購買人壽意外保險時遺漏申報過去醫療記錄(緊急!)(20分!)

雖然你媽的意外離去實在不幸，由於她買的是人壽加意外，賠償金額應該很高，保險公司理賠部會翻查投保人所有病歷，如因遺漏申報過往病歷而拒絕賠償是合法理由。1. 人壽保險（行內人稱為傳統保單）跟旅遊保（一般保險）的最大分別，在於投保時要作出申報健康狀況及相關病歷，雖然不知道你媽是在那一間保險公司投保，但必定有問及情緒病及住院紀錄等問題，除非agent沒有問及相關問題或你媽漏報，否則保險公司可能會拒保或附加額外條件才會受保。2. 雖然保險條例內有所謂不可爭議期，即保單生效後超過兩年，即使投保人遺漏申報資料，保險也不可追究漏報項目。但必須注意，假如投保人是刻意隱瞞以令保單生效則作別論，保險公司絕對有權拒賠。加上你媽投保至事發不足一年，能引用這條款機會不大。但假如你媽旅遊時有購買旅遊保險，因沒有需要投保前申報健康或病歷，所以不會發生以上拒賠問題。建議你和agent商討，看看可否作恩恤賠償，總比全份保單拒賠為佳。

Sorry for your loss.

The insurance company's reason to deny the claim is valid. However, it does not mean you are in a loss.

You have to understand that each insurance policy will have a contestable clause which is usually valid for certain time of the policy as a way for insurance company to contest the claim. Usually this clause is used to protect the insurance company from fraudulent information.

In theory, if an insurance company contests the claim and voids the policy, all premiums must be returned to you (like you have never bought the policy).

Back to your case - even the insurance company's contest of the claim is valid, it does not mean that the insurance company can get away with it. Although the evidence supports the insurance company's action, the cause of death of your mother does not. Your mother was killed in a crime, which was unforeseeable. The cause of death does not relate to the information omitted.

Also even with that information available with the application, could the policy still be issued? If so (even a higher premium), the insurance company's denial will become weaker.

The best way to do in this case - I will suggest you to find a lawyer to discuss.

Your case is arguable.