Case: A woman A died of gas poisoning while taking a shower at home. Her husband purchased two accident insurance policies for her from Insurance Company A, each with an insurance amount of 100,000 yuan, and purchased five accident insurance policies for her from Company B. We bought an accident insurance policy with an insurance amount of 100,000 yuan each from Company C, with an insurance amount of 100,000 yuan. We conducted an investigation after receiving the entrustment from Insurance Company A. After learning about its insurance status, we were cautious. They learned about the situation in detail from their husband B and his parents. There was no evidence that it was suicide. They also learned about the situation from the public security organs who dispatched police at the time. After on-site investigation, the police believed that it was a non-criminal homicide and allowed the family members to burn the body. The medical examiner concluded that death was caused by carbon monoxide poisoning.
When reviewing the policy, I found that the name of the deceased A was filled in the policyholder column, and A’s name was filled in the insured column, and the policyholder’s signature was in the signature column below the policy. It is the name of her husband B, and the insured’s signature column is unsigned and blank. The sales department of the insurance company confirmed that it was her husband who went to the sales department to purchase the insurance.
Insurance Company A made the decision in accordance with Article 56, Paragraph 1 of the Insurance Law, “If a contract that requires death as a condition for payment of insurance benefits without the written consent of the insured and recognition of the insurance amount, the contract shall be invalid.” The conclusion was reached that the policy was invalid and the claim was refused. (It is understood that Insurance Company B considered the case suspicious and reported it to the public security organ)
As far as Insurance Company A’s reasons for refusing compensation are concerned, I personally have the following questions:
First, who is the policyholder of this declaration?
The name of the deceased A is filled in the policyholder column at the beginning of the policy, and the signature column of the policyholder at the end of the policy is the name of someone else. Which of the names of husband B is the policy holder?
If A is the policy holder, is the signature in the insured column at the end of the policy absolutely necessary? If so, what is the logic behind it? It means that "the policyholder must obtain his or her written consent to take out an insurance with death as the condition for payment of insurance benefits for his or her own benefit." This is obviously unnecessary. Therefore, if the policyholder is the deceased, the policy should be valid.
If her husband B is the policy holder, it seems that Article 56 of the Insurance Law applies and the policy is invalid.
In my personal opinion, the policy holder should be the deceased. "The insured refers to the person who enters into an insurance contract with the insurer and is obligated to pay the insurance premium in accordance with the insurance contract." In this case, who made the insurance contract with the insurer and who paid the insurance premium? Is it necessary to verify whose property the insurance premium was paid from? What if it was paid from the couple’s property? Therefore, the insured person can only be the person named in the policy, that is, the person named in the insured column. Although it was actually her husband who went to the sales department to purchase the insurance, and although the signature in the signature column of the policy holder at the end of the policy was her husband B, the policy holder of this insurance contract should also be the deceased A, and her husband was just for it. The person in charge of purchasing insurance, not the parties to the insurance contract.
Second, the insurer is not strict in its review when underwriting
If the insurer is strict in its review when underwriting, the situation mentioned above will not happen, and since the insurance company is In this case, if a policy is issued for him, can it be regarded as a waiver of the right to refuse compensation because the insured did not sign? In this case, can the principles of waiver and estoppel be applied? If so, even if this policy The policyholder was the deceased’s husband X, so it seemed that the insurance company should not claim that the policy was invalid and refuse to pay compensation. Is it too rigid to apply Article 56 of the Insurance Law to refuse compensation?
Third, many policies in group accident insurance do not have the signature of the insured
In group accident insurance , especially in the case of anonymous insurance, most policies do not have the signature of the insured. In this case, if the insured dies due to an accident, can these policies be claimed in accordance with Article 56 of the Insurance Law? Invalid? In practice, we have never seen a case where an insurance company claimed that the policy was invalid.
Therefore, I personally think that the reason why the insurance company refused to pay compensation in this case does not seem to be very correct. If you suspect that there is a problem with the case, caution is necessary. I think it is safer to follow Company B’s approach and report the case to the public security agency.
Extended reading: How to buy insurance, which one is better, and step-by-step instructions to avoid these "pitfalls" of insurance