My wife drowned in the swimming pool, and the 30 million accident insurance amount was rejected. What is the reason for the refusal?

In fact, we buy insurance mainly to provide risk protection for ourselves and our families in advance, but in this complex society, many people regard insurance as a shortcut to "get rich" and thus make some heinous behaviors.

Then I'll start with "my wife drowned in the swimming pool and the 30 million compensation was rejected." Through this case, I will also popularize some insurance knowledge, hoping to help everyone.

0 1, real case

On June 20 18, during the National Day holiday, the Zhang family of three traveled to Sanya by car. Unexpectedly, on the night of staying in the hotel, an accident happened and his wife Hao drowned in the swimming pool. But after the accident, the first thing Zhang did was to report the case to the insurance company and demand compensation of 30 million yuan, and then notify the local police.

After receiving the report, the insurance company immediately sent personnel to investigate the matter. Because of the huge amount involved, the insurance company did not directly compensate, but cooperated with the police to investigate the case. It was in the process of investigation that the insurance company found clues and rejected Zhang's application on this ground, canceling the contract and deducting all the premiums.

02, case analysis

Why don't insurance companies pay more than 30 million yuan in insurance? It turned out that the insurance company found in the autopsy report of the deceased provided by the police that the insured Hao had obvious signs of being beaten and had multiple broken ribs, which may be accidental death.

In order to find out the truth, the police interrogated Zhang for 7 hours, and finally let Zhang tell the truth through a number of evidences. Zhang said that he was addicted to online games, not only lost his job, but also owed hundreds of thousands. At that time, he was obsessed with writing his wife as the insured and himself as the beneficiary. He bought nearly 30 million insurance money from many insurance companies, and then created this malicious insurance fraud case.

It's really irritating that such a thing happened. It is said that when Hao got married, her family gave her 800,000 yuan as a dowry, which made her live better. I didn't expect this to happen in the end.

But in my opinion, such malicious insurance fraud incidents can be completely avoided if insurance companies can strengthen management in the following aspects.

03. How to effectively avoid insurance fraud? I have two points.

(1) Strengthen business process management.

People who are a little more careful will find that in this insurance fraud case, there is an obvious omission in the local insurance business process, that is, when the insured and the beneficiary are not the same person, when signing such a huge policy, the agent did not give timely feedback to the insured and did not let the insured personally sign it, which made Zhang, who was lucky, create the accident.

If the insurance company can strengthen this management, when the insured and the beneficiary are both adults but not the same person, they should sign under the supervision of the agent. This can effectively reduce this situation even if it is not prohibited.

(2) Raise the threshold for recruiting salesmen.

Nowadays, many commercial insurance companies blindly lower the recruitment threshold of salesmen in order to expand their business, but they don't know that this behavior will eventually affect our policyholders. If the professional quality of the recruited salesmen is too low, it is easy to be deceived, which leads to people's lack of trust in insurance companies. To put it bluntly, this is to smash your own signboard.

However, if the insurance company can raise the recruitment threshold of salesmen in time and the salesmen's professional quality is high, our policyholders can effectively buy corresponding products according to their own needs, which is a sustainable development trend for both insurance companies and policyholders.