[Direct answer]In the Beijing area, purchasing "full insurance" doesn't mean that all losses can be compensated. "Full insurance" is not a legal concept and usually refers to a combination of compulsory auto insurance, commercial third-party liability insurance, vehicle damage insurance, and occupant liability insurance. The objects and limits of compensation for each type of insurance are different. According to the "Regulations on Compulsory Insurance for Motor Vehicle Traffic Accident Liability" (amended on March 30, 2012), compulsory auto insurance compensates third parties within the liability limits. After the comprehensive reform of auto insurance in September 2020, the liability limits are 180,000 yuan for death and disability, 18,000 yuan for medical expenses, and 20,000 yuan for property damage; commercial insurance compensates according to the contract terms, and situations such as drunk driving, unlicensed driving, intentional acts, and hit-and-run are usually excluded from coverage. The portion exceeding the limits or falling under exclusion clauses is borne by the infringer.

I. Problem Background and Typical Scenarios

Such questions are commonly encountered in several situations: first, the compensation amount for personal injury accidents far exceeds the insurance limit, and car owners are worried about having to pay out of their own pockets; second, in single-party accidents where the vehicle is damaged, they are unsure about how much the vehicle damage insurance can compensate; third, if the accident is entirely the other party's fault, they wonder whether their own insurance can be used; fourth, the insurance company partially refuses to compensate based on clauses such as non-medical insurance drugs and indirect losses; fifth, if the driver is involved in situations such as drunk driving or fleeing the scene of the accident, the entire compensation claim may be rejected. When handling similar cases in the Beijing area, the insurer usually compensates for losses according to the type of insurance, first with compulsory insurance, then with commercial insurance, and finally with the infringer's own responsibility. Relevant compensation disputes can be referred to for reference.Personal injury and medical disputesColumn.

II. Key points of dispute

Focus I: The corresponding relationship between insurance products and losses. Car damage insurance compensates for the damage to the insured vehicle; third-party liability insurance compensates for injuries to third-party individuals and property damage; and vehicle occupant liability insurance compensates for injuries to the insured vehicle's occupants. Losses exceeding the corresponding relationship are not compensated. Focus II: Limits and order of compensation. Compulsory insurance compensates within the limit first, and the insured party compensates for the insured vehicle's occupants. Any remaining shortfall is compensated by commercial third-party liability insurance according to the liability ratio, and any remaining shortfall is borne by the infringer. Focus III: The validity of exemption clauses. Clauses that are not promptly and clearly explained are not effective. Focus IV: Provisions on non-medical insurance drugs. Commercial insurance often stipulates that only drugs covered by medical insurance are compensated, and the validity and interpretation of these provisions are controversial in judicial practice. Focus V: Indirect losses, such as vehicle depreciation losses and operational vehicle downtime losses, are generally not within the scope of compensation or require special agreements. Specific provisions shall be subject to the currently effective laws, regulations, and judicial rulings.

III. Professional analysis by Henglue Lawyers

Based on the practical experience of lawyers from our firm, the disputes over so-called "comprehensive insurance" cases often focus not on whether compensation will be provided, but on which insurance coverage will pay and to what extent. Common scenarios include: car owners mistakenly believing that purchasing comprehensive insurance means everything is covered, only to discover afterward that the coverage for seat insurance is extremely low or that collision damage insurance has not been purchased at all; large-scale personal injury accident compensation exceeding the limits of compulsory insurance and third-party liability insurance, with the excess amount needing to be borne by the victim; insurance companies using clauses such as "out-of-pocket medical expenses" and "non-accident-related direct losses" to reduce compensation, while there may be defects in the clauses' disclosure and explanation; and commercial insurance being entirely excluded in the case of hit-and-run accidents, with compulsory insurance only handling personal injury compensation within the limits. In the judicial practice of Beijing courts, strict scrutiny is applied to the disclosure and explanation obligations of exemption clauses, and a strict distinction is made between direct and indirect losses in determining compensation items. Our lawyers advise that, after an accident, it is essential to immediately verify the coverage provided by the insurance policy and the limits of each insurance type. In the event of disputes over compensation, it is necessary to require the insurance company to provide a detailed explanation of the basis for refusing to pay compensation. Relevant litigation points can be referred to for reference.Personal injury and medical disputesColumn.

IV. Practical suggestions and legal basis

Action suggestions: 1. Report the accident to the insurance company promptly after the incident and preserve the evidence at the scene. Keep the accident determination letter and medical bills. 2. Check the corresponding insurance coverage and limits for each loss item and claim compensation within the limits of the compulsory insurance first. 3. For reasons such as refusing to compensate for out-of-pocket medications and indirect losses, require the insurance company to provide written justifications and review the validity of the clauses. 4. If the compensation exceeds the limits, evaluate the liable party's assets and consider litigation and preservation measures. 5. Provide truthful information when applying for insurance and select appropriate coverage types and amounts based on needs to avoid the misunderstanding of "full coverage". For more details on related claims settlement points, please refer to the relevant materials.Special services and other casesColum. In terms of legal basis, Article 21 and Article 23 of the "Regulations on Compulsory Insurance for Motor Vehicle Traffic Accidents Liability" (amended on March 30, 2012) stipulate the scope and limits of compensation for compulsory insurance; Article 17 of the "Insurance Law of the People's Republic of China" (amended and implemented on April 24, 2015) stipulates the obligation to provide explanations of exemption clauses, and Article 65 stipulates the right of direct recourse in liability insurance; Article 1197 of the "Civil Code of the People's Republic of China" (implemented on January 1, 2021) stipulates the items of compensation for personal injury.

5. Henglu Law Firm's Advice

Risk warning: Firstly, full insurance does not mean full compensation. The limits and exclusion clauses of various insurance types determine the final compensation amount. Secondly, commercial insurance usually excludes coverage for situations such as drunk driving, driving without a license, and hit-and-run. In these cases, the losses will primarily be borne by the infringer, and those involved in criminal activities may also face criminal charges. For more information, please refer to the relevant legal provisions.Criminal defense栏目；第三，医保外用药与间接损失的拒赔理由并非当然成立，应逐项审查；第四，人伤赔偿项目多、周期长，注意三年诉讼时效与伤残评定节点。建议尽早咨询Beijing Henglue Law FirmOn the official website, in the corresponding column, professional lawyers calculate the compensation gap and formulate a plan.

VI. Frequently Asked Questions

Q1: What specific types of insurance are included in "full insurance"?

"Full insurance" is not a legal concept. In business, it usually refers to a combination of compulsory motor vehicle liability insurance, commercial third-party liability insurance, vehicle damage insurance, vehicle occupant liability insurance, scratch damage insurance, and no-fault insurance, etc. The combinations of different insurance policies vary greatly. Compulsory motor vehicle liability insurance is a statutory mandatory insurance, while commercial insurance types are selected by the insured, and the insured amounts are independent of each other. When checking the insurance policy, it is necessary to confirm whether each type of insurance is listed, the limit of the insured amount, and whether there are any deductible provisions. Never assume that any loss can be compensated just because it's called "full insurance".

Q2: In which cases will insurance companies not pay out even if you've purchased full coverage insurance?

Common situations include: drivers driving under the influence of alcohol or drugs, driving without a license, or fleeing the scene after causing an accident, for which commercial insurance is usually exempt from liability; losses caused by intentionally staging an accident are not compensated; indirect losses such as vehicle depreciation and operational downtime are usually not covered by insurance; any portion exceeding the limits of each insurance type must be borne by the insured themselves; exemption clauses that are not promptly and clearly explained to the insured are not enforceable, but the victim or the insured must actively defend and claim their rights. After an accident occurs, the insured should verify the reasons for the denial of compensation and the effectiveness of the clauses one by one.

Q3: Who will bear the part of the compensation that exceeds the insurance limit?

The infringer shall bear the liability for compensation himself. The compensation order is as follows: the compulsory insurance shall first pay within the liability limit, namely 180,000 yuan for death and disability, 18,000 yuan for medical expenses, and 20,000 yuan for property losses; for the insufficient part, the commercial third-party liability insurance shall pay according to the proportion of liability for the accident; if there is still insufficient compensation, the infringer shall bear the liability for compensation according to the provisions of the Civil Code, including medical expenses, loss of working time, nursing care fees, disability compensation and other personal injury items. The liability and financial status of the other party's owner and the insurance company will affect the execution of the judgment, so it is advisable to claim compensation as soon as possible.

Q4: If the other party is fully at fault, will my own insurance cover the damages?

In principle, the other party's compulsory insurance and commercial third-party liability insurance should be paid first, and the insured's vehicle damage insurance and seat insurance can be supplementary. If the insured has purchased vehicle damage insurance, the insurer can first compensate for the vehicle damage according to the contract, and then exercise the right of subrogation to recover the compensation from the other party. This can help repair the vehicle faster. For personal injury and death losses, the insured should mainly claim compensation from the other party and their insurance company. Subrogation does not affect the other party's liability, and it is a common way to improve efficiency in full-liability accidents.

Q5: What items are covered by personal injury accident insurance?

According to Article 1179 of the Civil Code of the People's Republic of China, compensation for personal injury includes reasonable expenses for treatment and rehabilitation, such as medical fees, nursing fees, transportation fees, nutrition fees, and hospitalization subsidies, as well as income lost due to work interruption; for those who suffer from disabilities, there are disability compensation and assistive device fees; for those who die, compensation includes funeral expenses and death compensation. Compulsory motor vehicle liability insurance shall pay compensation within the limit first, and commercial third-party liability insurance shall supplement it according to the proportion of liability. The specific compensation shall be determined based on the liability determination and evidence.

The above Q&A is mainly based on judicial practice in Beijing. There may be differences in the adjudicative opinions in different regions. It is recommended to consult a professional lawyer based on the specific circumstances of the case.

If you are facing similar problems, it is recommended that you consult a professional lawyer as soon as possible with the evidence materials, so as to avoid missing the statutory time limit. →Personal injury legal services·Beijing Henglu Law Firm

Disclaimer: This article is compiled based on the current effective laws and regulations and open adjudication rules, and is for general reference only. It does not constitute a formal legal opinion on specific cases. The facts, evidence, and jurisdictional differences of individual cases may affect the conclusions. If you encounter disputes, please consult a practicing lawyer in time.