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保險(xiǎn)代理求償權(quán)實(shí)施(專業(yè)版)

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【正文】 ”第95條規(guī)定:“保險(xiǎn)人行使代位請(qǐng)求賠償權(quán)利時(shí),被保險(xiǎn)人已向造成保險(xiǎn)事故的第三人提起訴訟的,保險(xiǎn)人可以向受理該案的法院提出變更當(dāng)事人的請(qǐng)求,代位行使被保險(xiǎn)人對(duì)第三人請(qǐng)求賠償?shù)臋?quán)利。保險(xiǎn)人的代位求償權(quán)依照法律規(guī)定而發(fā)生,保險(xiǎn)人行使代位權(quán),不以被保險(xiǎn)人移轉(zhuǎn)請(qǐng)求權(quán)的行為為要件,只要具備代位權(quán)的行使要件,即可以以自己的名義行使被保險(xiǎn)人對(duì)第三人的賠償請(qǐng)求權(quán)。理論界對(duì)此仁者見仁,智者見智,歸納起來,有三種觀點(diǎn):1.被保險(xiǎn)人名義說該學(xué)說認(rèn)為,保險(xiǎn)人應(yīng)以被保險(xiǎn)人的名義行使代位求償權(quán)。”《日本商法典》第662條也做了相關(guān)的規(guī)定,可見大陸法系的許多國(guó)家都把保險(xiǎn)代位求償權(quán)的范圍嚴(yán)格地限制在保險(xiǎn)賠償?shù)姆秶畠?nèi),同時(shí)在不損害被保險(xiǎn)人的利益的前提下,保險(xiǎn)代位求償權(quán)可以和被保險(xiǎn)人向第三人的損害賠償請(qǐng)求權(quán)并存。保險(xiǎn)代位權(quán)既非成立于保險(xiǎn)合同生效時(shí),也非成立于保險(xiǎn)事故發(fā)生時(shí),而只能成立于保險(xiǎn)人給付保險(xiǎn)金之后。江朝國(guó)先生認(rèn)為“依一般私法的原則大皆以具有故意或過失為要件,但亦有例外采無過失責(zé)任者,因此第三人之故意或過失問題不屬保險(xiǎn)人實(shí)行代位要件之一。只要保險(xiǎn)人對(duì)被保險(xiǎn)人應(yīng)負(fù)保險(xiǎn)賠償責(zé)任的原因與被保險(xiǎn)人對(duì)第三人損害賠償請(qǐng)求權(quán)之原因相同,保險(xiǎn)人均可向第三人行使代位權(quán)。在行使保險(xiǎn)代位權(quán)的情形下,保險(xiǎn)人所負(fù)擔(dān)之風(fēng)險(xiǎn)實(shí)際上是以現(xiàn)有利益換取了期待利益?!盵[] 鄒海林著:《保險(xiǎn)法》,人民法院出版社1998年版,第218頁。保險(xiǎn)人放棄代位權(quán)的,第三人因保險(xiǎn)人棄權(quán)行為所取得的利益,可以對(duì)抗任何人。[[] Kenneth S. Abraham,Insurance Law and Regulation,the Foundation Press,1990, P202.]John F. Dobby認(rèn)為,保險(xiǎn)代位權(quán)有助于阻止被保險(xiǎn)人雙重獲利從而違背損害填補(bǔ)原則,同時(shí)還有維護(hù)社會(huì)公共利益(public policy)的作用,另外一個(gè)可能的作用是降低保險(xiǎn)費(fèi)率。依照羅馬法和日爾曼法思想,責(zé)任為義務(wù)不履行的必然結(jié)果,因?yàn)樨?zé)任關(guān)系的存在,債務(wù)關(guān)系才具有法律約束力。眾所周知,保險(xiǎn)的功能就在于對(duì)損失進(jìn)行補(bǔ)償,進(jìn)而達(dá)到社會(huì)經(jīng)濟(jì)生活的穩(wěn)定。因此,筆者認(rèn)為,保險(xiǎn)代位求償權(quán)是指在損害保險(xiǎn)中,第三人造成保險(xiǎn)事故應(yīng)負(fù)賠償責(zé)任的,保險(xiǎn)人自向被保險(xiǎn)人賠償保險(xiǎn)金之日起,在賠償金額范圍內(nèi)代位行使被保險(xiǎn)人對(duì)第三者請(qǐng)求賠償?shù)臋?quán)利。保險(xiǎn)代位權(quán)有廣義與狹義之分。在此種情況下,筆者主張被保險(xiǎn)人優(yōu)先說。因?yàn)楸kU(xiǎn)代位求償權(quán)的存在是以被保險(xiǎn)人對(duì)第三人有賠償請(qǐng)求權(quán)為基礎(chǔ)的。但隨著保險(xiǎn)行業(yè)的發(fā)展,人身保險(xiǎn)中出現(xiàn)了填補(bǔ)具體需要險(xiǎn),如健康保險(xiǎn)或意外傷害保險(xiǎn)中的醫(yī)療費(fèi)用保險(xiǎn),以填補(bǔ)被保險(xiǎn)人因治療疾病或意外傷害而產(chǎn)生的醫(yī)療費(fèi)用為目的。第三部分是關(guān)于保險(xiǎn)代位求償權(quán)的行使名義問題。其實(shí)質(zhì)是一種特殊的債權(quán)轉(zhuǎn)移制度。然而,我國(guó)有關(guān)代位求償權(quán)的法律制度卻不盡完善,《保險(xiǎn)法》和《海商法》的相關(guān)規(guī)定過于簡(jiǎn)單,存在許多疏漏之處。因?yàn)榇粰?quán)的取得是保險(xiǎn)人得以行使代位求償權(quán)的重要前提,所以研究這一部分亦顯得尤為重要。在這部分的最后,筆者指出,在肯定保險(xiǎn)人以自己的名義行使代位求償權(quán)的同時(shí),應(yīng)該相應(yīng)的以立法的形式強(qiáng)制規(guī)定被保險(xiǎn)人應(yīng)負(fù)有的協(xié)助義務(wù),以防止被保險(xiǎn)人在保險(xiǎn)人賠付完保險(xiǎn)金后,不履行協(xié)助義務(wù)而使保險(xiǎn)人的保險(xiǎn)賠償難以代位。正如前所述,被保險(xiǎn)人的家庭成員或者其組成人員與被保險(xiǎn)人之間存在利害與共之關(guān)系,若保險(xiǎn)人向被保險(xiǎn)人給付之后,基于代位權(quán)向其家庭成員請(qǐng)求返還,無異于向左手為保險(xiǎn)給付后,又自右手請(qǐng)求返還,故法律上將“家庭成員或者其組成人員”視為被保險(xiǎn)人。因此,再保險(xiǎn)人享有代位求償權(quán)這一點(diǎn)是不容置疑的。通過這一法律關(guān)系,被保險(xiǎn)人在獲得保險(xiǎn)賠償后,順利地將向第三人索賠的權(quán)利轉(zhuǎn)移給保險(xiǎn)人。并指出保險(xiǎn)代位求償權(quán)為財(cái)產(chǎn)保險(xiǎn)以及同財(cái)產(chǎn)保險(xiǎn)具有相同屬性的填補(bǔ)損失的保險(xiǎn)所專有的制度。T具體來說,當(dāng)保險(xiǎn)標(biāo)的由于第三人原因?qū)е碌谋kU(xiǎn)事故而受到損害時(shí),被保險(xiǎn)人有兩種途徑可獲賠償,既可向保險(xiǎn)人索賠,亦可向第三人提出損害賠償。允許保險(xiǎn)人代位行使被保險(xiǎn)人對(duì)第三人的損害賠償請(qǐng)求權(quán),是符合了公平正義的法理念,維護(hù)了民事活動(dòng)的穩(wěn)定性和連續(xù)性。更何況從訴訟經(jīng)濟(jì)的角度上分析,如果保險(xiǎn)代位權(quán)的設(shè)立僅僅是為了避免不當(dāng)?shù)美敲础氨槐kU(xiǎn)人只能夠就雙重請(qǐng)求權(quán)選擇一個(gè)行使或?qū)⒌谌素?zé)任作為除外不保風(fēng)險(xiǎn)即可達(dá)到目的,而沒有規(guī)定保險(xiǎn)人補(bǔ)償給付在先,代位權(quán)行使在后之順序的必要。所以,“保險(xiǎn)人行使代位求償權(quán)的行為,實(shí)質(zhì)上是利用法律賦予的特權(quán)進(jìn)行牟利的行為。]最終是為了保障被保險(xiǎn)人能夠得到充分補(bǔ)償。這條是對(duì)被保險(xiǎn)人應(yīng)協(xié)助保險(xiǎn)人行使代位請(qǐng)求權(quán)的義務(wù)性規(guī)定?!氨kU(xiǎn)法對(duì)第三人雖有代位請(qǐng)求權(quán),但如果第三人為要保人或被保險(xiǎn)人之家屬或受雇人時(shí),則除其有故意致成災(zāi)害之情形外,保險(xiǎn)人無代位請(qǐng)求權(quán)。因此,第三人主觀方面并不構(gòu)成行使代位求償權(quán)的條件。筆者認(rèn)為,保險(xiǎn)代位權(quán)屬法定債權(quán),不得依雙方當(dāng)事人的約定而成立。[[] [英]:《保險(xiǎn)合同法》(中譯本),何美歡、吳志攀等譯,北京大學(xué)出版社2002年版,第835頁。其基本理念是:保險(xiǎn)合同使被保險(xiǎn)人可以就承保范圍內(nèi)的損失向保險(xiǎn)人請(qǐng)求賠償,而保險(xiǎn)人并不直接受讓被保險(xiǎn)人對(duì)第三人的任何權(quán)利。2.從保險(xiǎn)代位求償權(quán)制度的目的看,其主要是為了防止被保險(xiǎn)人獲得雙重補(bǔ)償。對(duì)此問題,有以下幾種觀點(diǎn):
。具體來說,筆者贊同第二種觀點(diǎn)的理由如下:1.從保險(xiǎn)代位求償權(quán)的性質(zhì)看,其是保險(xiǎn)人的一項(xiàng)法定權(quán)利,取得無須被保險(xiǎn)人同意,行使更無須同意。[[] Raoul Colinvaux,The Law of Insurance, 5th ed., Sweet amp。在英美法中,一般稱為“意外收益”,這時(shí)如果保險(xiǎn)人對(duì)第三人提起代位訴訟中獲得的賠償額高于已付的保險(xiǎn)金,那么保險(xiǎn)人不能保留余額,余額屬于被保險(xiǎn)人。]筆者認(rèn)為,此認(rèn)識(shí)與保險(xiǎn)代位權(quán)之法理不符,也與各國(guó)保險(xiǎn)法的規(guī)定相矛盾。]如果將第三人非出自過失致保險(xiǎn)事故發(fā)生之情形排除在外,第三人將因受害人有保險(xiǎn)而不承擔(dān)責(zé)任。為了使被保險(xiǎn)人所領(lǐng)受保險(xiǎn)金能獲得實(shí)益,若被請(qǐng)求之第三人為與被保險(xiǎn)人有經(jīng)濟(jì)上或生計(jì)上之利害關(guān)系者,應(yīng)禁止保險(xiǎn)人對(duì)其行使代位權(quán)。但是,在保險(xiǎn)實(shí)務(wù)中,保險(xiǎn)人在支付賠款的同時(shí),往往要求被保險(xiǎn)人簽發(fā)賠款收據(jù)和權(quán)益轉(zhuǎn)讓書。并且在現(xiàn)行立法中也是行的通的。眾多的投保人交納保險(xiǎn)費(fèi),形成保險(xiǎn)基金,就是為了在保險(xiǎn)事故發(fā)生后能夠得到迅速的理賠,而在交付保險(xiǎn)費(fèi)之后,保險(xiǎn)人的利益與投保人的利益是相分離的。[[] 江朝國(guó)著:《保險(xiǎn)法論文集》(二),中國(guó)臺(tái)灣地區(qū)瑞興圖書股份有限公司1997年版,第396頁。并且,保險(xiǎn)只是為保險(xiǎn)標(biāo)的提供風(fēng)險(xiǎn)保障,并不解除第三者應(yīng)承擔(dān)的民事責(zé)任。由于保險(xiǎn)人在保險(xiǎn)事故發(fā)生后只能就被保險(xiǎn)人的實(shí)際損失進(jìn)行賠償,而這種財(cái)產(chǎn)損失的賠償不具備使被保險(xiǎn)人獲得額外利益的功能。斯蒂爾認(rèn)為可以把補(bǔ)償視為一種機(jī)制,通過這種機(jī)制,在被保險(xiǎn)人遭受到損失后,保險(xiǎn)人對(duì)其進(jìn)行補(bǔ)償,以使其恢復(fù)到損失前所處的經(jīng)濟(jì)狀況。[[] 李玉泉著:《保險(xiǎn)法》(第二版),法律出版社2003年版,第228頁。(4)the currency amount of subrogation. can not outrun the amount of the insurance money.The third part of the essay is on the nominal problem of the exercise of the right of subrogation. In the writer’s opinion, the insurer must exercise the right in his own nomination. The reasons are below: First of all, the right of subrogation is a legal right seen of the character of the right. And the acquisition of the right is not under the agreement of the third party. secondly, the object of the right is to prevent the insurant from acquiring double pensations. When the insurance accident take place, the insurer should take the place of the insurant to acquire the right to claim against the third party. Thirdly, it is good to abbreviate the pressure of the litigation in insurance practice. At the end of the part, the writer pointed out that the right of the insurer to exercise the right of subrogation in his own nomination must be confirmed, and at the same time, the obligation of insistant of the must be confirmed in the law, and as a result, the insurer can prevent the insurant from refusing to fulfill the duty to assist the insurer to exercise the right.The fourth part of the essay is on the restriction of the exercise of the right of subrogation. And this part is the keystone of the essay. In the part we discuss the restriction of the extent, object and the limitation period of exercise of the right.In the problem of the extend of exercise, the disputes of the scholar are focused on whether the right is applicable to the personal institute, such as medical institute. In my opinion, the medical institute is applicable to the extent of the subrogation. It is well known that the property institute is called “supply concrete demand institute”, and the personal institute is called “supply abstractiong demand institute”, with the developing of the insurance business, “supply concrete demand institute” appears in the personal institute, to pensate the insurant for the fee which is paid for the accident and physical reasons. However, the insurant also cannot acquire the illegal profit in the cure of illness or injury. And the writer think that medical institue is in the extend of the subrogation and it is applicable of the regulations of the subrogation.Concerning on the exercise object of the subrogation, the 47 article of the Insurance Law stipulate that: the insurer must not exercise the right to the family members of the insurant unless the family member of the insurant create the insured accident deliberately. This shows that the family member of the insurant can not be the object of the subrogation. The reason is that the family member and the insurant have the mon interest, if the family member is included in the object of subrogation, the pensation function of insurance will be damaged. But exceptive principle is also exerted, when the family member of the insurant create the inured accident deliberately, the family member is included in the object of the subrogation. But the article 28 of the Insurance Law s
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