What is accidental injury insurance common refusal situation inventory?
Accident insurance is a kind of personal insurance. Accident insurance has the advantages of low premium price and high insured amount. In addition, everyone needs to resist accidental risks. Therefore, accident insurance should be shared by everyone. However, there is a lot of professional knowledge in accident insurance, and the “accident” in the insurance field may be different from people’s cognition. So, what is accidental injury insurance, and under what circumstances will it be rejected?
1. What is accidental injury insurance?
There are many types of accident insurance, and the responsibilities covered are also relatively rich. The so-called “accidental injury insurance” mainly refers to a type of insurance product that includes accidental death and accidental disability. It should be noted that “accidents” in the insurance field need to have four elements: external, sudden, unintended, and non-disease. Even if the accident insurance has been insured, but the accident does not meet the above four elements, the insurance company will not recognize it as an “accident”.
After a user purchases accidental injury insurance, the insurance company needs to pay the insurance money in one lump sum according to the stipulations of the insurance contract if the body suffers injury or death due to an accident, such as a car accident, burn, or other accident. Accidental injury insurance may not contain accidental medical liability, which means that the insurance company will not reimburse the insured for medical expenses caused by an accident.
Accident insurance will be able to reimburse accident medical insurance called accident medical insurance. However, some accident insurances will take into account both accidental injury and accidental medical liability, such as comprehensive accident insurance and comprehensive traffic accident insurance.
2. Inventory of common refusal of compensation for accidental injury
Because the definition of “accident” in the insurance field is different from the “accident” that people think of in daily life, insurance companies will not pay for some accidents or situations that seem to be “accidental”.
1. Sudden death refusal
If the accidental injury insurance purchased by the user does not explicitly protect “sudden death”, the application will be rejected by the insurance company after the insured’s sudden death. Mainly because sudden death is often related to people’s body overload, which is caused by disease. It is contrary to the definition of “non-disease” and “external sudden” stipulated by the insurance company, so the insurance company will not pay compensation.
2. Death from heatstroke
Death from heatstroke is also a relatively common type of situation. Although it seems quite sudden, it is a disease that is related to the patient’s physical condition and does not meet the “accident” defined by the insurance company. Therefore, heatstroke is also rejected by accident insurance. A situation that pays more.
3. Falls due to illness
Some people accidentally fell and died, so they applied for accident insurance claims, but were rejected. There are times when a fall is just an incentive, and the illness is the direct cause of the death of the insured. Insurance companies often take the most direct, most effective, and most decisive reasons as the basis for compensation when assessing liability. That is to say, the most direct cause of the death of the insured is an illness rather than a fall, so the claim will be refused.
4. Individual food poisoning
Although food poisoning is in line with the definition of “foreign, unintended, and sudden” defined by insurance companies, personal food poisoning may be related to the individual’s gastrointestinal function. Only if the number of people with food poisoning reaches 3 or more, the insurance company It will be defined as an accident, and compensation will be given. Therefore, if everyone eats the same plate of food, and only one person is poisoned, the insurance company may refuse to pay.
If you don’t know what accident insurance is, you may wish to look at the coverage and compensation standards of this type of insurance. As a basic type of insurance, accident insurance plays a relatively large role in people’s lives and is more suitable for resisting all kinds of sudden accident risks. The premium price of this type of insurance is low, and it is recommended to configure one for yourself in case of an emergency.
