金融消費者保護法中公平合理原則之法律實證研究

A Legal Empirical Study of the Fairness and Reasonable Principles of Financial Consumer Protection Law

本文旨在以實證方法探索我國適用公平合理原則之狀況，以歸納我國實務之趨勢與標準並與各國之標準比較分析，以進一步為我國法提出建議。在比較法方面，本文分析美國、英國、澳洲等規範，發現其等對於公平合理原則之適用已有相當標準，值得我國參考。就對我國保險評議案件之實證研究，可以發現適用公平合理原則案件以壽險最多，但以保險輔助人適用機率最高。結果以對申請人部分有利或酌予補償為主，其中又以突破現行法者最多。但就整體而言，公平合理原則之適用比率逐年遞減，且似有逐漸傾向不突破現行法之現象。如以迴歸模型進行分析，可發現當案件屬於理賠爭議、財產上之請求、保險人可歸責、為第一屆及第二屆評議委員作成等情形時，保險人越可能被認定需要給付。這顯示評議委員之屆次確為重要因素，可能肇因於學習效果及近年有限縮適用本原則之傾向。再者，其他顯著因素則與立法例適用本原則之標準大致相符，這顯示我國目前雖然欠缺具體規範，但實際上已有相當參考因素，而可考慮進一步明文化。就結論而言，本文認為可擬定適用公平合理原則之規範，明示發動條件、效力範圍與參考指標等細節，以資明確，而無須直接限制本原則之適用，以保留本原則發揮功能之空間。

This study aims to explore the applications of fairness and rationality principle in Taiwan with empirical methods, to induce the tendency and to compare with standards of other countries, and then finally to provide recommendations for Taiwan. For comparative law analysis, this paper analyzes the laws of United States, United Kingdom, and Australia. It is found that they have developed standards for the application of fairness and rationality principle, and such rules can be considered by Taiwan. For empirical finding insurance ombudsman case analyses, we can find fairness and rationality principle is most usually applied in life insurance case, but the intermediary has the highest percentage. For the result of application, most of them are partial payments for applicant as well as breaking the current laws. Generally, the application of fairness and rationality principle is declining and the there is a tendency toward not breaking current laws. For regression analyses, they demonstrate that insurer is more likely asked to pay when the case is involving claim dispute, property claim, insurer who is attributable, and decisions made by the first and second sessions of Ombudsman. This implies the session of Ombudsman is an important factor, which may be contributed by learning-effect and a tendency to narrow down this principle in recent years. Moreover, other significant factors are approximately equivalent to other jurisdictions' standard. This implies that even without clear regulation, Taiwan already has substantial rules which are worthy of legislation. In conclusion, this study recommends to enactment relevant regulations for application of fairness and rationality principle, and to clarify conditions, scopes, standards and other details. Instead of restricting this principle, the suggested approach may not only improve parties' foreseeability, but also keep room for this principle's important functions.