In a traffic accident, the car hit someone else’s car. The insurance company settled the claim, but the other party asked for additional compensation for labor expenses. According to the law, there is

In a traffic accident, the car hit someone else’s car. The insurance company settled the claim, but the other party asked for additional compensation for labor expenses. According to the law, there is such compensation.

Case Facts: A travel company owned a large tourist bus. The company insures tourist vehicles with the insurance company, and the insurance types include third-party liability insurance, vehicle loss insurance and on-board liability insurance in the additional insurance part of the "Motor Vehicle Insurance Clauses" (99) (specifically The item is car seat insurance). During the insurance period, the vehicle collided with a passenger car driven by Feng during operation, causing injuries to the passengers of the insured vehicle and damage to the vehicle. The traffic police department determined that the travel company was secondary responsible for the accident and Feng was primarily responsible for the accident. The travel company filed a lawsuit in court over the traffic accident. The court ruled that Feng should bear 80% of the total loss, or 80,000 yuan, and the travel company should bear 20% of the total loss, or 20,000 yuan. After the verdict, the insurance company paid the travel company its share of 20,000 yuan. When the travel company applied to the court to enforce the 80,000 yuan loss of 80010 that should be compensated by Feng (including vehicle loss and passenger loss), the court suspended the execution because Feng was unable to perform. +The travel company then submitted a claim application to the insurance company, asking the insurance company to compensate the travel company for the uncompensated portion of the incident. The insurance company rejected its request. The travel company then took the insurance company to court.

The plaintiff, a travel company, proposed that Article 1 of the Additional Vehicle Liability Insurance Clause of the "Motor Vehicle Insurance Clauses" stipulates: If an accident occurs while the motor vehicle insured by this insurance is in use, As a result of the direct damage to the goods carried on the insured vehicle and the personal casualties of the people on the vehicle, the insured shall bear the financial compensation liability according to law, as well as the necessary and reasonable rescue and protection expenses paid by the insured to reduce the loss, the insurer Compensation is calculated within the insurance compensation limit stated in the insurance policy. If a travel company fails to safely transport passengers to their desired destination, it shall bear liability for breach of contract and compensate passengers for their losses. The financial compensation liability borne by the travel company should be all actual losses of the passengers, then the insurance company should also compensate this part of the losses of the travel company.

The defendant insurance company proposed that according to the provisions of Article 50, paragraph 2, of the Insurance Law: Liability insurance refers to insurance based on the insured's legal liability to third parties for compensation as the subject of insurance. The subject matter of liability insurance is neither property nor human life, but the insured's legal liability for compensation to a third party. It is entered into for the benefit of the third party. When an insured accident occurs, the insured will be deemed to have paid the third party the liability. When the personal and property losses of the three parties are caused, the insurance company will compensate the insured, not the insured but the injured third party. Article 1 of the on-board liability insurance clause signed between the travel company and the insurance company stipulates: During the use of the motor vehicle insured by this insurance, an accident occurs, resulting in direct damage to the goods carried on the insured vehicle and the death of the people on the vehicle. In case of personal injury or death, the insured shall bear the financial compensation liability according to law, as well as the necessary and reasonable rescue and protection expenses paid by the insured to reduce the loss. The insurer shall calculate the compensation based on the insurance compensation limit stated in the insurance policy. This agreement clearly states that the on-board liability insurance is a liability insurance, and the insurance company shall bear the claim obligation based on the liability of the insured travel company in the accident. In this case, 80% of the liability for the traffic accident lies with the third party Feng, and the insurance company has paid compensation based on 20% of the liability of the travel company. Therefore, the travel company's claim to require the insurance company to pay 80,000 yuan for the seat insurance on the car has no legal basis.

Judge’s Comments

The issue reflected in this case is whether the insurance company can be required to compensate the losses that should be compensated by the other party in the traffic accident? First of all, according to the contractual agreement between the parties, namely the "Motor Vehicle Insurance Clauses", the travel company's lawsuit actually includes two parts, namely the vehicle loss part and the passenger loss part. For vehicle loss insurance, Article 19 of the "Motor Vehicle Insurance Clauses" (hereinafter referred to as the "Clause") clearly stipulates that if the insured vehicle suffers losses within the scope of insurance liability, a third party shall be responsible for compensation. Claims should be made to third parties. If the third party fails to pay, the insured shall file a lawsuit. After the insured files a lawsuit, the insurer shall compensate according to the written compensation request submitted by the insured. The insurance company should pay compensation to the travel company. After the insurance company pays the compensation, it can obtain the right of subrogation from the third party. Therefore, there is no dispute about this part. However, there is no clear provision in the "Articles" about the on-board liability insurance part, that is, the passenger loss part, so disputes are likely to arise in practice.

Secondly, there are three legal relationships involved in this case. The first is that the travel company applies for insurance to the insurance company and signs an insurance contract, thereby forming an insurance contract legal relationship between the insurance company and the travel company; the second is that because the passengers take the travel company's bus, there is a relationship between the travel company and the passengers. The third is the legal relationship between the travel company and Feng for damages due to the traffic accident. What this case wants to resolve is the legal relationship between the insurance company and the travel company, so the insurance contract is the basis for determining the rights and obligations of both parties. In this case, the travel company purchased third-party liability insurance, vehicle loss insurance, and on-board liability insurance (specifically, on-board seat insurance) from the insurance company.

As for the vehicle liability insurance, that is, the vehicle seat insurance part, it is stipulated in Article 1 of the Additional Insurance Vehicle Liability Insurance Clause of the "Motor Vehicle Insurance Clauses": During the use of the motor vehicle insured by this insurance, an accident occurs, resulting in If the goods carried on the insured vehicle suffer direct damage and the personnel on the vehicle suffer casualties, the insured shall bear the financial compensation liability according to law, as well as the necessary and reasonable rescue and protection expenses paid by the insured to reduce the loss. Compensation is calculated within the insurance compensation limit stated in the insurance policy. In this case, the dispute between the two parties focused on the economic compensation liability that should be borne by the insured according to law in this clause.

According to this agreement, the scope of the insurance company's compensation for the travel company's on-board liability insurance is determined based on the size of the financial liability borne by the travel company. However, in this case, the scope of the financial compensation liability borne by the travel company is unclear. It can be clarified in two ways: 1. There is a breach of contract between the travel company and the passengers because the travel company failed to safely deliver the passengers to the destination. Liability, in this case, should be understood as liability for compensation in a broad sense (that is, the liability for breach of contract borne by the travel company in the basic legal relationship of the transportation contract); 2. The legal relationship between the travel company and the third party due to the legal relationship of damage compensation. The liability borne by the travel company (that is, in the legal relationship for damages, the travel company bears 20% of the liability). If according to the first interpretation, the financial compensation liability borne by the travel company should be all the actual losses of the passengers, then the insurance company should also compensate the travel company for this part of the losses. If according to the second explanation, the travel company only bears 20% of the losses, then the insurance company will only bear 20% of the losses, and the remaining 80% will be borne by the third party. According to Article 31 of the Insurance Law: When there is a dispute between the insured and the policy holder, the insured or the beneficiary regarding the terms of the insurance contract, the people's court shall make an interpretation in favor of the insured and the beneficiary. Therefore, the content of the dispute between the two parties should be interpreted in favor of the travel company. According to the first explanation, the economic compensation liability borne by the travel company refers to the liability for breach of contract due to the travel company's violation of the transportation contract. . Therefore, the amount that the insurance company should compensate is the total loss that the travel company should compensate the passengers. Since the insurance company has already paid 20% of the loss to the travel company, it should also pay the remaining 80% of the loss. Again, the first misunderstanding is that the provisions of third-party liability insurance in the Insurance Law are directly applied to vehicle seat insurance (vehicle liability insurance), and the second is the result of applying this provision: the same cannot be changed in the "Motor Vehicle Liability Insurance". "Vehicle Insurance Clauses" regarding the liability that shall be borne by the insured according to law! There are two understandings of the phrase "economic liability for compensation". At the same time, from the perspective of third party liability insurance: this third party is for others who have no relationship with the insured. For example, if an insured vehicle runs over a pedestrian on the side of the road and the vehicle is judged to bear 20% of the liability, and the pedestrian bears 80% of the liability, then the insurance company should only pay compensation based on 20% of the liability of the vehicle. For the other 80% of the liability, the insurance company has no obligation to pay regardless of whether the pedestrian is able to pay. However, the on-board liability insurance in this case has its special features. That is, the passenger and the travel company signed a transportation contract. According to this contract, the travel company’s liability for traffic jams is 100%. However, the on-board liability insurance in the "Motor Vehicle Insurance Clauses" The first clause of liability f is obviously unclear about this agreement, which leads to two interpretations of the travel company's liability in this case.

Finally, regarding the legal relationship between the travel company and the third party Feng for damages. In this case, the insurance company believed that the court had clearly ruled that the third party Feng should bear 8('s liability), so this part should not be compensated by the insurance company. In this case, it is the insurance contract signed by both parties that determines the rights and obligations of both parties. , and the legal relationship between the travel company and Feng is another legal relationship and has nothing to do with this case. In fact, after the insurance company compensates the travel company, it can obtain compensation from the third party Feng in accordance with the provisions of relevant laws. The right of subrogation.

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