保險法之合理期待原則——以美國法為中心

Doctrine of Reasonable Expectation in Insurance Law:Focusing on the Laws in the United States

定型化契約乃是以細小印刷、冗長、複雜且對一般人而言難以全盤理解之眾多條款所構成，故多未經契約當事人所閱讀。於保險的領域中，不僅使用標準化契約，其更採取以全盤接受或離開之基礎來提供給保險消費者，故又被稱為超級附合契約，因此，保險契約的文本是否符合當事人的真意，即有疑義。於1970年時，美國保險法學者Robert Keeton，歸納法院判決見解後，提出保險法上的合理期待原則。此原則確實能補充保險契約之內容，避免一方當事人享有顯失公平之利益，故經過數十年來的發展，多數州則採取修正版的合理期待原則並用於保險案件中，作為一種解釋性的工具。更有甚者，學者認為合理期待原則乃係一個適合保險監理之理念，能作為規範保險人市場上行為之標準。我國法規未明文合理期待原則，然而，自大約二十年前，我國法院已持續以合理期待原則作為解決保險爭議案件之基礎，因此，有對該原則作全盤瞭解之必要。本文將以美國法制為基礎，介紹及研究保險法上合理期待原則之理論發展與實務作法，並剖析我國目前現況。藉由參酌美國法之最新發展，除全面性建構合理期待之理論基礎、適用範圍外，並提出適合我國之相關建議。希望藉由本研究之進行，能進一步健全我國保險法律體系。

Standardized form contract is composed of many terms and conditions that are small in print, lengthy, complex and incomprehensible to read, so the party adhered to the contract most likely do not go through the contract thoroughly. In the contexts of insurance, standardized form contracts not only are used, but also serve as a take-it-or-leave-it basis for insurance consumers. Therefore, insurance contract is also called super-adhesion contract. As a result, it is doubtful whether the text of the insurance contract is the true expression of agreement of the parties. In 1970, Robert Keeton, a well-known insurance law scholar in the United States published an article where he identified the doctrine of reasonable expectation in insurance law after concluding the opinions from court cases in past decades. The doctrine can indeed supplement the contents of the insurance contract and avoid any party from taking the unconscionable advantage. Therefore, decades after development of the doctrine, the majority of states has adopted the revised version of the doctrine of reasonable expectation and used it in insurance as an interpretive tool. Moreover, scholars observed that doctrine of reasonable expectation is an ideal suitable for insurance regulation that can be used as a standard for regulating insurer’s market conducts. The doctrine of reasonable expectation has not been expressively stipulated in the laws and regulations in Taiwan. However, since about 20 years ago, some courts in Taiwan have continued to use the doctrine of reasonable expectation as the ruling basis in the insurance dispute cases. Therefore, it is necessary to fully understand this doctrine. This project will base on the legal system of the United States to introduce the theoretical development and the practice of the doctrine of reasonable expectation and examine the related issues in Taiwan. With reference to the latest development in the United States, this project will attempt to establish the comprehensive foundation and scope of application of doctrine of reasonable expectation and provide suggestions fitting to the legal system in Taiwan. It is hoped that this research can further improve the system in the contexts of insurance law.