被保险人危险增加通知义务司法适用之检讨——基于277个案例的裁判文书之分析

The Review on the Judicial Application of the Insured’s Duty of Disclosure of Increased Risk——Based on the Analysis of 277 Judicial Cases

我国《保险法》第52条关于被保险人危险增加通知义务之规定是对保险法中对价平衡原则、最大诚信原则和合同法中情事变更原则的贯彻。对司法实践中的疑难案例进行总结,可知我国司法裁判在危险增加通知义务之合同约定是否属于免责条款,如何判断危险显著性、持续性、不可预见性,以及被保险人未履行危险增加通知义务时,危险增加与保险事故发生存在何种因果关系保险人才可主张免责等问题上有争议。新近出台的最高人民法院《关于适用<中华人民共和国保险法>若干问题的解释(四)》只是对危险增加的样态进行了列举,并补充了危险持续性和不可预见性的判断要件,并未对上述问题予以可能的回应。有必要从法律解释、不确定法律概念具体化乃至成文法内法律续造的方法论层面对司法适用予以可能的检讨。

The insured's duty of disclosure of increased risk in Article 52 of Insurance Law of China is the result of implementing the principle of equilibrium between premium and coverage, the principle of utmost good faith and the principle of rebus sic stantibus in contract law. After analyzing difficult cases in judicial practices, we may conclude that there are disputes in current judgments over the issue of whether the contractual agreement on the duty of disclosure of increased risk belongs to an exception clause, over the issue of judging obviousness, continuousness and unforeseeability of the risk, the issue of which kind of causal relationship between the increased risk and the occurrence of an insurance accident can be used as an defense for the insurer to claim exemption when the insured fails to perform the duty of disclosure of increased risk. The newly-promulgated Interpretation IV of the Supreme People's Court on Several Issues Concerning the Application of the Insurance Law only enumerates modes of increased risk and adds elements of judging the continuousness and unforeseeablity of the risk, but fails to give possible response to the foresaid issues, so it is necessary to make possible review of the existing judicial application from perspectives of legal interpretation, defining uncertain legal concept and the methodology of making law in the statutory law.