Then, I'll take "a man accidentally drowned while driving, and the insurance amount10.97 million was refused compensation" as an example to talk to you about why insurance was refused compensation and what problems should be paid attention to when making claims to prevent claims from being refused compensation!
0 1, real case
This is a car accident in Jingmen. The client Zhou is a businessman with a higher risk awareness than the average person. From 1999, he bought more than 20 insurances from 1 1 insurance company, with a total insured amount of10.97 million yuan.
I thought these insurances would never be needed, but what he didn't expect was that accidents always come so suddenly. On June 1 day this year, Zhou accidentally fell into the pond and drowned. However, when the Zhou family claimed compensation from the insurance company, the insurance company refused to pay compensation on the grounds of "malicious fraud".
For the statement given by the insurance company, the Zhou family resolutely disagreed and filed a lawsuit with the court.
02, case analysis
People are dead, why do insurance companies refuse to pay compensation on the grounds of "fraudulent insurance"? It turned out that the insurance company thought that although Zhou started to take out insurance from 1999, he had taken out more than 20 insurances in 1 1 company before his death, which was a great suspicion of insurance fraud. In addition, when investigating the salvage site, the relevant claimant also found that Zhou did not unfasten his seat belt or open the window. According to these clues, the insurance company finally determined that the insured Zhou was very likely to have a "suicide" tendency. Is that really the case?
In fact, this is not the case. After investigation by many departments at the scene, there was finally evidence that Zhou's death was indeed an accident, and the court finally helped Zhou's family get back the compensation smoothly.
From this case of auto insurance refusal, it can be concluded that in fact, it is not enough to buy an insurance to really play a role, and it is also important to master the skills of claim settlement.
03. How can accident insurance be paid successfully? Remember these two points.
(1) Remember the terms of the contract before making a claim.
Many people always think that if they buy insurance, they can get compensation as long as they pay on time and have a physical examination on time. In fact, any insurance product has its own specific claims clause and exemption clause. The contract clearly States what can and can't be compensated, just like critical illness insurance doesn't pay for cancer in situ, accident insurance doesn't pay for sudden death and so on. So don't think that you can definitely pay for it if you buy insurance.
(2) Report the accident as soon as possible.
Remember to report the accident as soon as possible, which is often overlooked by many people. Some people even think of reporting to the insurance company more than ten days after the accident, but they don't know that doing so has a great influence on the settlement of claims in the later period of insurance.
Generally speaking, the best time to report accident insurance is within 2 days, that is, within 48 hours. Beyond this time, it will be difficult for insurance companies to collect on-site evidence and make claims in time.