论医疗责任保险人的抗辩义务

发布时间：2018-12-30 13:19

【摘要】：我国的医疗责任保险仅能起到将部分赔付事宜转移给医疗责任保险人的作用,但与患者谈判、解决医疗纠纷等真正使医疗服务提供者困扰的问题仍然存在。保险人无须承担抗辩义务的医疗责任保险是一个在设计上就有先天缺陷的半拉子诉讼保险。应将抗辩义务规定为医疗责任保险人的法定义务;以诉状内容为主、诉讼事实为辅的折中标准来判断抗辩义务之有无;明确被保险人为抗辩律师的实质委托人来解决律师保密义务的利益冲突、以聘任独立律师的机制解决保险人在权力保留抗辩中的利益冲突及以荣誉条款来解决是否与患者和解的利益冲突问题。最后,规定保险人在违反抗辩义务时的赔偿责任,尤其当保险人故意或重大过失而违反抗辩义务时,应承担精神损害赔偿责任。
[Abstract]:The medical liability insurance of our country can only play the role of transferring part of the indemnity to the medical liability insurer, but there are still some problems that really bother the medical service providers, such as negotiating with the patients and resolving the medical disputes. The medical liability insurance which the insurer does not have to undertake the defense obligation is a half-scale litigation insurance with congenital defects in design. The defense obligation should be defined as the legal obligation of the medical liability insurer, and the compromise standard of the contents of the pleadings and the fact of litigation should be used to judge whether the defense obligation exists or not. It is clear that the insured is the substantive client of the defense lawyer to resolve the conflict of interest of the lawyer's duty of confidentiality, To solve the conflicts of interest of the insurer in the defense of reserve of power by the mechanism of appointment of independent lawyers and to resolve the conflict of interest between the insurer and the patient by honor clause. Finally, it is stipulated that the insurer should be liable for moral damage when violating the defense obligation, especially when the insurer violates the defense obligation on purpose or gross negligence.
【作者单位】：广州医科大学;
【基金】：2015年度教育部人文社会科学研究一般项目《医疗责任强制保险制度研究》(15YJCZH193) 2016年广东省优秀青年教师培养计划项目《医疗纠纷预防与处理法律制度研究》(YQ2015131) 广州医科大学2014年度校级科研项目《医疗责任强制保险制度研究》(2014C17) 广东省哲学社会科学“十二五”规划课题2015年学科共建项目《医疗侵权法律适用实践研究》(GD15XGL35)的阶段成果
【分类号】：D912.28

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