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    Title: 論保險法之因果關係 —以承保範圍與事故發生之因果為中心
    Causation in Insurance law: Focusing on the Causation of the Insured Event
    Authors: 蕭宇良
    Hsiao, Yu-Liang
    Contributors: 張冠群
    Chang, Kuan-Chun
    蕭宇良
    Hsiao, Yu-Liang
    Keywords: 因果關係
    保險契約
    承保範圍
    危險事故
    除外事項
    相當因果關係
    近因原則
    契約解釋
    舉證責任
    Causation
    Insurance contract
    Insured event
    Peril
    Exclusions
    Adequate causation
    Proximate cause
    Interpretation of contract
    Burden of proof
    Date: 2020
    Issue Date: 2020-08-03 17:40:35 (UTC+8)
    Abstract: 在保險訴訟案例中,事故發生與承保危險是否具備因果關係,或是該事故是否由除外危險所造成,常為保險訴訟中重要之爭議,惟我國現行保險法並未明文規範保險因果關係之判斷標準,現行保險契約條款亦未詳細規範,保險因果關係之判斷標準需透過學說與實務發展建構。
    我國學說和實務有主張適用民法上之相當因果關係作為判斷標準,惟基於 侵權法因果關係與保險因果關係目的與架構上之不同,直接適用相當因果關係作為判斷標準在特定個案將產生問題。故本文認為,應適用近因原則作為判斷標準,並經過是否為獨立原因、是否條件因果、對事故發生原因力之貢獻、是否為開始因果歷程之原因力等參考因素,認定造成事故發生之近因係為哪個原因力,再加以判斷其係為承保危險、非保危險、除外危險,而決定保險人是否應為保險給付。
    In insurance lawsuits, the loss of accidents caused by whether the insured peril or exclusions is often an important issue. However, current Insurance Act in Taiwan does not explicitly regulate the test of insurance causation, and the phrases in insurance contracts are also deceptive simple. As a result, the standard of insurance causation needs to be constructed through the development of theory and precedent.
    Some scholars and courts often apply concepts form causation in tort law, especially “adequate causation”. However, the purpose and structure of tort causation and insurance causation are partly different. If courts apply adequate causation as the standard directly, it would lead to inconsistent decisions and cause unreasonable result in some cases. This article believes that “proximate cause rule” should be applied as the test of causation in insurance contract law. The approach identify the proximate cause of loss by considering some core factors, including whether the cause of loss is an independent cause, conditional causation, contribution to the chain of efficiency, and whether it is successive cause. The insurer’s liability of indemnity depends on whether proximate cause is result from insured peril or exclusions.
    Reference: 參考文獻及書目
    一、中文部分
    (一) 書籍
    1.Robert R. Pagano著,潘中道、郭俊賢譯,行為科學統計學,7版 (2005)
    2.王澤鑑,侵權行為法,初版,(2013)
    3.江朝國,保險法基礎理論,5版,(2009)
    4.林惠玲、陳正倉,統計學方法與應用下冊,4版,(2016)
    5.姜世明,民事訴訟法下冊,5版, (2018)
    6.許士宦,民事訴訟法口試講義(下),初版,(2017)
    7.陳彩稚,保險學,3版,(2012)
    8.陳榮宗、林慶苗,民事訴訟法,7版,(2010)
    9.陳聰富,因果關係與損害賠償,初版,(2004)
    10.陳聰富,侵權行為法原理,2版, (2018)
    11.葉啟洲,保險法,6版,(2018)
    12.劉宗榮,保險法,4版,(2016)
    13.劉明生,民事訴訟法實例研習,初版,(2013)
    14.魏大喨,民事訴訟法,初版, (2015)
    (二) 專書論文
    1.吳志正,揭開民事損害賠償法相當因果關係之神秘面紗,收於:王千維、黃立、林信和、詹森林、陳聰富、吳志正、姚志明、張倍齊,侵權行為因果關係之探討,頁148-222 (2019)
    2.沈冠伶,論新民事訴訟法中法官之闡明義務與當事人之事案解明義務,收於:沈冠伶,民事證據法與武器平等原則,頁1-22 (2012)
    3.林信和,論侵權行為的相當因果關係,收於:王千維、黃立、林信和、詹森林、陳聰富、吳志正、姚志明、張倍齊,侵權行為因果關係之探討,頁77-82 (2019)
    4.許士宦,不當得利返還訴訟中無法律上原因事實之舉證責任分配,收於:許士宦,爭點整理與舉證責任,頁191-252 (2012)
    5.詹森林,第三人之故意不法行為與因果關係之中斷—最高法院90年台上字第772號代客泊車案判決之研究,收於:王千維、黃立、林信和、詹森林、陳聰富、吳志正、姚志明、張倍齊,侵權行為因果關係之探討,頁91-101 (2019)
    (三) 期刊論文
    1.江朝國,不包括佔優勢原則,月旦法學教室,第89期,頁26-27 (2009)
    2.呂廣盛,除外責任 vs 不保事項,保險經營論壇,第56回,頁1-3 (2017)
    3.汪信君,「意外傷害」之定義與外來突發事故—─最高法院100年台上字第88號民事判決,月旦裁判時報,第9期,第59-68頁,(2011)
    4.汪信君,酒醉駕車、免責事由與因果關係──簡評最高法院九十八年台上字第二三四一號民事判決,月旦裁判時報,第2期,頁101-107 (2010)
    5.沈冠伶,重大醫療瑕疵與因果關係之舉證責任-最高法院 106 年度台上字第 227 號判決簡評,月旦醫事法報告,第10期,頁96-110 (2017)
    6.姜世明,醫師民事責任程序中之舉證責任減輕,月旦民商法雜誌,第6卷,頁5-29 (2004)
    7.張冠群,保險契約條款「疑義」之認定與解釋──評臺灣高等法院一○○年度保險上易字第一號判決,月旦法學雜誌,第201期,頁187-213 (2012)
    8.張冠群、蔣念祖,意外事故因果關係之認定──評臺灣高等法院106年度保險上字第15號民事判決,月旦裁判時報,第92期,頁50-63 (2020)
    9.許士宦,醫療責任訴訟之舉證責任,月旦法學雜誌,第246期,頁26-47 (2015)
    10.陳俊元,怒火地平線-墨西哥灣漏油案與保險契約之解釋,華岡法粹,第62期,頁49-73 (2017)
    11.曾允君,論保險法上除外事故與損失間因果關係之認定──以臺灣高等法院104年度保險上字第23號民事判決為導引,月旦裁判時報,第91期,頁79-89 (2020)
    12.黃國昌,舉證責任,月旦法學教室,第16期,頁32-36 (2004)
    13.劉宗榮,論保險契約的解釋—兼論保險法第五四條的修正芻議,月旦法學雜誌,第159期,頁112-130 (2008)
    14.潘維大,美國侵權行為法對因果關係之認定,東吳法律學報第7卷第2期,頁1-40 (1992)
    15.顏厥安,相當因果關係與社會科學方法論—由韋伯以及賴德布魯赫談起,中研院法學期刊,2019特刊2,頁53-127 (2019)
    (四) 網際網路
    1.Lawsnote法學資料庫,https://lawsnote.com
    2.司法院法學資料檢索系統,https://law.judicial.gov.tw/default.aspx
    二、外文部分
    (一) 書籍
    1.Cees van Dam, European Tort Law (2nd ed. 2013).
    2.Etti Baranoff, Risk Management and Insurance (2004).
    3.European Group on Tort Law, Principles of European Tort Law: Text and Commentary (2005).
    4.George Rejda & Michael McNamara, Principles of Risk Management and Insurance (13th ed. 2017).
    5.H.L.A. Hart & Tony Honor, Causation in The Law (2nd ed. 1985).
    6.James Goudkamp & Donal Nolan, Scholars of Tort Law (2019).
    7.John Lowry & P. J. Rawlings, Insurance Law: Cases and Materials (2004).
    8.John Lowry et al., Insurance Law: Doctrines and Principles (3rd ed. 2011).
    9.Meixian Song, Causation in Insurance Contract Law (2014).
    10.Robert Cooter & Thomas Ulen, Law and Economics (6th ed. 2016).
    11.Robert Merkin & Johanna Hjalmarsson, Compendium of insurance law (2007).
    12.Stephen R.Wilson & Michael Stockdale, English legal system (2nd ed. 2011).
    (二) 期刊
    1.Banks McDowell, Causation in Contracts and Insurance, 20 Conn. L. Rev. 569 (1988).
    2.Dudi Schwartz, Interpretation and Disclosure in Insurance Contracts, 21 Loy. Consumer L. Rev. 128 (2008).
    3.Eden, Scott M., I Am Having a Flashback ... All the Way to the Bank: The Application of the Thin Skull Rule to Mental Injuries- Poole v. Copland, Inc., 24 N.C. Cent. L.J.180 (2001).
    4.Erik S. Knutsen, Confusion about Causation in Insurance: Solutions for Catastrophic Losses, 61 Ala. L. Rev. 957 (2010).
    5.Erik S. Knutsen,Causation in Canadian Insurance Law, 50 Alta. L. Rev. 631 (2013).
    6.James J. Marchiano, State Farm Mutual Automobile Insurance Company v. Partridge:Expanding the Scope of Insurance Liability in California, 7 Pac. L. J. 57 (1976).
    7.Jeremiah Smith,Legal Causes of Action in Torts, 25 HARV. L. Rtv. 103 (1911).
    8.John Lowry & P. J. Rawlings, Proximate Causation in Insurance Law, 68 Mod. L. Rev. 310 (2005).
    9.Kenneth S. Abraham, A Theory of Insurance Policy Interpretation, 95 Mich. L. Rev. 531 (1996).
    10.Kenneth S. Abraham, Judge-Made Law and Judge-Made Insurance: Honoring the Reasonable Expectations of the Insured, 67 Virginia Law Review 1151 (1981).
    11.Malcolm Clarke, Insurance: The Proximate Cause in English Law, 40 Cambridge L.J. 284 (1981).
    12.Mark A. Geistfeld, Interpreting the Rules of Insurance Contract Interpretation, 68 Rutgers U.L. Rev. 371 (2015).
    13.Peter Nash Swisher, Causation Requirements in Tort and Insurance Law Practice: Demystifying Some Legal Causation Riddles, 43 Tort Trial & Ins. Prac. L.J. 2 (2007).
    14.Peter Nash Swisher, Insurance Causation Issues: The Legacy of Bird v. St. Paul Fire & Marine Ins. Co., 2 Nev L. J. 351, 352 (2002).
    15.Richard A. Fierce, Insurance Law - Concurrent Causation: Examination of Alternative Approaches, 10 S. Ill. U. L.J. 527 (1985).
    16.Richard W. Wright, Causation in Tort Law, 73 Calif. L. Rev. 1735 (1985).
    17.Robert E. Keeton, Insurance Law Rights at Variance with Policy Provisions, 83 Harv. L. Rev. 961 (1970).
    18.William Conant Brewer, Jr, Concurrent Causation in Insurance Contracts, 59 Mich. L. Rev. 1141 (1961).
    19.William L. Prosser, Palsgraf Revisited, 52, Mich. L. Rev.1 (1953).
    Description: 碩士
    國立政治大學
    風險管理與保險學系
    106358014
    Source URI: http://thesis.lib.nccu.edu.tw/record/#G0106358014
    Data Type: thesis
    DOI: 10.6814/NCCU202001086
    Appears in Collections:[風險管理與保險學系 ] 學位論文

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