" quarantine insurance " frequently get into claims disputes
"Don't worry about quarantine, count money while lying at home", "People sit at home, money comes from the sky", "Isolation is 200 yuan per day, and a cup of milk tea is guaranteed for one year"... In the past two years, due to the recurrence of the epidemic and the uncertainty brought by it, many insurance companies have taken advantage of the situation to launch "quarantine insurance". Users can get a total insurance amount of hundreds of thousands of yuan if they spend tens of yuan a year on their premium. As soon as the quarantine insurance was launched, it was highly sought after and became a "Internet celebrity" product. However, many policyholders reported that the isolation insurance was "difficulty in filing claims", and claims disputes have emerged one after another in recent years. Why are users unable to receive compensation due to the epidemic? What should consumers pay attention to when purchasing this type of product?
quarantine insurance complaints as many as more than a thousand
"Our building has been confirmed and the building has been closed. After applying for quarantine for so long, I refused to pay for it twice. So what's the use of buying quarantine insurance?" When Mr. Liu, a Shanghai user, consulted the insurance company's customer service, the other party said, "The insured person can only be protected because he is close to the new crown patient, or is in a medium- and high-risk area." This made him very angry. Many Shanghai users who have purchased isolation insurance reported that insurance companies refused to file claims on the grounds that "Shanghai has no medium- and high-risk areas."
is searched on a complaint platform with the keyword "isolation insurance". There are more than 3,000 related complaints, involving related products from multiple insurance companies. The reasons for refusal include "not meeting the classification of medium and high-risk areas", "unable to issue an isolation certificate", "lack of diagnosis certificate", " asymptomatic infected person is not a confirmed case", etc. The insurance company uses the insurance contract to explain the reasons for ’s refusal to pay. Consumers believe that the “substantive isolation facts” should be based on the “word game” rather than playing the “word game” according to the insurance policy clause.
An insurance company revealed that when making claims, the industry handles claims according to the insurance contract agreement, and uses the risk demarcation standards displayed on the mini program of the State Council’s client, but the claims caliber has been relaxed in the actual claims, and all compensations should be made. Some users have obtained "compensation compensation" from insurance companies through complaints and other means, but some users have reported that they have not received compensation yet.
product claims rules vary greatly
"quarantine insurance" became popular in the second half of 2021. Insurance products containing the responsibility for the COVID-19 isolation allowance protection were once popular because they hit the pain points of consumers and have high leverage ratio , bringing high traffic to insurance companies, but consumers complained constantly, and this Internet celebrity insurance product is controversial.
Song Zhanjun, deputy secretary-general of the Insurance Research Center of Beijing University of Technology and Commerce, introduced that in fact, isolation insurance was found before the outbreak of the new crown pneumonia epidemic. It usually appears in the form of quarantine allowance for specific infectious diseases additional insurance . Isolation insurance only entered the public's vision after the outbreak of the new crown pneumonia epidemic. The reason for its sales is that consumers hope to share the risks of reduced income or expenses caused by isolation through insurance. Insurance companies also regard it as an innovative drainage product, and sell it in insurance agent channels and Internet insurance platforms. The supply and demand ends jointly promote the popularity of quarantine insurance.
However, the isolation allowance insurance products lack pricing basis, and insurance companies follow the trend and pursue market traffic, laying hidden dangers for claims disputes. The reporter read a number of products and noticed that different products have great differences in the definition of relevant responsibilities. If consumers "close their eyes" to take out insurance, they will easily be rejected after the claim.
For example, the "Safety Insurance (including COVID-19 Isolation)" product launched by Ant Insurance and PICC Property Insurance. The isolation and compensation situation only includes centralized isolation, excluding home isolation, and the "centralized isolation self-paid loss allowance" liability only compensates the insured's self-paid accommodation expenses, meal expenses, quarantine expenses, and loss of work due to loss of work due to quarantine. Another "Huatai COVID-19 Isolation Insurance" also states that the insurance liability does not include home isolation, and only covers that the insured is subject to compulsory isolation in accordance with the law and regulations due to suspected infection or confirmed infection with COVID-19 due to taking public transportation, and does not include asymptomatic infections.
Industry insiders said that one of the reasons for the difficulty in claim settlement is that policyholders blindly take out insurance, and directly take out insurance without distinguishing the key points of the contract under the attractiveness of advertising gimmicks; in order to control claims risks, insurance companies also refined the disclaimer clause and added claims restrictions.
When insured, it is necessary to clearly ensure the liability of "quarantine insurance" in February this year, in response to the problems of false publicity and difficulty in claim settlement, the China Banking and Insurance Regulatory Commission's Property Insurance Department issued the "Urgent Notice on Standardizing the Operation of "quarantine" Subsidy Insurance Business", which regulates the "quarantine" subsidy insurance business, requiring insurance companies to standardize related products and not to conduct one-sided publicity and malicious hype for the purpose of attracting consumers' attention. Under the guidance of regulatory authorities, a large number of "isolation insurance" products have been rectified and re-listed.
Song Zhanjun introduced that after the release of the "Notice", the insurance company's publicity and sales pages have been relatively standardized. The situation of the previous one-sided publicity and malicious hype has improved, but the insurance company's recent compensation for the same case has been inconsistent, and the claims service power is insufficient, etc., which still cause trouble for consumers.
"And it should be seen that under the influence of the Omickron variant, there is a risk of excessive compensation for early product pricing. Insurance companies should fully understand the uncertainty of the epidemic and fully evaluate the operational protection capabilities and claims risks of isolation insurance." He suggested that insurance companies should clearly define claims conditions, avoid "consolidation compensation", and reduce the vague areas of claims; consumers should also further understand the compensation trigger conditions and claims material requirements of the product when purchasing, and make correct purchase decisions.
The banking and insurance regulatory department previously reminded consumers to understand the "two insurances" before purchasing isolation insurance, that is, "what is not covered" and "what is covered", and they should pay attention to keeping relevant isolation certificates after purchasing. It is particularly important to note that when purchasing an isolation insurance, the "isolation" that consumers understand is not necessarily the "isolation" defined in the insurance terms. Health monitoring, home isolation, etc. are not within the scope of the above-mentioned isolation insurance. Consumers should carefully read the insurance terms when purchasing, clearly ensure the liability and scope of obstacles, carefully judge whether it meets the actual needs of individuals, and be cautious in taking insurance. Before applying for claims, consult the insurance company where they are insured to understand the list of materials and relevant requirements during claims.
(Beijing Daily)
