When we are young and in good health, one person is full and the whole family is not hungry. We hope to have rich experience and a more perfect self. We seldom care about our physical and financial conditions. However, when a family is established, especially after the birth of a baby, the marriage and family parenting mode is started, and the idea of saving reserves for the family and children is realized. At a certain professional level, We will worry that accidents and physical changes will cause the existing family system to collapse. Coupled with the seemingly increasingly tense pressure on the state to provide for the aged, More and more family pillars, old and young, Began to consider buying insurance to provide you with an additional guarantee. Among the many options offered by insurance companies, Major sickness insurance, It is a variety that everyone has heard more. Today, Dr. Clove, from a medical point of view, Analyze some medical problems in major disease insurance for everyone, I hope I can provide some information for everyone’s decision-making. Critical illness insurance was introduced in South Africa in 1983. It was introduced into China in 1995. In order to make the insurance content more objective and scientific, In 2007, Cross-border Cooperation between Insurance Association of China and Chinese Medical Association, We have completed the formulation of the first unified disease definition for critical illness insurance in China’s insurance industry. The first industry standard operation guide for critical illness insurance in China-the standard for the use of disease definitions in critical illness insurance (hereinafter referred to as the “standard”) has been launched. Since then, critical illness insurance has a more scientific and accurate definition. Does critical illness insurance cover some what? The incidence of disease has an important relationship with the insurance company’s pricing of the type of insurance. Generally speaking, The higher the incidence of disease, The higher the risk the insurance company takes, Therefore, the insurance coverage covering the disease, Pricing should be increased accordingly. Judging from international experience, among the various diseases covered by heavy disease insurance, there are three to six diseases with the highest incidence rate and claim settlement rate. Therefore, the [specification] requires that if named after [critical illness insurance], the coverage must include the following six diseases: 1. Malignant tumors-excluding some early malignant tumors; 2. Acute myocardial infarction; 3. Sequelae of cerebral apoplexy-permanent dysfunction; 4. Major organ transplantation or hematopoietic stem cell transplantation-allotransplantation is required; 5. Coronary artery bypass grafting (or coronary artery bypass grafting)-thoracotomy is required; 6. End-stage renal disease (or uremic stage of chronic renal failure)-dialysis treatment or kidney transplantation is required. What is the chance of major diseases? This is a question that is difficult for conscientious professionals to answer, Because different diseases have different opportunities for different genders and ages. If the question to be answered is [how likely am I to suffer from these diseases], it should also include factors such as personal habits, location, heredity, etc. Is it impossible to know the risks of these diseases? Not necessarily. In 2013, the CIRC published a [Table of Experience Incidence of Major Diseases in China’s Life Insurance Industry (2006 ~ 2010)], which is the first Table of Experience Incidence of Major Diseases in China’s Life Insurance Industry. This table shows: 1. People of different ages and genders have different probability of occurrence of [major diseases]; 2. This [probability of occurrence], It refers to the probability of suffering from [major diseases] confirmed according to the diagnostic criteria stipulated in the insurance contract. Let’s give a few examples for everyone to understand: 1. That main economic pillar of the family: The experienced incidence rate of [six major diseases] for 45-year-old men was 0.003997, In other words, For every 10,000 45-year-old men who have purchased life insurance products that include critical illness insurance liability, About 40 people have suffered from any of the [six major diseases]. 2. Small white-collar workers who have just graduated and joined the work: The experienced incidence rate of 25-year-old women [six major diseases] was 0.000540, That is, for every 10,000 25-year-old girls who have purchased life insurance products that include critical illness insurance liability, About 5 people have developed any of the “six major diseases”. 3. Retired uncles and aunts: 60-year-old men and women, the experience incidence rate of the “six major diseases” is 0.017274 and 0.010487, i.e. About 172/10,000 (men) and 104/10,000 (women). If the above answers are still not satisfactory to you, or try to recall whether you have at least one family member or friend with the “six major diseases”? Which company has the best critical illness insurance? In addition to the six major diseases mentioned above, There are 25 diseases, The incidence is also high, [Specification] Exemptions listed by insurance companies in contracts cannot exempt these 25 diseases. Simply put, [Six Serious Diseases] Mainly refer to cancer, severe coronary heart disease, end-stage nephritis, Suffer from severe stroke, 25 kinds of diseases cover such as hepatitis, sensory disorders, and the most common diseases of nervous system and blood system. The 36 kinds and 42 kinds boasted by various families are actually more numerical concepts. 95% of the compensation for major diseases is concentrated in these 25 kinds of diseases. In fact, which one to buy is almost the same. So, the major disease insurance does not compensate what? Many people buy insurance, the most worried is that the insurance contract is difficult to understand, afraid of being cheated because they do not understand the contract, especially the so-called exemption clauses, which are various and difficult to say, and it is difficult to understand thoroughly. So, does [heavy disease insurance] not cover what? Generally speaking, The fundamental purpose of critical illness insurance is to provide financial support for the treatment of serious and costly diseases. Therefore, it pays for the most serious diseases and the most serious conditions. Some diseases with good prognosis, low risk and low cost, The insurance company won’t pay, Or be classified as light disease responsibility, Only a certain share will be paid in proportion. These [minor diseases] will actually include malignant tumors. Such as carcinoma in situ, partial borderline tumors, chronic myeloid leukemia, Hodgkin’s lymphoma, etc. In addition, out of the understanding of the original intention and the protection of the interests of insurance companies, there are also some clauses that do not settle claims. For example, the dog blood plot that everyone often sees in TV plays buys insurance for his spouse and then moves bad thoughts, intentionally hurts the other party and does not compensate. Because of one’s own fault, such as self-injury and suicide, intentional crime, drunk driving, no compensation; No compensation will be paid for the injuries caused by wars and riots. The consequences caused by nuclear explosion, nuclear radiation, etc. will not be compensated; Due to AIDS or congenital diseases, genetic consequences, do not compensate. Special attention should be paid to their own health conditions such as thyroid gland and breast nodules before purchasing insurance to truthfully inform the insurance company, otherwise there will be great differences and even legal disputes when relevant compensation is made. Once the disease occurs, there are what that can provide protection? Once the disease occurs, There will be several mechanisms to guarantee us. They are the medical insurance for urban workers, the medical insurance for residents, the new rural cooperative medical system and the serious illness insurance under the existing national medical insurance system. In addition, If you have purchased commercial health insurance, This mechanism will also begin to operate. Our country’s existing health care system will cover basic medical services. Meet the medical expenses in the list of essential drugs and the list of basic diagnosis and treatment, There will be corresponding state compensation, Patients pay lower costs for basic medical care. However, the coverage of the basic catalogue is limited. Some [good drugs], [imported drugs] may not be available, Or at one’s own expense. If there is serious illness insurance for towns and residents, After suffering from serious diseases, you can get a higher reimbursement rate, However, due to the higher total medical expenses, The remaining personal payment is generally not small. Commercial health insurance can provide better treatment protection at this time. For example, critical illness insurance can generally get full compensation after pathological diagnosis, You can get an extra financial support. Another example is that the coverage of high-end supplementary medical insurance is very wide. In particular, those who need to buy the latest drugs with less side effects at their own expense can generally get a high proportion of compensation through commercial insurance. With the latest targeted therapeutic drugs on the market, the cost of these self-paid drugs may sometimes reach 200,000 yuan or more. Who needs to buy heavy disease insurance? As mentioned in the first paragraph of the article, Generally speaking, Married people are more insured than unmarried people, Those with children are more insured than those without children. Those with higher incomes are more insured than those with lower incomes, This is very related to the family’s property reserve and upbringing responsibilities. Most people will have the idea that if they cannot afford insurance, it will be a waste. To be honest, if what you can’t compensate for is a lifetime of health and peace, even if you are ill, it is a good life that you find early and cure in time, then congratulations, the insurance company will never compensate is the winner in life.
