社会保险欺诈的界定

Definition of Social Insurance Fraud

社会保险欺诈的概念在形式逻辑层面可以采用内涵定义+列举式外延定义的方法予以界定。从不同法部门对欺诈规制的立法内容来看,欺诈有法律行为层面的欺诈与法定主义层面的欺诈之分,社会保险欺诈属于后者,有必要在立法上明确社会保险欺诈的概念、构成要件与法律后果。在社会保险领域中,道德风险与保险欺诈、保险诈骗之间为属种关系,外延上为相互包容的同心圆关系。根据我国现有立法,社会保险欺诈的构成要件由欺诈主体、欺诈行为、主观故意与危害结果组成,并且存在着欺诈表现行为缺乏抽象的类型归纳、欺诈行为的单向评价性、责罚手段欠缺层次化的体系构建等问题。

As far as formal logic is concerned,social insurance fraud can be defined by the definition of connotation and extension.From different legal branches to the content of the legislation of fraud,fraud has the law behavior dimension of fraud and the legal doctrine dimension of fraud,social insurance fraud belongs to the latter. According to our existing legislation,social insurance fraud constitutive elements consist of subject,objective behavior,objective and harmful consequences,the characteristics of social insurance fraud are as follows： the subject of widespread,fraud behavior lack of abstract type induction,fraud behavior of unidirectional evaluation,and punishment means lack of hierarchical system construction. In the field of social insurance,there are genus relationship among moral hazard,insurance fraud and insurance swindle,which is the extension of the mutual tolerance of concentric circles.