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Wang Lianshun v. China Life Insurance Company Yongshun County Sub-branch (2000) (Dispute over Insurance Contract)
王连顺诉中国人寿保险公司永顺县支公司保险合同纠纷案
【法宝引证码】

Wang Lianshun v. China Life Insurance Company Yongshun County Sub-branch (2000) (Dispute over Insurance Contract)
(Dispute over Insurance Contract)
王连顺诉中国人寿保险公司永顺县支公司保险合同纠纷案

Wang Lianshun v. China Life Insurance Company Yongshun County Sub-branch (2000)
(Dispute over Insurance Contract)

 

王连顺诉中国人寿保险公司永顺县支公司保险合同纠纷案

BASIC FACTS 
Plaintiff: Wang Lianshun, male, 49, cadre, domiciled at the dormitory of the Industrial and Commercial Bank of Yongshun County, Hu'nan Province. 原告:王连顺,男,49岁,干部,住湖南省永顺县工商银行宿舍。
Defendant: the Sub-branch of China Life Insurance Company of Yongshun County, Hu'nan Province, domiciled at Yongshun County, Hu'nan Province. 被告:中国人寿保险公司湖南省永顺县支公司。住所地:湖南省永顺县城。
Legal representative: Wang Chunyan, manager of the company. 法定代表人:王春燕,该公司经理。
Authorized agents: Yang Songpo, vice manager of the Sub-branch of China Life Insurance Company of Yongshun County, Hu'nan Province; and 委托代理人:杨松坡,中国人寿保险公司湖南省永顺县支公司副经理。
Deng Xingping, lawyer from San Ye Law Firm in Hu'nan. 委托代理人:邓兴平,湖南三页律师事务所律师。
Chen Xiaolan (hereinafter referred to as “Chen”), wife of Wang Lianshun (hereinafter referred to as “Wang”), brought a lawsuit at the People's Court of Yongshun County, Hu'nan Province (hereinafter referred to as “Yongshun Court”) against the defendant, the Sub-branch of China Life Insurance Company of Yongshun County, Hu'nan Province (hereinafter referred to as “Yongshun Life Insurance”), concerning their dispute over an insurance contract. During the litigation, Chen died of illness, and Wang continued the litigation. 原告王连顺之妻陈晓兰因与被告中国人寿保险公司湖南省永顺县支公司(以下简称永顺人保)发生保险合同纠纷,向湖南省永顺县人民法院提起诉讼。诉讼期间,陈晓兰病故,王连顺就本案继续诉讼。
Wang claimed: Yongshun Life Insurance had taken out the insurance policy on general gynaecological cancer survey for Chen, his wife who worked for Yongshun Life Insurance, with the insurance period to be three years and the insured amount to be 10,000 Yuan. However, when his wife was afflicted with the cancer within the insurance period, Yongshun Life Insurance refused to settle the claim. Wang requested Yongshun Court to rule that Yongshun Life Insurance pay the amount as stipulated in the insurance contract, and indemnify the mental loss caused to his wife due to its refusal to settle the claim. 原告诉称:被告单位曾为在该单位工作的我妻陈晓兰投保妇科癌病普查保险,保期三年,保费1万元。我妻在保期内患癌后,被告却拒绝理赔。请求判令被告按照保险合同的约定给付保险金,并赔偿我妻生前因被告拒绝理赔而遭受的精神损失。
Yongshun Life Insurance contended: It was true that the Company had taken out the insurance policy on general gynaecological cancer survey for its female employees in consideration of their benefits. However, as Chen was transferred out of the Company, there were no more insurable benefits to the Company, thus the Company cancelled the insurance contract by a business approval list. Since the insurance contract no longer existed, Wang's insurance claim was of course invalidated. Therefore, Yongshun Court should reject Wang's litigation claims. 被告辩称:为自己职工的利益,本单位曾给女职工投保妇科癌病普查保险是事实。但由于陈晓兰后来调出本单位,本单位已没有可保利益,因此以业务批单解除了该保险合同。保险合同不存在了,原告的理赔申请当然无效。应当驳回原告的诉讼请求。
It was verified by Yongshun Court through the trial: 湖南省永顺县人民法院经审理查明:
On October 30, 1995, the previous People's Insurance Company of China, Yongshun County Sub-branch (hereinafter referred to as “Yongshun PICC”) took out the insurance policy on general gynaecological cancer survey for its 6 female employees (including Wang's wife Chen). The insurance policy number was 95—018. Both the insurant and the insurer were Yongshun PICC, and both the insured and the beneficiary were the 6 female employees. The insurance period was three years, the insured amount was 10,000 Yuan and the premium was 40 Yuan per person. The said premium had been paid in a lump sum with the expenses of the work union of Yongshun PICC. 1995年10月30日,原中国人民保险公司永顺县支公司为本单位6名女职工(包括原告王连顺之妻陈晓兰)投保妇科癌病普查保险,保单号95--018,投保人和保险人均为永顺县保险公司,被保险人和受益人是这6名女职工,保期三年,保险金额1万元,保费每人40元。该保费已由永顺县保险公司工会经费中出资一次交清。
In June 1996, Yongshun PICC was divided into two companies, one was the life insurance company and the other the property insurance company. Chen was arranged to work for Yongshun Life Insurance. In July 1997, Chen was transferred from Yongshun Life Insurance to Ping An Insurance Company of China, Jishou Branch. On August 5 of the same year, Yongshun Life Insurance, by making a business approval list, cancelled the insurance contract with the reasons that Chen did not have the insurable benefits and did not notify Chen in written form. In January 1998, the People's Hospital of Tujia Nationality and Miao Nationality Autonomous Prefecture in west Hu'nan diagnosed Chen's illness as cancer, and then Hu'nan Tumor Hospital re-diagnosed her illness as endometrium adenocarcinoma. After being afflicted with the cancer, Chen submitted the application to Yongshun Life Insurance for the insured amount twice, separately in January and May of 1998. But Yongshun Life Insurance distributed a written notification on July 21 of the same year to Chen on refusing to pay the insured amount with the reasons that Chen was no longer entitled to the insurable benefits after being transferred and that the insurance contract had been invalidated. Chen therefore brought a lawsuit on February 8, 1999 but died of the cancer on July 8 of the same year. 1996年6月,原中国人民保险公司永顺县支公司分立为人寿保险公司和财产保险公司两个单位,陈晓兰被分到被告永顺人保工作。1997年7月,陈晓兰从永顺人保调往中国平安保险公司吉首分公司工作。同年8月5日,永顺人保作出业务批单,以陈晓兰不具有可保利益为由解除了保险合同,没有书面通知陈晓兰。1998年1月,湖南省湘西土家族苗族自治州人民医院诊断陈晓兰患癌症,后又经湖南肿瘤医院确诊为子宫膜腺癌。陈晓兰患癌后,曾于1998年1月和5月两次向永顺人保递交了给付保险金的申请。永顺人保以陈晓兰调离后已不具有可保利益,保险合同失效为由,于同年7月21日给陈晓兰下发了保险金拒付通知书。陈晓兰为此于1999年2月8日提起诉讼,同年7月8日因癌症恶化死亡。
PROCEDURAL POSTURE 
Yongshun Court held: 湖南省永顺县人民法院认为:
It was a due act permitted and supported by law for any entity to seek lawful benefits for its employees. As Yongshun PICC was engaged in insurance, and it took out insurance policy for its employees, this particular circumstance had determined that the insurant and the insurer who signed the insurance contract were the same person. However, different from the circumstance that someone concluded an invalid contract with himself, this insurance contract was still a contract concluded between two civil subjects at equal status. In light of the situation on contribution of the premium, Yongshun PICC Work Union should be ascertained to be the insurant of the insurance contract, while Yongshun PICC should be the insurer. To maintain the lawful rights and interests of the employees, to care for their lives and to serve them whole-heartedly were the functions of a work union. Therefore Yongshun PICC Work Union took out life insurance policy for the employees, which was an embodiment of performing its duties. In accordance with Paragraph 2 of Article 52 of the Insurance Law of the People's Republic of China, Yongshun PICC Work Union had insurance benefits over the insurance object; and in accordance with Article 12 我不休息我还能学of the Insurance Law, the life insurance contract in this case was an expression of the true intention between the parties, which was lawfully formed and therefore valid. 任何单位为自己的职工谋取合法利益,都是法律允许并支持的正当行为。由于保险是原中国人民保险公司永顺县支公司的业务,此次保险是该公司为自己的职工投保,这种特殊情况决定了该保险合同上投保人和保险人的签署是同一人,但这与自己和自己签订的无效合同情况不同,仍然属于两个平等民事主体之间签订合同。根据保费出资的实际情况,应认定这个保险合同的投保人是原中国人民保险公司永顺县支公司工会,保险人是该公司。维护职工合法权益,关心职工的生活,全心全意为职工服务,是工会的职能。工会在职工同意的情况下为职工投保人身险,是其履行职责的体现。依照《中华人民共和国保险法》第五十二条第二款的规定,原中国人民保险公司永顺县支公司工会对保险标的具有保险利益。依照保险法十二条聊五分钱的天吗的规定,本案的人身保险合同是当事人真实意思的表示,依法成立有效。
When Wang's wife Chen was working for Yongshun PICC, she was both an employee of Yongshun PICC and a member of Yongshun PICC Work Union, thus should be entitled to enjoy the remuneration of an employee and work union member. The insurance policy taken out by Yongshun PICC with its work union's contribution for its female employees was exactly the welfare remuneration offered by the Work Union to its members. Due to the formation of the insurance contract, Chen became a contractual party in the identity of the insured and the beneficiary. In accordance with Paragraphs 2 and 3 of Article 21 of the Insurance Law, Chen should be entitled to claim for the insured amount. 原告王连顺之妻陈晓兰在原中国人民保险公司永顺县支公司工作期间,既是原中国人民保险公司永顺县支公司的职工,也是原中国人民保险公司永顺县支公司工会的会员,有权利享受职工和会员的待遇。原中国人民保险公司永顺县支公司从该公司工会出资为其女职工投保,是该公司工会给会员的福利待遇。因保险合同的成立,陈晓兰以被保险人和受益人的身份成为合同当事人。依照保险法二十一条第二、三款的规定,陈晓兰享有保险金请求权。
Usually a contract may be modified or cancelled so long as both contractual parties have reached an agreement due to their consistent intention. However, in an insurance contract, the participation of the insured makes the contract related to his interests, therefore, the contract shall not be concluded, modified or cancelled unless the insured has been notified and has consented. But Yongshun Life Insurance cancelled the contract by a business approval list without inquiring Chen after Chen was transferred out of the company. They did this by taking advantage of the convenience that the life insurance contract was executed by the same person. This behavior of Yongshun Life Insurance had violated Article 15
光宗耀祖支撑着我去教室
of the Insurance Law and should not be binding.
 通常的合同,由于是签约双方的一致意思表示,所以只要签约双方协商一致,就可以变更或者解除。但是在保险合同中,由于有被保险人加入,合同与被保险人利害相关,因此只有在通知并征求被保险人的意见后,才能决定合同的订立、变更或解除。原告王连顺之妻陈晓兰从被告永顺人保调离后,永顺人保借该人身保险合同为同一人签署的便利,在没有征求陈晓兰意见的情况下,就以业务批单的形式解除合同。此举违背了保险法十五条的规定,不能发生解除的效力。
The flow of employees is a normal phenomenon in social development. Under a life insurance contract with the health of a flowing employee to be the insurance object, the insurance benefits of the insurant over the insurance object at the time of taking out the insurance policy might, due to the employee's flow, change after the insurance policy is taken out. The validity of a life insurance contract may only be determined on the basis of whether the insurant has the insurance benefits at the time of taking out the insurance policy, while not on the basis of the change in employees after the formation of the insurance contract. Only in this way could the stability of the contract be maintained. Yongshun Life Insurance's assertion that the contract in this case was invalid with the reason that Yongshun Life Insurance no longer had the insurable benefits after Chen has been transferred, should not be tenable. 人员流动是社会发展正常现象。以可流动人员的身体作为保险标的的人身保险合同,投保人在投保时对保险标的具有的保险利益,可能由于人员流动而在投保后发生变化。对人身保险合同,只能根据投保人在投保时是否具有保险利益来确定合同效力,不能随保险合同成立后的人事变化情况来确定合同效力,这样才能保持合同的稳定性。被告永顺人保以陈晓兰调离后,永顺人保已没有可保利益为由,主张本案合同无效,理由不能成立。
A lawfully formed contract is binding upon each party, and each party shall enjoy the rights and perform the obligations according to the stipulations in the contract. Chen was afflicted with gynaecological cancer during the insurance period, thus fell in the insurance coverage stipulated in the insurance contract. Yongshun Life Insurance should pay the insured amount as stipulated upon receipt of the application for settlement of the insurance claim. Wang's claim for ruling that Yongshun Life Insurance pay the insured amount should be supported; but his claim for ruling that Yongshun Life Insurance indemnify Chen for the mental loss should not be supported due to lack of corresponding evidence. Therefore, Yongshun Court rendered its judgment on August 11, 1999: 依法成立的合同,对各方当事人都有约束力,各方当事人必须按照合同的约定享受权利和履行义务。原告王连顺之妻陈晓兰在保期内患了妇科癌症,符合保险合同约定的承保条件,被告永顺人保在接到保险理赔申请后,应当按约定支付保险金。王连顺诉请判令永顺人保给付保险金,应当支持;诉请判令永顺人保赔偿陈晓兰的精神损失,由于没有提供相应的证据,不予支持。据此,湖南省永顺县人民法院于1999年8月11日判决:
I. Yongshun Life Insurance should pay Wang 10,000 Yuan of the insured amount; 谁敢欺负我的人  一、被告永顺人保给付原告王连顺保险金1万元;
II. Wang's claim that Yongshun Life Insurance should indemnify Chen for the mental loss should not be supported.   二、原告王连顺要求被告永顺人保赔偿精神损失,不予支持。
The 530 Yuan of acceptance fee should be borne by Yongshun Life Insurance. 诉讼费530元,由被告永顺人保负担。
After the judgment of the first instance became legally effective, the Intermediate People's Procuratorate of Tujia Nationality and Miao Nationality Autonomous Prefecture of Hu'nan Province lodged a protest against the judgment. The reasons are as follows: The insurance premium in this case was actually paid by Yongshun PICC, the ascertainment in the judgment of the fist instance that the premium was paid by Yongshun PICC Work Union lacked evidence and thus was a wrong ascertainment of facts; as Chen was not a party to the insurance contract and Yongshun Life Insurance had lost the insurance benefits, the ascertainment in the judgment of the first instance that the contract was still valid after Chen had been transferred out of Yongshun Life Insurance, was a wrong application of law. Then the Intermediate People's Court of Tujia Nationality and Miao Nationality Autonomous Prefecture of Hu'nan Province (hereinafter referred to as “the Intermediate Court”) ordered Yongshun Court to retry the case. 一审判决发生法律效力后,湖南省湘西土家族苗族自治州人民检察院提起抗诉。理由是:本案保费是由原中国人民保险公司永顺县支公司支出,一审判决认定由该公司工会经费中支出,证据不足,是认定事实的错误;陈晓兰不是保险合同的当事人,其调离永顺人保后,永顺人保已失去保险利益,一审判决仍认定合同有效,是适用法律不当。湖南省湘西土家族苗族自治州中级人民法院指令湖南省永顺县人民法院再审。
It was verified by Yongshun Court through retrial by forming a second collegial panel and according to the procedures of the first instance: 湖南省永顺县人民法院另行组成合议庭,依法按照一审程序再审查明:
The insurance premium was ascertained in the original judgment to be paid by Yongshun PICC Work Union, which could be proved by the attestation issued by Hu Chunhua, handler of this insurance business, in the name of Yongshun PICC. Although there was defect in the form of the attestation, the facts it proved were definite. Moreover, the audit on the accounting books of Yongshun PICC's management expenses implied that from October 1 to October 30, 1995, there were no documents on payment of the insurance premium for Chen and other 5 female employees. 原判认定本案保费是由原中国人民保险公司永顺县支公司工会经费中支出,有该保险业务的经办人胡春花以原中国人民保险公司永顺县支公司的名义出具的证明。虽然该证明存在着形式上的缺陷,但所证明的事实是确定的。另外,对原中国人民保险公司永顺县支公司的行政事业经费的会计凭证账查账,其结果是:从1995年10月1日至10月30日,该账中没有为陈晓兰等6名女职工支出保费的凭证。
Yongshun Court held after the retrial that the protesting organ did not provide any evidence to support its holding that the insurance premium was paid by Yongshun PICC; and its reasons that the insurance contract became invalid due to Chen's transfer and the insurant's loss of insurance benefits could not be tenable. In the original judgment, the facts were clearly ascertained, the evidence was sufficient, the law was correctly applied, the judgment was appropriately rendered, and the trial procedures were lawful, thus the original judgment should be sustained. Therefore, Yongshun Court rendered a judgment on May 16, 2000: 湖南省永顺县人民法院再审认为,抗诉机关认为保费是由原中国人民保险公司永顺县支公司支出,没有举出任何证据;认为陈晓兰调离后,保险合同因投保人失去保险利益而无效,理由不能成立。原判认定事实清楚,证据确实,适用法律正确,判处恰当,审判程序合法,应当维持。据此,该院于2000年5月16日判决:
The protest should be rejected and the original judgment sustained. 驳回抗诉,维持原判。
The 930 Yuan of litigation cost should be borne by Yongshun Life Insurance. 诉讼费930元,由原审被告永顺人保负担。
After the judgment was announced, Yongshun Life Insurance refused to accept it and appealed to the Intermediate Court with the reasons for appeal to be: 1. In the contract, Yongshun Life Insurance was both the insurant and the insurer; its modifying part of the contents in the insurance contract upon agreement reached through negotiation, and its making the business approval list on terminating its insurance liability to Chen were lawful civil acts; 2. Even if the termination of the insurance liability to Chen in the form of approval list was invalid, the contents concerning Chen in the insurance contract should also be regarded as invalid since Chen had been transferred and Yongshun Life Insurance no longer had the insurable benefits. 宣判后,永顺人保仍不服,向湖南省湘西土家族苗族自治州中级人民法院提起上诉。理由是:一、在本案合同中,上诉人既作为投保人又作为保险人,经协商一致变更保险合同的部分内容,作出终止对陈晓兰保险责任的业务批单,是合法的民事行为;二、即使以批单形式终止对陈晓兰的保险责任是无效的,由于陈晓兰已调离,上诉人已不具有可保利益,保险合同中涉及陈晓兰的部分也应当认定无效。
JUDGMENT'S REASONING 
The Intermediate Court held after the trial in the second instance: 湖南省湘西土家族苗族自治州中级人民法院经二审后认为:
The insurance contract in this case was ascertained not to have been cancelled, not only because it was cancelled in the form of an invalid approval list, but also because Chen was not notified and her opinion was not inquired at the time of cancellation. Although Chen was not a party to the insurance contract, as the insured and beneficiary of a life insurance contract, she was entitled to know the validity of the contract. Under the circumstance of being notified by no one, she had the reason to believe that the insurance contract still existed. However, it was not until she was afflicted with cancer and therefore applied for settlement of insurance claim did Yongshun Life Insurance issue the approval list on canceling the contract. Yongshun Life Insurance's behavior violated the principles of honesty and credibility in civil acts, and should of course be invalid. 认定本案的保险合同不能解除,不仅仅因为它是以无效的批单形式解除的,更因为解除时没有通知陈晓兰并征求她的意见。陈晓兰虽然不是该保险合同的签约人,但作为人身保险合同的被保险人和受益人,她有权知道合同的效力情况。在无人通知的情况下,她有理由相信该保险合同仍然存在。当她患了癌症并据此申请理赔时,上诉人永顺人保才出具解除合同的批单,此举违背了民事行为应当遵循的诚实信用原则,当然无效。
Only the agreement concluded between two or more civil subjects at equal status for establishing, modifying or terminating the relationship of civil right and obligation can be called a contract. The reason that the insurance contract in this case could be formed lay in that one party was Yongshun PICC as the insurer engaging in insurance business, and the other party was Yongshun PICC Work Union which represented the interests of the 6 female employees. Involving the interests of other 5 female employees, Yongshun Life Insurance did not want to deny the validity of the insurance contract, but tried to convince that the insurance contract was concluded by one person. This was neither consistent with the fact, nor conformed to the legal theory, thus was self-contradicting. Had Yongshun Life Insurance really concluded a “contract” with itself, then how to explain the “agreement reached through negotiation” in modifying the insurance contract? Yongshun Life Insurance's reasons for appeal could not be tenable. The original judgment was correct and should be sustained. Therefore, the Intermediate Court rendered a judgment on October 16, 2000 in accordance with Item (1) of Paragraph 1 of Article 153 of the Civil Procedure Law of the People's Republic of China: 只有两个以上的平等民事主体为设立、变更、终止民事权利义务关系而签订的协议,才可称为合同。本案的保险合同能够成立,就在于一方是从事保险业务的保险人原中国人民保险公司永顺县支公司,另一方是代表6名女职工权益的原中国人民保险公司永顺县支公司工会。上诉人永顺人保在还涉及其他5名女职工权益的情况下,既不想否认本案保险合同的效力,又要说服该保险合同是由其一人签订的,不但与事实不符,且与法理不合,自相矛盾。如果确实是自己与自己签订“合同”,变更保险合同的“经协商一致”又从何谈起?永顺人保的上诉理由不能成立。原判正确,应当维持。据此,该院依照《中华人民共和国民事诉讼法》第一百五十三条第一款第(一)项的规定,于2000年10月16日判决:
JUDGMENT 
The appeal should be rejected and the original judgment sustained. 驳回上诉,维持原判。
The 400 Yuan of acceptance fee in the second instance should be borne by Yongshun Life Insurance.

 案件受理费400元,由上诉人永顺人保负担。
 

     
     
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