"COVID-19 Insurance" was once the best-selling "network celebrity product" of various insurance companies. In order to seize the market, once a hundred flowers blossomed and competed for each other. Now the insurance has been taken off the shelf urgently, and it has become a "chicken feather in one place".
Public reports show that many policyholders in various places complain that it is difficult to settle claims because they cannot provide a "confirmed certificate". A doctor issued a diagnosis certificate, stating "novel coronavirus infection was confirmed", but the insurance commissioner told them that they would be infected with the lungs. After others diagnosed COVID-19 and submitted claims to customer service, it was too late to wait for the adjuster. What is even more incredible is that China Life's customer service said that "Omicron does not belong to COVID-19" and was once ranked first in hot search.
Today, Zhu Taiyang's COVID-19's illness is coming to an end, and his road to claim compensation has just begun.
Next, reporter Zhu shares his claim story.
Yang, I remember the insurance I bought before.
Many years later, I will still remember that cold night, burning pain all over, waiting in line all night and other diagnostic certificates. This year, Messi and I won the championship at the same time. He won the World Cup, I won the COVID-19, he won the World Cup and I took the thermos.
I still couldn't escape the epidemic that lasted for three years.
On February 7th, 65438, the joint prevention and control mechanism of the State Council issued the Notice on Further Optimizing and Implementing the Prevention and Control Measures of COVID-19, further optimizing the prevention and control measures of COVID-19, and adjusting the prevention and control policies of various places.
In less than a week, I was herding sheep in Beijing. At that time, my symptoms were fever and ache all over, and the antigen test showed "two bars".
At this time, the story of my first settlement with the insurance company began.
Like many young people, I usually have the habit of buying insurance. After Yang left, my first reaction was, "I may get rich" because I bought an insurance policy. I shared this matter in the department group and said that I must invite my dear colleagues to dinner. I was secretly happy at that time: this time, my preventive measures finally came in handy.
Reporter Zhu's departmental group chat record
In March this year 16, I insured myself with a COVID-19 isolation allowance version of Taiping Property Insurance on Alipay platform. The coverage includes "the total disability protection amount in novel coronavirus is 654.38 million yuan", "the diagnosis allowance in novel coronavirus is 20,000 yuan" and "the centralized isolation allowance in COVID-19 is 2,800 yuan". 69 yuan premium, insurance period 1 year.
This is my second COVID-19 insurance. The previous one just expired, which is another company's insurance, and it is also one year. Because I often need to contact people or things from all walks of life, what I like is that this kind of insurance is also subsidized. At that time, I never thought that I would really be diagnosed.
Out of professional habit, I carefully read the detailed terms of the contract at that time and found no misunderstanding or ambiguity. I feel that the big platform is guaranteed, so I am happy to insure it. The insurance process is simple. Click a few tick places, and the payment will be completed in less than 1 minute, and the insurance is successful.
In fact, as early as 2020, "COVID-19 Insurance" has been launched. At that time, many insurance companies included pneumonia in novel coronavirus into the scope of protection, mainly as an extension of accident insurance, critical illness insurance and medical insurance.
Since then, on 20021,major insurance companies have launched a series of new products to attract users, including COVID-19's confirmed claims, small claims, home isolation claims, etc., most of which cost tens of yuan. Whether it's isolation insurance or COVID-19 insurance, major online platforms have started to promote this kind of insurance products, and that's when I was insured by "planting grass".
Insurance companies never expected that in the last month of 2022, due to the great changes in epidemic prevention policies. The number of "sheep baa" in various places has soared, and claims settlement has become a big problem that has to be faced.
However, it was not until I really wanted to apply for a claim that I found that the purchase page showed "off the shelf" and I couldn't find the "claim" dialog box.
Insurance page
It is completely different from what I thought before. At this time, Internet insurance is no longer so "convenient", and everything has to go back to the most primitive way. It takes 1 minute to realize payment and complete "Internet insurance". When making claims, you still have to call customer service to report the case like traditional insurance.
After reporting the case, the customer service of Taiping Property Insurance sent the phone number of Gong Jiadong, the on-site surveyor of their claims department, to my mobile phone and said, "This is the exclusive docking person of my case."
But this adjuster seems to be very busy and the phone has been disconnected. 12 12 that night, after I made several persistent phone calls, the man who claimed to be his assistant finally answered the phone. I was told that I need to mail some paper proof materials and send them to an address in Hangzhou by express delivery. The other party added: "Neither antigen nor nucleic acid can do it. COVID-19 is sick and must have a doctor's diagnosis report. "
For diagnosis, I spent the night in the 3A hospital.
65438+February 65438+February 1 1 night, came to Luhe Hospital of Capital Medical University. This tertiary hospital is the largest general hospital in eastern Beijing and the designated hospital in COVID-19, Tongzhou District, Beijing.
That night, there was a northwest wind blowing in Beijing, and the temperature was MINUS 6℃. There is a long queue outside the hospital fever clinic. Some well-prepared patients wear thick coats or long down jackets, cotton caps and even helmets, so I can only keep stamping my feet in the cold wind.
In order to issue a diagnosis certificate, reporter Zhu stood in line outside the hospital in the cold wind at midnight.
About 2 hours later, I finally walked into the fever clinic with the team, and this was the beginning of the real registration queue. The fever clinic of this hospital is located on the north side of the west gate of the hospital. It is an independent two-story building. In the T-shaped aisle, there are rescue room, clinic, payment office, CT room, blood drawing room, pharmacy and toilet in turn. In the corridor about 2 meters wide, there are people waiting for the doctor to call, people waiting in line for examination, and patients who are taking intravenous drip.
At this time, the air in the fever clinic is filled with crowding, worry and anxiety. Because someone cut in line, a big brother angrily denounced the hospital security; Because the father lying on the stretcher had difficulty breathing, the middle-aged woman shouted "doctor, doctor, come and see"; The door of the fever clinic was constantly pushed open by 120 emergency medical staff, most of whom were haggard old people.
At about 2 am, I finally hung up the phone. There are about 200 patients in front of me at this time.
65438+February 65438+February, the data of Beijing Municipal Health and Health Commission showed that the number of fever outpatients in Beijing the day before was 22,000, which was 16 times that of a week ago.
Strictly speaking, it is impossible for me to come. I even feel that I am running medical resources at this time, but I can't help it, because the insurance company doesn't recognize the routine nucleic acid report, let alone the antigen test it has done, and I have to get the "diagnosis certificate" stamped by the hospital and signed by the doctor. Besides, I feel really bad. The only 999 Ganmaoling at home has expired 1 month, and the pharmacy shelves at the entrance of the community are empty.
At 3 am, the corridor gradually quieted down. Two fever clinics with an area of about 65,438+00 square meters surround patients and their families. Even in the middle of the night, doctors still maintain a fast speech speed. And I, sitting on a stool in the corner of the corridor, instantly felt that I was the happiest person here.
At 5: 40 in the morning, it was finally my turn. After I described my symptoms, the doctor gave me a list of single-tube nucleic acid, blood drawing and CT. 1 hour later, the blood test results came out, and the doctor gave me two boxes of medicine. "The results of CT and nucleic acid won't come out until the afternoon. Look at the official WeChat account of the hospital. Come back after the results come out. "
Well, to prove the diagnosis, I have to run again.
At 6: 48, I left Liuhe Hospital with two boxes of medicine and a whole blood test report. After staying up all night, my head hurts even more.
The next afternoon, I came to this hospital again and finally got my CT report and diagnosis certificate. After knowing the purpose of my prescription, the doctor sighed and said, "They are messing with you!" " "
The doctor gave the reporter Zhu a diagnosis certificate.
The materials were sent out, but the mobile phone of the adjuster didn't work.
When I prepared all the relevant materials and contacted the claim adjuster to mail them out, I found that the staff's mobile phone could not be dialed anyway.
I think he must be very busy. I'll wait and call a few more times. As a result, I called 37 times in two days and no one answered. In desperation, I contacted the customer service again and determined the materials, mailing address and contact information.
65438+February 15, the relevant materials were sent from Beijing, and on February 65438+February 17, EMS express showed that the express delivery was signed in Hangzhou.
In the three years since the epidemic, "COVID-19 Insurance" has been the "network celebrity product" in the insurance market. However, the situation of hot-selling products in the past has turned sharply. That is to say, the topic of "COVID-19 insurance does not pay" has rushed to the hot search these days, and China Life said that "Omicron does not belong to COVID-19"; The couple bought Taiping Property Insurance COVID-19 Insurance, but they were blacked out by the adjuster after being infected.
According to Cailian, during the gradual liberalization of epidemic control, all insurance products that can guarantee COVID-19's responsibility for diagnosis have been removed from the shelves or sold out directly. At present, it is difficult to find such insurance products that can be applied for compensation after diagnosis.
The surge in the number of people infected with COVID-19 virus has also brought a large number of claims, which has greatly improved the payout ratio of insurance companies. At the same time, there are endless complaints and disputes about the difficulty of COVID-19 Insurance, and all kinds of wonderful reasons for refusing to pay compensation appear frequently.
The dust of history also fell on my head.
12 18, the day after the courier showed the receipt, I wanted to make a phone call to ask about the situation. Unexpectedly, the regulator's cell phone stopped.
This phone seems to have fulfilled its mission and has not been connected today.
On February 22, 65438, six days after Taiping Property Insurance signed my claim materials, Yu, who claimed to be a staff member of the claim department, called me.
"In your case, the company can't compensate."
"Did you see the claim materials I submitted and then formally reply to me?"
"No, I can't see your materials, but the work order has been assigned to me. I am returning, you have to contact your adjuster. "
"He stopped!"
"Then contact 95589."
"Besides, you haven't read my materials, and the conclusion has come out?"
"The national epidemic prevention policy has changed"
"If the epidemic prevention policy changes, will it not follow the contract?"
"The big risks have changed. I can't answer this question. I record feedback. "
insurance contract
The next day, 65438+February 23rd, a customer service staff member of Taiping Group dialed my mobile phone.
"Hello, Mr. Zhu, we have received feedback. I don't know what claims materials you need?"
"Your claim materials have been signed for 7 days. The claimant in charge of me couldn't get through the phone at first, but then it stopped directly. In the meantime, I contacted customer service several times to inquire about the progress. Now you ask me this question? "
"Sorry, I didn't see your situation before the call was dialed."
"Since I saw it after dialing the phone, can you tell me about the progress of the claim?"
Since then, the other end of the phone has fallen into a long silence.
"Sir, let me record the feedback again."
"Can you tell me your work number?"
"Sir, I don't have a job number."
"What should I call you?"
Then, there was a beep from the mobile phone and the phone was hung up.
Text/Beijing Youth Daily reporter Zhu
Photography/Beijing Youth Daily reporter Zhu