on the highway, for this kind of injury that is completely predictable and completely preventable, it is not an accidental injury.

4.Non-Disease: Generally means that the injury was not caused by the insured's physical illness.

For example, pathological fractures caused by osteoporosis or sudden death due to chronic cardiovascular diseases are injuries caused by diseases and are not covered by the claim.

Accidents in everyday concepts such as heat stroke and sudden death are different from accidents in insurance, and they are generally not compensated.

Some accident insurance plans specifically list liabilities such as sudden death, which can be claimed.

Will Heat Stroke Death Accident Insurance pay? What is the best insurance to buy in the summer?

Whether heat stroke is covered by accident insurance depends on the exclusion clause of the insurance contract, and whether heat stroke is included in the scope of liability exemption.

The scope of accident insurance includes the following:

1. When the insured dies due to accidental injury, the insurer pays the death insurance benefit;

2. When the insured is disabled due to accidental injury, the insurer shall pay disability insurance benefits;

3. When the insured suffers medical expenses due to accidental injury, the insurer shall pay the payment;

4. When the insured temporarily loses his or her ability to work due to accidental injury and is unable to work, the insurer shall pay the insurance money to the insurer who has stopped work.

The accident insurance payout process is as follows:

1. After the occurrence of an insured accident, the insured reports to the insurance company, which can be carried out by means of ** report, online report, and network report;

2. Submit the claim materials required by the insurance company, such as insurance contract, identity certificate, diagnosis certificate, etc.;

3. After receiving the complete claim materials, the insurance company will review them and conduct a claim investigation to confirm whether the insured meets the claim conditions;

4. After the review is passed, the insurance company will transfer the insurance money agreed in the contract to the designated account.

It doesn't belong. Reason:

1. Regarding the verdict of this case, the judge who undertook the case said that in this case, high temperature is only one of the causes of the disease, and the direct cause is the patient's own physical function, so heat stroke is not external, but caused by internal factors. As we all know, not all people will have heat stroke or death from heat stroke in high temperatures, heat stroke is a disease, related to the physical function and physical fitness of each patient, high temperature will cause different degrees of changes in each person's own central dysfunction, sweat gland function and other physical functions, resulting in different degrees of onset. 2. Heat stroke is avoidable and predictable to a certain extent, and it is not sudden.

It is an objective common knowledge that high room temperature, high temperature work, hot exposure and other environmental high temperatures can cause heat stroke, and avoiding high temperatures can avoid heat stroke to a certain extent.

3. In recent years, it is not uncommon to apply for "personal accident insurance" and be denied compensation. A very important reason is that some consumers have some misunderstandings about the "accident" in "accident", thinking that "personal accident insurance" includes all accidents, which expands the scope of "accident".

4. How to determine whether an accident is an accident or not? In addition to having external, sudden, unintentional, and non-disease factors, it is also necessary to see whether it is violent, such as a sudden fall of a brick from the upper floor, crushing a pedestrian to death; In addition, it also depends on whether the risk of the accident is controllable, such as drunk driving, it cannot be an accident. In the present case, there was a time course for death due to heat stroke, and it was not drastic, it was foreseeable, such as people could go out less in hot weather, or move in shady places.

Therefore, heat stroke is not an accidental injury.

Extended reading: [Insurance] How to buy, which one is better, teach you to avoid these insurance"pits"

Legal analysis: Accidental injury is an objective event in which the body suffers injury, although the cause of heat stroke is excessive accumulation of heat in the body, the process of the accident is unforeseeable, and the consequences caused by heat accumulation are also in line with the characteristics of external, sudden, non-high-level original intention and non-disease, not caused by people's own diseases. If the insurance company does not exclude "death from heat stroke" from accidental injury in the insurance contract, it does not clearly state the specific circumstances under which the accidental injury is exempted.

In this case, it should be determined that the death from heat stroke was an accidental death, and the insurance company should be liable for compensation.

Legal basis: Article 12 of the Insurance Law stipulates that the policyholder of life insurance shall have an insurable interest in the insured at the time of the conclusion of the insurance contract.

The insured of property insurance shall have an insurable interest in the subject matter of insurance at the time of the occurrence of an insured event.

Deaths from heat stroke are generally accidental. Accidental injury refers to an injury in which the process of an accident is unforeseeable, and the consequences of the injury are also in line with the characteristics of external, sudden, unintentional and non-disease. For this type of accidental injury, if it is not related to the cause of work or the performance of duties, it is generally not a work-related injury.

[Legal basis].Article 14 of the Regulations on Work-related Injury Insurance.

In any of the following circumstances, it shall be found to be a work-related injury:

1) Being injured in an accident during working hours and in the workplace due to work-related reasons;

2) Being injured in an accident while engaging in work-related preparatory or finishing work in the workplace before or after working hours;

3) Injured by violence or other accidents during working hours and in the workplace due to the performance of work duties;

4) Suffering from occupational diseases;

5) Injured or unaccounted for in an accident while away for work;

6) Injured in a traffic accident or an accident involving urban rail transit, passenger ferry, or train for which they are not primarily responsible;

7) Other circumstances that laws and administrative regulations provide shall be recognized as work-related injuries.

The hot summer is often the season of high incidence of heat stroke and other diseases, about heat stroke, everyone often thinks that heat stroke is an "accidental" event, this is because it has a certain degree of chance, but medical enlightenment and grinding science believes that "heat stroke" is a disease, mainly because the body is in a higher temperature for a long time, resulting in changes in function. Therefore, to protect against the risk of heat stroke, you need to start by purchasing insurance.

Will Heat Stroke Death Accident Insurance pay? What is the best insurance to buy in the summer?

Accident insurance does not cover sudden death from heat stroke, so it is best for individuals to choose life insurance and health insurance if they want to get heat stroke death coverage. In contrast, life insurance is much broader than accident insurance, and under normal circumstances, natural death, or death and first-degree disability caused by illness or accident are covered by the scope of compensation. Therefore, death due to heat stroke can be covered by life insurance.

Generally speaking, if people with mild heat stroke can take timely measures, they can quickly recover their health. However, if the patient is not detected in time and becomes a severe heat stroke, it may cause complications such as cerebral edema, heart failure, and respiratory failure. Despite this, heat stroke still occurs from time to time in hot weather workers, and in case a worker is recognized as a work-related injury due to heat stroke caused by hot work, he or she can enjoy work-related injury insurance benefits.

Therefore, to protect against the risk of heat stroke, you can buy life insurance and health insurance.

To resist the hazards of heat stroke, you can strengthen your protection by purchasing life insurance and health insurance in advance, and it is an e-commerce platform that provides professional life insurance and health insurance. The following products are recommended for you:

PICC Life carefully selects term life insurance.

Century Taikang personal hospitalization medical insurance.

Extended reading: [Insurance] How to buy, which one is better, teach you to avoid these insurance"pits"

It is generally believed that heat stroke is a medical disease, mainly due to the long-term high temperature of the body, which leads to functional changes.

At the same time, heat stroke does not exceed the expectations of ordinary people, so it does not meet the definition of "accident" in the three conditions of "non-diseased, foreign, and sudden", so it does not belong to accident insurance liability.

However, if the insured falls down, becomes disabled or even dies due to heat stroke, it is an accident and can be compensated by accident insurance. At the same time, some experts said that because some patients suffer from cardiovascular and cerebrovascular diseases and other diseases, they feel unwell in a hot environment, suffer from heat stroke, aggravate their condition and even be hospitalized.

This situation falls within the scope of health insurance compensation, because the premise of health insurance compensation is whether the patient is hospitalized due to illness or other problems, so the above situation is actually only a part of the scope of health insurance compensation.

The above compensable situations are mainly for health insurance coverage. Patients generally cannot equate heat stroke hospitalization with heat stroke alone. In addition, for accidents caused by heat stroke, such as being hit by a car due to heat stroke, many insurance companies say that before making a decision, they should check whether they need to pay compensation based on the actual situation.

In addition, some insurance companies have also stated that life insurance should be paid in case of death due to heat stroke; If you die due to heat stroke at work, you should also be compensated for work-related injury insurance.

Heat stroke is not an accident, the hospital determines that heat stroke is a disease, which is caused by a problem with a certain function of the body, and accidental injury refers to the three conditions of non-disease, external and sudden, so heat stroke is not an accident insurance liability. Heat stroke is also exempted from liability by accident insurance, and accident insurance will not pay for death due to heat stroke.

Extended reading: [Insurance] How to buy, which one is better, teach you to avoid these insurance"pits"