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    Please use this identifier to cite or link to this item: https://tkuir.lib.tku.edu.tw/dspace/handle/987654321/74105

    Title: 我國傷害保險理賠爭議之探討與案例分析研究
    Other Titles: The claim disputation research and case stuty analysis of persnonal accident insurance in Taiwan
    Authors: 龍湘傑;Lung, Hsiang-Chieh
    Contributors: 淡江大學保險學系保險經營碩士在職專班
    郝充仁;李雅婷;Hao, Chung-Jen;Li, Ya-Ting
    Keywords: 傷害保險;理賠爭議;案例分析;訴訟;accident insurance;claim disputation;Case Study;Lawsuit
    Date: 2011
    Issue Date: 2011-12-28 18:04:45 (UTC+8)
    Abstract: 傷害保險具有低保費與高保障的特色,近年來已成為國人風險轉移的工具與不可或缺的保單之一。自從民國90年開放產險得以主約方式經營傷害保險後,傷害保險經營也越漸激烈,消費者的選擇雖更加多樣化,然而傷害保險條款對意外事故的認定、除外責任的界定等,因條款的定義不明確,致保險理賠爭議屢見不鮮。
    In Taiwan, with low premiums and high security feature, accident insurance has become an indispensable tool and one of policy for transferring from risk. Accident insurance business getting into intensive competition, since 2001 the property insurance companies was allowed to operate the accident insurance under master contract. Consumer choice more diverse, but the terms of accident insurance identification, definition of exclusion, etc., because of indefinable definition of terms commonly caused insurance claims disputes.

    Most of the accident insurance claim disputations owing to lack of obtaining insufficient relevant information or insurance concept, the insured always has difference awareness of accidental injury or misunderstanding the interpretations of provisions. There is a common controversy over the cause of accident insurance as “an accident” or “a disease” and how to identify between these two? Besides, the insurance companies often limit the insurance coverage in provisions reduction, and exempted from exclusion without evidence in detail would not be advocated.

    This research expounds on theory from domestic and foreign countries that combines with the opinion of practice in our country, simultaneously developed into more typical practice decision to further explore the claims between the policyholder and the insurance company. Analyzed the court’s opinion and compared specific recommendation for individual with expectation of offering a practical operation solution and learning model to the same controversy. Provided the suggestions to the authority, insurance company, and the insured. Eventually to shorten the cognitive differences and reduce complaints even litigation.
    Appears in Collections:[Graduate Institute & Department of Insurance Insurance] Thesis

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