理賠問題
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Q65 保險事故之通知時間與保險理賠的申請期間? | What are the notification timeframes and claim application periods for insurance incidents?
被保險人於保險契約有效期間內,遭受保險契約約定之意外傷害事故時,要保人、被保險人或受益人應於知悉意外事故發生後十日內將事故狀況及被保險人的傷害程度,通知保險公司。並於通知後儘速準備所需文件,向保險公司申請給付保險金。
保險公司應於收齊文件後十五日內支付保險金。逾期應按年利一分加計利息給付。如逾期支付賠款之原因可歸責於被保險人或受益人者,保險公司得不負擔利息。
When the insured suffers an accidental injury during the valid period of the insurance contract, the policyholder, insured, or beneficiary must notify the insurance company of the accident circumstances and extent of injury within 10 days of becoming aware of the incident. Required documents should be prepared and submitted promptly afterward.
The insurance company must pay the claim within 15 days of receiving complete documentation. Late payments will incur 1% annual interest. If the delay is attributable to the insured or beneficiary, the insurance company may not be liable for interest payments.
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Q66 成田飛台灣,班機延誤一天,請問信用卡保險可以補償的項目?
須請航空公司開立班機延誤憑證,保留因班機延誤期間餐飲、住宿費用單據正本,信用卡保險實支實付最高可理賠金額為保險限額。
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Q67 侵權的部分如果咬傷別人的狗也算嗎? | Does liability coverage include biting another person's dog?
算,狗狗視為財物損害。
Yes, dogs are considered property damage.
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Q68 在境內收到航空公司因天候取消班機,「旅程更改」可以理賠嗎? | Can I claim "Trip Modification" coverage for flight cancellation due to weather while still in domestic territory?
不行,旅程更改保險啟動須同時符合以下條件方可理賠
1.被保險人須於海外旅行期間
2.發生條款約定承保事故
被保險人還在中華民國境內,不符合「旅程更改」之理賠條件。No, Trip Modification coverage requires two simultaneous conditions:
1. The insured must be during overseas travel
2. The incident must be covered by policy terms.
Being within ROC territory does not meet Trip Modification claim conditions. -
Q69 被保險人失蹤之理賠處理方式為何? | How are insurance claims handled when the insured person is missing?
被保險人於其保險期間內因保險契約條款所約定之意外傷害事故失蹤者,於戶籍資料所載失蹤之日起滿一年仍未尋獲時,或要保人、受益人能提出證明文件足以認為該被保險人極可能因發生保險契約所約定之意外傷害事故而死亡者,保險公司將依保險契約之約定給付身故保險金。 但如日後發現該被保險人生還時,受益人應將已領取之身故保險金歸還保險公司。
If the insured person goes missing due to an accident covered by the insurance policy and remains unfound for one year from the date of disappearance as recorded in household registration, or if the policyholder or beneficiary can provide evidence suggesting the insured likely died from a covered accident, the insurance company will pay death benefits as specified in the policy.
However, if the insured person is later found alive, the beneficiary must return the death benefits to the insurance company. -
Q70 旅行文件損失險承保內容有哪些? | What does Travel Document Loss Insurance cover?
被保險人於海外旅行期間內,因本次旅程使用之旅行文件被強盜、搶奪、竊盜或遺失時,本公司依約定之保險金額給付保險金。
【貼心提醒】
※被保險人應在二十四小時內,向當地警政單位報案並取得報案證明。
During overseas travel, if travel documents used for the current trip are lost due to robbery, mugging, theft, or misplacement, the company will pay the agreed insurance amount.
[Reminder] The insured must report to local police and obtain a police report within 24 hours. -
Q71 基本地震保險可以理賠的項目有哪些?
一旦投保建築達到理賠標準,保險公司會先行給付「臨時住宿費用20萬元」,建築物方面則依投保保險金額(最高150萬元)給付。
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Q72 旅程中如果遇到航空公司安檢人員罷工,旅遊不便險可以理賠嗎? | Does travel inconvenience insurance cover situations where airport security staff are on strike?
(1)以「旅程取消險」為例,被保險人於預定海外旅程開始前七日至海外旅行期間開始前(尚未出國),因預定「搭乘之公共交通工具業者之受僱人」罷工,導致所預定搭乘之班次取消或延誤達二十四小時而必須取消預定的全部旅程,依保單約定範圍給付保險金。惟機場安檢人員並非「搭乘之公共交通工具業者之受僱人」故如果旅程中遇到航空公司安檢人員罷工導致旅程取消,不符合本承保範圍。
(2)以「班機延誤險」為例,保戶若因罷工事件造成預定搭乘的班機延誤或取消(不限是否已出國),仍搭乘「原訂」班機或改搭「其他」班機,因此延誤達四小時以上者,將依保單條款約定給付保險金,相關理賠申請文件請參考保單條款所列。
*請注意:依旅平險條款所示,要保人或被保險人向本公司申請訂立保險契約時已發生之事故乃屬於「特別不保事項」。故保戶若在航空公司已宣布班機取消或延誤才向本公司投保旅行不便險,則不在理賠範圍。
(3)以「旅程更改險」為例,保戶若於海外旅行期間(已出國)因「搭乘之公共交通工具業者之受僱人」罷工,因該罷工事件導致須進行旅程更改而所增加的交通或住宿費用,本公司依保單條款約定負理賠之責。惟機場安檢人員並非「搭乘之公共交通工具業者之受僱人」故如果旅程中遇到航空公司安檢人員罷工導致旅程取消,不符合本承保範圍。(1) For "Trip Cancellation Insurance", if a strike by employees of the scheduled public transportation carrier occurs between seven days before the planned overseas trip and before departure (not yet abroad), causing the scheduled flight to be cancelled or delayed by 24 hours, requiring full trip cancellation, insurance will be paid according to policy terms. However, airport security personnel are not employees of the transportation carrier, so if a trip is cancelled due to airport security personnel strike, it is not within the coverage.
(2) For "Flight Delay Insurance", if a strike causes the scheduled flight to be delayed or cancelled (regardless of whether abroad), and the insured still takes the "original" or "alternative" flight with a delay exceeding four hours, insurance will be paid according to policy terms. Refer to the policy for claim documents. *Note: According to travel insurance terms, incidents already occurring when applying for the contract are "special exclusions". If a policyholder purchases travel inconvenience insurance after an airline has announced flight cancellation or delay, it is not within the claim scope.
(3) For "Trip Modification Insurance", if a strike by employees of the public transportation carrier during overseas travel leads to trip modifications and additional transportation or accommodation costs, the company will compensate according to policy terms. However, airport security personnel are not transportation carrier employees, so trip cancellation due to their strike is not covered.