剖腹理賠遭拒 - 保險
By Erin
at 2021-02-05T16:52
at 2021-02-05T16:52
Table of Contents
在十個月時因醫生判定胎位不正需要剖腹產,
A保險公司一周理賠 (購買約5年)
B保險公司一周理賠 (購買約2年)
C公司團險 兩周理賠
D保險公司 表示要調病例,但因看到之前病例在8個月左右有寫過胎頭過大,表示要詢問
醫師是胎頭過大還是診斷證明書上的胎位不正。
他拒絕理賠的原因是,醫師不願意回答到底是哪一個,他們從資料上無法確定所以不賠
。
我確認後事實上是醫院不願意讓理賠人員直接面對醫師,所以D保險公司一直問不到答案,所以保險公司說他無法確認是那一個所以不賠。
(大概懷孕前一個月買的)
是不是因為我購買跟理賠時間太近 就被刁難?
謝謝大家的回覆
原則上不是保險購買壓線的問題,
更新今天收到的拒賠文件中內容,經向診所調閱就診住院病歷並向原就診醫師詢問超音波紙判讀結果遭拒本公司無法判斷有胎位不正和胎頭過大之情形,無法依台端所請給付。
病歷超音波他們都有得到,但他就是抓著八個月時胎頭過大一直想問醫師,問不到就拒賠?
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