论保险合同的射幸性特征

保险合同的射幸性特征似乎是保险合同的一个众所周知的特点。据考证,当保险制度于19世纪中叶传入中国后,我国学者将描述保险合同性质的“Aleato-ryContract”一词译成了射幸性合同。由此,保险合同具有射幸性特征一说便自然而然地流传到了今天。我国民法将有偿合同分为实定合同及射幸性合同。其中,实定合同在成立时,当事人的给付义务及给付的范围都已确定;而射幸性合同是指当事人一方或双方的给付义务取决于合同成立后约定的偶然事件的发生与否。大部分的有偿合同属于实定合同,     

保险合同免责条款的理解与法律适用

保险合同的免责条款是保险人维持正常运营、防范自身风险所必须具备的条款,也是我国法律所允许的保险人的一项正当权利。同时,为了防止保险人滥用此项权利,我国法律对保险合同的免责条款的效力也做出了一定的限制,要求保险人对免责条款履行提示与明确说明的义务,同时也规定了免责条款法定无效的情形。如何准确理解免责条款的内涵与外延,准确适用法律,本文采用比较法的角度,联系我国保险实践与保险诉讼司法实践情况,作了有益的探索,提出在适用法律时,应做到保护保险合同双方当事人利益的平衡及维护投保人、被保险人、受益人利益及防范保险欺诈的平衡。     

保险合同免责条款正当性实证研究

免责条款作为保险合同的核心要素,其正当性直接关系着保险消费者能否获得赔偿的重大利益诉求。本文基于机动车辆保险合同典型案例的实证分析,在对免责条款涉诉焦点问题客观分类的基础上,着重从免责条款效力评价规则和法律规制的构建,开展免责条款正当性研究。     

论我国保险合同复效制度中的若干问题

一、复效制度概述 （一）概述 1．复效条款与宽限期条款的关系 在人身保险合同中,合同双方通常会约定分期支付保险费。在投保人支付了首期保险费后．保险人对到期没有缴纳相应保险费的投保人给予一定时间上的宽限期,这就是所谓的宽限期条款。宽限期条款的意义在于避免合同生效后,因投保人一时无法按照合同约定的期限支付保险费而影响合同的效力,因此保险合同在宽限期内是有效力的。     

保险合同纠纷：赔与不赔

在签订保险合同时．投保人应当如实反映自己的情况．保险人更应当具有为投保人实现最大利益的善良注意义务．比如对免责条款的特别提示与解释。笔者特撰此文，通过法院对保险合同纠纷的处理，能够让人们对保险合同的相关法律规定有所了解．以便维护自己的权利；同时也希望保险公司通过诉讼，能够促进其在保险服务方面趋于完善。     

由一个案例谈保险合同的霸王条款

法律规范中的霸王条款,实际上就是“不公平条款”,指的是经营者单方面制定的逃避法定义务、减免自身责任的不平等的格式合同、通知、声明和解释等。在法律后果上往往造成接受格式合同的一方的利益当有而不有或者不当减而减。保险合同中的霸王条款涉及两种理解,一是指现行我国保险法法条中涉嫌霸王条款,二是指各保险公司的相关规定以及与投保人签订的具体保险合同条款中涉嫌霸王条款。显然,后者是在更广泛意义上使用和操作的,而前者有点类似于具体行政行为违法而提请审查抽象行政行为之关系,一般不直接在司法领域出现某个法条错误等论调。因此,本文也是从一个具体保险合同入手的。     

从“9．11”理赔谈保险合同的“不利解释”原则

保险合同不利解释原则的精神是倾向于保护投保人或被保险人的利益,但过于强调直接导致司法实践中对不利解释原则的滥用.不利解释原则是有一定适用范围的,它只适用于保险合同条款所用文字有歧义而致使当事人意图不明的情况,并且只适用于普通被保险人及附和性合同.在司法实践中我们要对不利解释原则给予合理定位,保证其在保险合同纠纷案中能得以正确的适用.     

论我国保险合同复效的规范构造北大核心CSSCI

我国《保险法》复效规范在理论逻辑与规范构造方面,不利于保护被保险人或受益人合理期待权,也不利于保险公司的长远利益。本文以复效规范的构成为研究对象,运用比较研究法、法律解释法、实证研究法得出如下结论:我国的复效模式是“强制复效+除外情形”,现有的复效规范的刚性与技术性应加强;复效规范适用于期交保费的寿险、健康险(含长期护理险)、年金险合同,不适用于意外伤害险;复效规范应加强保险公司的欠费通知义务,取消自动起算60天宽限期的规定;保险人于应交保费到期日前15日书面通知投保人和被保险人,确认保险合同效力中止阻却事由条款的适用选择;复效后的合同是原合同效力的恢复,保险人有权依据我国《保险法》关于危险显著增加通知义务规定,在复效时增加免责条款;自杀条款免责期间自原合同生效之日起计算,对于不可保之自杀风险,保险人有权拒绝复效申请。     

保险合同的法律特征

保险业务活动的展开,是随着保险合同的签订而开始的,保险合同行为与一般的商务行为不同,保险人一方是经济实力和专业实力特别强大的企业组织,而投保人一方总是单个的"消费者",保险合同又是以承受特殊危险的一种合同行为,因此,保险合同必然有其自身的特点,这里笔者从法律的角度谈谈对保险合同的观察与分析.     

保险合同的特约条款及其法律规制

特约条款是保险合同的当事人在保险合同基本条款之外,另行约定承认履行特种义务的条款.通常情况下,特约条款是保险人用以控制危险的工具,为了防止保险人滥用特约条款,必须对其进行相应的法律规制.     

存在道德风险的医院等级选择与最优公共医疗保险合同

通过构造一个医疗服务系统的均衡模型,分析了医院等级、居民道德风险与最优公共医疗保险合同之间的关系。研究表明只存在公共医疗保险体系时,如果政府部门之间缺乏协调机制,各自为政,中国的公共医疗保险支付方式将不能实现社会最优并消除道德风险;公共医疗保险合同可能引起社会福利的损失或引致道德风险。政府应该完善医院评价系统,对不同医院的水平给予准确的评级,特别是要建立起政府各部门之间的协调机制;理顺医疗服务价格体系;鼓励更多市场参与主体进入医疗保险领域,建立合理的疾病风险分担机制。     

论保险合同免责条款和保险人明确说明义务——《保险法》第17条和第19条的理解和适用

2009年修订后的《中华人民共和国保险法》（以下简称“新保险法”）根据保险市场信息的高度不对称性,即保险人处于相对强势地位的特点,强化了对投保人、被保险人、受益人利益的保护,其中一个重要表现就是规范格式条款。新保险法在免责条款的明确说明义务、无效免责条款的规定上做出了进一步修改和完善。本文从免责条款的性质及法律效果等角...     

Multiple Losses, EX ANTE Moral Hazard, and the Implications for Umbrella Policies

Under certain cost conditions the optimal insurance policy offers full coverage above a deductible, as Arrow and others have shown. However, many insurance policies currently provide coverage against several losses although the possibilities for the insured to affect the loss probabilities by several prevention activities (multiple moral hazard) are substantially different. This article shows that optimal contracts under multiple moral hazard generally call for complex reimbursement schedules. It also examines the conditions under which different types of risks can optimally be covered by a single insurance policy and argues that the case for umbrella policies under multiple moral hazard is limited in practice.     

Hidden insurance in a moral‐hazard economy

We analyze the general equilibrium of an economy in which a competitive industry produces nonexclusive insurance services. The equilibrium is inefficient because insurance contracts cannot control moral hazard, and welfare can be improved by policies that reduce insurance by increasing its price above marginal cost. We discuss how insurance production costs that exceed expected claim payments interact with moral hazard in determining the equilibrium's inefficiency, and show that these costs can make insurance premia so actuarially unfair as to validate the standard first‐order conditions we exploit in our analysis.     

Exclusive contracts and demand foreclosure

A firm may induce some customers to sign exclusive contracts in order to deprive a rival of the minimum viable size, exclude it from the market, and enjoy increased market power. This strategy may result in socially inefficient exclusion even if the excluded firm is present at the contracting stage and can make counteroffers. In addition, allowing for breach penalty clauses decreases firms’ incentives to exclude rivals, because such clauses allow a firm to use customers as a conduit for the transfer of another firm’s profits.     

Does Social Capital Reduce Moral Hazard? A Network Model for Non‐Life Insurance Demand*

We study the effect of social capital in an environment in which formal, marketed insurance contracts coexist with informal agreements. We show that in the absence of peer monitoring and social pressure, non‐marketed contracts crowd out formal ones due to moral hazard. We prove, by means of an equilibrium concept typical of the network literature, that social capital can reduce moral hazard in informal agreements. We then show that under certain conditions, social capital increases the demand for marketed insurance contracts. The theoretical model we outline provides us clear guidance to measure social capital in a provincial‐level data set. The empirical model, which is estimated controlling for panel and spatial structure, supports our claim that social capital increases the demand for non‐life insurance.     

Der neue Standard zur bilanziellen Abbildung von Versicherungsverträgen (IFRS 17) – Eine kritische Analyse der Auswirkungen auf die Versicherungsbranche

The new standard for the accounting of insurance contracts (IFRS 17) will entail substantial changes for the insurance industry. In the following article the new standard is critically analyzed. First and foremost the coming valuation model, the so-called building block approach, is presented which will be the basis for all insurance contracts within the scope of IFRS 17. (For certain insurance contracts, especially those with direct participation features, or for less complex or short-term insurance contracts, there are some modifications.) To be more precise, IFRS 17 introduces an enterprise-specific valuation approach that is grounded on the so-called fulfilment value. This fulfilment value is determined by four separate building blocks (fulfilment-cashflow, discount rate, risk margin and contractual service margin), which will be addressed in detail. Finally, major changes in performed accounting practices that insurance enterprises are confronted with and will have to adapt to in their financial statements and accounts are pointed out.     

Customers' perceptions on the dispute resolution clauses in Islamic finance contracts in Malaysia

This empirical legal study examines the perceptions of retail customers on the dispute resolution clauses contained in the governing law and jurisdiction clauses in Islamic finance contracts in Malaysia. Since Islamic financial institutions and their customers are more likely to opt for litigation in the event of a dispute, this study explores ways of providing for unambiguous dispute resolution clauses that are well understood by the parties. Such clauses are expected to incorporate effective dispute resolution processes such as mediation and arbitration through a multi-tiered mechanism. Primary data collected through survey questionnaire administered on 160 Islamic bank customers is analysed using both factor analysis and structural equation modelling. The empirical legal study reveals that there is a statistically significant direct effect of dispute resolution clauses in Islamic finance contracts on the legal awareness and understanding of the customers and indirect effect on the customers' dispute resolution channels. It therefore follows that there is a need to provide for more effective clauses that allow for mediation and arbitration in the governing law and jurisdiction clauses of Islamic finance contracts in Malaysia. Such alternative dispute resolution processes can be structured in a multi-tiered manner that will only allow for litigation as a last resort. This will allow Islamic financial institutions and their customers to make informed decisions about the best option for effective dispute management.     

Vom Beruf unserer Zeit zur nationalen Gesetzgebung

There is a broad consensus with regard to the necessity of reforming the german insurance contract law. Considerations about the necessary changes should include the globalisation of markets in a unified Europe, as well as methodical and other developments of the law in the recent past. Until recently, the international transfer of services was discussed rather theoretically and had less practical relevance. This has changed since the use of the internet has increased dramatically. Therefore, an explicit regulation in the law with regard to the applicable law and jurisdiction for insurance contracts with an international context is required.Alongside these changes, a reform of the insurance contract law code will have to include the development of the jurisdiction of German courts especially with regard to consumer protection clauses. The extent of this reform depends on the interpretation of the concept of a ?mature and responsible consumer“. Regarding jumbo risks, the question remains whether complete contractual autonomy should apply. With respect to the control of general terms and conditions by the courts, a more detailed regulation of dispositive clauses in the insurance contract law might be considered which one could revest to on in case of nullity of such conditions.There are many specific regulations that are susceptible to changes and amelioration. Every change needs to find a balance between the need to guarantee the autonomy of the contracting parties and the protection of the consumers / insured. For instance, a general right of the insured to withdraw from a contractual obligation would be inconsistent with essential principles of contract law.Lastly, certain branches of the insurance industry, which are not specifically addressed in the law, such as professional incapacity insurance, should be regulated in the future.     

A theory of mutual formation and moral hazard with evidence from the history of the insurance industry

Nonprofit, mutually owned insurance and banking organizationshave significant market shares in the insurance and bankingindustries. A first step in a systematic study of these financialmutuals is to examined the reasons for their formation. Doingso provides empirical support for the view that these mutualsarose as an efficient means of addressing contracting challengescaused by aggregate uncertainties and moral hazard. A formalmodel with this property is presented. We argue that informationasymmetries do more to explain the kinds of contracts offeredby financial mutuals than do agency problems between owners,managers, and customers.