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众多的人身保险理赔案件中,涉及不实告知理赔纠纷的占比一直较高,不实告知案件数量远远超过免责纠纷、条款理解纠纷、补偿原则纠纷等案件。虽然通过不断的立法和司法解释予以确认,但实务中因不实告知而拒付引发的诉讼及纠纷数量仍然居高不下。为尽量减少此类矛盾的发生,同时又使理赔结果相对客观、公平、符合保险本源及立法初衷,本文通过几种不同类型的不实告知情形进行简要分析,提出参考建议,以期在做好风险防范的同时最大限度地保证客户利益,从而更好地诠释保险在社会民生中的稳定与支柱作用。
Among the many cases of personal insurance claims, the proportion of cases involving false claims of claims has been relatively high, and the number of false reports far exceeds the number of exemption disputes, clauses understanding disputes and compensation principle disputes. Although confirmed through constant legislative and judicial interpretations, the number of litigation and disputes that have arisen as a result of dishonorings in practice has remained high. In order to minimize the occurrence of such contradictions and at the same time make the result of the claims relatively objective and fair and in line with the origin of insurance and the original intention of legislation, this article makes a brief analysis through several different types of false notification situations, puts forward suggestions for reference, Prevent and at the same time guarantee the interests of customers to the maximum extent so as to better interpret the role of insurance in social stability and pillars.