Per reporter: Tu Yinghao Yuan Yuan Per editor: Liao Dan
"59 yuan epidemic prevention insurance, home isolation for 1 day can receive 200 yuan, a cup of milk tea money guarantee for one year!"
With the severe situation of epidemic prevention and control, many insurance companies have launched so-called isolation insurance, which has low prices and convenient purchases, and has quickly harvested a large wave of traffic on social platforms.
However, with some consumers complaining that it is not "isolation can be settled", the voice of isolation insurance "easy to buy and difficult to lose" has gradually increased. The "Daily Economic News" reporter searched for "isolation insurance" on a complaint platform and found that it is common for consumers to deviate from the identification of insurance companies for "triggering" claims.
Is quarantine insurance a gimmick? The "Daily Economic News" reporter learned in the interview that the industry generally believes that isolation insurance has a certain protection need. An industry insider said that the original intention of insurance companies in designing products is to respect and protect the legitimate rights and interests of policyholders, "isolation insurance" insurance types and liabilities are relatively new, and the insurance liability, coverage scope and protection period of each product are different, and the insured still has to apply for insurance according to their real needs.
Xu Yuchen, a senior actuary, believes that as a customer acquisition product, isolation insurance is intended to narrow the distance between insurance companies and customers, and some insurance companies fail to achieve specialization and refinement in product design and operation, such as not making clear and clear provisions on common problems of isolation, it is easy to cause insurance claim disputes, causing damage to the company's brand and even the industry image, which is more than worth the loss.
Isolation insurance: It is actually an accident insurance with additional isolation liability
As early as February 2020, at the press conference of the joint prevention and control mechanism of the State Council, Liang Tao, vice chairman of the Banking and Insurance Regulatory Commission, said that in order to prevent infringement of consumer rights and interests, the CBRC prohibited insurance companies from developing single liability products such as exclusive new crown pneumonia insurance to prevent the emergence of insurance products that use the epidemic as a marketing gimmick. So what exactly is "quarantine insurance"?
The common "quarantine insurance" on the market is often accident insurance within one year. After the outbreak of the new crown epidemic, many insurance companies responded to market changes and customer needs, while bearing accident liability, expanded the coverage of insurance accidents caused by the new crown virus, which also included the allowance of compulsory isolation due to the new crown pneumonia prevention and control policy, so it is commonly known as "isolation insurance" by consumers.
The "Daily Economic News" reporter learned that since the fourth quarter of last year, affected by the rebound of the epidemic, coupled with the advantages of simple insurance, flexible protection period, and close to the people, isolation insurance has been sold on major travel platforms and third-party websites. Taking the third-party platform Huixue as an example, the average monthly insured number of related products has exceeded 60,000 since the fourth quarter of last year.
The common form of quarantine insurance on the market is accident insurance within one year. Including Taiping Property & Casualty Insurance, Modern Property & Casualty Insurance, and Zhonghui Property Mutual Insurance, many insurance companies have related products for sale. "Isolation insurance is a scenario-based accident insurance product." An insider of a property insurance company said in an interview with the "Daily Economic News" reporter that isolation insurance is not a type of innovative insurance, and the isolation insurance products designed by his company have been sold for more than two years, during which they have also undergone many iterations.
Although its essence is that accident insurance products have additional isolation liability, marketers often use "isolation compensation" as a selling point to promote when promoting products. The "Daily Economic News" reporter noted that taking a company's product as an example, the "isolation subsidy of 200 yuan / day" on its sales page was boldly marked, in fact, the product protection scope also includes accidental risk and new crown death protection of 100,000 yuan, as well as a maximum of 3,000 yuan of new crown pneumonia diagnosis allowance.
Industry: Two major reasons for the "difficulty of settling claims" problem
"At the end of last year, when I bought a ticket on the travel platform, I bought the isolation insurance of an insurance company. The insurance page indicates that there is a subsidy of 1,000 yuan / day for those who are centrally isolated due to the contact between transportation and new crown patients. When I filed my claim, I found that the free segregation was listed as a deductible liability in the terms. In the epidemic prevention policies of many places, the dense centralized isolation is free isolation. Consumer Xiao Li complained on a platform.
The "Daily Economic News" reporter noted that similar complaint cases related to isolation insurance are not uncommon, according to the reasons for the insurance company's refusal to claim, the case that seems to "trigger" the claim conditions is actually a situation of exemption clause.
"The first feeling that isolation insurance gives consumers is that as long as they are isolated, they can pay, but whether they can pay depends on the exemption of liability." Zhu Junsheng, research director of the China Insurance and Pension Research Center at Tsinghua University's Wudaokou School of Finance, told the Daily Economic News that the difficulty of settling claims for isolation insurance is mainly caused by two reasons:
First, the average premium is low, taking a low-priced aviation accident insurance as an example, the product contains a maximum of 20,000 yuan of isolation allowance, so the insurance company has made a stricter limit on the insurance liability;
Second, consumers need to provide proof of isolation and may encounter problems in real life. Therefore, in addition to clearly informing the scope of insurance in the publicity, the insurance company should also highlight what is not insured, and the insurance exemption is also a requirement of the insurance law, so that consumers can make a comprehensive balance before deciding whether to buy.
Xu Yuchen also believes that for insurance companies, first of all, it is necessary to clarify the insurance terms, for the insurable and uninsurable situations must be clear; secondly, to list the common problems on the sales page one by one, such as: whether it is a claim that is forced to be centralized and isolated as a sub-close connection, in actual operation, the city has different standards for the division of medium and high risk, and can clearly inform consumers of the claim conditions according to the situation of the specific city; in addition, in the claim process, it can also be according to the different requirements of different cities. List the documents that need to be provided by way of examples to make the product more professional and refined.
Big data risk control prevents adverse selection risks
Industry insiders also stressed that for consumers, when purchasing insurance, they must be based on their own needs, and they must also pay attention to the responsibility of insurance contracts. Wang Yin, general manager of Huixue Life Insurance Commodity Center, said in an interview that because the forms and responsibilities of such insurance types are relatively innovative, there are indeed some vague or confusing places in the sales and claims process. Wang Yin suggested that consumers should pay attention to the following issues when applying for insurance:
First, whether to meet the insurance rules, such as occupation, insurance region, number of shares and other requirements, such as before a customer has been in a medium and high-risk area and still bought this product in the isolation area, the insurance company will refuse compensation;
The second is to focus on the special agreement of the product and the exemption clause of liability, some customers refuse to claim because the policy specially states that the isolation allowance is compensated according to the policy dimension, rather than according to the number of copies of the policy, and the same policy even if it contains 5 parts, it is also paid according to the sum insured amount of 1 part, and for the other 4 compensation claims claimed by the customer, the insurance company refuses to claim according to the special contract;
Third, the information provided at the time of claim must be complete and meet the conditions for the claim, and some customers have been denied compensation because the quarantine certification documents submitted are issued by unofficial institutions.
"Daily Economic News" reporter learned from the latest in the industry that as of now, some companies have removed the "isolation insurance" related products, but the reason for the removal is temporarily unknown.
From the pricing of isolation insurance products, it is currently generally in one or two hundred yuan, and many products are only tens of yuan. Xu Yuchen believes that in terms of pricing, if the isolation insurance can achieve the purchase of the whole people, it is a profitable business. However, due to the existence of adverse selection risks, people in low-risk areas of the epidemic are not very motivated to apply.
Some insurance company insiders frankly admitted in their exchanges with reporters that as far as the isolation insurance business is concerned, there are many people who hold the mentality of drilling loopholes or even cheating insurance when applying for insurance. The reporter searched for "isolation insurance" on a social platform and found that there were thousands of relevant information, and even some people said that the minimum 9 pieces of 9 isolation insurance lay to earn, earning hundreds of yuan a day, and the wool should be shaved early!
In order to prevent the risk of adverse selection, insurance companies have also set up insurance rules accordingly, such as the isolation allowance insurance on the market basically takes effect after two days. In Xu Yuchen's view, insurance companies can also divide high-risk areas more carefully through big data risk control to prevent the risk of over-indemnity.
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