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1、1第十二章 赔付原则与做法1 向保险人索赔的时效保险合约是跟其他的合约或者侵权一样都是受到时效的限制。根据英国 1980 年Limitation Act 1980 ，普通的合约自诉因产生之日起 6 年内可以提起诉讼。针对货物保险这是从发生货损那天起算：Chrandris v. Argo Insurance Co Ltd (1963) 2 Lloyds Rep 65；The “Fanti” and The “Padre Island” (1990) 2 Lloyds Rep 191；The “Italia Express” (No. 2) (1992) 2 Lloyds Rep 281。其中在
2、The “Fanti” and The “Padre Island”，贵族院的Goff 勋爵是这样说：“I also accept that, at common law, the cause of action does not unless the contract provides otherwise arise until the indemnified person can show actual loss: see Collinge v. Heywood (1893) 9 Ad. & E. 634. This is, as I understand it, because a pr
3、omise of indemnity is simply a promise to hold the indemnified person harmless against a specified loss or expense. On this basis, no debt can arise before the loss is suffered or the expense incurred; however, once the loss is suffered or the expense incurred, the indemnifier is in breach of contra
4、ct for having failed to hold the indemnified person harmless against the relevant loss or expense.”。不像租船合约，英国保险市场通常是不会在保险合约中加入明示条文去约定比 6 年更短的合约时效（contractual time limit） 。但在美国的保险市场，在保险合约条文中加入1 年的合约时效限制是很常见：De Moncy v. Phoenix Insurance Company Hartford and Another (1929) 34 Lloyds Rep 201。2 通知保险人条文6
5、 年如此长的时效会给保险人带来几个方面的不利：首先是保险人很难预计应该准备多少的保险赔偿金；其次如果受保人只是在时效结束前提出索赔，保险人没有机会去参与向第三者索赔的行动。例如向船东提出索赔，通常是受到 1924 年海牙规则的强制约束，虽然根据协会货物条文（Institute Cargo Clause）第 16.2 条是要求受保人采取所有向第三者（包括承运人或托管人）索赔的行动，以保障保险人在赔付后所拥有的代位求偿权。但毕竟事后去质疑受保人采取的行动是否恰当仍是不容易，所以保险合约会有条文要求受保人在发生事故后尽快作出通知，这条文会以赔付的先决条件或一般合约条文的形式出现，这方面可去参阅本书第
6、四章第 4.4 段。这一条通知保险人条文（Notice of claims）并没有写在协会货物条文（不像协会船舶保险条文，例如在1/10/1983 的版本是在第 10.1 条，而在 1/11/03 国际船舶保险条文是在第 43.1 条） ，但Lloyds Marine Policy (MAR 91)与 Lloyds 格式的保险证书（certificate of insurance）中2就有这一条加黑了的条文如下：“In the event of loss or damage which may result in a claim under this Insurance, immediate
7、notice must be given to the Lloyds Agent at the port or place where the loss or damage is discovered in order that he may examine the goods and issue a survey report.”。通知保险人条文的主要作用在 Alfred McAlpine plc v BAI (Run-Off) Ltd (1998) 2 Lloyds Rep 694 的先例中有解释，Colman 大法官是说： “The obvious purpose of such pro
8、vision is to enable the insurers to take steps to investigate claims or occurrences which may give rise to claims, in order to minimize their exposure under the policy. They may wish to set in motion independent investigations or cause repair or reinstatement of insured property to be undertaken and
9、, in the case of a liability policy, to take over the defence of claims against the assured or negotiate directly with the third party claimants. Very often it may be in the interests of the insurer under a liability policy to be able to take steps to investigate circumstances which may give rise to
10、 a claim against the assured before any such claim has been made against or by the assured under the policy. Under such a policy an insurer may be better able to protect himself if evidence as to the occurrence can be obtained as early as possible, for, if delay occurs, witnesses may disappear and m
11、emories may fade and, if a claim is then made, an insurer may be severely prejudiced by having lost the opportunity of defeating or diminishing the third party claim.” 。 （让保险人去马上进行独立的调查取证，减少将来要赔付的损失。在责任保险去接管第三人对受保人的索赔或进行谈判。这调查取证越早越好，因为证据的存在与证据的力度会随着时间的过去而消失或减弱。 ）这种条文很早在海上货物运输就已经有先例涉及，其中就是上诉庭的 D&J Ko
12、skas v. The Standard Insurance Company Ltd (1927) 27 Lloyds Rep 59。在该先例，相关条文（保险证明的第 11 条）用词是如下：“In case of loss or damage happening to the property insured hereunder, same shall be reported to the representative of the company (see list on back hereof), or, if there be no such representative at the
13、place, to Lloyds Agent, as soon as the goods are landed or the loss is known or expected, and in the event of claim arising, all documents in connection therewith are to be submitted for approval.”。有关货物是皮革，从纽约运去突尼斯，中途货物遇到严重水湿。CIF 买方根据转让给他的保险证明去向保险人索赔，但通知给的太晚，到给通知的时候根本没有办法再去对损坏的皮革做出检验。保险人拒绝赔付，指受保人的货方
14、晚了去把事故通知最近的劳合社代理人（Lloyds Agent） ，而及时通知是向保险人索赔的先决条件（condition precedent） 。但上诉庭不同意，主要的理由就是写的不清楚，没有把这个条文明确说明是先决条件。毕竟，保险人去做出承诺赔付损失，如果有什么例外，例如是晚了通知，就可以不去赔付的话，责任是保险人要把这种例外情况写清楚。看来在海上货物保险的该通知条文只当作是一般性的条文，要把它提升，就要在保险3合约中加多一句如说明“如果没有及时通知保险人是可以拒赔” 。否则如果受保人没有去这样做，保险人只能是提出延误通知所带来的损失而不是拒赔。当然，如果受保人没有马上通知（immediat
15、ely notice）最近的劳合社代理人（在中国大陆据悉劳合社委任的代理人就是外代） ，没有让他去尽快委任检验师作出及时的调查取证与对损坏货物作出检验，就会带来将来保险人即使是赔付也会延误与增加困难，这对受保人也没有什么好处。还有，晚了通知劳合社代理人也有危险保险人指称受保人没有合理与及时施救。这种条文会根据不同的保险人作出调整，例如去通知的不是劳合社代理人，而是某一家货物检查公司（surveying company）或是某一家索赔代理（recovery agent） 。针对海上货物保险，估计及时通知保险人不像其他的一些保险合约，例如是投保责任保险。这种通知条文会去加上其他要求，例如受保人去把
16、知道的有关情况也马上告知保险人。举例说，在涉及专业疏忽责任保险的先例，就有这样的条文：“The Assured shall as a CONDITIIONAL PRECEDENT to their right to be indemnified under this Policy give to the Underwriters notice as soon as possible during the period of this Policy(a) of any circumstances of which the Assured shall first become aware which may give rise to a claim or loss against them or any of them; (b) of the receipt of notice from any person whether written or oral of any intention to make a claim aga
