第二十一条 投保人、被保险人或者受益人知道保险事故发生后,应当及时通知保险人。
Article 21 The applicant, the insured or the beneficiary shall notify the insurer in a timely manner of the occurrence of any insured event once it is known to them.
被保险人是指其财产或者人身受保险合同保障,享有保险金请求权的人,投保人可以为被保险人。
The insured refers to anyone whose property or person is protected by the insurance contract and who is entitled to claim for compensation. An applicant may be the insured.
受益人是指人身保险合同中由被保险人或者投保人指定的享有保险金请求权的人,投保人、被保险人可以为受益人。
The beneficiary with respect to the insurance of persons refers to that person designated by the insured or the applicant, and being entitled to claim for the insurance benefits. The applicant or the insured may be the beneficiary.
第二十二条 保险事故发生后,依照保险合同请求保险人赔偿或者给付保险金时,投保人、被保险人或者受益人应当向保险人提供其所能提供的与确认保险事故的性质、原因、损失程度等有关的证明和资料。
Article 22 When a claim for indemnity or payment of the insurance benefits is lodged with the insurer after the occurrence of an insured event, the applicant, the insured or the beneficiary shall, to the best of their knowledge and ability, provide the insurer with evidence and information which is relevant to ascertain the nature of, the cause for and the extent of the loss due to the occurrence of the insured event.
保险人依照保险合同的约定,认为有关的证明和资料不完整的,应当通知投保人、被保险人或者受益人补充提供有关的证明和资料。
If the insurer, based on the provisions of the insurance contract, considers the relevant evidence or information incomplete, then the insurer shall notify the applicant, the insured or the beneficiary with a request to provide the insurer with additional evidence or information.
第二十三条 保险人收到被保险人或者受益人的赔偿或者给付保险金的请求后,应当及时作出核定;对属于保险责任的,在与被保险人或者受益人达成有关赔偿或者给付保险金额的协议后十日内,履行赔偿或者给付保险金义务。保险合同对保险金额及赔偿或者给付期限有约定的,保险人应当依照保险合同的约定,履行赔偿或者给付保险金义务。
Article 23 The insurer shall, in a timely manner after the receipt of a claim for indemnity or for payment of the insurance benefits from the insured or the beneficiary, ascertain and determine whether to make the indemnity or effect the payment of the insurance benefits, and shall fulfill its obligations for such indemnity or payment within ten (10) days after an agreement is reached with the insured or the beneficiary on the amount of indemnity or payment. If the insurance contract specifies the sum insured or the period within which the indemnity or the payment of the insurance benefits should be made, then the insurer shall fulfill its obligation for indemnity or payment of the insurance benefits as specified in the insurance contract.
保险人未及时履行前款规定义务的,除支付保险金外,应当赔偿被保险人或者受益人因此受到的损失。
If the insurer fails to fulfill the obligations specified in the preceding paragraph in a timely manner then, in addition to the payment of compensation, the insurer shall compensate the insured or the beneficiary for any damage incurred thereby.
任何单位或者个人都不得非法干预保险人履行赔偿或者给付保险金的义务,也不得限制被保险人或者受益人取得保险金的权利。
No entity or individual shall illegally interfere with the insurer's obligation for indemnity or payment of the insurance benefits, or hinder the right of the insured or the beneficiary to receive the payment.
保险金额是指保险人承担赔偿或者给付保险金责任的最高限额。
The sum insured refers to the maximum amount which the insurer undertakes to indemnify or pay under its insurance obligation.
第二十四条 保险人收到被保险人或者受益人的赔偿或者给付保险金的请求后,对不属于保险责任的,应当向被保险人或者受益人发出拒绝赔偿或者拒绝给付保险金通知书。
Article 24 After receiving a claim for indemnity or payment of the insurance benefits from the insured or the beneficiary, the insurer shall issue to the insured or the beneficiary a notice declining indemnity or payment of the insurance benefits for any events not falling within the scope of the cover.
第二十五条 保险人自收到赔偿或者给付保险金的请求和有关证明、资料之日起六十日内,对其赔偿或者给付保险金的数额不能确定的,应当根据已有证明和资料可以确定的最低数额先予支付;保险人最终确定赔偿或者给付保险金的数额后,应当支付相应的差额。
Article 25 If the amount of indemnity or payment of the insurance benefits cannot be determined within sixty (60) days of receipt of the claim for indemnity or payment of the insurance benefits, and relevant evidence and information thereof, then the insurer shall effect payment of the minimum amount which can be determined by the evidence and information obtained. The insurer shall pay the balance after the final amount of indemnity or payment of the insurance benefits is determined.
第二十六条 人寿保险以外的其他保险的被保险人或者受益人,对保险人请求赔偿或者给付保险金的权利,自其知道保险事故发生之日起二年不行使而消灭。
Article 26 With respect to insurance other than life insurance, the rights of the insured or the beneficiary to claim for indemnity or payment of the insurance benefits shall expire if the insured or the beneficiary fails to exercise his/her rights to claim within two (2) years from the date when the insured or the beneficiary is aware of the occurrence of the insured event.
人寿保险的被保险人或者受益人对保险人请求给付保险金的权利,自其知道保险事故发生之日起五年不行使而消灭。
With respect to life insurance, the rights of the insured or the beneficiary to claim for payment of the insurance benefits shall expire if the insured or the beneficiary fails to exercise his/her rights to claim within five (5) years from the date when the insured or the beneficiary is aware of the occurrence of the insured event.
第二十七条 被保险人或者受益人在未发生保险事故的情况下,谎称发生了保险事故,向保险人提出赔偿或者给付保险金的请求的,保险人有权解除保险合同,并不退还保险费。
Article 27 The insurer may terminate the insurance contract and refuse to return the premiums paid if the insured or the beneficiary falsely claims that an insured event has occurred, and submits a claim for indemnity or payment of the insurance benefits, although such insured event has not occurred.
投保人、被保险人或者受益人故意制造保险事故的,保险人有权解除保险合同,不承担赔偿或者给付保险金的责任,除本法第六十四条第一款另有规定外,也不退还保险费。
If the applicant, the insured or the beneficiary intentionally causes the occurrence of an insured event, except as under the first paragraph of Article 64 of this Law, the insurer may terminate the insurance contract, bear no obligation for indemnity or payment of the insurance benefits and decline to return the premiums paid.
保险事故发生后,投保人、被保险人或者受益人以伪造、变造的有关证明、资料或者其他证据,编造虚假的事故原因或者夸大损失程度的,保险人对其虚报的部分不承担赔偿或者给付保险金的责任。
If the applicant, the insured or the beneficiary, following the occurrence of an insured event, provides forged and altered relevant evidence, information or other proofs, falsifies the cause of the occurrence of the insured event or overstates the extent of the loss, then the insurer shall bear no obligation for indemnity or payment of the insurance benefits for the portion which is falsified or overstated.
投保人、被保险人或者受益人有前三款所列行为之一,致使保险人支付保险金或者支出费用的,应当退回或者赔偿。
The applicant, the insured or the beneficiary shall refund or indemnify the insurer for any payments or expenses which were made or incurred by the insurer due to the commission of any act stipulated in the foregoing three paragraphs of this Article by the applicant, the insured or the beneficiary.
第二十八条 保险人将其承担的保险业务,以承保形式,部分转移给其他保险人的,为再保险。
Article 28 When an insurer transfers part of its accepted business to another insurer by way of cession, it is referred to as reinsurance.
应再保险接受人的要求,再保险分出人应当将其自负责任及原保险的有关情况告知再保险接受人。
When requested by the reinsurer, the ceding insurance company shall inform the reinsurer of the ceding insurance company's retained liability and all relevant information with respect to the direct insurance.
第二十九条 再保险接受人不得向原保险的投保人要求支付保险费。
Article 29 The reinsurer shall not demand payment of premiums from the applicant of the direct insurance.
原保险的被保险人或者受益人,不得向再保险接受人提出赔偿或者给付保险金的请求。
The insured or the beneficiary of the direct insurance shall not claim for the indemnity or payment of the insurance benefits from the reinsurer.
再保险分出人不得以再保险接受人未履行再保险责任为由,拒绝履行或者迟延履行其原保险责任。
The ceding insurance company shall not decline or delay fulfilling its obligation of the direct insurance on the basis that the reinsurer fails to fulfill the reinsurance obligation.
第三十条 对于保险合同的条款,保险人与投保人、被保险人或者受益人有争议时,人民法院或者仲裁机关应当作有利于被保险人和受益人的解释。
Article 30 If there is any dispute over the interpretation of clauses in an insurance contract between the insurer and the applicant, the insured or the beneficiary, then the People's Courts or arbitration organizations shall interpret such disputed clauses in favor of the insured and the beneficiary.
第三十一条 保险人或者再保险接受人对在办理保险业务中知道的投保人、被保险人或者再保险分出人的业务和财产情况,负有保密的义务。
Article 31 The insurer or the reinsurer shall be obligated to maintain confidentiality of information obtained in the course of conducting insurance business regarding the business and financial position of the applicant, the insured or the ceding insurance company.