重新设计消费者纠纷解决:英国和美国保险索赔冲突方法的案例研究

D. Schwarcz
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引用次数: 16

摘要

许多保险法律法规都是关于赔偿那些被错误地拒绝投保的消费者。然而,投保人在挑战保险公司的不利保险范围决定方面,相对而言没有多少现实的选择。对于那些最近遭受重大经济损失的人来说,诉讼往往过于缓慢和昂贵。与此同时,确实存在的替代性争议解决(ADR)选项,例如保险监管机构提供的调解服务或现有的保险仲裁变体,通常对大多数争议无效或不可用。本文通过着眼于英国创新的金融申诉专员服务(FOS)提出了一条新的前进道路,该服务与英国金融服务监管机构并行运作,并专门致力于解决消费者金融纠纷。文章认为,FOS的相对成功主要归因于它将美国使用的个人、不协调的保险ADR方案的元素融合在一起的方式。因此,本文的结论是,美国立法者可以通过战略性地重新思考保险纠纷解决的制度架构来显著改善保险赔偿。它还表明,英国的FOS可能会在保险以外的领域提供一种改善消费者纠纷解决的模式。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Redesigning Consumer Dispute Resolution: A Case Study of the British and American Approaches to Insurance Claims Conflict
Much of insurance law and regulation is concerned with compensating consumers who have been wrongly denied coverage. But policyholders nonetheless have relatively few realistic options for challenging an insurer's adverse coverage determination. Litigation is often too slow and costly for those who have recently suffered significant financial loss. Meanwhile, the alternative dispute resolution (ADR) options that do exist-such as the conciliation services that insurance regulators offer or the existing variants of insurance arbitration-are generally either ineffective or unavailable for most disputes. This Article proposes a new way forward by looking to the United Kingdom's innovative Financial Ombudsman Service (FOS), which operates parallel to the British financial services regulator and is devoted solely to resolving consumer financial disputes. The comparative success of the FOS, the Article argues, is attributable primarily to the ways in which it blends elements of the individual, uncoordinated insurance ADR schemes that are used in the United States. As such, this Article concludes that American lawmakers can significantly improve insurance compensation by strategically rethinking the institutional architecture of insurance dispute resolution. It also suggests that the British FOS may offer a model for improving consumer dispute resolution in realms beyond insurance.
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