【作者】 李秀兰；

【导师】 张旭；

【作者基本信息】 吉林大学 ， 法律， 2004， 硕士

【摘要】 保险诈骗犯罪与保险业的发展如影相随。由于保险业在我国起步较晚，保险法律法规尚在建立健全中，因而保险诈骗案件发生数量较多，保险诈骗犯罪已成为近年来金融领域中发案率较高的犯罪。保险诈骗犯罪的日益严重已引起金融界和法律界人士的广泛关注。但无论是金融界还是法律界都只注重对金融诈骗罪共同性和普遍性问题的研究，而对保险诈骗罪个罪的概念、构成特征、保险诈骗罪认定上的法律问题研究甚少；加之立法者对保险诈骗罪的认识存在一定的局限性造成保险诈骗罪现行立法的种种缺陷。这就给司法实践中正确认定、处理该罪带来一定的困惑。对保险诈骗罪的概念、构成特征、法定行为方式的认定、一罪与数罪、共同犯罪、犯罪未遂形态及犯罪着手等司法认定中应注意的问题以及保险诈骗罪现行立法缺陷及完善的研究、探讨对司法实践中正确认定、处理该罪，充分发挥刑法积极有效打击保险诈骗犯罪的作用具有重要意义。文章就以下几方面问题进行分析、探讨。保险是指人们共同分摊由于自然灾害和意外事故给个人、法人及其他组织所造成的损害的一种社会抵御方法，是一种集社会互助性和科学性为一体的经济损失补偿和人身损害给付制度。保险诈骗罪是我国1997年刑法规定的金融诈骗罪的罪名之一。从保险这一概念的特定含义出发，结合我国现行保险法和刑法对保险诈骗罪的规定，我们认为保险诈骗罪是指保险合同关系中的投保人、被保险人或受益人等违反保险法律法规之规定，以非法占有为目的，采用虚构保险标的、保险事故及事故原因、夸大损失程度或故意制造保险事故的方法，骗取保险金数额较大的行为。保险欺诈与保险诈骗的区别在于前者是一种民事违约、侵权行为，而后者是一种违法犯罪行为，保险欺诈无论是行<WP=55>为主体、行为方式都较保险诈骗丰富多样。保险诈骗罪的主体是保险合同关系的投保人、被保险人、受益人等特殊主体，保险公司工作人员以及保险事故的鉴定人、证明人、财产评估人只有在与投保人、被保险人、受益人有共同骗取保险金的故意并共同实施保险诈骗行为时才构成保险诈骗罪的共犯。保险诈骗罪的客体是保险制度和保险公司的财产所有权，且前者是主要客体，后者是次要客体。保险诈骗罪的主观方面是直接故意，并具有非法占有保险金之目的，过失与间接故意均不构成保险诈骗罪，保险诈骗罪与其它金融诈骗罪均以非法占有目的为构成要件。保险诈骗罪故意的内容是指行为人明知提出理赔的依据带有欺诈内容，且明知通过理赔申请能够获得保险金赔款，并希望这种欺诈理赔申请获赔的结果发生，并决心去实施保险金诈骗的心理。保险诈骗罪的法定行为方式是虚构保险标的、保险事故及事故原因、夸大损失程度或者故意制造财产损失的保险事故、故意造成被保险人死亡、伤残、疾病以骗取数额较大保险金，此外还包括为保险诈骗提供虚假证明的行为。在对行为人虚构保险标的骗取保险金的行为进行认定要注意对行为人虚构保险标的的方式和内容作广义理解；对制造保险事故、编造事故原因、夸大损失程度、故意制造保险事故骗取保险金的行为进行认定时，不仅要注意对这些行为方式本身的区别，而且要注意行为人的行为是否构成数罪；在对为保险诈骗提供虚假证明的行为进行认定时要注意区别行为人出具虚假证材料是出于故意还是过失。刑法198条第2款规定对行为人为骗取保险金而制造保险事故同时构成保险诈骗罪和放火罪、故意杀人罪等牵连的实行数罪并罚， 虽然造成同一法条中对同样性质犯罪触犯不同的罪名而出现不同的处罚原则的矛盾，但在目前保险诈骗犯罪理论及立法尚不成熟的情况下，这一规定却对有效打击保险诈骗犯罪和保护公私财产安全和人的生命健康起了积极作用，有其合<WP=56>理性。保险事故的鉴定人、证明人、财产评估人及保险公司工作人员与保险合同关系当事人有共同骗取保险金的故意并采用法定的行为方式骗取保险金时构成保险诈骗罪的共犯。保险诈骗罪存在未遂形态，如果行为人实施了保险诈骗行为而没有骗取数额较大的保险金不是不构成犯罪而是犯罪未遂。保险诈骗罪应以行为人实际骗取数额较大的保险金为既遂。我国现行保险诈骗罪在立法模式、犯罪客体、犯罪主体、犯罪对象、最高刑的设置等方面均存在一定的缺陷。建议对保险诈骗罪作如下完善：将结果犯的立法模式修改为行为犯的立法模式；取消刑法198条第2款，并对保险诈骗罪现行立法进行结构性调整，同时相应提高保险诈骗罪法定刑的幅度；增加对保险诈骗罪行为方式的概括性条款；取消对保险诈骗罪主体的特殊限制，规定为一般主体；扩大保险诈骗罪的犯罪对象；将保险诈骗罪的最高刑上升为无期徒刑，以保证刑法内部的协调性，真正做到罪刑相适应。我国保险诈骗罪立法与其它金融诈骗罪立法一样需要经历一个长期的不断完善的过程。更多还原

【Abstract】 The insurance fraud always develops with insurance industry. As an infant industry in China, insurance leaves much to be deserved in regulations and rules, which has caused a number of fraud cases and made the insurance fraud cases account for a considerable proportion in the financial field. The increasingly serious insurance fraud has drawn broad attention from circles of both finance and law. However, both circles only focus on the research on commonness and universality of financial crimes, but dabble very little into the concepts constituting characters and the insurance fraud affirmations of individual cases. In addition, legislations have various defects in current legislation, which bring sort of puzzlement in correct affirmation and handling the cases in judicial practice. It’s of vital importance to affirm the concepts, constituting characters and legal action patterns of insurance frauds, one crime and several crimes, co-crimitting, abortion of crime and setting of crime and such judicial problems which should be noticed, legislative defects in insurance frauds and improved research, discuss the accurate judicial affirmation and settle the crime fully exert criminal law to actively and effectively combat the insurance fraud. The thesis analyzes and discusses from the following several aspects.Insurance is a kind of social resisting method which people commonly proportion the damage to the person、artificial person and other organization which coursed by natural disaster and sudden accident, it is a kind of pay system of economical lose compensation and person lose payment which gather the social concur character and science character. In view of the specific meaning of insurance concepts and according to the insurance fraud regulations set in current insurance law and criminal law, we view that the insurance fraud refers to the act of policy holder, the insured and beneficiary in the insurance contract relation violating the regulations of insurance law to illegally occupy as its purpose, adopt making-up insurance target, insurance accidents and accidental causes and exaggerate loss degree or deliberately makes insurance accidents to swindle large sums of insurance. The difference between insurance cheat and insurance fraud is that the former is an act of civil breach of faith and infringement, while the latter is a criminal act. In terms of the action subject, action patterns, the latter is more various <WP=58>than the former. The subject of insurance fraud is the policyholder, the insured and beneficiary and such particular subjects in insurance contract relation, and the object is insurance system and the property ownership of insurance firms. What’s more, the former is the principal object while the latter is sub-object. The subjective aspect of insurance fraud is the direct deliberation, and the illegal purpose of occupying insurance money. Lapses and indirect deliberation neither makes up the in insurance fraud. The insurance fraud and other financial frauds all have constituting elements of illegal occupation. Crime of insurance fraud is one of the crimes of financial fraud which were prescribed by our station’s Criminal Law in 1997. The content of intent of crime of insurance fraud is that the man of action clearly knows the compensational basis have content of f cheat, and clearly knows he could obtain compensate fund of insurance money through payment application, and hopes the result of obtaining payment of this kind of fraud payment take place, and has the mind of deciding to put into practice insurance fraud. The insurance fraud’s legal action pattern makes up the insurance target, insurance accident and the accident causes, exaggerating the loss extent or deliberately makes the insurance accidents of property loss and causes death, disability and disease of the insured to defraud large amount of insurance money. In addition, the action of providing false proofs for insurance fraud is also included. When affirming the defrauding action conducted by the doer who makes up the insurance更多还原