Will the insurance plan affect the claim if you see a doctor during the waiting period?

Whether the insurance is compensable for illness during the waiting period depends on whether it is caused by an accident.

Generally speaking, as long as the risk to the insured is caused by an accident and the conditions for payment of the insurance product are met, the waiting period can also be paid, otherwise the claim will not be paid.

For example, critical illness insurance.

If you suffer from a contracted illness during the waiting period, the insurance company will not pay the claim.

However, if you get sick due to an accident and meet the conditions for critical illness insurance, such as limb loss or craniotomy.

etc., then even during the waiting period, it can be paid.

Swiped the medical insurance card according to the relevant regulations.

If there is an accident caused by a third party, the medical insurance card cannot be swiped and cannot be used at the same time.

If the type of medical insurance card is different, then its reimbursement scope is also different, so you can't report to a third party for compensation after swiping your medical insurance card.

The waiting period of insurance is also called the observation period, generally there is no abnormal physical examination report during the observation period will not affect the claim, but if you see a doctor during the waiting period, the physical examination report, the condition needs to be claimed, and it affects some subsequent claims, then it will not be compensated.

The waiting period in insurance translates to the waiting period stipulated by the insurance company. Once the insured is out of danger, the insurance company is not responsible.

Looking at the current major illness insurance in the market, the waiting period is mostly divided into two forms, one is 90 days and the other is 180 days. Theoretically, the shorter the waiting time, the better it is for the consumer.

However, if a critical illness or chronic illness occurs within a short period of time, the insurance company has reason to suspect that the claim is "insured by illness", and the claim settlement time may be longer. Claims processing may not be as fast.

Critical illness insurance clearly stipulates that during the waiting period, except for serious illnesses caused by accidents, it is a surrender premium; Serious illnesses not caused by accidents will not be compensated.

Theoretically, minor outpatient illnesses are not affected. However, if it is a chronic disease (high blood pressure, tuberculosis, diabetes, etc.), it will have an impact and be more troublesome.

If you don't understand the terms of the insurance, you can try to ask for help from a professional insurance claims team like Legal Insurance, they have a professional insurance claims team and lawyers, which is more efficient and trouble-free.

In fact, insurance products are not immediately claimed, it has a waiting period. It is generally not recommended to go for a physical examination during the waiting period, if the physical examination shows that the health is fine, once the problem is detected, it will have an impact on the policy. The insurance company is not responsible if an insured event occurs during the waiting period.

However, if you are diagnosed with a disease during the waiting period, it needs to be analyzed on a case-by-case basis.

1. Ordinary anomalies.

If the insured person is diagnosed with an ordinary health abnormality during the waiting period, although there is an illness, it is not a critical illness.

Within the scope of moderate and mild symptoms, it will not affect your protection rights and interests under normal circumstances. Consumers can choose to inform the insurance company or choose not to inform, and there is no impact anyway.

Second, the examination found mild symptoms.

If a mild illness is diagnosed during the waiting period, then the insurance company will definitely not pay, and it will also have a certain impact on the protection rights, but different products are handled differently, and there are generally two situations:

1. If the mild illness is invalid, the contract is valid.

During the waiting period, if a mild illness is diagnosed, the insurance company will not pay the compensation, and the mild illness benefit will be terminated, but the protection for critical illness, moderate illness, death and other benefits will still be effective, and the insurance company will still pay for these insured events after the waiting period.

2. Diagnosed with mild illness and the contract is invalid.

If a mild illness is diagnosed during the waiting period, not only will the insurance company not pay compensation, but the insurance contract will be terminated.

3. Diagnosed with a critical illness.

If a critical illness is detected during the medical examination, the insurance company will not pay the policy, and will usually terminate the policy directly and refund the premium to the consumer.

Test your anti-risk index, experts will interpret it for you for free!

If the disease is detected during the waiting period, it depends on the severity of the disease. If it is a disease that is enough to affect the insurance company's underwriting conclusion, the insurance company may not make a claim in the later stage, and it is generally necessary to provide supplementary notice, which may be subject to exclusion and underwriting. If the diagnosed disease falls within the scope of the disease specified by the insurance company, the insurance company generally does not pay for it, and the cost of ** needs to be borne by yourself.

If the insurance is out during the waiting period, will the insurance company not pay for it? Take a look at this article before you take out the insurance:

During the waiting period, the insurance company will not pay? If you don't understand, you'll suffer a big loss!

There are generally two waiting periods for critical illness insurance: 90 days and 180 days, and the 90-day waiting period is an excellent level. During the waiting period, if the insured is insured due to a non-accidental accident, the insurance company will not be liable for compensation. If you want to get the full coverage of critical illness insurance sooner, you may want to choose a product with a shorter waiting period.

It's not okay to not know enough about insurance knowledge before buying insurance, so you must take a look at these key knowledge points before applying for insurance:

Before buying insurance, you must first understand these key knowledge points!

However, it is more important to pay attention to the coverage and compensation strength of the product than the waiting period. For example, a good critical illness insurance will generally have the characteristics of additional compensation for critical illness, malignant tumor - severe multiple compensation, etc. Critical illness insurance with rich coverage, comprehensive coverage, and strong compensation can often bring more adequate protection to the insured.

So what does the well-protected critical illness insurance look like? If you want to know, don't miss this list:

Top 10 Popular Critical Illness Insurance Points Worth Buying!

If you are diagnosed with a disease during the insurance waiting period, you may need to look at the specific situation of the disease and the specific regulations of the insurance company and insurance product. If the waiting period is confirmed, the insurance company may refund the premium paid, and may supplement the health notice to cover the exclusions.

This article explains in more detail the situation of illness during the waiting period, if you want to know more about it, don't miss it: The insurance company will not pay for the insurance during the waiting period? If you don't understand, you'll suffer a big loss!

Usually, we can use the things we buy immediately, but the insurance is a little different, and many products will set a "waiting period".

In simple terms,If the insurance is out during the waiting period, the insurance company will not pay the claim

The reason why it is necessary to set a waiting period is mainly to prevent malicious insurance fraud and insurance with illness.

How long is the waiting period? There are slight differences between different types of insurance:

Critical illness insurance, life insurance: generally 90 - 180 days.

Medical insurance: Basically 30 days.

Accident Insurance: There is no waiting period and the policy is covered when the policy is in effect.

In addition to that, likeMillion Medical InsuranceThis one-year product usually has no waiting period if it is successfully renewed in the second year.

What we sayThe waiting period is relative to the disease。But accidents can't be done beforehandIf an accident occurs during the waiting period, the claim can be made normally

For example, if A takes out a critical illness insurance policy of 500,000 yuan, the waiting period is 90 days. A traffic accident on day 10 that results in both legs being amputated qualifies as critical illness insurance"Multiple limbs are missing"Claim conditions.

Therefore, whether it is accident insurance, critical illness insurance, medical insurance, or term life insurance, you can get a claim if you are insured due to an accident during the waiting period.

If we are really unfortunate and we go out of business during the waiting period, will our policy be invalidated? Let's take a look at the different types of insurance:

1. Does the policy have an impact on the critical illness insurance?

In the event of a critical illness during the waiting period, almost all products terminate the contract and refund the premium. However, if it is mild or moderate, there are generally three ways to deal with it:

End of the entire contract: Most products will terminate the contract and refund the premium. For example, Kanghuibao Ultimate Edition, Good Medical Insurance Lifelong Critical Illness, etc.

End of rider: Taking Hui Xin'an and Ruiying as examples, mild illnesses are insured with additional insurance. If a minor illness occurs during the waiting period, only the rider will lapse, and the critical illness of the main policy will continue to be covered.

The contract continues: This situation is the best, only the diseases found during the waiting period are not covered, and dozens of other diseases continue to be effective, such as Fosun Beidofeng No. 1, Taikanghui Health, etc.

I don't think that's the core factor in choosing a critical illness insurance, but it's good that we know what to expect.

2. What should I do with the insurance policy if other types of insurance are insured?

Compared with critical illness, the treatment of other types of insurance is simpler and more straightforward.

Medical insurance: Illness during the waiting period cannot be claimed, but the policy is still valid. If other illnesses occur after the waiting period, then you can make a claim.

Term life insurance: If you die of illness during the waiting period, the contract will end because the person is no longer there and can no longer be covered.

Accident insurance: There is no waiting period, and you can get the claim after the contract takes effect.

In general, the waiting period is a small probability event, but understanding it clearly in advance can also avoid claims disputes in the future, so it is good for everyone to pay proper attention.

Insurance companies have set up a waiting period of 3 to 6 months in critical illness products. That is, during the period after the policy is in force, the insurance company is not responsible for the critical illness of the insured, and generally only refunds the premium. The establishment of the waiting period significantly reduces the number of customers who are sick to apply for insurance, so we can define the essence of the waiting period as a mechanism for insurance companies to protect themselves.

If an insured event occurs during the waiting period of critical illness insurance, there are generally the following four ways to deal with it:1Refund of premiums paid, termination of contract; 2.

Return of the cash value of the policy, termination of the contract; 3.Decide whether to terminate the contract according to the way of risk; 4.If there is an accident during the waiting period, there is no liability, and the contract continues to be valid.

On the premise that the coverage content and insurance rate are roughly the same, priority should be given to products with short waiting periods.

The waiting period is when the beneficiary is not covered even if the insured person has an accident during the specified period of time when the contract is in force. Therefore, sickness during the waiting period will not be covered.

1. What is the waiting period for the four major insurances

The waiting period is generally calculated from the date of the first payment or the date of repayment after the interruption of payment, and this algorithm is only applicable to the first year of the policy, and for the insurance that can be renewed, the renewal year is generally free of the waiting period.

In this case, how long is the waiting period for the four major types of insurance?

1) Critical Illness Insurance

In general, the waiting period for critical illness insurance is 90-180 days, and the waiting period for a very small number of critical illness insurance is one year.

For example, the waiting period for Hengqin Worry-Free Life 2020Plus is 90 days, while the waiting period for Fosun United Health Beijixing is 180 days.

What kind of guarantee does it have, and what kind of guarantee does it "dare" require a waiting period of 180 days? If you know the detailed coverage of Beijixing, you will know:Evaluation and analysis of the advantages and disadvantages of Fosun Beijixing, who is more suitable?

2) Medical insurance

The waiting period for medical insurance is generally 30-90 days.

Among them, the waiting period for millions of medical insurance with strict health notices is basically 30 days, while the waiting period for cancer prevention medical insurance with more relaxed health notices is relatively long.

3) Life insurance

The waiting period for life insurance is basically 60-180 days, with a maximum of one year.

4) Accident Insurance

Since the waiting period is for sickness liability, not accident liability, there is no waiting period for accident insurance.

However, the effective date of the accident insurance contract is generally effective at 0:00 the next day, and even some accident insurance takes effect after a few working days.

Therefore, when purchasing accident insurance, it is necessary to pay attention to the effective time of the accident insurance liability.

In general, the waiting period for the more popular insurance companies on the market will not be very long.

Rather than the waiting period, we should pay more attention to the protection content of the product, after all, we buy insurance to avoid risks.

The issue of waiting period insurance is a very complex one, and different situations and different terms can lead to very different conclusions.

The purpose of the waiting period is to prevent the policyholder from taking out insurance to obtain the insurance money knowing that an insured event is about to occur.

The waiting period is basically 30 days, and some companies set 45 days and 60 days. If you don't feel well these days, it's basically not possible to go after buying insurance, because there is a 30-day waiting period. For medical insurance, if the waiting period is exempt, that is, the insurance company will not pay, but the contract is still valid;

For colds, fevers and diarrhea during the waiting period, or for the detection of a single illness, it is reasonable to exempt from liability during the waiting period.

After a single **, it is possible to apply for a claim for re-illness after the waiting period. After all, it is in accordance with the health notice when applying for insurance.

You can't just buy an insurance policy that prevents people from getting sick.

I hope that the children will grow up as soon as possible, healthy and happy.

No, the insurance company is in accordance with the contract for insurance claims, if the insurance company has no reason to refuse to pay or unreasonable, in this case you can complain to the CBIRC, you can refer to my previous "correct operation process in the event of a claim dispute" The following will tell you the main reasons why the insurance company will refuse to claim" 1. I did not truthfully inform if Hui had the diseases mentioned in the health notice, such as hepatitis B, thyroid nodules, etc., but concealed it in order to be able to insure. Once you apply for a claim in the future, and the insurance company finds the physical examination record or medical record when the claim is verified, the claim will also be denied. 2. If the claim threshold is not reached, there is a threshold for insurance claims, and if the claim standard is not met, then the claim will also be denied.

For example, our common million-dollar medical insurance generally sets a deductible threshold of 10,000 yuan. If the diagnosis and treatment cost is less than 10,000 yuan, then it will naturally not be reimbursed. There will be a clear definition in the same.

If the illness does not meet the requirements of the claim, it will not be compensated. Take our common stroke as an example, many people think that as long as they are diagnosed, they can apply for critical illness insurance claims, but in fact, if you want to make a claim for stroke, you must survive 180 days and clearly meet the standard of complete loss of function before the insurance company will pay out. 3. There are generally two situations in which this situation is not within the guarantee period:

1) During the waiting period, the insurance company will not be responsible for the accident during this period, so it will not settle the claim normally. 2) Insurance expiration, this situation generally appears in the need to re-insure the short-term insurance, such as one-year medical insurance, we pay one year for one year, if you forget to re-insure, when you want to make a claim, you find that the insurance has expired, and naturally will not be claimed. 4. What is covered by an insurance that meets the exclusion clause will be stipulated in the contract.

In the same way, what is not covered will also be clearly listed in the terms, which is what we call the disclaimer clause. If your actions fall under the exclusion clause, the insurance company will also not pay for the insured accident caused by it. There will be differences in the exclusion clauses of different types of insurance, depending on the contract or illegal acts such as drunk driving, drug abuse, and crime.