從我國法院判決論理財型人壽保險招攬糾紛之類型、特徵與解決之道

Abstract

理財目前是熱門議題，而相較於銀行、證劵業者，保險公司所提供之保險商品在理財服務領域上，也佔有很大之比例。從保險統計資料中發現，非理賠爭議案件申訴比率已逐漸超越理賠爭議案件；而非理賠爭議類型中，以保險招攬糾紛所占之比率最高；而若以招攬糾紛中的險種分類，又以投資型保險招攬糾紛最常見。本研究從我國法院實務判決中分析，發現不論是傳統保險商品、抑或投資型保險商品，均可能發生因為保險公司訴求投資理財而發生保險招攬糾紛。若以糾紛事實區別，要保人主張可分為:1.不知道買的商品是保險2.不知道買的商品是投資型保險3.保證保本或是報酬率爭議4.對於投資型保險之費用收取有爭議。 實務上常見之保險招攬法律爭議類型中，當事人之主張可分類為:1.要保人係受詐欺而為意思表示2.保險人之不當招攬係違反保護他人之法律3.投資型保險附加費用之條款對要保人顯失公平。然而因為要保人舉證困難，受詐欺之主張難以成立；再加上法院對於「違反保護他人之法律」要件認定尚未統一，要保人權益也無法有效確保。 本研究發現，學說或外國立法例上有關金融商品銷售行為規範中之適合性原則與說明義務，其實已經散見於我國各種法令中，只是未有統一規範。而我國金融服務業法草案已經針對金融商品銷售與保險招攬建立統一之行為規範，實值肯定。但是草案中關於金融服務業者違反適合性原則時，並無民事責任之規定，為免將來適用法律之爭議，本研究建議將違反適合性原則之業者明文課以推定過失責任，較可保護要保人權益，在法律體系上也可以與民法第一八四條第二項違反保護他人之法律互相銜接。然於草案通過前，希望可以先將適合性原則與說明義務全面納入保險招攬之行為規範，修正保險業務員管理規則以及保險經紀人管理規則，以提升保險招攬之品質。

Wealth management or asset allocation is a hot topic in recent years. Besides banks and security companies, insurance companies also deliver financial service to consumers by insurance products. It showed that non-claim dispute cases grew much more in numbers than claim dispute cases in government statistics. We also found that there are many insurance legal dispute cases both in traditional life insurance and unit-linked insurance products. This thesis divided insurance dispute into four types:1.The policy holder had no idea of buying a life insurance product 2.The policy holder had no idea of buying an unit-linked insurance product 3.Guarantee dispute in protection of investment principal or rate of return 4.Service charge dispute in unit-linked insurance product. Based on recent court decisions, the thesis divided legal dispute into three types: 1.fraud 2. The salesman violated paragraph 2 of Article 184,civil code, a statutory provision enacted for the protection of others and therefore prejudice to others 3. The terms and conditions in standard contracts violated the principle of good faith and are conspicuously unfair to consumers. In the study we found that the policy holders suffered the burden of proof and it’s hard to persuade the court in fraud cases. Furthermore, the court still didn’t have same decisions when the policy holder argued that the salesman violated paragraph 2 of Article 184, civil code. About the solution, first, we suggest that legislators should apply the concept of “Suitability” and “Disclosure” to the regulation of conduct of insurance service. Second, in the Draft of Financial Service Act, we suggest that financial service companies violate the rules of “Suitability” will be a prima facie evidence for the damage of consumers in order to protect policy holders and therefore deliver better insurance service to consumers.