保险消费者的合法权益保护研究

　　摘要

　　在现代社会，保险已经像血管一样深入到消费者生活的方方面面，已经成为了中国经济的重要组成部分。但与保险业快速发展的态势不相匹配的是我国的保险消费者保护法律体制仍处于空白状态，既无专门立法保护，亦无有效的纠纷解决机制。保险机构与保险消费者之间的利益冲突日益凸显，不仅侵犯了保险消费者的合法权益，更加削弱了保险行业的公信力，阻碍了保险业的深入发展。本文采用了规范分析法、案例分析法、定型分析法、文献研究法以期望研究结果能够具有一定的理论和实践意义。

　　本论文的研究内容分为四个部分：第一章以消费者概念的争议为切入点，论述保险消费者的概念及表现形式。分析保险消费者应当享有的权益，包括基础权利和辅助性权利两部分。第二章运用法理学、经济法和法经济学的基本原理，分析保险消费自身所具有的特性，考量保险消费者保护的必要性。第三章从我国保险消费者保护的现状出发，分析现有法律制度的缺陷，主要包括立法缺陷和监管缺位。第四章通过对美国《多德一弗兰克华尔街改革和个人消费者保护法案》相关内容的研究，总结该法案对我国保险消费者保护的重要启示，即强调立法理念和监管理念的导向作用，提高监管机构执行力和保障消费者知悉权，对保护保险消费者权益是非常有益且必要的。最后从立法和监管两个层面，提出了以保险消费者保护为价值导向的保险消费者保护法律制度的构想。提出制定金融消费者保护法的立法建议，并将保险消费者权益保护作为其中的专章进行规定，法律中必须要明确以保险消费者为本位的价值取向，突出民事救济。在监管机构的设置上，笔者坚持在中央层面设立金融消费者保护司，并内设独立的保险消费者保护司，作为国务院直属事业单位，行政地位与“三会”齐平，并享有履行其职责必须的规则制定权、行政权和一定程度的司法权。

　　本文通过学习和借鉴他人的理论研究成果，结合保险消费的特殊性以及我国保险消费者保护的现状，提出了新的观点。首先，本文不再囿于《保险法》的框架，而将研究视野拓宽到消法领域，并与消法的基础理论相结合，探讨保险消费者的法律界定与权益保护问题。其次，本文采用法经济学的有关理论，从市场经济运行规律出发，分析不同法制环境下，保险交易双方的行为选择，为研究保险消费者保护问题提供了实证基础。最后，目前我国对保险消费者保护进行系统研究的文献甚少，研究内容多集中在立法或监管或某一类纠纷解决机制上，并多以期刊的形式发表。甚少有研究能深入、全面地展示保险消费者保护法律体制的概况。因此，本文从立法、监管、纠纷解决机制以及信息披露制度四个方面出发，构建起了一个全面的、立体的保险消费者保护法律体系。

　　关键词：保险消费者；消费者保护法律；监管制度；立法保护；保险消费者保护机构

　　ABSTRACT

　　In modern society, Insurance has penetrated into the consumers' life inall aspects as the blood vessels. Insurance has become an important part ofChina's economy. However, china's legal system which is still in the blankstate does not match the fast developing pace of insurance. Now, neither wehave specific legislation, nor an effective dispute settlementmechanism.Conflicts between insurance agencies and insurance consumershas become increasingly prominent. In order to make sure the results of thisresearch has contribution to theoretical and practical significance in somecertain, author has adopted normative analysis method, case analysis method,stereotypes analysis method, literature research method in this paper.

　　This thesis is divided into four parts: Chapter one: The insuranceconsumer is placed in background of consumers. Dispute about concept ofconsumer is used as the starting point, and then author discusses the conceptand manifestation of the insurance consumer. Analysis ofthe interests of theinsurance consumers should enjoy. Chapter two: author uses the principles ofEconomic Law, Jurisprudence and Law and Economics to reconsider thenecessity of insurance consumer protection and analyze the characteristics ofinsurance consumption. Chapter three: based on the present situation of ourcountry insurance consumer protection, author analyzes the defects of existinglegal system, including the legislative and regulatory defects. Chapter four: bystudying the DODD-FRANK WALL STREET REFORM AND CONSUMERPROTECTION ACT, author has concluded several important enlightenmentsof consumer protection for our country. The bill emphasize the guiding role ofthe idea of legislation and regulation, and stress the importance of improvingregulatory agencies' executive power and ensuring consumers' right of beinginformed. Last but not the least, from aspect of legislation and supervision,author has presented a legal system concept which is value-oriented byinsurance consumer protection. To make a law on financial consumerprotection is suggested,which contains the content of insurance ConsumerProtection. The new law should clear its value, and give prominence to civilrelief. In terms of regulatory, author insists that a financial consumerprotection agency with insurance consumer protection agency in should be set.

　　It should act as an institution directly under the State Council, and itsadministrative status should as same as the China Insurance RegulatoryCommission, China Banking Regulatory Commission and China SecuritiesRegulatory Commission. The new institution should be equipped with enoughrule-making power, executive power and judicial power.

　　By learning from others' research and combining with the particularity ofthe insurance consumer and the status quo of China's insurance consumerprotection, author has put forward my own point of view. First of all, this isno longer confined to “Insurance Law” framework, which will study the fieldof consumer law to broaden horizons, and combine with the basic theory ofconsumer law, to explore the legal definition and rights protection issues ofthe insurance consumer. Secondly, starting from the market economymechanisms, I use the theory of Law and Economics analyze conduct of theparties in insurance transactions under different legal environment, whichproviding the empirical foundation for insurance consumer protection. Finally,little systematic research literature has been published on China's insuranceconsumer protection. Most research focus on legislation or regulation, or acertain type of dispute resolution mechanism, and mostly were published injournals. Rarely has study gone deep into comprehensive display of theinsurance consumer protection legal system profiles. Therefore, this paperbegins from the legislative, regulatory, dispute resolution mechanisms to builda comprehensive, three-dimensional insurance consumer protection lawsystem.

　　KEYWORDS: insurance consumer; legal system for consumer protection ;insurance supervisory system ; legal protection ; insurance consumerprotection agency
 

　　目录

　　摘要

　　ABSTRACT

　　引言

　　第1章保险消费者及保险消费者权益

　　1. 1保险消费者及主体范围

　　1.1.1消费者概念的界定

　　1.1.2保险消费者的概念

　　1.1. 3保险消费者的主体范围

　　1.2保险消费的特殊性

　　1. 2. 1消费标的物的无形性

　　1. 2. 2消费主体的特殊资格

　　1.2.3保险合同内容的专业化及其格式化

　　1. 2. 4消费结算方式的非即时性以及消费结果的不确定性

　　1.3保险消费者权益

　　1.3.1保险消费者的基础权利

　　1.3. 2保险消费者的辅助性权利

　　第2章我国保险消费者权益保护现状及缺陷

　　2.1保险消费者权益受侵害的原因

　　2.1. 1产品设计缺陷

　　2. 1.2销售误导

　　2. 1.3理赔机制不顺畅

　　2.2保险消费者保护现状

　　2. 2. 1民事法律对保险消费者的保护

　　2. 2. 2新监管举措对保险消费者的保护

　　2.3保险消费者保护机制的缺陷分析

　　2. 3. 1缺乏保险消费者保护的明确立法

　　2.3. 2保险监管落后于保险实践

　　第3章构建我国保险消费者保护机制的构想

　　3.1保险消费者保护的理论基础

　　3.1.1合同自由与合同正义原则

　　3.1.2信息不对称理论

　　3. 1.3消费者主权理论

　　3. 1.4自然垄断理论

　　3.2美国《多德一弗兰克华尔街改革和个人消费者保护法案》对我国的启示

　　3. 2. 1将保护金融消费者作为重要监管目标

　　3.2.2提高监管机构的执行力

　　3. 2. 3强化消费者的知悉权

　　3.3构建我国保险消费者权益保护体系的构想

　　3. 3. 1推进保险消费者权益保护立法

　　3. 3. 2完善信息披露制度

　　3. 3. 3设立保险消费者保护机构

　　3. 3. 4建立多模式纠纷解决机制

　　结论

　　参考文献

　　致谢