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Lu Yongfang v. Taicang Branch of China Life Insurance Company Limited (insurance contract dispute)
陆永芳诉中国人寿保险股份有限公司太仓支公司保险合同纠纷案
【法宝引证码】
  • Type of Dispute: Civil-->Company, Securities, Insurance, Bills, etc.
  • Legal document: Judgment
  • Judgment date: 01-18-2013
  • Procedural status: Trial at Second Instance
  • Source: 《最高人民法院公报》 2013年第11期(总第205期)

Lu Yongfang v. Taicang Branch of China Life Insurance Company Limited (insurance contract dispute) 陆永芳诉中国人寿保险股份有限公司太仓支公司保险合同纠纷案
[Judgment abstract] [裁判摘要]
In the absence of a specific method of premium payment in a life insurance contract, it should be deemed that the insurance applicant and the insurer have formed a particular transaction habit if they have long maintained a relatively fixed method of premium payment. If the insurance company's unilateral change of the transaction habit in violation of the principle of utmost good faith leads to the insurance applicant's failure to pay premiums in a timely manner, the policy should not be determined invalid, and the insurance company is not entitled to suspend the validity of the contract and terminate the insurance contract. 人寿保险合同未约定具体的保费缴纳方式,投保人与保险人之间长期以来形成了较为固定的保费缴纳方式的,应视为双方成就了特定的交易习惯。保险公司单方改变交易习惯,违反最大诚信原则,致使投保人未能及时缴纳保费的,不应据此认定保单失效,保险公司无权中止合同效力并解除保险合同。
Plaintiff: Lu Yongfang, female, 42, domiciled at Xinbei Street, Shaxi Town, Taicang City. 原告:陆永芳。
Defendant: Taicang Branch of China Life Insurance Company Limited, domiciled at Xianfu Street, Chengxiang Town, Taicang City. 被告:中国人寿保险股份有限公司太仓支公司。
Plaintiff Lu Yongfang, filed a lawsuit with the People's Court of Taicang City, Jiangsu Province for a dispute with Taicang Branch of China Life Insurance Company Limited (hereinafter referred to as “China Life Taicang”) over an insurance contract. 原告陆永芳因与被告中国人寿保险股份有限公司太仓支公司(以下简称太仓人寿保险公司)发生保险合同纠纷,向江苏省太仓市人民法院提起诉讼。
Plaintiff Lu Yongfang alleged that: through insurance agent Liu Ying, Lu Yongfang signed a Child's Lifetime Happiness insurance policy with China Life Taicang on February 13, 1997, with a payment period of 15 years. From 12:00, February 14, 1997, the start of the insurance period, Lu Yongfang should pay 720 yuan of premiums annually. China Life Taicang issued an advice of payment annually, and Lu Yongfang paid premiums as required by the advice. However, from 2009, China Life Taicang no longer issued the advice of payment for no reason, leading to Lu Yongfang's failure to pay premiums on schedule. Lu Yongfang reported the situation to China Life Taicang, but China Life Taicang rejected any premiums on the excuse of invalidation of the policy, from which the dispute arose. Therefore, Lu Yongfang brought an action in the court, requesting the court to order: (1) China Life Taicang should reinstate the policy's validity and continue to collect premiums; (2) China Life Taicang should compensate Lu Yongfang in the amount of 2,000 yuan for her loss arising from the reinstatement of the validity of the policy; and (3) The litigation costs should be assumed by China Life Taicang. 原告陆永芳诉称:经保险代理人刘英联系,陆永芳与被告太仓人寿保险公司于 1997年2月13日签订了一份少儿一生幸福保险的保单,保险期限自1997年2月 14日12时起,缴费期15年,年缴720元。太仓人寿保险公司每年发出缴费通知书,陆永芳按通知书缴费。但是,从2009年起,太仓人寿保险公司无故不再发出缴费通知书,导致陆永芳未能按期缴费,后陆永芳向太仓人寿保险公司反映情况,但太仓人寿保险公司以保单失效了拒收保费,引起纠纷,故诉至法院请求判令:(1)太仓人寿保险公司恢复保单效力,继续收取保费;(2)赔偿陆永芳为保单复效的损失2000元; (3)由太仓人寿保险公司承担诉讼费用。
...... 被告太仓人寿保险公司辩称:(1)保险法规定,缴纳保险费是投保人的义务;(2)保险费的催缴不是保险人的法定义务;(3)保险法规定人身保险合同超过两年未缴费的,永久失效。本案保险合同因超过两年未交费,所以本合同已经失效,请求法院驳回陆永芳诉讼请求。
 江苏省太仓市人民法院一审审理查明:
 1997年2月13日,投保人原告陆永芳向中国人寿保险公司太仓市支公司 (2003年变更为被告太仓人寿保险公司)投保了少儿一生幸福保险,被保险人董海威,保险期限自1997年2月14日12时起,缴费期15年,缴费方式为年缴,保险费 720元。保险条款“关于缴费、失效、复效的约定”第十一条载明:“按年缴纳保险费的缴费期限为保险单每年生效对应日所在的月”;第十二条载明:“缴费期限的次月为宽限期,宽限期内保险人仍负保险责任。如果在宽限期内仍未缴纳保险费,保险单自动失效,保险人不负保险责任”;第十三条载明:“在保险单失效后的两年内,投保人及被保险人如果仍符合本条款第三条规定的投保条件,可以向保险人申请复效。经保险人审核同意后,投保人补缴失效期间的保险费及利息,保险单方能恢复效力。”陆永芳投保时,直接缴纳了第一年保费,之后两年由太仓人寿保险公司业务员刘英每年上门向陆永芳收取现金保费。2000年开始太仓人寿保险公司委托邮政部门向陆永芳发送缴费通知单,至2008年陆永芳每年按照缴费通知单的提示向太仓人寿保险公司指定的银行缴纳保费,在银行直接领取保费收据。2009年太仓人寿保险公司仍委托邮政部门发送缴费通知单,但陆永芳称并未收到缴费通知单。2010年之后在缴费期即将届满之时,太仓人寿保险公司却终止了委托邮政部门向陆永芳发送缴费通知书的业务。2011年5月,刘英委托姐姐到陆永芳处上门办理银行代扣保费业务时,陆永芳知晓自己未按期缴纳保费致使保单失效,当月向太仓人寿保险公司申请复效,太仓人寿保险公司拒绝复效。
 江苏省太仓市人民法院一审认为:
 原告陆永芳为被保险人董海威向被告太仓人寿保险公司投保人身财产保险,太仓人寿保险公司签发了保单,保险合同依法成立并生效。根据最高人民法院《关于适用〈中华人民共和国合同法〉若干问题的解释(一)》第二条的规定,“合同成立于合同法实施之前,但合同约定的履行期限跨越合同法实施之日或者履行期限在合同法实施之后,因履行合同发生的纠纷,适用合同法第四章的有关规定”。因此,陆永芳、太仓人寿保险公司双方也应当按照《中华人民共和国合同法》第六十条第二款的规定,履行合同时遵循诚实信用原则,根据合同交易习惯履行通知、协助、保密等义务。保险条款关于缴费、失效、复效的约定中,投保人本应在每年的2月缴纳当年保险费,这是投保人应履行的义务,但保险条款中并未约定具体的缴纳方式,根据太仓人寿保险公司业务员刘英的证言及太仓人寿保险公司的陈述,订立合同后的第二年和第三年保险费是刘英上门收取,之后至2008年,投保人是按照太仓人寿保险公司委托邮政部门发送的缴费通知书告知的时间和地点缴纳保险费,双方已成就了特定的交易习惯。2009年,太仓人寿保险公司虽委托邮政部门发送缴费通知书,但邮政部门是否按约发送给陆永芳,太仓人寿保险公司并未提供证据证明。2010年在缴费期即将届满之时,太仓人寿保险公司却已不再发送缴费通知书,太仓人寿保险公司单方中断向陆永芳履行有效通知的义务,致使陆永芳未能及时缴纳保费,且重组并未改变太仓人寿保险公司应履行收取保费及通知交缴等习惯形成的义务。因此,对投保人二年内未能缴费致使保单失效应由太仓人寿保险公司承担责任,太仓人寿保险公司无权径依保险法的规定和保险条款的约定中止合同效力并解除保险合同,故对陆永芳要求太仓人寿保险公司继续履行合同义务的诉讼请求原审法院予以支持。关于陆永芳诉请太仓人寿保险公司赔偿损失 2000元一节,因陆永芳未能提供证据证明,不予支持。
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