There are two main ways to know the past medical history of the insured: one is to inquire the medical records through social security or the new rural cooperative medical system, and the other is to record the claims of commercial insurance in the Mainland. The former is the main channel of investigation at present.
The investigation process of insurance is probably like this:
1. After the accident, the customer needs to provide the policy number, identity certificate, confirmed disease certificate, drug list, treatment record, etc. When applying for a claim.
2. After receiving the customer's claims, the insurance company takes the customer's work and residence as the center.
Go to several big hospitals nearby, as well as local big hospitals, and get outpatient and inpatient records. If no suspicious records are found, the amount of compensation is not large, and it is usually lost soon.
3. If claims are made within 5 years after the insurance is completed, and the amount of claims is particularly large, then the waiting period has just passed.
Insurance companies will further expand the scope of claims investigation. Including the customer's physical examination records, medical insurance card consumption records, but also local hospital treatment records.
4. For customers whose household registration is not in the insured place, the insurance company will entrust a professional insurance investigation agency to run.
Go to your household registration and investigate the medical records of customers in major local hospitals.
Extended data
An insurance company refers to a company as a legal person established in accordance with the Insurance Law and the Company Law. Insurance companies collect premiums, invest the premium capital in bonds, stocks, loans and other assets, and use the income of these assets to pay the insurance compensation determined in the policy. Through the above business, insurance companies can get high return on investment, provide customers with appropriate insurance services at lower premiums, and make profits.
References:
Baidu encyclopedia-insurance company