【作者】 姜南；

【导师】 高晋康；

【作者基本信息】 西南财经大学 ， 人口学， 2008， 博士

【摘要】 就保险合同法整体而言,乃以利益平衡为其普遍的价值追求。可是,由于保险行业天然的射幸性、技术性以及附合性,具体规则的实践结果往往冲击着利益平衡价值并阻碍其实现。保险合同法定解除制度凭借其对保险合同效力的强行干预,在法定条件下赋予保险人单方解除合同的权利,对失衡的利益格局进行调试和矫正,从而完成对“公平”的“二次加工”。然而,法定解除也应当有它的适用范围。如果任由保险人利用自己的优势地位,针对投保方的任何微小的不当行为或客观危险的细微变化而主张解除合同,不仅使投保方丧失了签订保险合同的期待利益,失去了风险的保障,而且破坏了维护保险交易公平的基本秩序,间接地影响了保险人的形象和保险行业的稳健运行。因此,对于保险人而言,保险合同法定解除制度的“赋权”与“限权”功能并举;在现代保险交易日益消费化的境况下,基于保险方对弱势投保方的支配力,保险立法应当采取谨慎的态度以“权利限制”为重来建构保险合同法定解除制度。本文运用社会法学、比较法学、法律经济学、价值分析和案例研究等方法较为全面的对保险合同法定解除的相关规则进行检视,试图对司法实践和立法修改提出建议。全文除导论外,分为六章:导论主要说明论文选题的基本意旨、研究路径与研究方法,并对该问题的国内外研究现状进行述评。第一章对保险合同法定解除的一般问题进行探讨。与一般的债权合同相比,保险合同具有某些不同寻常的特性,正是这些特性决定了保险合同法定解除制度的特殊架构。基于保险合同的射幸性、附合性、信息不对称性以及远期服务性,在道德风险与逆选择的作用下,各方当事人均面临着是否能够获得期待中的回报的高风险。为恢复交易公平,法律在不同背景下对保险合同法定解除权的行使与限制进行选择。保险合同法定解除制度的功能体现在:一方面,法定解除制度通过对投保方自由的限制而补救着保险人的利益;另一方面,法定解除制度也经历了从赋予保险人最大限度的解除权到限制保险人解除权的行使以特别保护投保方利益的发展过程。尤其在现代保险业中,法定解除更是以其强制性的倾斜保护方式对保险人的泛化解除合同行为进行有效制约。通过与保险合同约定解除、保险合同终止以及保险合同撤销的比较,在保险合同效力领域对保险合同法定解除进行了科学定位。第二章以诚实信用和对价平衡为理论依托对保险合同法定解除制度进行分析。孕育“最大诚信”原则的历史背景发生变化,该规则的模糊性使司法实践存在偏离正常理性范围的可能;现代保险交易中,诚信原则的内在衡平精神足以为当事人和法官提供行为准则和判定依据,因而,应将诚信原则作为保险法律规范的理论基础和分析工具。保险合同法定解除制度以诚实信用为其理论支持,约束双方当事人的行为,修正不公平的交易结果,同时将通过诚信原则制度化的运用建立良好的市场信用秩序,进一步促进保险市场诚实信用的实现。在法定解除制度的发展过程中,制度本身始终以诚实信用为修正和调整的基本原则。“对价平衡”是保险交易的基本理念,是诚实信用在保险领域的具体体现。在法定解除制度中,对价平衡作为直接依据,以当事人是否获取不当利益为标准,确定保险人行使法定解除权的界限。在保险合同当事人之间对价失衡的矫正过程中,法定解除制度以强制性规范作为利益平衡的实现机制。第三章在法理学视野下厘定保险合同法定解除的原因并对其进行类型化研究。法定解除原因为何可以使一份有效保险合同原本所商定的权利义务关系终结?问题的答案与保险合同的效力理论密不可分。保险合同当事人之间的利益衡平是保险合同被遵守的原因,各解除原因之所以具有终止合同履行的效果,在于保险合同的利益衡平机制遭到损坏。理论上可以把解除原因类型化为违反先合同告知义务而导致的保险合同解除、情事变更(危险程度增加)而导致的保险合同解除以及违反其他合同义务(不缴纳或迟延缴纳保险费、怠于履行安全维护义务、故意制造保险事故)而导致的保险合同解除。在告知范围的构成要素中,重要性标准、询问规则及告知除外是决定投保方告知义务负担的关键因素。告知义务的违反既包括告知不实,即误告或错告,也包括应告知而不告知,即隐瞒和遗漏。根据主观归责主义,义务的违反还应当考察行为主体的主观心理状态。显著性、持续性及不可估计性共同构成危险程度增加的衡量标准。按照区分主观危险增加和客观危险增加的规范模式对保险合同对价失衡状态进行差别调整,使投保方对己方过错承担更为不利的法律后果。催告或一定期限届满是保险人在投保方不缴纳或迟延缴纳保险费情形下行使法定解除权的先决条件。投保方疏于维护保险标的的安全,将人为增加保险标的的危险程度,引发事前的道德风险。对于被保险人为履行道德上义务所致保险事故之行为,保险人并不当然具有解除权。第四章解构保险合同法定解除权的属性、功能及相关规则。法定解除权的行使是保险合同法定解除制度功能的实现途径。法定解除权的属性应当是多元的,它不仅仅是一种授权性规范,也是具有财产请求内容的形成权;从权利的行使致使保险人免除合同责任的角度而言,法定解除权也是保险人的抗辩权利。法定解除权契合于保险法的内在价值奠定了其合理性基础。保险人在被赋予合法解除保险合同权利的同时,也被附加了按照法律程序和相关规则主张权利的义务。具体而言,行使相对人、行使方式应予细化以增加可操作性。就行使期间而言,有单一标准与双重标准两种不同的处理规则。为防止保险人滥用法定解除权,法定解除权的排除规则尤为必要。就弃权规则而言,一旦保险人或其代理人有意识的将放弃解除权的意思表示以书面或者口头通知的明示方式或者采用特定行为所推定的默示方式传递给投保方,保险人嗣后不得再为行使解除权。就禁止反言规则而言,如果保险人事先以某种方式做出陈述或者承诺,并使投保方所信赖而实施了某种行为,法律将禁止保险人事后提出否认的主张或者反对的言辞,即使是错误的陈述也不例外。不可抗辩规则的扩大适用体现了对投保方消费者身份进行优先保护的法益思潮。第五章剖析保险合同法定解除的法律效果及法律救济机制。从法哲学角度而言,法定解除的效果应当秉承公平或者衡平的理念清理投保方与保险人之间的权利义务,取除一方多获取的利益,矫正违背正义的利益分配,恢复财产权益的应然归属。从经济学角度而言,保险合同法定解除效果的设计,首要功能在于以效率为标准进行行为选择,以成本——收益的计算等式对投保方的违约行为进行利益激励。考察各国立法例对保险合同法定解除溯及力问题的不同规定,揭示我国保险法理论界在肯定说、否定说及折衷说观点上的疏漏。由此提出,应在考量不同险种保险合同的自身性质差异性、保险合同当事人利益的有效维护以及社会整体效果的评判等因素基础上,区别对待损失补偿保险合同和定额给付保险合同的溯及力问题;并根据保险合同法定解除是否可归责于投保方的过错来判定其溯及力之有无。保险费返还之债务关系是溯及力问题的必然衍生结果;基于保险行业及保险经营的特殊性,在投保方违约而导致保险合同解除的情形下,对信赖利益的赔偿范围应该是严格限定的。第六章对我国保险合同法定解除制度加以评价并提出完善建议。我国保险合同法定解除制度的体系架构已经建立,但是仍然存在严重不足。为合理建构保险合同法定解除制度,从宏观而言,应当坚持保险交易所蕴涵的“对价平衡”原理,树立投保人利益至上的观念,明确保险合同法定解除具有“赋权”与“限制”双重功效;通过法定解除行使规则及效果等构成要素的设计,促使当事人自觉履行诚实信用义务。从微观而言,对于法定解除原因杂乱、义务履行主体不全面、义务履行标准模糊、义务主体主观心理状态不加区分、除外条款与例外情况的忽视、法定解除权行使规则不完整、解除权排除规则欠缺、法定解除后的权利义务清理不明确等问题提出针对性的解决方案。综上所述,全文的理论贡献在于:1、通过对保险领域的诚信与衡平的分析,论证强制性规范是保险合同法定解除制度在寻求保险交易公平过程中的客观需要。法定解除制度以“赋权”形式无疑为保险人提供着强有力的公力救济,可是,在保险方对弱势投保方具有高度支配力的现代保险业中,法定解除相关规则更应偏重于为投保方着想,扩大运用该制度的反向功能——限制保险人解除权的滥用。2、构建了一个较为合理且可行的保险合同法定解除制度体系。在这个体系中,厘清法定解除的具体原因并对其进行类型化分析,明晰保险人法定解除权的行使规则,以实现对保险领域中合同法定解除现象的深层次理解;尤为重要的是,本文以投保方的主观心理状态为切入点对法定解除的溯及力进行个别化设计。3、对保险合同法定解除中的一些基本问题提出自己的看法。(1)法定解除对于一份有效保险合同原本所商定的权利义务关系的终结力量,源于保险合同的效力根源,即当事人间的利益衡平。保险合同的利益平衡机制遭到损坏是保险人行使法定解除权的边界。(2)人类社会创设法律制度的目的并非仅仅规范主体的违规行为,更重要在于通过法律规则的预设指引人们在正常轨道上行事。通过对保险合同法定解除权行使规则及效果的设计,促使各方当事人自觉履行诚实信用义务,以实现保险市场之公平交易秩序。4、尝试运用经济学的分析工具对保险合同法定解除效果进行探讨。从经济学角度而言,保险合同法定解除效果的设计,首要功能在于以效率为标准进行行为选择,以成本——收益的计算等式对投保方的违约行为进行利益激励。相对于惩罚而言,有效激励更能抑制保险当事人的机会主义行为,更适宜建立法律制度与现实人性之间的良性、和谐关系,从而降低法律运行的成本,最有效的发挥出法律制度自身的高效率。尽管本文的研究取得一些收获,但由于研究条件、研究手段和笔者的学识、能力所限,论文还存在许多缺陷与不足,需要进一步努力研究,主要体现在:对于经济学研究方法的应用还仅限于初浅层次,有待于提高;法定解除权的排除规则尚缺乏进一步的实证分析;在保险合同法定解除与相关制度的比较中,仅仅限于制度的比较,缺乏对我国保险合同终止及合同撤销的进一步考察。更多还原

【Abstract】 Speaking of the insurance contract law as a whole, it takes the even of benefits as its universal value pursue. But because the insurance has its nature of technical, coincidental, as well as it involves lucky, the practice of concrete rule often attacks the benefit balance value and hinders its realization. The legal relieve system of insurance contract intervene insurance contract potency forcefully, It entitles the insurer to relieve the contract under legal condition, it carries on the debugging and rectifies to the unbalanced benefit pattern, thus completes the "second processing" to fair. However, legal relieves also must have its applicable scope. If leaves free the insurer to use its superiority status, to terminates a contract because of any slight misbehavior of the insured or any slight change of the objective dangerous. It will not only caused the insured to lose the anticipation benefit of signing the insurance contract and lost the risk safeguard, but also it will destroyed the basic order which maintenance the security of insurance transaction, indirectly affected insurer’s image and the steady operation of insurance. Therefore, regarding the insurer, the function of "bestow the power" and "limits the power" of legal relieves system of the insurance contract develops simultaneously. But under the condition that modern insurance transaction expends day by day. Based on the insurer’s control of the insured, the insurance legislation must have the discrete manner as heavy legally to construct the construction insurance contract take "the right limit" to relieve the system. The insurance legislation must be discrete and emphases "the right limit" to reconstruct the legal relieve system of insurance contract.This article use the method of social legal science, comparative law, legal economic, value analysis and so on to inspect the related rules of legal relieves system of insurance contract comprehensively. And it attempts to puts forward the proposal to the judicial practice and the legislation revision. The whole text divides into six chapters besides the introductory. The introductory mainly display the basic reason of selecting this topic, the way of research and the research method, and carry on the commentary and present situation to domestic and foreign research of this question.The first chapter: research on the general issues of statutory dissolution of insurance contract. Contrary to the general contract, insurance contract has special natures, which decide on the special institution of statutory dissolution. It provides remedial treatment to maintain the benefit of the insurer. From the aspect of historical development the legal relieve system of insurance contract experienced a developing process---from giving the insurer the maximum relieve power to limit the relieve power of the insurer to exercising special protect to the policy holder. In respect of the relative institutions, statutory dissolution of insurance contract has its right status.The second chapter; research on the statutory dissolution of insurance contract based on the honest credit and the price balance theory. Thus, we should take the good faith principle as the theoretical analysis tool of insurance law standard. The legal relieves system of insurance contract not only take the honest credit as its theory support, restrains the bilateral litigants’ behavior, revises the unfair transaction result, but also establish good market credit order through the institutional utilization of good faith principle, and it will do further promotion to the realization of honest credit of the insurance market. "Balanced to the price " is the basic idea of insurance transaction, is the concrete manifests of fairness of insurance transaction. The legal relieves system of insurance contract adjust the“unbalanced price”through depriving the benefit which the litigant gains, this is also exactly the power boundary that the insurer exercises legally relieves the contract.The third chapter; decide and analyze the reason that the legal relieve system of insurance contract exists under the vision of jurisprudence field and conducts the type research to it. Theoretically we can divide the“relieve reason”in to two types; relieve because of violation of the informing duty before contract is singed.; the changes of circumstances (degree of hazard increases) .as well as the violation of other contract duties (not to pay or delay to pays insurance premium, be negligent to fulfilling safe maintenance duty, intentionally makes the insurance contract accident). In the scope of the inform duty, the important standard, the inquiry rule and exception of the inform duty is the key aspect. To make decisions Inform duty includes not telling the truest, namely by tell by mistake or tell wrong. And it also includes“should inform but does not inform”, namely conceals and omission. According to the“subjectively decide the responsibility”principle, the violation of duty to also must inspect the subjective psychological condition. Remarkabilit, endurance and unestimatable nature together constitutes the standard of the degree that hazard increases. Adjust the“price unbalanced“condition according to the standard that the discrimination subjective danger increase and the objective danger increases to the insurance contract , and causes more disadvantageous legal consequence to the insurer because of his own mistake.The fourth chapter, analyze the character, function and the related rule of the legal relieve power of insurance contract. The exercising of legal relieves power is the main way to realize the function of legal relieves system of the insurance contract .Legal relieves power should be diverse, it is not only a kind of authorization standard, but also a kind of formation power that has the property request content. In the aspect that excurse the power can avoid the responsibility of the insurer, legal relieves the power is also the insurer’contradicts right. Legal relieve power agree with the intrinsic value. of insurance law , and that laid its rational foundation .The insurer has the responsibility of advocating his own rights by legal proceeding and the related rule while he has the rights to relieve the contract. Specially speaking, we must consume the exercises counterpart, exercises way to increase its operationally. As to the exercises period, it has two kinds of different processing rules; the one standard and the double standard .To prevent the insurer to abuses legally relieves power, the anti-rules of legal relieves power are especially essential.The fifth chapter; analysis the legal effect and legal relief mechanism of legal relieve system of insurance contract. Inspecting the legislation of various countries, they are different in the question of traces potency of legal relieves. Promulgates the oversight of the approval theory, the denial theory and the compromised theory in our countries insurance theory. And then proposed that, we should take in consideration the different nature of different insurance contract in the different danger own insurance contract, the effective protect of the litigant’s benefit, the judgment of the overall social effect ,and so on. Based on these factors we should be different in the question of trace potency of“loss compensates insurance contract”and the“fixed quantity pays insurance contract”; And according to the insurance contract and determine whether the legal relieves of insurance contract have the potency to trace according to whether the insurer has a mistake. The premium returns of insurance is the creation result of the trace potency question; Based on the particularity of the insurance profession and the insurance management, in the situation that the insurer break a contract , the scope of compensation to the trusts benefit is supposed to be the strictly defined.The sixth chapter; make appraise and propose consummate suggestion to the legal relieves system of insurance contract of our country. For the reasonable construction of legally relieve system of insurance contract, from the macroscopic aspect, we must persist in the“balanced to the price" principle of insurance exchange, set up the idea that the holder’s benefit is supreme, the legal relieves of insurance contract has dual effect ; "bestow the power" and "the limit the power ".Through the design of the exercises of legal relieving rules, the effect of this system and so on the urges the litigant to initiatively fulfill the honest and credit duty. From the microscopic aspect, proposes the pointed solution of the disorder of the reason of legal relieves, the incomprehensively of the fulfill of the duty, the fuzzy of the standard of the duty‘s fulfillment the in differentiate of psychology condition of the body who fulfills the contract, the neglect ion of the exception rules and the exceptional case; the integrity of legal relieves exercising rules; the short of anti- actually rule ; the unclear of the right and duty between the litigant after legally relieves.In summary, the theory contribution of the full text lies in:1. Through analyzing the honest credit and the price balance theory, proves that the compulsory rule is the objective need of the legal relieves system of insurance contract in the pursuit of fair in insurance transaction. The legal relieve system without doubt provide the powerful governmental relief to the insurer by bestowing the power, but in the modern insurance industry that the insurer has strong strength to control the weak the policy holder, the rules of legal relieves must consider more about the policy holder, expanse the utilizes of its reverse function to limit the insurer to abuse the power. 2. It builds up a more reasonable and feasible legal relieves system of insurance contract framework. In this system, decide and analyze the reason that the legal relieve system of insurance contract exists under the vision of jurisprudence field and conducts the type research to it, clear up the excising rule of legal relieves, realize the deep understanding; to the phenomenon of legal relieves of contract in insurance, which is especially important, this article takes the psychological condition of the insurer as the cutting point to design the traces potency of legal relieves individually.3. Propose my own view on some basic questions of the legal relieves of .insurance contract. (1)The termination strength of right-- duty relations which an effective insurance contract originally decided is rooted in the insurance contract potency, namely is concerned the benefit balance of the litigant. The insurance contract the damage of benefit balance is the boundary of the insurer to exercises the legal relieves. (2) the goal that human society establishes the legal system by no means merely standard people’s illegal behavior, which is more important, is that it can directs people’s behavior on the normal track through the legal rule supposed in advance. Through the design of the exercise rule and legal potency of legal relieves of the insurance contract, we can urges all the litigant initiatively fulfill the honest and credit duty, realizes the fairness of the insures market .4. Attempt to reach the legal potency of legal relieves of the insurance contract using the economic analysis. In the view of economic law, the design of the effect of legal relieves system of insurance contract the most important function lies in that it take the efficiency as the standard of behavior choice. This system drives the policy holder to violet a contract by the cost - income equality Compared with penalty, effective drive can do more to suppress insures’litigant’s opportunism behavior, and it is more suitable to establish a benign and harmonious relationship between the legal system and the human nature, thus reduces the cost of legal exercise display the high efficiency of legal system .more effectively.更多还原