医疗责任保险合同纠纷与条款完善——基于中国审判案例的研究

发布时间：2018-05-27 15:29

本文选题：医疗责任保险 + 合同纠纷　；参考：《保险研究》2015年01期

【摘要】：我国医疗责任保险业务尽管面临着较大的政策机遇和市场潜力,但目前仍然发展缓慢。除了医疗机构缺乏投保积极性、保险公司缺少经验数据和法律制度不完善外,医疗责任保险所面临的索赔风险也是制约保险公司业务发展的一个重要因素。本文通过分析国内医疗责任保险合同纠纷的判决,研究此类案件在医疗损害类型、保单限额及保障范围、保险条款、保险人抗辩理由以及法院审判思路等方面的基本特征,分析保险公司败诉的原因,针对其中存在的问题,指出保险人应完善医疗责任保险条款,严格履行条款说明义务,积极参与医疗纠纷的抗辩;同时法院在审判实践中应衡平保护保险合同双方当事人的利益。
[Abstract]:Medical liability insurance business in China is still developing slowly, although it faces great policy opportunities and market potential. In addition to the lack of enthusiasm of medical institutions, lack of experienced data and imperfect legal system of insurance companies, the risk of claims faced by medical liability insurance is also an important factor that restricts the development of insurance companies' business. By analyzing the judgment of the domestic medical liability insurance contract dispute, this paper studies the basic characteristics of this kind of case in the medical damage type, the policy limit and the scope of protection, the insurance clause, the insurer's defense reason and the court trial thought, and so on. This paper analyzes the reasons of the insurance company losing the lawsuit, and points out that the insurer should perfect the medical liability insurance clause, strictly fulfill the obligation to explain the clause, and actively participate in the defense of the medical dispute. At the same time, the court should protect the interests of both parties in the trial practice.
【作者单位】：中国人民大学财政金融学院;
【基金】：教育部人文社会科学重点研究基地中国人民大学民商事法律科学研究中心自设项目《综合性侵权损害救济机制的形成和完善》(项目标号:11MSFJD820007)的研究成果之一
【分类号】：D922.16;D923

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