Consumers should truthfully inform their health status when purchasing life insurance products, especially when purchasing health insurance products such as critical illness insurance and medical insurance.
"Health notification" is very important for both consumers and insurance companies, if consumers conceal something when applying for insurance, and need to make a claim later, they may be rejected by the insurance company because they do not truthfully disclose their health status at the time of application.
So, what is a "health notification"? What should I do if I don't fill in the health notice truthfully when applying for insurance? Let's take a look at it today.
1What is Health Notification?
Health notification is a health notice that the insurance company requires the insured to fill in the relevant content in order to understand the insured's physical health status, living habits and other information. During the insurance process, you need to fill in the relevant questionnaire according to the regulations of the insurance company to inform you, and the insurance company will underwrite the insurance according to the health notice.
2. What does the health notice generally include?
Health notices generally include: height, weight, smoking and drinking habits, past medical history, family medical history, medication and ** conditions, disease or surgical diagnosis records, etc.
3. Tips for filling in the health notice
When filling in the content of the health notice, we must follow the "principle of maximum integrity" and tell the truth. At present, the general notification method in the domestic insurance industry is limited inquiry and notification, that is, the policyholder or the insured bears the obligation to inform the matters that he knows or should know, and the insurance company informs the content of the inquiry truthfully, and does not need to inform if there is no inquiry.
So, speaking of which, there may be doubts among consumers, if a health examination is carried out in accordance with the requirements of the insurance company when purchasing insurance, can it be done without health notice?
Interpretation (III) of the Supreme People's Court on Several Issues Concerning the Application of the Insurance Law of the People's Republic of China
Article 5 When an insurance contract is concluded, if the insured undergoes a physical examination at a designated medical service institution at the request of the insurer, and the parties claim that the insured is exempted from the obligation to truthfully inform them, the people's court will not support it.
Where the insurer knows the results of the insured's physical examination, but still requests to terminate the contract on the grounds that the insured has not fulfilled its obligation to truthfully inform the relevant circumstances, the people's court will not support it.
In other words, consumers can't think of holding the mentality of "I have a physical examination anyway, you can read the physical examination report yourself" and not tell the truth, or perfunctory health notice; Truthful disclosure is not only responsible for the insurance company, but also responsible for oneself, otherwise, it will be deemed that the obligation to inform has not been fulfilled.
4What are the possible consequences of not telling the truth?
About 80% of the annual denials by insurance companies are due to the failure to truthfully inform the claims at the time of application.
If you have a fluke mentality, even if you successfully underwrite, when applying for a claim, if the insurance company finds that the insured does deliberately fail to tell the truth before applying for insurance, it can refuse to pay in accordance with the relevant provisions of Article 16 of the Insurance Law of the People's Republic of China.
Article 16 of the Insurance Law of the People's Republic of China stipulates that if an insurance contract is concluded and the insurer makes inquiries about the subject matter of the insurance or the relevant circumstances of the insured, the policyholder shall truthfully inform the insured.
If the policyholder intentionally or due to gross negligence fails to perform the obligation of truthful notification as provided for in the preceding paragraph, which is sufficient to influence the insurer's decision on whether to agree to underwrite or increase the insurance rate, the insurer has the right to terminate the contract.
The right to terminate the contract provided for in the preceding paragraph shall be extinguished if it is not exercised within 30 days from the date on which the insurer becomes aware of the reason for termination. If more than two years have elapsed since the date of the conclusion of the contract, the insurer shall not terminate the contract; In the event of an insured event, the insurer shall be liable for compensation or payment of insurance money.
If the policyholder deliberately fails to perform the obligation to truthfully inform, the insurer shall not be liable for compensation or payment of insurance money for the insured accident that occurred before the termination of the contract, and shall not refund the insurance premium.
If the insured fails to perform the obligation of truthful notification due to gross negligence, which has a serious impact on the occurrence of the insured accident, the insurer shall not be liable for compensation or payment of insurance money for the insured accident that occurred before the termination of the contract, but shall refund the insurance premium.
If the insurer is aware of the failure of the policyholder to truthfully inform the insurer at the time of conclusion of the contract, the insurer shall not terminate the contract; In the event of an insured event, the insurer shall be liable for compensation or payment of insurance money.
5 What should I do if I do not fill in the health notice truthfully when applying for insurance?
If the consumer has purchased an insurance product that has been covered, due to a moment of negligence, there are some health abnormalities that are not truthfully informed, and it takes a while to realize the importance of truthful disclosure.
In this case, the policy can be remedied by "supplementary notification" to the insurance company, and the policyholder can further supplement the content of the questions asked at the time of insurance application, such as the failure to inform the information, the notification is not detailed, or the notification is biased. After the supplementary notice, the insurance company will re-examine the original insurance contract of the policyholder.