保险诈骗罪基本问题研究

【作者】 李海英；

【导师】 刘德法；

【作者基本信息】 郑州大学 ， 刑法学， 2007， 硕士

【摘要】 以保险金为对象的诈骗犯罪的历史几乎与保险业一样古老，并且与保险事业同步发展，严重危及保险事业的发展。为有效打击该项犯罪，我国在现行《刑法》中，单独以第198条规定了保险诈骗罪，但在本罪的立法规定和司法适用中还存在许多值得研究的问题。本文力图从司法实践中常见的问题入手，对保险诈骗罪的基本理论问题展开较为深入地研究，以期服务于我国的刑事立法和司法实践。本文分为下述四个部分：第一部分是“保险诈骗罪概述”：文中重点论述了保险诈骗罪的概念，并将其界定为，保险诈骗罪是指投保人、被保险人、受益人以非法获取保险金为目的，采取虚构保险标的，编造保险事故及事故原因，夸大损失程度或者制造保险事故的方法，骗取保险金数额较大的行为；接着叙述了保险诈骗犯罪在国内外的现状；同时分析了现阶段保险诈骗犯罪所具有的突出特点和趋势；最后重点对国内外保险诈骗罪立法状况进行了回顾、分析和比较，特别是对我国保险诈骗罪的立法沿革进行了较为详尽的描述。第二部分是“保险诈骗罪的犯罪构成研究”：本文通过分析、探讨得出以下结论：保险诈骗罪侵犯的客体是复杂客体，即保险制度(或秩序)与保险人的财产所有权，其中，主要客体是保险制度(或秩序)，次要客体是保险人的财产所有权：保险诈骗罪的客观方面表现为单位或个人故意虚构保险标的，对发生的保险事故编造虚假的原因或夸大损失程度，编造未曾发生的保险事故，故意造成财产损失的保险事故，故意造成被保险人死亡、伤残或者疾病，骗取保险金数额较大的行为；保险诈骗罪的犯罪主体是特殊主体，即必须是投保人、被保险人或者受益人，自然人和单位均可成为本罪的主体；保险诈骗罪的主观方面只能是直接故意，并且具有非法骗取保险金的犯罪目的。第三部分是“保险诈骗罪司法认定中的若干问题”：在司法实践中，保险诈骗罪与非罪的认定标准在于：保险诈骗的数额是否达到了法定的标准和行为人主观上是否有骗取保险金的目的，只有符合这些条件方能构成保险诈骗罪，否则就不能以犯罪论处；保险诈骗罪属结果犯，因此它存在既遂和未遂形态；如果行为人进行保险诈骗所骗取的保险金数额较大，即构成保险诈骗罪既遂；如果行为人已经着手实施犯罪，由于行为人意志以外的原因未得逞的是犯罪未遂；区别保险诈骗罪的预备与未遂的关键在于正确认定保险诈骗罪中实行行为着手的时点，文章认为，应将行为人开始实施具有侵害保险金与保险制度的紧迫危险性的行为时，认定为保险诈骗罪的着手；在认定保险诈骗罪的罪数时，要注意分清是一罪还是数罪，犯保险诈骗罪，同时又可能构成放火罪、决水罪、投毒罪、故意杀人罪、故意伤害罪、非法拘禁罪、虐待罪等犯罪时，应为牵连犯，但按照《刑法》第198条第二款的规定，实行数罪并罚，而对于在实施诈骗时，伪造、变造国家机关公文证件、印章等犯罪行为则应按牵连犯从一重处断，如果行为人实施完犯罪的准备工作，又未着手进行保险诈骗，应以同一个行为构成了保险诈骗手段行为的既遂和目的行为的预备，是想象竞合，应根据从一重罪原则处断；单位为了自身利益，经集体研究决定以放火、杀人等手段故意制造保险事故骗取保险金的，由于单位不能成为放火罪、故意杀人罪的犯罪主体，对单位只能追究保险诈骗罪的责任，而对单位中的直接负责的主管人员和其他相关责任人员则应以放火罪、故意杀人罪等与保险诈骗罪实行数罪并罚。在共同犯罪问题上，笔者认为对保险公司的工作人员与保险诈骗行为人相互勾结骗取保险金时，应先根据实行犯的犯罪性质来确定共同犯罪的性质，然后再比较法定刑的轻重来决定是否分别定罪、定为何罪；对保险事故的鉴定人、证明人、财产评估人故意提供虚假的证明文件，为他人诈骗提供条件的，应按照《刑法》的规定，以保险诈骗的共犯论处。另外，文章还论述了保险诈骗罪与诈骗罪、合同诈骗罪、贪污罪、职务侵占罪以及提供虚假证明文件等罪的界限，从而使对保险诈骗罪有了较为深入的理解和认识。第四部分是“保险诈骗罪的立法完善”：文章在充分肯定我国保险诈骗罪刑事立法的优点的同时，对97刑法保险诈骗罪中的立法缺点进行了分析，提出了一些立法和司法完善的建议。认为在保险诈骗罪主观构成方面应当明确规定“以非法占有保险金为目的”；应弥补本罪犯罪主体规定之不足，认为保险人(保险公司)应当被追加为保险诈骗罪的主体之一；应改善本罪叙明罪状方式之不足，认为应增加“以其他方法进行保险诈骗活动的”这样一项概括性堵截规定，以避免出现法律真空导致对犯罪现象的放纵；应适当提高保险诈骗罪的最高法定刑，建议立法将保险诈骗罪的最高法定刑上升为无期徒刑，以维护刑法的内部协调，真正做到罪刑均衡。作者希望通过立法和司法的完善，有效打击该项犯罪，从而来减少保险诈骗的发生，使保险事业沿着正常的轨道发展，为我国的经济建设提供有力的保障。更多还原

【Abstract】 Insurance defrauding is a kind of traditional crime in the insurance domain, it’s history is almost as long as insurance, and it not only was born with insurance but developed with insurance, which has endangered the insurance development. In order to combat the crime of insurance fraud effectively, the 198th article of the Criminal Law of China prescribes the offense of insurance fraud independently. However, there are still some problems worth study in the aspects of it’s legislation and practice. The paper deals with certain common ones and makes specific analyses with the aim of providing service for the criminal legislation and judicial practice. This paper falls into 4 parts as fellow:Part 1 is entitled "A Survey of the Crime of Insurance Fraud." I mainly discuss the basic definition of insurance defrauding, Insurance defrauding means the actions of applicants, assured and beneficiary fabricating insurance objects, insurance accidents and reason, and overstating the extent of damage or making insurance accident in order to defraud insurance compensation illegally; then I introduce the situation and features of the crime of insurance fraud domestically and abroad, survey then analyze the legislation of the crime of insurance fraud ,especially the history of legislation in China.Part 2 is entitled "The Constitutive Characteristics of the Crime of Insurance Fraud", to which I give a detailed and in-depth analysis and propose my opinion. In my opinion, the objects encroached upon by the crime of insurance defrauding are complicated ones, such as insurance regulations of our country and property right of insurance company; objective aspect is cheating insurance company out of its property using means of fabricating insurance object, insurance accident and accident cause, exaggerating extent of damage or creating insurance accident and so on; The criminal subject of insurance defrauding is special one, which must be applicant, assured or beneficiary. Both of natural person and unit can be the subject of this crime. Insurance defrauding only can be the direct intention in subjective side and has criminal purpose by the way of defrauding insurance compensation illegally.Part 3 is entitled "The Problem in the Identification of the Crime of Insurance Fraud." In the practice of judicature, the prime standards believed should be clear, which belong to the crime of insurance defrauding or not, that is to say whether or not the amounts defrauded are more enough and conform to the legal standard, the behavioral persons have the intention of defrauding insurance compensation or not; in subject, Only conforming with the factors above can the crime of insurance defrauding be constituted, otherwise it can not be punished as crime. The crime of insurance defrauding belongs to the result crime, so it has accomplished and attempted forms, If the behavioral person gets more insurance compensation by defrauding, it constitutes accomplished crime of insurance defrauding. If the behavioral person has started the crime, which is unsuccessful, not because of the reason of the behavioral person’s intention itself, it should belong to attempted crime; The key of making a distinction between preparation and attempt of fraud of insurance is that we should fix the starting of practicing behavior. The author thinks, only the behavior which making insurance and insurance regulations of our country in danger is the starting of this crime’s practicing behavior; When the amounts of crime of insurance defrauding is believed, it should be clear that it is one crime or some crimes. When somebody commits the crime of defrauding, which perhaps has arsonist, the crime of breaching a dike、spreading poison, intentional committing homicide, intentional inflicting injury, unlawful detaining custody and mistreating at the same time, he should be punished with all the crimes according to the stipulations of the second item in the Article 198 Article of 1997 Penal Code. When a person carries out the defrauding, forges certificates, seals of state organs at the same time, he should be sentenced for the crime which is more serious than others, according to the conviction rules on implicating criminal in the Criminal Law Principle; if a person has completed the preparatory work of insurance fraud, but not starting applying for indemnity, he/she should also be sentenced for the crime which is more serious than others; if an insurance accident is organized by an entity, and commits other crimes in the same insurance fraud activities, while the subject of the crimes can not be an entity, the entity should be committed the crime of insurance fraud, and the head of the entity and other persons who are responsible for the activities should be committed concurrence of offenses. So about common crime which over two persons commit, the act of cheating insurance company out of its property with the collaboration of the inside and the outside should be determined by practicing behavior at first, and then they should be sentenced for the crime which is more serious than others; The judger, certifier of insurance accident and the property evaluator supply the false certificate documents intentionally and offer the defrauding conditions, he should be punished as the accomplice of insurance defrauding according to the stipulations of Penal Code. The article also has discussed the line between the crime of insurance defrauding and that of defrauding、contract defrauding、corruption、post invading and supplying false certificates etc, from which the crime of insurance defrauding could be understood and know ledged clearly.Part 4 is entitled "Thoughts on How to Improve our Legislation and Justice on the Crime of Insurance Fraud." In this part, I fully affirm the advantages of the legislation of 1997 Penal Code, analyze the shortcomings of the legislation of 1997 Penal Code, and then propose my suggestion. For example, I think that this crime must have illegal possession and that not only the special subject but also the insurants should be one of the subjects of this crime; the legal punishment of it should be enhanced; the manifestation style should be perfected. The author hopes that this article could combat and reduce the crime of insurance defrauding effectively, and make the insurance develop at the normal way and supply powerful guarantee for the economic construction in our country.更多还原