Do not remind you not to explain, the exemption clause is invalid!

Li Jiliang

When buying insurance, do you pay attention to the exemption clause of the responsibility? Recently, the judge of the Shaya County People's Court explained the law: Only the insurance company fulfilled the obligations of the reminder and clearly explained, and the exemption clause had legal effect.

Retrospective

On the evening of November 1, 2020, I went to a friend's house for dinner. Because my friend's house was not far away from my own house, after the dinner, I walked home according to a certain way. I did not expect that a car that came from a flying car was hit out a few meters away.

After the accident, Yi Mou was immediately taken to the hospital, but due to the serious injury, he died invalid.

Yi Mou's wife, Gu Gu, remembered that her husband had bought a small rural accident insurance insurance before his lifetime, and then applied to the insurance company for claims, but the insurance company was based on the test of alcohol in the blood during a traffic accident as a traffic accident. Reject claims.

The insurance company believes that when an accident occurs, Yimou is a state of drunk walking, and is not compensated according to the exemption provisions of "dying of alcohol, drugs, and controlling drugs" in the insurance contract, and will not be compensated.

Gu Mou said that when Yimou purchased insurance, she was also present. The insurance company did not explain the exemption clauses. She and Yi did not know about this content.

Due to many negotiations, in May this year, Gu Mou complained to the People's Court of Shaya County to ask him to pay an insurance compensation.

Trial site

The undertaking judge believes that the focus of the controversy in the case lies in whether the insurance company fully fulizes the obligation to inform the exemption clause; the road traffic accident death on the road after a wine is in line with the provisions of "died by alcohol" in the exemption clause. Essence

The court trial believes that in the insurance contract signed by a certain insurance company, although the responsibility exempt matters are reminded in the form of black body, the insurance company has not provided evidence that the obligations that have been fulfilled in explanation, confirming that the staff performed the insurance clause at the insurance site on the insurance site. Obligations to prompts and explanations. As an insurer, the insurance company does not prompt the insurer's exemption clause, and the exemption clause does not have the effect on the insured. In addition, the direct cause of death is a traffic accident, not an alcohol effect. Although Yi walks on the road after alcohol, it does not conform to the insurance liability of the death of alcohol to be exempted.

In summary, the court determined that the death of a certain death was in accordance with reasonable claims. Recently, the Shaya County Court ruled that an insurance company paid the insurance compensation to the wife of Gu, Gu, Gu. Both sides are convicted.

Judge remind

Rural minor accident insurance insurance is a form of personal insurance. It has the characteristics of low premiums, moderate guarantee, popular insurance policies, and simple claims. It is often collectively purchased by villages and villagers. Group insurance should make prompts and instructions that the insurers are sufficient to attract attention for the exemption clause.

The insured should also pay attention that even if the accident insurance is purchased, not all accidents can get claims. When insured, you must understand the guarantee responsibility and exemption clause in the policy.

Extended reading

How to count the clear reminder and explanation obligations?

Article 17 of the "Insurance Law of the People's Republic of China" stipulates that if an insurance contract is entered into the format provided by the insurer, the insurer provided by the insurer to the insurer shall attach the format clause, and the insurer shall explain the content of the contract to the insurer.

For the provisions of the insurer's responsibility in the insurance contract, the insurer shall make a prompt that is sufficient to attract the attention of the insurer on the insurance policy, insurance policy or other insurance vouchers, and to The insured person makes a clear explanation; if no prompt or clearly explain, the terms will not work.

It can be seen that the reminder and clear explanation of the insurer's attention to the insurer's attention to the exemption clause is an obligation that the insurer must fulfill the policyholder.

In insurance, the exemption clause generally has two ways to present, one is concentrated, and the other is decentralized presentation. Regardless of which presentation method is adopted, as long as it involves the content of the responsibility of the insurance company, the insurer needs to make a prompt and make a clear explanation. (Pomegranate/Xinjiang Legal Daily reporter Wang Chen Correspondent Mao Qianwen)

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