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由于不满保险公司的做法,随后田永红向保监会进行了举报。3月15日,田永红再次接到寇浩的电话,称保险公司无法进行理赔,只能退还100元保金。4月18日,在双方没有达成和解意向的情况下,田永红的银行账户收到保险公司100元的退保金。
律师:
保单签订就意味着生效
对于田永红父亲田世军购买保险却无法得到理赔一事,4月19日上午,华商报记者联系到中国人民人寿保险公司洛川支公司工作人员寇浩,寇浩表示,因为农村小额人身意外伤害险参保条件是针对身体健康的人,但田世军的残疾证显示其是盲人,不具备投保条件。而由于田永红后来向保监会进行了举报,他们只能按照合同条款进行处理,之前谈到的2.8万元救助金一事搁浅,只能退还100元保金。
而对于双方已签订保险合同,理赔时却被告知无参保资格原因,寇浩称该险种参保人数庞大,保险公司无法一一核实,但在保险推广期间,会通过当地的媒体和宣传单向居民宣讲参保条件。
对保险公司的说法,陕西旷达律师事务所李飞龙律师表示,当事人双方保单签订后,即意味着合同生效。出事后,保险公司以当事人不符合参保范围为由拒绝理赔,这是保险公司未尽到审查义务。至于通过媒体或者宣传单的形式宣讲相关参保条件,他们的对象为不特定人群,保险公司并不能免责。
4月19日下午,在中国人民人寿保险公司延安分公司,对于田永红的情况,该公司一位曹姓负责人表示,此前事情一直由洛川支公司负责办理,他们并不知情。目前他们已积极联系田永红进行处理,处理结果目前双方都满意,而针对投保过程中出现的问题,他们将积极采取措施完善相关环节,避免再次出现类似事件。
原标题:65岁盲人意外坠崖亡 投保已生效却因残疾遭拒赔
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