What should I do if there are disputes on online insurance?See how to deal with Baoshan Court →

In recent years, with the development of technology, the Internet insurance business has grown rapidly. Although consumers are increasingly convenient to insure, information disclosure, terms delivery and prompts of Internet insurance products often fail to fulfill their obligations. The insurance is relatively prominent.

Recently, the Shanghai Baoshan District People's Court (hereinafter referred to as the Baoshan Court) concluded a dispute over a personal insurance contract. The parties had controversial whether the insurer delivered the insurance clauses during the insurement of the online insurance and the prompts to explain the obligation. In the end, the insurance company failed to prove that it had fulfilled the above obligations, and the insurance would be paid.

Brief case

In August 2020, Zhang, as the insured and the insured, insured on the official website of an insurance company to insure "XX Driving Whether worry -free", including "XX Driver Accident Insurance (A)" and "A number) and" " XX driver and passenger accidental injury insurance ". From August 11, 2020 to August 10, 2021, the insurance amount of accidental injuries and disability is 300,000 yuan.

After the insurance, the insurance company only delivered the insurance policy to Zhang's "XX Driving Womanos" as a certificate of the insurance contract.

On October 25, 2020, Zhang had a road traffic accident, causing the car to destroy people. The traffic accident identification of the case was identified as the main responsibility of the outsiders of the accident, and the deceased Zhang bears the secondary responsibility of the accident.

Afterwards, Zhang's family members claimed to the insurance company to compensate 300,000 yuan in accidents, but the insurance company refused to compensate the insurance money on the grounds that Zhang's death did not belong to the scope of insurance. Therefore, Zhang's family members filed a lawsuit with the court.

The defendant's insurance company said that according to the "XX driver accidental injury insurance (A)" and "XX driver and passenger accidental injury insurance insurance" insurance clauses, Zhang's death was not the scope of insurance.

The plaintiff said that Zhang did not receive insurance clauses after insured, and only received the insurance policy of "XX Driving Wompeare", and the insurance company's insurance company should pay an accident of 300,000 yuan.

Therefore, the focus of the controversy in this case is whether Zhang knows the scope of insurance liability stipulated in the insurance contract involved in the insurance contract when insurance is insured.

The court believes

According to Article 17 (1) of the Insurance Law, if an insurance contract is concluded, and the format provided by the insurer, the insured order provided by the insurer shall be attached to the format clause, and the insurer shall explain to the insurer. Essence The insurance clause involved in the case is the formal clause provided by the defendant, which has the obligation to explain the format clause.

In this case, the insured Zhang's electronic insurance was conducted through the Internet. The plaintiff stated that the insurance clause was not received, and the defendant did not submit evidence to prove that its operating process on the electronic insurance and the specific content of the insured know the insurance clause. The two insurance clauses cannot be used as the basis for determining the rights and obligations of the two parties in this case. Whether the defendant in this case should claim the claims shall be determined based on the content recorded on the "XX Driving Womnolar Perspaignment" insurance policy. According to the content recorded by the insurance policy, the accident in this case belongs to the insurance liability scope of "XX Driving Whether worry -free".

After the trial of the Baoshan Court, the plaintiff's claim was supported by the plaintiff Zhang's family, and the defendant's insurance company compensated the plaintiff's accidental death insurance at 300,000 yuan. After the insurance company did not accept an appeal, the court in the second instance was maintained.

Judicial advice

The judge in this case found that the phenomenon of "leather" in the Internet insurance disputes on whether insurance companies delivered insurance clauses and fulfilling their prompt obligations were increasingly prominent. The reason is that because of online sales, all behaviors rely on the Internet. The insurer needs to rely on the operating procedure of the webpage to complete the delivery of the contract terms and prompts instructions, and put forward higher technical requirements for the insurer. The second is that some insurance companies and practitioners have "re -sale of light sales", which affects the greatest integrity principles of the insurance industry, and harms the environment of integrity in the insurance industry.

In view of the above issues, Baoshan Court issued a judicial proposal to the insurance company, pointing out two issues of the insurance company. One is insufficient evidence retention, and the second is that the regulatory regulations in the field of Internet insurance are not strictly implemented, and judicially proposed in a targeted judicial manner. Suggest:

1. It is recommended that insurance companies organize the study of Internet insurance regulatory documents issued by the Banking and Insurance Regulatory Commission.

2. Implementation of Internet insurance recovery management regulations, strictly follow the "Notice on Regulating the Standardous Management of Internet Insurance Sales Behavior", do a good job of controlling the sales page, refine the identification and preservation of the "operation trajectory", and realize the sales behavior to restore the restoration of sales behavior. , And in accordance with the provisions of the retrospective management data storage period.

After the above judicial proposals were issued, the insurance company had given feedback in a timely manner, and stated that it would strengthen the sales management of Internet business, strictly implement the "Notice of the China Banking Regulatory Commission on Regulating Internet Insurance Sales Behavior Reception Management"; pay attention to the sales side and the sales side and The problems encountered by the claims make the underwriting claims more professional, reduce the lawsuit of similar rejection, and save judicial resources.

Judge Tips

According to the relevant provisions of the Insurance Law, the insurance company, whether online or offline, should provide the insurance policy and the insurance clause to explain the content of the contract to the insured person. The obligation of clearly explained; the implementation of the above obligations shall be responsible for the insurer.

For the insured, when signing the policy and insurance clauses, you must also fully understand the meaning of the terms, and pay special attention to the terms of deepening deepening deepening.Source: Shanghai Baoshan official WeChat

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