| In recent years,many places in the case of insurance disputes,commercial three liability insurance should be paid non Medicare drug expenditure become the focus of litigation,the different courts to form a different referee.In fact,for non Medicare drug compensation in terms of the meaning,nature,validity,whether the insurer should implement specific explanation obligation and non health care costs of the claims and other issues,there are large differences in the circles of theory and practice.In this paper,case analysis,normative analysis and literature retrieval as the main research method of "non Medicare drug compensation in terms of the meaning,nature,validity,medical insurance claims and other issues should analyze some of the author’s view of three non commercial liability insurance,this paper mainly divided into the following four parts.The first part discusses the main facts of the case in the trial practice,four typical cases of the disputes between parties of different focus and the judgment of the court and the decision gist of view,to summarize in the practice of the focus of controversy of "non Medicare drug compensation terms: three non commercial liability insurance should not claim Medicare drug;non Medicare drug compensation in terms of nature is the general terms,terms of format or absolute invalid,or is required to fulfill the obligations of prompt and clear effect to be effective the exemption clauses and the terms of the cognizance of what is in force,absolutely invalid or conditional.The second part discusses the author through the concept of commercial liability insurance in three non Medicare drug compensation in terms of meaning,the insurance clauses and insurance exemption clause,the clause will be deemed in insurance contract exemption clauses.Then through the analysis of the academic terms of validity of differences,and finally puts forward the judgment method of clauses,namely according to the "insurance law" article seventeenth and the provisions of article nineteenth,the author believes that in the cognizance of "non Medicare drug compensation provisions,should be based on the" insurance law "article seventeenth the program on the judgment of the term because the insurer is to perform a specific explanation obligation and no prescribed in the insurance contract,to take effect,if the insurer fails to fulfill the specified obligations,as the terms are not included in the contract,of course,do not take effect,on the other hand,as the clause has been included in the contract,its effectiveness to be determined then,on the basis of the" insurance law "article nineteenth from the essence of the clause content itself is fair to examine its effectiveness without end.The third part of the three commercial liability insurance should be non Medicare drug claims,from the theoretical analysis,the non Medicare drug should be included in the scope of three commercial liability insurance payment,has a reasonable and legitimate basis.On the basis of this,it makes a further analysis on the determination of the scope of the accused in the practice of dealing with non medical insurance claims disputes,the distribution of the burden of proof between the original defendant and the reasons for the defense.The fourth part,put forward some legal countermeasures to the problem of non medical insurance payment.This part is based on the analysis of the second and the three parts,and puts forward some suggestions to improve our country’s insurance laws and regulations and judicial interpretation. |
