Is the infringement aggravating or inducing the victim's original disease, and is the medical expen

—— Luo Jixiu v. Huaan Insurance Company and other road traffic accident damage compensation cases

 

Organizer: Zhang Jihong Lawyer Jiangsu Yunya Law Firm

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[The purpose of the referee] There is a causal relationship between the infringement and the occurrence of a dangerous state in which the victim's original disease is aggravated or induced. In order to prevent the medical expenses incurred by the victim from being induced or aggravated, the medical expenses are reasonable expenses, and the losses belonging to the victim shall be compensated.

[basic case]

The plaintiff Luo Jixiu had various diseases such as rheumatic heart valve disease. On December 26, 2009, the defendant Wang Xiaoping piloted the 6AF6737 sedan and collided with pedestrian Luo Jixiu in front of the Baiyan Road Senior Citizen University in Chongqing. The traffic police department determined that Wang Xiaoping should bear all the responsibilities of this accident, and Luo Jixiu has no responsibility. Luo Jixiu was hospitalized at the Chongqing Three Gorges Central Hospital on the same day. The diagnosis was: soft tissue contusion in the waist and left wrist; rheumatic valvular heart disease; mitral regurgitation; closed injury of the waist and abdomen. On February 8, 2010, Luo Jixiu was cured and discharged. On March 11, the same year, Luo Jixiu sued the defendant Wang Xiaoping and Huaan Property Insurance Co., Ltd. Chongqing Branch (hereinafter referred to as Huaan Insurance Company) for the payment of medical expenses, nursing expenses and other related expenses totaling 15,590 yuan. In the lawsuit, the defendant applied for a review of the reasonableness of Luo Jixiu's treatment expenses. The appraisal agency's opinion submitted that Luo Jixiu was inconsistent with the injury in the prescription of Chongqing Sanxia Central Hospital. Shensong Yangxin Capsule, Xuesaitong, Xianling Bone葆, etc., the amount is 2595.67 yuan.

 

 [referee opinion]

The trial court of the first instance held that the medical expenses claimed by the plaintiff Luo Jixiu were 2,590.67 yuan and the drugs that were inconsistent with the injuries caused by the traffic accident should not be compensated by the defendant. The court ruled that the defendant Huaan Insurance Company compensated the plaintiff Luo Jixiu for medical expenses and hospital food subsidies for the loss of 5044.33 yuan within the limit of motor vehicle traffic accident liability compulsory insurance (not supporting the medical expenses of 2595.67 yuan which is inconsistent with the injury caused by this traffic accident) .

The plaintiff refused to accept the appeal.

The court of second instance held that, although the medical expenses provided by Luo Jixiu were 2,590.67 yuan, which was inconsistent with the trauma caused by the traffic accident, the accident caused by Luo Jixiu in this traffic accident may aggravate or induce other diseases such as heart disease. In order to prevent the occurrence of other diseases such as heart disease, the medical expenses of 2595.67 yuan is the loss of Luo Jixiu, and the compensation obligor should compensate. The court ruled that Luo Jixiu’s medical expenses (including 2,956.67 yuan in dispute) and hospital food subsidies totaled 7,640 yuan, which was paid by Huaan Insurance Company within the motor vehicle traffic accident liability compulsory insurance compensation limit.

[Case Analysis]

1. There is a causal relationship between the infringement and the occurrence of a dangerous state that aggravates or induces the victim’s original disease.

The original illness of the victim is caused by the victim's own cause and has nothing to do with the infringement. Before the infringement occurred, the victim had other diseases such as heart disease, but other diseases such as heart disease were not induced or the disease was mild. After the infringement, the victim's original relatively healthy state of stability is broken, and the decline in physical function leads to a decrease in the ability to resist the recurrence of the original disease or aggravation of the disease, and the dangerous state in which the original disease is aggravated or induced . Therefore, the infringement is the cause of the original disease being induced or aggravated, and there is a causal relationship between the two.

2. The cost of eliminating the infringement causing the original disease to be aggravated or induced to a dangerous state is a reasonable expense.

If the infringement causes the victim's original disease to be aggravated or induced to a dangerous state, if the corresponding medical measures are not taken in time, the risk of the original disease being induced or aggravated will be transformed into actual damage, and the damage will be expanded. . At this time, the victim takes appropriate medical treatment measures at the medical institution to eliminate the dangerous state caused by the infringement, prevent the original disease from being aggravated or induced, and is a reasonable measure taken to avoid the expansion of the damage. Therefore, the expenses incurred are reasonable. cost.

3. The cost of eliminating the original disease that is aggravated or induced to a dangerous state is the loss suffered by the victim.

The civil liability has the function of loss filling, and the victim shall be compensated for the losses suffered by the victim due to the infringement. The dangerous state is triggered by the infringement, and the elimination of the dangerous state is the obligation of the indemnity obligor, and the liability arising therefrom shall also be borne by the indemnity obligor. When the infringement has the actual danger of aggravating or inducing the original disease, the victim takes necessary medical measures to eliminate the dangerous state in which the original disease is induced or aggravated, and prevent the damage from being expanded. Therefore, the expenses directly directly lead to the victim's property directly. Reduction, belonging to the victim's loss range, the compensation obligation should be compensated.