Will insurance companies compensate for the novel coronavirus? How will insurance pay for the novel coronavirus?

We all know that the new coronavirus is a relatively powerful virus recently. It is highly contagious and can be spread in various ways. Many people have been infected and sick. So if you are infected with the new coronavirus, will the insurance company pay the claim? Let's take a closer look!

Will insurance companies compensate for the novel coronavirus?

Within the scope of insurance claims, compensation can be paid. The following situations are distinguished for COVID-19 insurance claims:

Medical insurance can be compensated. Medical insurance is generally a reimbursement type. After deducting the medical insurance portion and the deductible, you will be reimbursed for how much you spend. Although the treatment costs are currently borne by the state, in the long run, it can be used to reimburse the treatment costs of sequelae and complications.

Let’s talk about critical illness insurance. If the critical illness is caused by the new coronavirus pneumonia and meets the types of critical illness stipulated in the insurance contract, then you can claim compensation. Based on the symptoms of the new coronavirus pneumonia, the most likely serious illness is deep coma. If a deep coma occurs, even if you recover later, you can apply for compensation as long as you have relevant diagnosis certificates.

However, it should be noted that critical illness insurance generally has a 90-day or 180-day waiting period. If you have already purchased it, you don’t have to worry about this. If you are a new insured customer, you need to pay attention to the fact that many companies are now more humane, such as expanding the liability of COVID-19 in critical illness.

Next, let’s talk about life insurance. If the death is caused by the new coronavirus pneumonia, life insurance will definitely pay out.

How does the novel coronavirus insurance pay?

Faced with special risks such as the pneumonia virus, socially responsible insurance companies should appropriately expand their insurance liabilities and make insurance that was originally not payable payable, rather than asking customers to buy new insurance.

Compared with the hype mentioned above, the following insurance companies’ actions are very hardcore:

Tianan Life Insurance and Sunshine Life Insurance:

If you are diagnosed with novel coronavirus pneumonia before April 30, critical illness insurance will pay 30% of the insured amount.

Hong Kang Life Insurance:

Before the end of February, if death is caused by the novel coronavirus pneumonia, the three critical illness insurance policies will pay double the insured amount.

Allianz P&C Insurance:

Before April 30, Allianz Zhenai Medical Insurance (Thanksgiving Edition) expanded the liability to provide an additional compensation of 300,000 yuan for death and disability caused by infection with the new coronavirus.

Although it’s not much, it’s a good start under the supervision.

I hope that more and more insurance companies will join in so that insurance can play its due role when facing major social events.

What procedures are required for insurance claims?

1. Filing a case for investigation

After receiving a notification of a claim, the insurer shall immediately send personnel to conduct an on-site investigation to understand the circumstances and causes of the loss, check the insurance policy, and register a case.

2. Review certificates and information

The insurer reviews the relevant certificates and information provided by the policyholder, the insured or the beneficiary to determine whether the insurance contract is valid, whether the insurance period has expired, whether the loss is to the insured property, whether the claimant has the right to claim compensation, whether the location of the accident is within the coverage area, etc.

3. Determine insurance liability

When the insurer receives a request for compensation or payment of insurance money from the insured or the beneficiary, it shall, after verifying the facts and examining various documents, promptly determine whether it should bear the insurance liability and to what extent it should bear the insurance liability, and shall notify the insured or the beneficiary of the determination result.

4. Fulfilling the obligation to pay compensation

On the basis of determining the liability, the insurer shall, within ten days after reaching an agreement with the insured or the beneficiary on the compensation or insurance payment amount, perform the obligation to compensate or pay the insurance money for the insurance liability. If the insurance contract stipulates the insurance amount and the compensation or payment period, the insurer shall perform the obligation to compensate or pay the insurance money in accordance with the insurance contract.

After the insurer fulfills its obligation to pay compensation or insurance money in accordance with legal procedures, the insurance claim is concluded. If the insurer fails to fulfill its obligation to pay compensation or insurance money in a timely manner, it constitutes a breach of contract and shall bear corresponding liability in accordance with the regulations, that is, "in addition to paying the insurance money, it shall compensate the insured or beneficiary for the losses suffered as a result". The compensation loss here refers to the interest loss on the insurance money that the insurer should pay. In order to ensure that the insurer fulfills its obligation to pay compensation in accordance with the law and protect the legitimate rights and interests of the insured or beneficiary, it is clearly stipulated that no unit or individual may illegally interfere with the insurer's obligation to pay compensation or insurance money, nor restrict the insured or beneficiary's right to obtain insurance money.

Is there a time limit for insurance claims?

Insurance claims are subject to time limits, which include restrictions on the insured party - the time limit for making claims, and restrictions on the insurance company - the time limit for making claims.

Let's first look at the statute of limitations for claims. First of all, for the insured party, when an insurance accident occurs, it is necessary to actively apply for compensation within the specified period. If the specified time is exceeded, it will be regarded as a waiver of rights.

The time limit for claiming varies depending on the type of insurance. The time limit for claiming for life insurance is 5 years. If you do not file a claim after 5 years, it will be deemed as an automatic waiver. The time limit for claiming for other insurance is generally 2 years.

The 5 years and 2 years here are calculated from the date when the insured or beneficiary knows the occurrence of the insurance accident.

Let’s look at the statute of limitations for claims. There are three time-related provisions in the statute of limitations for claims. They are:

A determination conclusion will be issued within 30 days, which means that once the insured party makes a claim, the insurance company shall make a determination within 30 days after confirming receipt of the corresponding claim materials and shall notify the other party of the determination result in writing.

Payment of compensation within 10 days means that for those that fall within the scope of insurance liability, the insurance company will pay the compensation within 10 days after the compensation agreement is reached.

A claim rejection notice will be issued within 3 days, which means that for claims that are not covered by insurance, a claim rejection notice and reasons should be issued within 3 days from the date of determination.