《保险研究》20220807-《故意所致保险事故免责规定中故意的意涵及指向》（岳卫）

［摘   要］由于《保险法》并未界定故意所致保险事故免责中故意的具体内涵,相关解释论的展开必然受到民法学乃至于刑法学相关概念的影响。因此,故意所致保险事故免责的理论构成以及相关问题的解释论展开往往会不自觉地偏重于主观可归责性与否的考量。然而,保险的本质乃分散风险的经济制度,相关法律关系的解明应立足于双方约定的风险程度这一客观承保因素。据此,故意免责的法理基础应在于排除异常高度风险,因此其原则上属于任意性规定,在不违反公序良俗的情形下以故意行为为给付条件的保险契约并非当然无效。同理,故意概念的解释亦无需考量意志因素,只要行为人的故意行为与损害结果之间具有高度盖然性即可。同时,只要对保险事故具有故意,与其具有相当因果关系的损害均为保险人的免责范畴,而该相当因果关系的判断需要严格限制,实质亦宜以是否具有高度盖然性判断之。

［关键词］故意免责;故意的理论构成;故意的意涵;故意的指向;高度盖然性

［基金项目］2020年度江苏省社会科学基金一般项目“反保险欺诈的民事法理群构建研究”(项目编号:20FXB009)。

［作者简介］岳卫,南京大学法学院副教授,保险法研究所所长,法学博士。

On the Special Meaning of Intention in the Context of Intentional Exemption Clause

YUE Wei

Abstract：Since the Insurance Law does not define the specific meaning of intentional exemption,the development of relevant interpretation theory is inevitably influenced by the concepts of civil law (tort liability law) and even criminal law.Therefore,the theoretical constitution of intentional exemption and the interpretation of related issues tend to unconsciously focus on the consideration of subjective liability.However,the essence of insurance is an economic system to disperse risks,and the clarification of relevant legal relations should be based on the objective factor of the agreed risk degree.Therefore,excluding abnormally high risk should be the jurisprudence basis of intentional exemption clause.If public order and good customs are not violated,the insurance contract with intentional behavior as the payment condition should not be per se invalid.Similarly,the interpretation of the concept of intention does not need to consider the factor of will,as long as there is a high probability between the actor′s intentional behavior and the damage.At the same time,as long as the insured accident is intentional,the damage with proximate cause should be located in the scope of exemption of the insurer,and the judgment of proximate cause needs to be strictly limited to whether there is a high degree of probability.

Key words：intentional exemption clause;theoretical constitution of intention;meaning of intention;the direction of intention;high probability