Recently, some consumers complained to this magazine that when collecting premiums, insurance salesmen greeted them with smiles and were always on call, even without being called. However, when it came time to settle claims, they were hard to see, ugly, and difficult to handle; insurance salesmen also had problems

Complaints: It’s not that claims are difficult to settle, it’s that it’s difficult to connect the information provided by consumers with the procedures required by insurance companies. At the same time, insurance companies also pointed out that it’s difficult to conduct on-site inspections, investigate and collect evidence, control claims, and communicate with customers... So, what has been criticized over the years is that

How difficult is it to settle insurance claims, which is criticized by consumers and industry insiders?

The most prominent violation in the sales of personal insurance is insurance. Insurance is divided into personal insurance and property insurance according to the insurance subject matter. Personal insurance is specifically divided into life insurance, health insurance, children's insurance, pension insurance, accident insurance, etc. Life insurance can be divided into term life insurance and endowment insurance.

And whole life insurance, health insurance can be divided into critical illness insurance and medical insurance.

Recently, the China Insurance Regulatory Commission issued a notice on insurance consumption complaints in 2016.

The report shows that there are 16,039 consumer complaints involving personal insurance.

Among them, there were 13,686 complaints about insurance company contract disputes and 2,314 complaints about suspected violations of laws and regulations; there were 24 complaints about insurance intermediary contract disputes and 15 complaints about suspected violations of laws and regulations.

Judging from the types of complaints, among insurance company contract disputes, there were 5,651 underwriting disputes, accounting for 41.29%, which mainly reflected problems such as sales staff’s unclear explanation of terms, failure to fulfill their obligation to inform and explain, and calls made despite clear refusal by the other party.

There were 4,230 claims/payment disputes, accounting for 30.91%, mainly involving liability disputes for disease insurance, medical insurance and accident insurance. Consumers complained about insurance companies taking out insurance during the observation period, taking out insurance while sick, not falling within the scope of claims, and not having the disease or disability level.

It is controversial to refuse compensation for reasons such as meeting the compensation conditions.

There were 1,943 surrender disputes, accounting for 14.20%, mainly disputes over surrender conditions, procedures and surrender amounts.

Among the complaints about alleged violations of laws and regulations by insurance companies in personal insurance, there were 2,068 sales violations of various types, accounting for 89.37% of the total complaints about violations of laws and regulations, of which 2,015 were suspected of fraud and misleading, mainly manifested in promising high returns or untruthfully informing earnings, and

Bank wealth management, deposits, funds and other financial products promote and sell insurance products in the name, induce policyholders to not truthfully inform their health status, fail to answer return visit questions truthfully, sign on behalf of customers, copy risk warnings on their behalf, and induce consumers to withdraw on the grounds of policy upgrade.

Protect existing policies, purchase new insurance, etc.

Looking at sales channels, there were 7,802 complaints involving personal agents, accounting for 48.64%; and 3,389 complaints involving bank mail channels, accounting for 21.13%.

In terms of insurance types, the most complaints were about participating insurance with 5,803 cases, accounting for 36.18%; ordinary life insurance with 4,047 cases, accounting for 25.23%; and accident insurance with 2,389 cases, accounting for 14.89%.

Property insurance claims are difficult to settle because there are 16,403 complaints from auto insurance consumers involving property insurance.

Among them, there were 15,965 complaints about insurance company contract disputes and 382 complaints about suspected violations of laws and regulations; there were 51 complaints about insurance intermediary contract disputes and 5 complaints about suspected violations of laws and regulations.

In terms of the types of complaints, insurance company contract disputes accounted for 97.33% of the complaints. The most common complaints were claims disputes. There were 12,077 claims/payment disputes, accounting for 75.65% of the total contract dispute complaints. Among them, there were 10,160 auto insurance claim disputes.

Accounting for 84.13% of claims disputes.

The main complaints are as follows: the company makes a decision to refuse compensation or exempt from compensation based on the terms of the contract, but the consumer does not accept it; the two parties have disputes over maintenance plans, parts prices and labor hours; the claim settlement time limit is too long, the claim settlement materials are cumbersome, and the consumer experience

Bad and so on.

There were 2,412 underwriting disputes, accounting for 15.11%, mainly reflecting issues such as premium calculation disputes, underwriting without consent, deduction of premiums without consent, insufficient notification of insurance liability, untimely delivery of policies or invoices, and disturbing residents through telemarketing.

Looking at sales channels, the most complaints involved 4,313 personal agents and 2,525 telephone sales, mainly selling traditional insurance types such as auto insurance and corporate property insurance.

There were 1,721 cases through online sales channels, involving return freight insurance, flight delay insurance, travel accident insurance and various short-term new products. The two parties disputed whether the accident was covered by insurance liability. Consumers complained that the website sales did not fully disclose the insurance because they were denied compensation.

Important information.

Can't contact the insurance salesperson?

Many consumers who contacted insurance companies directly complained that when it came time to settle insurance claims, they could not contact the salesperson who originally signed the insurance contract with them, leaving them with no way to settle their claims.

Yang Wensu and Zhang Fengting of Minsheng Insurance Beijing Branch told reporters from Beijing Evening News Financial Weekly that if you cannot contact the insurance salesperson, first look at the prompt claims materials in the insurance contract service guide, or directly call the insurance company’s customer service hotline, or learn from the contract

For the address of the insurance company, go directly to the company counter.

Moreover, some life insurance companies provide mobile APPs or WeChat official accounts, where you can apply for claims directly.

Insurance consumers must be aware that if they have insurance-related needs, they should contact the insurance company directly.