Jul 17, 2022
In Have Your Pie- and eat it too!
When the general public buys insurance, the focus is more on what kind of protection the insurance policy can provide. For the dense and troublesome policy terms, most salespeople either skip it or simply explain it, and there are only a handful of policyholders who will carefully study the terms after they get the terms. However, insurance is a contract after all, and the norms of the rights and obligations of both parties are written in the terms. The insured must not neglect it. Zhang's mother (pseudonym) many years ago insured her son with company A's 2,000 yuan per day hospitalization life insurance. One photo background removing day, her son suffered a severe head contusion and a skull fracture due to an accident. He died after being hospitalized for more than 600 days. The insured was hospitalized for more than 600 days, but Company A's daily insurance benefits were only paid for 365 days. For the part of the hospitalization after more than 365 days (252 days in total), the claim was refused due to the "same hospitalization" rule. Zhang's mother refused to accept the application for review, and she also lost the case in the court. What is the reason? It turned out that the terms of the hospitalization medical insurance policy have provisions for the upper limit of the number of days of hospitalization, ranging from 365 days, 180 days, 120 days to 90 days, and stipulates that if the same disease is admitted to the same hospital multiple times. As long as the If the date of the second discharge and the date of readmission does not exceed 14 days, it will be regarded as the same hospitalization as the previous hospitalization, subject to the limit of the maximum number of days for payment. In other words, if multiple hospitalizations occur, the hospital must be re-admitted at an interval of 14 days after discharge. This hospitalization can be regarded as another hospitalization, and a limit of benefits will be activated. at there was a maximum payment limit, Zhang’s mother facilitated her discharge from