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	<title>評議中心 &#8211; 保險理賠ICU</title>
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		<title>為什麼評議成功卻拿不到理賠金？一定金額120萬是什麼？</title>
		<link>https://claimicu.com/%e7%82%ba%e4%bb%80%e9%ba%bc%e8%a9%95%e8%ad%b0%e6%88%90%e5%8a%9f%e5%8d%bb%e6%8b%bf%e4%b8%8d%e5%88%b0%e7%90%86%e8%b3%a0%e9%87%91%ef%bc%9f%e4%b8%80%e5%ae%9a%e9%87%91%e9%a1%8d120%e8%90%ac%e6%98%af/</link>
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		<dc:creator><![CDATA[Elise]]></dc:creator>
		<pubDate>Wed, 08 May 2024 06:54:36 +0000</pubDate>
				<category><![CDATA[保險知識]]></category>
		<category><![CDATA[人身保險]]></category>
		<category><![CDATA[一定金額]]></category>
		<category><![CDATA[保險理賠]]></category>
		<category><![CDATA[理賠]]></category>
		<category><![CDATA[申訴評議]]></category>
		<category><![CDATA[評議中心]]></category>
		<guid isPermaLink="false">https://claimicu.com/?p=1556</guid>

					<description><![CDATA[評議中心是什麼？ 評議中心的全名是「財團法人金融消費評議中心」。這個單位並不是私人企業，而是由政府捐款成立的。 [&#8230;]]]></description>
										<content:encoded><![CDATA[
<h3 class="wp-block-heading">評議中心是什麼？</h3>



<p>評議中心的全名是<strong>「財團法人金融消費評議中心」</strong>。這個單位並不是私人企業，而是由政府捐款成立的。在「金融消費者保護法」施行前，過去的機制是由各個不同的同業公會或其他單位處理。但這樣<strong>缺乏單一專責機構，且無法律依據</strong>。所以為了處理金融商品、服務的民事爭議，有必要訂立專門的法律規定。</p>



<p>隨著金融商品和服務越來越多元且專業，消費者和金融業者之間在財力、資訊和專業方面存在著明顯的不平衡，往往會導致交易糾紛。一旦發生爭議，如果只依賴法院途徑來解決，會花費很高的成本，但卻得不到相對的效益。因此，必要<mark style="background-color:rgba(0, 0, 0, 0)" class="has-inline-color has-palette-color-2-color"><strong>提供一個具有金融專業知識且能夠公平、合理、快速有效地處理爭議的機制</strong>。</mark></p>



<blockquote class="wp-block-quote is-layout-flow wp-block-quote-is-layout-flow">
<p><strong>簡單的說，評議中心扮演著在訴訟外，一個簡單、免費且快速處理金融爭議的角色。</strong></p>
</blockquote>



<hr class="wp-block-separator has-alpha-channel-opacity is-style-wide"/>



<h3 class="wp-block-heading">評議的流程</h3>



<figure class="wp-block-image size-large"><img fetchpriority="high" decoding="async" width="700" height="1024" src="https://claimicu.com/wp-content/uploads/2024/05/評議中心-1-700x1024.png" alt="" class="wp-image-1560" srcset="https://claimicu.com/wp-content/uploads/2024/05/評議中心-1-700x1024.png 700w, https://claimicu.com/wp-content/uploads/2024/05/評議中心-1-205x300.png 205w, https://claimicu.com/wp-content/uploads/2024/05/評議中心-1-768x1123.png 768w, https://claimicu.com/wp-content/uploads/2024/05/評議中心-1-1050x1536.png 1050w, https://claimicu.com/wp-content/uploads/2024/05/評議中心-1.png 1311w" sizes="(max-width: 700px) 100vw, 700px" /><figcaption class="wp-element-caption"><br>申訴評議流程圖</figcaption></figure>



<hr class="wp-block-separator has-alpha-channel-opacity is-style-dots"/>



<p>當消費者與金融業者發生<strong>消費糾紛</strong>時，消費者可以透過評議中心向金融業者申訴，<strong>金融業者需在30天內回覆</strong>，如果回覆的結果是消費者所能接受的，那麼該案件就結案。若仍有不服，<strong>可在申訴後的60天內提出評議申請</strong>。</p>



<p>小編之前也曾經與某銀行發生糾紛，因為○○銀行的不當註記，多次進線客服都未能解決。在小編申訴該銀行以後，○○銀行回覆承認是銀行自己行政上的疏失，願意合理且依照我的訴求解決問題。這才讓事件落幕，也因為如此，小編才會如此著迷的投入知識推廣。<mark style="background-color:rgba(0, 0, 0, 0)" class="has-inline-color has-palette-color-2-color">(題外話)</mark></p>



<p>評議前，評議中心會先建議雙方<strong>進行調處</strong>，也就是消費者和金融業者先坐下來聊聊，雙方各退一步，達成共識。但這不是強制性的，若有一方拒絕調處，案件則會進入評議階段。最終會有一個評議結果，<strong>在一定金額以下，保險公司應接受評議結果。一定金額以上，則不受約束。消費者則是可以選擇接受或不接受評議結果，並且可選擇自行調降額度，讓額度落在一定金額以下。</strong></p>



<hr class="wp-block-separator has-alpha-channel-opacity is-style-wide"/>



<h3 class="wp-block-heading">一定金額是什麼？</h3>



<p>根據金融消費者保護法<a href="https://law.moj.gov.tw/LawClass/LawSingle.aspx?pcode=G0380226&amp;flno=29" class="ek-link" target="_blank" rel="noopener"> § 29 &#8211; 2</a> ：</p>



<blockquote class="wp-block-quote is-layout-flow wp-block-quote-is-layout-flow">
<p> 對於評議委員會所作其應向金融消費者給付每一筆金額或財產價值在<strong><mark style="background-color:rgba(0, 0, 0, 0)" class="has-inline-color has-palette-color-2-color">一定額度</mark></strong>以下之評議決定，應予接受。</p>
</blockquote>



<p>而這個<strong>「一定金額」</strong>則是由爭議處理機構<strong> ( 也就是評議中心 ) </strong>擬訂，報請主管機關核定後公告之。目前一定金額的額度，<a href="https://www.foi.org.tw/Article.aspx?Arti=1818&amp;Lang=1" class="ek-link" target="_blank" rel="noopener">可參考評議中心網站</a>。就保險理賠而言，目前主要分為兩種金額。</p>



<figure class="wp-block-image aligncenter size-full is-resized"><img decoding="async" width="857" height="530" src="https://claimicu.com/wp-content/uploads/2024/05/評議中心-2.png" alt="" class="wp-image-1561" style="width:434px;height:auto" srcset="https://claimicu.com/wp-content/uploads/2024/05/評議中心-2.png 857w, https://claimicu.com/wp-content/uploads/2024/05/評議中心-2-300x186.png 300w, https://claimicu.com/wp-content/uploads/2024/05/評議中心-2-768x475.png 768w" sizes="(max-width: 857px) 100vw, 857px" /><figcaption class="wp-element-caption"><br>一定金額在保險理賠上的規範</figcaption></figure>



<blockquote class="wp-block-quote is-layout-flow wp-block-quote-is-layout-flow">
<p>一次給付型：財產保險、身故保險金、癌症/重大傷病一次金、投資型保單</p>



<p>多次給付型：多次給付型醫療保險</p>
</blockquote>



<p><a href="https://claimicu.com/life-insurance-call-for-payment-11601/" class="ek-link">》》》延伸閱讀：墊繳停效保單，成功爭取身故理賠金 460 萬。</a></p>



<hr class="wp-block-separator has-alpha-channel-opacity is-style-wide"/>



<h3 class="wp-block-heading">總結</h3>



<p>因為新世代媒體崛起，造成資訊大爆炸，現在的保戶也越來越懂得爭取自己的權益。</p>



<p>但資訊經常只有片面，許多保戶或業務員，誤認為只要將無法理賠的案件，送到評議中心就可以爭取到理賠。卻不知道，評議結果其實是有相關規範的。</p>



<p>至於自願降金額到底划算嗎？小編認為取決於後續走訴訟有沒有勝率，還有<strong><mark style="background-color:rgba(0, 0, 0, 0)" class="has-inline-color has-palette-color-2-color">求償金額</mark></strong>和<strong><mark style="background-color:rgba(0, 0, 0, 0)" class="has-inline-color has-palette-color-2-color">一定金額</mark></strong>差距多少 ( 假設求償500萬，卻自願降低到120萬，那肯定是很不划算的吧！)。</p>



<p>真的遇上了比較複雜的理賠問題，建議找專業的「<a href="https://claimicu.com/contact/" class="ek-link">保險理賠ICU團隊</a>」協助評估唷。</p>



<hr class="wp-block-separator has-alpha-channel-opacity is-style-dots"/>



<p>保險理賠 ICU，理賠 I see you</p>



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