How to deal with the insurance company's deliberate delay in claim settlement? What if I don't pay the claim?

When applying for insurance claims, we sometimes encounter unreasonable claims, so what should we do at this time?

Today I will introduce this topic to you!

Before the lecture, you can put away this insurance introductory guide:

"Super complete! Everything you want to know about insurance is here.

1. What if the insurance company makes unreasonable claims?

In case of unreasonable claims by insurance companies, the following methods can be adopted to solve the problem:

1, negotiate with the insurance company

If you think that the claim is improper and the claim meets the statutory conditions, the insured can find the insurance company's claim Commissioner to solve it.

2. Complain to China Banking and Insurance Regulatory Commission.

China Banking Regulatory Commission (CBRC) is the regulatory department of banking, insurance and other industries. If the problem is still unresolved after communicating with the insurance company, you can give feedback to the regulatory authorities: it is a good solution to complain directly at the petition reception place designated by the CIRC and its dispatched offices. Leave your thoughts with China Banking and Insurance Regulatory Commission or call China Banking and Insurance Regulatory Commission for 24-hour complaint.

3. Bring a lawsuit to the court

Citizens can use the law as a weapon to protect their rights and interests. If the first two methods can't be solved, you can bring a lawsuit according to law and let the court decide.

But generally speaking, there must be reasons for unreasonable claims, such as the following: the claim data we submitted are incomplete and lack of main evidence.

General insurance will not refuse to pay for no reason, because the most important way for insurance companies to obtain profits is the investment income of premiums, and refusing to pay is not a way to make money.

If consumers are really worried about this situation, it is no problem to choose a big company with strong claims settlement ability and good reputation. China Life Insurance and Tongfang Global Life Insurance are both good companies.

Take Tongfang Global Life as an example. It has made a lot of efforts in claims service. Last year, the "Tongyi Compensation" claims service system was launched, providing three major services: serious illness first compensation, small quick compensation and hospital direct connection.

The insured can enjoy good service from serious illness diagnosis to claim settlement.

In addition, Tongfang Global Life has maintained a very good cooperative relationship with many well-known top three hospitals in China, so users of insured products can enjoy good medical services.

For friends who pay more attention to claims service, the "easy to pay" service set by Tongfang Global Life can be called "convenience artifact".

I still have something to tell you here. Tongfang Global Life's own strength and product guarantee are excellent. You can click on the following article to learn:

How about Tongfang Global Life, what products are there, which one is good, and in-depth analysis.

Having said that for everyone, let's talk about the related issues that need to be paid attention to in insurance claims.

Second, what problems should I pay attention to when applying for insurance claims?

If you don't pay attention to the following points, subsequent claims may be quite troublesome and there is a great chance that you will be refused compensation:

1, to be honest

Tell the truth, we will understand that the insured must accurately inform the health status when applying for insurance, and if there is a medical history, it should be explained immediately.

In addition, many friends often fill in some very important information casually or wrongly because they ignore the importance of health notification, which will definitely become an important factor affecting the outcome of claims. To this end, seniors have done a lot of sorting work, and now I will give you a special article on health advice, suggesting that some friends in need collect it:

What are the tips for health notification when applying for insurance? 》

Step 2 go to the hospital

First of all, friends must make it clear that insurance does not guarantee corresponding compensation.

The premise for an insurance company to provide claims is not only that the accident situation meets the terms, but also that the hospital where the insured goes to see a doctor: it must be a designated hospital.

If it has been stipulated in the clause that the hospital that requires us to receive treatment must be a public hospital above Grade II, then the medical certificate provided by us is directly invalid if it is issued by a private hospital.

3. Claim data

From the moment you enter the hospital gate, you should properly keep all medical materials such as expense list, outpatient medical records, inpatient medical records and inspection reports. If the information submitted is incomplete, it will be a waste of time to reissue it, and mistakes will be made if you miss the limitation of claims.

At this point, I believe everyone understands that insurance claims are actually very easy. If it is in line with the provisions of the insurance situation, it is also settled according to the correct process. Even if the insurance company does not pay compensation, we still manage it.

Write it at the end

I am an expert in insurance, focusing on objective, professional and neutral insurance evaluation;

If the above content has not solved your problem, you can also come to the official account of WeChat to learn to bully and say that insurance consulting me;

I give you the most professional advice based on many years of experience in configuring insurance for 10W+ families.

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