因保險契約是最大誠信契約,所以要保人及被保險人在要保時應將要保書及體檢表內各項,以及保險公司指定醫師檢查健康狀況時之詢問事項,都需要實實在在詳詳細細的說明或填寫清楚,不能有過失遺漏、故意隱瞞或告知不實情事。否則,保險公司在契約訂定後二年內可以解除契約;即使事故發生後亦不負賠償責任,除非要保人 (或被保險人) 能證明保險事故發生原因與未告知事項無關。且因未盡告知義務解除契約時,其已繳的保險費不須退還。 核保人員須藉由要保書之陳述、銷售人員直接面對客戶之業務經驗判斷、政府或徵信社或其他保險人等之相關重要資料協助。再進一步分析危險因素,危險因素若高於一般平均標準,且無法避免、去除或降低,則核保人員可能建議保險人增加承保限制或直接拒保。 本文藉由說明告知義務之意義與核保之意義,並針對如何誠實告知義務與核保實務,配合案例分析的結果,來探討研究目的之明確及研究結果說明,最後分別針對台灣保險法、主管機關及保險公司提出建議,以供參考。
Because the insurance contract is the biggest contract in good faith, the proposer and the insured should be to protect the security and within the scope of the examination table, and insurance companies ask the physician to check health matters specified time, the need real details for more detailed instructions or write clearly, you can not fault omission, concealment or deliberately not told the truth thing. Otherwise, the insurance company after the contract set two years may rescind the contract; even after the accident also not be liable, unless the proposer (or the insured) can prove that the cause accident insurance has nothing to do with non-disclosure matters. And not entirely due to the duty of disclosure when the cancellation of a contract, the premium paid shall be refunded. Underwriting officer shall be to protect the book presentation, the sales staff directly to the relevant business experience to judge the government or other insurers or credit information agencies and other customers of important information to assist. Further analysis of risk factors, risk factors if the average is higher than the general standard, and can not be avoided, removed or reduced, the underwriting insurer might recommend increasing the coverage limit or direct insurance coverage. This article by descriptive sense and meaning of the underwriting of the obligation of, and for how honest obligation to inform and underwriting practices, with the case study results, to discuss the research clearly and study purposes of illustration, the last separately for Taiwan insurance law, the competent authorities insurance companies and make recommendations for reference.
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