人身意外保险中自杀事故的举证归属及实践中的举证内容研究

H. -. Kim, Hyung Ho Park
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引用次数: 0

摘要

意外险在意外险条款中被定义为保险事故,它要求非故意事故意义上的偶然性。同时,将“被保险人故意伤害自己”作为保险人赔偿的理由,并在附带条款中规定被保险人“处于精神或身体损失等不能自主决定的状态”,允许免除,并支付保险金。因此,意外险条款的条款结构错综复杂,各给付事由和免责事由所规定的要件的内涵和外延没有明确确立,造成了举证责任方面的各种问题。本文探讨了如何在被保险人自杀死亡时分配举证责任,以确定保险人的责任。通过这种方式,我们看到了有问题的判断所遗漏的东西,它只关注医学发现。意外险条款规定,故意发生的事故是保险人免除责任的理由,保险人必须证明该事故是故意发生的。另一方面,无法做出自由决定的状态是一种与意图不同的规范性判断。即使被保险人意识到结束自己的生命并故意自杀,他处于被排除在自由决策之外的状态,这一事实也淡化了被保险人故意死亡的责任可能性,减轻了保险合同中诚信的破坏程度。换句话说,即使自杀是故意事故,它也例外地包括在保险范围内。根据先例,不能自由决策的状态是综合考察各种事实确定的。在本案判决中,综合考察被保险人自杀的动机、自杀的方法和方式、抑郁的进展情况以及自杀前自杀者发出的问候,可以判断被保险人是在自由决策的状态下自杀的。目标判断只关注死者生前被专家诊断为“严重抑郁发作”的事实,承认在没有适当检查其他因素的情况下无法做出自由决定。不能自由决策的状态是指哪些事实因素影响了内在心理状态的形成过程以及影响的程度。因此,完全依赖医学发现并将其视为绝对的倾向是不合理的。有必要对围绕自杀的各种事实作出综合判断。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Study on the Attribution of Proof of Suicidal Accidents in Personal Accident Insurance and the Contents of Proof in Practice
Accident insurance, which is defined as an insurance accident in the accident insurance clause, requires contingency in the sense of an accident that is not intentional. At the same time, “in case the insured intentionally harms himself” is stipulated as the reason for indemnification of the insurer, and in the proviso that the insured is “in a state where he or she is unable to make free decisions such as mental or physical loss,” the exemption is allowed and the insurance money is paid. stipulated as a reason As such, the structure of the provisions of the accident insurance clause is complicatedly intertwined, and the connotation and extension of the requirements set forth in each reason for payment and reason for exemption are not clearly established, causing various problems regarding the burden of proof. In this paper, we reviewed how to distribute the burden of proof in order to recognize the liability of the insurer when the insured person dies by suicide. In this way, we looked at what was missed by the judgment in question, which only focused on medical findings. Accident insurance clauses stipulate that an accident that occurred intentionally is a reason for exemption from liability of the insurer, so the insurer must prove that the accident occurred intentionally. On the other hand, the state of being unable to make free decisions is a normative level of judgment that is distinguished from intention. Even if the insured was conscious of ending his own life and committed suicide intentionally, the fact that he was in a state of exclusion from free decision-making dilutes the possibility of blame for the insured's intentional death and mitigates the degree of destruction of good faith in the insurance contract. In other words, even though suicide is an intentional accident, it is exceptionally included in the scope of insurance coverage. According to precedent, the state of being unable to make free decisions is determined by comprehensively examining various facts. In the judgment at issue, when the motive for suicide, the method and mode of suicide, the progress of depression, and the greetings sent by the suicide just before suicide were comprehensively reviewed, it can be judged that the insured committed suicide in a state of free decision-making. The target judgment focused only on the fact that the deceased had been diagnosed with a “severe depressive episode” by a specialist during his lifetime, acknowledging the inability to make free decisions without properly examining other factors. The state of inability to make free decisions means what factual factors have influenced the formation process of the inner psychological state and to what extent they are influencing. Therefore, the tendency to rely exclusively on medical findings and to regard them as absolutes is unreasonable. It is necessary to make a comprehensive judgment on the various facts surrounding the suicide.
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