A Study on Personal Accident Insurance

• Main Authors: LIN,YI HUAN, 林羿歡
• Other Authors: Lo, Chun-Wei
• Format: Others
• Language: zh-TW
• Published: 2018
• Online Access: http://ndltd.ncl.edu.tw/handle/4hkr4v

碩士 === 逢甲大學 === 財經法律研究所 === 106 === The personal accident insurance is an essential type of insurance that grant guarantee on occurrence of accident. With property insurance companies joining in the accident insurance market in 2001 , the competition among the market has become more and more fierce. As the consumers are faced with more various choice, increased number of disputes regarding compensation follow subsequently. In term of the nature of the accident insurance, comparing to other types of insurance, it is able to provide high valued guarantee with relatively cheap premium, as the accident insurance purely provide guarantee upon accident injury and death rather than involve any function of deposit. With such nature, if the determination on the occurrence of an accident is not accurate, it is easy for it to be used on bad intentions by the malicious, and further , leading to thuggery, which deviate from the initial purpose of the insurance system set to be an economic mechanism for risk diversification. As a result, the determination on the definition of an accident becomes the core consideration in terms of insurance coverage, the paper will firstly recognize the essential elements of an insured accident of the accident insurance from the provision of Damage Insurance Model Clause, then discuss each element one after another, with consideration of relevant theories and experience in court and opinions from the Financial Ombudsman Institution, and will have deeper discussion and analysis on the controversial cases. Then, when it comes to the causation, the paper examines its actual application in the accident insurance in view of the theory of causation, and illustrate the ways to deal with the determination of the causation in theory and in practice respectively when there is contention between accidents and diseases. The last but not the least, since the assignment of the burden of proof is the crucial point for the benefits claimer to win the lawsuit, the paper firstly illustrate the intention of the system of the burden of proof, then review the burden of proof in an accident, and further, discuss the probative value for the procurator to examine the certificate of death, and its legal sense in an accident insurance.