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Chapter 381 Insurance contract disputes (5)

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    The trial has been going on for an hour and a half, Li Yike's legs are a little numb, he slightly adjusted his sitting posture, and then said: "Dear presiding judge, the plaintiff believes that the waiting period exemption clause should not apply to this case, the plaintiff Ms. Ma Yanyan and the defendant a Life Insurance  In the insurance contract signed by the insurance company, it is specified that the waiting period is 90 days from the date when the contract becomes effective (or finally reinstated). The plaintiff Ma Yanyan¡¯s first illness and diagnosis by the hospital occurred after the waiting period, so the insurance company should bear the compensation  Liability for insurance money. The defendant defended that the plaintiff found lesions during the waiting period because he confuses the concept between the discovery of suspected lesions and the diagnosis. In the exemption clause of the insurance contract for the waiting period, it is clearly stated that "During the waiting period, the diagnosis in the annex to the contract  It has been clarified that the exemption condition during the waiting period is a diagnosis. Therefore, the plaintiff was diagnosed with the disease after the waiting period, and the waiting period exemption clause cannot be applied; in addition, the insurance contract is a standard contract, and the "Contract Law"  Article 41 stipulates that if there is a dispute over the understanding of the standard terms, it shall be interpreted according to the common understanding. If there are two or more interpretations of the standard terms, an interpretation that is unfavorable to the party providing the standard terms shall be made. In this case, the defendant a life insurance company  As the party providing the standard contract, the interpretation of the waiting period clause is different from that of the plaintiff, Ms. Ma Yanyan, and should be interpreted against the life insurance contract of the defendant a. In summary, we request the court to support all the plaintiff¡¯s claims.¡±

    A standard contract is also called a standard contract, a finalized contract, and a standard contract. It refers to a contract in which one party pre-draws the terms of the contract, and the other party can only express full agreement or disagreement.  Therefore, for a party to the non-drafted terms of a standard contract, to conclude a standard contract, it must accept all the contract conditions; otherwise, the contract will not be concluded.  In real life, train tickets, boat tickets, air tickets, insurance policies, bills of lading, warehouse receipts, publishing contracts, etc. are all standard contracts and standard contracts.

    Du Kefan said: "The defendant made an argument."

    Chen Youjun said: "The defendant believes that this case is in line with the exemption of insurance liability for diseases occurring during the waiting period. Defendant a life insurance company feels sorry for the plaintiff, Ms. Ma Yanyan's illness, but the plaintiff's lawyer claims that Ms. Ma Yanyan did it after the waiting period.  Diagnosing the disease is ignoring the objective fact that the plaintiff, Ms. Ma, was ill. Although Ms. Ma was not diagnosed during the waiting period, it was already an objective fact that she was already ill at that time. Some diseases take a long time from the discovery of abnormalities, examination to diagnosis.  The plaintiff's lawyer cannot artificially separate a period of illness. The purpose of establishing the waiting period is to prevent the moral hazard generated in the process of concluding the insurance contract, that is, the insured knows that he is suffering from a disease and buys the insurance, thereby defrauding the insurance.  Among them, the basis for applying the waiting period should be based on whether the insured is sick during the waiting period, and the expression of diagnosis cannot be applied mechanically.¡±

    Li Yike said: "During the waiting period, if the disease stipulated in the annex to the insurance contract is diagnosed, the insurance company's exemption from insurance liability is clearly stipulated in the standard contract provided by the defendant insurance company, and the plaintiff also agrees with this agreement.  If there is a clear recognition of the diagnosis of the disease, the plaintiff only conducted a physical examination during the waiting period and found a suspected disease. This level is by no means "diagnosed"; in addition, please pay attention to the presiding judge.  The clause stipulates that if the plaintiff is sick and applies for compensation, he must provide a diagnosis statement from a tertiary hospital. Similarly, only the diagnosis statement from a tertiary hospital can prove that the plaintiff suffers from the claimable disease specified in the annex to the contract. A medical examination  The center's medical examination report obviously does not qualify as a 'diagnosed diagnosis', therefore, the defendant's defense is unreasonable, and it also reduces his contractual obligations."

    Du Kefan asked: "The plaintiff and the defendant haven't added anything yet?"

    Wu You said: "The court is requested to make a judgment as soon as possible. The plaintiff's family is not rich and urgently needs insurance compensation to support follow-up treatment expenses."

    Chen Youjun thought for a while, and said, "Please the court make a fair judgment."

    Du Kefan: "Okay, adjourn."

    Wu You and Li Yike walked out of the courtroom. Wu You proposed to visit Ma Yanyan in the hospital together. Today Ma Yanyan will be admitted to the hospital for the second round of treatment.

    Wu You has always been kind-hearted, and it is common to visit the parties involved.

    Of course Li Yike agreed.

    When the two arrived at the hospital, Ma Yanyan was lying on the hospital bed alone.

    Seeing Wu You and Li Yike coming, Ma Yanyan was very surprised. She tried to sit up with her weak body.

    "Lie down." Wu You stopped Ma Yanyan, and then motioned Li Yike to help Ma Yanyan roll the bed.

    "It's really troublesome Lawyer Wu and Lawyer Li." Ma Yanyan said apologetically.

    "Drink a glass of water." Ma Yanyan said, and then wanted to get up and pour water for Wu You and Li Yike.

    Her weak body couldn't support her movements at all, and she panicked for a moment.

    "Don't be too busy, we will do it ourselves." Wu Yousaid comfortingly.

    Wu You picked up the kettle and found that there was no water in it, so he signaled Li Yike to go to the water room to make a pot of hot water for Ma Yanyan.

    Ma Yanyan said shyly: "I'm really sorry, you two came to visit me so far, and you didn't have a sip of water, so you had to fetch water for me."

    Wu You waved his hand and said, "Don't be polite, it's just a matter of little effort."

    "By the way, are you the only one in the hospital, is there no one to accompany you?" Wu You asked.

    He thought of the past when he was hospitalized with stomach cancer, his elder brother Wu Fan came all the way from his hometown to accompany him, Li Yike also volunteered to watch for him at night, Lin Ziyao ran to the hospital day by day, a feeling of warmth flooded into Wu You's heart.

    ?A friend in adversity sees the truth, and he is really lucky to have relatives and confidants.

    Ma Yanyan said with a gloomy expression: "My parents passed away a long time ago. Most of my relatives are old. There is only one cousin. She will come to accompany me when I have the operation tomorrow."

    Ma Yanyan has always been single.

    "What about the surgery, who will take care of you?" Wu You asked with concern.

    The recovery period after surgery is the key.

    "I hired a nurse, who will come tomorrow." Ma Yanyan said angrily.

    The current salary of the nurse is 300 yuan a day. Ma Yanyan is so shy that she is reluctant to hire a nurse for another day. She only plans to hire a nurse from the day of the operation, so as to save a little bit.

    After talking for a while, Ma Yanyan's energy was a little low, Wu You told Ma Yanyan to take a good rest, and then left.

    Before leaving, Wu You went to the payment office to pay 10,000 yuan for Ma Yanyan's medical expenses.

    For representing Ma Yanyan's case, Wu You could only get 800 yuan from the Legal Aid Center.

    Seeing this, Li Yike respected Wu You a little more.  (Remember the site URL: www.hlnovel.com
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