On Feburary 15, sichuan Chengdu citizen thanked a gentleman to take young son young wise man (alias) the examination result such as medullary puncture, basic diagnose fastens leukaemia for acute marrow. Thank a gentleman to remember, ever bought overweight disease risk to the son, but when putting forward manage compensate to insurance company, be informed however, because young wise man does the time of the examination to be in " 90 days await period " inside, cannot manage compensate, can do the processing that remove fee only.
22 days, insurance company reply expresses, the client is in contract become effective 3 be in hospital inside 90 days, many is diagnose, specific description each are not identical, belong to special case, evaluating in new examine and verify in, follow-up meeting agrees by the contract appropriate is handled.
Bought serious illness risk to the son
Diagnose leukaemia however by rejecting claims
Thank a gentleman to tell red star news, 2018 male on November 14, when young son young wise man still does not arrive 1 year old, wife tall lady bought the insurance item of some insurance company for him, cast among them protect advocate of danger keep the specified number basically for 1.2 million, those who add lengthen risk is basic keep the specified number 1.2 million, two insurance premium add up to ten thousand eight hundred yuan. Time of contract become effective is on November 14, 2018 19:19 minutes.
On Feburary 5, because young wise man has a fever to be sent hospital of center of children of woman of the Chengdu City to check cure repeatedly.
Thank a gentleman to say, on Feburary 11, the doctor suggests to make further examination to the child, want to do lumbar puncture and medullary puncture. On Feburary 12, because draw-out example is not good, the doctor does medullary puncture again, example is mixed inside the courtyard respectively send toward Beijing orgnaization to check. On Feburary 14, thanked a gentleman to take the inspection report inside the courtyard, the result shows " medullary elephant considers AML (leukaemia of acute marrow cell) " , on Feburary 15, send outside examine to show as a result for " AML, M7? (inaccuracy is decided) " , the hospital continued to do immunity for young wise man cent, the examination of the project such as chromosome, judge integratedly.
On Feburary 21, illness of issued be in hospital diagnoses the hospital prove to show, diagnose for " acute marrow is cellular leukaemia (M7) , purulent poisonous disease " .
Thank a gentleman to say, according to each examination of 15 days, the doctor can decide basically what young wise man suffers from is leukaemia, two this ability remember husband and wife, once bought overweight disease risk to young wise man, leukaemia accords with one of 80 kinds of of a safeguard major diseases, "The disease related to malignant tumor " , immediately contacts insurance company to deal with manage compensate.
But 20 days, the staff member reply of insurance company expresses, the circumstance of young wise man is belonged to in " await period " inside diagnose, cannot manage compensate, can stop only, reimburse insurance cost.
Interrogative: Await period regulation " come on first and classics hospital diagnose "
Be be in order to make examination time to be allow or issued in order to check a result accurate?
Thank a gentleman to express, the staff member of compensate of insurance company manage explains, the diagnose time that is basis young wise man is pushed, 15 days of hospitals issued relevant examination result, the examination time of young wise man was on Feburary 11, and on Feburary 11, it is guarantee slip become effective the 89th day after fitly, still awaiting period inside, the basis is accordingly safe contract, cannot manage compensate, can do only retreat protect processing.
20 days, insurance company with circumstance of this guarantee slip " belong to " love full marks weighs disease " agree in the contract ' await period ' during the insurance accident inside " make guarantee slip stop processing, in reimbursing insurance premium the bank to get stuck.
But thank a gentleman to say, oneself do not agree with such explanation and insurance company one-sided to remove stoutly the behavior of the contract, because guarantee slip is medium, about awaiting period the explanation is: "From become effective of this additional risk contract (or finally answer effect) sun rises 90 days inside, insurant comes on first and be agreement of this additional risk contract via hospital diagnose " major disease " or " specific spend serious illness gently " , we (insurance company) do not assume insurance responsibility, the insurance premium of this additional risk contract that will return your place to pay, this additional risk contract termination. Advocate danger contract is stopped at the same time, return what what you pay advocate danger contract insurance premium. Time of these 90 days is become await period. Time of these 90 days is become await period..
About " come on first and classics hospital diagnose " , thank a gentleman to think, diagnose time should be a report issued time, is not the time that takes sampling to make an inspection originally, according to the inspection report of young wise man, this time is on Feburary 15, had exceeded 90 days " await period " .
21 days, in the paper quality that gets insurance company " manage compensate decides advice note " hind, thanked gentleman and wife to put forward appeal to insurance company.
Insurance company replies
Special case new examine and verify is evaluated
22 days, insurance company reply expresses, "Come on first and classics hospital diagnose " the fixed clause in be insurance contract, company general is carried out strictly according to the contract.
The client is in contract become effective 3 be in hospital inside 90 days, many is diagnose, specific description each are not identical, belong to special case, occurrence controversy.
Policy-holder offerred two new hospital illness prooves on March 21, expressive manage compensate appeals to beg demur, the company already was accepted, evaluating in new examine and verify according to new material at present in, follow-up meeting agrees by the contract appropriate is handled.
To contract become effective 3 be in hospital inside 90 days are recorded, thank a gentleman to express, on November 18, 2018, casting namely after protecting 4 days, because young wise man has eczema, family takes him to had gone to a hospital to had made series examination and treatment, diagnose reduces disease for immunity plaque, have hospitalization record truly early or late, but this disease is not in category of safeguard of serious illness risk.
Chengdu business signs up for - Yu Zunsu of red star journalist
