| 摘要: | 近幾年長年期健康險損率，隨保單年度經過而有上升趨勢，原因不外乎有部分不肖行為人，藉由特定保險事故向保險人投保並詐領保險金，惟以隱匿掩蓋或偽造資料訊息方式向保險人詐領保險金的研究說理並不充分，故本文認為此一議題仍有研究及釐清爭議的必要。
本文以保險法第64條據實說明義務為核心，討論以隱匿掩蓋或偽造資料訊息方式向保險人詐領保險金，適用刑法普通詐欺罪所生疑義，並肯認刑法詐欺罪無法解決道德風險之前提下，從保險契約關係之角度，按現行法規提出善用保險法第68條第2項特約訂定、利用內部核保規則對要保人加費、函釋處理人身保險要保書示範內容及注意事項等方式，來解決問題。
In recent years, the long-term health insurance loss rate up. The main reason is that the people insured the insurer with insurance accident and fraudulently obtained the insurance money.
This thesis is based on duty of disclosure, from the perspective of the insurance contract relationship. In a hope to serve as a reference for the insurance company. |
