傷害保險的市場因為產險業者的加入,消費者擁有更多選擇性,市場競爭更趨激烈,但同時理賠爭議亦隨之增加。而在傷害保險上,意外事故原因與意外事故結果間,往往混雜有其他因素,尤其傷害保險並不保障疾病危險,卻可常見意外事故介入疾病之因素,因此意外事故因果關係認定非常重要,也經常是理賠案件的爭議點。 本研究蒐集國內外有關主力近因原則與傷害保險的相關文獻,並加以整理分析,探討主力近因原則之定義與運用,以及論述傷害保險承保事故與損失間因果關係,最後透過國外判例及國內案例研究,探討傷害保險理賠糾紛,以期探求較佳的處理方式,減少理賠爭議產生。 The consumers have more choices since the general insurance companies join market of the accident insurance, and therefore the market competition is getting into white-hot. In the interim, the disputes on insurance claims have been increasing. The accident insurance covers accidental injury rather than diseases. Nevertheless, it is not rare that the claims are involved in other factors between accidental reason and accidental result, especially the diseases. Therefore it is very important to determine the causation between the cause and injury, which are often a key argument about a claim under accident insurance. As a result, we collect and analyze the relevant literatures of the proximate cause and accident insurance from domestic and foreign to look into the definitions and application of the proximate cause. In addition, we make a study on the causation between insured perils and injury. Finally, we anticipate to came out the solutions of mitigating dispute on claims by means of domestic and foreign case study.