Financial education is a case to explain the risk
01 The gist of the case
Accident insurance usually provides coverage in the event of injury or death caused by an accident. Accidents generally refer to sudden, unintentional, external, and objective events, and non-accidents are not covered by insurance.
02 Case Introduction
In November 2021, Chen took out the "Old Age Peace of Mind Insurance" with the insurance company, which is an accident insurance. In July 2022, Chen was farming in his own field, and his family found him kneeling in a ditch about 80 cm deep in the field, panting for air, and then immediately sent himself to Luoping Town Health Center for rescue and died after being rescued. The family reported to the insurance company in August and applied for accidental death insurance claims, and the insurance company's investigators consulted the hospital and informed the insured that there were obvious burn marks on his body at that time, and there was no obvious bleeding on the body surface, so it was inferred that the cause of death was heatstroke, and the death certificate was also registered as heatstroke, and after investigation, it was learned that Chen had a history of hospitalization such as urinary retention, neurogenic bladder dysfunction, chronic renal insufficiency, and type 2 diabetes. Because heat stroke is a type of heat stroke, heat stroke is related to individual differences, and does not meet the definition of "non-disease" in accidental injury, so the insurance company refused to pay on the grounds that the death of the insured due to heat stroke is not an accidental injury as agreed in the contract.
03 Case Analysis
Heatstroke is a condition caused by the body's inability to dissipate heat effectively when exposed to high temperatures for a long time. In hot weather, the human body will experience symptoms such as heat stroke, dehydration, and even death in severe cases. According to the insurance contract, accident insurance usually provides compensation for injury or death caused by an accident. Accidents generally refer to sudden, unintentional, external, and objective events, while heat stroke is a disease caused by prolonged exposure to high temperatures, which is a gradual development process. Therefore, by definition, heatstroke deaths do not fall under the category of accident insurance.
04 Case Enlightenment
When purchasing accident insurance, consumers should fully understand the important information such as the coverage and liability exemption of insurance products, and reasonably choose and purchase products that meet their needs. For some protection needs involving special working environments, it is recommended to choose special insurance types launched by certain insurance companies, such as high temperature insurance, heat stroke insurance, etc.