實支實付險種手術理賠問題 - 保險
By Edwina
at 2011-09-02T19:16
at 2011-09-02T19:16
Table of Contents
直接問一句:
有沒有理賠實例?
或者有保險公司的理賠部門可以詢問的?
今天先問了中國人壽與全球人壽,
對於"如手術費用無法協議, 是否可轉雜費項目理賠",
兩家公司的客服沒辦法回答這個問題,
也都不方便轉接其他可以詢問的部門....
要求客服人員能回答是太強人所難了點,
有誰確實能提供一個能詢問的管道?
(不限這兩家, 只要條款中有"超過全民健康保險給付之住院醫療費用"這句的都行)
※ 引述《kmkr122719 (出來跑的總是要還)》之銘言:
: 一般實支實付醫療險理賠方向可分成3大類(暫不論特殊理賠項目)
: (A)病房費
: (B)手術費
: (C)雜費
: 南山HS的(B)與(C)是合併計算 故不論是手術或醫療處置 這部份全都會賠 這沒問題
: 問題在於該南山業務對於"醫療處置"以及"未列舉在手術表裡的手術"認知有誤
: 未列舉在手術表裡的手術 要看條款裡是否寫會協商理賠或依健保點數理賠
: 若擔心這點會有問題 直接選條款明確寫出會協商理賠或依健保點數理賠的商品來買即可
: 如果此項醫療行為是被認定為醫療處置 且又不在手術表列舉會賠的範圍內
: 醫療處置明顯不是(A) 也不被保險公司認定為是(B) 那自然就會是(C)
: 除非買的是像富邦這種列舉式理賠項目
: 不然一般實支醫療險條款所寫的"超過全民健康保險給付之住院醫療費用"就有全部涵括
: 而不是照該南山業務說的理賠上會有糾紛
--
千金難買早知道,
萬般無奈想不到,
寧可保障先做高,
莫在事後才懊惱。
--
All Comments
By William
at 2011-09-07T03:19
at 2011-09-07T03:19
By Valerie
at 2011-09-08T10:18
at 2011-09-08T10:18
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at 2011-09-12T07:36
at 2011-09-12T07:36
By Adele
at 2011-09-16T21:10
at 2011-09-16T21:10
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at 2011-09-17T11:47
at 2011-09-17T11:47
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at 2011-09-20T09:48
at 2011-09-20T09:48
By Quanna
at 2011-09-23T13:31
at 2011-09-23T13:31
By Skylar Davis
at 2011-09-27T01:47
at 2011-09-27T01:47
By Heather
at 2011-09-29T02:35
at 2011-09-29T02:35
By Audriana
at 2011-10-01T05:32
at 2011-10-01T05:32
By Victoria
at 2011-10-05T18:16
at 2011-10-05T18:16
By Mason
at 2011-10-08T07:55
at 2011-10-08T07:55
By Caitlin
at 2011-10-11T15:02
at 2011-10-11T15:02
By Elizabeth
at 2011-10-15T13:48
at 2011-10-15T13:48
By Tracy
at 2011-10-19T18:14
at 2011-10-19T18:14
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at 2011-10-19T21:14
at 2011-10-19T21:14
By Cara
at 2011-10-22T03:02
at 2011-10-22T03:02
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