保險代位之本質，可說是整個保險代位體系之核心所在。本文乃以保險代位之本質—亦即求償模式為重心，對於保險代位之相關問題，依序加以討論。本文首先自保險代位存在之法理、以及學說上對其之批評加以分析、並提出回應。在保險代位之求償模式方面，我國傳統以來循大陸法系之傳統，採取法定債權移轉理論，而與英美法有所不同；英美法之架構近年來漸受學說之重視，甚至對其有所爭議，故實有釐清之必要。本文乃對英美保險代位之本質、架構加以探索，並對其與擬制信託之融合詳加分析，以求釐清其法律關係。除了英美以外，本文亦對其他主要國家之立法例詳加分析，並歸納為大陸法系與英美法系兩大系統。而中國大陸與台灣均屬於繼受法之地位，關於保險代位求償模式、名義等，亦可見受不同立法例所影響之軌跡；其許多條款與學說見解亦有疑義，值得我國引以為戒。於分析英美法與各國立法例，並審酌我國之背景後，本文乃嘗試對我國提出「保險代位求償模式相對論」—即原則上仍採取法定債權移轉理論，但在保險人與被保險人有特定具體之特約時，則可約定採取英美法之模式、或是自行約定其他求償模式。 另外，關於不足額保險、而應負責之第三人資力不足時，保險人與被保險人之間受償順序之問題，本文將由傳統的法釋義學方法出發，藉由對立法例、實務與學說見解的分析，以重新思考相關的法理基礎。本文也將使用法律經濟分析的方法，以經濟模型重新考量代位求償過程中可能的因素，重新驗證被保險人優先受償模式對於被保險人的效用。就結論而言，在損失填補原則的架構下，被保險人優先受償模式仍應為最適的解決方案。但此原則應有以法規或嚴格意定予以排除、修正之空間。在判斷順序上，可依三階段判斷：先檢視法規有無特別規定，再檢視當事人間是否有特別約定，若均無再適用被保險人優先受償模式以分配之。 對於特別保險—如全民健康保險法、勞工保險條例、強制汽車責任保險法等中之代位體系，本文亦加以分析，並同樣認為於適當之類型中，本文之保險代位模式求償相對論亦應可加以適用。在再保險與保險代位之適用問題上，本文肯認保險人對第三人之求償無庸扣除再保險之給付。而對於再保險是否、如何適用於保險代位，本文則認為可以三階段判斷之：首先，就再保險之類型為判斷；再判斷原保險人是否欲向第三人求償；如再保險之類型適合、又原保險人不欲向第三人求償時，則應允許再保險人向第三求償。最後，總結全文提出結論；並分三階段對於我國法提出相關建議，以供未來進一步之參酌。 / The nature of subrogation can be regarded as the core of the subrogation system. This research put stress on the nature of subrogation which was the subrogation. Regarding the related problems of subrogation, they will be discussed orderly. The article firstly starts to analyze from the existence of subrogation and the criticism for the theory to provide the responses. In the aspect of the way how subrogation operates, our country traditionally follows the Continental Law System to adopt the “legal assignment theory” which is different the Anglo-American Law System. The structure of Anglo-American Law System is stressed by the theory and is very controversial. Consequently, it is necessary to figure out the truth. This research is aimed at exploring the nature and structure of common law subrogation theory and analyzes other integration of the constructive trust to figure out the law relationship. Except for Anglo-American countries, this research also analyzes the lawmaking of other countries and induces the two main systems which are Continental Law System and Anglo-American Law System. Mainland China and Taiwan belong to the status of Succession Law. Regarding the subrogation and nominal, it can be seen that the orbit is affected by different ways of lawmaking. Understandings of many clauses and theories are still uncertain. Our country should learn a lesson from it. With analyzing the ways of lawmaking of common law and each country, and considering the background of our country, the research attempts to address the “relativity theory of insurance subrogation” to our country. In principle, it still adopts legal assignment theory. However, when the insurer and insured have specific agreement, they can negotiate to adopt the Anglo-American model or make other subrogation model by themselves. Other problems can arise with regard to payment priority between the insurer and the insured, particularly in cases of underinsurance and when the responsible third party has insufficient funds to make up the difference. The present study takes the traditional rechtsdogmatik approach as its starting point, analyzing legislative precedents, practical aspects and academic theories to re-examine the underlying legal principles. The paper also makes use of economic analysis of law techniques, employing economic models to reconsider the factors that may be involved in the subrogation process, and re-examining the efficacy of the insured-whole doctrine from the point of view of the insured. The main conclusions reached are that, within the framework created by the principle of indemnity, the insured-whole doctrine is still the optimal solution; however, there may be situations in which the insured-whole doctrine must be rejected or modified in light of legal or regulatory requirements or strict interpretation. Determination can be made in three stages. Firstly, the relevant laws and regulations should be examined to determine whether any special provisions apply. Then, an examination should be made to determine whether any special agreements exist between the parties concerned. If no special legal or regulatory provisions apply and no special agreements exist, then the insured-whole doctrine can be applied. For the subrogation systems in special insurances—for examples, the National Health Insurance, Labor Insurance, and Compulsory Automobile Liability Insurance, the research also analyzes them and considers that in the proper type, the relativity theory of insurance subrogation can be adopted. About the problems about reinsurance and subrogation, this research admits that insurer asks for subrogation for the third party not need to deduct from settlement of reinsurance. For reinsurer and how to apply to the subrogation, the research considers that it can be judged from three stages. If the type of reinsurance is suitable and the original insurer does not want to claim against the third party, it should be allowed that the reinsurer can claim against the third party directly. Finally, the research makes the conclusion and provides related suggestions to the law of our country to be viewed as the future reference.

全民健康保險法自民國83年8月9日公告並自民國84年3月1日施行，此一社會保險制度迄今已成為我國醫療保健系統重要支幹，然而，醫療費用每年約上漲8~10%，致使民國87年3月開始，財務已有入不敷出的情形，因此中央健康保險局（保險人）有一連串開源節流的政策 民國94年2月25日全民健康保險監理委員會第117次會議，委員發言多傾向支持擴大代位求償範圍。此外，全民健保公民共識會議之與會人員，一致認為保險事故如果係可明確歸責於第三人之事由所導致，全民健保之保險人於給付後，應該向第三人代位求償，以符公平正義原則，立法院爰於民國94年5月18日修正全民健康保險法第82條，增訂公共安全事故及重大之交通事故、公害或食品中毒事件為代位求償範圍，修正後條文為：「保險對象因發生保險事故，而對第三人有損害賠償請求權者，本保險之保險人於提供保險給付後，得依下列規定，代位行使損害賠償請求權： 一、汽車交通事故：向強制汽車責任保險保險人請求。 二、公共安全事故：向第三人依法規應強制投保之責任保險保險人請求。 三、其他重大之交通事故、公害或食品中毒事件：第三人已投保責任保險 者，向其保險人請求；未投保者，向第三人請求。 前項第三款所定重大交通事故、公害及食品中毒事件之求償範圍、方式及 程序等事項之辦法，由主管機關定之。」 修法之後，雖然擴大了健保局代位求償範圍，但限制仍多，且此次修法亦未明確釐清健保局在其他領域是否亦有代位求償權 本文首先敘述我國自民國84年正式實施全民健康保險時，尚有盈餘，然而自民國87年起首見保險支出超過保險收入，至民國96年時差額更高達新台幣136億元，除了繼續開發新財源與減少支出外，有無可能利用現有的制度切實實施，消除多數國民有「中央健康保險局將全國人民當成提款機的看法」，以及使實現加害者負其責任之公平正義，故本文針對於全民健康保險法第82條第1項第2款中中央健康保險局對公共安全事故強制投保之責任保險保險人代位權之相關問題加以探討，希望對於日益惡化瀕於破產邊緣之財務有所助益，接者大略簡介我國社會保險制度的演進，包括勞工保險、公務人員保險及其相關保險、退休公務人員保險、公務人員眷屬疾病保險、退休公務人員疾病保險、退休公務人員配偶疾病保險、私立學校教職員保險及其相關保險、農民健康保險與全民健康保險之演進與概況，之後於第三章再藉由歐、美等主要國家保險理論探討保險代位求償權之理論基礎以及人身保險適用代位求償權之理由，復接者討論保險代位求償權之性質、民法上行使代位權之限制、保險法上保險人代位權之性質與全民健康保險保險人之代位求償權；於第四章則討論目前我國中央與地方法規中有哪些場所或行業係屬須強制投保公共意外責任保險以及公共安全事故中全民健康保險保險人代位求償權之構成要件；於第五章則討論全民健康保險保險人可代位求償之金額尚須受到中央健康保險局實際所支出之醫療給付與強制責任保險之保險金額限制；於第六章則討論保險對象對於中央健康保險局代位求償權之保全有協助義務以及節妨礙代位之事由與代位求償權之消滅時效；第七章則是探討中央健康保險局行使代位求償權應注意事項；最後於第八章則是結論與建議。