保险法上道德风险控制机制省思

Reflections on Control Mechanisms of Moral Hazard in Insurance Law

长期以来,我国保险领域的道德风险问题因理论关注的相对不足而未得到有效应对和解决。“道德风险”在保险法上是一个与道德相关的规范性概念,内涵系投保方在拥有保险保障之后故意或因重大过失而导致损失发生或扩大,包含投保欺诈行为。保险制度曾因诱发道德风险这一负外部性而遭受质疑,但由于其巨大的制度收益和社会价值,有必要且应当通过发展道德风险控制机制来降低制度成本,促进社会福利最大化。保险法上的道德风险控制机制在我国司法上已得到较多关注、确认和适用,体现为技术、条款、原则、规则四种样态。在此基础上,应当以“技术手段和法律手段相结合”以及“道德风险的控制应符合比例原则”作为我国保险法上道德风险控制机制的基本建构原则,并从实施维度、时间维度、主体维度三个维度对道德风险控制机制进行类型整合,通过宏观体系的完善与微观规范的优化破解我国保险业的道德风险难题。

For a long time,the moral hazard problem in China’s insurance industry has not been effectively dealt with due to a relative lack of theoretical concern.In the field of insurance law,the expression of“moral hazard”is a normative concept which is concerned with morality and refers to that the insured party intentionally or gross negligently causes or expands the loss to occur or expand after having insurance coverage,including fraud during insurance contracting.The system of insurance has been doubted because of its negative externality of inducing moral hazard,but due to its huge institutional benefits and social value,it is necessary to develop moral hazard control mechanisms to reduce institutional costs and maximize social welfare.The moral hazard control mechanisms in insurance law have been extensively noticed,recognized and applied in China’s judicial practice,and are embodied in four forms:technologies,clauses,principles and rules.On this basis,“the combination of technical means and legal means”and“the control of moral hazard shall conform to the principle of proportionality”should be taken as fundamental construction principles of the moral hazard control mechanisms in China’s insurance law.Furthermore,the moral hazard control mechanisms should be integrated through three aspects:application,time and subject.In this way,the moral hazard problem in China’s insurance industry could be solved through the improvement of the macro system and the optimization of micro norms.