《保险研究》20201007-《<民法典>与保险人的说明义务》（李玉泉）

［摘   要］《民法典》对格式条款作了详细规定,结合《保险法》的相关规定,本文从保险人说明义务的含义及其理论基础、范围、履行和违反的后果等方面作了系统的论述。保险人的说明义务是一种法定义务、先合同义务,包括一般条款的说明义务与免责条款的提示和明确说明义务两层含义。违反一般说明义务,法律未规定不利后果；违反免责条款明确说明义务,该条款不产生效力,属于强制性义务规范。保险人说明义务应当限于格式化保险条款,免责条款明确说明是保险人说明义务的核心,其范围应限定在保险人免责条款这一关系风险保障的重要内容。投保人、被保险人违反法定或约定义务,保险人因此享有合同解除权的条款应当排除在免责条款之外,保险人法定免责条款不必进行明确说明。本文对《民法典》、《保险法》及其司法解释相关规定的理解,对保险实务如何进一步规范和完善,提出了具体的意见和建议。

［关键词］《民法典》；《保险法》；保险人；说明义务；免责条款

［作者简介］李玉泉,法学博士,研究员,中国保险学会法律专业委员会主任,曾任中国人民保险集团公司副总裁。

The Civil Code and the Disclosure Obligation of the Insurer

LI Yu-quan

Abstract：The Civil Code stipulates on standard clauses in depth. Taking relevant rules of the Insurance Law,this paper systematically elaborated on the disclosure obligation of the insurer,including its connotation,theoretical foundation,scope of application,execution and the consequence of violation. The insurer′s disclosure obligation is a statutory obligation and a pre-contract obligation. It includes the disclosure for general clauses and the reminder and explicit disclosure for exclusion clauses. The consequence for violating the general disclosure obligation is not legally stipulated,whereas violating the disclosure obligation for exclusion clauses renders these clauses void due to its statutory nature. The insurer′s disclosure obligation only applies to standard insurance contract clauses,and the explicit disclosure obligation for exclusion clauses,which should be limited to the insurer′s exclusions relevant to protection against risks,is at the core. The clause on insurer′s right of contractual interpretation due to the policyholder or the insured′s violation of statutory or agreed obligations,should be excluded from the exclusion clauses,and no explicit disclosure is required for the insurer′s statutory exclusion clauses. The paper offered some specific opinions and suggestions on how to further regularize and perfect insurance practices based on its understanding of the Civil Code and the Insurance Law and relevant judicial interpretations.

Key words：the Civil Code;the Insurance Law;the insurer;the disclosure obligation;exclusion clauses