A6 atelier Wei Ran
Win the lawsuit case experience is shared
Insurance liability of the underwriter is assumed whether does the account that the key consists producing insurance accident belong to accept insurance risk, insurant or 3 person raise claim for compensation to insurance company, should the loss of mark of quote proof insurance is caused by accept insurance risk, quote incapable, the underwriter does not assume liability to pay compensation.
One, brief introduction of details of a case
October 2014, inside goods area of discharge of field of some of area of Shanghai treasure mountain, of mark drive the person drives the death after the container of ahead of the dash against when container van. After the accident, management department of treasure mountain policeman issued an accident to prove, the condition that thinks to the person cannot drive when check accident happens and drive state, reason cannot check this accident is by drive illegal behavior of the person is caused.
Treasure mountain public security divided institute of bureau criminal science to issue drive dead circumstance of the person explains, think but preliminary platoon except comes violent and deadly possibility, drive the person is accorded with in drive the disease is broken out to die in travel process, the serious degree of the wave motion of insecurity of car of exhausted excuse me, spirit, mood or the mood change that collide because of car and produce happening that can cause a disease or aggravating disease, specific need to anatomize affirm.
This case dead family member without relevant section autopsy, cremate the dead's remains directly. After insurant compensate pays the dead the family member, to forensic to lodge a complaint, requirement insurance company assumes liability to pay compensation inside limitation of personnel responsibility danger on board.
2, controversy focus
The immediate cause that causes the dead's death cannot decide, whether does the underwriter need to assume liability to pay compensation?
3, legal analysis
Insurance law theory thinks, whether does the underwriter assume liability to pay compensation, depend on of accept insurance risk and insurance mark whether to exist between the loss causal, be sure namely the immediate cause principle on law principle. Immediate cause must be to cause damage the the directest, most effective, has decision effect reason that happen. Only immediate cause belongs to accept insurance risk and the insurance loss that causes by its just belongs to insurance liability.
This guarantee slip is danger of responsibility of the personnel on the car, risk of its accept insurance is the contingency of the personnel on the car, and a kind of situation that traffic accident attributes contingency, if the personnel on the car causes death because of traffic accident,belong to insurance liability. The dead because oneself disease is deadly or sudden death does not belong to accept insurance risk. Accordingly, because cause death accidentally,the personnel on the car is not, the underwriter does not assume liability to pay compensation.
To the dead dead reason cannot decide, if accuser asks the underwriter assumes insurance responsibility according to insurance contract, requiring the contingency such as proof traffic accident is the immediate cause that causes the dead's death, namely traffic accident collision and drive have between person death inevitable causal, if quote cannot, basis " holds whose quote " principle, accuser needs to bear the consequence with corresponding adverse quote.
4, handle a course
After receiving litigant data, staff of insurance company agency comprehends the spot collision picture that films at that time above all, damage of the car when be informed an accident is not serious, go on the spot then accident scene is examined, discover goods yard field is not big, the car travelling speed that moving is slower, the possibility that direct collision causes death is not large; Next, agency staff considered carefully to be sure the immediate cause principle of the law, inquired relevant case, analysed at the same time civilian the quote responsibility in telling a way allocates a principle then compose rejoin in detail shape is referred to the court before front courtyard; Finally, on agency staff front courtyard when rejoin actively, think: 1, drive the immediate cause that the person dies is its oneself disease is brought about, collision does not cause, and the risk of accept insurance of the insurance company in this case is the death that traffic accident causes, the basis must be the directest in immediate cause principle, the most effective, reason that has decision effect, do not answer to be paid by insurance company compensate so; 2, because insurance company has told prosecutor,matter of this case death exists controversy, and body of accuser one-sided cremation brings about dead reason to cannot be found out, should accuser assumes quote incapable adverse consequence.
Through cognizance, final court thinks, the insurance liability of this case underwriter is assumed whether does the account that the key consists maintaining insurance accident belong to accept insurance risk, whether is this case traffic accident to bring about drive the immediate cause that the person dies. To this, should give according to the immediate cause principle in insurance law analysis. Only immediate cause belongs to the risk that be protected, insurance talented person assumes compensate to pay duty. In this case, issued on November 19, 2014 from place of division of detect of punishment of substation of treasure mountain of Shanghai public security bureau the circumstance specification that about driving the person dies carries bright " ... the dead is accorded with in drive the disease is broken out to die in travel process, the serious degree of the wave motion of insecurity of car of exhausted excuse me, spirit, mood or the mood change that collide because of car and produce happening that can cause a disease or aggravating disease, specific need is anatomized affirm " content is knowable, drive the person's specific death reason needs to anatomize affirm, however accuser expresses to drive the person's remains brings back native place cremation by the family member, before cremation not cadaver check, cannot make clear cause of death finally, relevant adverse consequence should by accuser conceit. Because collision is caused,showing accuser to also have no any evidence to prove is drive reason of oneself of person death and rather than is caused. On put together, this academy thinks accuser proves to drive without evidence the person dies main, direct, critical account is be caused by of traffic accident collision, traffic accident collision and drive exist between person death inevitable causal, insurance company should not assume reason liability to pay compensation.
Case offers: Earth Shanghai branch
