[Brief Introduction]
Kunshan Gold H Company has insured employer liability insurance with an insurance company, and the insurance contract contains a clause of "automatically underwriting new employees", which stipulates that "this insurance policy extends the coverage of the insured's new employees during the insurance period. The insured should timely report the insurance information of new employees to the insurance company and pay the corresponding premium within 30 days after the new employees are hired." After the insurance contract is signed, Jinh Company shall declare the procedures for new employees to increase insurance coverage and for resigned employees to withdraw insurance coverage to the insurance company every 30 days. The insurance company shall make corrections according to the date of declaration and issue a correction form. On February 20, 2012, Mr. Li, a new employee of Golden H Company, entered the job and signed a labor contract on the 23rd of the same month. On March 1, when Mr. Li was on night shift (in the early morning of the second day), his right finger was injured at work and was hospitalized for treatment. Golden H Company immediately made an accident report to the insurance company. On March 16, Jinhe Company filled in the application for correction of additional insurance according to the uniform format required by the insurance company (the application was completed on February 17 last month), which was received by the insurance company on March 19.
On July 4, 2012, Mr. Li was identified as work-related injury, and on September 13, he was identified as work-related injury level 9. Because the insurance company did not pay compensation, Jin H Company was unable to pay Li's work-related injury benefits for the time being. Li applied to Kunshan Labor and Personnel Dispute Arbitration Commission for arbitration. On January 11, 2013, the arbitration commission ruled that Jin H Company paid Li's medical expenses and other benefits totaling RMB 185366.58. Later, Golden H Company fulfilled the ruling and paid the compensation for work-related injuries.
On February 1, 2013, the insurance company issued the Notice of Claim Settlement, believing that Mr. Li, an employee of Jinh Company, had an accident on March 1, 2012, and uploaded an endorsement for additional insurance on March 19, 2012. The endorsement came into effect on March 16, 2012. It is not the insurance liability of the insurance company, so the insurance liability for the accident is not established. Jin H Company believes that the insurance liability of the insurance company to Mr. Li starts automatically when Mr. Li is a new employee, because that is how the insurance staff publicized and recommended the insurance at the time of the initial insurance. How to declare is also according to the format materials provided by the insurance company. The declaration time did not exceed the requirements of the insurance company. However, the insurance company insisted on the reason for refusing to compensate, and the two parties failed to negotiate, so Jinh Company sued. The two courts in Shanghai both decided that Jin H Company lost the lawsuit. The reason of the court of first instance was that the employee was first employed and the time of applying for additional insurance was later. The "insurance period" of the employee in the correction form was calculated from the time of applying, so the insurance company should not be liable for compensation for the liability for work-related injury that was previously applied for later. The court of second instance held that the effectiveness of the insurance contract signed by both parties is conditional, that is, the insurance liability for each new employee starts from the declaration and payment of premium by Jinh Company to Ping An Shanghai Branch. Although the time of declaration is different from the time of payment, the endorsement of the insurance company agrees with the declaration of Jinh Company, so Ping An Company shall assume the insurance liability from March 16, 2012. It is a waiver of the right of Jinhe Company to conditionally declare but not timely declare after new employees enter the company. Therefore, Jin H's appeal was rejected.
