3.保险合同

INSURANCE CONTRACT INSURANCE CONTRACT (保险是投保人与保险人约定权利义务关系的协议。除了具有合同的一般属性之外，保险合同还具有独特的特征。保险合同是一种射幸合同，或者说是一种机会合同，这种合同的法律后果在订立合同时是不确定的。保险合同是最大诚信合同，一方面投保人在订立合同时对投保人的询问及有关标的情况有如实告知义务，在保险标的危险增加时保险人，并履行关于标的保证义务；另一方面，保险合同的保险人在订立保险合同时，具有向投保人说明保险合同内容的义务，在约定的保险事故发生时，有履行赔偿或给付保险金的义务。保险合同是有偿合同，也是双务合同。这种合同的双方当事人互享权利和义务。保险合同一般为合同。这种合同在订立时，由一方提出合同的内容，而另一方只能在此基础上做出同意或不同意的选择。保险合同是要式合同，这一特点体现在投保人与保险人订立保险合同，不能采取任意的方式，而是必须采用法律规定的方式，记载法律规定的事项，否则将影响保险合同的效力。) Contract No.:（合同号） Insurance Company:（保险公司） Insurant:（投保人） Policy No.:（险单号） 1. The Property Insured（保险财产） 2. Scope of Cover（责任范围） The Company shall indemnify the Insured in respect of the physical loss of or damage to the insured property stated in the Schedule during the period of insurance directly arising from the following perils: (在本保险期限内，若本保险单明细表中列明的保险财产因以下列明的风险造成的直接物质损坏或灭失（以下简称“损失”），本公司同意按本保险单的规定负责赔偿。) (1) Fire;（火灾） (2) Explosion; but not including explosion of a boiler or other pressure-relief devices; （爆炸，但不包括锅炉或其他泻压设备的爆炸） (3) Lightning;（雷电） (4) Hurricane, typhoon and tornado;（飓风、台风、龙卷风） (5) Storm, tempest and flood;（风暴、暴雨、洪水） But not including loss or damage caused by change in normal water level or inundation from sea water or water escape or leakage from the normal confines of any natural water course, lake or reservoir, canal or dam as well as loss of or damage to the insured property caused by storm, tempest or flood while being stored in the open or covered by or under a shed thatched with reeds, tarpaulins, straw, asphalt felt, plastic or nylon sheet; （但不包括正常水位变化、海水倒灌及水库、运河、堤坝在正常水位线以下的排水和渗漏，亦不包括由于风暴、暴雨或洪水造成存放在露天或使用芦席、篷布、茅草、油毛毡、塑料膜或尼龙等作罩棚或覆盖的保险财产的损失。） (6) Hailstorm;（冰雹） (7) Landslide, rockslide, avalanche;（滑坡、山崩、雪崩） (8) Volcanic explosion;（火山爆发） (9) Subsidence of ground; but not including loss or damage resulting from pile driving, groundwork or excavation; （地面下陷下沉，但不包括由于打桩、地下作业及挖掘作业引起的地面下陷下沉；） (10) Crashing aircraft and parts or articles falling from aircraft and other flying objects; （飞机坠毁、飞机部件或飞行物体坠落） (11) Bursting of water tank or pipe; but not including bursting of water tank or pipe due to rust. （水箱、水管爆裂，但不包括由于锈蚀引起水箱、水管爆裂） 3. Exclusions（除外责任） This Company shall not be liable for: （本公司对下列各项不负责赔偿：） (1) Loss of or damage to the insured property or expenses caused by intentional act or gross negligence of the Insured or his representative; （保险人及其代表的故意行为或重大过失引起的任何损失和费用） (2) Loss of or damage to the insured property caused and expenses incurred by earthquake or tsunami; （地震、海啸引起的损失和费用） (3) Depreciation, loss of market, loss of use and other consequential losses of any description; （贬值、丧失市场或使用价值等其他后果的损失） (4) Loss of or damage to the insured proper-ty or expenses incurred arising from war, warlike operation, hostilities, armed conflicts, terrorism, conspiracy insurrection, coup détat, strike, riot, and civil commotion; （战争、类似战争行为、敌对行为、武装冲突、恐怖活动、谋反、政变、罢工、暴动、民众骚乱引起的损失和费用） (5) Confiscation, requisition, destruction or damage by any action or order of any government de jure or de facto or by any public authorities; （政府命令或任何公共当局的没收、征用、销毁或毁坏） (6) Loss of or damage to insured property directly or indirectly caused or expenses incurred by nuclear fission, nuclear fusion, nuclear weapon, nuclear material, nuclear radiation and radioactive contamination; （核裂变、核聚变、核武器、核、核辐射以及放射性污染引起的任何损失和费用） (7) Loss or damage caused and expenses incurred by pollution of any kind or description whatsoever such as atmosphere, land and water pollutions but this does not include loss or dam-age caused by pollution arising from Perils specified in Article II of the Policy; （大气、土地、水污染及其他各种污染引起的任何损失和费用，但不包括由于本保险单第二条责任范围内列明的风险造成的污染引起的损失） (8) The deductibles stated in the Schedule to be borne by the Insured; （本保险单明细表或有关条款中规定的应由保险人自行负担的免赔额） (9) Loss or damage arising from any other perils not listed in Article II of this Policy. （其他不属于本保险单第二条责任范围列明的风险造成的污染引起的损失） 4. Treatment of Claim（赔付处理） The Company shall at its option, indemnify the Insured in respect of loss or damage falling within the scope of cover of the Policy by either: （如果发生本保险责任范围内的损失，本公司选择下列方式赔偿） (1) Paying the amount of the actual value of the property lost or damaged or; （按受损财产的价值赔偿） (2) Paying the necessary cost of repairing or restoring the damaged property to its nearest condition immediately preceding the damage or; （赔付受损财产基本恢复原状的修理、修复费用） (3) Repairing or restoring the damaged property to a condition near to other property of like kind and quality. （修理，恢复受损财产，使之达到与同类财产基本一致的状况） Indemnity under this Policy shall be based upon the sound market value of the property prevailing at the time of loss. If the sound market value of the damaged property is lower than the sum insured of such property, the claim shall be settled on its market value; If the sound market value of the property is in excess of the sum insured, the Company shall only be liable for such proportion of the claim as the sum insured of the damaged property bears to its sound market value. If the insured property enumerated in the Schedule is more than one item, the provision of this clause shall apply to each thereof. （受损财产的赔偿按损失当时的市价计算。市价低于保险金额时，赔偿按市价计算，市价高于保险金额时，赔偿按市价与保险金额的比例计算。如本保险所载项目不止一项时，赔偿按本规定逐项计算。） If a claim for loss of or damage to the insured item is settled on a total loss basis, the sal-vage value of such item shall be deducted from the indemnity payable by the Company. The Company may, at its option, decline the abandonment of any damaged property by the Insured. （保险项目发生损失后，如本公司按全部损失赔付，其残值应在赔款中扣除，本公司有权不接受保险人对受损财产的赔付。） In the event of loss of or damage to any equipment item insured forming part of a pair or set, the Company shall not be liable in respect of each of such item lost or damaged for more than its proportionate part of the sum insured on the complete pair or set. （任何属于成对或成套的项目，若发生损失，本公司的赔偿责任不超过该受损项目在所属整对或整套项目的保险金额中所占的比例） In the event of any loss occurrence, the Company shall also pay the Insured for the expenses reasonably incurred for taking necessary measures to minimize loss or damage to the least extent, but in no case shall such expenses referred hereto exceed the sum insured of the insured property. （损失发生后，被保险人为减少损失而采取必要所产生的合理费用，本公司可予以赔偿，但本项费用以保险财产的保险金额为限） Upon settlement of a claim, an endorsement shall be issued by the Company to reduce the sum insured corresponding to the property lost or damaged by the amount so settled from the date of loss, and no premium shall be refunded for the amount so reduced. If reinstatement of the sum insured is required by the Insured upon settlement of the claim, an additional premium for the reinstated amount shall be charged at an agreed rate, and be calculated on pro rata daily basis from the date of loss to the expiry of the insurance. （本公司赔偿损失后，由本公司出具批单将保险金额从损失发生之日起相对减少，并且不退还保险金额减少部分的保险费。如被保险人要求回复至原保险金额的，应按原约定的保险费率加缴回复部分从损失发生之日起保险期限终止之日止按比例计算的保险费） The time of validity of a claim under this insurance shall not exceed a period of ​​______ year counting from the date of loss. （被保险人的索赔期限，从损失发生之日起，不得超过______年） 5. Insured’s Obligations（被保险人的义务） The following obligations shall be strictly fulfilled by the Insured and his representative: （被保险人及其代表应严格履行下列义务） (1) The Insured and his representative, when applying for insurance shall make true answers or descriptions to the questions in the proposal and questionnaire or to any other questions raised by the Company. （投保时，被保险人及其代表应对投保申请书中列明的事项以及本公司提出的其他事项作真实的、详尽的说明或描述） (2) The Insured and his representative shall pay to the Company in due course the agreed premium in the manner as provided in the Schedule and Endorsements. （被保险人及其代表应根据本保险单明细表和批单中规定的按期缴付保险费用） (3) During the period of this insurance, the Insured shall at his own expense take all reason-able precautions, including paying sufficient attention to and putting into practice the reasonable recommendations of the Company, prudently selecting the workmen and employees and complying with all statutory regulations and safety operation procedures. （在保险期限内，被保险人应采取一切合理的预防措施，包括认真考虑并付诸实施本公司代表提出的合理的防损建议，由此产生的一切费用，均由保险人承担） (4) In the event of any occurrence which gives or might give rise to a claim under this Policy, the Insured or his representative shall: （在发生引起或可能引起本保险单项下索赔的损失时，被保险人及其代表应） notify the Company immediately and with-in ​​______days or any further period as may be agreed by the Company in writing, furnish a writ-ten report to indicate the course, probable reason and extent of loss or damage; （立即通知本公司，并在______天内或经本公司书面同意延长的期限以书面告知事故发生的经过，原因和损失程度） take all necessary measures to avoid aggravation of the loss or damage and minimize it to the least extent; （采取一切必要措施防止损失的进一步扩大并将损失减少到最低程度） preserve the spot affected and defective parts before an inspection is carried out by a representative or surveyor from the Company; （在本公司代表或检验师进行勘察之前，保留事故现场及有关实物证据） furnish all such information and documentary evidence as the Company may require for supporting the claim. （根据本公司的要求提供作为索赔依据的所有证明文件、资料和单据） 6. General Conditions（总则） 　　(1) Policy Effect（保单效力） The due observance and fulfillment of the terms and conditions of this Policy in so far as they relate to anything to be done or complied with by the Insured shall be a condition precedent to any liability of the Company under this Policy. （被保险人严格遵守和履行本保险单的各项规定，是本公司在本保险单项下承担赔偿责任的先决条件） 　　(2) Policy Voidance（保单无效） This Policy shall be voidable in the event of misrepresentation, misdescription or non-disclosure made by the Insured or his representative in any material particular in respect of this insurance. （如果保险人或其代表漏报、错报、虚报或隐瞒有关本保险单的实质内容，则本保险单无效） 　　(3) Policy Termination（保单终止） Unless its continuance be admitted by the Company in writing, this Policy shall be automatically terminated if: （非经本公司书面同意，本保险单将在下列情况自动终止） the insurable interest of the Insured is lost; （被保险人丧失保险利益） the risk of loss or damage is increased. （承担风险扩大） After termination of the Policy, the premium shall be refunded to the Insured calculated on prorate daily basis for the period from the date of termination to the date of expiry. （本保险单终止后，本公司将按日比例退还被保险人本保险单项下未到期部分的保险费） 　　(4) Policy Cancellation（保单注销） This Policy may be canceled at any time at the request of the Insured in writing or at the option of the Company by giving days prior notice to the Insured. In the former case the Company shall retain a premium calculated on short term rate basis for the time the Policy has been in force while in the latter case such premium shall be calculated on pro rata daily basis. （被保险人可随时书面申请注销本保单，本公司亦可提前_______天通知被保险人注销本保险单。对本保险单以生效期间的保险费，前者本公司按短期费率计收，后者按日比例计收） 　　(5) Forfeit of Benefit（权益丧失） If the claim is in any respect fraudulent, or if any fraudulent means or devices are used by the Insured or his representative to obtain any benefit under this Policy or if any loss or damage is occasioned by the intentional act or in the connivance of the Insured or his representative, then in any of these cases, all the rights and benefits of the Insured under this Policy shall be forfeited, and all consequent losses arising therefrom including the amount of claim paid by the Company shall be indemnified by the Insured. （如果任何赔偿含有虚假成分，或被保险人或其代表在索赔时采取欺诈手段企图在本保险单项下获取利益，或任何损失是由保险人或其代表故意行为或纵容所致，被保险人将丧失其在本保险单项下的所有权益。对由此产生的包括本公司已支付的赔偿在内的一切损失，应由被保险人负责赔偿） 　　(6) Reasonable Inspection（合理查验） The representative of the Company shall at any suitable time be entitled to attend the site and inspect or examine the risk exposure of the property insured. For this purpose, the Insured shall provide full assistance and all details and information required by the Company as may be necessary for the assessment of the risk. The above mentioned inspection or examination shall in no circumstances be held as any admission to the Insured by the Company. （本公司的代表有权在任何适当的时候对保险财产的风险情况进行查验。被保险人应提供一切便利及本公司的要求的用以评估有关风险的详情和资料。但上述查验并不构成本公司对被保险人的任何承诺。） 　　(7) Double Insurance（重复保险） Should any loss, damage, expenses or liability recoverable under the Policy be also covered by any other insurance, the Company shall only be liable to pay or contribute his proportion of the claim irrespective as to whether the other insurance is arranged by the Insured or others on his behalf, or whether any indemnification is obtainable under such other insurance. （本保险单负责赔偿损失、费用或责任时，若另有其他保障相同的保险存在，不论是否由被保险人或他人以其名义投保，也不论该保险赔偿与否，本公司仅负责按比例分摊赔偿责任） 　　(8) Subrogation（权益转让） Where a third party shall be held responsible for the loss or damage covered under this Policy, the Insured shall, whether being indemnified by the Company or not, take all necessary measures to enforce or reserve the right of recovery against such third party, and upon being indemnified by the Company, subrogate to the Company all the right of recovery, transfer all necessary documents to and assist the Company in pursuing recovery from the responsible party. （若本保险单项下负责损失涉及其他责任方时，不论本公司是否赔偿被保险人，被保险人应该立即采取一切措施行使或保留向该责任方追偿的权利转让给本公司，移交一切必要的单证，并协助本公司向责任方追偿） 　　(9) Dispute（争议处理） All disputes under this insurance arising between the Insured and the Company shall be settled through friendly negotiations. Where the two parties fail to reach an agreement after negotiations, such dispute shall be submitted to arbitration or to court for legal actions. Unless otherwise agreed, such arbitration or legal action shall be carried out in the place of .（被保险人与本公司之间的一切有关保险的争议应通过友好协商解决。如果协商不成，可申请仲裁或向法院提出诉讼，除实现另有协议外，仲裁或诉讼应在______方所在地进行） 7. Special Provisions（特别条款） 　　The following provisions shall be applied to all parts of this Policy and shall override the other terms and conditions of this Policy if any conflict arises. … （下列特别条款适用于本保险单的各个部分，若其与本保险单的其他规定相冲突，则以以下特别条款为准） 　　Property Insurance Policy（财产保险单） Policy No.: ______（保险单号码） Whereas the Insured named in the Schedule hereto has made to the ​​______Insurance Company a written proposal which together with any other statements made by the Insured for the purpose of this Policy is deemed to be incorporated herein and has paid to the Company the premium stated in the Schedule. Now this policy of insurance witnesses that subject to the terms and conditions contained herein or endorsed hereon the Company shall indemnify the Insured for the loss or damage sustained during the period of insurance stated in the Schedule in the manner and to the extent herein-after provided. （鉴于本保险单明细表中列明的被保险人向______保险公司提交书面投保申请和有关资料，并向本公司缴付了本保险单明细表中列明的保险费，本公司同意按本保险单的规定负责赔偿在本保险单明细表中列明的保险期限内被保险人的保险财产遭受的损坏或灭失，特立本保险单为凭） Schedule（明细表） Policy No.:______（保险单号） 1. Name and Address of the Insured: （被保险人名称或地址） 2. Location of the Property Insured: （保险财产地址） 3. Nature of Trade: （营业性质） 　　4. Insured Items and Sums Insured:（ 保险项目及保险金额） 　　 Insured Items:（项目） 　　 Sums Insured:（保险金额） 　　 Property Insured:（保险财产） 　　 Additional Expenses:（附加费用） Total Sum Insured:（总保险金额） 5. Deductible (any one accident) ​​______ .（每次事故免赔额） 　　6. Period of Insurance:（保险期限） 　　 ​​______months.（共_______月） From 00:00 of ______ to 24:00 of ______ （自_______至________止） 　　7. Premium Rate： （保险费率） Total Premium​​：（总保险费率） 8. Date of Payment:（付费日期） 　　9. Jurisdiction:（司法管辖） This Policy is governed by law of the People’s Republic of China. （本保险单受中华人民共和国的司法管辖） ​​______Insurance Company （保险公司） ​​______ (Authorized Signature) （授权签字） Insurant signature: （投保人） Date of Issue: （签发日期） Place of Issue: （签发地点） .常用结构 1、索赔期限 2、被保险人义务 3、赔付处理 4、保单效力 5、保单注销 .相关细节 1、核实常规信息。拿到合同的第一步，应是了解基本的联系方式和常规信息。对合同各种基本信息的了解很重要，至少在投保前了解这是什么公司，什么险种，代理人的身份等。第二步，对于保险责任的豁免条款与投保人的保证条款一定要有清晰的了解，在不清楚之处请保险人予以说明。 2、注意几个关键时间点：保险空白期、观察期（又称等待期、犹豫期、宽限期） 3、明确退出机制 4、明确保险责任范围 5、查看保单及投保单（要保书）复印件，并通过热线电话和网站核实或通过专业代理人（经办代理人和其他代理人）等来了解 6、对于保险合同中的关键条款，尤其是权利与义务的承担、通知义务、保证条款、责任豁免条款、要注重注明 .实用案例 1999年2月17日，M公司向某保险公司投保企业财产险，双方约定期限自1999年2月17日至2000年2月17日止。M公司遂写了投保单，投保单上注明其投保财产为： 固定资产，保险金额人民币200万元，包括厂房、机器设备等； 流动资产，保险金额人民币30万元，包括原材料、燃料、低值易耗品； 次日，保险公司经审查同意承保，其经办人某某在投保单上签字盖章，M公司缴纳保险费用后，保险公司即开具了保险单。由于工作疏忽，投保单的投保财产项目中“流动资产”一栏未载明原材料成分。M公司亦为提出异议。 1999年11月15日，M公司发生火灾，后经审计确认：固定资产损失六十万元，原材料损失20万元，家具成品损失15万元。事后，M公司向保险公司提出索赔，要求其支付99万元的全部财产损失。 保险公司携同消防人员对现场火灾进行勘察，结论为：失火原因不明，造成损失确实。但保险公司可以以原材料、成品不属于保险范围为由，仅同意支付保险金15万元，即固定财产的损失。为此，M公司诉至法院，要求保险公司赔偿其全部损失。