playarcadeonline| Insurance agent defrauds insurance investor court orders premium refund
Contribution: Chaoyang Court
Insurance agents promote the new business of "long-term insurance and short-term work" to the 47-year-old Mr. Wang.PlayarcadeonlineIt is said that he will pay 110000 yuan in a lump sum, repay the principal and interest a year later, and give priority to paying 10, 000 yuan of interest. Mr. Wang was refused when he asked the insurance company to refund the principal one year after taking out the insurance. Mr. Wang sued an insurance company to the people's Court of Chaoyang District, Beijing. Recently, the Chaoyang Court publicly ruled on the case in accordance with the law, determined that the sales behavior of Wang and Meng, insurance agents of an insurance company, constituted fraud, and ruled in accordance with the law to cancel the insurance contract signed by both parties, and an insurance company returned Mr. Wang's insurance premium of 100000 yuan. Mr. Wang's other claims are rejected.
Brief introduction of the case
Mr. Wang recalled that in May 2021, insurance agents Wang and Meng promoted a life insurance product to Mr. Wang, saying that as long as he paid 110000 yuan, he would first give 10, 000 yuan of interest when the contract was signed, and the principal of 110000 yuan would be refunded when the contract expired one year later. When signing the contract, Mr. Wang found that the payment period shown in the contract was 10 years and asked questions. Meng re-confirmed that the contract would expire as long as he paid the fee for one year, and refunded the principal of 110000 yuan after the expiration, and explained that this is a new business carried out by the company, called "long-term insurance and short-term work". After that, the two sides signed an insurance contract, and Meng gave Mr. Wang a year's income of 10,000 yuan in cash.
In May 2022, Mr. Wang asked a supervisor of an insurance company about the maturity and refund of the fee and was refused. The supervisor said that the payment period of the insurance policy was 10 years and everything was handled in accordance with the contract.
Mr. Wang believes that the salesperson of an insurance company cheated him in the sales process. Therefore, the insurance company was sued to the court, asking the court to cancel the insurance contract signed by both parties and requiring an insurance company to return 110000 yuan of insurance premium and interest.
The litigant agent of an insurance company told the court that the life insurance contract signed by Mr. Wang paid an annual premium of 110000 yuan for a period of 10 years, but Mr. Wang only paid once. As Mr. Wang failed to pay the renewal premium in accordance with the contract agreement, the insurance contract has been invalidated and does not agree to cancel the contract. And when Mr. Wang took out the insurance, the insurance agent Wang was no longer at work in the insurance company, and Meng was only a personal insurance agent, and there was no labor-employment relationship with the company. The insurance company only bears insurance liability for the insurance underwriting business that Meng is authorized to handle, and Meng's other behavior has nothing to do with the company.
The court found out that Mr. Wang insured the insurance products of an insurance company, in which the insurance policy agreed to pay for a period of 10 years, with an annual premium of 110000 yuan and a basic insurance amount of more than 940000 yuan.
Wang Mou and Meng Mou are insurance agents of an insurance company. Wang Mou holds the post of sales director. Meng Mou was instructed by Wang to make a promise to Mr. Wang that he only needs to pay 110000 yuan in the first year's insurance premium. you can get 10, 000 yuan, and 110000 yuan will be fully refunded after one year expires.
The court held that Meng and Wang, as insurance agents, should be very clear about the number of years and the amount of annual payment of the insurance products they sell, as well as the normative requirements for insurance agents to carry out business activities. and the two made statements and promises that were completely inconsistent with the agreement of the insurance contract involved in the case. The behavior of the two should be determined as having obvious fraudulent intention subjectively, which conforms to the situation of intentionally informing false information, and causes Mr. Wang to fall into inner mistake and take out insurance. The behavior of Wang and Meng has already constituted fraud.
Although Wang and Meng do not have labor relations with the insurance company, as insurance agents, their sales of the products involved in the case do not exceed the authorization of an insurance company to Wang and Meng, the court holds that the behavior of Wang and Meng still has the right to act as an agent, and the corresponding legal consequences should be borne by an insurance company as the principal.
After the insurance contract is revoked, an insurance company should refund Mr. Wang's premium of 110000 yuan, and Mr. Wang should also return the income of 10, 000 yuan. After offsetting the two, an insurance company should return Mr. Wang 100000 yuan.
Mr. Wang still blindly listened to the promise of the insurance agent when he saw that the payment period stipulated in the insurance contract was 10 years, and when he was prompted again to pay the fee and the amount of annual payment in the course of the return visit. in the course of the return visit, the request of the insurance agent was not taken seriously, and it was obviously not the duty of care to deal cautiously. Therefore, the court did not support its claim for interest loss.
To sum up, the court made the above decision of first instance, which has not yet entered into force.
After the judgment was made, the Chaoyang Court issued judicial advice to an insurance company, aiming at the behavior of the insurance agent found in the trial of the case to deceive the policy-holder and induce the policy-holder to conclude an insurance contract, the company has the problems of non-standard management of signing orders by insurance agents, private entrustment, and the return visit procedure is a mere formality. It is suggested that an insurance company should further strengthen the management of the entrustment work of individual insurance agents. We should better assume the management responsibility for the exhibition behavior of individual insurance agents, and take more effective measures to ensure the effectiveness of the return visit mechanism.
Judge interprets the law
About the concept of insurance agent. An insurance agent refers to an institution or individual that collects a commission from an insurance company and handles insurance business within the scope authorized by the insurance company according to the entrustment of the insurance company, including insurance professional agencies, part-time insurance agencies and individual insurance agents. This case involves an individual insurance agent, who signs a principal-agent contract with an insurance company and engages in insurance agency business, mainly selling insurance products, surveying related losses, settling claims and so on. What needs to be clear is that the relationship between the individual insurance agent and the insurance company is an entrustment contract, which is not an employee of the insurance company, and there is no labor contract relationship with the insurance company.
Another concept that is easily confused is the insurance broker. Insurance broker refers to an institution that provides intermediary services for policy-holders to conclude insurance contracts with insurance companies and collects commissions according to law, including insurance brokerage companies and their branches, based on the interests of policy-holders. The insurance broker employees that the policy-holder comes into contact with in the specific insurance process are among the insurance brokers who draw up insurance plans for the insured or the insured, handle insurance procedures and assist in claims, or provide disaster prevention and damage prevention, risk assessment, risk management consulting services, reinsurance brokerage and other business personnel for the client. Insurance brokers are not employees of insurance companies, and insurance brokers may have cooperative relations with several insurance companies, but according to the relevant provisions of the insurance law and regulatory authorities, insurance brokers act on the interests of policyholders.
In this case, the subject of the fraud against the policy holder is the individual insurance agent of the insurance company. As mentioned earlier, the insurance agent is not an employee of the insurance company, and the relationship between the insurance agent and the insurance company is an entrusted contract. However, according to the provisions of the Civil Code and the Insurance Law, the insurance agent shall bear the responsibility for the act of handling insurance business on his behalf according to the authorization of the insurer. The third paragraph of Article 53 of the regulations on the Supervision of Insurance agents of the Bank of China Insurance Regulatory Commission clearly stipulates that if individual insurance agents or employees of insurance agencies engage in insurance agency activities in violation of laws and regulations, the insurance companies, insurance professional agencies and concurrent-business insurance agencies shall bear legal liability in accordance with the law.
In fact, although insurance agents are not employees of insurance companies, the regulatory authorities clearly stipulate that insurance companies should entrust individual insurance agents with good conduct, and insurance companies should strengthen the management of the entrusted work of individual insurance agents. at the same time, the pre-post training and follow-up education for individual insurance agents should be strengthened, and the training content should at least include professional knowledge, legal knowledge and professional ethics. Insurance companies should also assume responsibility for the management of the behavior of individual insurance agents, maintain the standardized and orderly flow of personnel, strengthen daily management, monitoring and accountability, and prevent them from exceeding the scope of authorization or engaging in illegal and illegal activities. This is also the reason and basis for the insurance company to bear the consequences of the fraud committed by the insurance agent in this case.
The judge hinted
Tips for policyholders
Choose the product that suits you. The types of commercial insurance mainly involve two categories: insurance type and savings type, in which insurance products mainly include accident insurance, serious illness insurance, commercial medical insurance, life and term life insurance, and savings products mainly include annuity insurance, dual insurance, increased life insurance and so on. The majority of policy-holders must fully understand the contents of the insurance terms before taking out insurance, especially read carefully the bold and blackened parts, and correctly understand the core terms of the insurance liability, liability exemption, payment period and amount of the relevant products, to ensure that the products purchased really meet their own needs.
The purchase of insurance is not to deal with bank deposits, and it is not possible to repay principal and interest at maturity. With regard to the assumption of insurance liability, the insurance terms are more complex. We must ask more questions about the unclear areas, not only asking the insurance agent, but also directly calling the insurance company to verify and confirm, especially for some insurance products with high premium or insurance agents whose statements are obviously inconsistent with the contract.
Clearly judge the income agreed in the insurance contract. The insured must not be confused by the immediate interests when applying for insurance. the Insurance Law expressly prohibits the insurance agent from giving or promising to give benefits other than those agreed in the insurance contract to the insured, the insured or the beneficiary, the rights and obligations of both parties shall be enjoyed and borne in accordance with the written agreement of the insurance contract, and the commitments outside the terms of the contract will not be recognized by the insurance company, if a dispute arises. There is also a risk of not being upheld by the court.
Take the return visit of the insurance company seriously. In fact, the return visit procedure is a kind of procedure with certain supervision function set up by the insurance company in accordance with the requirements of the regulatory agency, which can prompt the policy holder to the core clause of the insurance contract, especially the terms that are deliberately ignored or misinterpreted by the insurance agent, so it must be taken seriously. Special attention should be paid to the content mentioned in the return visit that is inconsistent with the statement of the insurance agent and make inquiries or feedback to the insurance company in a timely manner. Especially in the promotion of electronic return visit since the beginning of 2020, policyholders should avoid randomly checking and answering questions in the return visit under the guidance of insurance agents, resulting in the loss of substantive meaning of the return visit.
Tips for insurance companies
Strictly abide by the requirements of the regulatory system. As important non-bank financial institutions, insurance companies should strictly abide by the requirements of national laws and regulatory institutions, and take real responsibility for the behavior of insurance agents. strengthen the construction of compliance with the recruitment, management, training and assessment of insurance agents.
Strengthen the management of agents' sales behavior standards. To seriously deal with the investigation and handling of the illegal behavior of insurance agents, we should not use the excuses of fraudulent sales of insurance agents as excuses such as exceeding the authority of agents, let alone look at sales performance, regardless of behavior compliance. or set unreasonable sales performance indicators for insurance agents to induce insurance agents to cheat, induce and other illegal and illegal behaviors.
Attach importance to the effectiveness of the return visit mechanism. Insurance companies should pay attention to the establishment of a return visit mechanism that can play a substantial role, especially for the ubiquitous online insurance, we should pay attention to avoid the situation that the return visit mechanism is also under the control of insurance agents and can not play a substantial role.
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