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看懂保险公司拒赔的“拖、赖、耗”手段,守护你的理赔权
吴晓波频道· 2025-07-25 17:03
Core Viewpoint - The article discusses the implications of the murder of the CEO of UnitedHealth Group, highlighting the company's high claim denial rate of 32% and the relevance of the book "Delay, Deny, Defend" in understanding insurance companies' strategies for denying claims [4][5]. Group 1: Insurance Claim Denial Strategies - The term "Delay" refers to insurance companies intentionally delaying claims processing, which can lead to prolonged financial strain on claimants [8][10]. - The term "Deny" signifies the practice of insurance companies refusing to acknowledge certain incidents as covered by insurance, often using confusing legal language to mislead consumers [16][22]. - The term "Defend" indicates that insurance companies may push consumers towards litigation, knowing that many will opt not to pursue legal action due to the complexities and costs involved [26][32]. Group 2: Comparison of Insurance Practices - The article emphasizes that while the U.S. insurance industry has a long history and experience, the claims handling and regulatory practices in China are often more consumer-friendly [36][41]. - It points out that U.S. insurance regulators may not provide the same level of transparency regarding claims data as seen in China, where regulatory bodies actively monitor and report on insurance company performance [43][45].
以案明纪释法丨离职后收受财物行为性质辨析
Core Viewpoint - The article discusses the complexities surrounding the issue of corruption related to former government officials accepting benefits from private companies after retirement, particularly focusing on the case of a former police official and the legal interpretations of such actions [1][2][3]. Basic Case Facts - Qiu, a former deputy director of a city's public security bureau, provided assistance to Liu, the actual controller of a technology and culture company, using his official position from February 2018 to the end of 2021 [2]. - After Qiu's retirement in July 2022, Liu began paying him 100,000 yuan monthly under the guise of research funding, totaling 1.4 million yuan by November 2023, which Qiu used for personal expenses rather than research [2][3]. Divergent Opinions - Three differing opinions exist regarding Qiu's actions: 1. Some argue it constitutes a violation of party discipline for accepting benefits related to his former position [3]. 2. Others believe it amounts to bribery, as Qiu provided benefits to Liu's company while in office and later accepted funds post-retirement [4]. 3. A third view agrees with the second but emphasizes the need for a prior agreement between Qiu and Liu regarding the funds [4][5]. Legal Framework - The article outlines legal precedents indicating that former officials can be prosecuted for accepting benefits if they had previously used their position to benefit the giver and had a prior agreement regarding the benefits [6][7][8]. - The necessity of a "prior agreement" is emphasized, which can be explicit or implicit, to establish the connection between the official's actions while in office and the benefits received post-retirement [9][10]. Analysis of Qiu's Actions - Qiu's actions during his tenure, where he facilitated Liu's business operations, are critical in determining the legality of the funds received after retirement [10]. - The relationship between Qiu and Liu, characterized by mutual assistance and the eventual agreement on post-retirement payments, suggests a potential violation of bribery laws [11][12][13].