Our correspondent Pu Xuan and reporter Lu Yanan report: A husband lost his life chasing other women, and when his wife went to the insurance company for compensation, she was flatly refused. Recently, the Financial Division of the Pudong Court made a first-instance judgment on this special insurance case: The insurance company should pay Ms. Zhang 400,000 yuan in insurance money.
Ms. Zhang's husband, Su Mou, who was just over 30 years old, got into an argument with a sex worker last May over the fee for prostitution. During the argument, the woman's cohabiting boyfriend rushed over upon hearing the news and stabbed Su Mou in the heart and left lung with a sharp knife, causing him to die from hemorrhagic shock.
Since Su Mou's company had previously purchased comprehensive accidental insurance for its employees, one of them, "Fu You Expert Group Accidental Injury Insurance," covered accidental death insurance money, with a maximum compensation amount of 400,000 yuan. For this reason, Ms. Zhang filed a claim application with the insurance company. Unexpectedly, more than a month later, the insurance company informed Ms. Zhang that Su Mou's act of prostitution violated relevant provisions of the "People's Republic of China Public Security Administrative Punishment Law" and was considered a criminal act. According to the insurance clause, "For accidents caused by crimes, resisting arrest, suicide, self-harm, fighting, or drunkenness, the company does not bear the responsibility for paying the insurance money," the insurance company refused to compensate.
In court, Ms. Zhang's representative believed that Su Mou only violated the Public Security Administrative Punishment Law and did not commit a crime. The insurance company's refusal to compensate damaged Ms. Zhang's legitimate rights and interests.
After deliberation, the court believed that Su Mou's behavior violated social ethics and should be condemned by public opinion, but there was no criminal behavior during the process of Su Mou's prostitution or even his murder. At the same time, Su Mou's death was due to external, sudden, unintentional, and non-disease-related accidental injuries, which fell within the scope of insurance liability agreed upon in the insurance contract. As the beneficiary of the insurance money, Ms. Zhang has legal and factual grounds for claiming the insurance money from the insurance company, hence the above judgment.