被保险人自杀索赔问题的中美法律比较——解析新《保险法》第四十四条  

A comparison of Sino-American laws regarding suicide claim——An interpretation on Provision 44 of the new Insurance law

作　　者：于涛[1] 

机构地区：[1]对外经济贸易大学国际贸易学院,北京100029

出　　处：《保险研究》2009年第3期9-16,共8页Insurance Studies

摘　　要：各国保险法通常规定,人身保险合同的被保险人在合同成立或复效后的一段时间内自杀,保险人不承担赔偿保险金的责任。但该规定涉及三个争议点,即:被保险人死亡原因的举证责任分配;死亡原因的举证责任标准;自杀如是在精神疾病的控制下,保险人是否应该赔付。美国的处理方法是:人寿保险由保险人承担自杀的举证责任,意外伤害保险先由受益人证明被保险人死于意外,再由保险人承担证明自杀的举证责任。但死亡原因的证明标准各州不同,以适用优势证据原则为主,兼有适用排除合理疑问原则。当自杀是在精神疾病的控制下所为时,绝大多数州都依据现行的保单条款允许保险人拒赔,只有少数州在确认该精神疾病已使死者丧失辨别能力时要求保险人赔付。我国在2009年2月28日保险法修订前,对该问题的规定较为滞后,但在修改后有了很大提高,对该问题设定了较为妥帖的法律规范,为日后进一步完善奠定了坚实的基础。Most countries＇ insurance laws stipulate that the insurer shall not be kept liable in case the insured commit suicide within a designated period of time after the insurance contract takes effect or is reinstated. There are three arguable points on this provision. Firstly, the burden of proof for the cause of death of the insured ; secondly, the criteria of the burden of proof; and thirdly, whether the insurer should pay the benefit when the insured commit suicide under the influence of psychological disorder. The United States＇ answers to these questions are as follows： In the case of life insurance, the insurer is responsible for providing evidences of the insured＇s suicide, while in the case of accident and casualty insurance, the beneficiary should first prove the insured＇s death due to an accident, and then the insurer provide evidence for the insured＇s suicide. But different states have different criteria for evidences of death. They mostly apply the preponderance of evidence principle and some apply the reasonable question exclusion principle. When the insured commits suicide under the influence of psychological disorder, most states allow the insurer to reject claim payment in accordance with the current contract provisions, and only a few states require the insurer to pay for the claims after ascertaining that the psychological illness has rendered the insured loss of discretion. Before the recent amendment on the Insurance Law on February 27, China＇s provisions on this issue are quite outdated, but this situation has been changed with the new amendment providing an appropriate solution. This has laid a solid foundation for further improvement in the future.

关 键 词：被保险人 自杀 举证责任 精神疾病 

分 类 号：F922.284[经济管理]