論傷害保險之保單條款解釋及舉證責任－兼評最高法院102年度台上字第578號判決

The Interpretation of Policy Wordings and the Burden of Proof in Personal Accident Insurance: Examining the Supreme Court Civil Judgment 102 Tai-Shang-Tzu 578

葉力旗(Li-Chi Yeh) ； 林建智(Jan-Juy Lin)

《風險管理學報》 21卷1期 (2019/06) Pp. 43-68

摘要

當傷害保險承保範圍發生爭執時，解釋保險契約條款應是紛爭解決的第一步；除應依據保險法探求當事人真意與適用「疑義利益歸諸被保險人原則」外，「合理期待原則」及「內容控制原則」等相關學理或規範，皆為可採行之補充方法。訴訟時，舉證責任之分配及減輕事由之例外適用，更會影響案件之最終勝敗。本文以為，法院首先應正確地解釋保險契約條款，再依據當事人所主張之權利各要件事實分配舉證責任。此外，前階段之契約解釋方法，不應誤用於後階段之舉證責任分配或減輕。

關鍵字

保單條款解釋 ； 疑義利益歸諸被保險人 ； 合理期待 ； 內容控制 ； 舉證責任

並列摘要

Regarding to the coverage disputes of personal accident insurance, the interpretation of the policy wordings shall be in the first step for resolving them. In addition to seeking the real intention of the parties and applying for the doctrine of contra proferentem provided by the Insurance Law, the doctrine of reasonable expectation and the principle of judicial review can be adopted as supplemented methods for the interpretation. In litigation, the distribution and the alleviation of the burden of proof may also affect the ultimate outcome of the judicial decisions. It is submitted that the court should first interpret the policy wordings correctly, followed by distributing the burden of proof based on the elements of the rights claimed by the parties. furthermore, the principles of wordings interpretation at the first stage shouldn't be mis-applied to the distribution or alleviation of the burden of proof at later stage.

並列關鍵字

interpretation of policy wordings ； contra proferentem ； reasonable expectation ； judicial review ； burden of proof

參考文獻

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