團體壽險是員工福利思潮下之產物，至今已成為分散、轉嫁企業人身及責任風險不可或缺之風險管理工具。而團體壽險以一張保險單承保多數被保險人，此項「團體」之特性使其在核保、保險費、部分有效性及契約條款之設計上，有別於一般之人壽保險。目前，各家保險公司之團體壽險保險單悉以主管機關制訂之「團體一年定期人壽保險單示範條款」為依據。此示範條款以團體為要保人、團體成員為被保險人，將團體壽險定位為由第三人訂立之人壽保險契約，使團體壽險契約受到欠缺保險利益而無效、有無保險法第一○五條之適用及指定、變更受益人之權利人為誰之質疑。其次，團體壽險契約條款中的保險契約構成部分條款、被保險人資格條款、保險契約終止條款、契約轉換權條款、免責條款及不可抗爭條款等亦存在諸多問題，實有檢討予以修正之必要。
因此，本文乃以探討示範條款所涉法律爭議問題為中心，參酌國內學說見解並比較美國判例及美國保險監理官協會所制訂之「團體壽險定義及標準條款模範法案」，對團體壽險契約條款之增訂及修正提出七項建議，包括重新定位團體壽險契約當事人、重視逆選擇防範及被保險人權益保障、明訂兩年不可抗爭期間及團體信用壽險不適用契約轉換權條款及受益人條款、修正個別被保險人保險契約終止之時點及保險人免責事由等，希冀本文之淺見能使示範條款更為完善。 / Group life insurance arises from the thought that employers have the responsibilities to take care of their employees. Until now, group life insurance has become an important part of industries’ risk management plans for distributing and transferring industries’ life and liability risk. Group life insurance insures more than five persons in one policy, and this “group” characteristic makes group life insurance different from general life insurance in many aspects: underwriting, premiums, partly effective and contract clauses. Presently, provisions of group life policies are based on“Model Provisions for Group Yearly Term life Policies”promulgated by competent authority. According to Article 2 of the model provisions, the policyholder is the “group”, and the members of the group are insureds. In other words, group life insurance is entered into by third party. This causes three problems needed to be solved: (1) If the policyholder has no insurable interest in the insured, shall group life insurance be void? (2) Is Article 105 of Insurance Act applicable to group life insurance? (3) Who has the right to designate or change the beneficiary? In addition, there are still some problems in other model provisions including the entire-contract provision, eligibility requirements provision, termination provision, conversion provision, exception clause and incontestability provision. It is necessary to review and revise the model provisions.
Therefore, this study focuses on related legal issues of the model provisions. Referring to scholars’ opinions and comparing American verdicts and “Group Life Insurance Definition and Group Life Insurance Standard Provisions Model Act” issued by The National Association of Insurance Commissioners, this study concludes by providing several suggestions in revising the model provisions: (1) The policyholder and the insured should be referred to as members of the group, not “group”. (2) Emphasize on preventing adverse-selection and protecting the insured’s right. (3) Augment incontestable period of two years and a clause which provides that conversion provision and beneficiary provision are not applicable to credit group life insurance. (4) Revise the termination provision and exception clause. Hope these suggestions will make the model provisions more perfect.
| Identifer | oai:union.ndltd.org:CHENGCHI/G0094358010 |
| Creators | 李琬鈴, Lee, Wan Ling |
| Publisher | 國立政治大學 |
| Source Sets | National Chengchi University Libraries |
| Language | 中文 |
| Detected Language | English |
| Type | text |
| Rights | Copyright © nccu library on behalf of the copyright holders |
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