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題名：美國法上保險人處理賠案之義務--兼評我國保險法之相關規定
書刊名：輔仁法學
作者：李志峰 引用關係
作者(外文)：Lee, Derek
出版日期：2013
卷期：46
頁次：頁153-264
主題關鍵詞：第一人保險；第三人保險；誠信善意與公平交易默示協定；信賴義務；處理賠案義務；調查義務；惡意行為；惡意侵權行為請求權；First-party insurance；Third-party insurance；Implied Covenant of Good Faith and Fair Dealing；Fiduciary duty；Duty to process the claims；Duty to investigate；Bad faith；Bad faith tort cause of action
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  • 被引用次數被引用次數:期刊(7) 博士論文(0) 專書(0) 專書論文(0)
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  • 共同引用共同引用:131
  • 點閱點閱:263
現代保險之目的，已從單純的損失填補轉化為對於被保險人財務安全與心境安寧之保障，欲達到此目的，則在危險事故發生後，保險人對於被保險人請求保險給付時，應予以妥善之處理。保險為最大誠信契約，契約雙方當事人於履行保險契約之時，不得為取得契約上之利益而做出有害他方當事人之行為。在被保險人提出理賠時，多處於財務上之弱勢地位，保險人能否妥善處理，關乎被保險人既有之事業能否儘速恢復而免於倒閉及對受害第三人之責任能否控制在一定範圍內。所以，被保險人向保險人告知賠案發生時，秉持誠信善意原則之保險人，為被保險人處理所遭遇之損失與面臨第三人之責任關係訴訟，應如同處理自己事務一般，如此，保險始能依被保險人之期待，真正發揮其保障被保險人心境安寧並具社會安定之功能。美國為全球保險最為發達的國家之一，各州法院於近百年間已將學者發展之相關理論，作為判決基礎而實際運用於司法實務中，並藉以建構保險契約當事人間義務之法律內涵；保險人亦對法院所採之見解對相關行為及契約條款作出調整，使其符合法令之內涵。本文以美國法制發展為立論重心，探討保險人處理賠案義務之性質、內涵、最新發展與改革。最後，剖析我國現況與缺失，參酌美國學說與實務見解，提出相關建建議，期能成為立法機關與相關單位之參考。
The purpose of modern insurance is transformed from indemnification against actual out-of-pocket loss to providing the insured with financial security and peace of mind. In order to achieve the aforesaid purpose, the insurer should appropriately process the claims submitted by the insured after the loss occurred. Insurance contract is contract of good faith and neither of the contractual parties should not do anything which will injure the right of the other to receive the benefits of the agreement when they implement the contract. The insured is vulnerable in finance when the claim is submitted and the claim-handling by the insurer is related to that if the insured's business can recover from the suffering and prevent from being into bankruptcy and the liability to the injured third party can be limited to some level. Thus, when the insured gives the notice of claims to the insurer, the latter should give the former's interests consideration equal to its own in the process of handling the claim. As a result, insurer can bring the peace of mind to the insured as the latter's expectation and achieve the function of social stability.The United State is one of the blooming markets in the world and the state courts have adjudged the insurance case based on the scholar's theories in the recent hundred years and established the legal contents of the contractual parties' duties. Afterwards, the insurer revises the related provisions in the insurance contract and adjusts the conducts to conform to the regulations in accordance with the court's opinions. This paper will focus on the development in the United States, to examine the characteristics, contents, the latest development and reform relevant to the insurer's duty to process the claims. In conclusion, this paper will analyze the current legislative conditions and policy clauses in Taiwan and presents the suggestions for legislation and amendments in Taiwan's policy clause with references to the regulations and judicial precedents in the United States.
期刊論文
1.李志峰(20121200)。論責任保險人和解義務之內涵--以美國法的發展為論述中心。輔仁法學，44，235-286。new window  延伸查詢new window
2.劉宗榮(20110500)。論保險人無正當理由拒絕同意被保險人與第三人和解--評臺南高分院九十七年度保險易上字第七號判決。月旦法學，192，166-177。new window  延伸查詢new window
3.施文森(20100700)。誠信原則與格式條款外之求償。月旦法學，182，95-116。new window  延伸查詢new window
4.陳榮一(19790600)。責任保險保護權利之給付的法律上性質。臺中商專學報，11，1-25。  延伸查詢new window
5.李志峰(20120300)。論被保險人之合作協助義務--兼析兩岸保險法與保險契約條款。核保學報，20，28-1+29-5。  延伸查詢new window
6.林建智(199709)。保險監理之理論基礎。保險專刊，49。new window  延伸查詢new window
7.劉春堂(20121001)。保險人確定及給付賠償金之期限。臺灣法學雜誌，209，101-113。  延伸查詢new window
8.Abraham, Kenneth S.(1998)。The Expectation Principle as A Regulative Ideal。Conn. Ins. L. J.，5，59-61。  new window
9.Butcher, Christopher(2008)。Good faith in insurance law: a redundant concept?。J. B. L.，5，375-384。  new window
10.Chutorian, Sandra(1986)。Tort Remedies for Breach of Contract: The Expansion of Tortious Breach of the Implied Covenant of Good Faith and Fair Dealing into the Commercial Realm。Colum. L. Rev.，86，373。  new window
11.Feeney, Cassandra(2011)。Are You “In Good Hands”? : Balancing Protection for Insurers and Insured in First-Party Bad-Faith Claims with A Uniform Standard。New Eng. L. Rev.，45，685。  new window
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14.Hersch, Joni、Viscusi, W. Kip(2004)。Punitive Damages: How Judges and Juries Perform。J. Legal Stud.，33，1。  new window
15.Holmes, Allen C.(1978)。A Contextual Study of Commercial Good Faith: Good Faith Disclosure in Contract Formation。U. Pitt. L. Rev.，39，381。  new window
16.Holmes, Eric M.(1979)。Is The Life after Gilmore’s Death of Contract?--Inductions from a Study of Commercial Good Faith in First-Party Insurance Contracts。Cornell L. Rev.，65，330。  new window
17.Houser, Douglas G.、Clark, Ronald J.、Bolduan, Linda M.(2004)。Good Faith as A Matter of Law--An Update on the Insurance Company’s “Right to Be Wrong”。Tort Trial & Ins. Prac. L. J.，39，1045。  new window
18.Jerry, Robert H.(199705)。The Wrong Side of the Mountain: A Comment on Bad Faiths Unnatural。Tex. L. Rev.，72，1317。  new window
19.Lowry, John、Rawlings, Philip(2005)。Insurers, Claims and the Boundaries of Good Faith。Modern Law Review，68(1)，82-110。  new window
20.Macey, Jonathan R.、Miller, Geoffrey P.(1993)。The McCarran-Ferguson Act of 1945: Reconceiving the Federal Role of Insurance Regulation。N.Y.U.L. Rev.，68，13。  new window
21.Syverud, Kent D.(1990)。Syverud The Duty to Settle。Va. L. Rev.，76，1113+1120。  new window
22.李志峰(200109)。論懲罰性賠償金之起源及其適用上的爭議。消費者保護研究，7，265-304。  延伸查詢new window
23.林建智、李志峰(20111000)。論責任保險人之抗辯義務--以美國發展為重心。東吳法律學報，23(2)，109-157。new window  延伸查詢new window
24.葉啟洲(20120115)。責任保險人之適當和解義務。臺灣法學雜誌，192，90-94。  延伸查詢new window
25.陳聰富(19971000)。美國懲罰性賠償金的發展趨勢--改革運動與實證研究的對恃。國立臺灣大學法學論叢，27(1)，231-264。new window  延伸查詢new window
26.Stempel, Jeffrey W.(2010)。The Insurance Policy as Social Instrument and Social Institution。William & Mary Law Review，51，1489-1582。  new window
27.Keeton, Robert E.(1970)。Insurance Law Rights at Variance with Policy Provisions。Harvard Law Review，83(5)，961-985。  new window
28.Keeton, Robert E.(1970)。Insurance Law Rights at Variance with Policy Provisions: Part Two。Harvard Law Review，83(6)，1281-1322。  new window
29.Richmond, Douglas R.(1994)。An Overview of Insurance Bad Faith Law and Litigation。Seton Hall L. Rev.，25，74。  new window
30.汪信君(20070300)。保險法告知義務之義務性質與不真正義務。國立臺灣大學法學論叢，36(1)，1-54。new window  延伸查詢new window
31.饒瑞正(20021000)。保險法最大善意原則之辨正。月旦法學，89，153-174。new window  延伸查詢new window
32.林誠二(20010500)。再論誠實信用原則與權利濫用禁止原則之機能--最高法院八十八年度臺上字第二八一九號判決評釋。臺灣本土法學雜誌，22，36-61。  延伸查詢new window
33.林建智(19930900)。論合理期待原則。保險專刊，33，157-166。new window  延伸查詢new window
34.楊宏暉(20090700)。誠信原則與契約締結相關說明義務的合理性。法學叢刊，54(3)=215，111-163。new window  延伸查詢new window
35.羅俊瑋(20120700)。英國2012年消費者保險（告知暨說明）法之立法例評析。中正財經法學，5，123-171。new window  延伸查詢new window
36.Davis, R.(1991)。The Origin of Duty of Disclosure under Insurance Law。Insurance Law Journal，4，71。  new window
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41.Polin, David(1998)。Insurer’s Failure to Investigate Claim in Good Faith。Am. Jur. Proof of Facts 3d，46，289。  new window
42.Schwartz Victor E.、Appel, Christopher E.(2009)。Common-Sense Construction of Unfair Claims Settlement Statutes: Restoring the Good Faith in Bad Faith。Am. U. L. Rev.，58，1477。  new window
研究報告
1.林勳發(200610)。保險契約法相關法律問題及其解決對策。  延伸查詢new window
學位論文
1.羅俊瑋(2010)。最大誠信原則於海上保險契約之適用(博士論文)。國立政治大學。  延伸查詢new window
圖書
1.O’strager, Barry R.、Newman, Thomas R.(2009)。Handbook on Insurance Coverage Disputes。Aspen。  new window
2.Windt, Allan D.(2010)。Insurance Claims and Disputes。West。  new window
3.Plitt, Steven(2008)。Couch on Insurance。West。  new window
4.葉啟洲(201107)。保險法實例研習。臺北市：元照。  延伸查詢new window
5.林誠二(200103)。民法債篇總論（下）。瑞興。  延伸查詢new window
6.陳繼堯(1996)。再保險學。陳繼堯。  延伸查詢new window
7.Anderson, Eugene R.、Stanzler, Jordan S.、Masters, Lorelie S.(1999)。Insurance Coverage Litigation。  new window
8.Appleman, John A.、Appleman, Jean(1979)。Insurance Law and Practice。  new window
9.Bjorkman, John M.(2010)。Law and Practice of Insurance Coverage Litigation。  new window
10.Farnsworth, E. Allan(2001)。Contracts。  new window
11.Fischer, Emeric(2006)。Principles of Insurance Law。  new window
12.Schlueter, Linda L.、Redden, Kenneth R.(1995)。Punitive Damages。  new window
13.Stempel, Jeffery W.(2006)。Stempel on Insurance Contracts。Aspen。  new window
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15.Jerry, Robert H.、Richmond, Douglas R.(2007)。Understanding Insurance Law。LexisNexis：Newark, NJ。  new window
16.Plitt, Steven、Rogers, Joshua、Maldonado, Daniel、Russ, Lee R.、Segalla, Thomas F.(1997)。Couch on Insurance。Sweet & Maxwell Ltd.。  new window
17.Baker, Tom(2008)。Insurance Law and Policy。N.Y.：Aspen Publishers Inc.。  new window
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21.Ashley, Stephen S.(2010)。Bad Faith Actions。West。  new window
22.Stempel, Jeffery W.(2010)。Stempel on Insurance Contracts。New York：Aspen。  new window
23.江朝國(1993)。德國保險契約法。  延伸查詢new window
24.林群弼(2003)。保險法論。臺北：三民書局。  延伸查詢new window
25.王澤鑑(2000)。民法總則。王澤鑑。  延伸查詢new window
26.江朝國(2009)。保險法基礎理論。瑞興圖書股份有限公司。  延伸查詢new window
27.施啟揚(2007)。民法總則。施啟揚。  延伸查詢new window
28.姚志明(2004)。誠信原則與附隨義務之研究。元照。new window  延伸查詢new window
29.王澤鑑(2009)。侵權行為法。王澤鑑。  延伸查詢new window
30.黃立(200611)。民法債篇總論。臺北：元照。  延伸查詢new window
31.Bjorkman, John M.(2000)。Law and Practice of Insurance Coverage Litigation。  new window
32.Horwitz, Morton J.(1977)。The Transformation of American Law。  new window
33.王澤鑑(199203)。民法債編總論。王澤鑑。  延伸查詢new window
34.Keeton, Robert E.、Widiss, Alan I.(1988)。Insurance Law。  new window
35.ASHLEY, STEPHEN S.(1997)。BAD FAITH ACTIONS。Paul, MN：West Group, St.。  new window
圖書論文
1.黃正宗(2001)。我國保險法的比較研析--法、德、日、美諸國法對我國保險契約法影響的探討。「中華民國產險保險公會」研討會。台北：中華民國產險保險公會。  延伸查詢new window
 
 
 
 
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