投保时支付成功，理赔遭拒需“退保”？ “佛医保”回应！

Group 1 - The core issue revolves around the rejection of a claim for the "Health·Foshan Insurance" policy purchased by a resident who did not meet the eligibility criteria, despite successfully obtaining a policy [1][2] - The insurance policy was marketed as having flexible eligibility requirements, stating that individuals only needed to meet one of seven conditions to enroll, with no restrictions on age, occupation, medical history, or residency [3][9] - The policy's promotional materials indicated that individuals could enroll without submitting any proof of eligibility, relying instead on a self-declaration process [9][12] Group 2 - The insurance company confirmed that the underwriting process did not require the submission of supporting documents, which raises questions about the adequacy of the verification process [12][14] - Legal experts noted that while the insurance company provided information about eligibility conditions, the lack of a thorough verification process at the time of enrollment could lead to disputes regarding the validity of the policy [13][14] - The "Health·Foshan Insurance" is a government-guided commercial health insurance product, with a significant number of policies issued and claims processed in recent years, indicating its popularity and the potential for similar issues to arise [12][14]