【作者】 徐慧丹；

【导师】 孙蓉；

【作者基本信息】 西南财经大学 ， 保险学， 2010， 博士

【摘要】 商业保险经营的负债性、长期性以及社会影响的广泛性,决定了作为债权主体以及保险产品需求者的保单持有人与保险公司经营具有内在的利益关系。保护保单持有人利益既是国际保险业发展的主要趋势,也是保险监管的根本目的,是各国政府普遍关注的重要课题。在任何一个国家保险业的发展历程中,保单持有人都发挥着不可或缺的推动作用。然而从我国保险市场的现实情况来看,侵害保单持有人利益的现象却大量发生。如何切实保护广大保单持有人的利益,保证我国保险市场的健康可持续发展是一个重要的理论和实践课题。本文在借鉴国内外学者已有研究成果的基础上,主要通过理论研究、案例分析、博弈分析、国际比较等方式,从外部法律、内部治理、自我保护三大维度,初步构建了我国保单持有人利益保护制度。本文包括七部分内容,主要内容简述如下：导论。本部分总结了研究的背景和意义、文献综述、论文的研究框架及研究方法,相关概念界定、文章研究的主要创新点与不足等。第一章保单持有人利益保护的理论溯源。本章主要阐述了消费者保护与附合契约理论、公共利益理论与代表性假说、利益相关者理论,从不同理论角度出发,说明了保单持有人利益保护的必要性和重要性。第二章中国保单持有人利益保护的历史演进及现行制度分析。本章首先对我国保单持有人利益保护的历史演进进行了梳理,其次,分析了我国现行保单持有人利益保护的制度安排及不足。第三章中国保单持有人利益受损的表现及制度分析。本章通过一些相关案例分析了保险市场上不同主体(尤其是保险公司及保险中介者)对保单持有人利益的可能侵害,并阐述了保险监管机构等监管主体监管乏力对保单持有人利益保护的可能影响,最后探讨了我国保单持有人利益受损的深层次的制度根源。第四章保单持有人利益保护的国际经验及启示。本章对英、美、德、日等国外保险业发达国家的保单持有人利益保护进行了分析,旨在为我国保单持有人利益保护的制度建设提供有益的借鉴和启示。第五章保单持有人利益保护的博弈分析。本章应用博弈论和信息经济学,分析了保险市场上三大主要参与主体即保险公司、保险监管者、保单持有人之间的博弈关系,通过实证分析得出：为保护保单持有人的利益,应加强诚信体系建设,减少保险市场的信息不对称,发挥非政府监管的重要补充作用以及建立对监管者的激励约束机制。第六章中国保单持有人利益保护的制度设计。在前文研究的基础上,本章结合我国国情,提出保单持有人利益保护应体现公正、安全、稳定、秩序的目标；其次,从正式制度及非正式制度两个方面探讨了现阶段我国保单持有人利益保护的制度约束；最后,从外部法律制度、内部治理以及自我保护三个维度分析和探讨了完善中国保单持有人利益保护制度的对策,其侧重点在于通过制度重构完善保险公司外部管制和保险公司内部治理结构,以强化对保单持有人利益的制度保护。本文的主要创新包括：第一,应用多学科的交叉理论知识与经验研究成果,首次较为系统地探讨了保单持有人的利益保护问题,初步构建了中国保单持有人利益保护的理论框架,探索设计了适合我国国情的保单持有人利益保护制度；第二,本文对保险市场上的三大主要参与主体——保险监管机构、保险公司以及保单持有人之间的关系进行了较为系统、详尽的博弈分析,通过博弈结果得出了几点有意义的结论；第三,本文从保单持有人参与公司治理的必要性及路径选择两方面,尝试性地探讨了保单持有人参与保险公司治理机制；第四,本文在查阅了大量外文文献的基础上,对英、美、德、日等国外保险业发达国家的保单持有人利益保护制度进行了较为深入地比较分析借鉴,拓宽了我国保单持有人利益保护研究的广度和深度。此外,本文提出了一些新的观点。笔者认为,当前我国保单持有人利益受损的根本原因在于制度缺陷,包括立法制度、行政监管制度、市场环境培育制度以及公司治理制度等；应建立保单持有人的申诉补偿机制以确保其利益受损时进行申诉以及获得合理的补偿；应建立外部法律制度、内部治理、自我保护三位一体的保护框架,多维度构建我国保单持有人利益保护的体系；等等。更多还原

【Abstract】 Commercial insurance operation has the characteristics of liabilities, long-term period and extensive influence on society, which decides the inner relation between insurance operation and policyholders who are both the creditors and the consumers of insurer. To protect the policyholders’interests is not only an international trend but the cardinal goal of insurance supervision. Policyholders are taking an impelling role in the process of any country’s insurance development. However, looking inside the practices in our country’s insurance market, we can see many cases that policyholders’interests are infringed. Thus, how to sufficiently protect the policyholders’interests and to ensure the healthy and sustainable development of our insurance industry is an importantly theoretical and practical subject.Learning from the existed researches at home and abroad, the dissertation adopts various methods like theoretical researching, cases analysis, gambling analysis, and comparing foreign experiences, for the aim of constructing the institution of protecting policyholders’interests in our country from the perspective of external supervision, internal governance and self protection.This dissertation is composed by seven parts. ChapterⅠserves as an introduction which is concerned with such areas as the aim and significance of this dissertation, literature review, analytical framework, methodology, as well as contribution and deficiency. ChapterⅡis theoretical perspective on protection of policyholders’interests. Reviewing the related theories of policyholders’ protection, this part gives attention to the theories of consumers’protection and cohesion contract, public interest theory and stakeholders theory, and demonstrates the necessity and importance of protecting policyholders’interests. ChapterⅢis the analysis of the history and status quo of Chinese policyholders’protection and its institution, including inadequacy in insurance law, insurance supervision, insurance governance structure and lack of self-protection awareness of policyholders. Chapter IV concerns with the performances that other parties (especially the insurers and insurance intermediaries) in China’s insurance market trespass on policyholders’interests. It also includes the analysis on deeper systematic cause why policyholders’interests are trespassed. Chapter V is about international comparison. This part laterally compares the institutions of policyholders’protection in US, UK, Germany and Japan, in order to provide useful experience for us. Chapter VI is the game analysis of policyholders’ protection. This part adopts game theory and information economics to build different gaming models among insurer, insurance supervisor and policyholder. These models are to helpful to conclude that, in order to well protect the policyholder’s interests, we should do our best to emphasize the construction of credit system, decrease information asymmetry, and bring insurance supervisors into full play. Chapter VII is the institutional design of policyholders’protection in China. Based on these theoretical and empirical results, this part puts forward to the aims of policyholders’protection. Then it starts from the perspective of external law system, internal governance and self protection to discuss how to perfect the institution of protecting policyholders’interests in China.The contributions of this dissertation are as follows:The first contribution is on the analysis framework in this field. By applying various theories, the dissertation tries to establish economic analytical framework combined theory with practice for the institution of protecting policyholders’interests in China. Secondly, the author gives systematical and detailed analysis on gaming of three parties including insurer, supervisor and policyholder, and puts some meaningful conclusions. Thirdly, the author analyzes the necessity of policyholders participating in insurer’s governance, and tries to build a model for their participation. Fourthly, the author compares the institutions of policyholders’ protection in four main advanced countries including US, Uk, Germany and Japan, which extends the depth of researches. Finally, the author also puts forward to some new points of view. It presents that we should create some conditions for policyholders to participate in corporate governance of insurers. Now the root reason of insufficiency in protecting policyholders’interests is the deficiency in system such as law system, supervision system, market system and corporate governance system. It is necessary to build a special policyholders’protection committee which involves in the representatives of policyholders, supervisors and law experts. We should build an overall protection framework from aspects of external supervision, internal governance and self protection.更多还原