一、責任保險

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責(ze)(ze)任(ren)(ren)(ren)保(bao)(bao)(bao)險(xian)(xian)(xian)，指以(yi)被保(bao)(bao)(bao)險(xian)(xian)(xian)人對第三人依法(fa)(fa)應(ying)負的(de)(de)民事賠償(chang)責(ze)(ze)任(ren)(ren)(ren)為保(bao)(bao)(bao)險(xian)(xian)(xian)標的(de)(de)保(bao)(bao)(bao)險(xian)(xian)(xian)，又稱為第三者(zhe)責(ze)(ze)任(ren)(ren)(ren)險(xian)(xian)(xian)。《保(bao)(bao)(bao)險(xian)(xian)(xian)法(fa)(fa)》第50條規定(ding)：責(ze)(ze)任(ren)(ren)(ren)保(bao)(bao)(bao)險(xian)(xian)(xian)是(shi)指以(yi)被保(bao)(bao)(bao)險(xian)(xian)(xian)人對第三者(zhe)依法(fa)(fa)應(ying)付的(de)(de)賠償(chang)責(ze)(ze)任(ren)(ren)(ren)為保(bao)(bao)(bao)險(xian)(xian)(xian)標的(de)(de)的(de)(de)保(bao)(bao)(bao)險(xian)(xian)(xian)。按保(bao)(bao)(bao)險(xian)(xian)(xian)標的(de)(de)的(de)(de)不(bu)同，可將(jiang)其分為雇主責(ze)(ze)任(ren)(ren)(ren)保(bao)(bao)(bao)險(xian)(xian)(xian)、產品責(ze)(ze)任(ren)(ren)(ren)保(bao)(bao)(bao)險(xian)(xian)(xian)、職業責(ze)(ze)任(ren)(ren)(ren)保(bao)(bao)(bao)險(xian)(xian)(xian)和公(gong)眾(zhong)責(ze)(ze)任(ren)(ren)(ren)保(bao)(bao)(bao)險(xian)(xian)(xian)等。

根據《保(bao)險(xian)(xian)(xian)法》的(de)規定，責(ze)(ze)任(ren)保(bao)險(xian)(xian)(xian)的(de)保(bao)險(xian)(xian)(xian)標的(de)顯然屬于(yu)民(min)事(shi)責(ze)(ze)任(ren)，后者又包括侵權(quan)責(ze)(ze)任(ren)和違(wei)約(yue)責(ze)(ze)任(ren)兩種。由于(yu)違(wei)約(yue)責(ze)(ze)任(ren)可以(yi)通過訂立信用保(bao)險(xian)(xian)(xian)合(he)同或保(bao)證保(bao)險(xian)(xian)(xian)合(he)同來解(jie)決，因(yin)此責(ze)(ze)任(ren)保(bao)險(xian)(xian)(xian)的(de)保(bao)險(xian)(xian)(xian)標的(de)即(ji)是(shi)侵權(quan)責(ze)(ze)任(ren)。

一般認為，1855年(nian)英國鐵路乘(cheng)客保(bao)險(xian)公(gong)司向鐵路部門提供鐵路承(cheng)運人責(ze)(ze)(ze)(ze)任保(bao)險(xian)，是歷(li)史上首次出現(xian)責(ze)(ze)(ze)(ze)任保(bao)險(xian)。1875年(nian)，英國又(you)出現(xian)了(le)馬車(che)第三(san)(san)者責(ze)(ze)(ze)(ze)任保(bao)險(xian)，可以看作(zuo)是汽車(che)第三(san)(san)者責(ze)(ze)(ze)(ze)任險(xian)的(de)(de)先(xian)導。隨著工業生產的(de)(de)不(bu)斷進步，責(ze)(ze)(ze)(ze)任保(bao)險(xian)的(de)(de)范圍也不(bu)斷增大，其(qi)在(zai)(zai)社會(hui)生活中的(de)(de)重(zhong)要性也日益突出。而如前所述，責(ze)(ze)(ze)(ze)任保(bao)險(xian)以被保(bao)險(xian)人對于第三(san)(san)者的(de)(de)侵權賠償責(ze)(ze)(ze)(ze)任為保(bao)險(xian)標的(de)(de)，這(zhe)使(shi)得其(qi)和(he)侵權法之間產生了(le)沖突。主要表現(xian)在(zai)(zai)以下兩個方面：

1、責(ze)任(ren)(ren)保(bao)險(xian)使(shi)侵(qin)(qin)權責(ze)任(ren)(ren)社會化。侵(qin)(qin)權責(ze)任(ren)(ren)本應由侵(qin)(qin)權行為(wei)人來承(cheng)擔，但責(ze)任(ren)(ren)保(bao)險(xian)使(shi)得侵(qin)(qin)權行為(wei)人（即投保(bao)人）的侵(qin)(qin)權責(ze)任(ren)(ren)轉嫁(jia)給保(bao)險(xian)公司(si)，并通過保(bao)險(xian)公司(si)這(zhe)一媒介轉嫁(jia)給整(zheng)個社會來承(cheng)擔。

一、告知義務的法律屬性

告知(zhi)義(yi)務是指在保險(xian)合(he)同成立(li)前，投保人對保險(xian)人的(de)訊問所承(cheng)擔的(de)說明(ming)或陳述(shu)義(yi)務。

（一）告知義務是法定義務

在(zai)普通合同(tong)中也存在(zai)告知義務的(de)問題。保(bao)險合同(tong)中的(de)告知義務是保(bao)險法特殊明確規定的(de)，這是在(zai)其(qi)他種(zhong)類合同(tong)中所沒有的(de)。

告知(zhi)義(yi)(yi)務(wu)是(shi)一(yi)項法(fa)定義(yi)(yi)務(wu)，但該項義(yi)(yi)務(wu)是(shi)否可以(yi)(yi)通過雙方(fang)的(de)(de)(de)(de)(de)約(yue)定予以(yi)(yi)免(mian)除(chu)，是(shi)一(yi)個(ge)有爭議的(de)(de)(de)(de)(de)問題。有學者認(ren)為(wei)，"告知(zhi)義(yi)(yi)務(wu)是(shi)法(fa)律要(yao)求(qiu)保(bao)(bao)(bao)險(xian)(xian)合(he)同當事人須為(wei)一(yi)定行(xing)為(wei)的(de)(de)(de)(de)(de)義(yi)(yi)務(wu)，義(yi)(yi)務(wu)人不能(neng)(neng)拒絕履(lv)行(xing)，更不能(neng)(neng)阻(zu)礙(ai)對(dui)方(fang)履(lv)行(xing)，雙方(fang)不能(neng)(neng)通過合(he)同約(yue)定排除(chu)該義(yi)(yi)務(wu)的(de)(de)(de)(de)(de)履(lv)行(xing)。"私(si)以(yi)(yi)為(wei)，告知(zhi)義(yi)(yi)務(wu)是(shi)為(wei)實現保(bao)(bao)(bao)險(xian)(xian)人的(de)(de)(de)(de)(de)技術性要(yao)求(qiu)而設立的(de)(de)(de)(de)(de)義(yi)(yi)務(wu)。在無限(xian)告知(zhi)主義(yi)(yi)的(de)(de)(de)(de)(de)方(fang)式(shi)下(xia)，如果保(bao)(bao)(bao)險(xian)(xian)人認(ren)為(wei)根據自己掌握的(de)(de)(de)(de)(de)情(qing)況(kuang)足(zu)以(yi)(yi)計(ji)算出(chu)保(bao)(bao)(bao)險(xian)(xian)費(fei)率，可以(yi)(yi)免(mian)除(chu)投保(bao)(bao)(bao)人的(de)(de)(de)(de)(de)告知(zhi)義(yi)(yi)務(wu)；在詢問回答主義(yi)(yi)的(de)(de)(de)(de)(de)方(fang)式(shi)下(xia)，詢問條款以(yi)(yi)外的(de)(de)(de)(de)(de)內(nei)容，視為(wei)保(bao)(bao)(bao)險(xian)(xian)人部(bu)分免(mian)除(chu)了投保(bao)(bao)(bao)人的(de)(de)(de)(de)(de)告知(zhi)義(yi)(yi)務(wu)，如果保(bao)(bao)(bao)險(xian)(xian)人未列詢問條款，可視為(wei)保(bao)(bao)(bao)險(xian)(xian)人全部(bu)免(mian)除(chu)了投保(bao)(bao)(bao)人的(de)(de)(de)(de)(de)告知(zhi)義(yi)(yi)務(wu)。

（二）告知義務是附隨義務

[論文關鍵詞]保險法告知義務(wu)誠實(shi)信用(yong)原則

[論文摘要]保險法上的(de)(de)告(gao)知義務，是保險合(he)同中(zhong)非真正義務，但告(gao)知義務是保險業合(he)理營運的(de)(de)制度基(ji)石。我們要對(dui)保險合(he)同的(de)(de)告(gao)知義務范圍作嚴格(ge)界定，從(cong)而才能減少糾紛，使(shi)之更具(ju)有操作性和(he)實(shi)踐性。

保(bao)(bao)(bao)(bao)險(xian)法(fa)上的(de)告(gao)(gao)(gao)知(zhi)，是指投(tou)(tou)保(bao)(bao)(bao)(bao)人(ren)(ren)(ren)在(zai)(zai)訂(ding)立(li)(li)保(bao)(bao)(bao)(bao)險(xian)合(he)同(tong)時就(jiu)與保(bao)(bao)(bao)(bao)險(xian)標(biao)的(de)危險(xian)程度相關的(de)情(qing)況向(xiang)保(bao)(bao)(bao)(bao)險(xian)人(ren)(ren)(ren)所做的(de)陳述或說(shuo)(shuo)明。其內容一般(ban)包(bao)括三個方面(mian):即對事(shi)實(shi)的(de)陳述，對將來事(shi)件和行為的(de)陳述，以及(ji)對他(ta)人(ren)(ren)(ren)陳述的(de)轉述。當今世界各國保(bao)(bao)(bao)(bao)險(xian)立(li)(li)法(fa)都(dou)規定在(zai)(zai)保(bao)(bao)(bao)(bao)險(xian)合(he)同(tong)訂(ding)立(li)(li)時，投(tou)(tou)保(bao)(bao)(bao)(bao)人(ren)(ren)(ren)或者被(bei)保(bao)(bao)(bao)(bao)險(xian)人(ren)(ren)(ren)應當將保(bao)(bao)(bao)(bao)險(xian)標(biao)的(de)的(de)有關重要事(shi)項(xiang)如(ru)實(shi)告(gao)(gao)(gao)知(zhi)保(bao)(bao)(bao)(bao)險(xian)人(ren)(ren)(ren)，這(zhe)就(jiu)是通(tong)常所說(shuo)(shuo)的(de)告(gao)(gao)(gao)知(zhi)義務。我國《保(bao)(bao)(bao)(bao)險(xian)法(fa)》第17條第1款(kuan)確(que)立(li)(li)了(le)告(gao)(gao)(gao)知(zhi)義務:“訂(ding)立(li)(li)保(bao)(bao)(bao)(bao)險(xian)合(he)同(tong)，保(bao)(bao)(bao)(bao)險(xian)人(ren)(ren)(ren)應當向(xiang)投(tou)(tou)保(bao)(bao)(bao)(bao)人(ren)(ren)(ren)說(shuo)(shuo)明保(bao)(bao)(bao)(bao)險(xian)合(he)同(tong)的(de)條款(kuan)內容，并可以就(jiu)保(bao)(bao)(bao)(bao)險(xian)標(biao)的(de)或者被(bei)保(bao)(bao)(bao)(bao)險(xian)人(ren)(ren)(ren)的(de)有關情(qing)況提出詢問，投(tou)(tou)保(bao)(bao)(bao)(bao)人(ren)(ren)(ren)應當如(ru)實(shi)告(gao)(gao)(gao)知(zhi)”。

如何確定告(gao)(gao)(gao)知范圍的？立法(fa)例上有無(wu)限告(gao)(gao)(gao)知主(zhu)(zhu)義和(he)詢(xun)問告(gao)(gao)(gao)知主(zhu)(zhu)義之分，無(wu)限告(gao)(gao)(gao)知主(zhu)(zhu)義要求(qiu)告(gao)(gao)(gao)知義務人不以保險(xian)(xian)人的詢(xun)問事項(xiang)為限，必須將有關危險(xian)(xian)的一切(qie)情況都如實(shi)(shi)告(gao)(gao)(gao)知保險(xian)(xian)人;詢(xun)問告(gao)(gao)(gao)知主(zhu)(zhu)義主(zhu)(zhu)張告(gao)(gao)(gao)知義務人只需對保險(xian)(xian)人的詢(xun)問如實(shi)(shi)回答即可。

目前我國大多數告知(zhi)(zhi)義務(wu)(wu)人對(dui)保(bao)險的(de)專業(ye)(ye)知(zhi)(zhi)識知(zhi)(zhi)之甚少，而保(bao)險人作為專業(ye)(ye)人員(yuan)，精通(tong)保(bao)險業(ye)(ye)務(wu)(wu)，知(zhi)(zhi)悉估(gu)計危險的(de)各種情況，況且，無限告知(zhi)(zhi)可能在一定程度上損及商業(ye)(ye)秘密，所以，在保(bao)險發展初期應以采(cai)詢問告知(zhi)(zhi)主義為宜，對(dui)雙方當事人也(ye)比較公平。否則，如(ru)果保(bao)險人怠于(yu)調(diao)查和詢問，卻要求(qiu)身為告知(zhi)(zhi)義務(wu)(wu)人作漫無邊際的(de)告知(zhi)(zhi)，不(bu)符合誠實信用原則的(de)要求(qiu)。

對此，我(wo)國(guo)(guo)《海商法》和《保(bao)(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)(xian)(xian)法》的(de)規(gui)(gui)(gui)定(ding)(ding)(ding)有差別。《海商法》第22條(tiao)規(gui)(gui)(gui)定(ding)(ding)(ding):“合同(tong)簽(qian)訂前，被(bei)保(bao)(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)(xian)(xian)人應當將其知(zhi)(zhi)道(dao)或(huo)在(zai)通(tong)常業務(wu)中應當知(zhi)(zhi)道(dao)的(de)有關影響(xiang)保(bao)(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)(xian)(xian)人據(ju)以確定(ding)(ding)(ding)保(bao)(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)(xian)(xian)費率或(huo)者確定(ding)(ding)(ding)是(shi)否同(tong)意(yi)承保(bao)(bao)(bao)(bao)(bao)(bao)(bao)的(de)重要情(qing)況(kuang)(kuang)，如實告(gao)知(zhi)(zhi)保(bao)(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)(xian)(xian)人。保(bao)(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)(xian)(xian)人知(zhi)(zhi)道(dao)或(huo)者在(zai)通(tong)常業務(wu)中應當知(zhi)(zhi)道(dao)的(de)情(qing)況(kuang)(kuang)，保(bao)(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)(xian)(xian)人沒有詢(xun)(xun)問(wen)(wen)的(de)，被(bei)保(bao)(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)(xian)(xian)人無需告(gao)知(zhi)(zhi)”，采用的(de)是(shi)主(zhu)(zhu)動告(gao)知(zhi)(zhi)主(zhu)(zhu)義，可能是(shi)基(ji)于海上風險(xian)(xian)(xian)(xian)(xian)不可預知(zhi)(zhi)性(xing)大，危險(xian)(xian)(xian)(xian)(xian)測定(ding)(ding)(ding)技術落(luo)后等作出的(de)考慮(lv)(lv)，但隨著現代科技和通(tong)訊的(de)日益發達，人駕(jia)御自然(ran)的(de)能力(li)已(yi)今非昔比，這種考慮(lv)(lv)的(de)基(ji)礎(chu)被(bei)大大削弱，詢(xun)(xun)問(wen)(wen)告(gao)知(zhi)(zhi)主(zhu)(zhu)義存(cun)在(zai)的(de)合理性(xing)遭(zao)到質疑。我(wo)國(guo)(guo)《保(bao)(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)(xian)(xian)法》第17條(tiao)第1款規(gui)(gui)(gui)定(ding)(ding)(ding):“訂立保(bao)(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)(xian)(xian)合同(tong)保(bao)(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)(xian)(xian)人應當向投保(bao)(bao)(bao)(bao)(bao)(bao)(bao)人說(shuo)明保(bao)(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)(xian)(xian)合同(tong)的(de)條(tiao)款內容，并可以就保(bao)(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)(xian)(xian)標(biao)的(de)或(huo)者被(bei)保(bao)(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)(xian)(xian)人的(de)有關情(qing)況(kuang)(kuang)提出詢(xun)(xun)問(wen)(wen)，投保(bao)(bao)(bao)(bao)(bao)(bao)(bao)人應當如實告(gao)知(zhi)(zhi)”。

1汽車保險的含義

在(zai)了(le)解汽車(che)保(bao)(bao)險(xian)(xian)之前,先介紹一下保(bao)(bao)險(xian)(xian)的(de)(de)含義。《中華(hua)人民共和國保(bao)(bao)險(xian)(xian)法》所(suo)稱保(bao)(bao)險(xian)(xian)是指投(tou)保(bao)(bao)人根(gen)據合(he)同(tong)約(yue)定,向保(bao)(bao)險(xian)(xian)人支付保(bao)(bao)險(xian)(xian)費,保(bao)(bao)險(xian)(xian)人對于合(he)同(tong)約(yue)定的(de)(de)可能發(fa)生的(de)(de)事故引起發(fa)生所(suo)造(zao)成的(de)(de)財產損失承擔賠(pei)償保(bao)(bao)險(xian)(xian)金責任(ren),或者當(dang)被保(bao)(bao)險(xian)(xian)人死亡、傷殘、疾病(bing)或者達到合(he)同(tong)約(yue)定的(de)(de)年齡、期限時承擔給付保(bao)(bao)險(xian)(xian)金責任(ren)的(de)(de)商業保(bao)(bao)險(xian)(xian)行為。

機(ji)(ji)動車(che)保(bao)(bao)(bao)險(xian)是保(bao)(bao)(bao)險(xian)中最為(wei)重要的(de)保(bao)(bao)(bao)險(xian)種(zhong)類,機(ji)(ji)動車(che)保(bao)(bao)(bao)險(xian)是綜合性保(bao)(bao)(bao)險(xian),屬于財產保(bao)(bao)(bao)險(xian)范(fan)疇,是運輸工具保(bao)(bao)(bao)險(xian)的(de)一種(zhong),它承保(bao)(bao)(bao)業(ye)務、商用和(he)民(min)用的(de)各種(zhong)機(ji)(ji)動車(che)因遭受自然災害(hai)或意外事故(gu)造(zao)成的(de)車(che)輛(liang)本身(shen)以(yi)及相關利益損(sun)失和(he)采(cai)取措施所支付的(de)合理費(fei)用,以(yi)及被保(bao)(bao)(bao)險(xian)人對第(di)三者人身(shen)傷害(hai)、財產損(sun)失依法應負有的(de)民(min)事賠(pei)償責任(ren)。

2汽車保險的分類

機動車保險按照承保條件分(fen)為(wei)主險和(he)附(fu)加險,見下表。

機(ji)動車(che)主險中的(de)機(ji)動車(che)損(sun)失(shi)險承保機(ji)動車(che)輛(liang)(liang)在使用(yong)過(guo)程中所(suo)(suo)創(chuang)造(zao)的(de)風險,即(ji)(ji)對(dui)于(yu)因(yin)車(che)輛(liang)(liang)本身損(sun)失(shi);第三者責任保險承保車(che)輛(liang)(liang)在使用(yong)過(guo)程中所(suo)(suo)創(chuang)造(zao)的(de)風險,即(ji)(ji)對(dui)于(yu)因(yin)車(che)輛(liang)(liang)使用(yong)給(gei)他人造(zao)成(cheng)的(de)人身傷害和財(cai)產(chan)損(sun)失(shi)依法應由(you)被(bei)保險人承擔賠償(chang)(chang)責任時,由(you)保險人負(fu)責賠償(chang)(chang)。

一、我國保險業誠信建設(she)的現狀(zhuang)

目前我國(guo)保(bao)(bao)險(xian)(xian)(xian)(xian)業在快(kuai)速發(fa)展的(de)(de)同時，市場出現(xian)了一(yi)些(xie)違(wei)背誠信原(yuan)則(ze)的(de)(de)現(xian)象(xiang)。一(yi)些(xie)保(bao)(bao)險(xian)(xian)(xian)(xian)公司(si)利用(yong)(yong)信息(xi)優(you)勢和保(bao)(bao)險(xian)(xian)(xian)(xian)業務(wu)專業性(xing)強的(de)(de)特點(dian)，在個別(bie)案件中(zhong)(zhong)拒賠(pei)(pei)不(bu)合理；違(wei)規經營，支(zhi)付過高的(de)(de)手續費(fei)、采用(yong)(yong)過低費(fei)率(lv)等惡性(xing)競(jing)爭行為，損害(hai)了保(bao)(bao)險(xian)(xian)(xian)(xian)公司(si)的(de)(de)社會(hui)聲譽。而(er)不(bu)少保(bao)(bao)險(xian)(xian)(xian)(xian)人在利益驅(qu)動(dong)下(xia)，許(xu)諾(nuo)虛(xu)假(jia)(jia)的(de)(de)高回報率(lv)，回避說明保(bao)(bao)險(xian)(xian)(xian)(xian)合同中(zhong)(zhong)的(de)(de)免責條款，一(yi)味向客戶(hu)推銷保(bao)(bao)費(fei)高卻不(bu)一(yi)定適用(yong)(yong)的(de)(de)險(xian)(xian)(xian)(xian)種；還會(hui)出現(xian)撕單、埋單、私(si)吞或(huo)挪用(yong)(yong)保(bao)(bao)費(fei)、制造(zao)假(jia)(jia)賠(pei)(pei)案、誤導甚(shen)至欺騙投(tou)保(bao)(bao)人等行為。而(er)一(yi)些(xie)投(tou)保(bao)(bao)人在投(tou)保(bao)(bao)時不(bu)履(lv)行如實告(gao)知(zhi)義務(wu)，或(huo)在不(bu)滿足(zu)投(tou)保(bao)(bao)條件下(xia)為獲取保(bao)(bao)險(xian)(xian)(xian)(xian)保(bao)(bao)障而(er)提供虛(xu)假(jia)(jia)信息(xi)；更(geng)有甚(shen)者(zhe)，騙保(bao)(bao)騙賠(pei)(pei)花樣翻(fan)新(xin)等等。這(zhe)些(xie)違(wei)背誠信道德和法律的(de)(de)行為對(dui)保(bao)(bao)險(xian)(xian)(xian)(xian)業的(de)(de)發(fa)展已(yi)造(zao)成了嚴重的(de)(de)損害(hai)。

二(er)、我國保險業誠(cheng)信(xin)現狀的成(cheng)因

1.制度缺陷

制度(du)缺陷(xian)主要(yao)表(biao)現在以下幾個方面。

（1）社(she)會(hui)信用(yong)體系不完善

一(yi)、我國旅游保險(xian)的現(xian)狀(zhuang)分析



近年來(lai),我國旅(lv)游(you)(you)業蓬勃發(fa)展(zhan),而作為旅(lv)游(you)(you)業軟環境之一的旅(lv)游(you)(you)保(bao)險卻嚴重滯(zhi)后于旅(lv)游(you)(you)業的發(fa)展(zhan),影響了旅(lv)游(you)(you)業的法制化(hua)(hua)、規范(fan)化(hua)(hua),對旅(lv)游(you)(you)業的發(fa)展(zhan)起(qi)到了消極作用。具體(ti)表現如(ru)下:

1、旅(lv)(lv)游(you)(you)(you)(you)(you)(you)(you)保(bao)(bao)險(xian)(xian)的(de)收(shou)(shou)(shou)入(ru)過低(di)。2000年(nian)(nian),我國(guo)(guo)旅(lv)(lv)游(you)(you)(you)(you)(you)(you)(you)收(shou)(shou)(shou)入(ru)超過4000億(yi)(yi)(yi)元(yuan)(yuan),而旅(lv)(lv)游(you)(you)(you)(you)(you)(you)(you)保(bao)(bao)險(xian)(xian)的(de)收(shou)(shou)(shou)入(ru),以市場份額(e)最(zui)高的(de)中國(guo)(guo)人(ren)壽保(bao)(bao)險(xian)(xian)公司為例,也僅(jin)(jin)為5888萬元(yuan)(yuan)。由此(ci)推算,中國(guo)(guo)旅(lv)(lv)游(you)(you)(you)(you)(you)(you)(you)保(bao)(bao)險(xian)(xian)的(de)保(bao)(bao)費(fei)收(shou)(shou)(shou)入(ru)不足1億(yi)(yi)(yi)元(yuan)(yuan),僅(jin)(jin)占(zhan)旅(lv)(lv)游(you)(you)(you)(you)(you)(you)(you)收(shou)(shou)(shou)入(ru)的(de)0.025%。2001年(nian)(nian),全國(guo)(guo)國(guo)(guo)內(nei)(nei)出游(you)(you)(you)(you)(you)(you)(you)的(de)人(ren)數7.84億(yi)(yi)(yi)人(ren)次,旅(lv)(lv)游(you)(you)(you)(you)(you)(you)(you)收(shou)(shou)(shou)入(ru)5566億(yi)(yi)(yi)元(yuan)(yuan),按每人(ren)購買10元(yuan)(yuan)的(de)旅(lv)(lv)游(you)(you)(you)(you)(you)(you)(you)保(bao)(bao)險(xian)(xian)計算,一年(nian)(nian)就該有70多億(yi)(yi)(yi)元(yuan)(yuan)巨額(e)保(bao)(bao)費(fei)收(shou)(shou)(shou)入(ru),而實(shi)際的(de)保(bao)(bao)費(fei)收(shou)(shou)(shou)入(ru)卻(que)只有這一數字的(de)20%左右。2002年(nian)(nian),國(guo)(guo)內(nei)(nei)旅(lv)(lv)游(you)(you)(you)(you)(you)(you)(you)收(shou)(shou)(shou)入(ru)為3878億(yi)(yi)(yi)元(yuan)(yuan),國(guo)(guo)內(nei)(nei)旅(lv)(lv)游(you)(you)(you)(you)(you)(you)(you)人(ren)數達8.78億(yi)(yi)(yi)人(ren)次。如果以現(xian)行旅(lv)(lv)游(you)(you)(you)(you)(you)(you)(you)保(bao)(bao)險(xian)(xian)較低(di)價格10元(yuan)(yuan)推算,國(guo)(guo)內(nei)(nei)旅(lv)(lv)游(you)(you)(you)(you)(you)(you)(you)保(bao)(bao)險(xian)(xian)費(fei)總(zong)收(shou)(shou)(shou)入(ru)可達87.8億(yi)(yi)(yi)元(yuan)(yuan).可以清楚地(di)看(kan)出,雖(sui)然旅(lv)(lv)游(you)(you)(you)(you)(you)(you)(you)業收(shou)(shou)(shou)入(ru)近(jin)年(nian)(nian)來每年(nian)(nian)都以迅猛的(de)勢(shi)頭增(zeng)長(chang),但是旅(lv)(lv)游(you)(you)(you)(you)(you)(you)(you)保(bao)(bao)險(xian)(xian)的(de)收(shou)(shou)(shou)入(ru)卻(que)增(zeng)長(chang)緩慢,與旅(lv)(lv)游(you)(you)(you)(you)(you)(you)(you)業的(de)發(fa)展不相協(xie)調,旅(lv)(lv)游(you)(you)(you)(you)(you)(you)(you)保(bao)(bao)險(xian)(xian)的(de)發(fa)展還有很大潛力(li)。

2、旅(lv)(lv)游(you)(you)(you)意(yi)(yi)外(wai)(wai)(wai)保(bao)險(xian)(xian)(xian)險(xian)(xian)(xian)種(zhong)少，產品單一。目(mu)前我國的(de)旅(lv)(lv)游(you)(you)(you)意(yi)(yi)外(wai)(wai)(wai)險(xian)(xian)(xian)險(xian)(xian)(xian)種(zhong)主要有四大類:旅(lv)(lv)游(you)(you)(you)人(ren)身意(yi)(yi)外(wai)(wai)(wai)傷害(hai)保(bao)險(xian)(xian)(xian)、旅(lv)(lv)游(you)(you)(you)意(yi)(yi)外(wai)(wai)(wai)傷害(hai)保(bao)險(xian)(xian)(xian)、住宿(su)游(you)(you)(you)客人(ren)身保(bao)險(xian)(xian)(xian)、旅(lv)(lv)游(you)(you)(you)救助保(bao)險(xian)(xian)(xian)。其各自(zi)的(de)內容見表(biao)1。這實際(ji)上是以普通的(de)意(yi)(yi)外(wai)(wai)(wai)傷害(hai)保(bao)險(xian)(xian)(xian)來代替旅(lv)(lv)游(you)(you)(you)保(bao)險(xian)(xian)(xian),旅(lv)(lv)游(you)(you)(you)保(bao)險(xian)(xian)(xian)的(de)自(zi)身定(ding)位不清。這些險(xian)(xian)(xian)種(zhong)無法涵蓋旅(lv)(lv)游(you)(you)(you)中遇(yu)到的(de)各種(zhong)風(feng)險(xian)(xian)(xian),比如旅(lv)(lv)行(xing)(xing)中行(xing)(xing)李遺失(shi)(shi)、證件遺失(shi)(shi)、因行(xing)(xing)李及(ji)證件遺失(shi)(shi)而引起的(de)額外(wai)(wai)(wai)的(de)旅(lv)(lv)行(xing)(xing)及(ji)食宿(su)費(fei)用、對他人(ren)的(de)傷害(hai)及(ji)造成他人(ren)財產損失(shi)(shi)的(de)賠(pei)償責任(ren)等。

3、開(kai)辦旅(lv)游(you)意(yi)外(wai)保(bao)(bao)(bao)(bao)險(xian)(xian)(xian)(xian)(xian)業(ye)(ye)務(wu)的公(gong)司(si)(si)較少(shao),且旅(lv)游(you)保(bao)(bao)(bao)(bao)險(xian)(xian)(xian)(xian)(xian)業(ye)(ye)務(wu)得不(bu)到重視。我國的旅(lv)游(you)保(bao)(bao)(bao)(bao)險(xian)(xian)(xian)(xian)(xian)有旅(lv)行社(she)責任保(bao)(bao)(bao)(bao)險(xian)(xian)(xian)(xian)(xian)和(he)旅(lv)游(you)意(yi)外(wai)保(bao)(bao)(bao)(bao)險(xian)(xian)(xian)(xian)(xian)兩(liang)種,分(fen)別屬于(yu)(yu)財產險(xian)(xian)(xian)(xian)(xian)和(he)壽險(xian)(xian)(xian)(xian)(xian),由(you)于(yu)(yu)我國法律規(gui)定財產險(xian)(xian)(xian)(xian)(xian)和(he)壽險(xian)(xian)(xian)(xian)(xian)必須由(you)不(bu)同的公(gong)司(si)(si)經營,所以它們(men)(men)分(fen)屬于(yu)(yu)不(bu)同的保(bao)(bao)(bao)(bao)險(xian)(xian)(xian)(xian)(xian)公(gong)司(si)(si)。目前(qian),國內只有三家比較大型的保(bao)(bao)(bao)(bao)險(xian)(xian)(xian)(xian)(xian)公(gong)司(si)(si)經營旅(lv)游(you)意(yi)外(wai)保(bao)(bao)(bao)(bao)險(xian)(xian)(xian)(xian)(xian)業(ye)(ye)務(wu)，它們(men)(men)分(fen)別是太平洋保(bao)(bao)(bao)(bao)險(xian)(xian)(xian)(xian)(xian)公(gong)司(si)(si)、泰康(kang)人壽保(bao)(bao)(bao)(bao)險(xian)(xian)(xian)(xian)(xian)股份有限公(gong)司(si)(si)、中(zhong)國人壽保(bao)(bao)(bao)(bao)險(xian)(xian)(xian)(xian)(xian)公(gong)司(si)(si)。

【摘要】人們對保(bao)險的(de)(de)(de)專(zhuan)(zhuan)利問(wen)題鮮有關注(zhu)，甚至認為保(bao)險沒(mei)有實(shi)(shi)現(xian)專(zhuan)(zhuan)利化的(de)(de)(de)可(ke)能。事實(shi)(shi)上，借(jie)助(zhu)商業(ye)(ye)方法專(zhuan)(zhuan)利的(de)(de)(de)考量(liang)，在(zai)滿足(zu)一定(ding)要件后(hou)，保(bao)險是(shi)能夠獲(huo)得專(zhuan)(zhuan)利的(de)(de)(de)。尤其在(zai)目前，我(wo)國(guo)的(de)(de)(de)保(bao)險業(ye)(ye)面(mian)臨嚴(yan)峻(jun)的(de)(de)(de)考驗，適時將專(zhuan)(zhuan)利戰略(lve)納入國(guo)內(nei)保(bao)險公司的(de)(de)(de)發展戰略(lve)之中，立足(zu)于中國(guo)特色的(de)(de)(de)保(bao)險商業(ye)(ye)方法專(zhuan)(zhuan)利法律制度是(shi)比較現(xian)實(shi)(shi)的(de)(de)(de)選擇。

【關鍵(jian)詞】保(bao)險；專利；商業方法(fa)專利；保(bao)險商業方法(fa)專利

【正文】

一(yi)(yi)(yi)伴隨經(jing)(jing)濟—社會變遷的(de)(de)(de)(de)大(da)潮，與其(qi)他金(jin)融(rong)(rong)業部(bu)門(men)類(lei)似，我(wo)(wo)國(guo)(guo)的(de)(de)(de)(de)保(bao)(bao)(bao)險(xian)業也(ye)踏入一(yi)(yi)(yi)個機(ji)遇[1]與挑戰(zhan)[2]并存的(de)(de)(de)(de)歷史時段。一(yi)(yi)(yi)來，國(guo)(guo)內保(bao)(bao)(bao)險(xian)業需要(yao)在(zai)(zai)多維度進一(yi)(yi)(yi)步(bu)(bu)推(tui)進和(he)深(shen)化改(gai)(gai)革步(bu)(bu)伐，這尤其(qi)集中在(zai)(zai)保(bao)(bao)(bao)險(xian)市場(chang)主體和(he)保(bao)(bao)(bao)險(xian)監管部(bu)門(men)兩個方面，[3]堪謂任重(zhong)而(er)道遠；二(er)來，向來被(bei)視為中國(guo)(guo)金(jin)融(rong)(rong)市場(chang)對外開放的(de)(de)(de)(de)一(yi)(yi)(yi)個重(zhong)要(yao)組成部(bu)分，保(bao)(bao)(bao)險(xian)市場(chang)歷經(jing)(jing)對外開放的(de)(de)(de)(de)三個發(fa)展(zhan)階段，許(xu)多實力雄厚、經(jing)(jing)驗豐富(fu)、競爭力十足的(de)(de)(de)(de)外國(guo)(guo)保(bao)(bao)(bao)險(xian)公司蜂擁(yong)而(er)入，已經(jing)(jing)對我(wo)(wo)國(guo)(guo)保(bao)(bao)(bao)險(xian)公司構(gou)成了(le)強大(da)的(de)(de)(de)(de)壓力。[4]作為配合(he)我(wo)(wo)國(guo)(guo)保(bao)(bao)(bao)險(xian)業發(fa)展(zhan)的(de)(de)(de)(de)重(zhong)要(yao)一(yi)(yi)(yi)環，《中國(guo)(guo)保(bao)(bao)(bao)險(xian)業發(fa)展(zhan)改(gai)(gai)革報告（1979～2003）》在(zai)(zai)宏(hong)觀上提(ti)出了(le)當前急(ji)待著手的(de)(de)(de)(de)法(fa)律作業，即“制定相(xiang)關(guan)法(fa)律法(fa)規和(he)規章”、“清理修(xiu)改(gai)(gai)現有的(de)(de)(de)(de)規章和(he)規范(fan)性文件”、“積極配合(he)國(guo)(guo)家(jia)司法(fa)機(ji)關(guan)，加快推(tui)進保(bao)(bao)(bao)險(xian)法(fa)的(de)(de)(de)(de)司法(fa)解釋工作”。[5]

就保險企(qi)業(ye)(ye)而(er)言，制(zhi)定合理的(de)(de)(de)(de)發展規劃，培育核心競爭力無疑具有舉足輕重的(de)(de)(de)(de)意義。而(er)在我國知(zhi)識(shi)經濟升溫和法治化高揚的(de)(de)(de)(de)背(bei)景下，適時把日益(yi)風(feng)行的(de)(de)(de)(de)“企(qi)業(ye)(ye)知(zhi)識(shi)產權戰(zhan)(zhan)略”[6]融入(ru)企(qi)業(ye)(ye)整(zheng)體的(de)(de)(de)(de)戰(zhan)(zhan)略決策(ce)中(zhong)，[7]使企(qi)業(ye)(ye)將知(zhi)識(shi)產權資源(yuan)的(de)(de)(de)(de)創(chuang)造、運(yun)用、保護維系于(yu)與其他戰(zhan)(zhan)略謀(mou)劃的(de)(de)(de)(de)交互協調、整(zheng)合之中(zhong)，進而(er)實(shi)現企(qi)業(ye)(ye)的(de)(de)(de)(de)最佳(jia)效益(yi)及其長(chang)遠(yuan)發展，自當是一種理想而(er)尚需(xu)探尋的(de)(de)(de)(de)路(lu)徑(jing)。

依循知識(shi)(shi)產(chan)權的(de)內在架構(gou)(gou)以及實務運作(zuo)的(de)經驗以觀，事(shi)實上，專(zhuan)利(li)(li)戰(zhan)略(lve)(lve)(lve)(lve)與商標戰(zhan)略(lve)(lve)(lve)(lve)構(gou)(gou)成了企(qi)業(ye)(ye)知識(shi)(shi)產(chan)權戰(zhan)略(lve)(lve)(lve)(lve)的(de)基本(ben)內容。商標或者(zhe)商標戰(zhan)略(lve)(lve)(lve)(lve)對于保(bao)(bao)險企(qi)業(ye)(ye)而言，并不(bu)陌生，人們的(de)認識(shi)(shi)也不(bu)會有多少偏(pian)差，那么專(zhuan)利(li)(li)呢？為了在企(qi)業(ye)(ye)競爭中保(bao)(bao)持自己的(de)優勢(shi)，日本(ben)特許廳曾將專(zhuan)利(li)(li)戰(zhan)略(lve)(lve)(lve)(lve)看作(zuo)是(shi)企(qi)業(ye)(ye)戰(zhan)略(lve)(lve)(lve)(lve)的(de)構(gou)(gou)成之一(yi)，而具體(ti)涉(she)及到(dao)保(bao)(bao)險業(ye)(ye)的(de)專(zhuan)利(li)(li)及專(zhuan)利(li)(li)戰(zhan)略(lve)(lve)(lve)(lve)時(shi)，我們卻能夠(gou)發(fa)現里面大有問題。

1資料來源與方法

本文(wen)(wen)以中國知(zhi)網、萬方數據庫和維普(pu)數據庫作為文(wen)(wen)獻檢索(suo)(suo)庫，檢索(suo)(suo)時間段為2009年1月(yue)－2013年12月(yue)，以“醫(yi)療保(bao)險談判”和“醫(yi)保(bao)談判”作為檢索(suo)(suo)詞(ci)，匹配方式為精確匹配，共(gong)檢索(suo)(suo)到56篇文(wen)(wen)獻，其中學(xue)(xue)術論(lun)(lun)文(wen)(wen)30篇，專題報道21篇，碩(shuo)士(shi)學(xue)(xue)位(wei)論(lun)(lun)文(wen)(wen)4篇，博(bo)士(shi)學(xue)(xue)位(wei)論(lun)(lun)文(wen)(wen)1篇。

2結果

2.1文(wen)(wen)獻(xian)發(fa)表時(shi)間分布(bu)從(cong)文(wen)(wen)獻(xian)的(de)(de)發(fa)表時(shi)間方(fang)(fang)面(mian)來(lai)看2009年(nian)(nian)4篇(7.14%)，2010年(nian)(nian)8篇(14.29%)，2011年(nian)(nian)17篇(30.35%)，2012年(nian)(nian)19篇(33.93%)，2013年(nian)(nian)8篇(14.29%)。關(guan)于醫(yi)療(liao)保險談(tan)判(pan)(pan)(pan)機(ji)制(zhi)的(de)(de)文(wen)(wen)獻(xian)研(yan)(yan)究(jiu)，總(zong)體上呈上升(sheng)趨(qu)勢。2009年(nian)(nian)的(de)(de)4篇文(wen)(wen)獻(xian)全部為專題報道。2010年(nian)(nian)，相關(guan)領(ling)域的(de)(de)學者(zhe)王琬、張(zhang)曉和李秀君(jun)等(deng)開(kai)始(shi)關(guan)注(zhu)醫(yi)療(liao)保險談(tan)判(pan)(pan)(pan)機(ji)制(zhi)這一新生事(shi)物，并(bing)相繼發(fa)表了一系(xi)列相關(guan)文(wen)(wen)章(zhang)［5－7］。2011年(nian)(nian)，關(guan)于醫(yi)療(liao)保險談(tan)判(pan)(pan)(pan)機(ji)制(zhi)的(de)(de)文(wen)(wen)獻(xian)顯著增多(duo)，研(yan)(yan)究(jiu)內容(rong)也逐漸豐富(fu)，涉及醫(yi)療(liao)保險支付方(fang)(fang)式(shi)、博弈(yi)視(shi)角下的(de)(de)談(tan)判(pan)(pan)(pan)模型(xing)以及談(tan)判(pan)(pan)(pan)機(ji)制(zhi)的(de)(de)理論與實踐等(deng)內容(rong)。2012年(nian)(nian)，研(yan)(yan)究(jiu)內容(rong)更加(jia)(jia)豐富(fu)，較之前增加(jia)(jia)了國外先(xian)進(jin)經驗以及鎮江和成都模式(shi)分析等(deng)多(duo)個方(fang)(fang)面(mian)的(de)(de)研(yan)(yan)究(jiu)。

2.2文章所(suo)提(ti)觀點的(de)(de)論(lun)(lun)(lun)述方法(fa)情(qing)況根據文章所(suo)提(ti)觀點的(de)(de)論(lun)(lun)(lun)述方法(fa)，可將文獻(xian)分(fen)為定(ding)(ding)(ding)性論(lun)(lun)(lun)述、定(ding)(ding)(ding)性中引(yin)用少量(liang)(liang)數字、定(ding)(ding)(ding)性定(ding)(ding)(ding)量(liang)(liang)結(jie)合(he)論(lun)(lun)(lun)述(定(ding)(ding)(ding)量(liang)(liang)數據沒有(you)(you)經(jing)過(guo)規(gui)范統計處(chu)理(li))、定(ding)(ding)(ding)性定(ding)(ding)(ding)量(liang)(liang)結(jie)合(he)論(lun)(lun)(lun)述(定(ding)(ding)(ding)量(liang)(liang)數據經(jing)過(guo)規(gui)范統計處(chu)理(li))四種。其中，定(ding)(ding)(ding)性論(lun)(lun)(lun)述最多，共(gong)36篇(pian)(pian)(pian)(64.29%)，定(ding)(ding)(ding)性中引(yin)用少量(liang)(liang)數字的(de)(de)有(you)(you)9篇(pian)(pian)(pian)(16.07%);定(ding)(ding)(ding)性定(ding)(ding)(ding)量(liang)(liang)結(jie)合(he)論(lun)(lun)(lun)述(定(ding)(ding)(ding)量(liang)(liang)數據經(jing)過(guo)規(gui)范統計處(chu)理(li))的(de)(de)有(you)(you)11篇(pian)(pian)(pian)(19.64%)，見表1;納入分(fen)析的(de)(de)4篇(pian)(pian)(pian)研究生(sheng)學(xue)位論(lun)(lun)(lun)文和(he)1篇(pian)(pian)(pian)博士學(xue)位論(lun)(lun)(lun)文全部都為定(ding)(ding)(ding)性定(ding)(ding)(ding)量(liang)(liang)結(jie)合(he)論(lun)(lun)(lun)述(定(ding)(ding)(ding)量(liang)(liang)數據經(jing)過(guo)規(gui)范的(de)(de)統計處(chu)理(li))。

2.3研究者(zhe)所屬單位(wei)情況從研究者(zhe)所屬單位(wei)情況來看，研究者(zhe)來源(yuan)廣泛，涉及到(dao)政(zheng)府(fu)部門(men)(如人力資(zi)源(yuan)與(yu)社(she)(she)會保(bao)障部門(men)、衛生行政(zheng)部門(men)、醫(yi)療(liao)(liao)(liao)保(bao)險管理(li)部門(men)等)、高(gao)校、藥企、媒體和(he)醫(yi)院等。來自高(gao)校的(de)最多，有26篇(pian)(46.43%);其次為來自各(ge)級政(zheng)府(fu)部門(men)的(de)文獻有21篇(pian)(37.50%);來自政(zheng)府(fu)部門(men)與(yu)高(gao)校和(he)社(she)(she)會合作的(de)有6篇(pian)(10.71%);來自藥企、媒體和(he)醫(yi)院的(de)最少，有3篇(pian)(5.36%)，見表2。由此可看出政(zheng)府(fu)部門(men)對于醫(yi)療(liao)(liao)(liao)保(bao)險談判機制研究非常重視，社(she)(she)會各(ge)界也關注(zhu)到(dao)醫(yi)療(liao)(liao)(liao)保(bao)險談判機制。

[內容摘要(yao)]：時下，伴隨人(ren)們風險(xian)(xian)(xian)意(yi)(yi)識的(de)(de)(de)增長，保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)業也越做(zuo)越大，但做(zuo)大的(de)(de)(de)同時，鑒于(yu)保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)法(fa)制訂(ding)過糙，保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)公司內部(bu)管(guan)理不完善尤(you)其(qi)是(shi)保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)人(ren)在(zai)展業過程(cheng)中(zhong)故(gu)意(yi)(yi)夸(kua)大其(qi)權限(xian)，做(zuo)虛(xu)假之(zhi)許諾(nuo)，投保(bao)(bao)(bao)(bao)(bao)(bao)人(ren)之(zhi)利(li)益(yi)于(yu)是(shi)常遭侵犯。很(hen)突出的(de)(de)(de)就表現在(zai)對于(yu)保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)責(ze)任(ren)期(qi)間的(de)(de)(de)認(ren)定(ding)上。保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)責(ze)任(ren)期(qi)間即保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)人(ren)承擔(dan)保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)責(ze)任(ren)的(de)(de)(de)起迄時間，只有(you)在(zai)此(ci)(ci)期(qi)間內發(fa)生(sheng)保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)事(shi)故(gu)，保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)人(ren)才須承擔(dan)保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)責(ze)任(ren)，因此(ci)(ci)需(xu)要(yao)對此(ci)(ci)做(zuo)以明確界定(ding)。本(ben)文(wen)主要(yao)圍繞保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)合同的(de)(de)(de)效(xiao)(xiao)力展開論(lun)述(shu)(shu)，從保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)合同的(de)(de)(de)訂(ding)立、生(sheng)效(xiao)(xiao)至其(qi)效(xiao)(xiao)力停止，最后簡要(yao)論(lun)述(shu)(shu)了一下保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)合同的(de)(de)(de)解除、終止問(wen)題。

[關鍵詞(ci)]：保(bao)險責任期(qi)間,追溯生效,合同解除,終止,要物契約

承(cheng)擔保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)責任是保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)人(ren)(ren)(ren)的(de)(de)(de)(de)(de)主(zhu)(zhu)合(he)(he)同義(yi)務，但(dan)因為(wei)保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)合(he)(he)同是一(yi)種(zhong)射幸契(qi)約，故(gu)其責任承(cheng)擔具有(you)不確定(ding)(ding)性，只有(you)在(zai)約定(ding)(ding)期(qi)間(jian)(jian)發生(sheng)(sheng)(sheng)(sheng)了約定(ding)(ding)事(shi)(shi)故(gu)時方(fang)須(xu)承(cheng)擔賠償(chang)或給(gei)付之(zhi)責。因此(ci)，保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)責任期(qi)間(jian)(jian)的(de)(de)(de)(de)(de)確定(ding)(ding)，對于(yu)保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)合(he)(he)同當事(shi)(shi)人(ren)(ren)(ren)雙(shuang)方(fang)的(de)(de)(de)(de)(de)權(quan)利義(yi)務保(bao)(bao)(bao)(bao)(bao)(bao)障(zhang)、風險(xian)(xian)(xian)的(de)(de)(de)(de)(de)分(fen)配與負(fu)擔，意(yi)義(yi)至關(guan)重要(yao)。保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)法(fa)(fa)(fa)律關(guan)系依(yi)其性質可分(fen)為(wei)二類：1、有(you)關(guan)保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)公司、保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)業監管之(zhi)規定(ding)(ding)，具有(you)強(qiang)制法(fa)(fa)(fa)的(de)(de)(de)(de)(de)色彩(cai)；2、有(you)關(guan)保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)契(qi)約之(zhi)規定(ding)(ding)，授予當事(shi)(shi)人(ren)(ren)(ren)意(yi)思自治權(quan)限較大，此(ci)處當有(you)民(min)(min)法(fa)(fa)(fa)基本原理(li)的(de)(de)(de)(de)(de)適用(yong)。一(yi)般民(min)(min)事(shi)(shi)法(fa)(fa)(fa)律關(guan)系中，法(fa)(fa)(fa)律行為(wei)有(you)效(xiao)(xiao)(xiao)是當事(shi)(shi)人(ren)(ren)(ren)負(fu)擔義(yi)務的(de)(de)(de)(de)(de)前提，在(zai)法(fa)(fa)(fa)律無(wu)特(te)別(bie)規定(ding)(ding)及當事(shi)(shi)人(ren)(ren)(ren)無(wu)特(te)別(bie)約定(ding)(ding)的(de)(de)(de)(de)(de)情況(kuang)下(xia)，二者的(de)(de)(de)(de)(de)存(cun)續(xu)期(qi)間(jian)(jian)應(ying)是相同的(de)(de)(de)(de)(de)。如，通(tong)常，法(fa)(fa)(fa)律行為(wei)成(cheng)立(li)并生(sheng)(sheng)(sheng)(sheng)效(xiao)(xiao)(xiao)之(zhi)時當事(shi)(shi)人(ren)(ren)(ren)即負(fu)有(you)履行之(zhi)義(yi)務（除附(fu)停(ting)止條(tiao)件(jian)與附(fu)始期(qi)的(de)(de)(de)(de)(de)法(fa)(fa)(fa)律行為(wei)之(zhi)外，成(cheng)立(li)之(zhi)時即生(sheng)(sheng)(sheng)(sheng)效(xiao)(xiao)(xiao)之(zhi)時）；特(te)殊(shu)情況(kuang)下(xia)，有(you)所謂(wei)追(zhui)溯生(sheng)(sheng)(sheng)(sheng)效(xiao)(xiao)(xiao)，即在(zai)雙(shuang)方(fang)達(da)成(cheng)合(he)(he)意(yi)并符合(he)(he)法(fa)(fa)(fa)定(ding)(ding)生(sheng)(sheng)(sheng)(sheng)效(xiao)(xiao)(xiao)要(yao)件(jian)之(zhi)后，將(jiang)契(qi)約之(zhi)效(xiao)(xiao)(xiao)力提前至某一(yi)時點(dian)。鑒于(yu)此(ci)，本文對于(yu)保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)責任期(qi)間(jian)(jian)的(de)(de)(de)(de)(de)探(tan)討將(jiang)主(zhu)(zhu)要(yao)圍繞保(bao)(bao)(bao)(bao)(bao)(bao)險(xian)(xian)(xian)合(he)(he)同的(de)(de)(de)(de)(de)效(xiao)(xiao)(xiao)力展開(kai)。

一(yi)、保險(xian)(xian)合(he)同(tong)的(de)(de)(de)成(cheng)立(li)、生(sheng)(sheng)效(xiao)(xiao)合(he)同(tong)的(de)(de)(de)訂立(li)通常需要(yao)經(jing)過要(yao)約(yue)與承諾(nuo)兩個(ge)階段，要(yao)約(yue)人(ren)向特定之(zhi)人(ren)發(fa)出具體而(er)明確之(zhi)要(yao)約(yue)（就合(he)同(tong)主要(yao)之(zhi)點已有表示），表明其(qi)訂約(yue)意(yi)圖，即(ji)要(yao)約(yue)一(yi)經(jing)承諾(nuo)便受拘(ju)束之(zhi)意(yi)；承諾(nuo)于要(yao)約(yue)有效(xiao)(xiao)期(qi)內(nei)到(dao)達要(yao)約(yue)人(ren)，并就合(he)同(tong)主要(yao)之(zhi)點未予變(bian)更(geng)，合(he)同(tong)即(ji)成(cheng)立(li)，否則(ze)構成(cheng)反要(yao)約(yue)。在(zai)雙方所訂之(zhi)合(he)同(tong)不違反法律(lv)規定時，即(ji)可在(zai)一(yi)定時期(qi)發(fa)生(sheng)(sheng)法律(lv)效(xiao)(xiao)力。當然要(yao)式合(he)同(tong)尚須(xu)具備一(yi)定形式，實踐性(xing)合(he)同(tong)則(ze)需一(yi)定之(zhi)交付。具體至(zhi)保險(xian)(xian)合(he)同(tong)的(de)(de)(de)成(cheng)立(li)、生(sheng)(sheng)效(xiao)(xiao)則(ze)有如下問題須(xu)明確：

1、一定(ding)之形式是(shi)否保險(xian)合(he)同(tong)(tong)生(sheng)效之要(yao)件？國外不少學者認(ren)為保險(xian)合(he)同(tong)(tong)的(de)成立，必(bi)須(xu)具備(bei)一定(ding)形式，在法(fa)律上(shang)才能有(you)效，故屬要(yao)式合(he)同(tong)(tong)。如保險(xian)單或(huo)保險(xian)憑(ping)證(zheng)等，其(qi)所記載(zai)的(de)事項原(yuan)則上(shang)不能任意變動(dong)。投保人對于保單內記載(zai)的(de)事項，要(yao)么同(tong)(tong)意，要(yao)么走開。因此(ci)保險(xian)合(he)同(tong)(tong)是(shi)一種附合(he)合(he)同(tong)(tong)。我國有(you)相當一部分人也持(chi)此(ci)種觀(guan)點，我們認(ren)為此(ci)種觀(guan)點值得商榷(que)。[1]

（1）、觀諸現行立(li)(li)法(fa)，§12—1前(qian)項規(gui)定：投保(bao)(bao)(bao)(bao)人(ren)提出保(bao)(bao)(bao)(bao)險(xian)(xian)(xian)要(yao)求，經保(bao)(bao)(bao)(bao)險(xian)(xian)(xian)人(ren)同(tong)(tong)(tong)意(yi)(yi)承保(bao)(bao)(bao)(bao)，并就合(he)(he)同(tong)(tong)(tong)的(de)條款達成(cheng)(cheng)協(xie)議(yi)，保(bao)(bao)(bao)(bao)險(xian)(xian)(xian)合(he)(he)同(tong)(tong)(tong)成(cheng)(cheng)立(li)(li)。即只要(yao)求當(dang)事人(ren)達成(cheng)(cheng)實質上(shang)的(de)意(yi)(yi)思(si)合(he)(he)致即可。同(tong)(tong)(tong)時(shi)，§12—1后項將(jiang)及時(shi)交付保(bao)(bao)(bao)(bao)險(xian)(xian)(xian)單(dan)(dan)或保(bao)(bao)(bao)(bao)險(xian)(xian)(xian)憑證(zheng)作(zuo)為(wei)(wei)保(bao)(bao)(bao)(bao)險(xian)(xian)(xian)人(ren)的(de)一(yi)項義務。§12—2規(gui)定：經投保(bao)(bao)(bao)(bao)人(ren)和保(bao)(bao)(bao)(bao)險(xian)(xian)(xian)人(ren)協(xie)商(shang)同(tong)(tong)(tong)意(yi)(yi)，也可以采取前(qian)款規(gui)定以外的(de)其他書面(mian)(mian)協(xie)議(yi)形式(shi)(shi)(shi)訂立(li)(li)保(bao)(bao)(bao)(bao)險(xian)(xian)(xian)合(he)(he)同(tong)(tong)(tong)。此(ci)處(chu)顯然是(shi)將(jiang)書面(mian)(mian)形式(shi)(shi)(shi)作(zuo)為(wei)(wei)保(bao)(bao)(bao)(bao)險(xian)(xian)(xian)合(he)(he)同(tong)(tong)(tong)訂立(li)(li)中的(de)一(yi)個必經環節，這與保(bao)(bao)(bao)(bao)險(xian)(xian)(xian)合(he)(he)同(tong)(tong)(tong)的(de)不(bu)要(yao)式(shi)(shi)(shi)性是(shi)否矛盾？對此(ci)應(ying)解釋為(wei)(wei)，當(dang)事人(ren)就保(bao)(bao)(bao)(bao)險(xian)(xian)(xian)條件(jian)（標的(de)、費(fei)率、危險(xian)(xian)(xian)）相互意(yi)(yi)思(si)表示一(yi)致者，契(qi)約于(yu)焉成(cheng)(cheng)立(li)(li)，保(bao)(bao)(bao)(bao)險(xian)(xian)(xian)單(dan)(dan)之(zhi)作(zuo)成(cheng)(cheng)與交付，僅(jin)為(wei)(wei)完成(cheng)(cheng)保(bao)(bao)(bao)(bao)險(xian)(xian)(xian)契(qi)約之(zhi)最后手續(xu)及書面(mian)(mian)證(zheng)據。而保(bao)(bao)(bao)(bao)險(xian)(xian)(xian)單(dan)(dan)縱已簽發(fa)(fa)，當(dang)事人(ren)仍得(de)以意(yi)(yi)思(si)表示尚未合(he)(he)致而主張保(bao)(bao)(bao)(bao)險(xian)(xian)(xian)契(qi)約未成(cheng)(cheng)立(li)(li)，或證(zheng)明保(bao)(bao)(bao)(bao)險(xian)(xian)(xian)契(qi)約所(suo)附之(zhi)停止(zhi)條件(jian)尚未成(cheng)(cheng)就以阻止(zhi)保(bao)(bao)(bao)(bao)險(xian)(xian)(xian)契(qi)約發(fa)(fa)生效力。

1姓名、年齡(ling)、出生日(ri)期等一般項目準確(que)無誤

投保(bao)人(ren)(ren)在購(gou)買保(bao)險時(shi)(shi)(shi),保(bao)險公(gong)司都要求(qiu)(qiu)(qiu)以被保(bao)人(ren)(ren)的(de)身份(fen)(fen)證或(huo)戶(hu)口簿(bu)為(wei)準填寫(xie)一般項(xiang)(xiang)目(mu)。在理賠(pei)時(shi)(shi)(shi)這是最基本項(xiang)(xiang)目(mu),為(wei)避免錯(cuo)誤賠(pei)付,保(bao)險公(gong)司要求(qiu)(qiu)(qiu)被保(bao)患(huan)者病歷的(de)一般項(xiang)(xiang)目(mu)與保(bao)單及身份(fen)(fen)證一致,如(ru)出(chu)現一項(xiang)(xiang)不符合,都會拒(ju)絕賠(pei)付。所以在病歷書寫(xie)時(shi)(shi)(shi)要求(qiu)(qiu)(qiu)絕對準確。姓名(ming)錯(cuo)誤多是由(you)(you)于書寫(xie)時(shi)(shi)(shi)使用別字(zi),常于入院時(shi)(shi)(shi)發生。如(ru)姓名(ming)由(you)(you)別人(ren)(ren),而患(huan)者本人(ren)(ren)由(you)(you)于病痛很(hen)少(shao)去核(he)對,住院治療期(qi)(qi)間如(ru)仍(reng)未發現,出(chu)院后病案(an)歸檔就無法更(geng)改。因此建議(yi)在掛(gua)號時(shi)(shi)(shi)盡量由(you)(you)患(huan)者自己書寫(xie)姓名(ming),入院后醫(yi)務(wu)人(ren)(ren)員(yuan)在得知其(qi)商業保(bao)險被保(bao)人(ren)(ren)身份(fen)(fen)后,再次提(ti)醒患(huan)者核(he)實;年(nian)齡錯(cuo)誤通常因為(wei)虛(xu)歲的(de)原故(gu)。書寫(xie)病歷時(shi)(shi)(shi)要求(qiu)(qiu)(qiu)詳細詢問(wen),填寫(xie)實足年(nian)齡;與年(nian)齡相比,出(chu)生日期(qi)(qi)更(geng)為(wei)重要,但很(hen)多患(huan)者,尤其(qi)老(lao)年(nian)人(ren)(ren),有時(shi)(shi)(shi)不能(neng)提(ti)供準確出(chu)生日期(qi)(qi),而由(you)(you)醫(yi)務(wu)人(ren)(ren)員(yuan)隨手填寫(xie),造成(cheng)與身份(fen)(fen)證不一致。避免上述(shu)問(wen)題的(de)最好辦法是要求(qiu)(qiu)(qiu)患(huan)者在住院期(qi)(qi)間提(ti)供身份(fen)(fen)證或(huo)戶(hu)口簿(bu)。

2提醒(xing)患者及時報案(an)

保(bao)險(xian)公司(si)規定被保(bao)人(ren)(ren)在因病住院后(hou)的三天內(nei)要及(ji)(ji)時通知保(bao)險(xian)公司(si)理(li)(li)(li)賠部門,稱為報(bao)案。理(li)(li)(li)賠部門在收(shou)到報(bao)案后(hou)核實情況,并告(gao)知被保(bao)人(ren)(ren)注意事項。這樣在患者(zhe)出院后(hou)才能及(ji)(ji)時得到賠付。所以醫務人(ren)(ren)員有必要在患者(zhe)住院時提醒其及(ji)(ji)時與保(bao)險(xian)公司(si)聯系,以保(bao)證將來能夠順(shun)利理(li)(li)(li)賠。

3要求患(huan)者提供準確病史

商業(ye)保(bao)險一般規(gui)定自(zi)投(tou)保(bao)之(zhi)日起三個月后(hou)生效,這(zhe)樣就(jiu)有效地避免了被保(bao)人(ren)在(zai)(zai)已獲知病(bing)(bing)情后(hou)的臨時(shi)投(tou)保(bao),減(jian)少保(bao)險公司(si)的損失(shi)。有個別投(tou)保(bao)患者(zhe)為(wei)了獲得賠付,在(zai)(zai)醫(yi)務(wu)人(ren)員詢問(wen)病(bing)(bing)史(shi)時(shi),部分隱瞞(man)病(bing)(bing)史(shi)、作虛(xu)假陳述,故意提前或推遲(chi)發病(bing)(bing)時(shi)間,這(zhe)就(jiu)會(hui)誤(wu)導(dao)醫(yi)生臨床思維(wei),導(dao)致(zhi)錯誤(wu)的診治結果(guo),給(gei)醫(yi)療工(gong)作帶來安全隱患。因此在(zai)(zai)實際(ji)工(gong)作中,醫(yi)務(wu)人(ren)員在(zai)(zai)得知其(qi)保(bao)險背景后(hou),更(geng)要仔細詢問(wen)病(bing)(bing)史(shi),并告知患者(zhe)隱瞞(man)或虛(xu)假陳述病(bing)(bing)史(shi)可能會(hui)嚴重影(ying)響疾病(bing)(bing)的診治,給(gei)自(zi)己(ji)造成不(bu)良后(hou)果(guo)。避免由此可能產(chan)生的不(bu)必要的醫(yi)患糾紛(fen)或保(bao)險糾紛(fen)。