Core Viewpoint - The article highlights the frequent disputes arising from "exemption clauses" in insurance contracts, emphasizing the need for clearer communication and understanding between insurance companies and policyholders [1][2][3]. Group 1: Insurance Disputes - Numerous insurance disputes occur due to complex and often overlooked exemption clauses in contracts, leading to challenges during claims [1][2]. - In a case involving a medical insurance claim, the insurer denied compensation based on a hereditary disease exemption, despite the court ruling that the insurer failed to adequately inform the policyholder about the exemption clause [1]. - Another case involved a significant illness insurance claim where the insurer rejected the claim based on a requirement for muscle biopsy, which the court found unreasonable as genetic testing was sufficient for diagnosis [2]. Group 2: Legal Obligations and Recommendations - Insurance providers are legally obligated to clearly explain exemption clauses to policyholders, and failure to do so renders such clauses ineffective [3]. - The insurance industry is urged to design clauses that align with medical advancements and avoid contradictory terms that can lead to disputes [3]. - Consumers are advised to thoroughly review insurance terms, especially exemption clauses and claims conditions, and seek clarification on any unclear terms to prevent future conflicts [3].
购买保险遭拒赔 “免责条款”真能免责吗?
Jin Rong Shi Bao·2025-08-27 01:56