The insurer signed to confirm and declare that it had fulfilled its obligation to clearly explain the exemption clause, but the garment factory could not produce evidence to the contrary to prove that the insurance company had not fulfilled its obligation to clearly explain.
A clothing factory in Shanghai recently called the editorial department of this newspaper to complain that an insurance company refused to pay for property theft and emergency rescue. The person in charge of the factory said that the factory applied to the insurance company for compensation for the loss of goods, but the insurance company refused to pay compensation on the grounds that the factory was unattended.
Last June, the garment factory signed an enterprise property insurance contract with an insurance company, with special clauses on theft insurance. The insurance period is from June 2006 to June 2007, with the insured amount of 400,000 yuan, and all the premiums will be paid off the next day.
During the National Day last year, all employees of the garment factory had a holiday, leaving only the staff on duty to look after the factory. One night, the personnel on duty left the factory without authorization during the inspection on duty and did not return to the factory until noon the next day. When he returned to the factory for inspection, he found that some of the cost clothes originally delivered the next day were stolen and the factory gate was obviously pried open. Besides the stolen clothes, the 2000 yuan cash he put in the drawer was also stolen.
The duty officer immediately reported the case to the public security department. After on-site investigation, the clothing factory lost about 250,000 yuan in property. As the case has not been resolved, the garment factory submitted a written claim report to the insurance company in July 2006.
After the survey, the insurance company immediately issued a notice of refusal to pay compensation to the clothing factory. According to the notice, according to the agreement of the "Special Clauses of Enterprise Property Insurance Clauses Attached to Theft Insurance" (hereinafter referred to as "Special Clauses"), "the insurer will not be responsible for the stolen losses caused by the unattended insurance address".
The person in charge of the garment factory insisted that "the insurance company should pay compensation, or else it would be necessary to buy theft and rescue?" He said that the two sides are still negotiating further. If the negotiation fails, the garment factory will formally sue the insurance company through legal channels.
According to the reporter's understanding, the insurance company insists that the garment factory handle enterprise property insurance in the insurance company and pay the insurance premium. The insurance contract is legal and valid, and both parties should abide by it. During the insurance period, the insurance property of the clothing factory was stolen, but it was stolen because the insurance address was unguarded. The fact that the insurance address has not been taken care of has been confirmed by the written materials provided by the insurer, and this behavior belongs to the exclusion liability in the insurance clause. "This is clearly stipulated in the special terms for theft and rescue signed at the beginning. If the garment factory sues us, we are willing to cooperate. "
However, the person in charge of the garment factory said that when signing the contract, the insurance company did not fulfill its clearly stated obligations, and the company did not fully understand the exclusion liability, nor did it know that "the insurance company will not pay for the unguarded theft".
Cases like the above have precedents in the past. How to punish past cases has certain reference value to this case. In this regard, the reporter interviewed three lawyers of our lawyer advisory group, namely, Mr. Bei from Shanghai United Law Firm, Mr. Shanghai Branch of Xinli Law Firm and Mr. Wu Dong from Shanghai Ye Hui Law Firm.
The views of the three lawyers are basically the same: whether the insurance company compensates depends on how the insurance contract signed by the two parties was agreed. If there is an exemption clause in the insurance contract, which stipulates that "the insurance address is stolen due to unattended, and the insurance company refuses to pay compensation", then it is completely reasonable for the insurance company to refuse to pay compensation; On the contrary, it is unreasonable for insurance companies to refuse to pay compensation.
Lawyer Bei Zhengming told the reporter that if there is no special exemption clause in the insurance clause, both parties can settle it through consultation. According to previous court cases, in this case, the court usually orders the insurance company to make appropriate compensation.
Obviously, the focus of the dispute in this case is whether the exclusion liability of the additional insurance clauses of property insurance is legally binding on the insured. The insurance company believes that the signature of the insured on the insurance policy has fulfilled the insurer's obligation to explain the standard terms stipulated in the Insurance Law. Agreement in the column of "Applicant (Signature)": The applicant declares that the above contents are true and has understood the contents and descriptions of your company's basic insurance clauses and additional insurance clauses, including exclusions. Once the applicant signs or seals this column, it proves that the insurer has fulfilled its obligation to explain the insurance clauses.
Judging from the current situation, the insurer has signed the confirmation and statement, which proves that it has fulfilled the obligation to clearly explain the exemption clause, but the garment factory can't produce the opposite evidence to prove that the insurance company has not fulfilled the obligation to clearly explain.
Therefore, the insured should be reminded to fill in the application form carefully before signing, and read the relevant matters and insurance clauses carefully before signing or sealing the application form. If you don't understand the terms, you should find the business personnel of the insurance company to explain them in time.
Once the applicant signs or seals the insurance application form, it is deemed that the insurer has fulfilled the obligation to explain the insurance clauses when underwriting, which also means that the applicant already knows the exclusions in the insurance clauses.