《保险研究》20240708-《共同保险纠纷的司法困境及其突破》（武亦文、王新宇）

［摘   要］通过对共同保险纠纷进行梳理,可以发现其司法实践之困境主要源于共同保险法律构造的不明确。为突破这一困境,本文对共同保险的法律构造进行了探究。共同保险的内部法律关系较为特殊,既非保险合同关系,亦非合伙关系,无法将其对应到实在法上任何一种法律关系。但因成立共同保险内部法律关系的行为系共同法律行为,而《民法典》关于合伙合同之规范又提供了关于共同法律行为最为庞大的规范群,故其存在类推适用合伙合同规范之可能。《民法典》第970条关于合伙事务决定、执行的规定即可类推适用于主次承保人间的法律关系。根据该条规定,主次承保人间应为委托关系。对次承保人和投保人而言,主承保人对外统一签订共保合同系代理行为,对外统一给付保险金则为《民法典》第523条规定的“约定的由第三人履行”。共同保险的外部法律关系仍为保险合同关系。在主承保人代理次承保人对外签订保险合同时,若未约定由主承保人统一给付保险金,以格式条款形式出现的共保条款则会对投保人一方利益产生重大影响。因此,根据《民法典》第496条第2款,主承保人还需对共保条款履行“提示+被动说明”义务。

［关键词］共同保险；合伙；格式条款

［作者简介］武亦文,武汉大学法学院副院长,教授、博士生导师,研究方向:保险法、卫生健康法;王新宇,武汉大学大健康法制研究中心研究人员,研究方向:保险法、卫生健康法。

The Judicial Dilemma of Co-Insurance Disputes and Its Breakthrough

WUN Yi-wen,WANG Xin-yu

Abstract：By sorting out co-insurance disputes,it can be found that the dilemma of judicial practice mainly stems from the lack of clarity of the legal structure of co-insurance.In order to break through this dilemma,this article explores the legal structure of co-insurance.The internal legal relationship of co-insurance is quite special.It is neither an insurance contractual relationship nor a partnership relationship,and it can not be corresponded to any legal relationship of positive law.However,since the act of establishing the internal legal relationship of the co-insurance is a common legal act,and the norms of the Civil Code on partnership contracts provide the largest group of norms on common legal acts,there is a possibility of applying the norms of partnership contracts by analogy.Article 970 of the Civil Code,which regulates the decision and execution of partnership affairs,can be applied by analogy to the legal relationship between the primary and secondary insurers.According to this article,the relationship between the primary and secondary insurers is a fiduciary one.For the secondary insurer and the policyholder,the conclusion of the co-insurance contract by the primary insurer on an external basis is an act of agency,and the payment of the insurance benefit on an external basis is an "agreed performance by a third person" as provided for in Article 523 of the Civil Code.The external legal relationship of co-insurance is still the insurance contractual relationship.In the case of an insurance contract concluded by the primary insurer on behalf of the secondary insurer,the co-insurance clause in the form of a form clause can have a significant impact on the interests of the policyholder if it is not agreed that the primary insurer will pay the insurance benefit as a whole.Therefore,according to Article 496,paragraph 2,of the Civil Code,the primary insurer is also obliged to perform the "reminder + passive statement" obligation with regard to the co-insurance clause.

Key words：co-insurance;partnership;form clause