摘要
保险人的恶意理赔是当下"理赔难"这一行业顽疾的一个重要症结。保险合同的关系型特质使保险人在理赔过程中极有可能出现机会主义倾向,采取违背善意且公平交易义务的严重恶意理赔行为。由于价值中立的立场以及受限于承诺履行利益的补偿范围,既有合同法之下的违约责任对此出现了规制乏力。为此,有必要超越既有的合同规范,采取从一般违约跨越到恶意侵权并上升到严重恶意侵权的逐层递进策略,借助侵权责任法之下的惩罚性赔偿机制来矫正这一失范局面。在抽取出严重恶意理赔行为作为嵌入起点的基础上发挥惩罚性赔偿机制的惩罚效应,通过彰显严重恶意理赔的应受责难性来填补违约责任在价值评判方面的功能缺失;同时,借助惩罚性赔偿机制的威慑作用来达到对保险人严重恶意理赔的遏制效应,确保保险消费者获得经济保障以及内心安宁这一固有权益的实现。
The insurer＇ s bad faith is one of the main factors which have caused the difficulty in settling insurance claims. Due to the relational characteristic of the insurance contract, it is very likely for the insurer to act opportunistically which is a breach of the duty of good faith and fair dealing. Since the liability system of breach of contract is limited by the value neutrality and the compensation doctrine of foreseeability of damages it cannot effectively deter the insurer＇ s bad faith behavior during the process of settling insurance claims. Therefore, it is necessary to surpass the present regulation of contract law and move into the liability system of bad faith tort and finally ascend to that of the serious bad faith tort. On this basis, the punitive compensation system can solve the problem of regulation failure. Punitive compensation should be applied to the serious bad faith tort in settling insurance claims. In this way, the punishment function will fill the blank of value judgments and the deterrence function can curb the serious bad faith in settling insurance claims. These measures can help the insurance consumers realize their inherent rights of obtaining financial security and peace of mind.
出处
《保险研究》
CSSCI
北大核心
2016年第4期88-98,共11页
Insurance Studies
基金
作者主持的2015年国家社科基金一般项目"恶意理赔的侵权救济研究"(15BFX177)
四川省哲学社会科学重点研究基地中国金融法研究中心资助的阶段性研究成果
关键词
惩罚性赔偿
关系型合同
机会主义行为
严重恶意理赔行为
punitive compensation
relational contract surance claims
opportunistic behavior
the serious bad faith in settling insurance claims
