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How to determine the compensation of insurance companies under the public liability insurance of catering enterprises

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Case: A catering enterprise has taken out public liability insurance with an insurance company, and it is agreed that during the insurance period, the insured shall be responsible for the economic compensation liabilities that the insured shall bear according to the provisions of the contract if an accident happens to a third party due to business operation within the scope specified in the schedule of this insurance policy. On a certain day during the insurance period, a customer slipped and fell in the bathroom while eating in the catering enterprise, and the floor was just cleaned, resulting in a number of medical expenses. The customer asked the catering enterprise for compensation of RMB 1,111, and the catering enterprise gave compensation. After that, the catering enterprise filed a claim with the insurer. Analysis: 1. In the case, the catering enterprise should bear the responsibility of economic compensation for the customer's injury. 1. The operator has the obligation to ensure the safety of the consumer's personal and property. Article 7 of the Consumer Protection Law stipulates: "Consumers enjoy the right to personal and property protection when purchasing goods and receiving services. Consumers have the right to require the goods and services provided by operators to meet the requirements of protecting personal and property safety "; Article 18 stipulates that business operators shall ensure that the products or services they provide meet the requirements of protecting personal and property safety, and shall give true explanations and clear explanations to consumers for the goods and services that may endanger personal and property safety. The above two articles stipulate the safety guarantee obligations of operators to consumers from the legal point of view, but they do not specify the scope of the safety guarantee obligations of operators to consumers. On the other hand, under what circumstances can operators be deemed to have violated the safety guarantee obligations to consumers. Article 6 of the Interpretation of the Supreme People's Court on Several Issues Concerning the Trial of Personal Injury Compensation Cases (hereinafter referred to as the Interpretation) stipulates that if a natural person, legal person or other organization engaged in business activities such as accommodation, catering, entertainment or other social activities fails to fulfill its security obligations within a reasonable range and causes personal injury to others, the people's court shall support it. According to the provisions of the Interpretation, there should be a "reasonable limit" for the scope of the operator's safety guarantee obligation for consumers. If the operator fails to fulfill the safety guarantee obligation within the "reasonable limit", the operator shall be liable for the personal injury suffered by consumers. If the operator fulfills the safety guarantee obligation within the "reasonable limit" and the personal injury of consumers is caused, the operator is exempted from liability. 2. How to determine the "reasonable limit" range of operators' safety protection obligations involves all walks of life, and it is difficult for operators from all walks of life to formulate a unified standard for the reasonable limit of consumer safety obligations. However, in practice, some basic principles can be followed when determining the "reasonable limit" of operators' safety guarantee obligations. Liu Chao and coach benny put forward seven standards for the "reasonable limit range" of operators' workplace safety obligations in the article "On the Standards of Operators' Workplace Safety Obligations" (No.23, 2118): legal standards, industry practice standards, rational person standards, predictability standards, reliability standards, controllability standards and cost-effectiveness standards. Regarding the standard of industry practices, it is proposed that "practices are often used to refer to the established practices of people engaged in certain industrial or commercial activities. For example, after cleaning the floor, most shops will put warning signs to remind customers that the road is slippery at this time"; Regarding the standard of foreseeability, it is proposed that "if the defendant can reasonably foresee that his actions (actions or omissions) will cause losses or damages to the plaintiff, then the defendant is considered to have the duty of care". The author agrees with the above viewpoint. 3. As far as customers are concerned, catering enterprises should bear the responsibility of economic compensation. As operators, catering enterprises should foresee that when customers enter the toilet, it is very easy to have accidents because the ground is wet and slippery; The danger of slippery ground after cleaning is controllable for catering enterprises; The cost of taking some necessary measures to prevent customers from falling on the wet ground is obviously much lower than the accident cost that customers should bear after falling. That is to say, no matter from the industry standard, the predictable standard, the controllable standard and the cost-effective standard, it should be within the reasonable range of safety guarantee obligations for catering enterprises to prevent customers from falling on the wet ground. In the case in question, according to the facts ascertained by the court, after the toilet floor was cleaned, the cleaner did not take timely measures to eliminate the slippery floor, such as laying anti-skid mats or drying the floor, nor did he remind the users of the bathroom to pay attention to the slippery floor, such as placing safety warning signs at the door or arranging special personnel to be on duty at the door. In doing so, the negligence or fault of catering enterprises is obvious, which belongs to the failure to fulfill the obligation of safety protection for customers. Therefore, customers should be liable for economic compensation for injuries. II. In this case, under the public liability insurance, the insurer shall be liable for compensation. As mentioned above, in the aforementioned case, the injury suffered by the customer when he slipped in the process of using the bathroom was caused by the catering enterprise's failure to do its best to ensure the safety within reasonable limits, and the catering enterprise shall be liable for financial compensation to the customer according to law. According to the liability insurance contract concluded by the catering enterprise and the insurance company, the insurance liability in this case is established and the insurance company shall be liable for compensation. Of course, under the premise that the liability for compensation has been determined, the insurance company should further investigate whether the compensation fee paid by the catering enterprise as the insured belongs to the scope of compensation according to law, and finally determine the compensation amount of the insurance company in combination with the provisions of the liability insurance contract.