What should I do if I am sick during the insurance waiting period?

Updated on healthy 2024-07-18
13 answers
  1. Anonymous users2024-02-12

    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!

  2. Anonymous users2024-02-11

    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!

  3. Anonymous users2024-02-10

    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!

  4. Anonymous users2024-02-09

    If an abnormality or disease is detected during the waiting period, there is no need to make supplementary notice, because if the health notification has been carried out at the moment of insurance, the insurance is underwritten in the physical condition at that time.

    The waiting period is generally calculated from the effective date of the contract or the date of reinstatement, and is only applicable to the first year of insurance, and for renewable policies, there is generally no waiting period for the renewal year.

    Set up a waiting period for insurance.

    The purpose is to prevent the policyholder from taking out insurance immediately knowing that an insured event is about to occur. In general, critical illness insurance.

    The waiting period is 90-180 days for medical insurance and 30 days for medical insurance. For example, the observation period is from November 15, 2019 to January 15, 2020, during which the insurance company is not responsible for compensation if the insured has an insured event. Starting from January 16, 2020, if the insured has an insured accident, then he can apply to the insurance company for compensation normally, and the insurance company will pay compensation in accordance with the contract.

    If the insurance is out during the waiting period, the insurance company generally refunds the premium paid and refuses to pay.

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

  5. Anonymous users2024-02-08

    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.

  6. Anonymous users2024-02-07

    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.

  7. Anonymous users2024-02-06

    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.

  8. Anonymous users2024-02-05

    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.

  9. Anonymous users2024-02-04

    No claims will be made. However, it is best for the insured to have the onset of illness and the time of diagnosis after the waiting period, because some insurance clauses are based on the onset of illness as the basis for claim review.

  10. Anonymous users2024-02-03

    The insurance company's coverage for illness is set up for the duration of your insurance.

    If the insurance has just expired for one day, then it is also the date of the expiration of the insurance, so the insurance company can also refuse to claim after the illness, because you have not renewed the policy or have not renewed it within the validity period or the policy has expired, then it is reasonable to refuse the claim if it is not within the scope of their policy!

  11. Anonymous users2024-02-02

    Yes, as long as the hospital issues a certificate that you found out about your critical illness after the waiting period, you can make a claim.

  12. Anonymous users2024-02-01

    If symptoms occur during the waiting period and the diagnosis is delayed after the waiting period, can the insurance pay for it?

    Hello dear, I'm glad to answer for you. If you are diagnosed with a contracted illness such as lung cancer, severe Crohn's disease, etc. Once diagnosed, no matter whether you know it in advance or not, you can't pay for it.

    Symptoms such as nodules, polyps, persistent fever, etc., have not yet reached the level of a diagnosed disease. If these symptoms are not related to the disease that was later diagnosed, Hyogi can compensate; If there is a connection, it will be more troublesome to make a claim.

    Symptoms appear during the waiting period, and the disease is later diagnosed with it. Depending on the type of insurance, the outcome of the claim will be different.

  13. Anonymous users2024-01-31

    Summary. Hello, I will not refuse to pay compensation, the insurance company should bear the insurance liability agreed in the contract to pay if the illness is found to be one day after the waiting period.

    Hello, I will not refuse to pay compensation, the insurance company should bear the insurance liability agreed in the contract to pay if the illness is found to be one day after the waiting period.

    Because after the waiting period, the insurance company needs to bear the insurance liability according to the contract.

    If I am hospitalized with anemia, will the insurance pay for it?

    Is it within the scope of medical treatment?

    It is necessary to inform the health questionnaire truthfully at the time of insurance application.

    It is necessary to inform the health questionnaire truthfully at the time of insurance application.

    Anemia is a disease.

    But anemia does not occur overnight. If the body of the brother of the insured clan has been marked with a record of anemia. If you do not truthfully inform the insurance company at the time of application, you will not be liable for compensation.

    However, if the insured has not had a medical examination before the anemia, and has not had any blood routine examination records in the hospital.

    After the observation period, the insurance company shall be liable for medical insurance compensation due to anemia.

    Further tests are also recommended to see what the cause of the anemia is. Diseases that cause anemia include aplastic anemia, pure red cell aplastic anemia, or Whitehall disease, lymphoma, multiple myeloma, etc.

    If a critical illness is diagnosed, then purchasing critical illness insurance will pay the insurance benefits.

    Different insurance products have different claim conditions and claim amounts.

    Commercial insurance is divided into life insurance and property insurance. Life insurance is divided into medical insurance, accident insurance, critical illness insurance, annuity insurance and whole life insurance. According to the terms of the specific commercial insurance contract purchased, Wang Ziyu will be compensated by the insurance company that meets the insurance liability.

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