Take B2 license to drive A2 car, refused to pay
Zhao because of its permitted driving type B2, and does not have the qualification to drive heavy semi-trailer tractor A2, so the insurance company on this ground, will refuse to the commercial part of the amount of the insurance compensation, and only bear the amount of compulsory insurance.
Personal Accident Insurance Clause
Article 7 of the insured suffered injuries resulting in death, disability or burns during the following periods, the insurer also does not bear the responsibility of paying benefits: (a) during war, military operations, riots or armed rebellion;
(b) during the period of drunkenness of the insured or the influence of drugs, controlled substances;
(c) (iii) The period during which the insured person is driving under the influence of alcohol, driving without a valid driver's license or driving a motor vehicle without a valid license.
According to the terms and conditions of the contract, the insurer is not liable to pay benefits in the event of the insured's death. The insurer's insurance liability for the insured terminates, and the net unfulfilled premium is refunded to the policyholder on a daily basis.
Case:
China's Jiangxi Network, the ancient Zhenzhen, Zhang Zhenwei reported: the owner of a motor vehicle driving and driving license is not consistent with the permitted type of motor vehicle accidents caused death, the deceased's family asked the insurance company to bear the responsibility of compensation within the scope of the commercial insurance, the insurance company has been exhaustive exemption clauses to inform the obligation of the reasons for the refusal to pay compensation. Recently, the Yudu County People's Court was commissioned by the Ganzhou Intermediate People's Court to make a final judgment on a dispute over the liability for a motor vehicle traffic accident, and ruled that the defendant insurance company should pay the plaintiff 220,000 yuan within the limit of compulsory insurance, and that the defendant logistics company should compensate the plaintiff 147,900 yuan.
May 25, 2012, TianMouDe driving heavy semi-trailer tractor (hauling heavy container semi-trailer) from the direction of YuDuXian to the direction of NingDuXian driving, line to YuYin highway 3km +980m, and from left to right across the road of pedestrian LuoMouFeng collision, cause LuoMouFeng by hospital rescue invalid death of road traffic accident.
After the Yudu County traffic police brigade to make a road traffic accident responsibility certificate, found that Tian Moude is responsible for the main responsibility of the accident, Luo Moufeng is responsible for secondary responsibility. TianMouDe driving heavy semi-trailer tractor (traction heavy container semi-trailer) vehicle is the defendant logistics company, TianMouDe is the company staff. The vehicle in the defendant's insurance company insured two compulsory insurance, in the defendant's insurance company insured 1 million yuan deductible commercial third party liability insurance, the incident are in the insurance period. It was found that Tian Mode was driving the vehicle involved in the accident which did not conform to the permitted driving type stated on his driver's license.
After the accident, the defendant logistics company to the plaintiff side to pay 10,000 yuan. Because the claim was unsuccessful, the plaintiff party then sued to the court for legal action.
Lawsuit, the defendant logistics company argued that the plaintiff over the compulsory insurance part of the accident according to the proportion of responsibility for the loss should be borne by the defendant insurance company in the commercial third party liability insurance coverage. The defendant insurance company argued that the two sides signed the insurance terms have agreed to "driving and driving license does not match the type of motor vehicle, the insurer is not responsible for compensation" of the exemption, and has informed the obligation, and Tianmude driving without a license, so the insurance company should be exempted.
The court of first instance that the defendant insurance company to Tian Moude driving without a license, the commercial third party liability insurance is not compensated for the claim, because the defendant insurance company submitted a form contract, did not submit evidence to confirm that the exclusion of insurance terms according to each other in accordance with the requirements of the detailed interpretation of the obligation, and the driver has a driver's license, only its driver's license does not match the type of permitted driving, the contract between the two sides did not explicitly agree on the exclusion clause. The contract between the two sides did not explicitly agreed, so the insurance contract exclusion clause agreement does not have effect, therefore, the defendant insurance company's defense is not valid, it should be in the commercial third party liability insurance coverage.
The defendant insurance company was dissatisfied with the judgment of the first instance, and considered that the judgment of the first instance was not based on sufficient grounds for it to bear the liability within the scope of the commercial third party liability insurance, and thus appealed to the Intermediate People's Court of Ganzhou City.
The court of second instance held that the defendant insurance company submitted the insurance policy and motor vehicle third party liability insurance terms in the first instance, the insurance policy had the seal of the defendant insurance company, the insurance terms of the exemption of liability part of the black highlighting, and the terms of the agreement to drive and the driver's license is not compatible with the permitted type of motor vehicle, the insurer shall not be responsible for the compensation, so it should be found that the defendant insurance company fulfilled the duty of reminder, and it should be found that the defendant insurance company was not responsible for the compensation of the motor vehicle. Therefore, it should be concluded that the defendant insurance company has fulfilled the duty of reminder, and the insurance clause is effective. Therefore, the defendant insurance company in the commercial third party liability insurance shall not be liable for compensation. Therefore, the court made the above judgment.
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