Some consumers have difficulty in making claims when purchasing "isolation insurance"

Experts point out that insurers should prominently state disclaimers rather than selective publicity

  News from this newspaper (Reporter Qu Xinyue) Affected by the recent new crown epidemic in Shanghai, Beijing and other places, the once popular "isolation insurance" has recently entered the peak period of claims acceptance.

However, many consumers found that the insurance company refused to pay because they were not in the medium and high risk area or could not prove that it was a close connection.

In this regard, industry experts believe that insurance companies should fulfill the responsibility of explaining the exemption clauses when promoting products, and insurance companies should not make selective publicity when selling such products.

  Recently, after more than a month of repeated communication and negotiation, Ms. Huang, a Shanghai consumer, finally received part of the compensation for the "isolation insurance" she purchased earlier.

"Although there is still a big gap between the money I got and the original agreement, I really don't have the energy to continue to toss." Ms. Huang said helplessly.

  According to the contract terms of the insurance product purchased by Ms. Huang, the premium is 59 yuan for one year, and the allowance for compulsory isolation due to the new crown pneumonia epidemic is 200 yuan per day, with a maximum compensation of 30 days.

However, in the process of handling the claims for Ms. Huang, the insurance company has repeatedly refused to pay the claims on the grounds that the quarantine area where she is located is not a medium-high risk area.

  Reporters searched on consumer complaint platforms and social platforms and found that there were not a few consumers who had the same experience as Ms. Huang.

The main reason for disputes is the refusal of compensation because they are not isolated in the medium and high risk area or unable to provide proof of close connection.

  In this regard, He Xiaowei, head of the Department of Risk Management and Insurance of the School of Insurance at the University of International Business and Economics, told reporters that although "isolation insurance" is a new product, its essence is a kind of compensation that takes the loss caused by the occurrence of a specific event as the object of compensation. property insurance.

As the seller of the product, the insurance company must explain the disclaimer clause in the obvious position of the contract, so that the consumer can clearly know which losses are insurable and which are not.

  Some consumers said that the purchase of "isolation insurance" was influenced by the product slogan.

For example, some insurance products say "home isolation has allowances", while other products emphasize "you can get 200 yuan per day in isolation, and a cup of milk tea can be guaranteed for one year" in a prominent position on the purchase interface.

  "For the purpose of attracting consumers, some insurance companies do not put the exemption situation in a very conspicuous position, which lays a hidden danger for future claims disputes." He Xiaowei believes, "When selling such products, insurance companies do not There should be selective promotion. If you always bring this kind of bad consumer experience to consumers, it will inevitably have a negative impact on the company's own brand and the social identity of the insurance industry as a whole."

  The reporter noticed that relevant regulatory authorities and industry associations have begun to regulate "isolation insurance".

For example, the China Banking and Insurance Regulatory Commission issued a document requiring that in the process of publicizing and selling "isolated insurance" products, insurance companies shall not make misleading publicity or explanations on important situations such as insurance products' liability for protection by means of deception, concealment or inducement. .

  "The emergence and recurrence of the epidemic in Shanghai, Beijing and other places has caused the event of isolation claims, which was originally a small probability, to appear continuously, and the claims have increased significantly, exceeding the insurance company's claims expectations, so they have fallen into a relatively passive situation. I believe that insurance companies will also be in a passive situation. The compensation standard of insurance products will be adjusted." He Xiaowei said.