近年來因國際與國內間天災或人為疏失接連發生，對於保險業而言，造成巨額保險金給付之損失，而再保險制度係為有效將風險分散之方式之一。我國保險業對於再保險安排依賴度普遍偏高，惟現行保險法就再保險制度之規範，僅於第三十九條至第四十二條有之，而無完備之立法，從而，再保險契約相關法律問題之研究對於原被保險人、原保險人及再保險人三方當事人而言係成為當前重要之課題。 　 　　再保險契約亦為保險契約之一類，故保險契約之基本原則亦可適用於再保險契約之中，主要有保險利益原則、最高誠信原則、損失填補原則等。其中由損失填補原則衍生出之法律問題，本文將具體探討者有二：一、原被保險人之直接給付請求權。二、再保險人之代位求償權。前者涉及民國九十六年保險法第四十條之修正，係賦予原被保險人對再保險人於另有約定時之直接給付請求權，該修正是否妥適，本文將詳加討論之。後者則為實務與通說容有爭議之問題，即再保險人是否享有代位求償權？原保險人於行使其代位求償權時，是否須將再保險人已為給付之部分扣除？本文亦加以討論之。另就最高誠信原則所衍生之法律問題，則為同一命運原則之解釋適用。實務上以同一命運原則拘束再保險人，使原保險人得以取得再保險保障，惟此原則仍應有其適用界線存在。參酌英美實務見解，本文將討論較常見之優惠賠款條款、懲罰性賠款條款及責任限額條款之解釋適用，並提出建議，以免爭議。希冀透過本文之探討得釐清再保險契約相關法律問題，對於法律工作者或實務工作者提供棉薄之幫助。

財務再保險係屬於新興的風險移轉方式之一，除了可以移轉傳統再保險之核保風險外，更可以將保險公司有很多無法以傳統再保險獲得分散的風險，如時間風險、投資風險等財務風險移轉出去。財務再保險可以增加保險公司的盈餘及提升經理人的績效，同時能減少潛在的危險暴露，避免準備金提存不足的問題，並且可以增加保險公司的承保能量，資助新契約的成長，兼具風險管理與財務規劃的新興工具。 相對的，財務再保險的實施，也延伸出相關的問題，如財務再保險係為融資借貸關係，而非實質危險轉移；因為準備金提存不足，無法支付未來重大的損失；為了掩飾盈虧，而誤導投資大眾。HIH與AIG集團涉及以財務再保險契約粉飾財務報表的行為，顯示財務再保險契約所造成的監理漏洞，另一方面，保險公司若不注重其企業本身營運的風險管理，而是以財務再保險契約尋求穩定公司收益的財務揭露，對於保險公司的長期經營並不是一件好事，同時對於投資人、監理機關的管理亦影響甚鉅。 除了監理機關對於財務再保險應加以規範外，保險公司內部之內部控制與內部稽核在企業中亦扮演重要角色。本研究就HIH與AIG集團兩個案之財務再保險問題，收集截至2005年HIH相關人員被澳洲保險監理機關起訴之起訴理由，與AIG被美國監理機關起訴人員的相關資料，分析這些被起訴原因之內部控制缺失，強調財務再保險內部控制與內部稽核的重要性，最後，針對保險公司實施財務再保險提出建議，同時對保險監理機關監管財務再保險也提出建議，希望對國內保險業者實施財務再保險有所助益，同時，也作為保險監理機關監管財務再保險的參考。 / Financial reinsurance is one of the alternative risk transfer arrangements. Unlike the traditional reinsurance arrangement where only the underwriting risk is transferred, other risks such as time risk and investment risk may also be transferred through such arrangement. Financial reinsurance increases an insurance company’s earning and the managers’ performance, and hence decreases the exposures of reserve inadequacy. Additionally, it is also a new tool for risk management and financial planning for its positive impact on new business growth through the enhancement on the company’s underwriting capability. On the other side, the use of financial reinsurance also leads to some problems. Specifically, when it is structured as a financial lease without any physical transfer of risks and used to window-dress poor financial performance in order to mislead the investors. Two international insurance companies, namely HIH (Health International Holdings) and AIG (American International Group), have tried to use the financial reinsurance arrangements to window-dress their financial statements in order to deceive the regulators. From a long term perspective, financial reinsurance arrangements used for stabilizing the financial results instead of enhancing risk management would certainly be detrimental to investors and insurance regulators. Besides the regulators who need to set up the regulations on financial reinsurance, the internal controls and internal auditing functions within insurance company also play an important role in terms of supervision. This thesis focused on two real life cases related to HIH and AIG by studying their problems with financial reinsurance and colleting the people being prosecuted by Australia regulator (APRA) and SEC as of the end of 2005, the internal control weaknesses caused by them and finally emphasizing the important of internal controls and internal audit function. Lastly, after studies these two cases, recommendations are made to insurance companies and local regulator on how to manage the use of financial reinsurance. Hopefully these suggestions would be helpful to them.

保險業承擔社會大眾轉嫁之風險，其自身亦需要透過風險之分散，以避免危險過度集中，而危及永續經營之能力。而保險市場之專業保險人間，常透過彼此技術之結合運用，達風險分散之目的。其中保險聯營，即為典型聯合數保險人之能量，合力承受特殊危險，協助個別保險人分散風險之方式，亦是目前各國或特定區域之保險業所偏好使用之制度之一。 保險聯營於我國已行之多年，保險業多利用其消納分散巨災或高度風險，抑或配合政府保險政策設立組織，對於我國保險市場而言，具有不可或缺之重要性。然而，保險聯營制度因為譯名與共同保險類似，導致實務對於此兩種同為保險人風險分散之制度產生觀念性之混淆，因無法確切了解其區別，所以產生立法上之錯誤及運作上之爭議。 本文以「保險聯營制度之研究-兼論保險業之風險分散方式」為題，試圖透過深入探討保險聯營制度，並比較其他類似方式，包括共同保險、再保險及交換業務等，以釐清各制度之差異，了解其功能、運作及契約當事人之法律關係；其次則介紹國內風險分散機制，以分析其本質，並就我國保險聯營實務問題為探究與建議。 本文研究結果發現，共同保險、再保險、交換業務及保險聯營制度，即便外觀及功能上多有重疊，但實際上係屬不同之機制。而國內風險分散機制，多數依其運作方式雖得歸類於保險聯營組織，惟究其與會員間之約定，得發現其混合其他風險分散機制之性質，因此不能單純以單一制度視之。關於保險聯營制度之實務問題探討，我國實務因對於「共保」兩字概念涵括範圍定義不一，造成保險法第一百四十四條之一之立法用字有所爭議，本文以為立法條文應儘量以明確用字，降低法律適用模糊的可能性；而聯營組織之型態，應以其功能性區別之，即組織本身若直接承接危險者或有其他對外代表性者，則應成立法人組織，使其享有法人權利，並履行法人義務；最後於公平法限制競爭之探討上，考量到保險聯營設立之特殊性，公平會之審查權限應受限縮，倘聯營組織之設立具備合理性及必要性，且其成效對於社會有顯著正面價值，應可排除公平法之適用。

本研究之主要貢獻為發展適合台灣營造綜合險保單（本體損失險）之風險曲線。 先前由Salzmann (1963)及Ludwig (1998)之相關研究，係採用美國市場之損失經驗，考量不同保單之承保範圍、不同保險標的、及不同之承保風險，直接引用美國市場風險曲線於台灣市場之通用性值得釐清。 本研究回顧台灣營造綜合險保單之承保範圍及除外條款，依據西元一九九六年至兩千年之損失經驗，發現台灣營造綜合險之損率深受天然災害如地震、颱風、豪雨所影響。 再保險安排可分成兩大類，一是比例再保險; 另一是非比例再保險。風險曲線是非比例再保險常用之計價方式之一。 比較先前之研究，本研究之風險曲線分佈集中在低層其主要之原因如下:- 一、 分析標的之可能最大損失(PML)偏低: PML代表某一特定危險所可能造成之可能最大損失。以道路工程為例，其可能最大損失小於30%之保額。由於道路工程大多綿延數十公里甚或更長，其工程本身呈線狀之分佈。換言之，非常不可能會有單一損失其損失金額超過保額之30%。 因此，道路工程之損失分佈不平均且分佈集中在低層。 二、 營造綜合險保期偏長: 營造工程其中一個特性為多年期的保險期間。 因為工程之進行往往需要花超過一年的時間來完成，因此，營造綜合險全損(損失金額等於保額)之機率，遠小於財產險因火災造成全損之機率。 三、 分析之承保風險不同: Salzmann (1963)僅針對火災此一危險因子來從事她的研究。就我們所知，美國大多數住宅皆是木造，屬可燃性建材，火災造成之影響相當大。 相反地，本研究標的大多利用不可燃性建材來興建，如鋼鐵或混凝土，故火災之影響性相對較小。 關鍵字: 非比例再保險、風險基礎計價、營造綜合保險 / The major contribution of this research is to develop the exposure curves suitable for the Taiwan Contractor’s All Risks (CAR) Insurance (Material Damage Cover). The exposure curves generated in Salzmann (1963) and Ludwig (1998) were originated from the loss experience in the United States. Considering the different types of policies, different types of risks, and different types of perils, the applicability of those curves in Taiwan market is discussable. This study reviews the scope of coverage, insuring clause and exclusions of the Taiwan Contractor’s All Risks Insurance. According to the loss records between 1996 and 2000, it’s understood that the result of the Contractor’s All Risks Insurance is highly influenced by the natural catastrophic perils, such as earthquake, typhoon and heavy rains. The reinsurance placement can be categorized into proportional and non-proportional reinsurance or called excess of loss reinsurance. Exposure rating is one of the common pricing methods for the excess of loss reinsurance. Compared with those two previous researches done by Salzmann (1963) and Ludwig (1998), the outcome of this analysis shows an unbalanced loss distribution which leans to the lower layers that is mainly because of the following reasons: - (1) Low PML percentage of analyzed risks: The PML represents the Probable Maximum Loss subject to a certain type of peril. Taking a road construction project as an example, the PML of a road construction project is less than 30% of the total sum insured. Usually, the length of a road construction project is tens of kilometers or even much longer. In consideration of its linear shape, it’s very unlikely to have a loss exceeding 30% of its total sum insured. Therefore there was very few or nil loss data above the 30% of the total sum insured that’s the reason why the loss distribution is unbalanced and leans to the lower layers. (2) Long Construction Period of a CAR Project: A character of a CAR project is having a multiple-year policy period because the construction work usually takes more than one year to be completed. Therefore the possibility to have a total loss case, loss amount equal to the total sum insured, is much less than a property risk with a fire scenario. (3) Types of Perils Analyzed: Salzmann (1963) carried out her research by analyzing the peril of fire covered under the homeowners’ policies. As we know, most of the houses in the United States are the wooden structures, which are combustible. Oppositely, the risks in this research are mostly constructed by using the non-combustible materials, such as steel or reinforced concrete. Keywords: excess of loss, non-proportional reinsurance, exposure rating, and contractor’s all risks insurance.

國內保險經營，長久以來即是人身保險及財產保險分業經營方式，但兩者的經營規模差距很大，據統計資料顯示，壽險業這五年來的傷害險保費收入，平均每年約有580億元，健康險平均年約1260億元，對於產險業整體業界總保費收入約1100億元的市場規模而言，實在是塊誘人和商機無限的新市場，能加入傷害險或健康險的經營，將是產險業者突破經營瓶頸的關鍵，不僅保險市場會產生蛻變，更會對消費大眾帶來多元的選擇與影響。 在此背景下，本研究主要探討產險業經營傷害險的績效，並舉個案實例經營此單一險種的過程，就其在商品研發、行銷、核保和理賠等各項作業流程，進行探討分析。經本研究個案分析，歸納出幾點問題，一是在經營策略面，以業績成長為首要的考量，自然會選擇通路商的行銷方式，所謂「掌握通路，就是贏家」，兩年來通路業績佔了該險種的73%，而其賠款金額佔率，亦佔了76%左右，經營績效的結果顯示出「成也通路，敗也通路」，如何強化通路商之管理是經營重點。二是由理賠資料分析統計，並與壽險業資料比較，發現有相關性趨勢，但卻有相對惡化的現象，諸如平均死亡率，男性比女性多出5倍以上，比壽險業的3倍高；平均每件死亡賠款230萬元，比壽險業的120萬元，高出近一倍，且又以男性50~59歲的年齡層最高，此點顯示出其商品是否有「保費太低而保障過高」的問題。三是其面臨人力和經驗不足的問題，加上缺乏醫療、法務、徵信調查等相關專業人員及其運作經驗，無法在核保和理賠作業時，因應實際的作業需求。 我國保險法經過兩次修正後，現在已開放產險業者得以經營傷害險，再者，有關健康險是否可進一步開放予產險業者經營，相信很快會經立法院通過修法審議。故本研究的結果，即是找出經營問題和原因，並提出改善建議，期能提供產險業者經營傷害險或未來健康險的參酌。 關鍵字：個人傷害保險、綜合率、非比率再保險 / In our insurance market, there are two types of operation, that is, life insurance and non-life insurance, but the business scale of the two types has a long way to go. According to the data, the average premium income of whole life insurance market of the personal accident and health insurance is about NT$58 billion and NT$126 billion per year respectively among these five years. Relative to the non-life insurance which premium income is about NT$110 billion, it’s really a captivating and unlimited new market that the non-life insurance can take the risk about the personal accident and health insurance. From my point of view, it will be the main key to break through the bottleneck of operation of the non-life insurance market. Not only the whole insurance market will be changed but also it can bring multi-choice and influence to consumers. Under this background, the main task of this research is discussing the non-life insurance’s result of operation the personal accident insurance. It has a real case that also includes the product of development, marketing, underwriter and claim for further discussion and analysis. According to the research of this case, it can generalize some points as below. The first is about the tactic of operation: we will choice the way of marketing way of channel if we consider the growth of premium income as primary issue. What is called” Someone will be a winner if he controls the channel”. In our company, the business of channel was occupied about 73% of the personal accident insurance and the claim also in the same situation was about 76% over the past two years. Unfortunately, the result of operation is “Control the channel will make someone success and failure”, so the key point of operation is how to enhance the management of channel. The second is about the statistics of claim: we compared with the data of life and non-life insurance and find some related trends, but there is a phenomenon of related aggravation, such as rate of average death, men are five times more than women in non-life insurance but only three times in life insurance statistics; the average indemnity of death is about NT$2.3 million in non-life insurance which is one time higher than life insurance market and especially with men that age level among in 50~59 years old. On the basis of above mentioned, it shows the problem of this product have higher indemnification but lower premium income. The third is about the problem of lack of manpower and inadequate experience, in addition, it also lack such relevant professional personnel as medical, legal and investigative, etc. So it can’t offer the demand of real operation in the underwriting and claim process. The law of insurance has already opened that the non-life insurance can operate the personal accident insurance after revision two times in our country. Moreover, we believe that will be passed through about the non-life insurance also can operate the health insurance by the legislative rapidly. After the analysis, the conclusion of this research is finding out the question and reason of operation and offering the suggestion of improvement. I hope it can provide some recommendations for the non-life insurance that will operate the personal accident insurance or oncoming of the health insurance. Key words: Personal Accident Insurance、Combined Ratio、Excess of Loss

再保險交易為國內產物保險業者經營業務及風險管理上不可或缺之工具，近年衍生融通資金及改善財務結構之財務面功能，並傳出國際知名保險業者不當運用之情事，而引起各國保險監理機關之重視，開始建立再保險完整之監理制度及詳細規範。就我國產險業而言，現行再保險交易分出業務之會計處理，可透過再保費支出、再保佣金收入、再保攤回賠款及提存未滿期保費準備減少數等會計科目，產生盈餘釋放數，進而操控公司財務報表。本研究擬探討我國產險公司是否會利用承作再保險交易從事盈餘管理。 本研究分別採用縱橫資料迴歸及分量迴歸兩種模型，以1994-2008年之國內12家產險公司為樣本，探討再保險交易量及再保險交易盈餘釋放數與盈餘管理動機之關聯。實證結果顯示我國產險公司，就資本市場動機而言，當期盈餘數愈低者，會避免虧損而從事愈多再保險交易或有愈高之盈餘釋放數，若當期盈餘低於前期愈多者，則有愈高之盈餘釋放數；就稅負動機而言，若為高稅負成本者，將從事較少再保險交易或有較低之盈餘釋放數；惟就監理動機而言，發現產險公司保單持有人盈餘與實收資本之45%的差距愈小者，反而從事愈少之再保險交易。 / Reinsurance is an indispensable tool for property-casualty insurers’ business operating and risk management. In recent years, reinsurance derived some financial functions such capital finance and financial structure improvement. Some of the world famous insurers had been found improper use of financial reinsurance, which caused regulators of various countries try to establish more supervisory systems and detailed standards to monitor such behavior. The present accounting procedures of reinsurance ceded-out business might release surplus through reinsurance premiums ceded, reinsurance commission earned, claims recovered from reinsures, and the decrease of unearned premium reserves, which release might give insurers to manipulate the financial reporting. Therefore, this research attempts to examine association between reinsurance arrangements and earnings management on Taiwan’s property-casualty insurers. This research applies panel data model and quantile regression model to test the reinsurance transactions and the surplus release associated with earnings management motivation. The data draw from12 property-casualty Taiwan’s insurers from 1994 to 2008. For capital market motivations, the evidence indicates that property-casualty insurers manage more reinsurance transactions or the higher surplus release to avoid losses, and manage the higher surplus release to avoid earnings decreases. For tax burden motivations, the result shows that the higher tax burden insurers have, the fewer insurers manage reinsurance transactions and the lower surplus release. However, for regulatory motivations, the empirical results indicate that the less difference between policyholders’ surplus and 45% of total capital has, the fewer reinsurance transactions are being managed.

傳統的保險人在面對保險契約所承保的風險時，常會藉由國際上的再保險市場來分散其保險風險。由於所承保險事件的不確定性，保險人需要謹慎小心評估其保險風險並將承保風險轉移至再保險人。再保險有兩種主要的保險型式，可區分成比例再保契約及超額損失再保契約，保險人將利用這些再保險契約來分散求償給付時的損失，加強保險人本身的財務清償能力。 本研究，主要在於建構未來損失求償幅度或頻率的預測分佈並模擬未來支付求償的損失。簡單重點重複抽樣法是一種從危險參數的驗後分佈中抽樣的抽樣方法。然而，蒙地卡羅模擬是一種利用大量電腦運算計算近似預測分佈的逼近方法。利用被選取危險參數的驗前分佈來模擬其驗後分佈，並建構可能的承保危險參數結構，將基於馬可夫鏈蒙地卡羅理論的吉普生抽樣方法決定最適自留額，同時運用於再保險合約決策擬定過程。 最後，考慮於不同的再保險契約下來衡量再保險人的自負財務風險。基本上我們研究的對象是針對保險人所承保的風險，再藉由上述的方法來模擬、近似以量化所衍生的財務風險。這將有助於保險人清楚地瞭解其承保的風險，並對其承保業務做妥善的財務風險管理。本研究提供保險人具體的模型建構方法並對此建構技巧做詳細說明及實證分析。 / Insurers traditionally transfer their insurance risk through the international reinsurance market. Due to the uncertainty of these insured risks, the primary insurer need to carefully evaluate the insured risk and further transfer these risks to his ceding reinsurers. There are two major types of reinsurance, i.e. pro rata treaty and excess of loss treaty, used in protecting the claim losses. In this article, the predictive distribution of the claim size is constructed to monitor the future claim underwriting losses based on the reinsurance agreement. Simple Importance Resampling (SIR) are employed in sampling the posterior distribution of risk parameters. Then Monte Carlo simulations are used to approximate the predictive distribution. Plausible prior distributions of these risk parameters are chosen in simulation its posterior distribution. Markov chain Monte Carlo (MCMC) method using Gibbs sampling scheme is also performed based on possible parametric structures. Both the pro rata and excess of loss treaties are investigated to quantify the retention risks of the ceding reinsurers. The insurance risks are focused in our model. Through the implemented model and simulation techniques, it is beneficial for the primary insurer in projecting his underwriting risks. The results show a significant advantage and flexibility using this approach in risk management. This article outlines the procedure of building the model. Finally a practical case study is performed for numerical illustrated.

近年來有關保險證券化（Insurance Securitization）之發展可謂為國際金融市場上之一項革命，而巨災債券乃為保險連結型證券之大宗，此一分散、消化巨災損失之新興金融技術，對於日益捉襟見肘的巨災風險再保險人而言，無疑成為了新的活水源頭。回顧我國，自從於八十八年九月歷經九二一大地震摧殘後，驚覺天然巨災之可怕，亟思研擬分散巨災損失之對策。就風險移轉之技術層面而言，引進巨災債券制度不失為一可行之良方。然巨災債券並無法直接適用於我國去年七月新通過之「金融資產證券化條例」，因此遂滋生若欲引進巨災債券制度時，我國現行法規架構應如何加以調整此一重大問題。又特殊目的再保險人（Special Purpose Reinsurer, SPR）所發行之巨災債券究為保險商品，抑或純粹為一種證券？監理機關對其又應採如何之監理架構，始能有效率地加以監理？而我國相關之稅制對此亦應採取如何之態度，方能吸引外資於我國進行巨災債券交易？此等皆國際保險監理上亦迭生爭議之議題，殊值研究。 因此，本文以下希望能借助比較法等研究方式，指出我國未來如欲繼受巨災債券此一制度時，應如何調整現存的法規架構與監理制度以符需求。希冀能對將來催生巨災債券制度提供一參考的方向。本文架構，安排如下： 第一章為緒論。闡述本文之研究動機與研究目的、研究範圍、研究方法，以及研究架構。 第二章討論國際金融市場上日益興起的「證券化」趨勢。本文先行整理各家學說見解對「證券化」之定義，再提出自身看法，並將巨災債券融入「證券化」的體系中，俾使其定位清晰，以利日後之理解推論。最後，再簡單介紹美、英兩國之證券化歷程，以使證券化之說明能更加完整。 第三章討論保險證券化於保險市場之崛起因素及該市場未來之展望。按保險證券化之興起背景，乃因傳統再保險市場之承保能量不足，保險業者用之因應頻繁之巨災及萎縮之再保險市場承保能量的替代方案，其主要類型有保險連結型固定收益證券、交易所的巨災選擇權及保險連結型資本融資證券三種。展望未來，雖然保險證券化商品有保險風險之不同質性等諸多挑戰，但無庸置疑的，保險證券化已是未來保險及再保險產業發展的新趨勢。 第四章討論巨災債券之交易架構及發展現況。按巨災債券交易架構者，簡單來說，係以欲進行風險移轉的分保人或一般企業所設立之特殊目的再保險人（或特殊目的保險人）為核心，向外放射出四個交易關係所架構而成。該四個交易關係乃：（一）為與分保人之間的再保險交易（或保險交易）；（二）為與利率市場上其他交易者間進行利率交換交易；（三）為與投資人之間的債券交易；（四）為與信託業之間的信託交易。另外，東京海上火災保險公司的地震風險證券化等等著名的巨災債券交易案例，均將於本章內作詳細之介紹。 第五章討論巨災債券之法規架構。由於巨災債券交易所涉之法規眾多，未免紛雜，本章乃將此大致區分為二大種類而加以討論：第一，為當事人間之法律關係：主要涉及美國商品交易法、期貨交易實務法、證券法、證券交易法、投資公司法、信託法及保險法；第二，為相關稅捐法制：主要為我國之證券交易稅條例、加值型與非加值型營業稅法及所得稅法。 第六章討論巨災債券交易之相關監理議題。按巨災債券交易之相關監理議題，通常涉及監理權限就應歸屬於何一機關？投資人是否應接受保險業監理法令之拘束？等等問題。最後，本章亦將提及新進的監理立法例－即美國伊利諾州保險交易所（Illinois Insurance Exchange）與美國保險監理官委員會（National Association of Insurance Commissioners, NAIC）之受保護帳戶公司模範法（Protected Cell Company Model Act）、NAIC特殊目的再保險機制模範法（Special Purpose Reinsurance Vehicle Model Act）及百慕達一九九八年保險修正法，以便完整呈現整個巨災債券監理之全貌。 第七章討論我國於引進巨災債券制度時所可能面臨之法規與監理制度相關議題。就我國現行法規制度而言，如欲引進巨災債券此一新興風險移轉方法，將面臨到許多挑戰與衝擊。諸如金融資產證券化條例並無法直接適用於巨災債券、我國是否可以於國內設置特殊目的再保險人，以及如何在國內外公開發行或私募巨災債券等等問題均是。其次，再就我國保險監理制度而言，如欲引進巨災債券制度則勢必亦需對整套保險監理制度作出適度之調整，方能竟全功，本章亦將詳究之。 第八章為結論。本章將擷取前揭各章討論之結果加以彙整，俾供將來我國引進巨災債券制度之參考。

再保險之目的，在於提供保險人保險保障。其方式乃再保險人就原保險人在原保險契約中所負之給付責任，予以部份或全部的補償。再保險契約就再保險人之再保險給付責任所為之約定，最常見者為「同一命運原則」之約定。依「同一命運條款」之字面解釋，此條款係指再保險人須與原保險人「同一命運」，於原保險人對被保險人為保險給付後，補償原保險人因對被保險人為保險給付所生之損害。 依據損害補償原則，須保險人之保險給付在保險契約及再保險契約之承保範圍內，再保險人始負再保險給付之責任。為了避免嚴格依據損害補償原則解釋再保險人之責任，造成保險人無法取得再保險保障之結果，並提高對於保險人之保障，再保險契約雙方乃藉由同一命運條款的相關約定，約定保險人只須證明其已向被保險人為補償給付且其給付係依「誠信」所為，再保險人即須同其命運，向保險人為補償給付。再保險人此一契約義務，乃再保險契約雙方當事人基於契約自由，於再保險契約中特別加入同一命運條款的結果。 保險人之「誠信」乃同一命運原則適用之基石，此為法院所共同肯認。然而，對於同一命運原則於個案中之具體適用，法院之看法似乎並無足夠的一致性。究竟，決定再保險契約雙方當事人權利義務的同一命運原則，法院如何解釋其適用上發生之爭議？又，法院對於抽象的誠信原則如何解釋？在同一命運原則的背景下，再保險人是否可以提出何種抗辯以免除其保險給付責任？最後，是否這些問題的解答可以有某程度的預測可能性，以供日後再保險契約雙方草擬同一命運條款之參考？ 針對保險人對被保險人所應為之補償，再保險人與原保險人可能有不同解釋，前者認為再保險人與保險人同一命運之範圍，應以原保險及再保險約定之範圍為限；後者則認為凡保險人所給付與被保險人者，再保險人皆須與其同一命運，負擔給付責任。縱使再保險契約雙方皆主張其以再保險契約之約定為給付責任範圍之界定基礎，然基於利益彼此對立之立場，雙方對於「契約約定」往往有不同詮釋。再保險契約雙方間之爭議，實務上常見者如，原保險人對被保險人所給付之通融賠款（Ex-gratia payment）、懲罰性賠償（Punitive damages）等，是否屬於再保險人與保險人同一命運之範圍？將此類爭議一般化，須探究者為，同一命運條款何種程度限制了再保險人對原保險人之給付表示異議的權利？ 另外，倘若再保險契約中沒有同一命運條款的約定，是否可認為此條款為再保險契約所「默示」（Implied）？此問題涉及同一命運原則的歷史背景，與再保險市場的運作實務息息相關，對於契約的解釋方法也有重要啟示。 同一命運原則為再保險交易發展史上，最常受到爭議的問題之一。現今之再保險交易環境已然愈趨複雜，不僅是所保危險之價額日趨提高，投入再保險交易之保險人數增加且交易類型複雜化，皆使得再保險交易雙方之風險分配及責任分擔，不再可以全然依賴保險人對於誠信原則之遵守。反之，應同時強調再保險與保險之不同，亦即，前者係由專業之保險人為交易雙方而進行之交易，故再保險人應可依其專業，對所保危險主動向保險人提出詢問，此亦顯示了保險人及再保險人間彼此合作愈趨重要，為再保險人負擔再保險給付責任之正當性基礎。本文嘗試處理以上提出的爭議問題，並對可能之解決提出建議。 / The reinsurance loss settlement clause, which appears in a variety of forms of wordings, historically has been one of the most difficult aspects of reinsurance law and practice. In recent days, more and more litigation has arisen as a result of such clauses. This study centers upon the interesting and oftentimes confusing issue of the scope and effect of such clauses, and how they define both the reinsured’s and the reinsurers’ liability. The purpose of reinsurance is to provide insurance protection by the reinsurer for the reinsured, namely, the insurer. At the beginning of reinsurance history when there were only a small number of insurers operating in the insurance market, insurers were fairly familiar with one another, and that resulted in a minimum of formality in doing business. In terms of reinsurance, reinsurers, when asked to pay by their reinsured, normally did not go out of their way to initiate a de novo review or assessment of the risk insured. The main reasons for such practice were, for one, insurers were so familiar with their business partners that they did not see the need for such re-assessment of the risk, and for another, in the past, the nature of the risks insured was not as complicated as those we are faced with nowadays. With a view to enhancing business efficiency and providing better protection for insurers, the parties that engaged in a reinsurance agreement oftentimes would insert into the agreement a “follow the fortunes” or “follow the settlements” clause. Such clauses bound the reinsurers to follow the fortunes/settlements of their reinsured without the reinsured’s liability having been proved, and restrained the reinsurers from refusing to indemnify the reinsured on the ground that liability did not exist under the original policy, provided that the reinsured had acted in a bona fide and businesslike way. In a word, the existence of the loss settlement clause was a logical consequence of the purpose of reinsurance, and the reinsurers’ obligation under such clauses was conditioned on the reinsured’s good faith. Reinsurance loss settlement clauses have been interpreted by the court rather favorably for the reinsured. Courts would normally find coverage for the reinsured, once they decided that the reinsured had acted in good faith in settling with the insured, even if they held that the reinsured had not been legally liable. This fact highlights the importance of the reinsured’s duty of utmost good faith in reinsurance law and practice. However, what exactly is good faith, and what are the reinsured’s obligations under the good faith requirement? Is there a general rule that the courts have developed to justify their finding of the reinsured’s good faith? If good faith, being abstract in itself and susceptible to courts’ subjective discretion, serves as the “standard” to evaluate or define the liability of the parties to a reinsurance agreement, how does it usually function? Does it at times seem so abstract and variable that the reinsurance agreement parties have a hard time predicting their liability under such a standard? Also, in this study, the questions of the implication of loss settlement clauses and the scope or effect of such clauses are explored. The former question asks, where the reinsurance contracts do not contain any “follow the fortunes or settlements” provisions, does the law, custom or practice read into the contracts any obligation on the reinsurer to follow its reinsured’s fortunes or settlements? This question is important in that it deals with the applicability of loss settlement clauses, and thus has a fundamental impact on how reinsurance contracts are interpreted. The latter question aims at clarifying how loss settlement clauses are applied to pertinent areas such as ex gratia payments, punitive damages, reinsurers’ liability caps, payments related to the Wellington Agreement and claims cooperation clauses. Specific examples are given here in order to better understand how loss settlements clauses are put to practical use. Discussion concerned with this question also demonstrates how a loosely worded loss settlement clause could give rise to disputes between the parties. To better define the parties’ rights and obligations under a reinsurance agreement, a more detailed review of how the reinsurance environment as a whole is functioning and how the courts interpret reinsurance loss settlement clauses is required. This issue will be even more worth pondering now that we are seeing a more complex reinsurance market where the parties’ interests are potentially conflicting, which is per se a challenge to the general view that the reinsurers should follow the fortunes or settlements of the reinsured.

本文主要以臺灣的產物保險業作為考察對象，探究產險業自日治時期發展起來後，直至戰後歷經接收與改組後的轉變，並以此為出發點探討戰後在產險業開放與管制的過程中，政府介入的積極性問題。臺灣的產險業發展雖然始於清代，但一直到日治時期才有專門的產險公司設立，而臺灣的產險市場也是在日治時期慢慢建立起來的。但是，由日治時期臺灣產險業的發展，除了大成火災保險株式會社是唯一本店設於臺灣的產險公司外，其餘皆是日本產險公司來臺設立的分店的情形來看，可以發現當時臺灣的產險市場規模仍未完全建立起來，這樣的情形直至戰後又有了新的發展。 　　戰後的接收與改組，使臺灣的產險業開始能夠朝向制度化發展，並建立起屬於臺灣自己的產險市場。戰後產險業的接收，將原先日治遺留下來的12家產險公司改組為臺灣產物保險公司，雖然仍有日產估價與戰爭保險賠償等問題尚未處理完成，但該公司的成立使臺灣的產險業務能開始慢慢走向正軌，並成為臺灣產險業發展的基礎之一。隨後，臺灣產物保險公司更與1949年隨政府而來的5家產險公司架構出屬於臺灣的產險業發展。 　　1950年政府對於產險市場的管制，減少了既存產險業的競爭性，並提供產險業相對穩定的發展空間，也因此在1950年到1960年間產險業務量得到大幅的提升。這不僅促成再保險制度的建立，以及1960年政府進行小幅度的市場開放，更使政府於1963年頒布保險法規。雖然隨後產險市場又再度進行管制，但此時臺灣的產險市場已由公營漸漸轉為民營發展，且制度與法規皆已確立，可說是完成一階段性的制度化發展。在此過程中，雖然政府以市場管制來穩定產險業之發展，並建立再保險制度與擬定保險法規，但實際上這些措施並非是政府積極規劃產險制度運作下的產物，而是受到市場與環境之影響不得不為之的結果。