从人身保险纠纷案谈投保人告知与保险人询问之博弈

Discussion on the Game Playing between the Policyholder’s Truthful Disclosure and the Insurer’s Inquiry Based on Personal Insurance Dispute Cases

在人身保险法律关系中,投保人如实告知义务应当是有限的,前提必须是保险人对其进行了详细询问、充分提示和明确说明。争议如实告知义务的举证责任在于保险人,其应对投保时有无对投保人进行健康询问以及询问的范围和内容、是否充分提示和说明等负举证责任,否则,投保人无告知义务。保险人是否有权解除保险合同,亦应由其承担举证责任;如其举证不足以证明投保人未如实告知且该情形足以影响其是否同意承保或者提高保险费率的,其解除行为不符合法律规定,法院应该不予采信。

In the legal relationship of personal insurance,the policyholder’s obligation to tell the truth should be limited,and the premise must be that the insurer has made detailed inquiry,full reminding and clear explanation.The burden of proof for the obligation of truthful disclosure in dispute lies with the insurer,who should bear the burden of proof for whether the insurer has made health inquiry,including the scope and content of the inquiry,and whether the scope and content have been fully reminded and explained.Otherwise,the policyholder has no obligation of truthful disclosure.As for whether the insurer has the right to terminate the insurance contract,the insurer should also bear the burden of proof.If the proof is not sufficient to prove that the policyholder did not tell the truth and the situation is enough to affect whether the insurer consent to insure or increase the premium rate,its termination of the contract does not conform to the law,and the court should not accept it.