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65岁盲人意外坠崖亡 投保已生效却因残疾遭拒赔

2017-04-27 04:51:06   

65岁的洛川农民生前购买100元的农村小额人身意外伤害险,今年1月老人外出劳作时不幸坠崖身亡,其子带着保险单前往承保的中国人民人寿保险公司洛川支公司理赔时却遭拒。

起因:

办后事时得知父亲买过保险

2017年1月1日,是新年的第一天,对于家住洛川县黄章乡元桌村的田永红一家来说,一点也高兴不起来。当天下午,田永红的父亲田世军在去果园的路上失踪,随后被发现坠沟不幸身亡。

“父亲出事后,家里人都很伤心。就在给父亲办理后事的过程中,村里的干部来到我家,称父亲生前曾在村上办过农村小额人身意外伤害险,可以通过保险进行理赔。”4月19日,田永红告诉华商报记者,得知父亲生前还买过人身意外保险,他赶紧在家里找到父亲的保单,并根据保单上的理赔程序,给中国人民人寿保险公司洛川支公司报案,而保险公司工作人员寇浩到达田家了解情况当场也表示,参加了保险可以按相关条款进行理赔。

据田永红讲,料理完父亲的后事,他就立即向中国人民人寿保险公司洛川支公司提供了理赔所需的家庭关系证明信、保险金继承协议书等文件,要求进行理赔,但此时保险公司的态度却发生了变化,“保险公司称接到举报,有人反映我父亲身有残疾,并办有残疾证,无法理赔。”

田永红称,对于保险公司的说法,他不予认可接受,“我父亲是患有残疾,有青光眼视物障碍,但还能下地干活。当时买保险的时候,保险公司委托的村干部并没有说不能办理,而且我父亲已经连续两年买了这个意外险,保险公司自己没尽到核实责任,现在人意外身亡了,到理赔的时候却被告知,父亲患有残疾不符合理赔条件,这种说法放在任何一个人身上都无法接受。”

当事人:

理赔不成 退回保金100元

根据田永红提供的保单显示,其父亲田世军购买的中国人民人寿保险公司的人身意外险保金每年100元,意外伤害身故基本保险金额为6万元。保单背面的投保提示第一条的规定为:出生满28日至65周岁,身体健康的农村居民,均可作为被保险人由本人或对其具有保险利益的其他人作为投保人向本公司投保本保险。

“保险公司认为我父亲隐瞒了身体残疾的情况,最后提出了救助2.8万元的和解办法,但遭到我的拒绝。”田永红表示,根据保单约定,父亲意外身亡保险公司需承担6万元的理赔金,但保险公司以父亲患有残疾为由只给2.8万救助金,这违背了保险合同的约定,他无法接受。

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