Case Summary

In March 2024, the defendant Du Mou was involved in a traffic accident with a small ordinary passenger car driven by a third party, Zhang Mou, while driving a light van, resulting in damage to the vehicle. The traffic police department determined that the defendant Du Mou was mainly responsible for the accident, while the third party Zhang Mou was secondiously responsible. The defendant Du's vehicle was insured with compulsory traffic insurance and commercial third-party liability insurance by the defendant B insurance Company. Zhang's vehicle was insured with A motor vehicle damage insurance policy of 250,000 yuan from the plaintiff. This accident caused a repair loss of 26,000 yuan to Zhang's vehicle. According to the insurance contract, the plaintiff, Insurance Company A, paid 26,000 yuan for vehicle repair to Zhang. Zhang issued a compensation agreement and a letter of transfer of rights and interests to the plaintiff, stating that it accepted 26,000 yuan as the total compensation for this subrogation. At the same time, the right to recover the above-mentioned compensation shall be fully transferred to the plaintiff, and assistance shall be provided to the plaintiff in recovering the losses from the third party. The plaintiff filed a lawsuit with the court, demanding that the two defendants compensate 26,000 yuan. Among this, the defendant, Insurance Company B, should first compensate the plaintiff 2,000 yuan within the limit of the compulsory traffic insurance. If the compensation is insufficient, Insurance Company B should bear 70% of the compensation liability within the scope of the commercial third-party liability insurance, totaling 26,000 yuan. The part that the insurance company cannot compensate shall be compensated by the defendant Du. Defendant B Insurance Company argued that defendant Du had issued a notice of waiving the claim to another company, stating that the vehicle had changed its usage nature and was engaged in business activities. The insured waived the claim for the plaintiff's vehicle damage, and thus the plaintiff's losses were not borne in this case. After investigation, it was found that the defendant Du had signed and fingerprinted at the insured section of the declaration of waiving the claim.

Court Hearing

The court, after hearing the case, held that although Du issued a statement of waiving the claim, the validity of this statement did not automatically extend to the third party and the plaintiff. The defendant, Insurance Company B, still should bear the burden of proof as to whether there were any exemption grounds and whether it had fulfilled the obligation to prompt and clearly explain the exemption clauses. As the defendant, Insurance Company B, failed to submit evidence to prove that Du's driving of the vehicle to carry goods was an operational activity, nor did it provide evidence to prove that it had fulfilled its obligation to prompt and clearly explain the relevant exemption clauses to the policyholder, the defendant, Insurance Company B, should not be exempted from its liability for compensation. After the Anqiu court's judgment, the defendant insurance company filed an appeal, but the second-instance court upheld the original judgment.

The Judge's Statement

Where a motor vehicle is involved in a traffic accident and causes damage to a third party, the third party, as the infringed party, has the right to request the insurance company that the insured has taken out insurance to bear the liability for compensation in accordance with relevant regulations. The declaration signed between the insurer and the insured with the nature of waiving the claim is merely an internal commitment or agreement between the two parties regarding the performance of the property insurance contract, and it is of great significance to the third party who suffers losses due to the insurance incident, and does not automatically have effect on the third party. If the insurer can prove the factual reasons for the commitment or agreement signed with the insured to waive the claim, and such factual reasons are indeed the exemption grounds stipulated by law or the insurance contract, then such exemption grounds can be determined to be valid. Furthermore, the ultimate effect of the exemption clause also depends on the fact that the defendant insurance company has fulfilled the obligation of informing and explaining the exemption clause when signing the insurance contract with the policyholder. If it fails to provide evidence to prove that it has fulfilled the obligation of informing and explaining, the clause will not take effect.

This article is reprinted from the wechat official account "Shandong Higher People's Court". We express our gratitude here!