Due to the recent COVID-19 epidemic in Shanghai, Beijing and other places, the once hot sales " isolation insurance " has recently entered the peak period for claims acceptance. However, many consumers have found that insurance companies have refused to pay compensation because they are not in medium- and high-risk areas or cannot be proven to be close contacts. In this regard, industry experts believe that insurance companies should fulfill their responsibilities in the disclaimer clause when promoting products. When selling such products, insurance companies should not conduct selective publicity.
Recently, after more than a month of repeated communication and negotiation, Shanghai consumer Ms. Huang finally received part of the compensation for the "quarantine insurance" she had purchased previously. "Although the money I got was still quite different from what I agreed on, I really didn't have the energy to continue to struggle." Ms. Huang said helplessly.
According to the terms of the insurance product contract purchased by Ms. Huang, the premium is 59 yuan per year. The allowance for compulsory isolation due to the new crown pneumonia epidemic is 200 yuan per day, and a maximum compensation of 30 days can be paid. However, during the process of handling the claims, the insurance company refused to file claims on the grounds that her isolation area was not a medium- and high-risk area.
The reporter found on the searches of consumer complaint platforms, social platforms, etc. that there are many consumers who have the same experience as Ms. Huang. Refusal to compensate because it is not quarantined in a medium- and high-risk area or is unable to provide a proof of close contact is the main reason for the dispute.
In this regard, He Xiaowei, head of the Department of Risk Management and Insurance of the School of Insurance of the University of International Business and Economics, told reporters that although "isolation insurance" is a new product, its essence is a property insurance that uses the losses caused by specific events as the object of compensation. As the seller of the product, it is necessary for an insurance company to explain the disclaimer clause in the obvious position of the contract, so that consumers can clearly know which losses can be insured and which losses cannot be insured.
Some consumers said that the original purchase of "quarantine insurance" was affected by the product slogan. For example, some insurance products have "home quarantine is subsidy", while others emphasize that "you can get 200 yuan a day in isolation, and a cup of milk tea costs one year to protect you."
"For the purpose of attracting consumers, some insurance companies did not place the disclaimer situation in a very eye-catching position, which laid hidden dangers for future claims disputes." He Xiaowei believes that "insurance companies should not conduct selective publicity when selling such products. If they always bring this bad consumption experience to consumers, it will inevitably have a negative impact on the company's own brand and the overall social recognition of the insurance industry."
reporter noticed that relevant regulatory departments and industry associations have begun to standardize "isolation insurance". For example, China Banking and Insurance Regulatory Commission issued a document requiring that insurance companies should not make misleading or explain the important situations such as the protection liability of insurance products through deception, concealment or induction.
"The emergence and recurrence of the epidemic in Shanghai, Beijing and other places has caused the incident of isolation claims to be a low-probability, and the compensation situation has increased significantly, exceeding the insurance company's claims expectations, so it is in a relatively passive situation. I believe that insurance companies will also adjust the compensation standards of insurance products in the future." He Xiaowei said.
Source: Workers' Daily
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