How would your medical history affect life insurance underwriting? (Chinese Article)

Estimated reading time 6 minutes

10Life Team

14 Nov 2021
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10Life Team

14 Nov 2021

Estimated reading time 6 minutes

很多人有美麗誤會,以為人壽保險不保事項少,隨時都可以成功投保。事實上,不保事項少並不等於核保過程寬鬆,尤其隨着年齡增長,身體陸續出現小毛病,分分鐘成為拒保或徵收附加費理由!那麼,於核保時,保險公司會考慮甚麼因素?受保人會因患上甚麼疾病而有可能被拒諸門外?10Life今天就用例子跟大家說明。

投保申請時需如實披露 若資料不盡不實或影響索償

除了透過經紀或代理購買人壽保險外,現時不少保險公司都提供網上投保,方便消費者獲得保障。線上與線下的投保均要求受保人如實申報資料,受保人須按最高誠信原則(utmost good faith),向保險公司提供準確和真實的資料。不然,保險公司最終仍可能拒絕賠償。

投保的過程中,保險公司會通常會詢問受保人的職業、身高、體重、吸煙習慣、病歷。如投保人不幸曾患指定疾病,或難以直接於網上投保,屆時可能要先聯絡客戶服務員或保險中介人繼續處理。核保過程中的病歷問題,較為常見的包括以下疾病:

  • 糖尿病
  • 癌症
  • 心臟病
  • 中風
  • 肝臟疾病
  • 腎臟疾病

即使曾患指定疾病 拒保與否非一刀切

保險公司一般會考慮多項因素,才決定是否受保。以糖尿病為例,若受保人不幸患有糖尿病,便須要進一步回答跟進回題,例如糖尿病的類型、病發年齡、血糖控制程度、有否出現拼發症等等。如有需要,保險公司或要求受保人進行驗身、尿液檢驗、血液測試 - 糖化血色素 (HbA1c)等,再決定是否需要徵收非標準保費或拒絕受保。

值得留意的是,保險公司不一定因嚴重疾患而拒保。事實上,一些大眾認為的「小病」,如脂肪肝、胃酸倒流等,也可能成為拒保或的原因(見表1)。因此,應趁身體健康時買人壽保險,方為上策。

表1:核保人壽保險時,保險公司對不同疾病的考慮因素

疾病 保險公司可能考慮的因素
睡眠窒息症 徵狀、呼吸不足指數 (AHI)、血液含氧量、是否有接受治療
哮喘 吸煙習慣、發病紀錄
乙型肝炎 血液測試結果、是否有接受藥物治療、飲酒習慣、是否有併發症
高血壓 血壓數值、有否有其他心血管風險因素、關連的疾病或併發症
脂肪肝 肝功能指數、是否有併發症
胃食道反流
(俗稱胃酸倒流)
徵狀、胃鏡檢查結果、是否有併發症
註:以上資訊由10Life提供,僅供參考,並非銷售建議。資訊更新至2021年11月9日。


定期人壽保險純保障
性價比高

我們早前文章曾指出,與終身人壽保險相比,定期人壽保險不含儲蓄成份,保費低,保障高,為消費者提供較高的身故賠償槓桿(即身故賠償÷已付保費)。10Life分析了現市場上十多個定期壽險產品,並依據產品的賠償倍數和條款逐一評分。大家可在選購前,運用10Life產品解碼器」貨比三家,分析產品異同。

2:比較定期人壽保險的賠償倍數(10年付款期)

假設35歲非吸煙男士,身故賠償為港幣$1,000,00010年付款

產品 首年保費
(港幣)
10年平均
保費(港幣)
賠償倍數 (槓桿)1 備註
第1年身故 第10年身故
$1002 $6402 10,000.0 X 156.3 X 每10年續保
$3733 $8263 2681.0 X 121.1 X 每年續保
$870 $870 1,149.4 X 114.9 X 每10年續保
$6304 $8734 1587.3 X 114.5 X 每10年續保
$910 $910 1,098.9 X 109.9 X 每10年續保
$5155 $9795 1,941.7 X 102.1 X 每10年續保
$1,030 $1,030 970.9 X 97.1 X 每10年續保
$1,031 $1,031 969.9 X 97.0 X 每10年續保
註:
1. 賠償倍數(槓桿)= 身故賠償÷已付保費。
2. 此年保費己計算富衛自主保定期保障計劃的首年保費一折及第二年期起保費七折優惠,需於FWD網頁輸入優惠碼 「FLD90TL」。受保險公司條款及細則約束。
3. 此年保費己計算保泰人壽Bowtie人壽保的5個月保費豁免優惠,需於保泰人壽網頁輸入優惠碼 「BOWTIE1011」。受保險公司條款及細則約束。
4. 此年保費己計算Blue WeCare定期人壽2的首次保費七折優惠,需於Blue網頁輸入優惠碼 「AY10LST30」。受保險公司條款及細則約束。
5. 此年保費己計滙豐保險滙家保的首年6個月月費優惠,需於滙豐保險網頁輸入優惠碼 「6MHFRE」。受保險公司條款及細則約束。6. 保險公司有權更改優惠,而毋須另行通知。讀者投保前應向保險公司了解優惠詳情(如有)。
7. 定期人壽之產品均同一假設:35歲非吸煙男性,假設首年的身故賠償為HK$1,000,000,10年保障期及每10年續保。
8. 以上資訊由10Life提供,僅供參考,並非銷售建議。資訊更新至2021年11月9日。


延伸閱讀

  1. 定期人壽保險不一樣 保障期點揀?
  2. 香港人均保險供款地上最強 保障依然唔夠?點解定期人壽保險 總被人置之不理?
  3. 點解人壽保險的不保事項特別少?對比人壽保險及一般保險的保障及不保理念
  4. 【賠定唔賠?】拆解人壽保險 爭議個案 關鍵細節大公開


註:以上資訊由10Life提供,更新至2021119日,僅供參考,並非銷售建議。

Disclaimer

10Life Product Comparison and 10Life Insurance Ratings are developed by 10Life Financial Limited, an authorised insurance broker company licensed with the Insurance Authority under License Number FB1526. 10Life Product Comparison and 10Life Insurance Ratings are developed for generic customer segments using mathematical calculations based on product information, facts and data, and are not influenced by any partnerships with or fees received from insurance companies.

Any information on 10Life Platform ("10Life Information"), including but not limited to Product Comparison, Product Ratings, Blog Articles are intended for general education purpose and reference only. None of the 10Life Information is intended, nor should they be considered or relied upon, as regulated advice, insurance, financial, investment or professional advice, recommendation, approval, endorsement, invitation or solicitation in respect of any insurance, financial or investment products. 10Life Information does not take into account your individual needs. Reading 10Life Information should not be considered as conducting a suitability assessment, and is not sufficient to form the basis of any decisions to purchase any insurance products. You should rely on information authorised by insurance companies, carry out your own research and/or seek independent advice from licensed intermediaries before purchasing any insurance products or making any insurance decisions. While reasonable effort is used when collecting, validating and updating 10Life Information from various channels, none of 10Life Group and its subsidiaries, affiliates, agents, directors, officers and employees will be responsible for any liability, claim or loss arising from or associated with you using 10Life Information. No warranty, representation or guarantee is given by 10Life Group and its subsidiaries on the accuracy, completeness and timeliness of the information.

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