Answer difficult questions of motor vehicle insurance

A flying stone, the insurance of vehicle lights, car mirror glass, whether to belong to the insurance responsibility?

1, processing opinion: should belong to the insurance liability in "collision" responsibility. But because the front car dropped or falling objects do not belong to this meeting. Must be not object to he fang.

2, reason: "collision" responsibility explanation: refers to the insurance vehicle collision with the outside still or motion of objects in the accident impact.

3, should provide proof materials: the actual claims process, should carefully examine loss traces, confirmation, shall be paid to the insured to produce relevant proof case. If traces of inconsistent or not sure, should be asked to provide traffic team insurer (road accident) or the police station, the security office (non road traffic accident) certification. This may require the insured issued rights assignment.

4, note:

(1) in the underwriting, should as far as possible to check the vehicle lights, car mirror and vehicle windshield glass is intact.

(2) the vehicle windscreen in uninsured additional breakage of glass case, due to the above causes of loss, the insurance company shall not pay.

(3) the bogey publicity, so as to avoid the adverse selection in accordance with the law.

(4). Stones cause body part of the loss, with reference to the above interpretation.

Two, motor vehicle from rolling in the process of moving pedestrian stones, iron will the wounded, whether to belong to the responsibility of insurance?

1, processing opinion: belong to the scope of the third party liability losses, the insurance company should be in accordance with the relevant provisions by accident liability and insurance contract persons in the accident compensation.

2, reason:

(1) according to the "general rules of the civil law" Tenth stipulates: "although the parties have no fault, but the cause of each other's personal injury shall bear civil liability according to law, it shall bear civil liability." And the provisions of article 123rd: "in the high altitude, high pressure, flammable, explosive, toxic, radioactive, high-speed transport, causing damage to the surrounding environment is highly dangerous operation, it shall bear civil liability." The driver is not in this case fault, but it can not be ruled out the civil liability for compensation.

(2) based on the third party liability insurance "the insured person or allow qualified driver in the use process of vehicle insurance, accident, direct damage causes the third suffers from a personal injury or property, in accordance with the law shall be the amount of compensation is paid by the insured, the insurer in accordance with the" provisions of the road traffic accident processing method "and the contract of insurance compensation." The insurance company should be based on the relevant provisions of the insurance contract liability and the insured are negative in the accident compensation.

(3) in determining the amount of compensation, according to the "motor vehicle third party liability insurance clause" the sixteenth stipulation: "except as otherwise provided herein, insurance according to the insurance vehicle side in the accident responsibility proportion, bear corresponding responsibility for compensation."

(4) in this case, to require the insured to provide the proof material, the road traffic accident, shall provide transportation team responsibility confirmation and mediation; non road traffic accident, must provide the Public Security Bureau of the public security departments to prove; if the mediation fails, the insured shall request the proceedings to resolve, otherwise, the insurance the company will not be liable for compensation.

In addition, the wall of motor vehicles, or other objects down over the pedestrians or other property damage, should be in accordance with the third party liability insurance liability.

Three, after insurance accident happens, the insured fails to report in 48 hours to the insurance company, the insurance company can decline?

1, processing opinion: should be given different treatment according to the actual situation.

(1) for failing to report within 48 hours, resulting in vehicles or other property insurance losses or cause insurance accident insurance company is unable to measure the loss, to expand or can not be identified losses not covered. If the consequences are serious can all exclusions.

(2) for more than 48 hours to report, without causing adverse consequences, and can provide the insurance accident loss and accident time prove accurate, can give compensation in accordance with the actual loss.

(3) for the occurrence time and the insurance contract in force time or end time very close to the situation, should strictly control the actual effect, and to investigate and collect evidence.

2, reason:

(1) "insurance law" twenty-first stipulates: "the insurant, the insured or the beneficiary know after insurance accident happens, it shall timely notify the insurer."

(2) "clause" motor vehicle insurance thirtieth stipulates: "the insurance of motor vehicles after insurance accident happens, the insured person or the driver shall take reasonable measures to protect, rescue, and notify the insurer within 48 hours.

The responsibility of the accident can not be identified, loss could not be determined, further loss due to unexpected times case, the insurer has the right to refuse compensation to determine the loss and expanded part of the loss."

(3) in the original insurance policy has been clear to the insured, "after insurance accident happens, notify the insurer within 48 hours."

(4) from the actual situation, the interests of the insured and by the development of insurance business in consideration, for indeed due to force majeure or negligence, not acts of kindness timeout report, should master a wide. For malicious behavior or questionable behavior, should be strictly controlled.

Four, operational vehicles in accordance with the non operating insurance and private vehicle accidents in the course of operation, the insurance company will compensate?

1, comments: no compensation.

2, reason:

(1) "insurance law" thirty-sixth article: "within the validity period of the contract, the risk of the objects of insurance have increased, the insured in accordance with the contract, it shall timely notify the insurer, the insurer has the right to demand for increase in the insurance premium or to terminate the contract."

"The obligation to notify the insured fails to perform any of the provisions of the preceding paragraph, which occurs due to the dangerous level of insurance mark increased insurance accident, the insurer shall not bear the liability of compensation."

(2) "clause" motor vehicle insurance seventh stipulates: "any of the following circumstances, regardless of any cause any losses and expenses of insurance of motor vehicles, the Insurers shall not be liable for: (three) the insurance of motor vehicles in any of the following situations: 2, to change the use of nature or has the right to transfer, not to the insurer for correcting procedures."

According to the provisions of laws and provisions above, for the above situation, the insurance company shall not be liable for compensation.

Five, the insurance vehicle is flowerpot fell from upstairs or other object smashed, whether to belong to the insurance responsibility?

1, comments: this loss, can constitute a car insurance of liability of "external objects collapse" responsibility. However, the insured to the insurance company claims, should grasp the following approach:

(1) can be found in the third party (i.e., can find a pot or other object master), should require the insured to third party claim. If the third party refuses to pay, the insured shall bring a lawsuit, the court case, the insurer according to written compensate the insured's request, should be part of or all of the compensation in accordance with the contract of insurance, the insured must give Xiang Di three party the right of recovery assign in whole or in part to the insurer, and assist the insurer to the third party claim.

(2) if you can't find the third party, according to the "terms" motor vehicle insurance seventeenth stipulates: "the insurance of motor vehicles occurred within the scope of insurance liability shall be responsible for the loss of third, but could not find the third party, the insurer shall make compensation for the losses, but in line with the implementation of 30% provisions for compensation of the amount of deductible franchise." Handle.

Note: at this time, must be provided transportation team insurer (road traffic accidents) or the police station (non road traffic accident) certificate, issued by the insurance company accident otherwise, no compensation.

2, reason:

(1) "the external objects collapse" refers to: "insurance vehicle other than itself composed of matter and occupy a certain space of individual fall or depression, caused the loss of vehicle insurance."

"Inverted" means: refers to people or things lying down with.

Flower pots and other objects belong to the insured vehicle outside of themselves, are composed of material and occupy a certain space of individual. Its fall, can be considered from the balcony fall down. Therefore, the loss should belong to the responsibility of insurance.

(2) the compensation way reason, has stated in the comments, in addition to not repeat.

(3) at the request of the insured provide proof, should hand in accordance with clause to the insured patient explanation; on the other hand, can be based on the "insurance law" the forty-fifth stipulation: "the insurance after the accident, before the insured does not compensation insurance, the insured waives claim for indemnity against the third party. Right, the insurer shall bear no obligation for indemnity."

"Due to the fault of the insured, the insurer is unable to exercise the right of indemnity by subrogation, insurer may deduct the insurance compensation." The insured can not provide the relevant materials of proof, the insurer is unable to exercise the right of subrogation, so according to this article, the insurer may refuse to compensate or deduct the corresponding compensation.

In addition, according to the provisions of the second paragraph of "insurance law" twenty-second: "the insurer in accordance with the provisions of the insurance contract, considers the relevant evidence and materials incomplete, shall notify the applicant, the insured or the beneficiary for additional evidence and materials."

(4) in the interpretation to the insured, why should the situation of flower pots or other object owner compensation, can be used "the general principles of the civil law" 106th stipulates: "citizens, legal persons fault encroach upon state or collective property, infringement of property, person, shall bear civil liability." And the 126th article of shelving material, hanging objects "buildings or other and building collapse, falling, falling and causes damage to others, its owner or manager shall bear civil liability, but is able to prove that he has no fault except."

Six, about the actual claims process in car accident crane freight problem.

Suggestion: in the next insurance, will be printed rescue fees (mainly crane freight) and the original insurance policy issued to the insured person (affixed with the insured, and affix the seal), at the same time, to the insured, if it costs more than the standard cost, immediately notify the insurance company, the insurance people agree, due to the cost and labor expenses, the insurance company can compensate, or in accordance with the standards for approved compensation.

At present, should be in the insured accident report, inform the insured in accordance with the reasonable, necessary lifting costs paid. If the insured person has to pay transportation costs, it should be determined in consultation with the insured amount shall be paid, at the same time, shall strictly examine the hanging freight bill, the non lifting property insurance expense item deleted. For example: the goods carried by a car while rescue.

Whether seven, involving third litigation insurance companies can claim?

1, processing opinion: for the loss of insurance coverage, the consent of the insurer, the insured, reduce the loss arising and litigation or arbitration third party's costs, the insurance company can compensate.

2, reason:

"Insurance law" fiftieth stipulates: "the liability insurance of the insured to the third party damage caused by the insured is brought to arbitration or litigation, unless otherwise stipulated in the contract, paid by the insured to arbitration or litigation expenses and other necessary and reasonable expenses, shall be borne by the insurer."

But the charges, calculated at third the amount of compensation, and result in third other loss amount and, in the insurance contract shall be listed in the third party liability insurance, the maximum compensation limit.

Eight, the insurance vehicle was other people down, or antenna car parts were damaged, whether the insurance responsibility?

1, comments: do not constitute liability insurance, the insurance company shall not compensate.

2, reason:

(1) the loss does not belong to the liability insurance included in the scope of the internal loss. (do not belong to the "collision" responsibility)

(2) according to the "provision" of article tenth of motor vehicle insurance: "other does not belong to the scope of insurance liability losses and costs, the insurer shall not be liable for."

Nine, disability identification fee, insurance company can claim?

1, processing opinion: in a certain amount and the insurance prior consent, can compensate.

2, reason:

(1) "insurance law" forty-eighth article: "insurance, paid by the insurer to identify and determine the nature of the insurance accident, reason and insurance mark loss degree necessary, reasonable expenses, shall be borne by the insurer."

(2) "the motor vehicle third party liability insurance clause" sixth stipulates: "the insurance of motor vehicle accidents in the insured or a valid driver in use process, the direct loss caused third party to suffer casualties or property, the insured shall be the amount of compensation paid by the insurer in accordance with, the insurance contract, for more than the compulsory motor vehicle traffic accident liability limitation above part of insurance compensation for each item."

Reminder: autopsy premiums, the insurance company is not responsible for compensation.

Involving personal injury cases ten, third party liability insurance, for the drugs at their own expense, whether the compensation?

1, comments: no special circumstances, no compensation.

2, reason:

(1) "approach to road traffic accidents" provisions of article thirty-seventh of the question of compensation standards related to damage; in the "interpretation" further on medical expenses stipulated: that is limited to the scope of medical drugs.

(2) non Medicare drugs must be used when the rescue, should also be referred to the relevant provisions of public health services. More than the provisions, no compensation.

(3) special circumstances, need to use the non Medicare drug or need to purchase drugs, must be issued by the hospital certificate, and shall obtain the consent of the traffic team and insurance companies agreed not to pay, otherwise. This article is based on the "road traffic accident treatment measures" provisions of article thirty-ninth: "the traffic accident the injured and disabled need hospitalization, hospital, nursing, there should be a medical certificate, and agreed to by the public security organs. Unauthorized hospitalization, transfer, use of nursing staff, since the purchase of drugs more than the hospital or hospital days notice of refusal to discharge, its cost is wounded and disabled bear."

Reminder: in the adjustment process, should be required to be provided issued by the hospital prescription and medication list the insurer. (note to the insured person to report to the police, to inform.)

Eleven, to cover the third party liability insurance, and the uninsured non deductible special risks, if the insured person to assume full responsibility, and the amount of compensation has been more than third limitation of liability, the amount of compensation is determined in accordance with the third party liability maximum compensation limit, or in accordance with the third party liability insurance the maximum compensation limit of 80%?

1, processing opinion: should be in accordance with the third party liability insurance the maximum compensation limit of 80%.

2, reason: "motor vehicle third party liability insurance clause" the seventeenth stipulation: "the insurer under the insurance of motor vehicle party in the accident responsibility proportion, compensation in accordance with the provisions in the absolute amount of deductible franchise: 20% full responsibility, bear the main responsibility of the 15% franchise, franchise the 10% bear equal responsibility, deductible 5% negative secondary responsibility."

Twelve, because the third party liability caused the loss of vehicle insurance, but can not find the third party, according to the provisions should be how to pay?

1, treatment:

(1) based on the "provision" of article seventeenth: motor vehicle insurance "insurance motor vehicle within the scope of insurance liability shall be responsible for the loss of third, but could not find the third party, the insurer shall make compensation for the losses, but in line with the implementation of 30% provisions for compensation of the amount of deductible franchise" treatment.

(2) the accident proof: must be provided transportation team insurer (road traffic accidents) or the police station, the security office (non road traffic accident) certificate, issued by the insurance company accident otherwise, no compensation.

2, reason:

At the request of the insured provide proof, should hand in accordance with clause to the insured patient explanation; on the other hand, can be based on the "insurance law" the forty-fifth stipulation: "the insurance after the accident, before the insured does not compensation insurance, the insured waives claim for indemnity against the third party rights, the insurer shall bear no obligation for indemnity."

"Due to the fault of the insured, the insurer is unable to exercise the right of indemnity by subrogation, insurer may deduct the insurance compensation." The insured fails to provide the relevant materials of proof, the insurer is unable to exercise the right of subrogation, so according to this article, the insurer may refuse to compensate or deduct the corresponding compensation.

In addition, according to the provisions of the second paragraph of "insurance law" twenty-second: "the insurer on the basis of the insurance contract, considers the relevant evidence and materials incomplete, shall notify the applicant, the insured or the beneficiary for additional evidence and materials."

The qualification of the thirteen, traffic team responsibility book, substandard vehicles causing traffic accidents due to driver brakes, and the car accident responsibility burden, the insurance company will decline?

1, processing opinion: refusal reasons not fully.

2, reason:

(1) "clause" motor vehicle insurance seventh stipulates: "any of the following circumstances, regardless of any cause any losses and expenses of insurance of motor vehicles, the Insurers shall not be liable for: (three) the insurance of motor vehicles in any of the following situations: 1, unless otherwise agreed in writing to the insurance contract, insurance accident insurance of motor vehicles not issued by the traffic administrative department of the public security and other relevant departments of the driving license, license plate, or temporary plate or temporary mobile card, or not according to the provisions of the inspection or inspection unqualified."

At present, the Department of transportation (2) inspection of vehicles, are therefore, after the accident happens in the vehicle, the insurance company is not that before the accident, the brake of vehicle insurance is not qualified.

From the above analysis, should be rejected according to this and, not a good enough reason. However, in consultation with the insured, determine a you can accept the proportion of compensation, it should be noted at this time, require the insured the written consent of both parties agreed proportion of compensation.

Specify fourteen, traffic team responsibility confirmation, insurance of vehicle traffic accident caused by "overload", and to judge the insured or allows the driver must bear the responsibility for the accident, if the insurance company to pay?

1, processing opinion: not to pay.

2, reason:

(1) "insurance law" the thirty-fifth stipulation: "the insured shall abide by the relevant state fire, safety, production, labor protection and other aspects of the provision, maintain the safety of insurance mark."

Rule thirty-sixth: "within the validity period of the contract, the risk of the objects of insurance have increased, the insured in accordance with the contract, it shall timely notify the insurer, the insurer has the right to demand for increase in the insurance premium or to terminate the contract."

"The obligation to notify the insured fails to perform any of the provisions of the preceding paragraph, which occurs due to the dangerous level of insurance mark increased insurance accident, the insurer shall not bear the liability of compensation."

(2) "clause" motor vehicle insurance eighth stipulates: "the insurance of motor vehicles the following causes of losses and costs, the insurer shall not be liable for: (five) insurance motor vehicle in violation of provisions" motor vehicle loading of the people's Republic of China Road Traffic Safety Law "and other laws and regulations."

That book is not listed, depending on the circumstances.

Fifteen, about the "tire damage alone" should be how to compensate the problem.

1, the tire damage alone, the insurance company shall not pay.

2, tire and rim and damage, also the hub has apparent sign of collision, tires and wheels with compensation, according to the tire wear degree negotiation proportion compensation.

3, a moving tire burst, wheel is not damaged, and the lower arm or rod and other components on the same side of the damage, the lower arm and other parts of the damage loss, the insurance company responsible for compensation, and the tire is not responsible for.

Sixteen, about the "broken glass alone".

1, this article applies only to the windshield glass and the window glass, not including lamps, car mirror glass.

2, emphasize: as long as the broken glass alone, whether as caused by the collision, the insurance company shall not be responsible for compensation, and the "collision" responsibility is not contradictory. Because the motor vehicle insurance contract is specified in the insurance liability insurance, and, in the listed insurance liability, the liability exemption stated reason in terms of loss, insurance companies are not the compensation.

3, as long as the insured "broken glass alone" additional risks, the glass damage, precondition fact, traces are no problem, no longer need to provide proof of insurance accident.

Seventeen, according to the new car to purchase price to determine the old insurance vehicle insurance amount, once a part of the loss, the loss when the car repair exceeds the amount of the actual value, because of how compensation?

Treatment suggestions:

1, for the life of a certain period of time the vehicle, is no longer recommended underwriting car caustic danger.

2, if the important customers, for the vehicle insured car caustic danger, in insurance, insurance special agreement "column indicate the insured vehicle where there is a partial loss, if the cost of repairs to the car accident that the real value, the insurance company paid the actual value of a property."

3, if without any explanation of the circumstances, in this case, and can be resolved through consultation and. If the customer requirements must be in accordance with the repair mode compensation, not to take a one-time compensation, but also in the repair is completed, a test after repair of vehicle. In order to avoid moral hazard.

Eighteen, the insurance contract, insurance vehicle sales, but did not transfer, this kind of situation, whether the insurance company may refuse to compensate?

1, processing opinion: should refuse compensation.

2, reason:

According to the "provision" motor vehicle insurance seventh article: "the following circumstances, regardless of any cause any losses and expenses of insurance of motor vehicles, the Insurers shall not be liable for: (three) the insurance of motor vehicles in any of the following situations: 2, change the nature of the use or ownership transfer, not to the insurer to revise procedures."

Nineteen, the insurance vehicle is not stolen, some components but vehicles, how to deal with the insurance company?

1, treatment:

The insurance company shall not compensate.

2 reasons: motor vehicle, "the whole car robbery loss insurance clause" the sixth stipulation: "the period of insurance, motor vehicle insurance in the insured or a valid driver in use process, due to the following causes loss of motor vehicle insurance, the insurer shall indemnify according to insurance contract: (three) the whole car insurance of motor vehicle theft, robbery, robbery after the damage, or cause the car parts, ancillary equipment lost the reasonable expenses needed to repair."

Article eighth the following provisions; "losses and costs, the insurer shall not be liable for: (a) non full car robbery, only the car parts or ancillary equipment was stolen, robbed, robbed, damaged."

From the above two meanings, that part of the loss of vehicle insurance only after the occurrence of the whole car stolen and find the place, only to pay the insurance company.

Twenty, the insurance vehicle was upstairs and sulfuric acid and other corrosive liquid damage, whether to belong to the responsibility of insurance?

1, processing Views: a lack of insurance responsibility, the insurance company shall not pay.

2, reason:

(1) the loss does not belong to the scope of insurance liability losses, therefore the insurance company is not liable to pay.

(2) according to the "provision" motor vehicle insurance tenth stipulates: "the other does not belong to the scope of insurance liability losses and costs, the insurer shall not be liable for."

Twenty-one, the insurance of vehicles, machine cover is lifted, resulting in the loss of vehicle insurance, the insurance company will compensate?

1, processing opinion: not to pay.

2, reason: definition of "collision" responsibility ", refers to the motor vehicle insurance and accidental coincidence solid objects outside the cargo loading provisions with the vehicle impact." Therefore, its parts and its occurrence of impact, does not belong to the motor vehicle insurance liability in "collision" responsibility.

Whether twenty-two, third party liability insurance midway can surrender?

1, processing opinion: according to the relevant provisions of the "insurance law" should be allowed to surrender.

2, reason: "insurance law" fourteenth article: "unless otherwise agreed or agreed in the contract, after the establishment of insurance contract, the applicant may terminate the insurance contract."

In 3, the actual work in the:

In insurance, insurance special agreement bar state: "in addition to total loss or loss of vehicle insurance, and legal transfer vehicle, third party liability insurance shall not refund."

Twenty-three, partial loss of vehicle insurance, in has not been closed before (or closed), can you surrender?

1, processing opinion: No.

2, reason: "insurance law" forty-second article: "part of the objects insured losses, the insurer within thirty days after the compensation, the applicant may terminate the contract of insurance." Thus, the insured vehicle in danger, only in the insured claims payable within thirty days after the surrender, qualify.

Twenty-four, how to understand the "air operations object crashes" insurance responsibility?

"Air operations object crashes" refers to the meaning of the "meteorite or aircraft air vehicle damage caused by falling objects of insurance, the insurance liability. Hanging crane hook or off and lifting arm broken, caused the loss of vehicle insurance, as the insurance liability."

"Literally run" of the word is: go round and begin again to work (especially a planet, travel etc.)

This article mainly refers to the meaning of the air is running or movement of objects falling down, so falling objects in the fall before the due and certain movement, more specifically is a dynamic object fell, resulting in loss of vehicle insurance, belong to the insurance liability.

Attached: Chinese Insurance Regulatory Commission to "reply on the interpretation of the operation object falling insurance coverage in the motor vehicle insurance clauses"

"Motor vehicle insurance clause" in the vehicle damage insurance "air operations object crashes" insurance liability interpretation, on the hook or hanging arm broken explanation:"...... Hanging crane hook or off and lifting arm broken, caused the loss of vehicle insurance, as the insurance liability." However, terms are not due to the crane hook or a hanging arm off and on its own loss made detailed provisions.

For a hook or a hanging arm itself loss, should not lump together. If the hook or the jib loss or external force, such as accidental collision with other objects and broken, the on hook or boom caused loss, should be regarded as the insurance liability. If the hook or boom due to its own internal factors and the occurrence of broken, its own losses, shall not be regarded as the insurance liability, but the hook or the jib crane caused by other parts of the loss, should be regarded as the insurance liability.

Twenty-five, ignition caused by lighting fire vehicle insurance, whether or not compensation?

1, treatment suggestions: to liability insurance in the fire, the insurance company shall compensate.

2, reason: most of the car front machine cover domestic travel without lighting device, in the dim light conditions to the driver to repair the added obstacles, especially vehicle malfunction in outdoor situations. When the vehicle fuel system leakage fault, in order to prevent the accident more accidents, eager to forcibly maintenance vehicle is a normal reaction behavior. Although the negligence should avoid fire operation rules, but not yet constitute intentional behavior, excluded liability provisions of this serious negligence is not insurance clause. Therefore, this situation caused the accident of fire liability insurance liability, the insurance company shall compensate.

In the motor vehicle insurance clauses are caused by the intentional act of insurance and the insurance accidents and loss is listed as the insurer's liability exemption. But "intentionally" behavior and the insured "negligence" are two completely different state of the mind. Deliberately refers to the act have been foresee own behavior one can or should foresee his behavior will cause some effects, but because of negligence not foreseen or have foreseen but too confident but failed to avoid. By the intentional act the insurer and the driver because of the existence of moral risk, does not belong to the risk of unpredictable, so large numbers of insurance will be removed from the underwriting risk. The accident occurs in most of vehicle insurance, the insured person or the driver more or less the existence of such as improper treatment measures such as negligence, except for some violation of duty of the insured and the high risk and is classified as a liability exemption of fault condition, other conditions by the insured or the driver's negligence caused accident insurance, the insurer shall, according to the insurance contract compensation, but according to the provisions the insurer or the driver responsibility and the size of the insurance contract franchise deducts the corresponding.

Twenty-six, paint particles falling in the insurance on the vehicle, whether or not compensation?

1, comments: do not belong to the insurance liability, the insurance company shall not compensate.

2, reason: the vehicle insurance is the responsibility of specifying the responsibility. Insurance companies bear only clauses and the losses caused by the accidents. The rest should be regarded as risk insured themselves. Especially particles due to its chemical properties, strong adhesion, solidification and attachment together, not easy to remove. The collision between the adhesion and body paint or differences. Specify the responsibility it not vehicle insurance, the insurance company shall not compensate. Owners should request directly to the victim liability.

In the theory of insurance, insurance of liability is generally divided into the designated insurance and all risks two forms. The specified risk only bear the policy specified insurance liability, liability risk for listed outside shall not bear all risks; only in the policy specified except responsibility, risk of except responsibility all be borne. But these two provisions form alone have their limitations, inevitably therefore, for a more reasonable, effective control of risks, the insurance clause and China adopted a comprehensive two forms, both listed underwriting liability, exemption from liability insurance is specified, only undertake the insurance contract listed in responsibility, all not listed, shall not bear. The exemption clause in the "other does not belong to the scope of insurance liability mainland losses and expenses" provisions of the provisions of the scope of responsibility is more clear, more rigorous. Therefore, the responsibility for not listed in the policy, the Claims Officer should be based on the insurance theory and contract exclusions, be reasonable, fully safeguard the legitimate interests of the insurer.

Twenty-seven others injured, driving of vehicle insurance insured, whether to belong to the third party liability?

1, comments: do not belong to the third party liability insurance coverage, the insurance company shall not pay.

2, reason: in general, there are four kinds of people basically can be excluded from "third", namely the insurer, the insurer is the driver, car accident and their family members. For the above situation caused damage to bear responsibility for the perpetrators, the insured has no liability in the law. So, for the victims of cost of treatment costs, the insurance company is not responsible for compensation.

Note: when determining whether third party liability insurance belongs to the scope of responsibility, should follow a principle: the perpetrators itself cannot obtain indemnity, the insurer to pay the victim's loss, and ultimately can not fall in the hands of the insured.

Twenty-eight, the vehicle used by criminals, the third loss, whether or not compensation?

1, processing opinion: the insurance company is not responsible for compensation.

2, reason: criminals not allow the insured to qualified drivers. Therefore, the vehicle used by criminals, should be borne entirely by the criminals, the insured without any compensation liability to the third party. But in public security organs cracked the case, often criminals is unable to bear losses, as vehicles for the pledge, require the insured or the insurance company to compensate the victims of economic losses to put back the stolen vehicle. This approach is no legal basis. The Supreme People's Court on this issue on June 25, 1999 to the Henan Provincial Higher People's Court of reply, and announced the national. Reply: "provisions of the motor vehicles using theft, cause material losses of victims, the party shall be liable for damages in accordance with the law, all the stolen motor vehicle is not liable for damages." Accordingly, for the insurance of vehicle theft and robbery occurred during the third party property damage, the insured does not have to bear the liability of compensation, the insurer also need not assume insurance responsibility. Because of a complex, the Supreme People's Court Reply is not explicitly robbed vehicles and vehicle accident caused third casualties and the question of responsibility. But according to the approved spirit, should can infer: use Daoqiang vehicle accident, causing personal injuries, all robbed stolen vehicle is not liable for damages, liability for damages in accordance with the law shall be borne by the perpetrators personally.

Twenty-nine, the insurance vehicle in normal driving process, because the sudden braking and other reasons, resulting in the car and the front collision caused by the loss of the vehicle, the insurance company should compensate?

1, processing opinion: should not compensation.

2, reason: according to the "motor vehicle insurance clause" thirty-third of "collision" explanation for the "motor vehicle insurance and the loading the goods specified and body outside the solid objects outside the direct impact". Carriage and insurance vehicle front as a whole, the collision between the vehicle and the outside world, the non insurance accident impact, so it should be a refusal. If the insured vehicle in the non normal driving process, such as the overturning accident, the car and the front collision caused by loss of the vehicle, the insurance company should be compensated.

Thirty, accident victim's dependents are planning to have children, whether or not compensation?

1, processing opinion: should be compensation.

2, reason: this argument is that, outside of family planning children without hukou, or whether the children enjoy the same rights account of children. "Approach to road traffic accidents", "dependent" to "the deceased or disabled the actual custody in lose labor ability before, no other source of living", not on what the plan of the rights of children to limit. And according to the relevant provisions of the general principles of the civil law ":" the citizen (natural person) from birth to death, enjoy civil rights and assume civil obligations in accordance with the law. The citizen (natural person) the capacity for civil rights are equal. Therefore, family planning and other children account children enjoy equal civil rights, cannot discriminate against.

Thirty-one, because the vehicle ignition leads to other third party property damage to the third party property, whether the compensation?

1, processing opinion: belongs to the third party liability the scope of compensation, the insurance company shall pay compensation.

2, reason: the liability exemption some item is common used car damage and three of two main risks. Such as "drinking, driving without a valid licence". Others were applied to the main risk their. Result in third loss for the spontaneous combustion fire proof, as long as liable for legal insurance for third of the losses, the insurance company should bear the responsibility for compensation.

Thirty-two, vehicle theft when the driver does not have a driver's license, whether to belong to pilfer the insurance responsibility? The insurance company will compensate?

1, processing opinion: the insurance company can pay.

2, driving without a license is one of exclusion clause. But only for the three party damage and for driving without a valid license causes the insurance vehicle liability is excluded liability scope. In the case of driving without a license, there is no necessary connection with vehicle theft, no causal relationship between legal sense. The current pilfer rush to deal with an emergency clause also did not make provisions, the insurance company should be compensated.

Thirty-three, the insured waives the right to insurance company claim, on whether the victim?

1, treatment suggestions.

2, reason: "insurance law" the forty-ninth stipulation: the insurer of liability insurance of the insured to third party damage, in accordance with the law or the agreement in the contract, directly to the third party compensation insurance. But the current law of our country has not made clear provisions on the issue, the insurance contract generally do not involve the question, therefore, in this case, the insurer is not directly to the victims of the third legal obligations of direct payment of the insurance benefits. The insured to renounce the accident claims, is in fact not claim compensation from the insurance company, therefore the insurance company may not filing the case handling of the affair. The victim has no right to claim directly from the insurer.

Thirty-four, take the initiative to report accident fled the scene after the surrender, should decline?

1, processing opinion: traffic team responsibility confirmation judgment does not belong to the accident, the insurance company should pay compensation, such as decision for hit and run, should be a refusal.

2, reason: China's "road traffic accident treatment measures" have a special interpretation of "escape", namely "after a traffic accident, traffic accident to escape the responsibility, the parties did not report to the public security organs and fled the scene." (see definition of "Tenth road traffic accident treatment measures") the interpretation shows the subjective purpose of the parties involved in the accident escape is to escape the legal responsibilities shall be investigated, therefore can not be any accident escape behavior are simply identified as escape. If the driver's behavior from the subjective aspect no escape, public security organs have not been run cases, therefore, the insurer should make general claims processing.

Reminder: in the adjustment process, should strictly examine the hit and run, and then to the transportation department report a case, to check whether for drunk driving, driving without a license and other behavior that led to the accident.

Thirty-five, the automobile market price changes, the insurance vehicle has a total loss, how to calculate the amount of compensation?

1, processing opinion: in accordance with the provisions of the motor vehicle insurance clauses, where the total loss, according to the insurance amount and the actual danger value low, to determine the amount of compensation.

2, reason: explicit insurance clauses, in a total loss of motor vehicle, calculation of compensation in the amount of insurance, but the insurance amount is higher than the actual value, not to exceed the actual value at the time of the calculation of compensation claim. According to the principle of compensation for the loss of insurance, the insurer must compensate for the actual loss of the insured are within the scope of responsibility, the purpose is to make the compensation insurance to insurance before the accident situation, be compensated the insurer cannot obtain more or less than the loss.

Thirty-six, the court will be insured vehicle sinking, causing the vehicle all people change, not to the insurance company for correcting the situation of vehicle insurance, insurance, insurance company can decline?

1, opinions shall be twelve.

2, reason: "insurance law" thirty-third stipulates: "the transfer of the subject-matter insured shall notify the insurer, the insurer agrees to continue after underwriting, the alteration of the contract in accordance with the law." Motor vehicle insurance clauses stipulated in the period of validity of the insurance contract, insurance vehicle resale, transfer, gift for others, change in the use or increase in the risk exposure, the insured shall notify the insurer in writing in advance and apply for correction. Therefore the original insurance vehicle court decision was sinking, vehicle ownership has changed, and the insured is not according to the law and the contract notice for compulsory. According to the stipulations of the contract, the insurer has the right to refuse compensation.

Thirty-seven, exaggerating the loss amount of fraud, whether the insurer can all the twelve?

1, processing opinion: according to the relevant provisions of the "insurance law", to praise the loss of most of the insurance company shall not pay.

2 reasons: motor vehicles, provisions of the insured does not comply with the obligations of good faith, is to hide the fact, forged documents, manufacturing Jiaan fraud, the insurer has the right to refuse compensation. But when the insured people exaggerate the loss amount, the insurer is entitled to part with that fact lose most of exclusions clause together, not explicitly stipulated. But the "insurance law" the twenty-seventh stipulation: after insurance accident happens, the insurant, the insured or the beneficiary with forged, fabricated documents, materials or other evidence, fabricating false facts or overstates the extent of the loss, the insurer is not liable for compensation or insurance payment on the part of the responsibility of false. Therefore, for part of the loss of the insured exaggerated, the insurer shall not claim is legitimate, but for the insured expenses, still should be compensated.

For the insured the behavior, according to the "insurance law" 131st article: "the insurant, the insured or the beneficiary commits one of the following acts, insurance fraud, which constitutes a crime, shall be investigated for criminal responsibility according to law:...... (five), fabricated, and proof of forgery insurance accident data and other evidence, or cause, instigate, buying others to provide false evidence, information or other evidence of the cause of the accident, fabricating or exaggerating losses, defrauds insurance money. One of the acts listed in the preceding paragraph, if the circumstances are minor, does not constitute a crime, shall be given administrative penalties in accordance with the relevant provisions of the state."

In addition, the "criminal law" the 198th stipulation: "in any of the following circumstances, of insurance fraud, the amount is relatively large, is less than five years imprisonment or criminal detention, a fine of ten thousand yuan one hundred thousand yuan fine; if the amount involved is huge or other serious circumstances, five years to ten years in prison, be in twenty thousand yuan of above two hundred thousand yuan of the following a fine; if the amount involved is especially huge or other especially serious circumstances, department for more than ten years in prison, a fine of twenty thousand yuan and two hundred thousand yuan fine or confiscation of property:

...... (two) the insurant, the insured or the or the beneficiary intentionally causes losses to the occurrence of an insured accident degree, defrauds insurance money;......

Where a unit commits a crime, it shall be fined, and the person in charge directly responsible and other directly responsible personnel, is less than five years imprisonment or criminal detention; if the amount is enormous or other circumstances are serious, department for more than five years to ten years in prison; the amount is especially huge or other if the circumstances are especially serious, department for more than ten years in prison.

Insurance accident identification, proof of property assessment, who intentionally provide false documents, and provide conditions for others to commit fraud, shall be punished as an accomplice in insurance fraud."