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购买大病保险的7大陷阱（7majorpitfallsinbuyingseriousillnessinsurance）Abstract:withthedevelopmentofmedicaltechnology,thecurerateofseriousdiseasesisincreasing,andmoreandmorepeoplebuyseriousdiseasesinsurance.Expertssuggestthatfamiliesbuyinsurancefirstchoicehealthinsurance,seriousillnessinsuranceisessentialinhealthinsurancecoverage.Foradescriptionofthedefinition,butseriousillnesscompensationstandardsandotheraspectsoftheseriousillnessinsuranceclausesarealotofprofessionalmedicalterminology,theinsuredmaynotfullyunderstandthereference,untiltheclaim,theinsurancecompanywillcompensatecanlose,cannotlosecannotlose,thisguaranteeistruesecurity?So,todaywehavetoelaborateonthe7trapstobuyinsurance,forinsurancepolicyholders'guiding".Atrap:thecompensationaccordingtothedeathisnotaccordingtotheillnessTaiyuanpeopleDongGuozhuencounteredsuchathing,hiswifeWangknittingApril2003sufferedbrainstembleedingtothehospital,diedthesameday.Sadly,toMrDongGuozhu'srelief,hiswifeboughtahealthinsurancepolicyin2000atthePacificInsuranceCompany'sTaiyuanbranch.Afterthedeathofhiswife,afterconsultingadoctor,DongGuozhulearnedthatbrainstemhemorrhagebelongstoastroke,oneofthe12majordiseasesandstrokearelistedintheinsurancecontract,accordingtohisunderstanding,thismeansthathiswifedied,theinsurancecompanyaccordingtothemajordiseasestogivecompensation.Accordingtothecontractofinsurance,theinsuranceamount forthepaymentofmajordiseasesshallbe30thousandyuan.However,whenDongGuozhuwenttogetinsurance,theinsurancecompanyonlyagreedtopay6000yuanofdeathinsurance.Theinsurancecompanybelievesthatthetermsofthecontractandhaveacleardefinitionofstroke,strokeisduetosuddencerebralvascularlesions,leadingtocerebralhemorrhage,cerebralthrombosis,cerebralembolism,cerebralinfarctioninducedbypermanentnervedysfunction.Theso-calledpermanentnervedysfunction,referstotheaccidentoccurred6monthslater,theinsurancerecognizedbythemedicalinstitutions,neurologicalspecialistidentified,stillleftthefollowingobstacles:1vegetativestate;2,morethanonelimbfunctioncompletelylost;3,twoormorelimbmovementorsensorydisturbance,andlifecannottakecareofthemselves.Thatistosay,accordingtostrokeclaims,mustmeetthe3conditions,andtoachievethespecifiedperiodof6months,andtheinsuredisthekingofwoolobviouslydoesnotmeettheconditionsoftheinsuranceclausesinstroke.Itisamajordisease,accordingtotheprovisionsofthecontract,onlybythedeathofthepaymentoftheinsurancebenefits6000yuan.Intheprovisionofgoldpaymentmanyinsurancecompaniesdeathinsuranceamount,themajorityofcompaniesarepaidaccording totheprovisionsoftheinsuranceamount,buttherearealsosomecompaniesto"deathinsurance"fortherefundofthepremiumpaid.Ifthesameamount,thesameprice,butnotlosetheamountofdeath,refund,equaltothreecustomersintheinsuranceliabilityshallbeentitledtoairouta"death",theinsuredisobviouslybelongtounfairterms.Traptwo:treatmentisnotinaccordancewiththeprovisionsoftheinsurance,thendonotpayInNovember9,2005,DongHongsiwonalawsuitforoneyearandfinallywonthe100thousandyuaninsurancefromtheChinaLifeInsuranceCompany,KunmingbranchofLimitedbyShareLtd.InJanuary2005,DongHongsi,42,sufferedfromacutenecrotizingpancreatitisandunderwentintubationanddrainageattheSecondAffiliatedHospitalofKunmingMedicalUniversity.Thecostoftreatmentwasmorethan30thousandyuan.Afterleavinghospital,DongHongsiremindshertwoyearsagotobuythelife-insurancecompany"Corelle'smajordiseaseinsurance,insurancepremiums5010yuanperyear,amountedto100thousandyuan.His"acutenecrotizingpancreatitis"isoneofthe21majordiseasesthathavebeenagreeduponininsurance.Sohefiledaclaimwiththeinsurancecompany,buttheinsurancecompanyrefusedtopayforit.InresponsetoDongHongsi'squestion,theinsurancecompanyexplained:"accordingtothetermsoftheinsurance,thestandardforacutenecrotizingpancreatitisisdiagnosedasacutenecrotizingpancreatitis,whichrequiresremovalofnecrotictissue.", Surgicalresectionoflesionorpartialresectionofpancreas.Theinsuredisnotthedangerousconditionofresectionorpartialpancreasresection,hasnotyetreachedintermsofpaymentconditions,theproposedtemporarynocompensationforcriticalillnessinsurance."ButDongHongsi'sattendingdoctorindicatedthat,atpresenttheclinicalacutenecroticpancreatitistreatmenthastheconservativetreatmentandthesurgerytreatmenttwokindsofways.Surgicaltreatmentisnecessaryforpatientswithseriousillness.Themainmethodofoperationisdrainage.Perfusionplusdrainageisactuallyaclearingoperation.Buttheexplanationwasnotapprovedbyinsurancecompanies,andtheinsurancecompanyinsistedthat"drainage"and"removalofnecrotictissue"werethetwotypeofsurgeryandstillrefusedtopayforit.AlthoughDongHongsihadwonthelawsuit,buttheinsurancecompany'sriskofmajordiseasesremainawashinsimilarterms,provisionsrequiresurgicalmethodintreatmentofpatientsmustbeinaccordancewiththeprovisionsoftherequirements,wecangetpaid,butmanyofthemareoutofdatetreatment.Forexample,aprovisionofaforeigninsurancecompanyintermsofdangerous,"cancer:......Notissuesmearsandneedlebiopsyresultswereusedaspathologicalevidence......"Butthedoctorexplainedthatnowallistorelyonthepathologicaldiagnosisofcancertissuesmearsandbiopsyresults,ifyoudonotincludethetwo,itcanonlysampleinspection,buttheinspectionmethodexcludesthenowrelativelyhighincidenceofcancer(suchaslungcancer,gastriccancer,esophagealcancerandearlycancer,etc.)thatistosay,thepatientcan waituntillatetogotothehospitaltocheck,orwillnotgetthecompensationofinsurancecompany.Mr.hoinsuredamajorillnessinsurancepolicyof400thousandyuan,withanannualpremiumofnearly80thousandyuan.Twoyearslater,theleftkidneywassurgicallyremovedfromcancer.Whentheclaimwasmade,theinsurancecompanysaiditcouldnotpayforit.Thereasonwassimple:thetotalphysicaldisabilitystipulatedintheclausewasthecompletepermanentdisabilityofthebody.Theabsenceofleftkidneyduetoleftrenaldiseasedoesnotcorrespondtothetotaldisabilityofthebody,andtwokidneyshavebeenlost.Butiftwokidneysarelost,itmeansthattheinsuredpersonhasdied,andthemajorillnessinsurancehaslostitsmeaning.Trapthree:theaddedextraresponsibilityisonlyagimmickManyinsurancecompanieshaveanadditionalliabilityoutsidetheinsuranceliability,sothatthepolicyholdersmistakenlyassumeadditionalresponsibility,themoretheybuythemorevalue,infact,manyoftheseadditionalresponsibilitieshavenopracticalsignificance.Forexample,someinsurancecompaniesto"seriousillnessafterthewaiverofnonpaymentofeachperiodofinsurancepremium"as"anotherinsuranceliability."".Andafterthemajordiseaseclaims,thecontractliabilityhasbeenterminated,theinsurancecompanynolongerbearanyprotection,theinsuredalsonolongerhavetheobligationtopaytheinsurancepremium,wherecanIusethewaiverofunpaidinsurance?Inaddition,therearesomeinsurancecompanieswillbe"all residualliability"isalsoincludedinthe"fullpaymentinsurance"category,the"totaldisability"noconceptofthecustomerwillfeelthatthisresponsibilityisveryfavorable.Infact,inmorethan17kindsofdiseasestoprotecttheillnessterms,willhavefullresponsibilityforthe"dismantlingofresidualdeafness,blindness,aphasia,paralysisandsoforth,scatteredhiddeninthe"Nmajor",intheinsuranceliability,andthenseparatelyputforward"totaldisabilitypayment,ispurelyfalsecompassion.Buttherearealsosomevaluableadditionalresponsibilitiesinmajordiseaseinsurance.Provisionssuchaslifedignity,advancepaymentandautomaticcushionpremiumclause.Thedignityoflifeaheadofpaymentmeansthatwhentheinsuredpersonsuffersfromend-stagediseasesandthesurvivaltimeiswithinacertainperiod,theinsurancepremiummaybepaidinaccordancewiththeinsuredamount.Thatis,tolimitthescopeofaseriousillnesstoanunlimitedextent,regardlessofwhetherthediseaseisaguaranteeoftheseriousillnessrange,aslongasthehospitalprovedthattheperson"soondied",youcanapplyforinsurancebenefits.Theautomaticpaypremiumclausestipulatesthatwhentheinsuredpersonfailstopaythepremiumintimeforbusinesstrip,theinsuranceeffectcanbeextendedtothecontinuingpremium.Trapfour:thescopeofseriousillnessisnotwide,moreusefulNowbiginsurancecompaniesarecompetingforcustomers, Thereare500kindsofdiseasesincluding10kinds,30kinds,40kinds,andmostofthemevenclaimmorethanonekind.Theinsured,ofcourse,feelsthatthemoresicknessthebetter,butitisnotthecase.In2003,MrFOKsufferedfromupperrightrenalclearcellcarcinoma.Hewasadmittedtothehospitalandunderwentrightnephrectomy.Duringhospitalization,Mr.Gongmadeareporttotheinsurancecompanyafteritwastwelve,thereasonisthatthediseaseisnotmorethan500ofcases.Anothercompanyonlyhas10kindsofcolumndetailsincaseswithcancer(carcinomainsituexceptcarcinomainsitumorecommonlyreferstocancerconfinedtothemucosaorskinsquamousepithelium,basementmembraneofthecancerhasnotyetdestroyed."Insitucancerisanearlycancer,andaftersurgeryandtraditionalChinesemedicine,mostofthepatientsarefullyrecovered."thetermhasincludedallcancers,includingtherightuppercellclearcellcarcinoma.Thusitcanbeseenthatthemorekindsofdiseasescoveredbytheinsuranceclauses,thegreaterthescopeofprotection.Intheamountofpayment,theprovisionsofthecompanyisalsodifferent.Mostcompaniespaybythesumoftheinsuredortheinsuredamount.Buttherearealsoseriousillnessinsurancecompanywillbedividedintotwocategories:"aseriousillnesswithpaymentof80%oftheinsuredamount,with"twodisease"claimsto20%.thatistosay,whentheinsuredwasdiagnosedwithseriousillness,inothercompaniescangetaone-time$200thousandpayment,andinthiscompanycanonlyget160thousandyuan,againwithanother"twodisease"totherestofthe40 thousandyuancompensationtotheinsured.Trapfive:withlowpremiumstoinducepolicyholderstobuyshort-terminsuranceTherearetwobigdangerous:consumptionandaccumulation.Consumptiontypemeansthatifthereisnoaccidentwithinayear,themoneywillbewasted;andthecumulativetypewillbepaidacertainamounteachyear.Itwillcontinueformanyyearsandtheprotectionwillbecontinuous.Usuallyveryhighage(suchas88),iftheprovisionsofthisperiodhadtheillnessinsurance,accordingtotheamountofinsuranceclaims,theinsurancecontractissuspended;ifyouhavenodisease,theinsurancecompanywillrefundtheinsuredinsurance.Becauseofthis,comparedtoconsumptionandaccumulationtype,thepremiumismuchcheaper.Manyagentswillusethisasanexcusetoluretheinsuredinvestmentandconsumptionofbigdangerous.Althoughtheone-yearinsuranceseemscheap,butthereisnotmuchrealsecuritysignificance.Iftheannualrenewal,duetothelargedangerousrateisincreasedwiththeincreaseofage,theinsuredinvestmentmoreclearly.Longandbigdangerousisgenerallyinaccordancewiththecorrespondingratesofinsurancewhenyoustart,theannualbalanceofpayment.Theyoungertheinsured,thelowerthepremiumsrequiredtopay.Intheamountof$200thousand,forexample,Ms.Xueattheageof34renewal,only1040yuanpremium,attheageof44andrenewal,thepremiumhasincreasedto1780yuan,andinthe45yearoldrenewalpremiumhassurgedto4220yuan.Iftheinsuredinsuranceconsumptionyearafteryeartheriskofmajor diseases,thetotalpremiumsactuallyhavefarhigherthanthepurchaseofthecumulativeriskofmajordiseases.StillmissXueasanexample,ifshewantsbeforetheageof50hasbeenaseriousillnessinsuranceguarantee200thousandyuan,accordingtotheshort-term,renewalevery5years,every5yearsofrenewal,paypremiumstotaling95thousandyuan.Andaccordingtolong-termcalculation,at30yearsofageone-timeinsurance,20yearspaid,thetotalpremiumpaidonly52thousandyuan.Trapsix:additionallargedangeroushighcostNowtheinsurancecompanysometimesintroducedasanadditionalriskofseriousillnessinsurancecoverage,theadditionalinsurancepremiumisrelativelycheap,butasthemainriskofthecorrespondingadditionalinsuranceresponsibilityisnotnecessarilytheapplicantneeds,andcombinationofthesemainrisksandadditionalriskstendtomeetcertainproportion,sototheend,paymorethanasinglehighrisk.Inaddition,manyinsurancecompanieshaveintroducedamajorriskofparticipatinginthedisease,butalsohigherthanthenondividendtype.Infact,buythemainriskisbestnottobuydividends.Becausedividendsdividendcommitmentisnotguaranteed,isexpected,andbuybigdangerousistobuysecurityratherthaninvestment,Thepursuitofmaximumprotectionistheminimumexpense,soitisnotnecessarytospendmore.Trapseven:theinsurancecompanymaychangethetermsatwill Manyhealthinsuranceclausesordangerousintheadjustmentscopeoftheprovisionshaveaseriousillnessorinsurancepremium.Asalifeinsurancecompanyinseriousillnessinsuranceclauses:definitionandscopeoftheadjustmentofinsuranceinsuranceamount,majordiseasesandmajoroperations,theresponsibilityofinsurancewillbeinaccordancewiththeamountofinsurance,thenewmajordiseasesandmajorsurgeryandscope."Therearealsoprovisionsinthecompanyclause:"thecompanyreservestherighttoraiseorlowerthepremiumrate",whichisactuallya"despot"clausethatseriouslydamagestherightsandinterestsoftheclients.Iftheinsuredtoseriousillnessinsurancepremiums4000yuan/insuredinsuredamountof$100thousandinthesecondyears,theinsurancecompanyistold:premiumincrease500yuan,ifitcontinuestomaintainthepolicyeffect,accordingto4500yuan/yearpayment;andrefusedtocontinuetopay,thentheterminationofthecontract.Inthisway,nomatterwhichmethodischosen,theinsuredisinsured.Infact,themajordiseases,thescopeofmajoroperationsandtheinsurancepremiumrateareoneofthecorecontentsoftheinsurancecontract,andtheadjustmentisactuallyasubstantialchangeinthecontentsofthecontract.Inaccordancewiththelaw,majordiseases,majoroperationrangeandtherateofpremiumadjustmentsbeforehavebeensignedandhasnotyetfulfilledtheinsurancecontract,theinsurerinaccordancewiththeprovisionsofthenewadjustmentforchange,theinsuredshallobtainthepriorconsentortheinsuredor agreement,theinsuredortheinsurerhastherighttorangetheadjustedratesortermsmakechoicewhetherornottoacceptthe.Therefore,wheninvestinginmajordiseaseinsurance,weshouldpayspecialattentiontowhethertherearesimilartermsinthecontract,ifthereis,itisbesttogiveup,soastoavoidinfringementoftheirowninterests.
