保险合同免责条款的法律规制研究

发布时间：2018-03-27 11:36

本文选题：保险合同　切入点：免责条款　出处：《中国海洋大学》2014年硕士论文

【摘要】：保险，是投保人根据合同的约定，向保险人支付保险费，，保险人对于合同约定的可能发生的事故因其发生所造成的财产损失承担赔偿保险金责任，或者当被保险人死亡、伤残、疾病或者达到合同约定的年龄、期限时承担给付保险金责任的交易行为。近年来，为了促使保险交易更加简便、快捷，满足经营者对更高经济效率以及更低交易成本的追求，保险合同已经普遍以格式合同的形式出现。作为保险合同的一个重要组成部分，保险合同免责条款具有兼顾各方利益平衡、防范道德风险等重要积极功能，对保险合同双方具有重要的法律意义。我国对保险合同免责条款进行了法律规制。保险合同免责条款作为保险条款不可分割的内容，需经行政监管部门的审批与备案；保险人在订立保险合同时，应当履行对不保险合同免责条款的提示与明确说明义务；免除保险人依法应承担的义务、加重投保人、被保险人责任以及排除保险相对人依法享有的权利的免责条款应被认定为无效；当保险合同双方对保险合同免责条款的理解产生分歧时，应当首先适用文义解释、目的解释、体系解释以及补充解释等一般合同条款解释方法，在仍无法获得通常理解的时应适用保险合同条款特有的疑义利益解释原则。但是，关于保险合同免责条款的范围、提示与明确说明义务的履行、免责条款的效力认定以及相关条款解释等问题，相关法律规定仍存在较多缺陷，损害了保险公司的信用和形象，致使法院在司法审判中大量同案不同判情形出现。 “实践的混乱直接缘于法律的匿乏与滞后，并根本源于理论的困惑与模糊。”因此，以完善立法为出发点并同时规范和统一行政监管、司法裁判等法律规制行为是非常有必要的。对于我国现行法律体系，应对保险合同免责条款进行明确界定，通过取消一般说明的规定、引入询问说明规则、明确“说明生效”条款的范围、以书面解释及询问说明相结合的方式补充明确说明方法、适当引入冷静犹豫期制度等方面，对保险人提示与明确说明义务的相关规定进行完善，通过改善《保险法》第十九条的条款逻辑、设置疑义利益解释方法的运用规则、科学引入满足合理期待的原则等方面，对免责条款效力认定及内容解释的规定进行完善；对于目前保险合同免责条款的行政监管，应进一步完善行政监管相关法律规定，并进一步加强政府机关行政监管职能的履行与效果；对于目前保险合同免责条款司法审判实践，应当进一步加强保险免责条款案件纠纷中法官自由裁量权运用的合理性，在裁判时法官应加强对典型案例的借鉴意识。此外，还需加强对保险创新产品的知识产权保护。
[Abstract]:Insurance is the payment of insurance premium to the insurer by the policyholder in accordance with the agreement of the contract, and the insurer shall bear the liability for compensation for the property losses caused by the possible accident agreed upon in the contract, or when the insured dies or is disabled, In recent years, in order to make insurance transactions easier and faster and satisfy the operators' pursuit of higher economic efficiency and lower transaction costs, As an important part of the insurance contract, the exemption clause of the insurance contract has the important positive functions of balancing the interests of all parties, preventing moral hazard, and so on. It has important legal significance to both parties of insurance contract. The exemption clause of insurance contract is regulated by law in our country. As an inseparable part of insurance clause, the exemption clause of insurance contract needs to be approved and put on record by the administrative supervision department. The obligation of prompt and clear explanation of the exemption clause of the non-insurance contract shall be fulfilled; the insurer shall be exempted from the obligation according to law and the applicant shall be aggravated, The liability of the insured and the exemption clause which excludes the rights enjoyed by the relative party according to law shall be considered invalid; when there are differences in the understanding of the exemption clause in the insurance contract between the two parties to the insurance contract, the interpretation of the meaning and purpose shall be applied first. The interpretation of general terms of contract, such as system interpretation and supplementary interpretation, should be governed by the principle of interpretation of doubtful interests specific to the terms of the insurance contract when it is still impossible to obtain the usual understanding. However, with regard to the scope of exemption clauses in insurance contracts, There are still many defects in the relevant laws and regulations, such as the performance of the obligation of prompt and clear explanation, the validity of the exemption clause and the interpretation of the relevant clauses, which have damaged the credit and image of the insurance company. As a result, the court in the judicial trial of a large number of concurrent cases of different judgments appear. "the confusion of practice lies directly in the obscurity and lag of the law, and it originates from the confusion and vagueness of the theory." therefore, taking the perfection of legislation as the starting point and standardizing and unifying administrative supervision at the same time, It is very necessary to regulate the behavior by law, such as judicial adjudication. In the current legal system of our country, the exemption clause of insurance contract should be clearly defined, and the rules of inquiry and explanation should be introduced by canceling the provisions of general explanation. To clarify the scope of the "statement of effectiveness" clause, to supplement the clear explanation method by the combination of written explanation and inquiry explanation, to introduce the system of calm and hesitant period appropriately, and to perfect the relevant provisions of the insurer's obligation of prompt and clear explanation. By improving the article logic of Article 19 of the Insurance Law, setting up the rules of application of the interpretation method of doubtful interests, introducing scientifically the principle of meeting reasonable expectations, and so on, the provisions of the validity of exemption clauses and the interpretation of contents are perfected. For the current administrative supervision of exemption clauses in insurance contracts, we should further improve the relevant legal provisions of administrative supervision, and further strengthen the performance and effect of the administrative supervision functions of government organs; for the current judicial trial practice of exemption clauses in insurance contracts, It is necessary to further strengthen the rationality of the use of the judge's discretion in the dispute of insurance exemption clause, and to strengthen the reference consciousness of typical cases in the adjudication. In addition, it is necessary to strengthen the protection of intellectual property rights of insurance innovative products.
【学位授予单位】：中国海洋大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：D922.284;D923.6

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