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案例 1992年5月18日傍晚六时,海南省临高县饮食服务公司会计王圣光,在广西壮族自治区统计局桂林培训中心西湖饭店507房卫生间内死亡,死亡原因不详。 死者王圣光。男,58岁,生前由所在单位为其投保了人身意外伤害满期还本保险,保险金额10000元,缴保险费300元。案发后,受益人(死者遗孀)向保险公司要求给付保险金。当时,理赔员认为,该被保险人是在上卫生间“解手”时发生死亡的,疾病是事故的近因,因此,拒付了保险金。
Case On May 18, 1992, at 6pm in the evening, Wang Shengguang, an accountant of Linggao County Catering Service Company of Hainan Province, died inside the bathroom of Room 507, West Lake Hotel, Guilin Training Center, Guangxi Zhuang Autonomous Region Bureau of Statistics. The cause of death is unknown. The deceased Wang Shengguang. Male, 58 years old, by his unit during his lifetime to insure the personal accident reparations full maturity insurance, the insurance amount of 10,000 yuan, 300 insurance premiums paid. After the incident, the beneficiary (deceased widow) to the insurance company asked to pay insurance. At the time, the claims adjudicator believed that the insured person died while getting on the toilet and that the disease was the proximate cause of the accident. Therefore, the insured person refused to pay the insurance premium.