Why is it often said that insurance is ten buy nine pits? Why is it often said that insurance does not pay that it does not pay?
After reading this article, you must be like a mirror.
Many people actually trust the role of insurance, but they are afraid of the endless routine of insurance.
In fact, as long as you find the right way and avoid the pit, it is not difficult to buy the right insurance.
The purpose of the master brother is very simple, that is, I hope that you will no longer be led by the nose of the salesman, and you can better control and make good use of insurance.
The following figure is a summary of the "four major pits" of insurance since I entered the industry:
A few days ago, I have introduced the first two pits of insurance common, (there is a link at the end of the article, you can jump to view)
Today I will continue to explain the other two "big pits", and I will also sort out these pits one by one, so that insurance can meet with you naked.
First, the pit of the four major types of insurance
The four most needed and practical insurance plans for ordinary people: million medical insurance, critical illness insurance, accident insurance, and term life insurance.
Medical insurance: can resist the risk of serious illness, dozens of millions of hospitalization costs can be covered;
Critical Illness Insurance: Can be used to cover the loss of income caused by serious illness, used for nursing expenses, daily expenses, etc.;
Accident insurance: can cover large and small accidents in life, injury, disability, death are within the scope of protection;
Term life insurance: only the death and total disability are insured, mainly to cope with these extreme situations of "no one to feed the child, no one to support the parents, and the family to fall apart".
It can be seen that insurance is closely related to our lives, and it can also escort our life, old age, illness and death.
However, although insurance is useful, it is clear that many people have been frightened and would rather not buy it than wade through this muddy water.
To this end, Master Brother has picked up the pits of the four major risks in one go, and has filled in 95% of the pits for you.
The pit marked in red in the font, we have all previously demonstrated the case in one fell swoop, and will not expand on it.
The thick font mark pit will seriously affect the conclusion of the claim, and the master brother will start to elaborate.
As for the other pits, although the impact is not large, it is also necessary for everyone to understand.
Without further ado, let's take a look at them one by one
1. Serious illness insurance
Critical illness insurance is one of the most criticized types of insurance, and a single denial case can stir up thousands of waves.
The voice of "this does not pay, that does not lose" of serious illness insurance spread all over the sky.
The pits of critical illness insurance come half from protection and half from terms.
Let's take a closer look:
(1) Guarantee the shortage of two pounds
In addition to the 28 statutory serious diseases, the CBRC also stipulates 3 statutory minor diseases: malignant tumors - mild, mild acute myocardial infarction, mild stroke sequelae, all major illness insurance must include these diseases, and the claim conditions are exactly the same.
But in fact, the highest incidence of mild/moderate diseases is far more than 3, according to the previous experience of the master brother, there are 12 kinds.
For example, mild diseases will be seen without carcinoma in situ, coronary intervention, chronic renal failure, etc.
Moderate symptoms are generally seen without moderate stroke sequelae, moderate area burns, etc.
If some products cut corners and reduce one or two kinds, it will inevitably affect our claim probability.
(2) Diagnosis can be compensated
Serious illness insurance, the original meaning is very simple, get sick to lose money.
However, in practice, it is a difficult process, and various denial plots are staged.
Therefore, some netizens summed up a reasonable quote: It is true that 80% of people will get serious illness in their lifetime, but it is difficult for you to become sick as required by the contract.
Serious illness insurance is to lose money when you get sick, but it is not to lose money when you are diagnosed!
Of the 28 common serious diseases stipulated by the CBIRC, the claim rate accounts for 95%, of which 3 diseases are diagnosed and compensated, 6 diseases are operated to compensate, and 19 diseases can be compensated if they reach the agreed state of the disease:
Of course, you don't have to worry that such compensation conditions will be too harsh, after all, the probability of malignant tumor claims in the diagnosis and compensation is 60%-90%; and this is also the industry rule.
There is a saying in the industry: to buy serious illness insurance is to buy terms. Only in this way can serious illness insurance really play its role.
In addition to the above two kinds of large pits, in terms of protection, there are also some pits with less impact, such as:
(3) Serious illness insurance must protect the death, and you can get money without getting sick
Does critical illness insurance protect death? It's always been a hot topic.
The master's advice is that if the budget is sufficient, it can be added; if the budget is limited, the combination of critical illness insurance + term life insurance will be more cost-effective.
(4) The more serious diseases, the better
No, the statutory 28 high-incidence serious diseases, the claim rate has accounted for 95%, and the excess diseases are just indiscriminate.
If you encounter this kind of propaganda: "More than 700 kinds of serious illness insurance!" Except for the nails, hair and teeth are not protected, everything else is guaranteed", then we must be careful, not pit or deceive.
(5) The number of times the major illness claim must be paid, the better.
In fact, it is a good thing to pay multiple claims for serious illnesses, a long life, no one can be sure of the number of serious illnesses and cancer; but to consider the budget, if in the case of the same premium, buying a higher sum insured is more practical than multiple claims.
Of course, the number of times of serious illness compensation is not as much as possible, it is not easy for people to get two serious illnesses in a lifetime, and most of the serious illness insurance that can lose five or six times is just a gimmick.
(6) Grouped multiple times to pay for serious illness insurance, cancer is not grouped separately.
For major illness insurance that is grouped multiple times, only one of the diseases in the same group can be covered.
Therefore, the more dispersed the high-incidence severe illness grouping, the higher the probability of multiple claims; if cancer is grouped with other high-incidence serious diseases, the probability of consumers making secondary claims will be greatly reduced.
The text is a bit awkward, you can directly look at the picture:
As mentioned above, product A has a higher probability of claims than product B, because the malignant tumors of product A are grouped separately, and the high incidence is also relatively scattered.
2. Medical insurance
Medical insurance is a type of reimbursement insurance, and if the conditions are met, how much reimbursement is spent.
However, there are also many factors that affect reimbursement, such as not being covered, going to the wrong hospital, and so on.
Moreover, a very important dimension of evaluating a medical insurance is "renewal", and insurance companies are also easy to bury pits.
Let's take a look at it together:
(1) The basic guarantee is less than two pounds
There are 4 basic benefits of million medical insurance: inpatient medical treatment, special outpatient treatment, outpatient emergency before and after hospitalization, and outpatient surgery.
Normally, these four benefits are mandatory for all million medical insurance plans.
If any of the above guarantees are missing, then the basic guarantee of this product is directly unqualified.
For example: Zhen X Infinite Medical 2021, lack of outpatient surgery; Beijing X Life 2020, lack of outpatient surgery and hospitalization before and after outpatient emergency.
(2) Can be renewed for a lifetime
Many people have been misled by this kind of product, on the one hand, listening to the flickering of the salesman, on the other hand, seeing the words 99 years old and 100 years old in the terms, they believe it.
However, this is not the case, and there is a major bug in such a renewal clause: that is, "discontinuation", and the product cannot be renewed after it is discontinued.
Some time ago, Too X Life made a fuss, I don't know if you have an impression;
The company's agent claimed that its own medical insurance can guarantee the renewal of the insurance to 80 years old/ 100 years old, and after the subsequent products were discontinued, there was an incident that shocked the whole network of "agents denouncing their own companies".
This is the pot of the insurance company, when the training is given to inform the agents that they can always renew the insurance; but the terms are in black and white, and the agents do not have a close look?
In short, so far, there is no million medical insurance that can guarantee a lifetime of renewal, the longest is only 20 years.
And we also have to look for the four words "" in the renewal clause, even if the product is discontinued, the 20-year guarantee will not change.
Therefore, if someone bullies that millions of medical insurance can be renewed forever, don't be fooled.
(3) Purchased drugs are not guaranteed
Millions of medical insurance is undoubtedly a type of insurance that has been very popular in recent years, and hundreds of pieces of leverage have leveraged millions.
However, while the guarantee is becoming more and more homogeneous, "purchased drugs" has become a bright guarantee to open up the distance between products.
Although many targeted drugs for the treatment of cancer are included in the medical insurance list, these drugs are generally out of stock in major hospitals, and medical insurance is not 100% reimbursable.
The importance of purchased drugs is self-evident, but there are still many products that lack this protection, such as: National X such as E Kangyue C, Ping X e Shengbao 2020, etc.
In addition, the following medical insurance precautions should also be known:
- The lower the deductible, the better, not necessarily, 10,000 deductible is the standard of most medical insurance, although there are 0 deductible million medical insurance, but the price will also double; and 0 deductible million medical insurance, renewal is not stable.
- Reimbursement is not limited to hospitals, go to the wrong hospital may directly refuse to pay, most millions of medical insurance can only be reimbursed
- Important protection limits, such as Tai X every year, are buried in special outpatient clinics, and the most expensive chemotherapy, radiotherapy, targeted therapy and other projects for the treatment of cancer can only be reimbursed up to 200,000 yuan per year.
- Can not advance medical expenses, tens of thousands of hospitalization costs, many people are difficult to bear, if the insurance company can advance payment, it will solve our worries; this protection is generally in the value-added services, there is no pity.
3. Accident insurance
Accident insurance is simple and the premium is cheap, but it is not just a matter of buying one.
I've seen a one-word difference denied, and I've seen someone who falls off a tall building that doesn't meet the definition of height and is denied compensation.
The cheapest, cat greasy and many kinds of insurance, let's pick up the pits:
Accident insurance has three core benefits: death/disability/accident medical treatment, one of which is indispensable.
However, not all accident insurance plans are designed to be so satisfactory, and some accident insurance plans will lack accidental medical and disability coverage.
Although the accident is not fatal or injured, after all, the injury accounts for the majority, and the master brother has handled many claim cases, and it is also the bumps and bumps in life.
Therefore, the role of accidental medical treatment is self-evident.
Some products are more alternative, do not cover disability, only total disability can be paid, basically to achieve "blindness in both eyes" or "paralysis of the whole body" state.
Disability coverage, as the exclusive trump card protection of accident insurance, is not a sinkhole.
Most of the accident insurances that lack protection occur in offline products, such as: Ping X Life is 100% safe and 100% safe, and China X Life is one million as expected.
(2) A lot of cat grease is hidden in the special agreement / insurance instructions
90% of the denials of accident insurance are hidden in special agreements and inside;
Most salespeople will not mention it, which will cause you to ignore it, and eventually cause a denial of compensation.
This refers to only some products, taking a product term as an example:
The most impactful of these are Articles 3 and 7.
3) There are restrictions on falling from a high altitude
The altitude here is defined as more than 10 meters, which is almost three stories high.
This means that if you crash on the 4th floor, more than 10 meters high, you will not lose a penny for the accident insurance you bought.
If we go on a mountaineering trip and accidentally fall to our feet, we will be ruthlessly refused compensation.
Because the insurance company may not be able to figure out whether you are out of step or maliciously fraudulent.
There are also products with a height of 3 meters or 5 meters, which we must pay close attention to.
4) Bicycle accident, drowning death, the sum insured is halved
Bicycle accident, drowning death, the sum insured is only half of the compensation.
Insurance companies make such regulations, most likely to avoid moral hazard, in case someone uses a high-altitude fall to commit suicide, or drowning to cheat insurance.
But for other people who want to get an accident protection, it is really unfair; fortunately, some accident insurance products now have no special agreement on these two items, and everyone can pay attention to it when buying.
In addition, the following precautions for accident insurance should also be understood:
- Accident insurance has high requirements for occupation, although most accident insurance does not have health information, but the requirements for occupation are extremely high, after all, the risk of firefighters and traffic police is much higher than that of office white-collar workers.
- Sudden death, heat stroke, individual food poisoning... Accidents in insurance always meet four conditions: and most of these accidents are caused by illness. However, many accident insurance now have sudden death protection attached to it, which can be paid special attention.
- There are many insurance requirements, and some products have health notices; annual income will be asked, such as annual income less than 100,000 can not be bought; there will be insurance limits, such as Little Bee No. 2:
- Some hospitals are not insured, and when an accident occurs, hospital treatment in some areas cannot be reimbursed, such as Beijing's Pinggu District, Huairou District, Miyun County, etc.; because insurance fraud incidents often occur in these areas, insurance companies blacklist these hospitals in order to avoid the recurrence of such incidents.
4. Term life insurance
Life insurance is the simplest, only protecting death and total disability, and there are not so many pits.
But there are some caveats that we cannot let our guard down.
Some strange products are not protected and disabled, such as: Ping X Life Xiao Anding Shou.
This means that if the following total defects occur, the product will not lose a single point.
The difference between total disability and death is still quite large.
(2) Disclaimer of Warranties
Although life insurance is simple and only covers death and total disability, not all deaths will be covered.
In the part of the exemption clause, compensation will be denied, such as: intentional injury, suicide within two years, illegal crimes, drunk driving and drug use, etc.
These denials are also reasonable, after all, insurance is not an umbrella for your crime.
However, there is one thing we should pay special attention to, drunk driving, driving without a legal and valid driving license, driving a motor vehicle without a valid driving license, most of the life insurance is not compensated, these situations are very easy to occur in our lives, we must cherish life, abide by discipline and law.
(3) There are income restrictions and insurance limits
For example, the income cannot be less than 50,000 yuan, and the cumulative sum insured of life insurance in the past cannot be higher than 3 million yuan.
Why should we review the income of the insured and limit the sum insured, in fact, in order to prevent moral hazard and fear of insurance fraud.
After all, "killing relatives" insurance fraud occurs from time to time, and the means are extremely bad.
Second, the pit of the brand
I have to say that many people's "vigilance" against insurance is used in the wrong place.
Do not care about product protection, only have a fondness for "brand";
Do not pursue economic practicality, but always believe that you get what you pay for.
Although these are also conventional concepts, they are blocked by insurance information gaps thousands of miles away.
Buy insurance, everyone does not want to spend more money, everyone hopes that the accident can be successfully settled, but it is not that the more expensive the insurance, it will definitely be able to settle the claim, there is no half-cent relationship.
Insurance is a paper contract, the compensation conditions and requirements are written in black and white in the terms, whether you can pay, depends on the terms of the agreement, not money, not the so-called large company.
However, in the end, each has its own love and opinion, and all the master brother can do is to point out the advantages and disadvantages, and it is everyone who makes the final decision.
Not only the brand theory, the reason is as follows:
1. Better protection for large companies?
Some people spent 10,000 to buy a major illness insurance, and some people spent 7,000 to match the four major insurance types.
There are not a few such cases, and many people are also bitter because of this.
It can be seen that a major illness insurance of a large factory has a premium that covers the four major insurance types.
Prices vary widely, and the guarantees vary widely, so it is really not necessary to pay for the so-called "big brands".
In addition, if you know that the registered capital of insurance companies will exceed 200 million, if you have read the annual reports of insurance companies, you may not just focus on brands.
2. Faster claims for big brands?
The key to insurance claims is to look at the terms and conditions, and it really has nothing to do with the size of the insurance company.
If the terms are met, all insurance companies will pay; if the terms are not met, no insurance company will pay.
The insurance company's claims report will explain everything:
There is data and truth, no matter how big or small the company, the odds are above 96%, and the gap between the companies is not large.
Some friends may feel that large companies value word of mouth and reputation the most, and they will pay compensation if they make a fuss, so it is very wrong to think that the insurance company is not a charity, even if it is in court, whether it should be refused or rejected, unless the facts of the case are favorable to us.
Third, write at the end
The pit of insurance, master brother summed up seven seven eight eight, help everyone avoid 95% of the trap should not be a word!
However, the master brother must solemnly state that the insurance has been cut so many pits, not to arouse everyone's anger at insurance, but to let everyone better control insurance.
We cannot ignore the pit of insurance, but we must pay more attention to the role of insurance.
The master brother team has to handle 100 claim cases every month:
Among them, behind each benefit is the hope and economic pillar of the whole family.
When we buy insurance, we do not want to get rich, but to face it more calmly after the risk comes.
So, instead of hating insurance, try to be friends with it.
However, the insurance market is inevitably mixed, in order to sell products, some salespeople will inevitably make a big fuss, exaggerate the scope of protection, exaggerate the benefits of the product; even if we do not have the ability to distinguish between fire eyes, at least we should find one or two professionals to advise you.
Code so many words, it is not easy, if there is some help for everyone, but also hope not to hesitate to give praise!
To buy insurance, you must understand two types of "big pits"! Stop being cut leeks (click to view)