Case Summary

   This case is a typical property insurance contract dispute. Plaintiff A, as a daily chemical products enterprise, purchased the "Property All Risks Insurance (2009 Edition) Policy" (Policy No. PQYC2023xxxxxx) from Defendant B on August 28, 2023 to ensure production and operation safety. The insurance period is from August 30, 2023 to August 29, 2024. The insurance subject includes buildings and decorations (insurance amount of 1 million yuan), inventory raw materials (2 million yuan), inventory packaging materials (2 million yuan), inventory finished products (3 million yuan), and machinery and equipment (2 million yuan), with a total insurance premium of 10000 yuan.

   On June 30, 2024, a sudden rainstorm occurred in Jiading District, Shanghai, causing the plaintiff's workshop on the first floor at No. 22xx, Xinxiangjiang Road, Anting Town to suffer a serious flooding accident. The accumulated water in the rainstorm caused a large area of water soaking on the PVC floor of the workshop floor, which bred mold and seriously affected the safety of the production environment. After the accident, the plaintiff immediately activated the emergency plan and commissioned a professional maintenance unit, Beijing Wuzhou Jiajie Air Conditioning Refrigeration Service Co., Ltd., to conduct a loss assessment. After evaluation, the ground maintenance cost is 177832.41 yuan.

   The plaintiff filed a claim against the defendant based on the insurance contract, but the defendant only agreed to calculate the compensation based on the insufficient insurance coverage ratio. The approved claim amount was 3650.26 yuan, which was significantly different from the plaintiff's actual loss. There was a significant disagreement between the two parties regarding the compensation plan, and the plaintiff sought legal means to resolve it.

Lawyer intervention

   Lawyer Zhang Yuling, a graduate student in law at Hunan University of Technology, has passed the national unified legal professional qualification examination. She has a solid foundation in law and is familiar with the process of handling cases. Passionate about the legal profession, diligent and meticulous in work, down-to-earth and willing to work, strong sense of responsibility, team spirit, and good service awareness. During the process of studying with lawyers, I have accumulated rich experience in handling cases and made every effort to safeguard the legitimate rights and interests of the parties in each case.

Investigation process

   Lawyers from Beijing Rude Law Firm have demonstrated a high level of professional competence and litigation strategy ability during the case handling process, mainly reflected in the following key aspects of their work:

1、 The construction of the evidence system has led to the systematic collection and organization of five core types of evidence by the legal team: firstly, insurance contract documents, including application forms, original policies, and attachments; The second is the accident certification materials, including the rainstorm certificate issued by the meteorological department, on-site photos and videos, and maintenance assessment report; The third is the basis for calculating losses, such as the qualification certificate of the maintenance unit, cost details, and value-added tax invoices; The fourth is communication records, covering email correspondence, WeChat communication records, phone recordings, etc. during the insurance application process; The fifth is the legal basis, including relevant provisions of the Insurance Law, similar case judgments, etc.

2、 The legal argumentation has been deepened, and the lawyer team has conducted in-depth legal research on the focus of the case dispute. Firstly, according to Article 17 of the Insurance Law, it is argued that the defendant has not fulfilled the obligation to clearly explain the exemption clause, and the relevant clause is not effective. Secondly, citing Article 55 of the Insurance Law, it is pointed out that the prerequisite for the application of insufficient insurance is that the insurer has fulfilled its obligation to explain, and in this case, the defendant did not inform the actual value of the insured subject matter when applying for insurance, so it cannot unilaterally determine insufficient insurance after the occurrence of the accident. Thirdly, regarding the deduction of maintenance costs, the lawyer cited the contract provisions of the Civil Code, emphasizing that taxes are statutory expenditures and planned profits are reasonable remuneration for maintenance units, all of which fall within the category of direct losses.

3、 During the two court hearings on July 21 and November 7, 2025, Lawyer Rude adopted an active litigation strategy in formulating the trial strategy. Lawyer Zhang Yuling emphasized three core points in court: firstly, as a professional insurance company, the defendant, despite knowing the actual value of the insurance subject matter, still accepted the insured amount of 1 million yuan, which should be regarded as the agreement of both parties to fully insure; Secondly, during the insurance process, the defendant did not prominently indicate the deductible clause, and the plaintiff was unaware of it; Thirdly, the maintenance evaluation report shall be issued by a qualified third-party organization, with reasonable cost composition, and the defendant shall not arbitrarily deduct without justifiable reasons.

4、 Professional technical support, the Rude lawyer team has also introduced insurance appraisers to review the loss amount, ensuring the reasonableness of the repair cost of 177832.41 yuan is supported by professional technical expertise. In response to the defendant's claim that the value of the insurance subject matter is 23381106.97 yuan, the lawyer requests the defendant to provide evaluation basis and calculation process, questioning the rationality of their evaluation method.

Case outcome

   The final court adopted the majority of the defense opinions of lawyers from Rude Law Firm and made a fair judgment: the defendant should compensate the plaintiff with insurance money of 146834.10 yuan within ten days from the effective date of this judgment;

Lawyer's reminder

  Through the agency process of this case, RuDe Law Firm has summarized the following important insights for reference by enterprises and insurance consumers:

1、 Risk prevention during the insurance application stage requires a thorough understanding of the actual value of the insured subject matter to ensure that the insured amount matches the insured value. For the standard terms provided by insurance companies, it is important to focus on insurance liability, exemption clauses, deductible amounts, etc

The core content requires insurance companies to provide clear explanations for professional terminology and special agreements. It is recommended to fix the communication content in written form to avoid disputes in the future.

2、 Emergency response after an accident: In the event of an insurance accident, measures should be taken immediately to prevent the expansion of losses, and evidence should be fully established. This includes taking on-site photos and videos, preserving damaged items, promptly notifying insurance companies to inspect the site, and commissioning qualified institutions to assess losses. All communication records should be properly preserved to form a complete chain of evidence.

3、 The indispensability of professional lawyers, as insurance claims disputes involve legal knowledge in multiple fields such as insurance law, contract law, and evidence rules, requires the intervention of professional lawyers. Lawyer from RuDe Law Firm has proven through this case that professional legal analysis, evidence organization ability, and courtroom skills can effectively combat the unreasonable refusal of insurance companies and maximize the protection of policyholders' rights and interests.

4、 The practical significance of the principle of good faith is that insurance contracts are the greatest contracts of good faith, and insurance companies shall not use their professional advantages and information asymmetry to harm the interests of policyholders. The policyholder should also truthfully disclose important facts and jointly maintain the healthy development of the insurance market.