Accidentally broke a bone while skateboarding in the park, and the insurance coverage of 150,000 was denied. Why can’t it be compensated even if I haven’t gone on a trip?

Forty years ago, the insurance industry was just established. At that time, the sales channels were mainly offline manual sales. But it is different now. With the rapid development of the Internet, as long as people need insurance, they can get it without leaving home. Buy online.

Having said that, the Internet is a professional channel after all. When buying insurance, many of us will be deceived if we don’t pay attention. This results in people preferring to believe in offline insurance instead of buying insurance offline. I would like to trust the Internet for insurance.

01

Case details

This case occurred in April 2017. The details are as follows. On the eve of Qingming Festival, the woman Cheng and her friends invited They went on an outing in Wuyuan, Jiangxi Province. For safety reasons, they bought themselves a travel accident insurance before departure, with a premium of 200 yuan and an insured amount of 150,000 yuan.

In mid-March 2019, Cheng accidentally fell between the stairs while skateboarding in the park below his home. After examination and identification at the hospital, Cheng's calf joint was fractured. Shortly after being discharged from the hospital, Cheng applied for accidental injury compensation from the insurance company. However, the insurance company did not accept her claim application and refused compensation on the grounds that the accidental injury was not caused during travel.

Cheng was not convinced, and so was travel accident insurance. If accidents are covered, why shouldn’t they be compensated? In order to get back the compensation he deserved, Cheng took the insurance company to court and asked the insurance company to compensate him 150,000 yuan in insurance money.

02

Case Analysis

Perhaps in the eyes of some people who do not understand insurance, this approach of the insurance company is indeed unreasonable, but is this really the case? ? During the trial of the case, the court held that for any insurance contract concluded through the Internet, telephone, etc., the insurance company needs to prompt and clearly explain the disclaimer clauses of the contract through web pages or audio, video, etc. If the policyholder accepts and agrees, then the exemption clause of the contract will come into effect.

Subsequently, the insurance company provided the court with evidence that Cheng had indeed read the corresponding insurance disclaimer clauses when applying for insurance electronically, and in the bottom line of the insurance application column, it also clearly stated "If you do not agree, "With the above insurance statement, we will no longer be able to continue to apply for insurance." In other words, since Cheng was able to successfully apply for insurance, he must have done so after agreeing to the insurance statement.

Therefore, in this case, the court finally dismissed Cheng’s lawsuit.

03

There are two main points to summarize this case:

(1) In fact, the main source of the dispute in this case lies in the mismatch between the insurance accident and the coverage. Cheng purchased travel accident insurance, and the time when her accident occurred was not during her travels. Some people may think that both are accident insurances, and there is not much difference. But in fact this is not the case, because the risks encountered by travel accident insurance are much greater than usual risks. Not only the coverage is different, but there are also some differences in the insurance amount and premium. Therefore, the essential difference between the two types of accident insurance is still very big. , we must not confuse them.

(2) Some people think that online insurance is not reliable. For example, insurance companies will prompt and clearly explain policy disclaimers through web pages, audio, video, etc. If the policyholder or the insured agrees, then the exemption clause will be effective.

Just like Cheng in this case, even if he doesn’t want to admit it, as long as the insurance company has these video or recording evidence, these can directly affect Cheng’s insurance claim.