反保险欺诈与公序良俗理论适用问题研究——以日本法的研究为中心

A Research on the Application of the Principle of Public Order and Good Custom in Anti- Insurance Fraud——Centered on the Study on Japanese Law

对于保险欺诈风险,公序良俗理论作为私法的一般原则存在其适用的必要性及可能性。对于公序良俗原则违反与否的具体判断,应在个案中抽取主观、客观因素予以综合考量。违反公序良俗的保险合同原则上当然无效,保险人无需承担保险金给付责任同时亦无需返还保险费。对于是否违反公序良俗的判断时点,应当包括合同订立及履行时。公序良俗理论的形成与发展与案例的类型化分析密不可分,针对我国反保险欺诈的现状,近年需要着重关注"利用保险合同融资"以及"约定高额保险金额"两种类型的风险。

For the insurance fraud risk, the theory of public order and good custom, as a general principle of the private law, is applicable both as a necessity and a possibility. When deciding whether the public order and good custom is violated or not, various subjective and objective factors of individual cases should be investigated and considered comprehensively. Insurance contracts conflicting with the public order and good custom are obviously ineffective as a principle, and the insurer is not obliged to pay the insurance benefit or make a refund of the premiums paid. As for the point of time for judging on the violation, the time of on-boarding and the duration of contract execution should be both included. The formation and evolution of the theory of public order and good custom is inseparable with the categorized analysis of judicial cases. Against the anti-insurance fraud situation in China, special attention should be paid to the two types of risks of "financing through insurance contracts" and "high insurance benefit promise".