I thought that buying group accident insurance could reduce risks, but two lawsuits came to no avail. I still have the 10,000 yuan policy in my hand, but it has become "waste paper." Mr. Kang’s warning warned policyholders that commercial insurance cannot replace work-related injury compensation. Who is the beneficiary of group insurance? Don’t “look at the smoke and mirrors.”
1
The boss pays for insurance for his employees.
“Employees who produce furniture will inevitably have work-related injuries. Every year, employees’ medical care and work-related injury compensation are a big expense, so they spend almost 10,000 yuan on insurance every year.” April 2005 On the 11th, Boss Kang purchased Tianan Insurance Co., Ltd.'s (hereinafter referred to as the "Insurance Company") main insurance group personal accident insurance, with a maximum coverage of 300,000 yuan per person, and additional group accident medical insurance coverage of 654.38 yuan per person. 0 million yuan.
On April 5, 2006, Chen Jian, an employee of a furniture factory, accidentally crushed fingers 1 to 4 of his right hand while working in the workshop. It was recognized as a work-related injury by the Shunde Labor and Social Security Bureau and rated as a fifth-level disability by the Foshan Labor Ability Appraisal Committee.
Kang Qingqiang, the person in charge of the furniture factory, reached a mediation agreement with Chen Jian: Kang Qingqiang paid Chen Jian a one-time compensation of 6.5438 million yuan. On May 22, the furniture factory paid Chen Jian 80,000 yuan in cash and issued an IOU. The remaining 20,000 yuan was paid by the insurance company.
2
The insurance company insisted on paying compensation to the injured.
Since there was no stipulation on the beneficiary in the group insurance contract, when the furniture factory filed a claim with insurance information, disability identification, and medical documents, the insurance company proposed to pay the insurance money to the injured Chen Jian, but refused to transfer the insurance money to the injured Chen Jian. The money is paid directly to the furniture factory.
In the courts of first instance and second instance, the furniture factory and the insurance company had a heated debate over whether the furniture factory could require the insurance company to pay insurance compensation.
The court held that the beneficiary of personal insurance is designated by the policyholder or the insured. When the policy holder designates a beneficiary, it must be designated by the insured. As the insured, Chen Jian asked the insurance company to pay the insurance money directly to him and denied naming the furniture factory as the beneficiary. Although the furniture factory has reached a mediation agreement with Chen Jian on work-related injury compensation and paid part of the money, the furniture factory, as an employer, is liable for compensation for employee injuries. Work-related injury compensation and insurance compensation cannot be substituted for each other.
In addition, the right to request insurance payment refers to the right of the insured or the beneficiary to request the insurer to perform the insurance payment obligation according to the contract, and it belongs exclusively to the insured or the beneficiary. In this case, the insured furniture factory was not the insured or beneficiary in the insurance contract and had no right to require Tianan Company to pay insurance money. The Foshan Intermediate People's Court ruled to revoke the first-instance judgment of the Shunde District Court and reject the appellant's lawsuit against the furniture factory.
Three
Statement: Workers’ compensation is not a substitute.
Yesterday afternoon, the reporter interviewed Stephanie, deputy director of Guangdong Gujinlai Law Firm, which handled the case. "Many companies have a fluke mentality when purchasing group accident insurance, thinking that purchasing such commercial insurance can reduce their own risks. In fact, commercial insurance purchased for employees cannot replace workers' injury compensation." Stephanie pointed out that only by obtaining the insured Only when the insured company agrees and clearly stipulates that the beneficiary is the insured company can the company directly obtain compensation. It is best to have a clear written agreement.
In addition, some insurance companies pay group insurance compensation directly into the account agreed upon when signing the insurance contract; however, many of them are insured corporate accounts, which can easily make the policy holder mistakenly think that he should be the beneficiary. , the insurance company should promptly inform you of the true situation.
Buy group insurance to avoid “looking at the smoke and mirrors”
In response to Boss Kang’s question about group insurance compensation, the reporter consulted different insurance companies in Foshan:
Insurance
In the case of the main insurance group personal accident insurance and the additional group accident medical insurance, Ms. Yu from Ping An Insurance of China and Ms. Chen from Generali Insurance said that the insured amount can reach millions of yuan. But the cost of this insurance is also very high. Generally, companies will purchase insurance for their employees with a coverage limit of 200,000 yuan.
Insurance beneficiary
As for the beneficiary of group insurance, the above three insurance companies all stated that if there is no beneficiary agreed in advance, the insurance company’s compensation will be paid to the insured. Not an insured company.
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