刑事訴訟法第208條修正後之制度落差與重建——以醫療鑑定與保險犯罪防制為核心

Institutional Gaps and Rebuilding Following the Amendment of Article 208 of the Code of Criminal Procedure: A Focus on Medical Appraisal and Insurance Crime Prevention

本文探討2023年《刑事訴訟法》第208條修正後，對醫療鑑定與保險犯罪防制體系產生的衝擊。修法原意在於透過引入「具名原則」與強化「機關鑑定」，提升司法鑑定之程序正當性與證據可信度。然而，研究發現新法在實務運作上出現嚴重落差。由於缺乏配套的法律保護與責任豁免機制，致使檢警與保險業面臨舉證真空的困境，造成防詐實務倒退。本文透過德、日、美等國制度比較，發現了「制度移植落差」。為解決這個問題，本文建議可透過施行細則回復醫審會報告之準證據地位、採取「法人具名、醫師匿名」模式以平衡法律責任與倫理壓力等方式，以重建司法、醫療與金融三方之信任與協作機制。

This paper examines the impact of the 2023 amendment to Article 208 of the Code of Criminal Procedure on the medical appraisal (or medical expert witness system) and the insurance fraud prevention system. The original intent of the amendment was to enhance the procedural legitimacy and evidentiary credibility of judicial appraisals by introducing the "Named Principle" and strengthening the role of "Institutional Appraisals." However, the study finds a significant discrepancy in the practical implementation of the new law. The lack of corresponding legal protection and immunity mechanisms has led to an evidence vacuum for prosecutors, police, and the insurance industry, causing a practical regression in fraud prevention. By comparing the systems of Germany, Japan, and the United States, this paper identifies a "System Transplant Gap." To resolve this issue, the paper suggests measures such as restoring the quasi-evidentiary status of Medical Review Committee reports through implementing rules and adopting a "Corporate Named, Physician Anonymous" model to balance legal liability and ethical pressure. These steps aim to rebuild the mechanism of trust and collaboration among the judicial, medical, and financial sectors.