保險人風險調查義務之研究

Abstract

保險法所制定告知義務濫觴於海上保險時代，當時保險標的之風險估計困難，必須藉由被保險人告知義務作為單一且唯一之核保基礎，以解決契約雙方之資訊不對等，惟現今科技進步，保險人風險估計技術逐漸提升，管道亦多樣化，保險人之資訊弱勢不若以往，得否單方面主張告知義務違反之權利，解除保險契約，逐漸受到質疑，尤其訴訟中被保險人開始以保險人未為風險調查，甚至是保險業務員亦有告知妨害行為介入為由，作為解除權阻卻之障礙抗辯，從而本文擬以保險人風險調查義務作為研究中心，以該調查義務與被保險人告知義務之關係開展，探討風險調查義務之建立必要。由於保險法基本原則為最大善意原則及對價平衡原則，甚至是消費者保護理論，本文將以上述原則作為風險調查義務之基礎。\n目前我國關於保險人風險調查義務之依據多於保險法第62條有所提及，然該條得否作為風險調查義務之依據產生疑義，從而本文將透過禁反言原則作為解釋方法，於現行法架構下闡釋保險人風險義務如何作為告知義務解除權障礙抗辯之事由。\n此外，為避免風險調查義務之存在大幅增加保險人經營成本，並轉嫁於全體保險消費者，風險調查義務之內容即風險調查之範圍必須有所界定，由於美國法對於保險人風險調查義務已有所著墨，本文將藉由美國法判例所形成見解，介紹風險調查義務之內容；就保險人積極告知妨害行為，則以日本法作為借鑒，作為我國未來立法之參考。

This thesis is aimed to examine the duty of disclosure of insured. As known that the duty to disclosure imposed to the insured was established from the era of marine insurance. It was because at that time it was hard for the insurer to estimate the risk of the subject matter insured, through the duty of disclosure of the insured, it could reduce the disadvantages of information asymmetry. However, during the past decades, the background of marine insurance and the relationship between the insurer and the insured have been changed rapidly; therefore, it’s time to observe the duty of disclosure of the insured especially from the aspect of insurer’s duties. Hence, this thesis will try to establish the insurer’s duty to investigate and its legal effect when the duty was breached, and also to deal with issues related to Insurance Act Article 62. For comprehensively solving issues of the insurers’ acts of intentional or gross negligence, it should be noted that this thesis was focused on the issues including but not limited to the situations when the insurers inactively breach the duty to investigate, but also the situations when insurers actively intervenes the duty of disclosure of insured.