- 學位論文
保險法中有關復效條文對保險公司及保戶之影響
Study on Impacts of How the Clauses of Reinstatement in Taiwan’s Insurance Law Affect Insurance Corporations and Insured Persons
摘要
台灣保險業經過數十年之發展，目前共計有本國及外商人壽壽險公司共三十家，各壽險公司對新契約的成長投注十分關注，並以新契約業務為前提，對於外勤人員之教育訓練亦以新契約招攬為重點。然而，新契約業務誠屬重要，但有效契約之繼續率更不容忽視。因保險契約多為長年期之契約，且保戶續繳保費維持契約效力之變數甚多，不時會造成契約效力之停止。就保戶與業者兩者之立場，皆不樂見已持續多年之保單因一時之原因而無法持續。故如何將停效之保險單運用合理且公平之機制予以恢復其效力，創造保戶及壽險公司雙贏，將是重要議題。 近年來，因消費者意識的抬頭，及主管機關對於保戶申訴之看重，其中有關保單復效的糾紛亦不在少數。保險法自開始立法即已對復效訂出相關規定，但因環境改變、經濟成長、各項法令之設立修正及主管機關監理等，再加上消費者意識抬頭，對於長期以來復效之作業在保險法與施行細則及示範條款不一致之規定下造成保戶與壽險公司之爭議或興訟，因此於九十六年七月十八日三讀通過並經總統公佈施行之保險法中，即針對復效條款重新審視及研擬，並將參考國外作法，對壽險公司無條件接受保戶復效的時間加以規範。 本研究為探討保險法中復效條款對於壽險公司及保戶之影響，透過不同領域之專家學者進行深入訪談，做出以下之結論： 1.確實達到保護消費者之目的。 2.明訂相關規則，避免保戶與壽險公司間認知之差異，減少爭議之發生。 3.對壽險公司雖將增加其逆選擇風險、金流之預估及作業時效之壓力等影響，但可藉此提升復效作業之風控。 4.壽險公司目前尚無明顯調整其復效之相關作業。 5.壽險公司除依賴或授權銷售通路提供保戶於保險契約復效之服務外，尚須強化與保戶之聯繫與服務。
並列摘要
Abstract: The insurance industry in Taiwan has developed for several decades. Up to date, the numbers of local and foreign life insurance corporations have amounted to 30. Now, as a result of the increasingly high competition of the market, they have to put a great deal of efforts on the growth of the new business contracts and therefore, inevitably, this part becomes the focus of the education training on sales agents. Indeed, the growth of the new business contracts is important; however, the customer retention rate is also crucial. Generally speaking, insurance contracts are usually long term contracts, for that reason, the variables for the insured persons to continually pay the insurance fee to sustain its validity is another currently-encountered issue which is not supposed to be neglected. From the perspectives of the insured persons and insurance dealers, they both are not willing to see the contract which has been paid for years to be suspended because of the temporary financial difficulty. Therefore, how to scheme a fair and reasonable mechanism to reinstate the insurance and meanwhile, create a win-win situation bilaterally is significant and urgent. Owing to the rise of consumer awareness and the authority’s changing attitude toward customer complaints, the disputes on insurance reinstatement occur more and more often these years. Besides, due to the changing environment, economic growth, revision or creation of each insurance-related law, the attitude of the insurance commissioner and the rise of consumer awareness, the regulations related to insurance reinstatement which had been used before seem to be out of date. These are all the reasons why the enforcement of the insurance law always conflicts with the demonstration clauses of reinstatement, which have been causing disputes and litigations for a long period of time. Therefore, on July 18th, 2007, the newly-declared insurance law was revised in the light of clauses of reinstatement and the authority also referred to the resources from other countries to amend the clauses related to “whether the reinstatement duration should be accepted by life insurance corporations without any condition”. The study focuses on how the clauses of reinstatement in Taiwan’s insurance law affect insurance corporations and insured persons. The following conclusions are gained through the interviews with the experts in different fields. 1. Ensure the customers’ right. 2. Specify associated regulations to prevent disputes caused by understanding discrepancy. 3. The insurance corporations will have higher pressure in ways such as adverse selection risk, cash flow and process time; however, the risk management can be enhanced. 4. Life insurance corporations have no obvious adjustment toward the operation of reinstatement so far. 5. Life insurance corporations should not only provide customers the service of reinstatement of insurance contract through authorizing or relying on sales channels, but also have to reinforce the service quality and the communication with customers.