摘要
关于商业健康险与社会医疗险在赔付领域发生竞合,是否应当适用损失补偿原则这一问题,司法实践中始终未形成统一答案。通过对保险法理论以及相关的司法解释、部门规章进行梳理分析后得出,费用补偿型商业健康保险应当适用损失补偿原则,而定额给付型商业健康保险不适用该原则。未来应当修改立法,从明确损失补偿原则的适用范围和赋予保险人建议义务两个角度出发,有效解决该争议。
As to whether the principle of compensation for losses should be applied in the conflict between commercial health insurance and social medical insurance in the field of compensation,there has never been a unified answer in judicial practice.Through the analysis of the theory of insurance law,relevant judicial interpretation and departmental rules,it is concluded that the principle of loss compensation should be applied to the cost-compensated commercial health insurance,while the principle of loss compensation should not be applied to the fixed-payment commercial health insurance.In the future,legislation should be amended to effectively solve the dispute from the perspective of clarifying the scope of application of the principle of loss compensation and endowing the insurer with the obligation of suggestion.
作者
沈志康
Shen Zhikang(Economic Law School,East China University of Political Science and Law,Shanghai 200042,China)
出处
《黑龙江工业学院学报（综合版）》
2019年第6期74-78,共5页
Journal of Heilongjiang University of Technology(Comprehensive Edition)
关键词
商业健康保险
损失补偿原则
法律冲突
commercial health insurance
principle of compensation for loss
conflict of laws
