Study On The "Non-medicare Drug Deductible" Clauses Of Commercial Insurance For Third Party Liability Of Motor Vehicles

With the development of social economy and the increase of the number of motor vehicles,the number of motor vehicle accident liability disputes has been rising sharply.Risks in the process of litigation,commercial three central African drug health care expenses claim problems often become the focus of dispute of the case,due to the lack of a clear legal regulations and judicial interpretation level regulation,have no consensus,academic field and practice field around the court's handling of the issue and created a connection with different phenomenon.Non-medical insurance drug deductible clause,refers to the insurer and the policyholder in the signing of motor vehicle third party liability commercial insurance contract agreed,the insurer to the third party injured treatment beyond the national basic medical insurance similar medical expenses standard fee exemption liability clause.In judicial practice,local courts hold different opinions on the nature determination and effectiveness judgment of this provision,which makes the nature and effectiveness of this provision in the trial practice in an uncertain state,seriously affecting the order of insurance transaction and damaging the judicial credibility.In this paper,four cases are taken as the entry point to reveal the confusion of the judgment on the non-medical insurance drug deductible clauses in judicial practice,and thus to conclude the problem of the non-medical insurance drug deductible clauses,namely :(1)there is confusion in the determination of this clause in theory.The main focus is on the qualitative and validity of the provisions of the application of the rules.(2)there are disputes over the subjects who bear the costs of non-medical insurance drugs.The existence of this dispute needs to be traced back to the legality and effectiveness of the clause itself,and the reasonableness of the value orientation of the clause content and its impact on the society also serve as the consideration factors to determine the subject of the undertaking.(3)there are problems with the basic system of non-medicare drug deductible clauses.Compulsory traffic insurance and commercial insurance constitute the third party liability insurance system for motor vehicles in China.The system of compulsory traffic insurance is not enough to protect thethird party victimized.The itemized limit of compulsory traffic insurance is far from enough to meet the needs of the personal injury of the third party injured in the general traffic accident,so as to give the space for the existence of non-medicare drug deductible clauses.Commercial insurance is closely related to the vital interests of the people,but the state has not adopted laws and regulations to regulate it.Instead,China insurance industry association,which has no legislative or administrative functions,makes relevant rules,which is not conducive to safeguarding the interests of the public.In the current third party liability insurance system for motor vehicles,the compensation for the non-medical drug expenses is excluded within the insurance limit of the commercial three parties,which makes the claims for the non-medical drug expenses appear vacant and seriously affects the restoration of social order after traffic accidents.In the trial practice,there is no relevant judicial interpretation or unified guidance,resulting in the chaos of each court acting independently.For the non-medical insurance drug deductible clauses,if we want to analyze the reasons from the system level,we should not stay in the "model clauses of comprehensive commercial insurance for motor vehicles of China insurance industry association" formulated by China insurance industry association,but should study the relevant content of compulsory traffic insurance system.Besides,the compulsory insurance and voluntary insurance of most countries outside the region all exist under the same system of rules.Based on the thinking of the scientific rationality of the motor vehicle third party liability insurance system in China,this paper investigates the concept,limitation and exclusions of the motor vehicle compulsory liability insurance system in Germany,Japan,the United States,France and Taiwan.The relevant enlightenment obtained from the investigation is as follows: first,the insurer shall not refuse to pay the insurance benefits on the grounds of defense against the insured or other drivers,but shall pay the insurance benefits first,and then exercise the right of subrogation against the responsible person.Second,the insurance limit is high,the priority protection victimized third party's personal injury loss.Third,the exclusions are strictly limited.The solution of non-medical insurance drug deductible.First of all,the non-medical insurance drug deductible has the nature of standard terms,disclaimer terms and "waiver of insurer's liability".Therefore,the rules of enactment,validity and interpretation should be adjusted in accordance with the insurancelaw of China.Secondly,from the Angle of the terms to conclude rules,effectiveness,the medicare drug franchise clause for do not conform to the rules in the process is concluded,the insurer is often fails to fulfill its obligations,the essence of tips and specified but to request the insurer to sign the policy-holder statement or extract text prepared material as evidence.The content of the clause itself violates the principle of fairness,exempts the insurer from liability,limits the rights of the insured,and damages the interests of the injured third party.Therefore,this article should not have the legal effect.Third,the non-medical insurance drug costs should be borne by the insurance company.The reason lies in: first,the non-medical insurance drug deductible does not have the legality.China insurance industry association is a industry self-disciplinary organization,the formulation of the China insurance industry association of motor vehicle comprehensive commercial insurance clause"demonstration actually common constraints the underwriter and policy-holder,insurant,suffer the rights and obligations to a third party infringes the interest of insurant,suffer a third person,beyond the association should have permissions,intervened in the market economic order.Therefore,commercial tripartite insurance directly refers to the provisions of non-medicare drug deductible in the model clause,which lacks legal basis.The non-medical insurance drug deductible clause violates the fair principle and the honest credit principle of the civil law,and also violates the basic spirit of loss compensation in the insurance law of our country.Second,the non-medical insurance drug deductible does not have the rationality.No matter from the perspective of the basic function of commercial insurance,the reasonable expectation of the insured or the protection of the rights of the injured third party,the non-medical drug deductible is not reasonable.Accordingly,cost of blame medical treatment USES medicine ought to assume by the underwriter.Finally,the third party liability insurance system of motor vehicles should be improved to fundamentally solve the problem of non-medical insurance drug deductible.Perfect the compensation mechanism and introduce the practice that the overseas insurer cannot refuse to pay the insurance money on the grounds of defense against the insured.Increase the limit of compulsory insurance and increase the proportion of medical expense limit.We will improve insurance coverage and establish a mechanism to cover the cost of non-medical insurance drugs.We will improve laws and regulations as well as trial guidelines to standardize insurance business services for commercialenterprises,protect the rights of parties involved,and maintain market order and transaction expectations.