When an employer purchases group accident insurance, and after the occurrence of an insured accident, the employer pays compensation to the employee and receives the insurance money on behalf of the employee, resulting in disputes over the transfer of the right to claim the insurance money of the group accident insurance. How should the validity of the transfer of the right to claim insurance money for group accident insurance be determined in judicial practice?
Referee Rules
1. After the occurrence of an insured accident, the right to claim the insurance money of the construction group accident insurance is not personally dependent, and the act of the construction personnel transferring the right to claim the insurance money is a legal disposition of their own rights - a construction company v. an insurance company in a life insurance contract dispute case
The gist of the case: In the case of a dispute over the settlement of group accident insurance for construction personnel (hereinafter referred to as the group accident insurance for construction workers), the specific situation of the construction enterprise and the nature of the construction personnel shall be comprehensively considered for the determination of the insured. After the occurrence of the insured accident, the right to claim the insurance money of the construction group accident insurance is changed from an expectable claim to an ordinary claim, which is not personal dependent, and the act of the construction personnel transferring the right to claim the insurance money is a legal disposition of their own rights.
Case No.: (2023) Yu 08 Min Zhong No. 1635
Trial court: Intermediate People's Court of Jiaozuo City, Henan Province
Source: People's Court Daily, December 14, 2023, page 7
2. After the occurrence of an insured accident, the insured has the right to transfer the right to claim insurance money - an insurance dispute between Jiang and a company and an insurance company in Duchang
Gist of the case: After the occurrence of an insured event, the insured has the right to transfer the right to claim insurance money, which is a kind of contractual claim, and the transfer of the right only needs to follow the requirements of voluntary assignment of contractual claims and notify the insurer.
Case source: Jiangxi Court Network Release date: 2022-03-22
3. After the occurrence of the insured accident, the insured's transfer of the right to claim the insurance money to the policyholder is a transfer of the insurance claim, which is not personal dependence, and does not belong to the situation that cannot be transferred under the law, and the transfer should be deemed legal and valid
The gist of the case: After the occurrence of the insured accident, the insured's transfer of the right to claim the insurance money to the policyholder is not a change of the beneficiary in the insurance contract, but an assignment of the insurance claim, which is not personal dependence and is not a non-transferable circumstance under the law. The transfer agreement involved in the case was an expression of the true intentions of both parties, did not violate the provisions of the law, was legal and valid, and the policyholder obtained the right to request the insurance company to pay the insurance money according to the policy.
Case No.: (2020) Su Min Zai No. 287
Trial court: Jiangsu Provincial High People's Court
Case source: China Judgments Network Release date: 2021-03-29
4. After the occurrence of the insured accident, the heirs of the insured authorize and fully entrust the policyholder to handle the claim and collection procedures with the insurance company, and the heir has essentially transferred the right to claim the insurance money to the policyholder, Fujian Huidong Construction Engineering Co., Ltd., after obtaining the insurance compensation
The gist of the case: After the occurrence of the insured event, the claim of the insured or the beneficiary against the insurer has been determined, and the beneficiary right is converted into the right to claim for insurance payment, which is property and certainty, and in principle, it is a claim of a pure property nature, and does not have personal dependence and is transferable, unless there is a situation that cannot be transferred. The insurance contract involved in the case did not specify a beneficiary, and the insurance money, as the insured's inheritance, should have been decided by the insurance company whether to pay the insurance money to the insured's heirs, but the insured's heirs authorized and fully entrusted the policyholder to handle the claim and collection procedures with the insurance company, so the insured's heirs had essentially transferred the right to claim the insurance money in the insurance contract to the policyholder after receiving the insurance compensation.
Case No.: (2020) Yue Min Shen No. 5998
Trial court: Guangdong Provincial High People's Court
Case source: China Judgments Network Release date: 2020-12-23
5. After the occurrence of the insured accident, after receiving the compensation payment from the insured, the legal heirs of the insured legally transfer the right to claim insurance money from the insurance company to the insured, and the transfer is legal and valid - Chinese Life Insurance Co., Ltd. Guangdong Branch and Sichuan Tengfeng Electric Power Engineering Co., Ltd. Life Insurance Contract Dispute Case
The gist of the case: If the policyholder purchases group accident insurance from the insurance company, and after the insured accident occurs, the policyholder has paid compensation to the legal heirs of the insured, and the amount of compensation is greater than the insured amount, and the legal heirs of the insured transfer the right to claim insurance money from the insurance company to the policyholder, and the transfer does not violate the provisions of the law, does not harm the public interest, and does not damage the legitimate rights of the state, the collective and the third party, the transfer is legal and valid.
Case No.: (2020) Yue 01 Min Zhong No. 3956
Trial court: Intermediate People's Court of Guangzhou Municipality, Guangdong Province
Judicial perspectives
Determination of whether the right to claim insurance money in a life insurance contract can be transferred
Before the promulgation of the judicial interpretation, there was controversy in judicial practice as to whether the right to claim insurance money in a life insurance contract could be transferred. There are three main points of view:
The first view is that the right to claim insurance money is a contractual claim, and the beneficiary, as a creditor, has the right to decide whether to make the assignment. The second view is that the purpose of a life insurance contract is to protect the beneficiary from obtaining relief after the death of the insured, and the right to claim insurance benefits is conditional on the insured suffering an accident, and may be closely related to the life of the beneficiary, and has a strong personal character, and should not be allowed to be transferred. The third view is that the judgment should be made according to the occurrence of the insured accident, before the occurrence of the accident, the right to proceeds is an expectation right attached to a specific personal relationship and cannot be transferred casually, and after the occurrence of the accident, the right to proceeds is transformed into a claim for the payment of insurance money, which is not fundamentally different from ordinary creditor's rights, and there is no legal basis for prohibiting its transfer.
Finally, the Judicial Interpretation of the Insurance Law (III) adopts the third view. Article 13 states: "After the occurrence of an insured event,
If the beneficiary transfers all or part of the right to claim the insurance money corresponding to the insured event to a third party, and the parties claim that the transfer is valid, the people's court shall support it, except where it cannot be transferred according to the nature of the contract, the agreement of the parties or the provisions of law. The third view is adopted in the judicial interpretation for the following reasons:
1. The transfer of the right to claim insurance money is allowed, which is in line with the principles of contract law.
The transfer of contractual rights is essentially a transactional act, and allowing the transfer of contractual rights is an important embodiment of the principle of freedom of contract. For the debtor, the assignment of creditor's rights only changes the object of debt performance, and does not add an additional burden to the debtor. From the perspective of encouraging transactions and increasing social wealth, as long as it does not violate the law and social public morality, it should be allowed to be transferred. As a contractual right, the right to claim insurance benefits should be allowed to be transferred.
2. Distinguish whether an insured event occurs or not, and make provisions to meet the requirements of the assignment of creditor's rights.
According to the Insurance Law of the People's Republic of China, the right to decide on the change of the beneficiary of life insurance belongs to the insured, and the beneficiary has no right to transfer its right to income when the insured accident has not yet occurred, and after the occurrence of the insured accident, the claim of the insured or the beneficiary against the insurer has been determined, and the right to claim insurance money is property and certain, and in principle, it is a claim of a pure property nature, which is no different from the transfer of other ordinary property rights and can be freely transferred.
3. The transfer of the right to claim insurance money is allowed, which is in line with the actual needs of the insurance market.
Modern life insurance not only has the function of paying compensation, but also has the functions of savings, investment, financing and so on. In particular, in recent years, the rapid development of investment-linked insurance has made the need for the transfer of insurance claims increasingly urgent. If the transfer of the right to claim life insurance money is prohibited, the development of the insurance market will be hindered and the practical demand for the circulation of funds by insurance consumers will be inhibited.
4. The exclusion of restrictions on the transfer of the right to claim insurance money is in line with the provisions of Article 79.1 of the Contract Law. For example, Article 24.2 of the Judicial Interpretation on Road Traffic stipulates that: "If a party claims that the transfer of the right to claim for personal injury or death insurance or the creation of a guarantee for compulsory traffic insurance is invalid, the people's court shall uphold it." The above-mentioned provisions only prohibit the transfer of the right to claim personal injury insurance money of compulsory traffic insurance, but do not prohibit the transfer of the right to claim personal injury insurance money of commercial insurance. The purpose of this provision is to protect the benefits of the right of the victim and his or her close relatives to claim the insurance money.
(Excerpted from Sun Ming and Wang Xueshan, eds., "Reference for the Trial of Insurance Contract Cases", People's Court Press, 2018 edition, pp. 185~186.) ）
Note: 1. See Article 545 of the Civil Code of the People's Republic of China.
2. It has been amended to Article 21 of the Interpretation of the Supreme People's Court on Several Issues Concerning the Application of Law in the Trial of Cases of Compensation for Damages in Road Traffic Accidents (amended in 2020).
Letters of the law
1. Civil Code of the People's Republic of China
Article 545:A creditor may transfer all or part of the creditor's rights to a third party, except in any of the following circumstances:
(1) It cannot be assigned according to the nature of the obligatory right;
(2) It shall not be transferred in accordance with the agreement of the parties;
(3) It shall not be transferred in accordance with the provisions of law.
Where the parties agree that non-monetary claims may not be assigned, they must not be used against a bona fide third party. Where the parties agree that monetary claims may not be assigned, they must not be used against a third party.
2. Insurance Law of the People's Republic of China (Revised in 2015)
Article 39 The beneficiary of life insurance shall be designated by the insured or the policyholder.
The policyholder's designation of a beneficiary is subject to the consent of the insured. The insured shall purchase life insurance for the worker with whom the employee has an employment relationship, and shall not designate any person other than the insured and his close relatives as the beneficiary.
If the insured is a person with no or limited capacity for civil conduct, his guardian may designate a beneficiary.
3. Interpretation of the Supreme People's Court on Several Issues Concerning the Application of the Insurance Law of the People's Republic of China (III) (2020 Revision)
Article 13 After the occurrence of an insured event, the beneficiary transfers all or part of the right to claim the insurance money corresponding to the insured accident to a third party, and the parties claim that the transfer is valid, the people's court shall support it, except that it shall not be transferred according to the nature of the contract, the agreement of the parties or the provisions of law.
Source: Fa Xin No. 2976