August 2017

契约之续订乃基于原契约自动续约条款而产生者 保险人于接受要保人于原契约订立时所告知之信息后 要保人无须再履行契约订立时之据实说明义务(台湾)

黄郁婷 律师
台湾高等法院台南分院于民国105年3月24日作成104年保险上易字第7号民事判决(下称「本号判决」)指出,契约之续订乃基于原契约内定自动续约条款而产生者,保险人于接受要保人于原契约订立时所告知者后,要保人即无须再履行契约订立时之据实说明义务。
本号判决事实为被上诉人以自己为要保人及受益人、伊母亲为被保险人,向上诉人投保系争保险契约并附有「自动续保附加条款」,于每一年度保险期间届满后,保险契约将自动续保并已经三次自动续保。嗣后被上诉人母亲因意外误饮农药,中毒休克死亡,被上诉人依系争保险契约条款,向上诉人申请保险理赔,上诉人以被上诉人未据实告知其母亲患有失智病史为由解除契约拒绝给付。然被上诉人则主张其母投保时并无失智症并未违反告知义务等理由,提起本件诉讼请求上诉人给付保险金。
本号判决指出,按续约于法律上之意义为再订约,原则上应负据实说明义务,惟若该契约之续订乃基于双方当事人于原契约内定有自动续约条款而产生者,显然表示双方当事人有意以原契约之内容不加改变而继续其效力,且保险人已接受要保人于原契约订立时所告知之信息,故要保人亦无须再履行契约订立时之据实说明义务。本号判决进而认为上诉人于第二次及之后续约,均不再要求重新填写系争告知事项,于此情形下,应认被上诉人及其母亲无须再履行说明义务。此外,由于上诉人并未举证证明,被保险人罹患失智症之情形,是否已达到保险法第59条所谓已达保险人应增加保险费或终止契约之程度而应通知保险人之危险增加情形,故本号判决认定上诉人抗辩被上诉人及其母亲违反告知义务解除契约云云,并无理由。
然本号判决最终以被上诉人母亲乃系自杀,并非因意外误饮农药致死,被上诉人不得据此请求保险金为由,废弃原审判决改判驳回被上诉人之第一审之诉。

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