意外伤害保险之举证责任分配问题研究

Research on the Allocation of Burden of Proof in Accidental Injury Insurance

意外伤害保险所具有的消费便利、保费低和保额高的特点,受到消费者的欢迎,逐渐成为消费者选择最多的商业保险,是我国人身保险重要的组成部分。然而,在司法实践中,与意外伤害保险相关的纠纷案件数量远超同为人身保险的健康保险和人寿险。我国法律对于其举证责任的分配并没有明确的规定,这导致在司法实践中出现同案不同判、法律适用不标准等问题。首先对于“意外性”的认定,需要有一个明确的标准。其次是关于意外伤害情形下证明责任的分配问题。对于一般意外伤害情形,当事故原因明确、证据易得时,采用“谁主张,谁举证”的原则。对于复杂意外伤害情形(如猝死、自杀等),由于事故原因难以确定且可能由多种因素引起,法院需合理分配举证责任,并考虑使用近因原则或比例原则来划分保险责任。对举证责任进行一个合理的划分,是解决此类纠纷的关键。

The characteristics of convenient consumption,low premium,and high coverage of accidental in-jury insurance have been welcomed by consumers and gradually become the most popular com-mercial insurance among consumers.It is an important component of personal insurance in China.However,in judicial practice,the number of dispute cases related to accidental injury insurance far exceeds that of health insurance and life insurance,which are both personal insurance.There is no clear provision in Chinese law regarding the allocation of the burden of proof,which has led to issues such as different judgments for the same case and non-standard application of the law in judicial practice.Firstly,there needs to be a clear standard for determining“suddenness”.The second issue is the allocation of burden of proof in the case of accidental injury.For general acci-dental injury situations,when the cause of the accident is clear and evidence is readily available,the principle of“whoever asserts,who provides evidence”is adopted.For complex accidental in-jury situations(such as sudden death,suicide,etc.),due to the difficulty in determining the cause of the accident and the possibility of multiple factors causing it,the court needs to reasonably al-locate the burden of proof and consider using the principle of proximate cause or proportionality to divide insurance liability.A reasonable division of the burden of proof is the key to resolving such disputes.