道德危險的除外界限與最大善意原則

Boundary of the Excluded Moral Hazard and Principle of Utmost Good Faith

道德危險的排除是保險法的重要規範之一。現行保險法規定要保人或被保險人故意致使保險事故發生時，保險人不負承保責任。重大過失所致之損害，則屬於保險人的承保危險。最高法院於1997年首度以最大善意原則的違反，來使保險人對於有重大過失的被保險人亦無須負責。迄今已有多件法院判決採取同一見解，實質上修正了保險法的規定。此外，也有判決採用過失相抵的概念，使得保險人得因被保險人的重大過失，減少自己的保險金給付義務。可能是因為欠缺法律上的依據，這些創新的判決還未成為多數見解。新見解的缺點是提高了法律關係的不確定性，而且有違反立法決定的疑慮。從臺灣司法實務發展趨勢可得知，保險法第29條第2項規定或許有所缺失，導致法院必須在個案中，透過實質架空立法者意旨之解釋方向，以達成個案之正義。從比較法角度為觀察，我國保險法第29條第2項規定與2008年前德國保險契約法第61條規定，皆採全有全無之立法原則，因此德國司法實務亦產生與我國司法實務類似的修正。然德國在2008年保險契約法第81條規定在改採重大過失酌減給付制後，此一現象已不復存在。本文整理分析臺灣眾多案例，並比較分析臺德保險法制後，提出我國保險法修正條文建議，希望能在保障被保險人與防制道德危險之間取得平衡。

One of Insurance law function might be the exclusion of moral hazard, Taiwan Insurance Act 1963 Article 29 Section 2 provided that the insurer could refuse to indemnify for damage caused by the proposer or insured (hereafter policyholder)’s willful act. And the insurer was liable to indemnify for damage caused by the fault of policyholder. From the view of interpreting above statute, there are two approaches in Taiwan judiciary. Major approach is represented by Taiwan Civil Supreme Court Judgment Tai Shan Tsu No. 2141(1997), the judgment rules that the insurance event caused by policyholder gross negligent act, which is equivalent to breach of utmost good faith, and the insurer could refuse to indemnify. As a matter of fact, the approach substantially revises Insurance Act 1963 Article 29 Section 2. There have been many lower courts followed Taiwan Civil Supreme Court Judgment Tai Shan Tsu No. 2141(1997). Minor approach is according to Taiwan Civil Code 1999 Article 217, the insurer could pay less amount of insurance payment, if policyholder gross negligently contributes in causing or aggravating insurance event. But minor approach obviously disobeys Taiwan Insurance Act 1963 Legislator’s intention. From the above Taiwan judiciary development, we could have known that there is a defect in Taiwan Insurance Act 1963 Article 29 Section 2. The defect attributes to the court to achieve case justice by caverning out the statute. In the view of comparative law, Taiwan Insurance Act 1963 Article 29 Section 2 and old German Insurance Contract Act 1908 Article 61 take all-or-nothing principle, and old German judiciary has the similar trend with Taiwan. However, when German Insurance Act 2008 Article 81 takes proportionality principle, the development has been disappeared completely. This article analyses the difference between German and Taiwan Insurance Law, and tries to submit an amendment of Taiwan Insurance Act.