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保险合同类型案件汇编 | 法宝双语案例

北大法律信息网 2020-09-20

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1. 赵青、朱玉芳诉中美联泰大都会人寿保险有限公司意外伤害保险合同纠纷案
Zhao Qing and Zhu Yufang v. Sino-US United MetLife Insurance Co., Ltd. (A case about dispute over an accidental injury insurance contract)

2. 仇玉亮等诉中国人民财产保险股份有限公司灌云支公司等意外伤害保险合同纠纷案
Qiu Yuliang et al. v. PICC Property and Casualty Company Limited Guanyun Sub-branch et al.(case of dispute over the accident insurance contract)

3. 陆永芳诉中国人寿保险股份有限公司太仓支公司保险合同纠纷案
Lu Yongfang v. Taicang Branch of China Life Insurance Company Limited (insurance contract dispute)

一、赵青、朱玉芳诉中美联泰大都会人寿保险有限公司意外伤害保险合同纠纷案

Zhao Qing and Zhu Yufang v. Sino-US United MetLife Insurance Co., Ltd. (A case about dispute over an accidental injury insurance contract)

【裁判要旨】

意外伤害是指由于外来的、突发的、非本意的、非疾病的原因导致身体受到伤害的客观事件。饮酒过量有害身体健康属生活常识，被保险人作为完全民事行为能力人，对此完全可以控制、避免，故饮酒过量导致身体损害不是基于外来的、突发的和非本意的因素，不属于意外伤害，被保险人据此申请保险公司支付保险金的，人民法院不予支持。

[Judgment Abstract]

“Accidental injury” refers to an objective event in which a person suffers from bodily injury for any external, unexpected, involuntary, and non-disease causes. It is common sense that excessive drinking is harmful to health. As a person with full capacity for civil conduct, the insured has the capacity to fully control and avoid excessive drinking. Therefore, the bodily injury caused by excessive drinking is not an external, unexpected, and involuntary factor and it was not an accidental injury. If the insured claims for the payment of insurance proceeds with the insurance company based thereon, the people's court should not uphold such claim.

来源：《最高人民法院公报》 2017年第9期（总第251期）

Source Note：SPC Gazette, Issue 9, 2017 (No. 251)

【法宝引证码】CLI.C.9818158

[CLI Code] CLI.C.9818158(EN)

二、仇玉亮等诉中国人民财产保险股份有限公司灌云支公司等意外伤害保险合同纠纷案

Qiu Yuliang et al. v. PICC Property and Casualty Company Limited Guanyun Sub-branch et al.(case of dispute over the accident insurance contract)

【裁判要旨】

学校的教学环境、活动设施必须符合安全性要求，以保障学生生命健康不受损害。若因可归责于学校的原因导致学生生命健康权受损，按照投保的校园方责任险应由学校承担赔偿责任的，应当依据保险合同约定由保险公司代为赔偿。学校以免除己方责任为条件与家长签订人道主义援助补偿协议，应主要认定其所具有的补偿性，而非免除保险公司的赔偿责任，在学校怠于请求保险赔偿时，不应依据该协议剥夺受害人的保险索赔权。

[Judgment Abstract]

The teaching environment and activity facilities in a school must comply with safety requirements to protect students from any damage to life and health. Where the damage to a student's right to life and health is attributable to the school, and if the school shall be liable for compensation according to the school liability insurance purchased, the insurer shall compensate on behalf of the school according to the insurance contract. The humanitarian assistance and compensation agreement concluded between the school and parents on the condition of exempting the school from any liability shall mainly be deemed compensatory rather than to release the insurer from the liability for compensation. Therefore, if the school is slack in claiming insurance compensation, the victim shall not be deprived of the right to make insurance claims in accordance with such an agreement.

来源：《最高人民法院公报》 2017年第7期（总第249期）

Source Note：SPC Gazette, Issue 7, 2017 (No. 249)

【法宝引证码】CLI.C.9241978

[CLI Code] CLI.C.9241978(EN)

三、陆永芳诉中国人寿保险股份有限公司太仓支公司保险合同纠纷案

Lu Yongfang v. Taicang Branch of China Life Insurance Company Limited (insurance contract dispute)

【裁判摘要】

人寿保险合同未约定具体的保费缴纳方式，投保人与保险人之间长期以来形成了较为固定的保费缴纳方式的，应视为双方成就了特定的交易习惯。保险公司单方改变交易习惯，违反最大诚信原则，致使投保人未能及时缴纳保费的，不应据此认定保单失效，保险公司无权中止合同效力并解除保险合同。

[Judgment Abstract]

In the absence of a specific method of premium payment in a life insurance contract, it should be deemed that the insurance applicant and the insurer have formed a particular transaction habit if they have long maintained a relatively fixed method of premium payment. If the insurance company's unilateral change of the transaction habit in violation of the principle of utmost good faith leads to the insurance applicant's failure to pay premiums in a timely manner, the policy should not be determined invalid, and the insurance company is not entitled to suspend the validity of the contract and terminate the insurance contract.

来源：《最高人民法院公报》 2013年第11期(总第205期)

Source Note：SPC Gazette, Issue 11, 2013 (No. 205)

【法宝引证码】CLI.C.1798733

[CLI Code] CLI.C.1798733(EN)

责任编辑：李泽鹏

稿件来源：北大法宝英文编辑组（Mani）

审核人员：张文硕

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