Why do ordinary people find it difficult to settle commercial insurance claims?

For example, if you have a refrigerator and a TV but don't have a rice cooker, if you are hungry and want to cook, neither of these appliances can help you cook. In the same way, the insurance you buy is education**, but if you take it to reimburse for illness, it will definitely not work.

There are many professional terms, the first person does not clearly inform the terms of the contract, the customer does not accurately know and understand the content of the contract, the interest uncertainty of the participating product, the subjective opinion of the customer... are all reasons why it is difficult to settle a claim, just like buying a TV as a refrigerator, there must be no reason to settle a claim.

Personally, I think that the main reason is that I don't understand that there are many ways and means of insurance claims, and different reporting statements and proof content must definitely get different results.

When buying insurance, you can't buy it blindly, because the type of insurance you buy is different, so it is difficult to settle a claim.

Because of insexuality, it is difficult to settle insurance claims due to this illusion.

If you study the terms of the insurance thoroughly, you will know what can and cannot be compensated.

It is still necessary to have a more professional insurance ** person around you, because it is professional, so rest assured.

It's not difficult, because I'm the -,- in the claims industry

First of all, you must be clear about what kind of insurance you are buying.

You can rest assured that you can make a claim as long as you have all the documents required for your claim under the conditions indicated in the insurance contract. It's just that when you buy insurance, you need to pay attention to the protection responsibility of the insurance, and under what circumstances it is to pay what part. For example, in critical illness insurance, there is a minor and critical illness benefit in critical illness insurance, and the compensation is paid in addition to the additional benefit under insurance, or the compensation is reduced from the share of the original sum insured.

In general, it is not difficult to settle a claim. Because the insurance company has a legal effect, as long as the conditions for compensation are met, the insurance company has no reason to refuse to pay. As long as you buy the right type of insurance, it's OK.

If you buy a critical illness, it is recommended to buy a wide range of critical illnesses, so that the scope of critical illnesses is relatively wide, and it is not easy to fall into the void. In the event of a critical illness risk, critical illness insurance only pays the critical illness sum insured and does not reimburse the cost of hospitalization**, so it is necessary to separate and improve the coverage of hospitalization. Hopefully my explanation will give you some help.

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

Commercial insurance can generally run claims in the following ways:

1.After the insured has an insured accident, it is also necessary to notify the insurance company in time and report the case;

2.Prepare claim materials according to the requirements of the insurance company, such as medical expense reimbursement, which generally requires the preparation of the insured's ID card, bank card, outpatient medical record, outpatient invoice, disease diagnosis, total invoice for hospitalization expenses, general list of hospitalization expenses, medical insurance statement, and discharge record; In the case of an accident, it is usually necessary to prepare an accident certificate; If it is a critical illness claim, it is generally necessary to prepare a pathological diagnosis certificate or a hospital diagnosis report. If it is a death claim, it is generally necessary to prepare three death certificates, that is, the cremation certificate, the certificate of household registration cancellation by the public security organ and the medical death certificate issued by the hospital, but many insurance companies simplify the claim procedure and may only need two of them;

3.After the insured is discharged from the hospital, the reimbursement information can be submitted to the insurance company to apply for a claim; If it is a death or disability claim, then it is sufficient to prepare the documents and submit them to the insurance company to apply for a claim;

4.If the insurance company approves the information, the claim will be paid into the bank account designated by the beneficiary of the insured's death.

Consumers have taken out insurance products, once out of insurance, as long as the conditions for claims are met, then, the insurance company needs to bear the responsibility for claims. In reality, there are many cases where insurance claims are difficult, and there are generally the following reasons:

1. When applying for insurance, the salesman misled, and the insurance policy does not protect the content of the insurance;

2. The insurance product itself has insufficient protection clauses;

3. The insured is sick or the insured fails to fulfill the obligation to tell the truth;

4. The policyholder has insufficient understanding or wrong understanding of the insurance terms.

Commercial insurance generally includes life insurance and property insurance, and life insurance is divided into traditional life insurance and new life insurance. Traditional life insurance includes critical illness insurance, medical insurance, life insurance, accident insurance, annuity insurance, etc.; The new type of life insurance includes participating insurance, universal insurance and investment-linked insurance. Want to know what are the differences between different types of insurance claims?

The claims process of commercial insurance can generally be divided into the following parts:

1. After the insured has an insured accident, he or she needs to notify the insurance company in time to cancel the accident and report the case;

2. Prepare the materials required to apply for a claim, according to the different insured accidents, the prepared claim information is also different, such as critical illness insurance, you need to prepare the hospital's diagnosis certificate, relevant department appraisal certificate, etc.

3. Submit the claim materials to the insurance company for a claim, and the insurance company will verify the claim information after obtaining the claim information, and the claim can be made if the audit is passed, and the insurance company needs to inform the reason for the failure to pass the review.

Generally speaking, the insurance company will make a review result within 5 days, and the complicated one will not exceed 30 days, and the insurance company will pay the insurance benefits within 10 days after reaching a claim agreement. In addition, during this period, it is also very likely to encounter claims disputes that are worried about small partners. In fact, in addition to the reasons of the insurance company, a large part of the reason for the occurrence of claim disputes is due to consumers, such as incomplete preparation of claim materials, insurance during the waiting period, touching the exemption clause, not meeting the insurance provisions of the claim liability, or not truthful health notice.

Therefore, when we make a claim, we must carefully check whether the claim information is missing, look at the dry bucket file to see if the exemption clause has been touched, etc., and we must tell the truth before buying insurance, otherwise it will affect our claim. If you want to know how to make a claim quickly and well, you can click on the following article to take a look:【Insurance Claim】What are the correct postures that are fast and good?

If you don't lose, you will be on the plate!

Hope!