意外傷害保險事故中舉證責任分配之發展新趨勢

Abstract

我國保險法第131條第2項規定：「前項意外傷害，指非由疾病引起之外來突發事故所致者。」而我國保險法學者認為意外傷害事故包含「外來性」、「突發性」及「非自願性」等要件，惟就意外傷害事故究竟採何種因果關係加以認定則付之闕如，故學說及實務較常加以論述及援用者包括「相當因果關係說」及「主力近因原則」。此外，意外傷害事故之舉證責任究竟應如何分配，由於我國學說上通說係採「規範說」，即主張權利存在之人，應就權利發生之法律要件存在之事實為舉證;否認權利存在之人，應就權利妨害法律要件、權利消滅法律要件或權利受制法律要件負舉證責任。\n本文擬先就本文擬從保險法第131條「意外傷害事故」之規範要件出發，再論述「意外傷害事故」因果關係之認定，並說明民事訴訟法有關「舉證責任」分配之法理，檢視現行學說及各級法院近10年來之實務見解對於有關「意外傷害事故」舉證責任是否妥適，最後嘗試提出「意外傷害事故」舉證責任分配之發展新趨勢。

Article 131, Item 2 of the Insurance Act stipulates:「The term "injury by accident" as used in the preceding paragraph refers to physical harm caused by unforeseen external events other than illness.」The doctrine of insurance act advocates that "injury by accident" include "externality"、"bursty" and "involuntary" , and there are no criterions about which causation of injury by accident should be applicable. The doctrines and the judgments are more frequently discussed " The Adequate Cause Theory " and " The Proximate Cause ". As for the distribution of the burden of proof of injury by accident, the doctrines are based on the "The Normative Theory", that is, the person who claims the existence of rights, the fact that the legal elements of the right to exist should be proved ; the person who denies the existence of rights, the burden of proof shall be borne by the right to impede the legal elements, the rights to eliminate the legal elements or the legal elements of the rights.\nThis paper intends to start from the norm of the "injury by accident" form Article 131 of the Insurance Act, and then discusses the determination of the causal relationship of "injury by accident", and explains the legal basis of the" Burden of proof " in the Civil Procedure Act, and examines the current doctrine. And the judgments at all levels in the past 10 years have been appropriate for the burden of proof of "injury by accident", and finally try to put forward a new development trend of the allocation of burden of proof of "injury by accident".