意外发生后没及时报案，保险公司可以全额拒赔吗？近日，内蒙古自治区通辽铁路运输法院审理的 一起团体意外险理赔纠纷案，明确"及时报案"并非保险理赔的唯一前提，为消费者维权提供了指引。 责任编辑：杨喜亭 案情信息显示，2024年6月，李某所在单位为其投保了团体意外伤害保险，其中意外医疗保额为 5000元，保险期限为1年，保障范围涵盖日常意外导致的医疗费用支出。保险期间内，李某不慎摔伤， 造成椎体压缩性骨折，随后住院手术治疗11天，累计花费医疗费7092.19元，个人实际支出4168.48元。 事故发生后，李某因全力配合治疗，未能及时向保险公司报案。待身体康复后，他向保险公司提交 理赔申请，却遭到拒绝。保险公司辩称，李某未在事故发生后及时报案，导致公司无法核实保险事故的 性质、原因，依据保险合同及法律规定，有权拒绝全部赔偿。双方协商无果，李某诉至法院，要求保险 公司履行赔付义务。 法院经审理查明，李某所投保的团体意外伤害保险合法有效，其摔伤事故发生在保险期间内，且属 于保险合同约定的保障范围。结合李某提交的住院病历、诊断证明、医疗费票据等证据，能够清晰证 实"不慎摔伤"的事故性质、原因及个人实际支出的医疗费用金额，事 ...

Core Viewpoint - AM Best has awarded Samsung Property & Casualty Insurance (China) Co., Ltd. an "A" (Excellent) Financial Strength Rating (FSR) and an "a" Long-term Issuer Credit Rating (ICR), with a stable outlook [1] Group 1 - The company has established a stable commercial insurance business and a continuously growing personal insurance portfolio, supported by two major shareholders [2] - Samsung P&C offers a wide range of insurance products, including corporate property insurance, liability insurance, engineering insurance, accident and health insurance, and return shipment insurance [2] - The company's risk-adjusted capital strength is assessed to be at the strongest level, supported by a conservative investment strategy, good liquidity, and comprehensive reinsurance arrangements [2] Group 2 - Following a change in equity, the company's capital strength has significantly improved, with its local solvency margin well above regulatory minimum requirements [2] - Both major shareholders have strong credit foundations and are expected to continue providing financial and non-financial support to the company in the medium term [2] - AM Best believes that Samsung P&C's overall risk management practices are appropriate for its risk profile [2] Group 3 - Samsung P&C was established as the first wholly foreign-owned property insurance company in China in April 2005, following a solid operational foundation in the country [3] - The company entered the auto insurance market in June 2010 and was the first foreign property insurance company to operate direct sales for auto insurance [3] - In August 2022, Samsung P&C underwent a capital increase approved by the Shanghai Banking and Insurance Regulatory Bureau, introducing Tencent and four other new shareholders, officially transforming into a joint venture supported by strategic partners [3] Group 4 - AM Best, established in 1899, specializes in credit ratings for the insurance industry and insurance-related securities, with its headquarters in the United States and regional offices in various global cities [3]

Core Viewpoint - The company has been committed to its mission of serving the public through financial services, focusing on five key areas: technology finance, green finance, inclusive finance, pension finance, and digital finance, as it celebrates its 20th anniversary [1][8]. Group 1: Technology Finance - The company actively supports national strategies by investing in various manufacturing enterprises, addressing the long-term financing needs of high-tech industries and strategic emerging sectors [2]. - Investments cover areas such as 5G, cloud computing, big data, artificial intelligence, and GPU chips, facilitating the transformation of technological achievements into new productive forces [2]. - Customized insurance products for executives and R&D personnel in high-tech companies have provided coverage for 20 million individuals, aiding in talent retention and attraction [2]. Group 2: Green Finance - The company emphasizes green development as a foundation for high-quality growth, investing in low-carbon transition enterprises and supporting technologies for carbon reduction and capture [3]. - It holds several billion in green bonds and invests in private equity funds focused on green energy companies, aligning with the goals of carbon neutrality and sustainable development [3]. - The company integrates environmental, social, and governance (ESG) criteria into its asset allocation and risk management frameworks to enhance financial risk control [3]. Group 3: Inclusive Finance - The company aims to meet diverse financial needs by developing insurance products for small and micro enterprises, offering comprehensive health management services [4]. - It has expanded insurance coverage for the elderly, allowing individuals up to 80 years old to obtain policies, thereby increasing accessibility for older populations [4]. - The company collaborates with local governments to provide tailored commercial insurance solutions, serving over 18 million users across 25 cities [4]. Group 4: Pension Finance - The company addresses aging population challenges by expanding insurance coverage for seniors and enhancing financial services tailored to their needs [6]. - It has developed a range of medical insurance products suitable for various health conditions of the elderly, establishing a comprehensive health service system [6]. - The company promotes the integration of new pension industries with financial services through investments in innovative pension-related enterprises [6]. Group 5: Digital Finance - The company is advancing its digital transformation to enhance service efficiency and customer experience, utilizing AI across various operational areas [7]. - It has implemented AI-driven solutions in agent operations, underwriting, and health management, significantly improving service delivery and risk assessment [8]. - By 2025, the company aims to provide insurance coverage for 77 million clients and has paid out over 50 billion in claims, demonstrating its commitment to high-quality financial services [8].

Core Insights - Ping An Health Insurance Co., Ltd. released its 2024 Sustainable Development Report, showcasing its practices and achievements in sustainable insurance, responsible investment, social welfare, and corporate governance [1] Group 1: Financial Performance - In 2024, Ping An Health Insurance reported a sustainable insurance premium income of 13.039 billion yuan and a responsible investment scale exceeding 4.449 billion yuan [1][2] - The company made public welfare donations exceeding 2.636 million yuan [1] Group 2: Strategic Initiatives - The company is focusing on five major areas, including technology finance, green finance, inclusive finance, pension finance, and digital finance, to enhance its service offerings and support high-quality development in strategic emerging industries [2] - In technology finance, Ping An Health Insurance is developing group medical, disease, and accident insurance products aimed at R&D personnel in high-tech industries [2] - The green finance initiative includes a responsible investment scale of 4.449 billion yuan, with approximately 781 million yuan allocated to green investments [2] Group 3: Health Management and Social Responsibility - The company is transitioning from traditional insurance to a model that integrates proactive health management services with insurance coverage, promoting a "health insurance + health service" strategy [3] - Ping An Health Insurance is actively fulfilling its corporate social responsibility by engaging in medical health assistance, rural revitalization, and social volunteer services [3]