我国医疗责任保险法律制度研究

发布时间：2018-03-06 17:26

本文选题：医疗纠纷　切入点：医疗风险　出处：《山东财经大学》2016年硕士论文　论文类型：学位论文

【摘要】：医疗行为是一项要求高专业、高技术水平,具有高度风险性的行为。近几年来,由于医疗损害行为导致的医疗事故案件数量不断上升,“医疗暴力事件”频频上报,导致医患关系日趋紧张,仅依靠尚不完善的医疗侵权责任体系已经无法适应这一严峻现实。我国部分地区已经尝试通过推行强制性的医疗责任保险来改善十分紧张的医患关系以及医生为规避风险采取防御性治疗等问题,但是总体来说,由于我国医疗责任保险缺乏统一的法律制度规范和有效的制度设计,保险公司推出的保险产品与医疗机构的实际需求存在较大差距,再加之理赔程序繁琐复杂,并不能及时有效解决医疗纠纷,导致实行自愿投保的地区,医疗机构参保率很低。因此,除了制度本身存在的问题,还存在诸如是否应该赋予受害患者直接赔偿请求权、各地政府主导的强制保险对象以大中型医院为主是否合理、医疗责任保险是否能够帮助医院解决令其困扰的医疗纠纷问题以及医疗责任保险条款如何设计等问题。为了研究这些问题,本文除了绪论和结语外,主要有以下五个章节:第二章主要介绍了医疗责任保险的基础理论以及医疗责任保险在国内外的发展情况。从责任保险与民事赔偿责任制度的关系入手,进一步探讨了医疗责任保险制度与侵权责任制度的关系,两者之间是相互联系、相互影响的。第三章主要介绍了医疗责任保险的法律关系。从医疗责任保险合同入手,分别介绍了保险人、投保人和被保险人以及第三人之间的法律关系,同时对医疗责任保险的责任范围、免责事项等做了详细研究。最后笔者认为,在医疗责任保险合同中应该赋予受害患者直接赔偿请求权,并进一步分析了第三人直接请求权的可行性依据。第四章主要是对我国医疗责任保险制度的现状分析。首先介绍了我国医疗责任保险的创设及发展,虽然我国已经有部分地区开始推行医疗责任保险,但是真正贯彻落实的并不多,较多的省市还只是停留在政府的纸面文件上;其次是分析了目前制约我国医疗责任保险制度发展的制约因素,即市场需求不足、法律制度不完善等。第五章主要介绍了美国医疗责任保险制度。首先介绍了其发展历程及两次医疗责任保险危机,并总结了爆发危机的原因;其次总结美国医疗责任保险制度发展经验对我国的启示。第六章主要是通过对以上几章论述,认为我国医疗责任保险制度宜采用专门立法的方式,并制定统一的医疗责任保险条例,完善医疗责任保险法律条款,最后对条款设计提出了自己的构思。
[Abstract]:Medical behavior is a kind of behavior requiring high professional, high technical level and high risk. In recent years, the number of medical malpractice cases caused by medical damage behavior has been increasing, "medical violence" has been reported frequently. Leading to growing tensions between doctors and patients, Only relying on the imperfect medical tort liability system has been unable to adapt to this grim reality. Some areas of our country have tried to improve the very tight doctor-patient relationship and doctors' behavior through the implementation of compulsory medical liability insurance. Such issues as risk aversion and defensive treatment, But generally speaking, due to the lack of unified legal system and effective system design of medical liability insurance in our country, there is a big gap between the insurance products launched by insurance companies and the actual needs of medical institutions, and the procedures for settling claims are cumbersome and complex. Medical disputes cannot be resolved in a timely and effective manner. In areas where voluntary insurance is carried out, the participation rate of medical institutions is very low. Therefore, in addition to the problems existing in the system itself, there are also problems such as whether the injured patients should be given the right to claim direct compensation. Is it reasonable for local governments to direct compulsory insurance to large and medium-sized hospitals? Whether the medical liability insurance can help the hospital to solve the problems of medical disputes and how to design the medical liability insurance clause. In order to study these problems, this paper, in addition to the introduction and conclusion, There are five chapters as follows: the second chapter mainly introduces the basic theory of medical liability insurance and the development of medical liability insurance at home and abroad. The relationship between the medical liability insurance system and the tort liability system is further discussed. The third chapter mainly introduces the legal relationship between the medical liability insurance system and the tort liability insurance system, starting with the medical liability insurance contract, the third chapter mainly introduces the legal relationship between the medical liability insurance system and the tort liability system. This paper introduces the legal relationship among the insurer, the insured, the insured and the third party respectively. At the same time, the author makes a detailed study on the scope of liability insurance, exemption from liability and so on. In the medical liability insurance contract, the injured patients should be given the right to claim direct compensation. Chapter 4th mainly analyzes the current situation of medical liability insurance system in China. Firstly, it introduces the establishment and development of medical liability insurance in China. Although some areas of our country have begun to implement medical liability insurance, but the implementation of the implementation of the real is not many, more provinces and cities are still only staying on the paper documents of the government; Secondly, it analyzes the restrictive factors that restrict the development of medical liability insurance system in our country at present, that is, insufficient market demand. Chapter 5th mainly introduces the medical liability insurance system of the United States. First, it introduces its development course and two medical liability insurance crises, and summarizes the causes of the crisis. Secondly, it summarizes the enlightenment to our country from the development experience of the medical liability insurance system in the United States. Chapter 6th mainly discusses the above chapters, and thinks that the medical liability insurance system of our country should adopt the special legislation method. It also formulates the unified medical liability insurance regulations, consummates the medical liability insurance legal provisions, and finally puts forward its own conception to the clause design.
【学位授予单位】：山东财经大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：D922.182.3

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