多保魚
得了大病保險公司為什麼不賠？如何防止重疾險理賠被拒？
說shuo到dao買mai保bao險xian，很hen多duo人ren第di一yi反fan應ying是shi購gou買mai重zhong疾ji險xian，重zhong疾ji險xian給gei付fu的de理li賠pei金jin除chu了le能neng減jian少shao疾ji病bing帶dai來lai的de收shou入ru損sun失shi以yi外wai，還hai可ke以yi減jian輕qing家jia庭ting的de經jing濟ji壓ya力li。但dan很hen多duo朋peng友you都dou表biao示shi，重zhong疾ji保bao險xian好hao歸gui好hao，但dan是shi理li賠pei手shou續xu也ye挺ting麻ma煩fan的de，稍shao有you不bu慎shen就jiu有you可ke能neng被bei拒ju。接jie下來多保魚小編將通過一個重疾險拒賠案例和大家聊一聊如何防止重疾險理賠被拒？
一、案例詳情
2018年5月份的時候，50歲的張某在一家保險公司自己投保了一份保額為20萬的重大疾病保險，因為自己年齡比較大，保險公司考慮到風險問題，重疾險的包的也相對來說有些小貴，年交保費1.2萬元。
投保才過2geyue，yiwaijiuturanlaixi，zhangmouzaijiazhongturanyundaole，jiarenjianzhuangganjinsongquyiyuan，jingguoyixiliedejianzha，yishenggeichudezhenduanjieguoshitadelejixingzhongzhengyixianyan，zhegejibinghaitingyanzhongde，yishenggaosuzhangmoudejiaren，jinkuaizhiliaoyimianjibingzaicichuxianehua。zaizhuyuanzhiliaoqijian，zhangmoujiashujiedaoyiyuan6次下達的病危通知書，萬幸的是，在花費了101萬醫療費用的時候，張某終於脫離了生命危險。
在(zai)醫(yi)院(yuan)治(zhi)療(liao)期(qi)間(jian)，張(zhang)某(mou)告(gao)訴(su)家(jia)人(ren)自(zi)己(ji)有(you)買(mai)過(guo)保(bao)險(xian)，讓(rang)家(jia)人(ren)幫(bang)忙(mang)搜(sou)集(ji)資(zi)料(liao)找(zhao)保(bao)險(xian)公(gong)司(si)申(shen)請(qing)理(li)賠(pei)，張(zhang)某(mou)認(ren)為(wei)這(zhe)個(ge)疾(ji)病(bing)這(zhe)麼(me)嚴(yan)重(zhong)，保(bao)險(xian)公(gong)司(si)肯(ken)定(ding)會(hui)理(li)賠(pei)的(de)，誰(shui)知(zhi)在(zai)申(shen)請(qing)理(li)賠(pei)的(de)時(shi)候(hou)卻(que)被(bei)保(bao)險(xian)公(gong)司(si)因(yin)急(ji)性(xing)重(zhong)症(zheng)胰(yi)腺(xian)炎(yan)不(bu)屬(shu)於(yu)重(zhong)疾(ji)險(xian)合(he)同(tong)承(cheng)保(bao)範(fan)圍(wei)內(nei)而(er)拒(ju)賠(pei)了(le)。保(bao)險(xian)公(gong)司(si)給(gei)出(chu)的(de)這(zhe)個(ge)拒(ju)賠(pei)理(li)由(you)，讓(rang)張(zhang)某(mou)一(yi)家(jia)人(ren)非(fei)常(chang)不(bu)爽(shuang)，患(huan)者(zhe)住(zhu)院(yuan)期(qi)間(jian)醫(yi)院(yuan)下(xia)達(da)了(le)6次病危通知書，治療費用也花了101wan，baoxiangongsijupeibupei？nandaojixingzhongzhengyixianyanhaibusuanzhongdajibing？wokanbaoxiangongsijiushiguyibupei，zuozhejuhuazuohuangzi。zhangmoudejiarenyuexiangyueshengqi，yushijiangbaoxiangongsigaoshanglerenminfayuan。
二、案例分析
庭審的時候，保險公司辯稱，按照合同規定，張某患急性重症胰腺炎不在重大疾病合同範圍，所以保險公司有權拒絕賠償。
法(fa)院(yuan)在(zai)經(jing)過(guo)詳(xiang)細(xi)的(de)調(tiao)查(zha)之(zhi)後(hou)，認(ren)為(wei)過(guo)錯(cuo)在(zai)於(yu)保(bao)險(xian)公(gong)司(si)，理(li)應(ying)賠(pei)償(chang)保(bao)險(xian)金(jin)，業(ye)務(wu)員(yuan)在(zai)簽(qian)訂(ding)保(bao)險(xian)合(he)同(tong)的(de)時(shi)候(hou)，並(bing)沒(mei)有(you)向(xiang)張(zhang)某(mou)如(ru)實(shi)說(shuo)明(ming)重(zhong)大(da)疾(ji)病(bing)的(de)理(li)賠(pei)範(fan)圍(wei)，買(mai)完(wan)保(bao)險(xian)之(zhi)後(hou)保(bao)險(xian)公(gong)司(si)也(ye)沒(mei)有(you)盡(jin)到(dao)提(ti)示(shi)義(yi)務(wu)，因(yin)此(ci)該(gai)合(he)同(tong)屬(shu)於(yu)無(wu)效(xiao)合(he)同(tong)，而(er)張(zhang)某(mou)罹(li)患(huan)的(de)急(ji)性(xing)重(zhong)症(zheng)胰(yi)腺(xian)炎(yan)，導(dao)致(zhi)張(zhang)某(mou)經(jing)曆(li)了(le)多(duo)次(ci)大(da)型(xing)手(shou)術(shu)，治(zhi)療(liao)期(qi)間(jian)的(de)費(fei)用(yong)也(ye)非(fei)常(chang)高(gao)，這(zhe)完(wan)全(quan)符(fu)合(he)重(zhong)大(da)疾(ji)病(bing)保(bao)險(xian)的(de)定(ding)義(yi)。最(zui)終(zhong)，法(fa)院(yuan)判(pan)定(ding)張(zhang)某(mou)提(ti)出(chu)的(de)理(li)賠(pei)要(yao)求(qiu)是(shi)合(he)理(li)的(de)，保(bao)險(xian)公(gong)司(si)不(bu)能(neng)耍(shua)賴(lai)，需(xu)要(yao)賠(pei)償(chang)張(zhang)某(mou)20萬的理賠金。
zaizhegeanlizhong，womenlejiedaolebingbushibingbushisuoyoudezhongdajibingdouzaibaoxianlipeifanwei，baoxiandelipeixuyaogenjuhetonglaizhixing，dangranyeyouyixieteshuqingkuang，birushuofuhezhongdajibingbaoxiandedingyiqiedadaoxiangguanlipeidetiaojian，zuoguoduocishoushu，zhiliaofeiyonggaodeng，zhexieqingkuangdouyouquanliyaoqiubaoxiangongsijinxingpeichang。
三、如何防止重疾險理賠被拒？
womenmaibaoxianzhuyaoshiweiletongguobaoxianjiangfengxianzhuanjiageibaoxiangongsi，dangfengxianlailindeshihou，baoxiangongsigeidaowomenxiangyingdebuchang，danyouyuhenduorenbulejiebaoxianlipeideguocheng，suoyizaitoubaoshihuoduohuoshaodedouhuiyouyixiedanxin，haipazijimaidebaoxianhuichuxianlipeijiufen，jiexialaiduobaoyuxiaobiangeidajialiaoyiliao，ruhefangzhizhongjixianlipeibeiju？
1、投保時如實告知不要隱瞞身體健康狀況
guanyurushigaozhizijideshentijiankangzhuangtaiduobaoyuxiaobianzhiqianduocifanfuqiangtiao，zhegeshifeichangzhongyaode，yeshijuedinglipeinengbunengpeifudeguanjianyaosu。henduorenbaozhejiaoxingxinliyiweiyinmanyixiayemeiguanxi，zhiyaobaoxiangongsimeiyoufaxianjiunengchenggongtoubao，shubuzhi，jishibaoxiangongsidangshimeiyoufaxianzhegewenti，danshizailipeideshihouyehuitiaozhadeyiqingerchu，daoshihoujupeibushuo，zhiqiansuojiaodebaofeiyesuanshidashuipiaole。yinci，womenzaitoubaodeshihou，yidingyaorushijinxingjiankanggaozhi，baoxiangongsizailipeishikeyiqingsongdizhadaowomendegezhongxinxi，yueshiyinmanduizijiyuebuli。
2、盡量不要在等待期申請理賠
任(ren)何(he)一(yi)款(kuan)保(bao)險(xian)投(tou)保(bao)了(le)之(zhi)後(hou)都(dou)會(hui)有(you)等(deng)待(dai)期(qi)，設(she)置(zhi)這(zhe)個(ge)等(deng)待(dai)期(qi)的(de)作(zuo)用(yong)就(jiu)是(shi)防(fang)止(zhi)別(bie)有(you)用(yong)心(xin)的(de)人(ren)騙(pian)保(bao)，如(ru)果(guo)在(zai)此(ci)期(qi)間(jian)不(bu)幸(xing)出(chu)險(xian)，保(bao)險(xian)公(gong)司(si)肯(ken)定(ding)不(bu)會(hui)理(li)賠(pei)的(de)，因(yin)此(ci)，我(wo)們(men)在(zai)買(mai)保(bao)險(xian)的(de)時(shi)候(hou)一(yi)定(ding)要(yao)趁(chen)著(zhe)身(shen)體(ti)很(hen)健(jian)康(kang)的(de)時(shi)候(hou)早(zao)早(zao)購(gou)買(mai)，或(huo)者(zhe)選(xuan)擇(ze)等(deng)待(dai)期(qi)比(bi)較(jiao)短(duan)的(de)保(bao)險(xian)產(chan)品(pin)。
3、記得按時繳納保費，不要讓保單失效
ruguoyinweimouxieyuanyin，wangjijiaonabaofeidaozhibaodanshixiao，shenqinglipeideshihou，baoxiangongsiyeshibuhuipeifude。yaoxiangbaoxianbushixiao，zhejiuxuyaowomenpingshidingqizhenglibaodan，zhizuobaodanjianshibiao，fangzhiwangjijiaobaofeideqingkuangchuxian。
4、高發的重大疾病一定要覆蓋到
womengoumaizhongjixiandeshihou，zongshihuihulvezhongjixiandehetongbaozhangfanwei，renweibaoxianbaozhangdejibingduojiushiyikuanhaobaoxian，qishibudui，baoxianzhiyounengbaozhangyixiegaofadejibingcaisuanshiyikuanhaobaoxian，ruguohetongzhongmeiyoufugaidaozhexiegaofajibing，chuxianzhihou，rongyiyinqibubiyaodelipeijiufen。goumaizhongjixianbaozhangdejibingshuliangbushizuizhongyaode，yaokantashifoufugaidaogaofadejibing。ruguojingjitiaojianyunxudehua，jinliangxuanzebaozhangjiaoduodechanpin，duiyujingjitiaojianbuzudeqingkuangxia，keyixuanzebaozhangjichudezhongjibingzhongbaohanzainei。
5、留意合同中的免責條款
大(da)多(duo)數(shu)人(ren)認(ren)為(wei)，如(ru)果(guo)自(zi)己(ji)購(gou)買(mai)了(le)重(zhong)疾(ji)保(bao)險(xian)，並(bing)患(huan)有(you)嚴(yan)重(zhong)疾(ji)病(bing)，保(bao)險(xian)公(gong)司(si)一(yi)定(ding)會(hui)賠(pei)付(fu)。事(shi)實(shi)上(shang)，要(yao)想(xiang)保(bao)險(xian)理(li)賠(pei)也(ye)是(shi)有(you)條(tiao)件(jian)的(de)，符(fu)合(he)重(zhong)疾(ji)合(he)同(tong)規(gui)定(ding)的(de)範(fan)圍(wei)內(nei)才(cai)可(ke)得(de)到(dao)賠(pei)償(chang)。因(yin)此(ci)，我(wo)們(men)在(zai)投(tou)保(bao)時(shi)，要(yao)留(liu)意(yi)保(bao)險(xian)合(he)同(tong)中(zhong)加(jia)黑(hei)、加粗、放大等特殊字體，尤其是保險合同中的免責條款，看清楚保險合同再簽訂，避免影響到後期的保險理賠。
寫在最後
消xiao費fei者zhe在zai購gou買mai保bao險xian之zhi前qian，要yao先xian了le解jie自zi己ji的de真zhen實shi需xu求qiu和he保bao費fei預yu算suan，在zai預yu算suan允yun許xu條tiao件jian下xia，選xuan擇ze適shi合he的de保bao險xian公gong司si和he保bao險xian產chan品pin。等deng到dao投tou保bao環huan節jie的de時shi候hou，也ye要yao仔zai細xi閱yue讀du保bao險xian條tiao款kuan、如實做健康告知，投保後也要妥善的保管好相應的資料。好啦，今天分享到此結束，希望這篇文章能夠對你有所幫助。
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