试论影响保险合同的基本因素

第一部分风险管理和保险基础第1章风险第2章风险管理第3章保险第4章影响保险合同的基本因素第5章保险合同的内容及其分析第4章影影响保保险合同同的基基本因素素§4.1AgencyLaw代理法Thelawofagencydealsbasicallywiththelegalconsequencesofpeopleactingonbehalfofotherpeopleororganizations.代理关系系涉及到到三方：：principal委托人人、agent代代理人人和athirdparty第第三方。。Theprincipal(insurer))createsanagencyrelationshipwithasecondparty(agent)byauthorizinghimorhertomakecontractswiththirdparties(policyholders)ontheprincipal’sbehalf.Sothesourceoftheagent’sauthorityistheprincipal.ExpressedorImpliedAuthority明明示权权限与默默示权限限明示权限限Whenanagentisappointed,theprincipalexpresslyindicatestheextentofhisorherauthority..默示权限限Byenteringintotherelationship,,theprincipalimpliesthattheagenthastheauthoritytofulfilltheprincipal’’sresponsibilities.BindingAuthority约约束权限限Abinder(暂暂保单))：theagreementthatexistsbeforeacontractisissued.在在正式保保险合同同发出之之前的协协议。主要用于于财产责责任保单单。人寿健康康保险代代理人一一般只能能发出conditionalbinder((有条件的的暂保单单).Aconditionalbinderimpliesthatcoverageexistsonlyiftheunderwriterultimatelyaccepts(orwouldhaveaccepted)theapplicationforinsurance.WaiverandEstoppel

弃权权与禁止止反言Waiveristheintentionalrelinquishmentofaknownright..弃权意味味着有意意放弃已已知的权权利。为为了弃权权，一个个人必须须知道他他享有这这种权利利并有意意放弃它它。Estoppeloccurswhentheinsureroritsagenthasledtheinsuredintobelievingthatcoverageexists.当保险公公司或代代理人让让被保险险人相信信保险关关系已经经建立起起来的时时候，禁禁止反言言原则开开始生效效。AgencybyEstoppel禁禁止反反言的代代理关系系Anagencyrelationshipmaycreatedwhentheconductoftheprincipalimpliesthatanagencyexists-anagencybyestoppel..如保险人人暂停一一个代理理人的工工作，但但仍留有有一些blankpolicies空白白保单在在代理人人手中；；或被停停止工作作的代理理人把一一些业务务送给保保险人而而保险人人接受了了这些业业务时。。§4.2RequirementsofaContract合合同的基基本要件件保险合同同又称保保险契约约，它是是保险关关系双方方之间订订立的一一种在法法律上具具有约束束力的协协议。根根据当事事人的双双方约定定，一方方支付保保险费于于对方，，另一方方在保险险标的发发生约定定事故时时承担经经济补偿偿责任或或者当约约定事故故出现时时履行给给付义务务的一种种法律行行为。任何一份份协议要要具有法法律效力力，必须须满足以以下基本本条件：：1、Theremustbeanofferandanacceptance..2、Theremustbeconsideration.3、Thepartiestothecontractmustbecompetent.4、Itspurposemustbelegal..5、Thecontractmustbeinlegalform..§4.3DistinguishingCharacteristicsofInsuranceContracts保险合同同的特征征1、basedonutmostgoodfaith最大诚信信.Potentialinsuredsareheldtothehigheststandardsoftruthfulnessandhonestyinprovidinginformationfortheunderwriter.最大诚信信(1)representations陈陈述Whenyouarenegotiatingwithaninsurerforcoverage,youmakestatementsconcerningtheexposure.Thesestatementsarecalledrepresentations.(2)concealment隐瞒瞒Youmustalsorevealthosematerialfactsabouttheexposurethatonlyyouknowandthatyoushouldrealizearerelevant..MaterialFact

重要要事实MaterialFact:theinsurermustprovethattheinformationwassoimportantthatifthetruthhadbeenknown,theunderwriterwouldnothavemadethecontractorwouldhavedonesoonlyondifferentterms.2、contractsofadhesion附和性合合同.Mostinsurancecontractsarepreparedbytheinsurerandthenacceptedorrejectedbythebuyer.ExpectationsPrinciple预期原则则Theobjectivelyreasonableexpectationsofapplicantsandintendedbeneficiariesregardingthetermsofinsurancecontractswillbehonoredeventhoughpainstakingstudyofthepolicyprovisionswouldhavenegatedthoseexpectations.投保人和和未来的的受益人人有关保保险合同同的客观观的合理理预期是是应当被被满足的的，即使使煞费苦苦心解读读出来的的保单条条款可能能否定他他们的预预期。因此，现现代方法法在解释释附和性性保险合合同时1.tofavortheinsuredwhentermsofthecontractdraftedbytheinsurerareambiguous.当合同条条款出现现歧义时时作有利利于被保保险人的的判决。。2.toreadthecontractasaninsuredwould..从被保险险人的角角度来解解读合同同。3.todeterminethecoverageonthebasisofreasonableexpectationsoftheinsured.在被保险险人的合合理预期期基础上上理赔。。3、contractsofindemnity补偿性..Thatmeanstheinsureragreestopaynomore(andnoless))thantheactuallosssufferedbytheinsured.Thepurposeoftheinsurancecontractistorestoreyoutothesameeconomicpositionyouhadbeforetheloss,nottoimproveyoursituation..(1)InsurableInterest可可保利益益a.Apersonnotsubjecttolossdoesnothaveaninsurableinterest.b.Wheninsurableinterestmustexist:inpropertyinsurance,theinterestmustexistatthetimeoftheloss;lifeinsurancerequiresaninsurableinterestonlyattheinceptionofthecontract.c.Extentinsurableinterestlimitspayment.theinsuredorthesubject:thepersonwhosedeathrequirestheinsurertopaytheproceedsofalifeinsurancepolicy..thebeneficiary:thepersonorotherentityentitledtotheproceedsofthepolicyuponthedeathofthesubject.theownerofthepolicy:thepersonorotherentitywhohastheauthoritytoexercisealltheprematurityrightsofthepolicy,suchasdesignatingthebeneficiary,,takingapolicyloanandsoon.(2)Subrogation代位位追偿Thisrightgivestheinsurerwhateverclaimagainstthirdpartiestheinsuredmayhaveasaresultofthelossforwhichtheinsurerpaid.在第三方方给被保保险人造造成了损损失，而而保险人人赔偿了了这个损损失后，，被保险险人将向向第三方方索赔的的权利转转给保险险人。(3)ActualCashValueProvision实际现金金价值thereplacementcostatthetimeoftheloss,lessphysicaldepreciationincludingobsolescence.损失发生生时的重重置成本本减去折折旧。或fairmarketvalue公公平市价价theamountawillingbuyerwouldpayawillingseller.(4)OtherInsuranceProvision重复保险险条款Thepurposeofotherinsuranceprovisionininsurancecontractsistopreventinsuredsfrommakingaprofitbycollectingfrommorethanoneinsurancepolicyforthesameloss.4、Pe