腎結石做體外震波碎石手術,只能申請圓融處理? - 保險
By Yuri
at 2015-03-26T21:28
at 2015-03-26T21:28
Table of Contents
本人最近因為腎結石做了體外震波碎石手術除去結石,
由於有在三商美邦保手術險,所以和業務申請手術相關補助,
但得到的結果不甚滿意,業務和我說,我必須要簽核一張圓融處理方案
的單子,這次的手術才能理賠,而這張單子的附加條件就是,
如果我在90天內又發生腎結石,而又去做了同樣的手術,這樣的話就不賠。
http://imgur.com/R1afzNJ
我查了一下當初的保單,他列的所有我有保的手術中,最接近我這次手術名稱的是
輸尿管鏡取石術併超音波碎石術or碎石取出術(電冰取石經尿道),
我越想越不對勁,難道我所做的手術,一定要跟他所列的名稱一模一樣,
我才能沒有附加條件的領取我該領的賠償嗎?
現在新型的手術這麼多樣,只要名稱不一樣他們就可以有一堆理由不賠,
或是有附加條件的賠償? 那我這份保單到最後不就如同廢紙?
(因為有更先進的手術我當然不會去用舊型的,但保單內可能只保舊型的手術名稱)
想請問一下各位先進,我遇到的事情再保險界是很正常的嗎?
是我自己要求太多還是這是我該去爭取的呢?(我想爭取為什麼我一定要簽圓融條款)
我也不想當奧客,所以決定先上來版上問清楚,再請各位大大幫忙一下囉^^
補充一下:我這次保的內容和手術比較有關的是:
常春住院醫療保險附約手術保險金、新住院醫療保險附約(HSRSC)
--
由於有在三商美邦保手術險,所以和業務申請手術相關補助,
但得到的結果不甚滿意,業務和我說,我必須要簽核一張圓融處理方案
的單子,這次的手術才能理賠,而這張單子的附加條件就是,
如果我在90天內又發生腎結石,而又去做了同樣的手術,這樣的話就不賠。
http://imgur.com/R1afzNJ
我查了一下當初的保單,他列的所有我有保的手術中,最接近我這次手術名稱的是
輸尿管鏡取石術併超音波碎石術or碎石取出術(電冰取石經尿道),
我越想越不對勁,難道我所做的手術,一定要跟他所列的名稱一模一樣,
我才能沒有附加條件的領取我該領的賠償嗎?
現在新型的手術這麼多樣,只要名稱不一樣他們就可以有一堆理由不賠,
或是有附加條件的賠償? 那我這份保單到最後不就如同廢紙?
(因為有更先進的手術我當然不會去用舊型的,但保單內可能只保舊型的手術名稱)
想請問一下各位先進,我遇到的事情再保險界是很正常的嗎?
是我自己要求太多還是這是我該去爭取的呢?(我想爭取為什麼我一定要簽圓融條款)
我也不想當奧客,所以決定先上來版上問清楚,再請各位大大幫忙一下囉^^
補充一下:我這次保的內容和手術比較有關的是:
常春住院醫療保險附約手術保險金、新住院醫療保險附約(HSRSC)
--
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