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装修工人摔伤逾180天后死亡遭保险公司拒赔,法院这样判决
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7月26日,澎湃新闻记者从上海金融法院获悉,近期,该院二审审结了一起涉意外伤害险的案件。最终,该院驳回保险公司上诉,维持一审关于保险公司赔付55万元的判决结果。
工人意外跌落致颅脑损伤,七个月后身亡
上海金融法院介绍,邓某为某工程公司雇佣人员,公司为邓某等装修工人投保了意外伤害险,其中保险责任第六条(一)必选责任部分约定:“被保险人遭受意外伤害事故,并自事故发生之日起180日内因该事故身故的,保险人按意外伤害保险金额给付身故保险金。”
一日,邓某在工地从事拆除工作时,不慎从1.7米的脚手架处跌落,造成严重颅脑损伤,其后五个月,邓某经多次手术治疗,出院诊断为“植物人”“全身瘫痪”。经居家护理两个月后,邓某不幸身故。鉴定意见指出,邓某死亡原因不排除系严重颅脑损伤并发感染死亡。
邓某家属起诉要求保险公司赔偿意外身故保险金。保险公司辩称,依照保险合同约定,邓某身故时间距意外事故发生之日已超过180天,不属于保险责任。