保险人说明义务的理论与实务探析

发布时间：2018-02-09 17:51

本文关键词： 保险人说明义务理论实务　出处：《华东政法大学》2012年硕士论文　论文类型：学位论文

【摘要】：保险人的说明义务自1995年我国《保险法》诞生之日起，便是学界一直研究的课题。至今已经过去17年，但是这个问题依然还在讨论中。实务中的主要问题是说明义务缺乏可操作性的评判标准，导致保险业务中的大量纠纷，重创了保险业在广大人民群众心目中的应有的形象。有鉴于此，笔者通过大量资料的整理研究，试图提出一些现行说明义务的完善意见。本硕士论文由三个部分组成。第一部分：介绍保险人说明义务的定义、特征、国内外此项法律制度的历史沿革，以及与投保人告知义务的异同之处。第二部分：阐述了保险人说明义务的法理基础。首先，说明义务的法律基础源于民法的霸王条款即最大诚实信用原则。其次，由于保险合同的格式条款在保险业的广泛运用，合同法中的格式条款理论为说明义务提供了依据。最后，保险相对民众的知识水平，具有天生的专业性、复杂性，故经济学中的信息不对称理论也在法学学科中为保险人说明义务提供了理论支持。第三部分：此部分是本文的重点内容。分别从六个方面审视了实践中的问题及提出完善建议。第一方面：说明义务的履行主体。对保险人及其员工、保险代理人、保险经纪人提出不同的履行说明义务的要求。第二方面：说明义务履行的时间和对象。时间上，说明义务履行的是先合同义务。对象上，保险人说明的对象应为投保人或其代理人，而非被保险人。第三方面：说明义务的范围。将保险合同条款分为四类，分类提出了履行说明义务的不同标准，，并总结了实务中说明义务的八大问题，提出自己的浅显意见。第四方面：说明义务的履行标准。对形式标准与实质标准进行了一一阐述。本文支持实质标准中的“修正的一般标准”作为说明义务的履行标准。第五方面：说明义务的履行方式。“说明”与“明确说明”在操作中很难做明确区分。应推行不同条款不同说明标准的分层机制即：“免除保险人责任条款”执行“保险人提示规则+保险人主动说明规则”；“一般保险条款的说明义务”执行“保险人提示规则+投保人主动询问说明规则”。第六方面：违反说明义务的法律后果。其法律后果有不发生效力和解除合同两种观点。我国采用不发生效力说，笔者认为需依照具体案情而定，不能一概而论。
[Abstract]:Since the birth of the Insurance Law in 1995, the insurer's obligation of explanation has been the subject of academic research. However, this issue is still under discussion. The main problem in practice is the lack of operational criteria for the evaluation of obligations, which leads to a large number of disputes in insurance business. In view of this, the author tries to put forward some suggestions on the perfection of the present explanation obligation through the collation and study of a large number of materials. This thesis consists of three parts. The first part introduces the definition and characteristics of the insurer's obligation to explain, the historical evolution of the legal system at home and abroad, and the similarities and differences between the insurer and the policyholder. The second part expounds the legal basis of the insurer's obligation of explanation. Firstly, the legal basis of the obligation of explanation originates from the principle of maximum good faith in civil law. Secondly, due to the widespread application of the form clause of insurance contract in the insurance industry, The theory of format clause in contract law provides the basis for explaining the obligation. Finally, the level of knowledge of insurance in relation to the public is inherently professional and complex. Therefore, the theory of information asymmetry in economics also provides theoretical support for the insurer's obligation of explanation in the subject of law. The third part: this part is the main content of this paper. It examines the problems in practice from six aspects and puts forward some suggestions. The first aspect: the main body of performance of the obligation. The insurer and its employees, insurance agents, insurance agents, insurance brokers put forward different requirements for the performance of the obligation. The second aspect: explain the time and object of performing the obligation. In time, it is the prior contract obligation to show the obligation to perform. On the object, the object of the insurer's explanation should be the policyholder or its agent, but not the insured. The third aspect: expounding the scope of obligation. The article of insurance contract is divided into four categories, which puts forward the different standards of fulfilling the obligation of explanation, summarizes the eight problems of explaining obligation in practice, and puts forward its own simple opinions. Aspect 4th: the standard of performance of the obligation of explanation. The formal standard and the standard of substance are expounded one by one. This paper supports the "modified general standard" in the substantive standard as the standard of performance of the obligation of explanation. Aspect 5th: the manner in which the obligation is to be fulfilled. It is difficult to make a clear distinction between the "description" and the "clear description" in operation. A hierarchical mechanism with different specifications and standards should be implemented, namely, "exemption from insurer liability clause" "the insurer prompts the rule the insurer takes the initiative to explain the rule"; "the general insurance clause's explanation duty" carries out "the insurer prompts the rule the policy-holder to inquire the explanation rule". 6th aspects: the legal consequences of breach of the obligation of explanation. There are two views on the legal consequences of the breach of the obligation of explanation: no effect and rescission of the contract. In our country, the theory of no effect is adopted, the author thinks that it should be decided according to the specific circumstances of the case, and can not be generalized.
【学位授予单位】：华东政法大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：D922.284

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