《保险研究》20260102-《保险伦理相关问题研究》（周伏平、赵大玮）

［摘   要］保险伦理发挥着保障行业存续和健康运行的基础性作用，伦理缺位会导致违规违纪、利益侵占等多种问题。本文试图从保险的特性、法律原则、组织起源等出发，对保险伦理问题进行探讨。研究发现，由于保险双方信息的高度不对称性、合同的射幸性以及活动全过程具有内生性等特点，伦理责任是一种在保险法规之上形成的、高于一般商业活动的自我道德约束；最大诚信原则要求保险人与投保人双方在法律底线之上践行伦理，构成保险伦理的基石；相互保险组织是保险业组织起源的早期形态。进一步地，本文通过“金手指”事件、HIH保险与公平人寿危机、销售误导等中外经典案例，揭示伦理失范如何导致行业“囚徒困境”。最后，分析了大数据与人工智能带来的算法歧视、数据隐私和技术黑箱等新挑战，提出了面向未来的综合治理建议：坚持互助共济的保险本源，将监管底线固化与行业长期主义自救相结合，加强德法共治，以构建一个更具韧性和公信力的伦理生态体系。

［关键词］保险；道德；伦理；法律；保险伦理；伦理责任

［作者简介］周伏平，经济学博士，中国准精算师，北美准精算师，中国保险保障基金有限责任公司副总经理；赵大玮，上海一垄园信息科技咨询有限公司。

An Exploration of Issues Related to Insurance Ethics

ZHOU Fu-ping，ZHAO Da-wei

Abstract：Insurance ethics plays a fundamental role in ensuring the insurance industry’s survival and healthy operation.The absence of ethics will undoubtedly lead to violations，disciplinary offenses，and encroachment of interests.The author explores on the insurance ethics issue from the unique characteristics of insurance，legal principles，and organizational origin.It reveals that due to the high information asymmetry between insurance parties，the aleatory nature of insurance contracts，and the endogeneity of the entire insurance activity process，the ethical responsibility in insurance activities is a self-moral restraint formed above insurance laws and higher than that of general business activities.The principle of utmost good faith requires both insurers and policyholders to practice ethics above the legal baseline，therefore it is regarded as the cornerstone of insurance ethics.The organizational origin of the insurance industry is traced back to its early form as mutual insurance organizations.Through classic domestic and foreign cases such as the “Golden Fingers” incident，the HIH Insurance and Equitable Life crises，and sales misrepresentation，it is revealed how ethical misconduct can lead to the industry’s “prisoner’s dilemma.” The new challenges brought by big data and artificial intelligence，such as algorithmic discrimination，data privacy，and technological black boxes，are analyzed，and forward-looking thoughts and suggestions for comprehensive governance are proposed：the original goal of mutual aid in insurance should be adhered to;combine the solidification of regulatory bottom lines with the industry’s long-termism self-rescue;and strengthen the combined governance of morality and law to build a more resilient and credible ethical ecosystem.

Key words：insurance;morality;ethics;law;insurance ethics;ethical responsibility