保险责任时间限制条款的效力分析

The time limit clause of the insured liability: Definition and Application

保险人对被保险人在保险事故发生后限定时间内的伤亡,给付保险金的条款,称为保险责任时间限制条款。鉴于该条款免除了保险人限定期限之外的赔付责任,其效力经常受到质疑,国内外法院对此亦持有不同观点。其实,该条款的设置蕴含了一定的价值功能,系为了限定合理的承保风险、精算保费以确定对价以及确立保险事故与伤亡间的因果关系,故不能将其作为免责条款或无效条款而否认其效力。该条款本质系界定保险责任范围的有效条款,需结合其价值功能具体考量适用,考量因素主要为被保险人的伤亡与保险事故是否具有直接因果关系、理赔与否是否符合被保险人的合理期待。

The time limit clause of the insured liability refers to the situation where the insurer assumes the insured liability when the insured person suffers from death or casualty within the set period in the contract. In view of the fact that the clause exempts the insurer from liability for indemnity beyond the limited period of time, its validity is often questioned, and domestic and foreign courts hold different views on it. The clause seems to exempt the insurer from certain liability, but its essence targets to confine the insured risks within reasonable realm, to calculate premium to determine consideration and to define the cause and effect between the accident and the casualties. Thus such clause should not be deemed as sheer liability exemption or invalid. It is necessary to combine its function and value when it is related to concrete application in the contract. The factors include the consideration on the cause and effect mentioned above and on whether the compensation lives up to the expectations of the insured person.