| 摘要: | 關於因果關係之認定為學說亂流區，雖然大致上可分為相當因果關係與主力近因說，仍為ㄧ不確定又複雜之概念。我國最高法院實務見解多傾向採取「相當因果關係」，意外事故為死亡之主要有效原因者，具備相當因果關係。簡言之，無此意外，亦不生此結果；有此意外，按一般情形足生此結果，意外傷害保險公司應負理賠責任。而主力近因說認為如無意外事故，即不會提前死亡，故意外事故係導致死亡結果之主動的、有效的原因。
觀察我國最高法院之判決，雖以相當因果關係與主力近因原則為兩大原則審查因果關係，不過其皆未有明確詳述其思考過程，僅草率交代採取之標準，使得保險訴訟案件徒增紛擾。
本文將參考美國法院通常之作法，其除了主力近因原則外，尚有反併存原因之條款之適用，並以美國實務上的判斷標準作為檢視我國最高法院判決之依據。
本文先介紹意外傷害之定義及要件，再以各法域之因果關係出發，切入本論文之研究中心，就保險法之傷害保險之因果關係作細部討論，提出不同學說看法及各國比較法。最後針對我國最高法院之判決加以歸納整理，分析實務上對因果關係認定之判斷標準，以美國法院通常處理之方法作為本文之立場，檢視我國就傷害保險之因果關係如何認定，並予我國法制建議。
Regarding the identification of causality as the turbulent area of the doctrine, although it can be roughly divided into adequacy and the Efficient Proximate Cause Rule, it is still a concept of uncertainty and complexity. The opinions of the Supreme Court of China tend to adopt a " adequacy ". Accidents are the main effective causes of death and have considerable causality. In short, there is no such accident and there is no such result. With this accident, as a general result of this result, accident insurance company should bear the liability for compensation. The principle of proximate cause if there is no accident, it will not die in advance. The intentional accident is the active and effective cause of death.
Observing the judgment of the Supreme People's Court of Taiwan, although causality was examined on the basis of the principle of causality and principle of the efficient proximate cause, neither of them explicitly elaborated on the process of thinking. Instead, they swiftly accounted for the criteria adopted and made confuse of the cases of insurance suit.
This article will refer to the practice of the United States Courts. Apart from the principle of proximate cause, there are anti-concurrent cause provision. Although this article unable to evaluate , it is still introduced by judging standards in the United States and as the basis of the judgment of Taiwan.
This article first introduces the definition and requirements of accidental injury, and then proceeds from the causation of various jurisdictions, cuts into the research focus of this thesis, discusses the causality of injury insurance of the insurance law in detail, puts forward different opinions and compares different countries. Finally, it summarizes the judgments of Taiwan's Supreme Court, analyzes the judgment criteria of the determination of causation in practice, and uses the method of American courts as the position of this article. It examines how the causality of injury insurance in Taiwan is determined and makes recommendations to our country’s legal system. |
