仙桃杨某购买医疗保险时隐瞒疾病，仍判保险公司理赔
<div class="wx_rich_media_content" id="jsWxContainer"><section data-role="outer" label="edit by 135editor"><section data-role="outer" style='padding: 10px;background-repeat: repeat;background-position: center center;background-size: auto;box-sizing: border-box;'><section data-tools="135编辑器" data-id="123202"><section style='margin: 10px auto;'><section style='display: flex;justify-content: flex-start;margin-bottom: -20px;'><section style='width: 65px;box-sizing:border-box;'><span class="wxart_image" wx-style='display:inline-block;vertical-align: inherit;width: 100%;display: block;box-sizing: border-box;'></span></section></section><section data-autoskip="1" style='line-height: 1.75em; letter-spacing: 1.5px; color: rgb(89, 89, 89); border-width: 1px; border-style: dashed; border-color: rgb(129, 209, 246); padding: 15px 10px; border-radius: 10px; margin-right: 10px; margin-left: 10px; box-sizing: border-box;'><p style='text-align:center;line-height: 2em;'><span style='font-size: 17px;letter-spacing: 2px;'>购买医疗保险时</span></p><p style='text-align:center;line-height: 2em;'><span style='font-size: 17px;letter-spacing: 2px;'>保险业务员通常会对投保人进行询问</span></p><p style='text-align:center;line-height: 2em;'><span style='font-size: 17px;letter-spacing: 2px;'>投保人也有如实告知的义务</span></p><p style='text-align:center;line-height: 2em;'><span style='font-size: 17px;letter-spacing: 2px;'>为啥投保人隐瞒疾病</span></p><p style='text-align:center;line-height: 2em;'><span style='font-size: 17px;letter-spacing: 2px;'>最终还能得到赔偿呢？</span></p></section><section style='display: flex;justify-content: flex-end;margin-top: -25px;'><section style='width: 35px;box-sizing:border-box;'><span class="wxart_image" wx-style='display:inline-block;vertical-align: inherit;width: 100%;display: block;box-sizing: border-box;transform: rotate(25deg);'></span></section></section></section></section><section data-role="paragraph"><p style='text-align:center;'><span class="wxart_image" wx-style='display:inline-block;vertical-align: inherit;width: 135px;box-sizing:border-box;'></span></p></section><section data-tools="135编辑器" data-id="125361"><section style='margin: 10px auto;'><section style='display: flex;justify-content: flex-start;margin-bottom: -8px;'><section style='flex-shrink: 0; width: 10px; height: 10px; display: flex; align-items: flex-start; box-sizing: border-box;'><section style='width: 6px;height: 6px;background-color: rgb(78, 132, 216);border-radius: 100%;overflow: hidden;box-sizing:border-box;'><br></section></section></section><section data-autoskip="1" style='line-height: 1.75em; letter-spacing: 1.5px; padding: 10px 13px; border-width: 1px; border-style: solid; border-color: rgb(78, 132, 216); box-sizing: border-box;'><p style='text-indent: 2em;line-height: 2em;'><span style='font-size: 17px;letter-spacing: 2px;'>近日，仙桃法院民二庭依法审结了一起人身保险合同纠纷案。</span></p></section><section style='display: flex;justify-content: flex-end;margin-top: -8px;'><section style='flex-shrink: 0; width: 10px; height: 10px; display: flex; align-items: flex-end; justify-content: flex-end; box-sizing: border-box;'><section style='width: 6px;height: 6px;background-color: rgb(78, 132, 216);border-radius: 100%;overflow: hidden;box-sizing:border-box;'><br></section></section></section></section></section><section data-role="title" data-tools="135编辑器" data-id="95751"><section style='text-align: center;margin:10px auto;'><section style='display:inline-block;'><section style='width:45px;margin-left:-4px;box-sizing:border-box;'><span class="wxart_image" wx-style='display:inline-block;width: 100%;display: block;vertical-align: inherit;box-sizing: border-box;'></span></section><section style='padding:10px;margin-top:-45px;box-sizing:border-box;'><section style='box-shadow:0px 0px 10px #cce6ed;padding:6px;border-radius:10px;box-sizing:border-box;'><section data-bcless="darken" data-bclessp="30%" style='border-width: 1px;border-style: dashed;border-color: rgb(204, 230, 237);background: rgb(242, 250, 252);border-radius: 8px;box-sizing: border-box;'><section data-brushtype="text" style='font-size: 16px;letter-spacing: 1.5px;padding: 6px 1em;box-sizing: border-box;'><span style='color: #757576;'><strong><span style='font-size: 18px;'>案情回顾</span></strong></span></section></section></section></section></section></section></section><section data-tools="135编辑器" data-id="96198"><section style='max-width:100% !important;width:100%;margin:10px auto;box-sizing:border-box;' data-width="100%"><section style='display: flex;justify-content: space-between;align-items: flex-end;width: 90%;margin-right: auto;margin-left: auto;box-sizing:border-box;max-width: 90% !important;transform: rotate(0deg);-webkit-transform: rotate(0deg);-moz-transform: rotate(0deg);-o-transform: rotate(0deg);' data-width="90%"><section style='width:16px;box-sizing:border-box;transform: scaleX(-1);-webkit-transform: scaleX(-1);-moz-transform: scaleX(-1);-o-transform: scaleX(-1);'><span class="wxart_image" wx-style='display:inline-block;vertical-align: inherit;width: 100%;display: block;box-sizing: border-box;'></span></section><section style='width:16px;box-sizing:border-box;'><span class="wxart_image" wx-style='display:inline-block;vertical-align: inherit;width: 100%;display: block;box-sizing: border-box;'></span></section></section><section data-autoskip="1" style='border-width: 1px; border-style: solid; border-color: rgb(112, 205, 213); letter-spacing: 1.5px; line-height: 1.75em; color: rgb(62, 62, 62); margin-top: -12px; padding: 1em; box-sizing: border-box;'><p style='text-indent: 2em;line-height: 2em;'><span style='font-size: 17px;letter-spacing: 2px;'>2021年6月，杨某在仙桃某保险公司为自己投保了一份保额百万元的医疗保险，保险期内杨某被医院确诊为胃恶性肿瘤，经住院治疗花费医疗费10万余元，其中个人支付金额7万余元。出院后，杨某向保险公司提交理赔申请。</span></p><p style='text-align:center;line-height: 2em;text-indent: 0em;'><span style='font-size: 17px;letter-spacing: 2px;'><span class="wxart_image" wx-style='display:inline-block;vertical-align: inherit;width: 354px;box-sizing:border-box;'></span></span></p><section style='text-align: center;text-indent: 0em;line-height: normal;'><p style='font-size: 17px;letter-spacing: 2px;'><br></p></section><p style='text-indent: 2em;line-height: 2em;'><span style='font-size: 17px;letter-spacing: 2px;'>保险公司在理赔调查时发现，杨某有高血压病史，不符合保险单健康告知中的约定，便以杨某在投保时未履行如实告知义务为由拒绝赔付。因多次沟通未果，杨某将保险公司诉至法院。</span></p></section><section style='height: 3px;background: rgb(249, 141, 185);border-right: 1px solid rgb(112, 205, 213);border-bottom: 1px solid rgb(112, 205, 213);border-left: 1px solid rgb(112, 205, 213);border-top: none;box-sizing: border-box;overflow: hidden;'><br></section></section></section><section data-role="title" data-tools="135编辑器" data-id="95751"><section style='text-align: center;margin:10px auto;'><section style='display:inline-block;'><section style='width:45px;margin-left:-4px;box-sizing:border-box;'><span class="wxart_image" wx-style='display:inline-block;width: 100%;display: block;vertical-align: inherit;box-sizing: border-box;'></span></section><section style='padding:10px;margin-top:-45px;box-sizing:border-box;'><section style='box-shadow:0px 0px 10px #cce6ed;padding:6px;border-radius:10px;box-sizing:border-box;'><section data-bcless="darken" data-bclessp="30%" style='border-width: 1px;border-style: dashed;border-color: rgb(204, 230, 237);background: rgb(242, 250, 252);border-radius: 8px;box-sizing: border-box;'><section data-brushtype="text" style='font-size: 16px;letter-spacing: 1.5px;padding: 6px 1em;box-sizing: border-box;'><span style='color:#757576;'><strong><span style='font-size: 18px;'>法院审理</span></strong></span></section></section></section></section></section></section><section data-tools="135编辑器" data-id="96198"><section style='max-width:100% !important;width:100%;margin:10px auto;box-sizing:border-box;' data-width="100%"><section style='display: flex;justify-content: space-between;align-items: flex-end;width: 90%;margin-right: auto;margin-left: auto;box-sizing:border-box;max-width: 90% !important;transform: rotate(0deg);-webkit-transform: rotate(0deg);-moz-transform: rotate(0deg);-o-transform: rotate(0deg);' data-width="90%"><section style='width:16px;box-sizing:border-box;transform: scaleX(-1);-webkit-transform: scaleX(-1);-moz-transform: scaleX(-1);-o-transform: scaleX(-1);'><span class="wxart_image" wx-style='display:inline-block;vertical-align: inherit;width: 100%;display: block;box-sizing: border-box;'></span></section><section style='width:16px;box-sizing:border-box;'><span class="wxart_image" wx-style='display:inline-block;vertical-align: inherit;width: 100%;display: block;box-sizing: border-box;'></span></section></section><section data-autoskip="1" style='border-width: 1px; border-style: solid; border-color: rgb(112, 205, 213); letter-spacing: 1.5px; line-height: 1.75em; color: rgb(62, 62, 62); margin-top: -12px; padding: 1em; box-sizing: border-box;'><p style='text-align:center;line-height: 2em;text-indent: 0em;'><br></p><p style='text-indent: 2em;line-height: 2em;'><span style='font-size: 17px;letter-spacing: 2px;'>仙桃法院经审理认为，保险公司在得知投保人杨某未履行如实告知义务时享有合同解除权，但保险公司并未提交证据证明其已在法定期限内即得知解除事由之日起30日内解除保险合同，也未与杨某就拒绝赔偿事宜及保险合同存续另行达成一致意见，故保险公司仍应按合同约定承担保险责任。</span></p><p style='text-indent: 2em;line-height: 2em;'><br></p><p style='text-align:center;line-height: 2em;text-indent: 0em;'><span style='font-size: 17px;letter-spacing: 2px;'><span class="wxart_image" wx-style='display:inline-block;vertical-align: inherit;width: 287px;box-sizing:border-box;'></span></span></p><p style='text-indent: 2em;line-height: 2em;'><br></p><p style='text-indent: 2em;line-height: 2em;'><span style='font-size: 17px;letter-spacing: 2px;'>为减轻双方诉累，承办法官在庭后多次与双方当事人沟通，最终双方达成一致意见，被告保险公司一次性向原告杨某支付保险理赔金共计5万余元，该案得到圆满解决。</span></p></section><section style='height: 3px;background: rgb(249, 141, 185);border-right: 1px solid rgb(112, 205, 213);border-bottom: 1px solid rgb(112, 205, 213);border-left: 1px solid rgb(112, 205, 213);border-top: none;box-sizing: border-box;overflow: hidden;'><br></section></section></section><section data-role="paragraph"><p><span class="wxart_image" wx-style='display:inline-block;vertical-align: inherit;width: 235px;box-sizing:border-box;'></span></p></section><section data-tools="135编辑器" data-id="96127"><section style='margin:10px auto;'><section style='text-align:right;margin-right:5px;margin-top:15px;transform: rotate(0deg);-webkit-transform: rotate(0deg);-moz-transform: rotate(0deg);-o-transform: rotate(0deg);'><section style='width:1.5em;display:inline-block;box-sizing:border-box;'><span class="wxart_image" wx-style='display:inline-block;width: 100%;display: block;vertical-align: inherit;box-sizing: border-box;'></span></section></section><section style='border-width: 2px;border-style: solid;border-color: rgb(76, 68, 113);background: rgb(125, 172, 238);padding-right: 6px;padding-bottom: 6px;margin-top: -22px;margin-right: 15px;box-sizing: border-box;'><section style='background:#fefefe;border-right:2px solid #4c4471;border-bottom:2px solid #4c4471;box-sizing:border-box;'><section data-autoskip="1" style='letter-spacing: 1.5px; line-height: 1.75em; color: rgb(62, 62, 62); padding: 1em; box-sizing: border-box;'><p style='line-height: 2em;text-indent: 2em;'><span style='font-size: 17px;letter-spacing: 2px;'>保险人享有拒绝赔偿的权利以保险合同的解除为条件，因此</span><span style='color: #1e9be8;'><strong><span style='font-size: 17px;letter-spacing: 2px;'>保险人即使享有合同解除权，也不能在保险合同未解除时直接拒赔</span></strong><strong><span style='font-size: 17px;letter-spacing: 2px;'>。简而言之，保险人若想拒赔，需要解除合同或者与对方就拒绝赔偿事宜及保险合同存续另行达成一致，否则人民法院不予支持。</span></strong></span></p><p style='line-height: 2em;text-indent: 2em;'><span style='font-size: 17px;letter-spacing: 2px;'>本案中，<span style='color: #212122;'>保险公司在知道有解除事由之日起30日内未行使解除权，解除权消灭，保险合同依然有效，对双方仍具有约束力，保险公司应按合同约定承担给付保险金的责任。</span></span></p></section></section></section></section></section><section data-role="paragraph"><p><span class="wxart_image" wx-style='display:inline-block;vertical-align: inherit;width: 208px;box-sizing:border-box;'></span></p></section><section data-tools="135编辑器" data-id="96259"><section style='width:100%;margin:10px auto;max-width:100% !important;box-sizing:border-box;' data-width="100%"><section data-autoskip="1" style='border-width: 1px; border-style: solid; border-color: rgb(51, 51, 51); letter-spacing: 1.5px; line-height: 1.75em; color: rgb(62, 62, 62); padding: 1em; box-sizing: border-box;'><p style='text-indent: 2em;line-height: 2em;'><span style='font-size: 17px;letter-spacing: 2px;'>保险合同条款较多，大部分投保人没有仔细阅读就勾选已阅读或者直接签字确认，导致发生保险事故时出现免赔或拒赔的情况，本案中如保险公司及时行使解除权，杨某的理赔则可能无法实现。</span><span style='color:#1e9be8;'><strong><span style='font-size: 17px;letter-spacing: 2px;'>在此提醒投保人，在购买保险时一定要仔细阅读保险条款，避免因自身原因发生免赔或拒赔。</span></strong></span></p></section><section style='text-align:right;transform: rotate(0deg);-webkit-transform: rotate(0deg);-moz-transform: rotate(0deg);-o-transform: rotate(0deg);'><section style='width:40px;background:#fefefe;margin-right:10px;display:inline-block;box-sizing:border-box;'><span class="wxart_image" wx-style='display:inline-block;width: 100%;display: block;margin-top: -40px;vertical-align: inherit;box-sizing: border-box;'></span></section></section></section></section><section data-role="paragraph"><p><span class="wxart_image" wx-style='display:inline-block;vertical-align: inherit;width: 190px;box-sizing:border-box;'></span></p></section><section data-tools="135编辑器" data-id="96092"><section style='width:100%;margin:10px auto;max-width:100% !important;box-sizing:border-box;' data-width="100%"><section><section style='width:80px;margin-left:15px;margin-top:10px;box-sizing:border-box;'><span class="wxart_image" wx-style='display:inline-block;width: 100%;display: block;vertical-align: inherit;box-sizing: border-box;'></span></section><section data-autoskip="1"><section data-role="outer" label="edit by 135editor"><section data-tools="135编辑器" data-id="101146"><section style='margin: 10px auto;'><section style='overflow-y: auto;height: 219px;width: 100%;display: inline-block;max-width: 100% !important;box-sizing:border-box;' data-width="100%"><section style='padding: 1em;box-sizing:border-box;'><p style='vertical-align:inherit;'><br></p><p style='box-sizing: border-box; letter-spacing: 1.5px; line-height: 2em;'><span style='font-size: 17px;'>《中华人民共和国保险法》第十六条规定，订立保险合同，保险人就保险标的或者被保险人的有关情况提出询问的，投保人应当如实告知。<br> 投保人故意或者因重大过失未履行前款规定的如实告知义务，足以影响保险人决定是否同意承保或者提高保险费率的，保险人有权解除合同。<br> 前款规定的合同解除权，自保险人知道有解除事由之日起，超过三十日不行使而消灭。自合同成立之日起超过二年的，保险人不得解除合同；发生保险事故的，保险人应当承担赔偿或者给付保险金的责任。<br> 投保人故意不履行如实告知义务的，保险人对于合同解除前发生的保险事故，不承担赔偿或者给付保险金的责任，并不退还保险费。<br> 投保人因重大过失未履行如实告知义务，对保险事故的发生有严重影响的，保险人对于合同解除前发生的保险事故，不承担赔偿或者给付保险金的责任，但应当退还保险费。<br> 保险人在合同订立时已经知道投保人未如实告知的情况的，保险人不得解除合同；发生保险事故的，保险人应当承担赔偿或者给付保险金的责任。<br> 保险事故是指保险合同约定的保险责任范围内的事故。<br> 《最高人民法院关于适用<中华人民共和国保险法>若干问题的解释（二）》第八条规定，保险人未行使合同解除权，直接以存在保险法第十六条第四款、第五款规定的情形为由拒绝赔偿的，人民法院不予支持。但当事人就拒绝赔偿事宜及保险合同存续另行达成一致的情况除外。</span></p></section></section></section></section></section></section></section></section></section></section></section><section data-role="outer" label="edit by 135editor"><section data-tools="135编辑器" data-id="120372"><section style='margin: 10px auto;display: flex;justify-content: center;'><section style='transform-style: preserve-3d;'><section style='font-size: 16px;color: rgb(140, 183, 246);background-color: rgb(242, 245, 255);padding: 5px 15px;margin-top: -9px;margin-left: 6px;box-sizing: border-box;transform: translateZ(5px);-webkit-transform: translateZ(5px);-moz-transform: translateZ(5px);-o-transform: translateZ(5px);'><strong data-brushtype="text">END</strong></section><section style='display: flex;justify-content: flex-end;margin-top: -10px;transform: translateZ(10px);-webkit-transform: translateZ(10px);-moz-transform: translateZ(10px);-o-transform: translateZ(10px);'><section><section style='width: 0px;height: 1px;border-right: 10px solid transparent;border-top: 10px solid rgb(137, 221, 208);overflow: hidden;box-sizing:border-box;'><br></section><section style='width: 0px;height: 1px;border-left: 10px solid transparent;border-bottom: 10px solid rgb(255, 255, 255);margin-top: -10px;overflow: hidden;box-sizing:border-box;'><br></section></section></section></section></section></section><section data-role="paragraph"><section data-role="outer" style='outline: 0px; max-width: 100%; letter-spacing: 0.544px; color: rgb(34, 34, 34); text-align: right; visibility: visible; font-family: system-ui, -apple-system, BlinkMacSystemFont, Arial, sans-serif; box-sizing: border-box !important;'><section data-role="paragraph" style='outline: 0px; max-width: 100%; box-sizing: border-box !important;'><section data-role="paragraph" style='outline: 0px; max-width: 100%; box-sizing: border-box !important;'><section data-role="paragraph" style='outline: 0px; max-width: 100%; box-sizing: border-box !important;'><section data-role="paragraph" style='outline: 0px; max-width: 100%; box-sizing: border-box !important;'><section style='outline: 0px; max-width: 100%; line-height: normal; text-align: justify; box-sizing: border-box !important;'><span style='outline: 0px; max-width: 100%; font-size: 15px; letter-spacing: 0.5px; box-sizing: border-box !important;'></span></section><section style='outline: 0px; max-width: 100%; line-height: normal; text-align: justify; box-sizing: border-box !important;'><span style='color: rgb(68, 68, 68); font-family: Tahoma, Helvetica, SimSun, sans-serif;'><br></span></section><section style='outline: 0px; max-width: 100%; line-height: normal; text-align: justify; box-sizing: border-box !important;'><span style='color: rgb(68, 68, 68); font-family: Tahoma, Helvetica, SimSun, sans-serif;'>来源：湖北省仙桃市人民法院</span></section></section></section></section></section></section></section></section></section></div><p></p>
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