求助：保险claim被拒，这种情况应该怎么索赔？

saitu

基本情况是这样的，2月初飞悉尼买了ACE的travel insurance，回来的时候飞机不幸晚点八个小时。
然后回来就claim ACE, 今天刚收到ACE的reply，denial for claim。
ACE 的解释如下，大概的意思的是我们提供的延误的原因是因为从新加坡过来的飞机延误， 这个在他们的policy wording没有cover。
实在觉得他们的这个解释很扯，但是真心不太懂该怎么跟他们argue。
所以求助保险达人，这种情况应该怎样处理？
多谢各位的帮助了。

Updates
Dear All
I just confirm the reason for the delay as stated in Scoot Facebook page, it stated as "Impacted by the delay in the return to service of one of our aircraft which was undergoing scheduled maintenance.", so in this case, can I claim as derangement of the scheduled flights?
Appreciate again for your generous help.

Reply from ACE

We refer to the above claim. Upon reviewing the claim documents available to us, we have noted the following:

Travel period: 10-17 Feb 2014
Scheduled departure : Sydney on 17 Feb 2014 @ 13:50
Actual departure : Sydney on 17 Feb 2014 @ 21:55
Hours of delay : 8 hours 5 minutes
Reason for delay : Late arrival of incoming aircraft from Singapore
We would like to draw your attention to the following Section of the Policy Wording:

SECTION 12 – TRAVEL DELAY
If, during the Period of Insurance, whilst the Insured Person is on a Journey, the departure of the Scheduled Flight is delayed for at least six (6) consecutive hours at any single location in the itinerary supplied to the Insured Person, due to Strike or industrial action, adverse weather conditions or mechanical breakdown/derangement of the Scheduled Flight or due to grounding of the Scheduled Flight as a result of mechanical or structural defect, the Company will pay the Insured Person the relevant Benefit amount specified in the Certificate of Insurance for every full six (6) consecutive hours of delay (the delaybeing calculated from thedeparture time of the Scheduled Flight specified in the itinerary), up to the maximum Benefit amount specified in the Certificate of Insurance. The delay must be verified in writing by the operator of the Scheduled Flight or their handling agent(s) as well as the number of hours delayed and the reason for the delay.

In this instance, inview that the late arrival of the aircraft is not a covered reason for delay, we regret to advise that the Policy will be unable to respond to the claim for Travel Delay.

小五

刚一早和公司确认过, late arrival of aircraft是结果, 当时找航空公司拿delay证明的时候最好让他们写上是什么原因, 比如空港管制, 天气差, 还是机械故障或设备需维护。

目前建议你再和他以derangement of the scheduled flights这条去试试。希望能帮到你。

我的新天地

In this instance, inview that the late arrival of the aircraft is not a covered reason for delay, we regret to advise that the Policy will be unable to respond to the claim for Travel Delay.

想帮你，但是合约里面有对Travel delay的确切定义，就是只保障所列出的原因导致的航班延误（due to Strike or industrial action, adverse weather conditions or mechanical breakdown/derangement of the Scheduled Flight or due to grounding of the Scheduled Flight as a result of mechanical or structural defect 罢工、行业整体约束性行为、恶劣天气、机械故障或结构缺陷造成的起飞延误或落地）。对于从新加坡乘坐这趟航班去悉尼的乘客有可能因为以上所列出的原因给予他们赔偿，但你所乘坐的航班是因为晚点到达造成延误就不在条约受保范围（否则保险公司两头都要赔偿了），但从理性来讲，这就是条款，我们在投保的时候是接受了条款才购买的产品。若还想争取，我会建议你追问你们的航班为什么晚点到达？更具体的原因是不是保险公司所列出的保障范围？祝你好运。

我的新天地

发重复了。

frekiwang

这种很灰色的，可以说，是因为飞机飞来时因天气原因/机械故障原因导致延迟到达而延误。

居家用品

保险都这样的 你习惯就好了 我也中过 根本没有机会claim回来的 所以我现在都不买了 都是扯淡

waittt

这个保单保的是列明风险（named risks/perils），没有列明的当然不在承保范围

不过保险有个近因原则（proximate cause），这个并不是指时间上最接近事故的原因，而是造成事故的决定性原因

你这个case可能可以进一步找出飞机迟到的原因 - 不可能无缘无故晚8个多小时吧？很可能是天气或者机械故障

不过问题是policy wording说的是flight不是aircraft，所以尽管是同一架飞机，可能前一个航班晚点可以赔，你的航班就会拒。

基本同意新天地同学的看法，不过有没有机会争取，可能需要做这个险种的人的专业意见

eastman47

记得有一次我的回程飞机
也是因为来的飞机delay的原因
迟飞了6个多小时

问柜台拿了证明迟飞的信
以及登机卡等 去claim
赔了100多块 。。

不过是另一间A公司

saitu

小五 发表于 19-3-2014 01:52
刚一早和公司确认过, late arrival of aircraft是结果, 当时找航空公司拿delay证明的时候最好让他们写上是 ...

Thank you very much for your kind help.
Sorry I can not type chinese right now.
I just confirm the reason for the delay as stated in Scoot Facebook page, it stated as "Impacted by the delay in the return to service of one of our aircraft which was undergoing scheduled maintenance.", so in this case, can I claim as derangement of the scheduled flights?
Appreciate again for your generous help.

茄子

楼主这个简单，你去给航空公司写个信，说你想要一个飞机延误原因的信来claim保险，你需要的延误原因是以下几条之一（从保险条款copy过来）。然后拿信去claim就可以。