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| 文章编号：1672-3104(2015)03-0050-08 |
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保险侵权欺诈的识别与私法规制——以《保险法》第27条为中心 |
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马宁 |
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（西北政法大学民商法学院，陕西西安，710063） |
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| 摘 要： 我国《保险法》第27条的侵权欺诈比第16条的法律行为欺诈对保险人威胁更大。侵权欺诈行为人主观上应限于“直接故意”，客观上须实施了虚构、制造保险事故，虚构事故原因或夸大损失的行为。但虚构保险标的、隐瞒抗辩事由、使用欺诈性工具不在其列。在规制措施上，应将虚构事故原因和夸大损失与虚构、制造保险事故做相同处理，允许保险人免除责任，确定解除权的行使不具有溯及力，但对欺诈行为实施后，解除权行使前提起的索赔，保险人得免除责任。当被保险人、受益人为多人时，个别人的欺诈原则上不影响他人的权利。 |
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| 关键词： 《保险法》；保险欺诈；侵权欺诈；识别；私法；规制 |
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Identification and civil law’s regulation of insurance tort fraudulent:focus on Article 27 of “Insurance Law” |
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MA Ning |
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（School of Civil and Commercial Law, Northwest University of Politics and Law, Xi’an 710063, China） |
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| Abstract: The tort fraud provided in Article 27 of “Insurance law” is a greater threat to underwriter’s interests than legal behaviors fraud provided in Article 16. The tort fraud infringer’s subjective aspect should be limited to “direct intent,” and its objective aspect consists of making up and effecting insurance accident, fabricating the cause of accident or exaggerating loss sum. But making up insured object, concealing defense, using fraudulent devices are not included in the means of tort fraud. In regulation measures, “Insurance Law” should treat behavior of making false statements to accident causes and increasing loss sum equally to behaviors of making up and effecting insurance accident, allow underwriters to remove their insurance liability, and ensure that the right of rescission shall not be retroactive. But once the fraud is effected, the underwriter should be released from the insurance liability for claims made before the right of rescission. Finally, if the insured is of several persons, fraudulent claims of one insured or one beneficiary would not, in principle, affect other insured or beneficiaries’ right to claim an insurance benefit. |
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Key words: Insurance Law; insurance fraudulent; tort fraudulent; identification; civil law; regulation |
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