從第三人利益契約理論檢視人壽保險給付、抗辯與返還問題

Examining Issues of Life Insurance Benefits, Defenses, and Refunds Through the Lens of the Third-Party Beneficiary Contract Theory

人壽保險是最典型的第三人利益契約，除保險法另有規定外，第三人利益契約之理論與相關規定，可用以解決人壽保險的爭議問題。受益人得拒絕享受利益，而視為其自始未取得其權利，並將保險金額作為被保險人之遺產。受益人取得權利，來自要保人之指定行為，具有繼受取得的性質，故保險人得以保險契約所生之一切實體法或程序法上之抗辯，對抗受益人。保險契約中關於合意管轄及保單借款抵銷之約定，保險人得對受益人主張之。要保人指定受益人但並未放棄處分權者，受益人須待保險事故發生時，始取得保險契約上之權利。在保險事故發生前，保單價值之權益屬要保人所有。若於法院扣押保單價值後發生保險事故，扣押命令之效力不受影響，受益人僅能取得扣押時保單價值之金額以外的保險金請求權。同理，要保人受監護宣告後，監護人若代理申請變更要保人或受益人為自己，實質上為受讓受監護人之財產，違反民法第1102條。要保人與受益人間，亦有一定之對價關係存在。若對價關係不存在，受益人應將保險金請求權或所受領之保險金返還與要保人。保險契約無效或解除時，若對價關係仍存在，應由要保人返還受益人所受領之保險金。若對價關係為無償時，保險人得向受益人請求返還所受領之保險金。

Life insurance is the most typical example of a third-party beneficiary contract. Unless otherwise specified by Insurance Act, the theories and provisions related to third-party beneficiary contracts can be applied to resolve various disputes in life insurance.
Beneficiaries may refuse to accept the benefits, which is treated as if they never acquired the rights in the first place, causing the insurance proceeds to be treated as part of the estate. The beneficiary’s rights arise from the policyholder's designation, which is of a derivative nature. Therefore, the insurer may invoke all substantive and procedural defenses arising from the insurance contract against the beneficiary. Provisions in the insurance contract regarding jurisdiction agreements and policy loan offsets are subject to Article 270 of the Civil Code and Article 22, Paragraph 3 of the Insurance Act, allowing the insurer to assert such terms against the beneficiary.
If the policyholder designates a beneficiary but does not relinquish the right to dispose of the designation, the beneficiary acquires contractual rights only upon the occurrence of the insured event. Before such an event occurs, the policy value remains the property of the policyholder. If an insured event occurs after the court imposes a seizure on the policy value upon request, the effect of the seizure order remains unaffected. The beneficiary can claim only the insurance proceeds exceeding the seized policy value. The insurer must pay the beneficiary the balance after deducting the policy value from the insurance proceeds.
Similarly, if a policyholder is placed under guardianship and the guardian, acting as a statutory agent, changes the policyholder or beneficiary to themselves, this act essentially transfers the ward's property to the guardian. This violates Article 1102 of the Civil Code and constitutes unauthorized representation. There is also a specific consideration relationship between the policyholder and the beneficiary, which may be gratuitous or for value. If this consideration is invalid or rescinded, the beneficiary must return the insurance proceeds or the right to claim insurance benefits to the policyholder under Articles 179 or 259 of the Civil Code.