防疫保險重複投保爭議問題【本期企劃】 試閱
A Study on Double Insurance of Pandemic Insurance
防疫保險可以設計為定額給付或實支實付型。定額給付型之人身保險無複保險相關規定之適用，保險人承保後，不得以被保險人重複投保為由解除契約或拒絕理賠，但於保險契約尚未成立生效時，保險人可將重複投保之事實列入保險法第64條之書面詢問事項，保險人承擔危險之締約自由亦應被尊重。然因重複投保不影響保險事故發生率，亦難以認定與事故發生之因果關係，保險人之解除權難以行使。而實支實付型之防疫保險是否有複保險之適用，司法院大法官釋字第576號解釋等實務與學說見解分歧，亦是爭議不斷。本文認為，若訂約時要保人隱匿重複投保之事實，可於契約條款中約定保險人之解除權；亦可利用保險競合之概念，於契約中約定比例負責條款、溢額條款或不負責任條款，以控管風險並貫徹公序良俗。
Pandemic insurance can be designed as fixed benefit or reimbursement benefits, and the life insurance with fixed benefit does not apply to the relevant regulations of double insurance. After insurer underwrites and issues the insurance policy, it shall not cancel the contract or deny the claim on the ground that the insured has double insurances on the same insured events. Before the insurance contract takes effect, the insurer can include the fact of double insurance in the written inquiry items in application according to Article 64, Insurance Law, and the insurer’s freedom of contracting to take risks should be honored. However, double insurance will not affect the occurrence rate of the insured event and it is difficult to determine the causal relationship between double insurance and the insured event, so the insurer cannot have the right to cancel the policy. Both in practice and theory, there are still arguments over whether the pandemic insurance with reimbursement benefits can apply the regulations of double insurance (e.g. Justice Interpretation No. 576). The author suggests that if the applicant conceals the fact of double insurance, the cancellation right may be clearly stipulated in the contract. Or we can apply the concept of other insurance clause to clearly list proportional liability clauses, excess clauses or irresponsible clauses in the contract to control risks and implement public order and good morals.
026-041
