| Abstract: | 我國保險法自民國18年制定公布迄今已近九十年，即使自民國52年將保險法與保險業法合併為一法，全面修正施行迄今亦已逾四十年。在此期間，保險法雖經多次修正，但主要係針對保險業法部分而為修正，至於保險契約法部分，修正幅度終屬有限。然保險契約法乃規範保險契約權利義務之準繩，在保險事業高度發展之今日，現行保險法有關保險契約之規定，已處處顯露出高度爭議，不僅其作為保險契約權利義務準繩之作用日漸消失，且造成保險契約當事人間理賠糾紛日益增多，已至應立即著手全盤修正之地步。依據委託研究契約，本研究之研究內容涵蓋下列各項，茲予以臚列並提出本研究之解決對策： 1、有關保險契約當事人究以要保人或被保險人為主體？本研究第2章及第3章加以詳細分析，發現我國保險法規定受到英美法系及大陸法系之雙重影響，加上保險實務作法亦不一致，常造成適用上之困擾。為有效解決問題，本研究認為唯有修正保險法始能克竟其功，並提出甲案、乙案及丙案三種修法建議方案，其中以甲案最為可採。 2、關於保險經紀人於保險契約中法律地位為何？本研究第4章加以詳細分析，發現保險經紀人業務多樣化已是實務發展趨勢，且各國在監理上多加強經紀人之責任，以維護交易秩序，爰提出保險法第9條之修正建議條文。 3、關於保險利益相關問題，本研究第6章首先分析保險利益對於所有險種是否均有適用，並認為在現行規定下，應對於所有險種均有適用。其次分別就財產保險及人身保險之保險利益範圍逐一加以檢視是否符合實務需要，進而提出對保險法第14條、第15條、第16條及第20條之修正建議條文。最後則討論保險利益之存在時點，並據以提出保險法第17條之修正建議條文。 4、關於團體保險，主要法律問題包括當事人、保險利益、被保險人列名及同意、受益人等，經本研究比較分析後，認為目前在短期策略上可先修訂團體保險示範條款，即可解決上述問題；俟保險法全面修正時，再增訂團體保險專節規定。 5、關於待記名傷害團體保險，左列各項問題，本研究認為短期策略只須先將「待記名傷害險團體承保辦法」修正為「待記名團體傷害保險示範條款」即可，而長期策略則建議修正保險法。 6、關於複保險規定之適用範圍，大法官釋字第576號解釋雖謂人身保險不適用，然本研究第7章透過理論分析，認為複保險制度源自損失填補原則，故人身保險中性質上屬損失填補性質者仍有適用之可能性。惟理論上並非凡屬損失填補保險，即當然有所適用，仍須進一步探究其保險標的是否得以金錢估計。據此分析，本研究認為人身保險中之信用壽險及限額型失能給付保險仍應適用複保險之規定；至於健康保險與傷害保險中之限額型醫療費用保險，固屬損失填補性質，但因其標的無從估計，應無適用之餘地。據此結論，本研究提出對保險法第35條、第37條及第38條之修正建議條文。 7、關於保險契約內約定其他保險之條款，即為學理上所稱之保險競合。由於現行保險法對此完全未設規定，本研究經由分析後，提出增訂保險法第38條之1 之修正建議。 8、關於保險法第72條及保險法第169條規定，於實務運作上有無窒礙難行之處，本研究第9章分析後認為保險法第72條固無窒礙難行之處，但基於保險標的之價值經常處於波動狀態，承保時查明標的物價值，並無太大實益，爰建議維持原條文規定。至於保險法第169條有關超過部分無效之規定，顯與保險法第76條第1項他方得解除契約之規定相矛盾，鑑於保險法第169條之規定無法有效防範道德危險，爰建議刪除該條文中「除違反部分無效外，」等字樣。 9、關於汽車保險部分，本研究第11章經比較各國制度後，認為短期策略上暫無於保險法中增訂專節規範之必要，僅需修正保險法中之原則性規定，將現行汽車保險單中不合保險學理之處加以修改即可，至於較為細節性、技術性之部分，可以示範條款或基本條款模式（作為審查保單之基準）加以規制。至於長期策略則可規劃於保險法中增訂汽車保險專節加以規範。 10、關於信用保險部分，本研究第12章經比較各國制度後，認為雖信用保險與保證保險有其差異性，但如涉及金錢債權與保險給付之問題，兩者無須於保險法上特別界定其差異性，故於保險法之規範上並無必要加以區分。但於保險契約條款部分，應注意人壽保險契約中以債務人生命身體所投保之「信用壽險」之道德危險之防範。 11、關於保證保險部分，本研究第13章經比較各國制度後，認為修法方向上，應將員工不誠實行為直接由保證保險之定義加以分界，並另以員工誠實保險為規範。 12、經由立法例之比較及保險實務之兼顧，本研究提出之解決方案包括：（1）建議修正保險法第90條，確認責任保險人有協助抗辯及和解之義務，如有違反應負賠償責任。（2）建議修正保險法第93條，賦予保險人有自由選擇是否約定和解同意權條款之權利；將原條文但書修訂為該條第2項，對於有約定和解參與條款之保險人，加重其責任；另增訂該調第3項，對於無約定和解參與條款之保險人，減輕其責任。 13、本研究第15章詳細比較各國制度後，認為為強化申訴制度之功能，以減少訟源，應於保險法中明定申訴調處機構之設立，爰建議增訂保險法條文，賦予申訴制度之法源及申訴決定之法律效力，並授權主管機關訂定作業細則。 14、關於保險法第107條規定對未成年人或心神喪失或精神耗弱之人為被保險人，其死亡給付保險金額是否允當？本研究第8章分析比較各國立法例後，認為道德危險之防範應重於保險業務之開展，故死亡給付完全禁止之規定，仍應維持；至於考慮到此等人之保險需求，例外應容許投保喪葬費用保險，但在理賠方便方面，現行實務上定額給付之作法雖有違反損失填補原則之虞，仍有可取之處，為避免性質上之矛盾，本研究建議修正第107條，將喪葬費用改稱喪葬津貼，並維持授權主管機關訂定限額之規定，以適應社會經濟狀況之變動。 15、關於保險契約究屬要式契約或非要式契約？本研究第5章從中外學說、立法例、保險實務及法院判決等角度切入，詳細比較分析，獲得結論認為除當事人特別約定，夠誠意定要式契約外，原則上保險契約應解釋為不要式契約，始能維護雙方權益，並促進保險事業之發展，從而提出保險法第43條及第44條之修正建議條文。 16、關於是否需先經要保人簽名申請投保，得否採非書面申請投保方式辦理？本研究第5章綜合觀察保險實務運作模式之多元化趨勢，認為申請投保不以採取書面投保方式為必要，以免影響保險業務之發展，而現行保險法亦無相關限制，就此本研究未提出修法建議。此外，本研究另行提出保險契約法未來修法之整體藍圖規劃及歸納出修法建議草案，作為本研究之結論。 The Insurance Act of Republic of China has been enacted for nearly 90 years since 1929. Although it has been revised for several times during this period, most of the revision was regarded to the part of insurance regulation law of this Act and the part of insurance contract law was relatively limited. However, the insurance contract law is the most important tool to decide and balance the rights and duties of the insurance contract parties and the provisions regarding to the insurance contracts of the Insurance Act has caused a lot of controversies fro a long time, it is obvious that the part of insurance contract law of this Act should be revised as soon as possible. The research content required by the research-delegating contract and the solutions submitted by the research team are listed as the following: 1.Regarding to the insurance contract parties, we analyze this issue in Chapter 2 and Chapter 3 and find that the Insurance Act was affected by both civil law system and common law system in its process of adoption and there is inconsistence in the business operation practice. To thoroughly and effectively resolve this issue, the best way is to revise the Insurance Act. There are 3 revision proposals submitted in the research report. 2.Regarding to the legal status of an insurance broker in an insurance contract, we analyze this issue in Chapter 4 and find that it is admitted that the insurance brokers’ business is moving toward multiplication and that the insurance brokers’ responsibility has been enhanced. To resolve this issue, we submit the revision draft of Section 9 of the Insurance Act. 3.Regarding to the insurable interest issues, we analyze them in Chapter 6. At first we discuss whether the provisions on insurable interest in the insurance Act apply to all kinds of insurance and find that the answer is positive at present. And then we examine the insurable interest of life and non-life insurances item by item to see is there any problem in the business operation and submit the revision draft of Sections 14, 15, 16 and 20 of the Insurance Act. Finally we analyze the point of time to decide the existence of insurable interest and submit the revision draft of Sections 17 of the Insurance Act. 4.Regarding to the group insurance issues, we find that in the short term the workable solution is to revise the “Modal Provisions of Group Life Insurance Policy” and in the long term is to revise and add a independent section in the Insurance Act. 5.Regarding to the “To-be-named” group insurance issues, we find that in the short term the workable solution is to revise and transform the “To-be-named Group Insurance Regulation” into the “Modal Provisions of To-be-named Group Life Insurance Policy” and in the long term is to revise and add an independent section in the Insurance Act. 6.Regarding to the application scope of double insurance provisions of the Insurance Act, the Grand Justice has announced an interpretation that they do not apply to life insurances, but after analyzing it in Chapter 7 we find that as the double insurance provisions derive from the principle of indemnity, some kinds of life insurance having the nature of indemnity are still applicable. According to this conclusion, we submit the revision draft of Sections 35 to 38 of the Insurance Act. 7.As to the other insurance we submit the revision draft of adding Section 38-1 of the Insurance Act. 8.Regarding to the provision of Sections 72 and 169 we find in Chapter 9 that there is no difficulty in the practice of operation, but Section 169 is inconsistent with Section 76. It is admitted that the effectiveness of Section 169 to the prevention of moral hazard is not enough, we submit the revision draft of that Section of the Insurance Act. 9.Regarding to the Automobile insurance, after comparing the systems among some major countries, we find in Chapter 11 that in the short term the workable solution is to revise the related policies and in the long term s to revise and add an independent section in the Insurance Act. 10.Regarding to the Credit insurance, after comparing the systems among some major countries, we find in Chapter 12 that even though there are some differences between Credit insurance and Surety and Fidelity insurances, they are almost the same and, therefore, it is no need to differ each other. And in the short term the workable solution is to revise the related policies and in the long term to revise and add an independent section in the Insurance Act. 11.Regarding to the Surety and Fidelity insurances, after comparing the systems among some major countries, we find in Chapter 13 that to distinguish the Surety insurance from the Fidelity insurance and then set up an independent section for the Fidelity insurance in the Insurance Act should be the right road to the revision of the Act. 12.After both comparing the systems among some major countries and considering the practical operation, We submit 2 solutions in Chapter 10: (a) We suggest that the Section 90 be revised to ascertain they are the Insurers’ duties to assist the Insured in defending the claim and to assist the Insured in compromising with the Victim. (b) We suggest that the Section 93 be revised to give the Insurers a choice right to decide whether to incorporate a “taking-part-in” clause in the policies or not. 13.After comparing the insurance complaints systems among some major countries in Chapter 15, we find that it is necessary to establish an insurance complaints system in the Insurance Act and, therefore, we suggest the Insurance Act be revised and the Regulation be enacted 14.Regarding to Section 107, we compare the systems of major countries in Chapter 8 and submit a revision draft. 15.Regarding to the formality of an insurance contract, after comparing from the viewpoints of theories, other countries’ legal systems, insurance practice and courts judgments, we find in Chapter 5 that an insurance contract is not a formal contract except stipulated otherwise in a clause of a policy. Based on this viewpoint we submit a revision draft of Sections 43 and 44 of the Act. 16.Regarding to the issue of the written application, we find that to avoid the interfere of doing business of the insurance industries there is no need to provide that the engagement of an insurance contract through a written application is the only modal. |
