customers have encountered the situation when life insurance events occur but are denied compensation for benefits. So what to do in this case.
- 1. Please carefully review the notice or document from the insurance company about the reason for the refusal
- 2. Re-understand the terms of insurance products
- 3. Ask an insurance advisor or call the insurance company directly
- 4. Thanks to the help of experts in the field or civil lawsuit
When denied insurance benefits, many customers feel extremely uncomfortable and distracted. Don't worry too much, the information below will help you know the smartest way to handle it.
1. Please carefully review the notice or document from the insurance company about the reason for the refusal
Please check whether the life insurance company's notice of the reason for your specific rejection of compensation. From there, find the most suitable solution to solve. Here are some common denial notices:
- Having disease before participating in insurance: Most of the current life insurance companies refuse to compensate if you hide the disease / declaration without illness, have never been cured, treat related diseases when filling out the application. registration. In other words, this is a form of life insurance profiteering, not new but extremely popular.
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- Making false claims on insurance claim documents: Customers make false statements about themselves, in which current health status is the most important. That will be the basis for compensation for benefits when insurance events occur. If you do not declare it properly, you will be denied compensation.
Please review the notice of rejection from the insurance company carefully
- Exclusion does not support: Many excluded diseases are not covered, eg HIV. You need to check with the paid support checklist specified in the insurance policy before making claims.
- Do not buy complementary products about that risk: For example, if you have dental related diseases without buying dental supplements, you will not be compensated. Because this is a benefit of supplementary insurance products, not integrated with the main product.
- Not the insured person in the contract : Many customers now only buy insurance for their children / others but I do not buy the same. By the time of the risk to yourself, ask the insurance company to compensate. This is a very ridiculous case.
- In the case of insurance exclusion: Currently, the Law on Insurance Business has clear provisions on exclusion terms. In addition, some companies also add their own terms in each insurance product. Please open the contract and review if there is a notice of violation of the exclusion case before filing a complaint.
2. Re-understand the terms of insurance products
If the customer violates the main product exclusion terms and supplementary insurance terms, check to make sure. If it is a violation, you should not complain because it is extremely time-consuming and most people who are still in the end are still buying insurance.
See more: Not every money is allowed to participate in life insurance
If an insurance policy is bought for another person but is linked to himself or herself when you buy an additional product, you still have the right to receive the allowance as stated in the insurance policy. In this case, you have the right to appeal and ask the insurance company to compensate in accordance with the regulations.
If your claim does not contain errors or has small errors, does not affect your benefits, you should contact the insurance company to negotiate and adjust. If it is not possible at that time, it must still be done to ensure the benefits for the next risks.
If you meet all the requirements for the above exclusion clause, do not violate any of the terms, then proceed to the next step below:
3. Ask an insurance advisor or call the insurance company directly
When you still find it difficult to understand, contact a counselor or insurance company for an explanation. Prepare before the insurance contract to compare and chat honestly and effectively. Talk deeply about the problem you are having. Ask for explanations of all questions, especially the reasons why I am being denied compensation.
Ask the insurance advisor to explain or call the life insurance company directly
In case the consultant and the insurance company still have not resolved clearly so that you understand, you still feel unsatisfied, then proceed to step 4:
4. Thanks to the help of experts in the field or civil lawsuit
Consult with a lawyer, seasoned experts in the field to judge whether the error is from your side or the insurance company. Or you can ask for assistance from Vietnam Insurance Association, Insurance Supervision Department. These organizations guarantee the interests of the insured as well as the insurers when conflicts arise. Ensure accurate and transparent resolution of needs from both sides. Another solution is to inform and ask for assistance from the Department of Insurance Supervision and Civil Lawsuits if it is suspected that the insurance company has fraudulent acts.
Thus, to protect the best life insurance benefits when participating, you first need to choose the right life insurance product based on your actual needs. At the same time, it is necessary to understand the terms of exclusion, to declare truthfully, full information, to sign clearly. Participating in life insurance is like a form of investment for health and life value in a relatively long time. So be serious. Only so, will you be "protected" best when unfortunate events happen (risks, illness, injury, death).
Hopefully, the above sharing will help you get the best way when you are unfortunately denied payment of life insurance benefits from insurance companies.