Research On The Principle Of Indemnity Applied In Medical Expenses Insurance

The principle of indemnity is a very important principle in insurance law,which aims to fill the loss of the insured.It contains filling the loss of the insured and forbidding unjust enrichment by the insured. It has been widely recognized that the principle of indemnity applies in property insurance. The principle of indemnity does not apply in insurance of the person with no provisions of insurance subrogation rules,double insurance rules,insurance concurrent rules according to the provisions of the Insurance Law of the People’s Republic of China(hereinafter referred to as Insurance Law).However, medical expenses insurance is very special in insurance of the person with property attributes sometimes.There are no provisions whether the principle of indemnity can be applied in medical expenses insurance according to the Insurance Law.Now,theorists and practitioners also have a big cognitive difference in this issue.But the cost compensatory medical expense insurance has been approved by the Measures for the Administration of Health Insurance and Interpretations of the Supreme People’s Court on Issues Concerning the Application of the Insurance Law of the People’s Republic of China(III)(hereinafter referred to as Interpretations III of the Insurance Law).Although some breakthroughs have been made via department regulations and judicial interpretation with accepting the cost compensatory medical expense insurance,the provisions are general and lack of specific rules.The principle of indemnity applied in the field of medical expenses insurancelimited by the current classification of insurance. "Compensatory insurance" and "quota insurance" classification has not been taken by our country from the perspective of insurance benefits determination,the classification,instead,is taken from the perspective of the subject matter insured,which makes legislation biased exist in the limitation of the scope of the principle of indemnity from the point of subject matter insured.On the other hand,it only emphasizes the personal attribute of medical expenses insurance with the property attribute neglected and the principle of indemnity is denied erroneously because of the point of person can not be measured in monetary terms.With the view of the compensating trait of medical expenses insurance,preventing unjust enrichment, correcting classification of insurance,the principle of indemnity applied in the medical expenses is very important.In view of the application of insurance subrogation rules in medical expenses insurance,the insurance subrogationshould be permitted in it,and it should be allowed to change the payment order established by the made whole rule and the priority of the insured rule in the contract.And we suggest that double insurance rules should be applied in the medical expenses insurance using the amount of loss as a measure.And we should establish information sharing mechanism by learning from the Coordination of Benefit provisions of the United States to coordinate insurance compensation order. Facing the medical expenses insurance concurrence,we should distinguish the concurrence happened between commercial insurances or happened between social insurance and commercial insurance.When the concurrence happened between commercial medical expensesinsurances,we should give priority to the agreement by the parties.When we coordinate the concurrence between commercial medical expensesinsurance and social medical expensesinsurance,we suggest the commercial insurers should take different rates and payment standards by asking the insured whether there is a socialmedical expenses insurance in advance.In order to solve the problem that the insurer charge higher premiums but refuse to pay insurance benefits with the excuse of the insured already achieving the payments by other means after the insurance accident.This thesis researches the referee viewpoints of judicial practice and the operation of insurance company using the method of case studies.Show the comparison of different rules in our country and outside using the method of comparative analysis to discern the pros and cons.And expound the specific details of the principle of indemnity applied in medical expenses insurance using the method of value analysis.