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对人身保险合同中因医疗费用引发的纠纷,其焦点主要是能否实行损失补偿原则。因现行法律对适用此原则未予明确和保险理论对适用此原则的肯定,致使各地法院对同类医疗费用纠纷案件判决结果呈多样性。从各地的判例来看,大多数忽视了一个重大事实,即合同双方当事人义务履行先后顺序的认定。如从法理上弄清这一先后顺序的逻辑关系,各地判决结果应该是一致的。一、案情简介被保险人江某在2001年4月18日向中国人寿保险股份有限公司临澧支公司(以下简称保险公司)投保了人身意外伤害保险及附加意外伤害医疗保险,保险期为一年,意外伤害保险金额15000元,意外伤害医疗保险金6500元。2002年4月9日,江某在其单位湖南金健药业有限公司工作时意外摔伤,其伤情经常德市司法鉴定中心鉴定为二级伤
The main focus of disputes over medical expenses caused by medical expenses in the life insurance contract is whether compensation for loss can be implemented. Due to the current law does not apply this principle is not clear and insurance theory of the application of this principle affirmed, leading courts in different regions of the same type of medical expenses disputes cases were diversified. Judging from the jurisprudence of various places, most overlook the major fact that the obligations of both parties in the contract are to be fulfilled in the first place. For example, from the jurisprudence to ascertain the logic of this sequence, the results of the judgments around should be the same. I. Brief introduction of the case Jiang was insured on April 18, 2001 to China Life Insurance Co., Ltd. Linqu branch (hereinafter referred to as the insurance company) personal accident insurance and additional accidental injury medical insurance, the insurance period of one year, Accidental injury insurance amount 15000 yuan, accidental injury medical insurance 6500 yuan. April 9, 2002, Jiangmou in his unit, Hunan Jin Jian Pharmaceutical Co., Ltd. accidental falls, the injury is often identified as a secondary city of Forensic Forensic Center injury