Why do many people dislike insurance?

I bought insurance, hoping to pay for it.

Finally, people who have not experienced the horror of being quilted all the way will not understand.

Often because of one sentence, you lose hundreds of thousands!

Childe was in the insurance company, heard of such a customer:

Mr. Fu is an ordinary taxi driver in Zhengzhou with a monthly salary of 5,000 yuan. His wife works in the assembly line of a local electronics factory, but she doesn't earn much a month. Her daughter has just entered junior high school.

Because it is a taxi, it is prone to all kinds of accidents, so I often buy accident insurance for myself.

At that time, he bought an accident insurance policy guaranteed by 50 yuan for one year, with the insured amount of 1 10,000.

According to his description, he thought it was a good deal:

But after reading it, the salesman told him that he still needed to buy medical insurance, critical illness insurance and life insurance.

Moreover, his accident insurance only pays for the total disability, not the disability.

He didn't listen.

Unfortunately,

Five months later, while running the night shift, Mr. Fu ran into the green belt and rushed to the opposite road, which eventually led to the amputation of his left leg.

At first, Mr. Fu thought that his accident insurance could cover all this.

However, the result surprised him. This accident insurance with a coverage of one million only reimbursed the medical expenses of 1.2 million. As for the disability caused by amputation, he has not lost a penny.

Mr. Fu was very angry. He called the agent who sold his insurance.

Someone pointed to the insurance policy and said, look clearly, it was an accidental death, and the total disability compensation 1 10,000. Your amputation is just a disability, you can't pay for it!

At that time, this incident caused great trouble to my company.

But as a consumer, Mr. Fu doesn't know these things, and his son is helpless.

Complete disability is complete disability, disability is disability,

Amputation is only level 7 disability, not total disability.

The real total disability in the insurance contract is:

If you want to get 6.5438+0 million, unless Mr. Fu cuts off his feet,

As a result, only the left foot is amputated now, which is considered as a seven-level disability. It is reasonable to compensate 40% of the insured amount, and 654.38+00,000 can compensate 400,000.

Because the accident insurance he bought only compensated for the total disability, not the disability, so he couldn't get the 400 thousand.

I feel sorry for him, too.

It is said that insurance companies like to play "word games", and Mr. Sun is one of the victims of this "word game".

Sometimes a simple sentence, total disability and disability, can lose hundreds of thousands less,

So in the eyes of many people, insurance companies are liars:

No way, ordinary people don't understand insurance at all, and the insurance clauses are extremely complicated.

Take Mr. Fu as an example,

Do you blame the insurance company?

This must be strange,

Blame the insurance company for not being patient enough to explain the terms a little,

But only insurance companies?

I'm afraid not,

What is clearly written in black and white on the insurance clause is not a lie, and even the salesperson has repeatedly reminded Mr. Fu.

But we consumers,

In fact, it is not clear about the real difference caused by these two words.

Childe has been in the business for more than ten years.

I have indeed seen many such insurance clauses, and some small details will affect the payment results.

Today, I will take stock of the insurance clauses of these "swindlers" for you.

I hope everyone can avoid stepping on such a pit in the future.

In order to avoid unnecessary attacks, all the sons here have hidden the product names.

Mr. Fu bought a lot of accident insurance in the market:

Explain what accident insurance covers first.

Accident insurance generally covers three responsibilities: accidental death, accidental disability and accidental medical treatment.

The so-called accidental death means that the insurance company will pay for it in one lump sum because of accidental death. Of course, many insurances also compensate for total disability, such as severe brain injury, mental retardation, inability to take care of themselves, or becoming a vegetative state, which is similar to death.

The so-called accidental disability is because of accidental disability, such as broken hands and feet. The insurance company will judge a disability level according to the disability assessment standard of life insurance, and then compensate a certain percentage of the insured amount according to the level, such as the 10-level disability 10% insured amount, and 50,000 yuan will be compensated for 500,000 yuan.

The so-called accidental medical treatment means that you are injured by accident. Insurance companies will also reimburse the expenses incurred by going to the hospital for treatment, such as surgery, medicine and hospitalization.

Let's take a look at these two insurances:

One product is "accidental total disability or death insurance",

Class B products are "accidental death insurance liability", "accidental disability insurance liability" and "accidental medical insurance premium".

On the other hand, product A has no disability and no medical treatment.

As mentioned above, the disability is divided into ten levels, and each level pays the insurance amount according to a certain proportion. The first payment 100%, the tenth payment 10%.

Mr. Fu's amputation of his left foot can only be regarded as a seven-level disability.

I broke a leg. Is it not serious?

How to compensate for the two products?

A product does not pay compensation, because it only pays for total disability and death.

Product B can be compensated according to seven levels of disability, and 1 10,000 can compensate 400,000.

80% of the medical expenses incurred in the process can also be reimbursed after deducting the deductible of product B 100 yuan. ..

Total disability and disability, a word difference, hundreds of thousands!

Actually, apart from the accident of broken leg and amputation,

We often encounter accidents such as cats scratching dogs, burns and scalds. Product A doesn't even cover these, so what kind of accident insurance is this?

It's a pity that products like A sell quickly in reality, so you must look carefully when buying accident insurance.

Or two kinds of accident insurance that are particularly popular in the market, the basic insurance liability problem is not big.

However, if you look at the exemption part of the insurance notice, it is also tricky.

A product says that high altitude accidents do not compensate, and high altitude is defined as more than two meters;

Product B said that the death or total disability caused by falling from high altitude only paid 6.5438+million yuan, while the altitude became 654.38+ 00 meters and above.

2m10m is just a number.

How different are they?

Let's assume that Lao Wang fell from two floors (6 meters).

Intermediate medical expenses, possible disability compensation,

Product b can compensate, but product a won't.

Two meters and ten meters, a word difference, may cause a gap of hundreds of thousands!

Many insurance products, not only the terms themselves,

Insurance information, health notification and other places will also set obstacles.

This is a dog blood operation to narrow the scope of compensation in the insurance notice.

People have to take precautions.

These are two kinds of life insurance, and the responsibility is simple.

You can lose money if you are dead or completely disabled.

1 10,000 is 1 10,000, and buying 2 million is 2 million.

But here, everyone should pay attention to that some clauses do not compensate for the total disability!

For example, the product A above only includes death and does not compensate for total disability.

So what does this mean?

For example, Lao Wang was unfortunate. He had a car accident, was permanently paraplegic, and completely lost his joint skills.

Clause b can compensate, but clause a won't.

Like product A, it can be called a mudslide in the market.

know

The reason why life insurance will compensate for the total disability is that the total disability has basically lost the ability to work in a serious degree.

Let's look at these descriptions: "blindness", "useless joints of limbs" and "unable to chew and swallow"

Very, very serious.

Therefore, as a life insurance, it is very reasonable, compassionate and humanized to add the total disability to the compensation.

Therefore, the vast majority of life insurance products on the market have died and are completely disabled.

What's even more funny is that product A without compensation for total disability is more expensive than product B. ..

The same is 654.38+00,000, male is 30 years old, and the payment is 20 years, and it is guaranteed to be 60 years old.

A product 3 130 yuan and b product 1460.

Expensive, poor sense of responsibility, IQ tax paid properly.

These are two kinds of critical illness insurance, which are said to guarantee "two compensations for cancer".

Cancer is a malignant tumor in the contract and is called the king of diseases. The domestic survival rate is only 30%-40%.

Treating cancer generally costs 340 thousand. If the most advanced proton heavy ion therapy is used, the cost can exceed 700 thousand to 800 thousand.

Many people have no money and have to give up treatment, which is one of the reasons for the low cancer survival rate in China.

Cancer is not only difficult to treat, expensive to treat, but also prone to recurrence and metastasis, so many critical illness insurances have the option of paying for cancer twice.

But the time required for their second cancer compensation is different:

Product A can get cancer compensation every three years after the first cancer.

Product b can get cancer compensation five years after the first cancer.

What is the difference between three years and five years?

There is a medical term called "five-year survival rate".

The doctor's interpretation of this word is: if the cancer patient is still alive within 5 years after receiving effective treatment, it means that the cancer of this patient has been effectively controlled, and even reached the level of "cancer basically cured".

To put it bluntly, if someone has cancer and doesn't die within 5 years after treatment, it basically proves that his cancer has been cured.

We all know that cancer is easy to recur and difficult to cure.

With the second compensation for cancer, you can treat the first cancer for several years.

You can still pay for further treatment, and you won't give up treatment because you have no money.

But if Lao Wang suffers from cancer for the first time and has been treated for three years, his money will be spent.

At the end of their tether, product A will lose another 600,000 yuan, and product B will not lose a penny.

So what's the use of this second compensation for cancer?

If old Wang Neng had lived for five years, he would have been well. Do you need a second payment?

Three years and five years,

The difference between just one word,

In reality, it is really possible to drag people to death.

Or just these two critical illness insurances:

If you look closely,

Product B not only requires that the interval between the second compensation for cancer should be five years, but also requires that the order of onset should comply with its regulations.

Let's look at the above two terms. Let me give you a concrete example:

Lao Wang unfortunately got a malignant tumor, and five years later, he unfortunately got a malignant tumor, so no problem, both terms can be compensated.

But if Lao Wang suffers from other serious diseases (such as acute myocardial infarction) for the first time, he will get malignant tumor five years later.

I'm terribly sorry,

Product A can compensate, but product B won't.

Do you see the difference?

The problem is that product A has a second paragraph.

Product A can pay 120% of the insured amount if it gets sick for the second time, regardless of whether it gets cancer for the first time or not.

But product b needs you to grow a tumor for the first time, and you will pay for it for the second time. If the first serious illness is not a tumor, then no matter how many times you get a tumor, you don't need money!

Then the question comes, the same responsibility, who can control the order of his illness?

Product b above, if the first serious disease is not cancer,

You can't use this "cancer two compensation" guarantee.

Isn't this an obvious pit?

But unfortunately, product B sells well in the market, that is, there is a product called "X Fu". I don't know if you have guessed.

I didn't expect that just one cancer responsibility made such a big difference.

Everyone must be careful not to be cheated.

This is a 2 million medical insurance policy, which can reimburse the medical expenses of special clinics.

For example, go to the clinic for kidney dialysis, cancer radiotherapy and chemotherapy.

There are many treatments for cancer, not only radiotherapy and chemotherapy,

You can also take targeted drugs, or use immunotherapy and endocrine therapy.

But not all medical insurance will reimburse these.

For example, product A only reimburses radiotherapy and chemotherapy.

But all the treatments mentioned above in product B are reimbursed.

Don't look, there are two more lines, and the difference is big!

Anyone who has seen The Road to Survival knows that,

Among them, a box of tens of thousands of pieces, a few boxes a month, and a suite of anticancer drugs a year are all targeted drugs.

Such an expensive medicine, product A is not reimbursed,

Do you want to tell the doctor to take targeted drugs, "No, my insurance doesn't cover targeted drugs, so you'd better shave my head and give me radiotherapy"?

I buy insurance in order to have more choices when treating diseases, rather than using insurance to limit my choices.

This kind of medical insurance only reimburses cancer radiotherapy and chemotherapy,

Whoever buys it will step on the pit!

The first two million medical insurance, only pay a few cancer treatments on one responsibility.

These two products, even the most basic responsibilities are gone.

One million yuan medical insurance has four responsibilities: hospitalization, special outpatient service, outpatient operation and emergency treatment before and after hospitalization.

Hospitalization expenses: such as bed fee, meal fee, medical treatment fee, examination fee, treatment fee, medicine fee and operation fee will be reimbursed.

Special outpatient service: most of the millions of medical insurance are only reimbursed for three yuan, including outpatient renal dialysis, outpatient malignant tumor and outpatient anti-rejection treatment after organ transplantation.

Outpatient surgery: there are common operations, and there is nothing to say.

Emergency before and after hospitalization: 7 days before hospitalization and 30 days after hospitalization. If the expenses need to be reviewed before hospitalization or after discharge, they can be reimbursed.

But some millions of medical treatments will secretly give you a few.

For example, product A only has inpatient medical treatment and special needs outpatient service, and there is no general outpatient service and emergency service before and after hospitalization.

The four basic responsibilities of product B have been completed.

Lao Wang went to the hospital for appendectomy, and the money for the operation was not reimbursed for product A, but for product B.

If a doctor asks for a reexamination after discharge, product A will not be reimbursed, and product B will be reimbursed.

As a million-dollar medical service,

Are you ashamed of this lack of responsibility?

Millions of medical insurance, the most important thing is the renewal conditions.

The millions of medical insurance we see now is generally one-year.

The biggest problem is,

I can buy this million medical insurance this year. If my health changes next year or my products are taken off the shelves, can I still buy them?

At present, the best products on the market can be guaranteed to be renewed for X years.

For example, product A has the right to guarantee renewal.

But the word "Bao Xu" is like a golden signboard, and everything depends on it.

For example, product B, the terms of which say "continuous insurance", will be interpreted as that it can also guarantee renewal.

What's the difference between them?

For example, Lao Wang has cancer this year and will be insured continuously next year. Product a can be renewed and product b can be renewed.

There is no difference,

However, Lao Wang got cancer this year, and products A and B will be removed from the shelves next year.

Product A is guaranteed to be renewed for 6 years and can be renewed within 6 years.

Product b is off the shelf, so there is no way to continue insurance.

Can only wait for the arrangement of the insurance company, the price increase or directly refuse to kill.

Do you see the difference?

For this "continuous insurance" product,

I can't guarantee that he won't take it off the shelf. It is very different from "guarantee renewal".

There is another category, called renewal insurance, which is often confused with guarantee renewal.

For example, product C, the terms say "you can apply for renewal".

Friends, let's be clear,

"Possibility" and "guarantee" are completely two concepts.

The product has been taken off the shelf, which is totally force majeure. Without the product, there is no way to renew the warranty.

Even if it says "it can last until the age of 10000", it is useless.

Space is limited, so I won't continue to mention it.

I don't want you to look at the pictures here with me to find out the differences.

The key is to learn to avoid pits when buying insurance.

In order to see the true face of insurance clauses, we must first learn to read insurance clauses.

It is impossible to learn to read insurance clauses, but as consumers, we can learn to read some basic parts.

What we need to see most are insurance notices, health notices and insurance contracts.

Insurance notice

If you buy insurance on some internet platforms, we will generally see insurance instructions.

You can't buy insurance indiscriminately.

In order to prevent some people from buying inappropriate products,

In the insurance notice, which groups of people this product will apply to and which risks are excluded are clearly listed.

However, some insurances, if you want to set a pit for you, will set many unreasonable exemption clauses in the insurance notice, or some standards are too strict.

Therefore, it is the first step to buy an insurance and understand its insurance requirements.

Health notice

Not only can't you buy insurance indiscriminately, but not everyone can buy it.

Health insurance, in particular, has certain requirements for personal health.

Insurance companies usually ask the insured about his physical condition, whether he has suffered from a certain disease in the past, or whether he has settled claims before taking out insurance.

This step is to screen out people at high risk. If people who are already sick also buy insurance,

In the end, either the insurance company loses money and everyone can't afford the insurance policy, or everyone's premiums are rising, so it is meaningless to buy insurance.

Health information must be taken seriously. For every disease,

If you think you have it or look like it, don't buy it

If it is online shopping, you can take smart underwriting. If you are not sure, you can apply for manual underwriting. If it is offline purchase, you can directly apply for manual underwriting.

insurance contract

After we pay the premium, we will receive the insurance contract after a certain period of time.

This is the most complicated clause and the place with the most pits.

Getting an insurance contract mainly depends on the guarantee liability and exemption clauses provided in it.

The chief security officer is like this:

It explains in detail how to compensate for the danger during the waiting period.

How to pay for serious illness, moderate illness and minor illness after the waiting period?

Pay attention to whether this is a premium or a premium.

Whether life insurance has only death but not total disability or both, whether there is a lack of medical insurance liability,

Or whether the second compensation for cancer listed above can be compensated.

The exemption clause is so long:

It lists which cases have not been compensated,

Generally speaking, the exemption clause mainly exempts the insured from committing suicide or intentional injury to cheat insurance.

Or the insured is out of danger due to illegal crimes, war nuclear explosions and other issues.

In essence, the problem is not big, mainly because I am afraid that some insurance clauses will be exempted too much, and everything that should not be exempted will be written in.

Insurance is a very professional field,

Even if we know how to treat insurance clauses, it is inevitable that we will feel obscure because of too many technical terms.

At this time, you can go to some professional medical websites such as Lilac Doctor and WeChat applet such as Tencent Medical Code to learn professional medical knowledge.

If you can't tell which responsibility is good or bad, you can also look at the insurance evaluation written by many professionals online.

In the worst case, you can ask me.

It is estimated that after reading the article, everyone will say that there are two kinds of insurance: one is no compensation and the other is no compensation.

Does insurance refuse to pay to make money?

Of course not!

The profits of insurance companies come from three different points:

Absolute difference: the difference between the estimated risk rate and the actual risk rate. For example, it was originally expected that 100 people would escape, but only 5 people actually escaped. Then the compensation 10 premium collected will have a surplus, and the insurance company will have a profit. Refusing to pay compensation can make the number of people actually out of danger less than 10, thus realizing profit.

Fee difference: insurance companies have costs to operate every product and store in all parts of the country. If the cost is saved, the insurance company can also make a relative profit.

Spread: for some wealth management insurance products, the insurance company will give us a profit, but at the same time, after the insurance company receives our premium, it will also invest to get a profit, just like bank deposits and loans. As long as the insurance company achieves a higher "loan income" than the "deposit income" given to us, it can make money.

In reality, when designing a product, insurance companies usually predict the risk rate of the people covered by this product.

For example, domestic life insurance products are designed according to the death probability recorded in the China Life Insurance Experience Table issued by the China Insurance Regulatory Commission.

At the beginning of product design, the assumed probability of getting out of danger is almost the same as the actual probability of getting out of danger, and the "dead difference" can hardly generate profits.

What if the insurance company refuses to pay compensation?

Insurance companies don't like to refuse compensation so much.

Two reasons:

From the data point of view, the rejection rate of insurance companies is not high.

Gongzi found the claim amount and claim rate of insurance companies in the first half of 19.

It can be seen that the lowest payout ratio is above 97%, generally at 98% and 99% for both large and small companies.

Insurance companies don't make profits by refusing compensation.

From the perspective of motivation, insurance companies are unwilling to keep refusing to pay compensation.

The insurance industry is a highly competitive industry, and the frequency of consumers buying insurance is also very low, not to mention any brand.

If an insurance company gives consumers an impression of refusing to pay compensation, refusing to pay compensation and refusing to pay compensation, then consumers can easily turn to other companies.

On the contrary, I have seen too many insurance companies lose money when they shouldn't, for nothing but reputation.

Then why are the insurance clauses so different?

Mainly lies in the actuarial team that designs insurance products. They think that some responsibilities are likely to cause long tail risk (a lot of losses in the future) or moral hazard (the possibility of fraudulent insurance).

From the perspective of insurance companies, these terms have been deleted.

However, such a modification objectively leads to the inability to meet the normal protection needs of consumers, which is quite "one size fits all".

This is a very helpless thing.

What we need to know is that the insurance we buy is essentially a contract with an insurance company.

When the contract is written, you will be paid. If the contract is not written, the salary will not be paid. Insurance companies don't make money by refusing to pay.

What we really need to learn is,

By studying the terms, you can avoid the insurance with incomplete protection and buy the insurance that is really cheap and suitable for you.

Son, as an insider, you can't say, you, don't change,

What you can do is to read the terms more carefully every time you recommend them.

Try to remind everyone and help everyone.

This is the reason why Gongzi has been writing persistently and sticking to the road of insurance science popularization.

Your praise is my motivation to move on.

Above.

If you still don't understand, you can leave a message or a private message. Codewords are not easy. If you find it useful, you can give me a compliment as encouragement.

Pay attention to big money. Buy the right insurance and save half the money!