【裁判要旨】医疗机构在与患者就民事责任自行协商并达成赔偿协议履行完毕后,据此向承保的保险公司提出医疗责任保险理赔申请,保险公司以医院违反保险合同条款为由拒绝赔付导致双方发生争议的,法院应具体审查保险合同的相关条款与赔付责任之间的关系以及保险合同条款自身的正当性与可行性,以确认其效力。 The main purpose of the referee medical institutions in consultation with patients on civil liability and reached a compensation agreement after the completion of the implementation, pursuant to the insurance company underwriting medical liability insurance claims, the insurance company to breach of contract terms of insurance refusal to pay the two sides In case of dispute, the court shall examine in detail the relationship between the relevant clauses of the insurance contract and the liability to pay and the legitimacy and feasibility of the terms of the insurance contract in order to confirm its validity.