点击上图▲订阅会员 本期内容节选自《细读商业经典》读书会员课，这期课程由陈凤山老师解读 《Delay,Deny,Defend》，登录吴晓波频道APP，可收看完整内容。 【点击订阅】 整理 / 巴九灵（微信公众号：吴晓波频道） 2024 年 12 月 4日 ，美国最大的医疗保险公司——联合健康保险公司的首席执行官，在曼哈顿的希尔顿酒店外被人枪杀，马上成为全美国热点 事件。 警察在收集现场的证据时，发现现场有遗落的弹壳，上边有三个英文： delay , deny , depose 。 目前这个事件的调查还未结束，因此未有官方结论。 3 个 D 开头的英文到底什么意思？ ◎ 第一个单词， Delay 。 Delay 本身的意思就是延迟、延误。 放到本书应该理解成"保险公司在理赔时故意拖延"。 书中有一个案例，一个叫 Price 的人在工作中受伤后，向保险公司申请理赔。保险公司一开始就跟他要材料，而且反复要，要过的再要，之后让 他配合做检查。 但检查完，当price催促它处理时，它总是以正在调查中来拖延。 这一拖就拖了 10 年。 但综合各种信息，方方面面都指向了两个字：拒赔。 据统计，联合健康保险公司的拒赔率是 3 ...

Core Viewpoint - The Beijing Financial Court has held a press conference to introduce the case handling situation regarding the insurance rights of new economy workers, highlighting eight typical cases that address the complexities and challenges in ensuring these rights in the rapidly evolving gig economy [1][2]. Group 1: Identification of Actual Insured Parties - The court clarified the rules for identifying actual insured parties in new economy insurance, emphasizing the complexity of insurance contracts due to multiple subcontracting and extended transaction chains [2]. - A case involving a dispute between an insurance company and a rider demonstrated the application of "penetrating" judgment to identify the rider as the actual insured party, resulting in a compensation of 600,000 yuan to the rider's legal heirs [2][3]. Group 2: Clarification of Responsibilities and Insurance Types - The court addressed the relationship between new occupational injury insurance and commercial insurance, confirming that new economy workers can claim compensation from both types of insurance [3]. - In another case, it was established that employees could still claim compensation from group accident insurance even after the employer fulfilled their civil liability, thereby protecting workers' rights [3]. Group 3: Insurance Company Practices - The court criticized insurance companies for their "easy entry, strict exit" practices and formalistic underwriting behaviors, ruling that insurers cannot void contracts based on the insured's occupation if they waived underwriting [3][4]. - This ruling aims to encourage the insurance industry to strengthen integrity and operate in a more standardized manner [3]. Group 4: Protection of Insurance Interests - The court recognized the insurance interests of insured parties in cases of "mixed employment" among related companies, which complicates the identification of actual employment relationships [4]. - The court also clarified the relationship between employer liability insurance and additional 24-hour accident insurance, stating that claims should be based on the primary insurance's liability conditions [4]. Group 5: Review of Insurance Clauses - The court emphasized the need for strict examination of special clauses in insurance policies that limit coverage, ensuring that such clauses are mutually agreed upon [4]. - This move aims to promote transparency in insurance terms and prevent insurers from evading responsibilities under the guise of special agreements [4]. Group 6: Application of Causation Principles - The court explained the application of the "proximate cause principle" in cases of refusal to pay due to unlicensed driving, stating that insurers cannot deny claims if the cause of the accident is not directly related to the exempted behavior [5][6]. - This clarification provides a legal framework for similar cases, requiring insurers to meet both formal validity and substantial relevance criteria when applying exemption clauses [6]. Group 7: Overall Impact - The release of these typical cases reflects the Beijing Financial Court's commitment to protecting the insurance rights of new economy workers and promoting high-quality development in the new economy [6].