Since the emergence of COVID-19, some insurance companies have launched relevant insurance products. In March this year, a Shanghai consumer spent 59 yuan to buy a XX love worry free insurance, which focuses on "Xinguan". Because the residential area was sealed for a long time, when the consumer applied for isolation allowance, the insurance company refused to pay compensation several times, on the grounds that "there are no medium and high-risk areas in Shanghai during this period of time".
At present, the matter has been highly concerned by Shanghai Consumer Protection Commission. In the message area, many netizens also said: "I also bought it. If there is any successful claim settlement, please share your experience", "I also bought it, because there is no compensation for home isolation" and "no compensation for isolation insurance, although the street has issued an isolation certificate". It seems that the consumer's experience is by no means an exception.
So, is the reason why the insurance company refuses to pay compensation Tenable? According to the contract terms displayed by consumers, it is clear that if the insured becomes the close contact of patients with new crown, or is centrally isolated or isolated at home because he is in a medium and high-risk area, he can get an isolation allowance of 200 yuan a day and a ceiling of 6000 yuan.
The current situation is that although consumers are centrally isolated or isolated at home, they are indeed not in medium and high-risk areas, because since Shanghai entered the epidemic prevention emergency state, they are managed according to the sealing and control area, control area and prevention area. If you pick words, it seems that the insurance company has reasons to refuse compensation.
But don't forget that the principle of utmost good faith is the basic principle of the insurance law and the most basic code of conduct that the parties to the insurance contract and related parties must abide by in insurance activities. It is applicable to the conclusion, performance, dissolution, settlement of claims, clause interpretation, dispute settlement and other links of insurance activities.
In other words, it is not difficult for insurance companies to find out whether insured citizens are isolated during the epidemic. If they insist on playing concept and word games on the terms of the contract, it will inevitably violate the principle of good faith and be difficult to be accepted by consumers.
Moreover, the division of three districts in Shanghai is a more stringent prevention and control measure than the division standard of medium and high-risk areas. During the epidemic, most citizens "stay at home" and are in fact isolated at home. If they are closely connected, they will be centrally isolated. Obviously, compared with the name, whether the insured becomes close or isolated is the more practical and reasonable criterion in the insurance contract.
According to media reports, the insurance company concerned contacted consumers after the incident and said that this situation would be handled as a case. However, it is worth noting that this is the result of the handling after consumers repeatedly contacted the insurance company without results and the media intervention. I'm afraid the insured with similar experience is not a "case". The insurance company's small 99 is that most people don't have enough time and energy to negotiate with the insurance company.
Indeed, the introduction of "new crown" isolation insurance, insurance companies also have to bear certain risks, and it is understandable to set strict standards with contract terms. However, in the final analysis, selling insurance is honest and fair. If insurance companies think they can't bear the risk, they can adjust their business in time instead of using word games to deal with consumers.
Surging chief commentator Li Qinyu