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http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/22005
標題: | 論責任保險人處理賠案之義務群建構與違反效果 A Study on the Liability Insurers’ Duties concerning Claims Handling and the Effects |
作者: | Yun-Zhu Hong 洪韻筑 |
指導教授: | 汪信君 |
關鍵字: | 任意責任保險,損害填補功能,權利保護功能,處理賠案義務,調查義務,通知義務,適當和解義務,抗辯義務,補償義務, Liability Insurance,Function of Indemnity,Function of Right-protection,Duty to Process the Claims,Good Faith, |
出版年 : | 2018 |
學位: | 碩士 |
摘要: | 自危險事故發生後,且為責任保險人所獲悉開始,案件即進入賠案處理程序,又責任保險人如何處理賠案,於此過程中負有何等義務,攸關被保險人權益甚鉅。有鑑於責任保險人與被保險人間存有難以消弭的利益衝突問題,實難期待保險人會如同對待己身之利益般地公平關照被保險人之利益,且於保險實務中,保險人乃挾其龐大資力與豐沛的法律資源與一般要保人訂約,雙方之經濟、智識、資訊條件均不對等,而此地位不對等之情形不僅在締約時發生,亦持續於後續之履約過程中,故在賠案處理過程中,被保險人之權益如何受到妥適保障,乃本文亟欲關切之所在。
觀諸現行保險法對責任保險人賠案義務之規範,在設計上確實有所不足,蓋從責任保險之客觀保護功能以觀,除「損害填補功能」外,其亦具有「權利保護功能」,即藉由保險人之給付,幫助被保險人回復至未受第三人請求前之狀態,換言之,保險人應負有協助被保險人脫免或減輕對第三人之賠償責任之義務。又損害填補功能乃對應至保險人之給付保險金責任(又稱為補償義務),此於保險法第90條已有明文;惟權利保護功能之落實,則有賴另行課予保險人事案調查、通知、適當和解及抗辯義務,此為現行法所付之闕如。 基於保險契約亦為債法上契約之一種,故本文嘗試以民法債之關係義務群理論,作為擴張責任保險人處理賠案義務類型的根據,從而確認其除依法負有補償之主給付義務外,基於誠信原則之法理,亦應負有事案調查、抗辯、適當和解之從給付義務,以及適時通知被保險人之附隨義務。而本篇除探討以上五種義務之具體內涵,亦將研析倘若保險人違反此些義務,被保險人應基於何種請求權基礎求償,及其得請求損害賠償範圍為何之議題。 This thesis is aimed at determining the legal basis and contents of the liability insurer’s duty to process the claims. It is clear that the insurer’s decision regarding the claims, such as whether to settle or to try the case, exerts a great impact on the insured’s rights and interests. Furthermore, there are irreconcilable conflicts of interest between the insured and the insurer, who possesses abundant funds and professionals that provide predominant bargaining power over the insured. As a result, this thesis holds it is of great importance to make sure the insurer treats the insured fairly, at least to give the insured an equal footing on the process of claims operations. However, Insurance Act provides inadequate protection for the insured of liability insurance. According to insurance theory, liability insurance contains two functions. One is the function of indemnity, which requires the insurer to indemnify against insured perils;the other is the function of right-protection, which mandates the insurer to assist his insured with minimizing the liability to the third party. Although the function of indemnity is enshrined in Article 90 of Insurance Act, the function of right-protection has not yet been regulated by Insurance Act. In order to bring the function of right-protection into practice, this thesis proposes four duties on the liability insurer to be included in the law. They are the duty of investigation, the duty of notice, the duty of settlement and the duty of defense. In addition to Insurance Act, Civil Code is applicable to insurance contracts and the insurer’s main obligation to provide indemnification is also well established under Civil Code. This thesis, therefore, applies the general contract law under Civil Code to determine the legal basis and contents of the liability insurer’s duty in claim procedure. The findings conclude the insurer is obligated to honor the rule of good faith enshrined in Civil Code by fulfilling his accessory obligation and collateral obligation under insurance contracts. Upon the occurrence of insured perils, the insurer has duties to settle cases in a suitable manner, to investigate the incidents and to raise defenses accordingly subject to his accessory obligation; he also has a duty to notify the insured of claims operations subject to his collateral obligation. This thesis examines the characteristics, contents, and major legal issues related to the above-mentioned duties, and it further extends its discussion to the calculations of damages upon any breach of the duties. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/22005 |
DOI: | 10.6342/NTU201802298 |
全文授權: | 未授權 |
顯示於系所單位: | 法律學系 |
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