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网约车发生交通事故后保险公司应该如何理赔

2017-08-09 10:01:25   中国青年网

□ 叶 宇

【裁判要旨】

以自用名义投保的车辆从事网约车营运活动,显著增加了车辆的危险程度,被保险人应当及时通知保险公司。被保险人未作通知,营运中发生交通事故致他人人身损害的,保险公司可以在第三者责任商业保险范围内免赔。致车辆损害的,保险公司可不予理赔。

【相关法条】

《中华人民共和国保险法》第十六条第四、五款 投保人故意不履行如实告知义务的,保险人对于合同解除前发生的保险事故,不承担赔偿或者给付保险金的责任,并不退还保险费。投保人因重大过失未履行加实告知义务,对保险事故的发生有严重影响的,保险人对于合同解除前发生的保险事故,不承担赔偿或者给付保险金的责任,但应当退还保险费;第十七条第二款 对保险合同中免除保险人责任的条款,保险人在订立合同时应当在投保单、保险单或者其他保险凭证上作出足以引起投保人注意的提示,并对该条款的内容以书面或者口头形式向投保人作出明确说明。未作提示或者明确说明的,该条款不产生效力;第五十二条 在合同有效期内,保险标的的危险程度显著增加的,被保险人应当按照合同约定及时通知保险人,保险人可以按照合同约定增加保险费或者解除合同。保险人解除合同的,应当将已收取的保险费,按照合同约定扣除自保险责任开始之日起至合同解除之日止应收的部分后,退还投保人。被保险人未履行前款规定的通知义务的,因保险标的的危险程度显著增加而发生的保险事故,保险人不承担赔偿保险金的责任。

【案情概况】

被告张某自购家用小客车于2015年3月在被告人保南京分公司为该车投保交强险、商业三者险,保险期间均一年。保单上的使用性质为“家庭自用汽车”。同年7月28日,张某通过打车软件接到网约车订单,驾车运送乘客途中转弯时,与原告程某某驾驶电动车碰撞,致程身体受伤。经医院诊断,程某为急性闭合性重型颅脑损伤,住院治疗花费医疗费用加残疾赔偿金、精神损害抚慰金等共计27万余元。

当地交警大队出具宁公交证字〔2015〕第0018号道路交通事故证明称,无法查清程某某遵守交通信号灯的情况。程某某诉至法院,请求判令张某和该保险公司赔偿其上述医疗等费用。

江苏省南京市江宁区人民法院作出一审判决认为,在不能证明程某某有闯红灯等过错行为,张某行驶转弯未能避让程非机动车直行,存在过错应负事故全部责任;张某将家庭自用车改为营运车使被保险车辆危险程度显著增加,且未通知保险公司,故保险公司在商业三者险内不负赔偿责任。

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