Reply on Issues Relevant to Insurance Contract Disputes
关于保险合同纠纷案件有关问题的复函
Arising from a specific Municipal Higher People's Court case, the China Insurance Regulatory Commission issued opinions that may be referred to by subsequent judicial decisions.
(Issued by the China Insurance Regulatory Commission on February 21 2006.)
(中国保险监督管理委员会于二零零六年二月二十一日发布。)
Chongqing Municipal Higher People's Court:
重庆市高级人民法院:
Your Letter Requesting Advice on Issues Relevant to Insurance Contract Disputes ([2005] Yu Gao Fa Min Zhong Zi No.174) has been received. After study, we provide you the following reply on relevant issues:
你院关于咨询保险合同纠纷案件有关问题的函(〔2005〕渝高法民终字第174号)收悉。经研究,现就有关问题函复如下:
1. Obligation of Truthful Disclosure
一、 关于如实告知义务
Pursuant to Article 17 of the Insurance Law, the obligation of truthful disclosure by the proposer at the time of conclusion of an insurance contract should be a disclosure by query, i.e. the insurer asks questions in written or oral form and the proposer is obligated to make a disclosure. If the insurer has raised relevant issues on the risk inquiry form and the proposer leaves such portion blank, the proposer should be deemed to have failed to perform his disclosure obligation.
依据保险法第十七条规定,投保人订立保险合同时的如实告知义务,应当属于询问告知,即保险人以书面或者口头形式提出询问,投保人有义务进行告知。如果保险人对有关事项已在风险情况询问表上提出,投保人未填写,应视为投保人未履行告知义务。
Pursuant to Article 5 of the Insurance Law and Article 60 of the Contract Law, the parties to an insurance contract should abide by the principle of good faith in exercising their rights and performing their obligations, and in the course of the performance of the contract should perform incidental good faith obligations such as the obligation of notification, assistance, etc. based on the nature and objective of the contract and trade practice. At the time the insurance is taken out, if the proposer is well aware or ought to know of certain important matters that have a bearing on the risk attaching to the subject matter of the insurance and would have an impact on the insurer's decision on whether or not to underwrite the insurance or increase the premium rate, the proposer should, based on the principle of good faith, provide an appropriate explanation or disclosure thereof, regardless of whether the insurer expressly asked about such matters. If the proposer deliberately fails to perform such good faith obligation, he is liable for damages for negligence in the conclusion of an agreement pursuant to Items (2) and (3) of Article 42 of the Contract Law. Furthermore, pursuant to Article 37 of the Insurance Law, if the degree of risk attaching to the subject matter of the insurance increases after the formation of an insurance contract, the proposer bears an obligation of notification in accordance with the contract. If the proposer fails in such obligation, the insurance company is not liable for indemnification for any insurable accident occurring due to the increase in the degree of risk attaching to the subject matter of the insurance.
依据保险法第五条、合同法第六十条规定,保险合同当事人行使权利、履行义务应当遵循诚实信用原则,合同履行过程中应当根据合同的性质、目的和交易习惯履行通知、协助等诚信附随义务。投保时,如果投保人明知或应当知道某些重要事项涉及保险标的风险,影响到保险人决定是否承保或提高保险费率,即使保险人没有进行明确询问,投保人基于诚信原则,也应进行适当说明或者告知;如果投保人故意不履行这种诚信义务,依据合同法第四十二条第(二)、(三)款,投保人要承担缔约过失的损害赔偿责任。此外,依据保险法第三十七条,保险合同成立后,保险标的危险程度增加的,投保人按照约定负有通知义务;否则,对因保险标的危险程度增加而发生的保险事故,保险公司不承担赔偿责任。
2. Interpretation of Insurance Clauses
二、 关于保险条款解释
The letter you sent us was not accompanied by a sample of the specific insurance clauses, making it difficult for us to determine the actual version of such clauses. Deducing from the time the insurance was underwritten, the clauses of such All Risks Property Insurance should be the ones formulated, issued and implemented by the People's Bank of China in 1996. Pursuant to the relevant provisions of our Circular on the Administration of the Record Filing of Property Insurance Clauses and Premium Rates (Bao Jian Fa [2001] No.120), the clauses of such insurance should, before the revision by the China Insurance Regulatory Commission, continue to be handled in accordance with the original provisions of the People's Bank of China. If an insurance company continues to use such clauses, it is not required to carry out record filing procedures. The China Insurance Regulatory Commission is not responsible for interpreting insurance clauses that were neither formulated or revised by it. For the interpretation of the relevant terms and expressions in such clauses, you are asked to refer to the People's Bank of China, Circular on the Issue of the Clauses of, and Premium Rates for, and and the Interpretation of the Clauses Thereof (Yin Fa [1996] No.187). The Interpretation of the Clauses of All Risks Insurance attached to the said Circular does not expressly define the term 'dangerous structure', however the third item (which reads as follows, "those which are not conducive to the thorough implementation of relevant government orders or provisions, such as illegal structures and other premises or buildings that the government has ordered demolished or renovated within a specified period of time") of the explanation of the main reasons of Article 3 concerning "property listed that does not fall within the insured scope of the subject matter of the insurance" may serve as a reference criterion. The term 'sudden landslip' is defined in Article 4 as "the sudden downward slippage under the force of gravity of unstable rock masses, earth masses or man made accretions on a slope".
你院来函未附本案涉及的具体保险条款文本,因此我们难以确定该条款实际版本。根据承保时间推断,该《财产保险综合险》条款应是由中国人民银行于1996年制定并颁发实施的。根据我会《关于财产保险条款费率备案管理的通知》(保监发〔2001〕120号)的有关规定,该险种的条款在中国保监会未修订前,仍按中国人民银行的原规定执行。保险公司继续使用该条款,不需履行有关报备手续。而非由中国保监会制定或修订的保险条款,中国保监会不负责解释。该条款有关朮语的解释,请参考中国人民银行在《关于印发<财产保险基本险>和<财产保险综合险>条款、费率及条款解释的通知》(银发〔1996〕187号)。该通知所附的《财产保险综合险条款解释》中对“危险建筑”未作出明确定义,但其第三条关于“所列明的财产不属于本保险标的承保范围”主要原因说明的第三项“不利于贯彻执行政府有关命令或规定,如违章建筑及其它政府命令限期拆除、改建的房屋、建筑物”,可以作为一个参考标准;第四条中对“突发性滑坡”的定义为“斜坡上不稳的岩体、土体或人为堆积物在重力作用下突然整体向下滑动”。
3. Insurance Assessment
三、 关于保险公估鉴定
Pursuant to the Provisions for the Administration of Insurance Assessment Institutions issued by us, an insurance assessment company is a work unit whose establishment was approved by the China Insurance Regulatory Commission in accordance with the law and that, upon appointment by a party to an insurance policy, engages in appraisal, survey, assessment, loss evaluation and adjustment with respect to the subject matter of insurance. The objection by a concerned party to the assessment conclusion reached by an insurance assessment company appointed by a concerned party falls within the scope of facts subject to determination and should be determined through in an investigation by a court.
依据我会发布的《保险公估机构管理规定》,保险公估公司是依法由中国保监会批准设立的,接受保险当事人委托,专门从事保险标的的评估、勘验、鉴定、估损、理算等业务的单位。保险公估公司接受当事人一方委托所作的相关鉴定结论,当事人如有异议,属于事实认定范畴,应由法院作出调查认定。
The foregoing opinions are provided for your reference.
clp reference:3900/06.02.21promulgated:2006-02-21以上意见,供参考。
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