机动车辆理赔过程中定损问题研究

发布时间：2019-05-07 03:03

【摘要】：随着我国机动车保有量不断增长，路况日益复杂，交通日益拥挤，交通事故随之增加，因此越来越多的车主选择购买商业车险。车辆定损是机动车辆理赔程序中非常关键的一个环节。车辆定损，是保险评估机构对事故车辆的现存价值和修理项目、方式及费用等做出评估和鉴定，并基于此保险人决定赔偿金额的行为。实务由于定损权归属不明导致当事人争议频发，因此解决此类问题实属必要。本文除引言外，正文共分五章。第一章是对两个典型案例的案情介绍，，案例一是被保险人未与保险公司协商径行维修或评估的情况；案例二是保险公司定损后被保险人认为定损金额偏低而自行委托评估或维修、保险公司拒赔的情况。第二章主要是案件的争议和焦点分析，争议焦点是保险当事人如何选择保险评估机构，产生这一纠纷的根本原因在于保险当事人对于各自在保险理赔定损中的权利义务还处于“剪不清理还乱”的混乱当中。另外，定损机构做出相互矛盾的评估报告时当事人各执一词，互不认可。究竟如何决定理赔依据，是解决问题的难点之处。第三是文章的核心和重点，将全面分析案件中存在的法律关系，一方面，文章从保险合同法的角度，全面剖析保险理赔程序中的双方权利义务，进而理清双方如何选择定损机构这个问题，这也是本文的一个特色，因为很少有理论研究详细探讨理赔过程中的保险当事人的权利义务；另一方面，从保险评估机构的角度，对不同类型的定损机构做了分析，尝试着引入第三方保险公估机构定损的制度。第四章，首先本文将本着平衡保护保险合同双方权利的角度，给出关于案件的审理意见。其次本文将针对目前车辆理赔过程中定损纠纷居高不下的问题提出立法建议和制度完善，体现了本文对实务中问题的看法，从三个角度展开：（一）保险合同当事人方面，规范车险合同格式条款的解释说明义务、明确协商确定评估机构的原则，对于弥补相应的法律上的空白、解决保赔双方纠纷提供了一个可行的途径；（二）保险评估机构方面，有必要修改现保险法第五章，明确其保险中介机构的法律地位，并将其作为保险理赔的第三方评估机构，这也是本文的制度创新之处；（三）保险消费者方面，提高投保人或被保险人的法律意识，培养他们对保险市场的全面、理性认识。而指定修理厂险附加险的推广可以满足投保人专业维修点维修的需要。
[Abstract]:With the increasing number of motor vehicles in our country, the road conditions are becoming more and more complex, traffic is increasingly crowded, and traffic accidents are increasing, so more and more car owners choose to buy commercial car insurance. Vehicle damage determination is a very important link in the process of motor vehicle compensation settlement. Vehicle damage is an act in which the insurance evaluation institution evaluates and appraises the existing value, repair items, ways and costs of the accident vehicle, and determines the amount of compensation based on this insurer. Due to the unclear attribution of the right of damages, the disputes of the parties are frequent, so it is necessary to solve this kind of problems. In addition to the introduction, the text is divided into five chapters. The first chapter is the case of two typical cases, the first case is the insured did not negotiate with the insurance company to repair or assess the situation; The second case is the insurance company after the insured thinks the fixed loss amount is on the low side and entrusts the assessment or the maintenance on its own, the insurance company refuses to compensate. The second chapter is mainly about the dispute and focus analysis of the case. The focus of the dispute is how the insurance parties choose the insurance evaluation institution. The fundamental reason for this dispute is that the rights and obligations of the insurance parties in the insurance claim settlement are still in the confusion of "clean-up or disorderly". In addition, the decision-making agency makes conflicting assessment reports when the parties adhere to each other, do not agree with each other. How to decide the basis of claim settlement is the difficult point to solve the problem. The third is the core and focus of the article, which will comprehensively analyze the legal relationship existing in the case. On the one hand, the article comprehensively analyzes the rights and obligations of both parties in the insurance claims settlement procedure from the perspective of the insurance contract law. This is also a characteristic of this paper, because there are few theoretical studies on the rights and obligations of the insurance parties in the process of settlement of claims; On the other hand, from the point of view of insurance evaluation institution, this paper analyzes the different types of loss determination mechanism, and tries to introduce the third-party insurance evaluation institution loss determination system. In the fourth chapter, this paper first of all, in the light of the balance of the protection of the rights of both sides of the insurance contract, gives the opinions on the trial of the case. Secondly, this paper will put forward legislative suggestions and perfect system in view of the problem of high loss dispute in the process of vehicle claims settlement, which reflects the view of this article on the problems in practice, starting from three angles: (1) the parties to insurance contracts, the parties to the insurance contract, and the parties to the insurance contract. Standardizing the obligation of explanation and explanation of the form clauses of automobile insurance contract and clearly determining the principle of evaluation organization through consultation provide a feasible way to fill the corresponding legal gap and solve the dispute between the two sides of insurance and indemnity. (2) in the aspect of insurance evaluation institution, it is necessary to amend the fifth chapter of the current insurance law to clarify the legal status of its insurance intermediary, and to regard it as a third-party evaluation institution for insurance claims, which is also the institutional innovation of this article; (3) in the aspect of insurance consumers, raise the legal consciousness of the insured or insured and cultivate their comprehensive and rational understanding of the insurance market. The promotion of additional risks of designated repair plant insurance can meet the needs of professional maintenance points for policy holders.
【学位授予单位】：华东政法大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：D922.284

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