A Research On The Application Of Principle Of Compensation In Medical Expenses Insurance

The principle of loss compensation is a basic rule in the Chapter with regard to the property insurance in Insurance Law of China.Such a principle contains two aspects,one is to compensate the loss of the insured,and the other is to prevent the insured from getting extra benefits.However,for the insurance of medical expenses the loss of health or even lives of the insured and the suffering of the relating relatives could not be calculated by money,therefore,whether the principle of loss compensation should be applied in the medical expense insurance has been disputed in the academic circles and in practice.This dissertation will discuss such a problem.First,this dissertation collects and analyzes 50 cases getting from the web of the Court Judgements and Decisions,which show that there exist different judgements and decisions as to the similar cases,this dissertation studies the different reasons in the cases.Second,this dissertation introduces three different theories in the academic circle of insurance which bases on the human value,hidden ethical troubles and unreasonable enrichment.This dissertation finally makes comments on the different theories.Thirdly,this dissertation puts forwards that the principle of loss compensation does not apply to the medical expense insurance.This dissertation holds the opinion that the values of loss compensation principle as the basic principle is to ensure the development of insurance industry and protects the interests of the insured.Besides,the medical expense insurance has the characteristics of aleatory contract,which makes us to perform the contracts according to the articles.Further,the articles that exempt the obligation shall be interpreted in favor of the interests of the insured.So,the principle of loss compensation does not meet the value of medical expense insurance.Lastly,this dissertation summarizes the arguments.Through the discussions of the dissertation,the author could clearly draw such a conclusion:from the essential nature of the insurance contract,the parties should stick to the articles of the contract;from the format nature of the insurance contract,the obligations should not be exempted if not clearly stated;from the loss suffered of the insured,the non-application of the loss compensation principle originates from the nature of medical expense compensation.