In Insurance, What Are Policy Exclusions?

The insurance policy is referred to as the "policy". Written proof of the insurance contract between the insurer and the applicant. The main contents of the insurance policy include: (1) the two parties' explanations on the subject matter of the insured, including the name of the insured, the name of the insured subject and its place or state of storage, the amount of insurance, the duration of the insurance, the insurance premium, etc. (2) The rights and obligations of both parties, such as liability and non-compliance. (3) Annotated conditions refer to the terms of insurance or other conditions agreed upon by the parties, as well as matters such as policy changes, transfers and cancellations. Insurance policies are the main manifestation of signing insurance contracts. To simplify the form, legally-appointed insurance policies, insurance certificates or temporary insurance policies can also be used. ^[1]

Policy

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The insurance policy must clearly and completely record the rights and obligations of both parties to the insurance. The insurance policy mainly contains the names of the insurer and the insured,

In insurance practice, an insurance company generally issues an insurance policy only after the policyholder pays the premium. However, under special circumstances, the insurance company is also willing to issue an insurance policy in advance, allowing the policyholder to pay the insurance premium after a period of time. Retain large customers, allow them to pay insurance premiums within the date of issue of the insurance policy), and in the insurance policy, the policyholder's payment situation and the effectiveness of the insurance policy are also explained accordingly. As far as the author knows, the insurance company's description of the above matters in the insurance policy has several different expressions. Although the words are not very different, they will have different legal effects on the insurance policy, and then affect whether the insurance company should Liability.

The insurer is not liable for an accident before the premium is paid

This special agreement is an exemption clause. Before the policyholder pays the premium, the insurance contract has been established and legally valid. Accidents that occur before the insurance premium is paid fall into the scope of compensation agreed in the insurance contract. However, due to the above provisions, the insurance company enjoys the exemption. The insurance company can refuse compensation for this exemption. Moreover, the insurance company may continue to demand insurance premiums from the policyholders in accordance with the provisions of the insurance contract in force. After the insured pays the insurance premium, the insurance company shall bear the compensation liability for the insured accidents that still occur during the insurance period. It should be noted that the above exemption clause should be clearly explained to the policyholder, otherwise it will not have legal effect.

The insurance policy does not take effect until the premium is paid

The special agreement is a clause with effective conditions. Before the insurance premium is paid, the insurance policy has been established, but it has not taken effect. In other words, the insurance policy will only take effect if the insured has paid the insurance premium. The condition for the insurance policy to be effective is that the insured pays the insurance premium to the insurance company. For accidents that occur before insurance premiums are paid, insurance companies are not liable for compensation because the insurance policy has not taken effect. Of course, an insurance company cannot claim insurance premiums from an insured person with an insurance contract that does not take effect.

The insurance policy is invalid until the premium is paid

This special agreement is the result of the parties expressing wrong intentions, and whether the insurance policy is invalid. It can only be seen whether the contents of the insurance policy violate the mandatory provisions of laws and administrative regulations. If so, the insurance policy is invalid. Otherwise, the insurance policy will not Invalid legal consequences. In other words, the invalidity of an insurance policy is not something the parties can agree on, and it can only be judged according to the corresponding laws and administrative regulations. In practice, the true expression of the parties should be explained according to the specific circumstances of the case. If the true expression of the parties is that the insurance policy is not effective before the insurance premiums are settled, the true expression of the parties is a clause with conditions of validity of the insurance contract .

The insured pays the insurance premium within five days from the date of insurance

This special agreement is the termination clause of the contract, and the insurance contract takes effect when the insurance company issues an insurance policy. If the policyholder fails to pay the insurance premium within five days from the date of initiation of the policy (the date of issuance of the insurance policy), the insurance contract is still in force. In the event of an insured event occurring during this period, the insurance company shall still be liable for compensation. However, from the sixth day of the insurance date, if the insured has not paid the insurance premium, the validity of the insurance contract will be terminated. In the event of an insurance accident during this period, the insurance company is not liable for compensation and it is not entitled to apply for insurance. People ask for insurance premiums.

The situation in which insurance policies are pledged for financing has emerged in real life. As of 2013, Chinese laws have adopted a vague attitude of unclear opposition and explicit support for such businesses, which has hindered the development of insurance policy pledged businesses. Both the theoretical and practical circles say that the pledge of insurance policies is limited to the right to claim the return of cash value, and deny the pledgeability of the right to claim insurance funds under the insurance policy.

Insurance policies are divided into property insurance policies and life insurance policies .
Regarding the property insurance policy , the Supreme People's Court Law Letter (1992) No. 47 of April 2, 1992 "Letter on Whether Property Insurance Policy Can Be Used as Mortgage" expressly prohibits pledge of property insurance policy. The pledged property shall be a specific property that can be discounted or sold. A property insurance policy is a written proof that the insurer and the insured have entered into an insurance contract. It is not a security or a property that can be discounted or sold. Therefore, the property insurance policy cannot be used for pledge.
With regard to life insurance policies ,

After receiving the insurance policy, you should pay attention to:

Acceptance of insurance policy

When you receive the policy, you should check whether the following documents are available:

(1) Original policy

(2) Insurance clause

(3) Formal receipt of insurance premiums

(4) Notification of change

(5) Statement of cash value. If the insurer is in place, he should sign the policy delivery letter and fill in the policy number and date of receipt.

Insurance policy check

All the items on the original insurance policy and the insurance premium receipt should be checked one by one. If there are errors, the insurance company and the salesman should be promptly corrected.

Think twice about insurance policies

Ten days from the date of receiving the policy is called the cooling-off period or hesitation period, which allows the policyholder to "backtrack." Therefore, we should take the time to read and study the insurance clauses carefully, and pay special attention to the insurance period and insurance liability. If the insurance is withdrawn, the insured should submit it in writing, which can be delivered through the salesperson or directly (post), the insurance company will refund the premium without interest, and the insurance contract is invalid.

Filing of insurance policy

Some insurances, such as life insurance, take more than ten years, decades, or even a lifetime, so it is best to include important information about the policy (such as company name, type of insurance, policy effective date, payment date, premium amount, salesperson name and Contact phone number, insurance company address, phone number, etc.) for emergency needs.

Insurance policy custody

The insurance policy and related documents must be properly kept. Pay attention to waterproof, moisture-proof, fire-proof and insect-proof. It is best to put it in a plastic folder and then store it in a safe place.

Insurance policy replacement

In case the insurance policy is lost, you should report to the insurance company to make up for the loss in time, so as not to delay the payment or compensation of the insurance premium.

Change of insurance policy

If the applicant applies for changing the policy content (such as changing the payment method, changing the policyholder or beneficiary, changing the identity document, changing the communication address or contact phone number, increasing the insurance amount, etc.), he should carefully fill in the change application form, and pass the salesman with the policy Or I personally send (send) it to the insurance company to handle relevant matters in time.

Insurance policy

If the insured happens to be out of insurance, the insured should report the insurance in a timely manner, explain the time, place, and circumstances of the insurance in detail, and send the insurance notice to the insurance company through the salesperson or in person within the prescribed period for claim formalities. .

Surrender of insurance policy

The policyholder can apply for surrender after the policy has been in force for two years and the insurance premium has been paid for two years. The insurance company will pay the surrender according to the amount stated in the cash value statement, and the policy effect will be suspended.