If the car owner reports the insurance claim after settling the matter privately, the insurance company must still pay the compensation!
2024-08-15
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Hunan Daily Omnimedia Reporter He Jinyan
In recent years, the number of motor vehicles has increased rapidly. When encountering minor scratches on the road, many car owners choose to "settle privately". However, the disputes caused by this are increasing.
Recently, the People's Court of Liuyang City announced a car insurance case. The reporter sorted out the case of Zijin Property Insurance Co., Ltd. Hunan Branch (referred to as "Zijin Property Insurance") to help you understand this knowledge point.
【Case】
On January 23 last year, a car accident occurred at an intersection in Liuyang City, Changsha. At that time, Tang Jun (pseudonym) was driving a car to turn left, and Huang Bin (pseudonym) was riding an electric bike straight ahead, and the two accidentally collided.
"At that time, I got out of the car to check and asked Huang Bin if he was injured. He said he was fine." Tang Jun said. So the two of them agreed not to call the police or report the accident to the insurance company. Tang Jun compensated Huang Bin 1,800 yuan for the repairs and "settled" the accident privately.
At 9 o'clock that night, Huang Bin suddenly felt unwell and was sent to the hospital for surgery. He was hospitalized for more than a month and spent more than 99,000 yuan on medical expenses. According to judicial appraisal, Huang Bin's digestive tract perforation was caused by the trauma of the accident and was assessed as a grade 9 disability.
Who was responsible for this accident? Huang Bin sued Tang Jun and Zijin Property Insurance to the court, claiming more than 360,000 yuan in damages.
The reporter learned that Tang Jun's car was insured with compulsory traffic insurance and commercial third-party liability insurance at Zijin Property Insurance. Because Tang Jun did not call the police or report the insurance in time, Zijin Property Insurance refused to pay the compensation.
After trial, the court found that both parties were at fault in the traffic accident, with Tang Jun bearing 80% of the responsibility and Huang Bin bearing 20% of the responsibility; when the accident happened, Huang Bin did not feel obvious pain, and both parties subjectively determined that there was only minor property damage, so they evacuated the scene after consultation on their own, which was reasonable; on the night of the incident, Huang Bin was sent to the hospital for treatment, and Tang Jun immediately called the police and reported the insurance, and cooperated with the investigation. There was no intent or gross negligence, and the insurance company should bear the insurance liability.
In accordance with relevant legal provisions, the court ordered Zijin Property Insurance to compensate Huang Bin more than 300,000 yuan; Tang Jun to compensate Huang Bin more than 9,000 yuan.
【Talk about "risk"】
What should the car owner do after an insurance accident occurs?
The policyholder, the insured or the beneficiary should notify the insurance company in a timely manner and protect the accident scene; if special circumstances make it impossible to report the accident in a timely manner, the insurance company should be informed immediately after the emergency situation disappears and relevant evidence should be preserved.
If the policyholder, the insured or the beneficiary fails to notify the insurance company in a timely manner intentionally or due to gross negligence, making it difficult to determine the nature, cause, extent of loss, etc. of the insurance accident, the insurance company generally does not bear liability for compensation or payment of insurance money for the part that cannot be determined.
