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论医疗责任保险人的抗辩义务 被引量:5

Study on the Medical Liability Insurer's Duty to Defend
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摘要 我国的医疗责任保险仅能起到将部分赔付事宜转移给医疗责任保险人的作用,但与患者谈判、解决医疗纠纷等真正使医疗服务提供者困扰的问题仍然存在。保险人无须承担抗辩义务的医疗责任保险是一个在设计上就有先天缺陷的半拉子诉讼保险。应将抗辩义务规定为医疗责任保险人的法定义务;以诉状内容为主、诉讼事实为辅的折中标准来判断抗辩义务之有无;明确被保险人为抗辩律师的实质委托人来解决律师保密义务的利益冲突、以聘任独立律师的机制解决保险人在权力保留抗辩中的利益冲突及以荣誉条款来解决是否与患者和解的利益冲突问题。最后,规定保险人在违反抗辩义务时的赔偿责任,尤其当保险人故意或重大过失而违反抗辩义务时,应承担精神损害赔偿责任。 The current medical liability insurance in our country can only play the role of transferring part of the payment to the medical liability insurance, but with the patient to negotiate and resolve medical disputes and other real problems still exist in the medical service providers. The insurer need not bear duty to defend of the medical liability insurance is a congenital defect of uncompleted litigation insurance in the design. We should set up defense obligations as the statutory obligations of medical liability insurer. The main content in the complaints, litigation facts, supplemented by the compromise standard is used to judge duty to defend the with and without. And clear by the insurer defense lawyers the essence of clients to solve the conflict of interest between the confidentiality obligations of lawyers, to appoint an independent counsel mechanism to resolve the insurance people in power reservation conflicts of interest in the defense and in terms of honor to address whether patients reconciliation of conflicts of interest. Finally, when providing the liability of the insurer in breach of the defense obligations, especially when the insured doing intentionally or major negligence that breach of defense obligations, they should bear the liability for mental damages.
作者 徐喜荣 XU Xi-rong(Guangzhou Medical University, Guangzhou 511436 China)
机构地区 广州医科大学
出处 《河北法学》 CSSCI 北大核心 2017年第8期70-86,共17页 Hebei Law Science
基金 2015年度教育部人文社会科学研究一般项目<医疗责任强制保险制度研究>(15YJCZH193) 2016年广东省优秀青年教师培养计划项目<医疗纠纷预防与处理法律制度研究>(YQ2015131) 广州医科大学2014年度校级科研项目<医疗责任强制保险制度研究>(2014C17) 广东省哲学社会科学"十二五"规划课题2015年学科共建项目<医疗侵权法律适用实践研究>(GD15XGL35)的阶段成果
关键词 医疗责任保险 抗辩义务 判断标准 利益冲突 心境安宁 medical liability insurance duty to defend judgment criteria conflict of interest a state of mind at peace
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