保险案例分析及大陆与香港保险差异分析

Insurance and Risk management

Case Study

Draft 保险案例分析及大陆与香港保险差异分析

Glossary of Terms and Abbreviations

1The amount of indemnity--CASE491 2Insurable Interest---CASE517 3延展讨论-香港保险与内地保险12

Section1

The amount of indemnity--CASE49

Draft The insured's private car was seriously damaged at a traffic accident.The insurer's loss adjuster declared it to be beyond economic repairs and indicated that the pre-accident market value of the car was in the range of HK$155,000to HK$160,000.

The insured disagreed with the assessment from the insurer's side and produced different estimations of the value of the damaged car by another loss adjuster and a car dealer which disclosed that the pre-accident market value of the car was approximately HK$180,000.The Complaints Panel weighed all conflicting evidence and finally requested the insurer to increase the settlement to HK$180,000.

Case 49

Section 1–The amount of indemnity --CASE 49

Draft Section1–The amount of indemnity--CASE49

保险赔偿金额

赔偿金额定义：

根据赔偿原则规定，保险公司赔偿予保单持有人的责任只限于投保人所损失财物之市值，因此，若投保人财务之价值于损失时因某种原因而贬值，保险公司只根据“赔偿基础”支付保单持有人财务之折旧价值。

Draft Section1–The amount of indemnity--CASE49

案例分析---保险赔偿金额

投保人汽车严重损毁----视汽车发生“全损”

保险公司理赔师指定该车辆市值：15.5万—16.0万港币

另外理赔师和车辆代理估价：18.0万港币

Draft Section1–The amount of indemnity--CASE49

案例分析----保险赔偿金额

分析得出，投保人投保金额和汽车市值是关键，存在几种情况：

1.如果投保人投保金额＜汽车市值，一旦发生全损，保险公司根据投保金额进行赔付；

2.如果投保人投保金额＝汽车市值，一旦发生全损，保险公司根据汽车市值（投保金额）赔付给投保人；

3.如果投保人投保金额＞汽车市值，一旦发生全损，保险公司根据汽车市值赔付给投保人。

Draft Section1–The amount of indemnity--CASE49

案例分析---保险赔偿金额

根据案例提供的信息，我们认为投保人在投保时所设定的金额就是保险公司理赔师所设定的车辆意外前的市值，既15.5万—16万，因此保险金额就是以上数值，那么汽车发生全损后，汽车市值发生贬值如果低于投保金额，则保险公司会按照汽车市值进行赔偿，汽车市值如果高于投保金额，则保险公司会按照投保金额15.5万—16万进行赔偿。因此在案例中，投保人要求保险公司增加赔偿额到18万港币，是不合理的。

备注：如果在为车辆购买保险时，投保人觉得保险公司所设定的保险金额明显低于汽车市值，那么投保人可以选择别家保险公司进行投保，或是叫第三方公正机构开出评估证书来确保投保人的投保利益。

Section2

Insurable Interest---CASE51

Draft Section2–Insurable Interest---CASE51

Case51

The insured's vehicle was found stolen.The loss adjuster's investigation revealed that the insured was only the registered owner of the vehicle,but not the actual beneficial owner.In fact,the vehicle was bought by the insured's friend,who was unable to obtain insurance coverage due to his involvement in an accident resulting in third party bodily injury which occurred two years ago.In order to assist him to obtain insurance coverage,the vehicle was registered under the name of the insured.

The insurer considered that the insured had no insurable interest on the vehicle.It refused to honour the theft claim and was of the view that the insurance contract should be void ab initio. Though the Complaints Panel considered that the insured,being the registered owner of the vehicle, would have an insurable interest on the vehicle,it fully appreciated the fact that the insurer would almost definitely have declined the policy application from the real owner and user of the vehicle.In view of the significant difference in the hazard associated with the insured and the real beneficial owner of the vehicle,the Complaints Panel concluded that there was a material misrepresentation. The Complaints Panel thus supported the insurer to decline the claim.