SIMPLE PERSONAL INSURANCE COMPENSATION DISPUTE CASE
FANG ZEPO VS. HUI COUNTY INSURANCE COMPANY
Plaintiff: Fang Zepo, male, 24 years of age. Teacher, Donglong Middle S Huilai, Guangdong.
Defendant: Huilai Branch Insurance Company, People's Insurance comp China.
Legal representative: Lin Shuijiang, Manager.
Attorney: Xie Weiming, deputy chief, Personal Insurance Section, Huilai Insurance Company.
Attorney: Huang Liefeng, Lawyer, Huilai law Firm.
The plaintiff Fang Zepo initiated the lawsuit against the defendant
Branch Insurance Company, People's Insurance Company of China (here referred to as the Branch Company) for refusal to pay his father's personal insurance compensation. The Court, by conducting public here ascertains:
The plaintiff's father Fang Fengrong was an employee of the Huilai Food Products Company before his death. On May 12,1985, Fang Fengro hospitalized because of illness and the case was diagnosed as bladder disease The hospital conducted an operation of partly cutting the bladder Transplanting the left urethra on Fang Fengrong and he was discharged the hospital after this operation for resuming his work . In August 198 Huilai County Food Products Company persuaded the employees and work apply for the cover of simple personal insurance and explained clear conditions of applying for the cover. Following that, as the C contributed 2 yuan for each of its employee, Fang Fengrong contributed to voluntarily apply for 5 covers of the simple personal insurance currency was 15 years. When the insured lives up to the termination currency or dies because of illness or unexpected accidents, the ins company shall pay the insurance money 1,140 yuan RMB. However, the ins policy declares that such patients as suffering from cancer may not app the cover. The insurance company issued to Fang Fengrong simple per insurance certificate. On May 8, 1987, Fang Fengrong was hospitalized b of emergent illness and the case was diagnosed as the upper alimentary hemorrhage recurring ulcer, the transfer of the bladder cancer
operation, the urethra infection and the whole body exhaustion. He d August 19. Afterwards, the plaintiff apply to the defendant for payment the insurance money on the strength of the insurance certificate defendant refused to pay the insurance money except the refunding premium on the ground that the plaintiff concealed his application con and applied for the cover with illness, therefore, he was not under the of cover. The plaintiff was not satisfied and initiated the lawsuit the Court.
The above facts is supported by the diagnose of the hospital and the w evidences of the insurance company and the Food Products Company evidences sufficient to be ascertained.
The Huilai County People's Court holds: Although Fang Zepo's father Fengrong had suffered from the bladder cancer before applying for the of insurance, he resumed his work after the operation. The HUILAI Hospital concluded that the cause of Fang Fengrong's death was not on transfer of bladder cancer. Therefore, it is inappropriate for the defy to claim the invalidity of the insurance contract on the ground that Fengrong concealed the application conditions when applying for the cover accordance with the provisions of Article 85 and Paragraph II, Article the general Principles of Civil Law of the People's Republic of Lawfully established contracts shall be protected by law. The creditor have the right to demand that the debtor fulfill his obligations as spec by the contract. In accordance with the provisions of Subparagraph Paragraph 2, Article 5 of the Clauses for the Simple Personal Ins (Category A) that "Where the insured dies of illness or from an unexpected hurting incident during the currency, the whole amount of insurance shall be paid, the defendant should pay to the plaintiff the whole insurance money. Based on the above, the Court decided on June 13, 1989:
I. The simple personal insurance contract, concluded between Fang Fengro the Huilai Branch Insurance Company, PICC shall be valid.
II. The defendant shall pay to the beneficiary delegated by Fang Fen the plaintiff Fang Zepo Insurance money 1,140 yuan; the payment shall b within ten days after coming into effect of the decision.
The defendant was not satisfied with the judgment of the first instant lodged an appeal before the Shantou City Intermediate People's court ground stated in the original trial.
The Intermediate court holds through conducting hearings: The simple personal insurance contract concluded between the appellant and the appellee's Fang Fengrong clearly indicates, those patients as suffering from cancer not apply for the cover. Fang Fengrong had suffered from cancer before
the application and was not completely recovered after the operation long after, he died of the worsening illness. Fang Fengrong's conditions did not conform to the application conditions. However Fengrong concealed his illness and applied for the cover of insurance accordance with the provisions of Article 7 of the Regulations for Personal Insurance that, should there be any concealment or deceit insured or applicant on the application conditions, the insurance c shall not pay the insurance money, the civil act of Fang Fengro invalid. In accordance with the provisions of Paragraph I, Article 61 General Principles of Civil Law, after the civil act of appellee's Fang Fengrong has been determined as null and void, the Insurance Co shall undertake no obligations of payment for Fang Fengrong's death. Ho the premium paid by the insured shall be refunded. The appellee claims payment by the appellant of the insurance money. As the grounds there insufficient and the claim shall therefore not be recognized. inappropriate for the Court of the original trial to determine as value personal insurance contract concluded between the appellant an appellee's father Fang Fengrong and therefore the judgment should corrected.
Based on the above, the Intermediate Court, in accordance with the provision of Subparagraph II, Paragraph I, Article 151 of the Civil Procedure the People's Republic of China (for trial implementation), decide November 17, 1989;
I. The judgment of first instance by the Huilai County People's Court be rescinded.
II. The appellant the Huilai Branch Insurance Company, PICC shall p appellee Fang Zepo the refunded premium RMB 60 yuan and the payment should made with ten days after the coming into force of the judgment.
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII