商法——人身保险

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,Personal insurance,1,Concept,Personal insurance is insurance under which the subject matter of insurance is the life and body of a person.,人身保险是以人的寿命和身体为保险标的的保险。,2,Form,An insurance contract shall contain the following:,保险合同应当包括下列事项：,1. Name and domicile of the insurer;,（一）保险人的名称和住所；,2. Names and domiciles of the proposer and the insured, as well as the name and domicile of the beneficiary in the case of personal insurance;,（二）投保人、被保险人的姓名或者名称、住所，以及人身保险的受益人的姓名或者名称、住所；,3,3. The subject matter of insurance;,（三）保险标的；,4. Insurance liability and liability exemptions;,（四）保险责任和责任免除；,5. Term and starting date of coverage;,（五）保险期间和保险责任开始时间；,6. The insured amount;,（六）保险金额；,7. Insurance premium and the payment method;,（七）保险费以及支付办法,4,8. Method for payment of indemnities or insurance benefits;,（八）保险金赔偿或者给付办法；,9. Liability for breach of contract and dispute resolution; and,（九）违约责任和争议处理；,10. Date of conclusion of contract.,（十）订立合同的年、月、日。,5,The proposer and the insurer may agree upon other matters relating to the insurance.,投保人和保险人可以约定与保险有关的其他事项。,6,Personal Insurance Contract 人身保险合同,A beneficiary refers to a person who has been designated by the insured or the insurant to enjoy the right to insurance claims.,受益人是指一个人已经指定被保险人或被保险人享受保险索赔的权利。,The insurant or the insured may be the beneficiary.In appointing beneficiaries ,the insurant shall get the approval of the insured .,投保人或被保险人可以是受益人。在指定受益人,投保人必须经被保险人同意。,If the insured is a person incapable of civil acts or whose capability of civil acts is restricted ,the guardian shall appoint the beneficiaries .,如果被保险人是一个无民事行为能力或限制民事行为能力人,监护人应指定受益人。,7,Personal Insurance Contract,Article 31,A proposer shall have an insurable interest in the following persons:,1. him/herself;,2. his/her spouse, children or parents;,3. other family members or close relatives, in addition to those aforementioned, who have a foster, support or maintenance relationship with the proposer; and,4. employees who have an employment relationship with the proposer.,8,第三十一条,投保人对下列人员具有保险利益：,（一）本人；,（二）配偶、子女、父母；,（三）前项以外与投保人有抚养、赡养或者扶养关系的家庭其他成员、近亲属；,（四）与投保人有劳动关系的劳动者。,9,In addition to the circumstances mentioned in the preceding paragraph, the proposer shall be deemed to have an insurable interest in the insured if the insured consents to theconclusion of the contract by the proposer on his/her behalf.,除前款规定外，被保险人同意投保人为其订立合同的，视为投保人对被保险人具有保险利益。,If, at the time of the conclusion of the contract, the proposer does not have an insurable interest in the insured, the contract shall be invalid.,订立合同时，投保人对被保险人不具有保险利益的，合同无效。,10,If the age of the,insured reported by the proposer is false and the insureds true age does not comply with the age restriction,specified,in the contract, the insurer may,terminate,the contract and,refund, in accordance with the contract, the cash value of the policy. The third paragraph and sixth paragraph of Article 16 hereof shall apply to the exercise by the insurer of its right to terminate the contract.,11,投保人申报的被保险人年龄不真实，并且其真实年龄不符合合同,约定,的年龄限制的，保险人可以,解除,合同，并按照合同约定,退还,保险单的现金价值。保险人行使合同解除权，适用本法第十六条第三款、第六款的规定。,12,If the age of the insured reported by the proposer is false, resulting in the proposer paying a lower insurance,premium,than the insurance premium that should have been paid, the insurer shall have the right to correct the same and request the proposer to make up for the premium in short, or, when paying insurance benefits,disburse,the same in proportion to the percentage of the insurance premium that should have been paid accounted for by the insurance premium actually paid.,13,投保人申报的被保险人年龄不真实，致使投保人支付的,保险费,少于应付保险费的，保险人有权更正并要求投保人补交保险费，或者在,给付,保险金时按照实付保险费与应付保险费的比例支付,。,14,If the age of the insured reported by the proposer is false, resulting in the proposer paying a higher insurance premium than the insurance premium that should have been paid, the insurer shall refund the excess premium to the proposer.,投保人申报的被保险人年龄不真实，致使投保人支付的保险费多于应付保险费的，保险人应当将多收的保险费退还投保人。,15,Article 33,A proposer,may not take out a personal insurance policy,stipulating death as a condition for payment of insurance benefits for a person without capacity for civil acts,and an insurer may not insure the same.,proposer,n.投保人 take out 办理(保险)手续,personal insurance,人身保险,stipulating,.,as a condition,以.为条件,a person without capacity for civil acts,无民事行为能力人,第三十三条,投保人不得为无民事行为能力人投保以死亡为给付保险金条件的人身保险，保险人也不得承保。,16,The restrictions,of the preceding paragraph,shall not apply to personal insurance policies,taken out by parents for their minor children. However,the total of the insurance benefits,payable upon the death of,the insured,may not exceed the limit,specified by the State Councils insurance regulatory authority.,preceding,adj.前述的,apply to,. 适用于.,minor children,未成年子女,pay upon,以.为支付条件,insurance benefits,保险利益,exceed the limit,超过限制,specif,y v.详细说明,the State Councils insurance regulatory authority.,（ 国务院监督管理机构),父母为其未成年子女投保的人身保险，不受前款规定限制。但是，因被保险人死亡给付的保险金总和不得超过国务院保险监督管理机构规定的限额。,17,Article 34,A contract,stipulating death as a condition for payment of insurance benefits,shall be invalid,without the consent of the insured and his/her approval of the insured amount.,consent,n.同意 the insured 被保险人,the insured amount 保险金额,第三十四条,以死亡为给付保险金条件的合同，未经被保险人同意并认可保险金额的，合同无效,18,An insurance policy document,issued in accordance with a contract stipulating death as a condition for payment of insurance benefits,may not be transferred or pledged,without the written consent of the insured.,insurance policy document,保险单,in accordance with,以.为依据,transfer,v.转让 pledge v.质押,按照以死亡为给付保险金条件的合同所签发的保险单，未经被保险人书面同意，不得转让或者质押。,19,The restrictions,of the first paragraph hereof,shall not apply to personal insurance policies,taken out by parents for their minor children.,hereof,adv. 于此；关于此点,父母为其未成年子女投保的人身保险，不受本条第一款规定限制,20,Personal Insurance Contract,Article 35 A,proposer,may, in accordance with the contract, pay the entire insurance,premium,to the,insurer,in one lump sum or pay it in,installments,.,第三十五条,投保人,可以按照合同约定向,保险人,一次支付全部保险费或者分期支付保险费。,insurer,21,Personal Insurance Contract,Article 36,（第一款）,If the contract provides for the payment in installments of the insurance premium, and the,proposer, after payment of the,initial,installment of the insurance premium, fails to pay an installment within 30 days after the date of a reminder from the insurer or within 60 days after the specified time limit, the validity of the contract shall be,suspended,or the,insurer,shall reduce the insured amount in accordance with the conditions specified in the contract, unless otherwise provided in the contract.,第三十六条 合同约定分期支付保险费，,投保人,支付首期保险费后，除合同另有约定外，投保人自,保险人,催告之日起超过三十日未支付当期保险费，或者超过约定的期限六十日未支付当期保险费的，,合同效力中止，或者由保险人按照合同约定的条件减少保险金额。,请确认您的保险合同无欠交保险费,22,Personal Insurance Contract,（第二款）,If an insured event occurs in respect of the insured during the period specified in the preceding paragraph, the,insurer,shall pay the insurance benefits in accordance with the contract, but may deduct the,outstanding,insurance premium,t,herefrom,.,被保险人在前款规定期限内发生保险事故的，,保险人,应当按照合同约定给付保险金，但可以扣减欠交的保险费。,23,Proposer,n.,申请人，提案人；投保人,Insurer,n.,承保人，保险公司,Premium,n.,费用，额外费用；保险费；奖赏，奖励；（商品定价、贷款利息等以外的）加价,Installment,n.,部分；分期付款；（丛书杂志等的）一部，一期,Initial,adj.,最初的；开始的；首字母的,Suspend,vt.,暂停；延缓；暂停；悬浮,vi.,暂缓；悬浮；无力支付,Therefrom,adv.,从那里，从此；从中；由此,24,If the validity of a contract is suspended in accordance with Article 36 hereof, its validity shall be restored after the insurer and the proposer reach agreement thereon through consultations and the proposer pays the outstanding insurance premium. However, if the parties fail to reach an agreement within two years from the date on which the validity of the contract was suspended, the insurer shall have the right to terminate the contract.,the insurer terminates the contract pursuant to the preceding paragraph, it shall, in accordance with the contract, refund the cash value of the policy.,25,第三十七条,合同效力依照本法第三十六条规定中止的，经保险人与投保人协商并达成协议，在投保人补交保险费后，合同效力恢复。但是，自合同效力中止之日起满二年双方未达成协议的，保险人有权解除合同。,保险人依照前款规定解除合同的，应当按照合同约定退还保险单的现金价值。,26,Article 38 An insurer may not resort to litigation to require payment from a proposer in respect of life insurance premiums.,第三十八条,保险人对,人寿保险,的保险费，不得用诉讼方式要求投保人支付。,The period of limitation of actions for the lodging of a claim with the insurer for payment of insurance benefits by the insured or beneficiary of a life insurance policy shall be five years, counting from the date on which he learnt or ought to have learnt of the occurrence of the insured event.,人寿保险的被保险人或者受益人向保险人请求给付保险金的诉讼时效期间为五年，自其知道或者应当知道保险事故发生之日起计算,27,The period of prescription for the lodging of a claim with the insurer for payment of indemnities or insurance benefits by the insured or beneficiary of an insurance policy other than a life insurance policy shall be two years, counting from the date on which he learnt or ought to have learnt of the occurrence of the insured event.,人寿保险以外的其他保险的被保险人或者受益人，向保险人请求赔偿或者给付保险金的诉讼时效期间为二年，自其知道或者应当知道保险事故发生之日起计算。,28,受益人的确定,Article 39 The beneficiary of a personal insurance policy shall be designated by the insured or proposer.,第三十九条 人身保险的受益人由被保险人或者投保人指定,29,Where the beneficiary is designated by the proposer, the consent of the insured must be obtained. If a proposer takes out personal insurance policies on workers with whom it/he/she has an employment relationship, it/he/she may not designate anyone other than the insured or their close relatives as beneficiaries.,投保人指定受益人时须经被保险人同意。投保人为与其有劳动关系的劳动者投保人身保险，不得指定被保险人及其近亲属以外的人为受益人。,30,Where the insured is a person without capacity for civil acts or with limited capacity for civil acts, the beneficiary may be designated by his/her guardian.,被保险人为无民事行为能力人或者限制民事行为能力人的，可以由其监护人指定受益人。,31,受益顺序及份额,Article 40 The insured or proposer may designate one or more persons as beneficiaries.,第四十条 被保险人或者投保人可以指定一人或者数人为受益人。,32,Where there is more than one beneficiary, the order and proportions in which insurance benefits shall be paid shall be determined by the insured or proposer. Where proportions for benefits distribution are not determined, benefits shall be divided equally among the beneficiaries.,受益人为数人的，被保险人或者投保人可以确定受益顺序和受益份额；未确定受益份额的，受益人按照相等份额享有受益权。,33,Article 41 The insured or proposer may change the beneficiary and shall notify the insurer thereof in writing.,被保险人或者投保人可以变更受益人并书面通知保险人。,Once the insurer receives written notice of the change of beneficiary, it shall endorse the same on the insurance policy document or other insurance certificate or affix an endorsement slip thereto.,保险人收到变更受益人的书面通知后，应当在保险单或者其他保险凭证上批注或者附贴批单。,34,A change of the beneficiary made by the proposer shall be subject to the consent of the insurer.,投保人变更受益人时须经被保险人同意,35,Article 42,In any of the following circumstances, if the insured dies, the insurance proceeds shall become part of his/her estate and the insurer shall perform its obligation of paying the insurance benefits in accordance with the PRC Inheritance Law.,第四十二条,被保险人死亡后，有下列情形之一的，保险金作为被保险人的遗产，由保险人依照,中华人民共和国继承法,的规定履行给付保险金的义务：,36,Article 42,1.no beneficiary was designated or the designation of the beneficiary is unclear and determination thereof is impossible;,（一）没有指定受益人，或者受益人指定不明无法确定的；,37,Article 42,2. the beneficiary dies before the insured, and there is no other beneficiary; or,（二）受益人先于被保险人死亡，没有其他受益人的；,38,Article 42,3. the beneficiary loses or waives his/her beneficiary rights in accordance with the law, and there is no other beneficiary.,（三）受益人依法丧失受益权或者放弃受益权，没有其他受益人的,。,39,Article 42,If the beneficiary and the insured both die in the same event and the sequence of their deaths is impossible to establish, the beneficiary shall be assumed to have died first.,受益人与被保险人在同一事件中死亡，且不能确定死亡先后顺序的，推定受益人死亡在先。,40,Article 42,其基本特征是：（,1,）遗产必须由被继承人生前合法拥有，具有合法性；（,2,）遗产必须是被继承人死亡时所遗留，具有特定的时间性；（,3,）遗产仅限于被继承人遗留的财产权利和义务，具有财产性；（,4,）遗产必须是依,继承法,的规定能够转让给他人的财产，具有可转让性；（,5,）遗产必须是被继承人生前的财产权利与一定范围的财产义务的统一体，具有总体性。,41,法条释义,本条是关于未指定受益人时以及受益人和被保险人同时死亡时保险金的处理。,本条包括两层含义。一是未指定受益人时保险金的处理。遗产是指被继承人死亡时所遗留的、依照,继承法,规定能够转移给他人的财产权利及一定范围的财产义务。,42,第二层含义是被保险人和受益人同时死亡，保险金应该是谁的遗产。,保险法,明确规定，受益人与被保险人在同一事件中死亡，且不能确定死亡先后顺序的，推定受益人死亡在先，被保险人死亡在后。有了这样的规定以上问题就迎刃而解了。,保险法,对此做了明确规定，对实践具有积极的指导作用。,43,Article 43 If the proposer deliberately causes the death, injury, disability or illness of the insured, the insurer shall not be liable for payment of insurance benefits. Where the proposer has already fully paid insurance premiums for two or more years, the insurer shall refund the cash value of the insurance policy to the other entitled beneficiaries in accordance with the contract.,第四十三条投保人故意造成被保险人死亡、伤残或者疾病的，保险人不承担给付保险金的责任。投保人已交足二年以上保险费的，保险人应当按照合同约定向其他权利人退还保险单的现金价值。,44,If a beneficiary deliberately causes the death, injury, disability or illness of the insured or deliberately attempts to murder the insured, such beneficiary shall forfeit his/her beneficiary rights.,受益人故意造成被保险人死亡、伤残、疾病的，或者故意杀害被保险人未遂的，该受益人丧失受益权。,45,suicide clause:,自杀条款,Article 44 If a contract stipulates the death of the insured as a condition for payment of insurance benefits and the insured commits suicide within two years from the date of formation of the contract or the restoration of its validity, the insurer shall not be liable to pay the insurance benefits, unless the insured, at the time of his/her suicide, was without civil capacity.,第四十四条以被保险人死亡为给付保险金条件的合同，自合同成立或者合同效力恢复之日起二年内，被保险人自杀的，保险人不承担给付保险金的责任，但被保险人自杀时为无民事行为能力人的除外。,46,If the insurer is not liable to pay insurance benefits according to the preceding paragraph, it shall, in accordance with the contract, refund the cash value of the policy.,保险人依照前款规定不承担给付保险金责任的，应当按照合同约定退还保险单的现金价值。,Grace period provision 宽限条款,Misstatement of age provision 年龄误报条款,Incontestable provision 不抗辩条款,47,问题一：被保险人自杀所引起的事故是保险责任还是除外责任？,自杀条款设立的宗旨是：,第一：防止发生道德危险，保护保险人的利益,第二：保护被保险人家属或者受益人的利益,所以把它作为保险责任或者是除外责任都是不合适。而应该是一种不完全的保险责任,1、在对被保险人自杀动机或者目的。直接推定为自杀的目的或者动机是其他原因，而不是仅仅为了获得保险赔付。,2、从赔付金的来源看。是用广大的投保人的钱来赔付被保险人的。对于保险人来言的不公平可能只体现在年终利润分配和财务会计上。,48,应该把这个2年作为保险金额的部分赔付和全部赔付的分界点，而不是作为保险责任和除外责任的分界点。,例如规定：在保险合同成立之后第一年内被保险人自杀的，保险人可以赔付保险金额的30%，在第二年内被保险人自杀的，保险人赔付保险金额的60%，被保险人在第二年之后自杀的，保险人承担前额的赔付。,这样既保障了受益人或者保险人家属的利益，又不至于给保险人造成太大的损失。,49,问题二：法条只规定无民事行为能力人作为除外，那么限制民事行为能力呢？,限制民事行为能力也不可能产生通过自杀来获得保险赔付的动机。,问题三：法条规定保险人仅退还保险单的现金价值是否合适？是否应该加上利息和孳息？,保险说到底与存款，债券，股票一样都是一种投资行为。那么既然是投资那就应该有收益吧？所以应该退还现金价值及其所产生的孳息。,50,Article 45,If the insured willfully commits a crime or resists lawfully applied criminal enforcementmeasures, resulting inhis/her injury, disability or death, the insurer shall not be liable to pay insurancebenefits. If the proposer has paid in full two or more years of insurance premiums, the insurer shall, inaccordance with the contract, refund the cash value of the policy,.,51,第四十五条,因被保险人故意犯罪或者抗拒依法采取的刑事强制措施导致其伤残或者死亡的，保险人不承担给付保险金的责任。投保人已交足二年以上保险费的，保险人应当按照合同约定退还保险单的现金价值。,52,Article 46,If the occurrence of an insured event such as death, injury, disability or illness of theinsured is caused by the act of a third party, the insurer shall not be entitled to the right of recourseagainst the said third party after paying the insurance benefits to the insured or beneficiary. However,the insured or beneficiary shall still retain the right to claim compensation from the said third party.,53,第四十六条,被保险人因第三者的行为而发生死亡、伤残或者疾病等保险事故的，保险人向被保险人或者受益人给付保险金后，不享有向第三者追偿的权利，但被保险人或者受益人仍有权向第三者请求赔偿,。,54,Article 47,If the proposer terminates the contract, the insurer shall, in accordance with the contract,refund the cash value of the policy within 30 days from thedate of receipt of the notice of terminationof the contract.,投保人解除合同的，保险人应当自收到解除合同通知之日起三十日内，按照合同约定退还保险单的现金价值。,55,