論保險契約上客觀危險篩選法律效果之研究─ 以對價平衡原則之退讓與法律行為基礎理論之引進為中心

就保險契約義務違反之法律效果設計，晚近外國保險契約法制已逐漸揚棄兩極化法律效果之「全有全無」原則立法例，並擁抱層級化法律效果之「或多或少」原則立法例，舉告知義務規定為例，在參與2018年國際保險法學會全球會議之國家中，已將近三分之二國家跟隨「或多或少」原則之浪潮，反觀我國2018年12月所預告保險法修正草案，仍未見漣漪。有鑑於此，本文即以告知義務規定所屬之客觀危險篩選制度作為研究標的，並自其法理基礎出發，透過解釋論上法之尋找，進而調和現行客觀危險篩選法制設計之不當。自我國學說實務向來所強調之對價平衡原則以觀，除強調「個別」對價平衡更勝於具法律正當性「總體」對價平衡外，似將「主觀」、「客觀」對價平衡之優先地位有所誤認。而保險契約所承保之客觀危險乃保險契約之基礎，且基於(最大)誠信契約及射倖契約性質尤重契約基礎，或許可思考重新建構客觀危險篩選法制之法理基礎，以民法誠信原則下具體化規定之情事變更原則所發展之法律行為基礎理論為法理基礎更為妥適，亦即以維持訂約時契約雙方當事人對於客觀危險之「主觀重大認識」(主觀法律行為基礎)，並維持契約存續期間客觀危險之「客觀情狀」(客觀法律行為基礎)，一旦上述二者契約基礎發生變動，即屬法律行為基礎之干擾，而對價平衡本身即屬干擾與否之標準之一，此時法律效果乃契約內容調整為主，契約效力解消為輔，進而維繫保險契約正義，同時與「或多或少原則」有異曲同工之妙，因此，立法者應思考修正相關規定，而在我國保險法修法引進之前，透過解釋論上實質援引法律行為基礎理論，亦不失為可行之道。

關鍵字

客觀危險篩選；對價平衡原則； (最大)誠信原則；情事變更原則；法律行為基礎理論

並列摘要

In terms of the violation of duty in insurance contract, many jurisdictions recently have started to embrace the "more or less" principle instead of the "all or nothing" principle regarding the legal effects of such violation. Take the duty of disclosure for example, nearly two-thirds of countries in International Association of Insurance Law (AIDA) World Congress 2018 have accepted the "more or less" principle, while there is no sign of following the trend in the 2018 Taiwan Insurance Act Draft. Based on above observation, this study would take the objective risk selection as research target, and aim to find out the proper dogmatic interpretation to meet the "more or less" and alleviate "all or nothing". In Taiwan, the principle of equilibrium is considered as the legal foundation of the objective risk selection. With respect to the risk and premium in the insurance contract, most opinions from judicial holding and scholars highlight that the individual equilibrium is more important than the global equilibrium. However, the former is not entitled by Civil Code or Insurance Act; whereas the latter could be found in Insurance Act. In addition, this study aims to set the priority for subjective equilibrium in front of objective equilibrium regarding individual equilibrium. From this study's perspective, we should reconstruct the legal foundation of objective risk selection. The "Geschaftsgrundlage" theory (Die Lerne von der Geschaftsgrundlage) which is derived from good faith in civil code could be the original idea. The "Geschaftsgrundlage" theory can be divided into two parts: "Subjeive Geschaftsgrundlage" and "Objective Geschaftsgrundlage". Both are contractual foundation in insurance contract. The former means that the policyholder should maintain the subjective understanding of the objective risk between the parties of insurance contract. The latter means that the policyholder should maintain the circumstances regarding objective risk. The study concludes: (a) Once an alteration of contractual foundation has been established, it is considered as interference of "Geschaftsgrundlage", then the legal effects is adaptation of contract at first and the disadvantaged party may revoke or terminate the contract. And the principle of equilibrium between the risk and premium is just one of criteria. (b) The theory of "Geschaftsgrundlage" achieves the goal of "more or less" principle from a different way; furthermore, it maintains the justice of Insurance Contract. The study findings may serve as a guide for further research on the Amendment of Taiwan Insurance Act to avoid the inappropriateness of "all or nothing" from the dogmatic interpretation.