保險法上危險變動與通知義務之研究─以對價平衡原則為中心

A Study on the Change of Risk and Duty of Notification in Taiwanese Insurance Act - Focus on the Principle of Risk Equivalence

陳仕儒(Shih-Ju Chen)

指導教授 ： 汪信君

國立臺灣大學/法律學院/法律學研究所/碩士(2017年)

https://doi.org/10.6342/NTU201703815

摘要

本文主要針對危險增加、減少、消滅等情形，就我國保險法上相關規定，探討解釋上以及實際運作上可能產生的問題，參考我國學說、實務上見解，並借鏡歐洲保險契約法原則、德國保險契約法、日本保險法相關規定，以對價平衡原則為核心，期能提出可行的解釋方法或改善建議。
本文將說明危險情事變動的類型及定義。除了討論危險增加情形外，本文為一併說明危險減少、危險消滅、危險變更及危險補償等情況，將以危險變動概稱之。危險變動除了重要性、持續性、不可預見性三個要件外，本文並參考比較法，並提出危險變動應於保險申請書提出後所發生，以及僅限於客觀實質危險二要件。此外，本文觀察若干實務見解，釐清通知義務與告知義務之適用、危險變動要件之持續性如何認定、保險契約復效時是否有危險增加適用，以及綜合討論被保險人犯罪或違規時是否屬於危險增加情形。
為了釐清通知義務與危險變動效果的不同，本章著重說明危險變動通知義務的相關規範。應注意者，歷來討論危險變動時，經常將違反通知義務的效果與危險變動後契約的調整畫上等號，然從比較法上可以得知，危險變動通知義務雖然是為了後續契約調整而來，但通知義務既然是獨立義務即有其要件及效果。我國關於危險增加通知義務的條文並非完善，本文參考比較法後，認為應通知之事項應限於具客觀重要性者，且建議將危險變動因素於契約書面明載，以及違反時效果應優先選擇調整保費而非解除契約，以盡可能維持契約效力。
此外，本文以對價平衡原則為基礎，探討危險變動後契約關係的調整。時序上，先有危險變動發生後方產生通知義務，而通知義務履行後，契約當事人應就如何調整契約即是本章核心。危險增加情形，除違反通知義務效果外，最重要的是依據對價平衡原則，就增加的危險程度為終止契約、調整保費或減少保險給付等調整，比較法上規定值得借鑑。另外，本文也討論到因危險增加而終止契約時損害賠償範圍為何以及相關權利的時效或除斥期間。危險減少與危險消滅則較為簡單，比較法上規範與我國類似，所以大致討論到減少保險費權利性質、因無法就保費合致而終止契約後，保險費是否應返還，以及相關權利的時效或除斥期間等問題。
最後，本文對於上開有關比較法上危險變動及通知義務機制之運作，暨我國保險法規範、學說見解及實務見解之說明下，所發現各個加以改進之處，提出本文觀點與修法建議。

關鍵字

危險變動 ； 危險增加 ； 危險減少 ； 通知義務 ； 對價平衡原則

並列摘要

This thesis is focusing on the different scenarios of change of risk, including the aggravation of risk, decrease of risk and cease of risk. Since several problems are born from the defects of the current legislation of Taiwanese Insurance Act and daily practice, this thesis hereto discuss the domestic theories and cases and further refer to the relevant regulations of Principles of European Insurance Contract Law, the German Insurance Contract Act and Japanese Insurance Act, based on the Principle of Risk Equivalence, to present a practical explanation of Taiwanese insurance act and recommended amendment.

The different scenarios and definition of change of risk will be discussed. This thesis will not only discuss the aggravation of risk, but also explain the decrease of risk, cease of risk, change of risk and risk compensation, hereinafter the “change of risk”. As to the definition of change of risk, in addition to the materiality, constancy and unforeseeablity, this thesis referred to comparative laws and added two elements of change of risk, that the change of risk happens only after the tender offer of insurance contract has been made and the risk shall be limited to substantial risk. Moreover, we can found there are some cases demonstrate the different applications between duty of notification and obligation of disclosure, the determination of constancy, whether the increase of risk applies to the reinstatement of an insurance policy and whether the criminal commitment or violation of traffic rules constitutes the increase of risk.

To clarify the difference between the duty of notification and the effect of change of risk, this thesis will focus on the relevant regulations of duty of notification. While discussion usually treat the effect of violation of duty of notification and the adjustment of insurance contract caused by the change of risk equally. We can learn from the comparative laws that the duty of notification is a separate duty and has its own elements and effect, though its purpose is to initiate the adjustment on the contract caused by change of risk. The current legislation about the increase of risk under Taiwanese law is not complete enough; hence, after consulting to comparative laws, we can conclude that the situations required to be notified shall be both substantially material and have been stated in written. Besides, in relation to the effect of the violation, in order to sustain the insurance contract, to adjust premium shall be first considered than to dismissal the contract.

The discussion of how to adjust the insurance contarct after change of risk taken place is based on the principle of risk equivalence. After the duty of notification has been performed, the adjustment of the contract is the theme of this chapter. As to the increase of risk, other than the effect of violation of duty of notification, the contract shall be adjusted by terminating the contract, adjusting premium or reducing the insurance payment pursuant to the principles of risk equivalence. In addition, this thesis will discuss about the indemnity resulted from the termination of contract and the prescription of relevant rights. After that, the decrease of risk and cease of risk are simpler while those comparative laws are similar to Taiwanese laws. This thesis will introduce the nature of the right to reduce the premium, whether the premium should be refunded after the contract has been terminated and the prescription of relevant rights.

After all, the conclusion of this thesis will present the personal insights and recommended amendments to the current legislation as the summary of discussions over domestic theories and practices and comparative laws.

並列關鍵字

Change of risk ； aggravation of risk ； decrease of risk ； duty of notification ； the principle of risk equvalence

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