三商理賠被刁難 - 保險
By Xanthe
at 2015-02-26T12:59
at 2015-02-26T12:59
Table of Contents
我保的是三商享健康。
我去年11月住院,主治醫生在醫生證明上有著名使用自費藥物名稱,總收據是三萬多元。
可是實支實付理賠送出去以後,理賠部以病歷上沒有紀錄,所以只給付日額的錢,並且告訴我如果我要自費藥物的理賠,我要重開醫生證明,而且要註明住院期間使用的部分。
後來我和醫院聯絡過,醫院表示,哪有人要求開使用劑量的醫生證明,而且醫院說病例上本來就不會有紀錄,該紀錄只會在護理人員的施打紀錄中。
而後我致電三商理賠部,說明醫生不開這種要劑量的醫生證明,理賠部改要求我必須自己提供施打紀錄。
我覺得我根本就是被耍了,理賠部很清楚病例上不會載明自費藥物的紀錄,卻以這個做為不理賠的依據,這根本是刁難保戶。
保戶依據合約提供收據,醫生證明,自費明細,剩下來是三商理賠調病例的問題,他調不到施打紀錄,又不是保戶的錯,卻要我提供非合約上的施打紀錄。
我自己的業務員只能當傳話筒,無法幫我爭取權利,我現在不知道如何是好。
我問過我富邦的業務,他說他做富邦多年,從來沒看過有這種要求,並且告知他其他客戶在剖腹產理賠時,三商也要提供其他保險公司不需要的產程紀錄。
我買個保險為什麼理賠要這麼委屈,早知道理賠這麼不乾脆,根本就不要買這家保險,享健康的醫療費上限這看起來很高,理賠的時候刁難的要命,連區區三萬都這麼龜毛。
Anyway,我有請教過幾個不同的業務員,他們給我的申訴建議都不太一樣,有人要我直接找評議會,有人要我先三商申訴,還有人要我找消基會,不知道正確的流程是?還有我要怎麼寫我的申訴單?
我打的很長,先謝謝看完這篇的人。
前面刪文多次是因為我用的軟體po上去以後,看的內文有點奇怪,所以重po。
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Sent from JPTT on my Samsung SM-N9005.
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