有些保险争议,不分享您不知道!错过了,您就失去索赔的机会了!

A是自僱室内装修师傅,在装修单位凿牆时不慎弄伤左眼,3星期后因视网膜脱落及人工晶体脱位入院。事故后他的左眼通红及痛楚,其后视力逐渐模煳,他表示曾大力搓揉眼睛。

保险公司指A在4年前左眼植入了人工晶体,由于大力搓揉眼睛会导致人工晶体脱位,实属预期及可以预見的结果,故保险公司认为有关受伤并不属意外,遂拒绝投诉人的意外索偿。

惟投诉委员会得悉主诊医生其后确定其视网膜脱落及人工晶体脱位,是因为小石碎片击中左眼所致。 由于主诊医生确定这是一宗意外事故,因此投诉委员会较为相信A的左眼是因为意外而受伤,并直接及纯粹由外在因素造成。

投诉委员会裁定A投诉得直,保险公司需根据其个人意外保单,赔偿暂时性伤残保障及医疗费用。

如果您在保险知识上想要有进一步了解,欢迎PM滚钱趣!

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