第五章 他國保險適合性原則相關規範
第一節 歐盟指令
國 立
政
治 大 學
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N ation a l C hengchi y Uitnrsive
91
第五章 他國保險適合性原則相關 規範
經前面章節說明美國保險領域的適合性原則適用狀況，本章將整理、
介紹歐盟、英國、德國目前關於保險領域之適合性原則相關規範。
第一節歐盟指令
歐盟所訂定之相關指令中，涉及保險領域之適合性原則者有 2002 年 頒布之保險中介指令（Directive 2002 92 EC of the European Parliament and of the Council of 9 December 2002 on insurance mediation），以及於 2004 年 頒 佈 「 金 融 市 場 指 令 」（ DIRECTIVE 2004/39/EC OF THE EUROPEAN PARLIAMENT AND OF THE COUNCIL of 21 April 2004 on markets in financial instruments, MiFID）。
第一項 保險中介指令
一、本指令之適合性原則規範：
保險中介指令中，與適合性原則較接近之規範，規定於該指令第 3 章 中介人資訊提供責任章節中，第 12 條仲介人提供之資訊307，該條第 1 項 要求中介人於締結保險契約以前，或於續約前（如有必要），仲介人應告 知的事項中，第(e)款事項為保險中介人是否為專屬特定保險公司的代理人，
以及其所提供的契約是否基於公平分析（Fair analysis）義務而給予建議 (gives advice)308；若中介人告知客戶其係基於公平分析而給予建議，則同
307 Directive 2002/92/EC, CHAPTER III INFORMATION REQUIREMENTS FOR INTERMEDIARIES, Art. 12 Information provided by the insurance intermediary,.
308 See id. 1(e): ”Prior to the conclusion of any initial insurance contract, and, if necessary, upon amendment or renewal thereof, an insurance intermediary shall provide the customer with at least the following information: ……(e)…… In addition, an insurance intermediary shall inform the customer, concerning the contract that is provided, whether: (i) he gives advice based on the obligation in paragraph 2 to provide a fair analysis, or (ii) he is under a contractual obligation to conduct insurance mediation business exclusively with one or more insurance undertakings. In that case, he shall, at the customer's request provide the names of those insurance undertakings, …”.
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國 立政
治 大 學
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N ation a l C hengchi y Uitnrsive
92
條第 2 項規定，保險中介人有義務(is obliged to)分析市面上足夠數量 (sufficiently large number)之保單，使其能給予符合其專業標準的建議以及 客戶需求(meet the customer's needs)309；亦即，若中介人告知客戶其所提 供之建議係基於公平分析所作出，則負有公平分析之義務。
另外，中介人於契約訂定以前，至少應以客戶提供之資訊為基礎，具 體說明客戶的要求及需求(demands and needs)，以及如有提供建議，該建 議的原因為何；這些說明的詳細程度，應依照所提出之保險契約的複雜程 度而有所調整310。
二、本指令之適用範圍：
本指令第 1 條第 1 項規定適用範圍為於歐盟會員國內設立或希望設立 並從事保險中介行為之自然人或法人；所謂保險中介行為，指介紹、提出 或從事其他準備簽定保險契約的行為，或簽定此類契約，或協助管理或執 行 此 類 契 約 ， 特 別 是 於 索 賠 的 情 形 ， 若 前 述 行 為 由 保 險 業 (insurance undertaking)311或其員工為之，不被認為是保險中介312；此外，如果相關的 資訊提供，是進行其他專業行為時偶然為之313，且該資訊提供之行為，非 為協助客戶簽訂、完成保險契約、對保險公司權利之專業管理、調整及對 申請理賠之專業估價，則非屬保險中介314；同條第 5 項定義保險中介人為：
為獲取傭金(remuneration)而從事保險中介之自然人或法人。
309 See id. Art. 12-2: “When the insurance intermediary informs the customer that he gives his advice on the basis of a fair analysis, he is obliged to give that advice on the basis of an analysis of a sufficiently large number of insurance contracts available on the market, to enable him to make a recommendation, in accordance with professional criteria, regarding which insurance contract would be adequate to meet the customer's needs.”
310 See id. Art. 12-3.
311 依本指令 Art. 2-1 之定義，Insurance undertaking 指從事 73/239/EEC 指令第 6 條所稱人身保險 以外之直接保險（direct insurance），或 79/267/EEC 指令第 6 條所稱之直接人身保險之事業。
312 See id. Art. 2-3:” insurance mediation’ means the activities of introducing, proposing or carrying out other work preparatory to the conclusion of contracts of insurance, or of concluding such contracts, or of assisting in the administration and performance of such contracts, in particular in the event of a claim. These activities when undertaken by an insurance undertaking or an employee of an insurance undertaking who is acting under the responsibility of the insurance undertaking shall not be considered as insurance mediation….”
313 例如稅務顧問於諮詢時提及保險契約。
314 supra note 307, Art. 2-3: “…The provision of information on an incidental basis in the context of another professional activity provided that the purpose of that activity is not to assist the customer in concluding or performing an insurance contract, the management of claims of an insurance undertaking on a professional basis, and loss adjusting and expert appraisal of claims shall also not be considered as insurance mediation.”
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同條第 5 項則規定了｢妥適性(appropriate)｣之要求及警告義務；其要求 會員國應確保投資公司於提供第 4 項以外(other than)之投資服務於其客戶 時，詢問(ask)客戶於特定種類之產品或服務的投資相關知識及經驗，以使 公司得以評估其所設想之投資服務或商品對客戶而言是否妥適317；若認為 有不適當，公司應給予客戶警告(warn)318。若客戶不提供資訊或提供不足，
公司則應向客戶警告上開情形使公司無法判斷服務或商品對客戶是否妥 適319。本條設有免責規定，如投資服務機構僅係單純執行（execution）客
315 Directive 2004/39/EC, Art. 19 Conduct of business obligations when providing investment services to clients, (1).
316 See id. Art. 19(4): “When providing investment advice or portfolio management the investment firm shall obtain the necessary information regarding the client's or potential client's knowledge and experience in the investment field relevant to the specific type of product or service, his financial situation and his investment objectives so as to enable the firm to recommend to the client or potential client the investment services and financial instruments that are suitable for him.”
317 See id. Art. 19(5): “Member States shall ensure that investment firms, when providing investment services other than those referred to in paragraph 4, ask the client or potential client to provide information regarding his knowledge and experience in the investment field relevant to the specific type of product or service offered or demanded so as to enable the investment firm to assess whether the investment service or product envisaged is appropriate for the client.”
318 See id. Art. 19(5), subparagraph 2: “In case the investment firm considers, on the basis of the information received under the previous subparagraph, that the product or service is not appropriate to the client or potential client, the investment firm shall warn the client or potential client. This warning may be provided in a standardised format.”
319 See id., Art. 19(5), subparagraph 3: “In cases where the client or potential client elects not to provide the information referred to under the first subparagraph, or where he provides insufficient information regarding his knowledge and experience, the investment firm shall warn the client or potential client that such a decision will not allow the firm to determine whether the service or product envisaged is appropriate for him. This warning may be provided in a standardised format.”
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戶之指示、單純接待轉介（reception and transmission）客戶之指示，或因 而附隨提供投資服務，且符合所列之所有條件時，則無需取得客戶相關資 訊，亦無須履行第 5 項之妥適性義務320。
此外，若為投資服務機構接受其他機構之轉介而提供服務時，前者可 以倚賴後者提供之客戶資訊而為適合性之判斷；後者對所資訊傳遞之完整 性（completeness）與精確性（accuracy）負責321。準此，因客戶對中介投 資服務之機構所提供之推介仍有信賴，故中介機構對客戶最終取得之商品 推介或投資建議之妥適性，仍應負責322。
第 21 條則為投資人最佳利益（terms most favorable to the client）執行 其指示，亦可以認為是適合性原則之規範。該條要求會員國應要求各投資
第 1 條指出本指令適用於投資公司(investment firms)，投資公司從事 投資服務為職業的法人324；緊接著在指令第 2 條臚列了許多除外情形，第
324 Directive 2004/39/EC, art.4-1.
325 Directive 73/239/EEC of 24 July 1973 on the coordination of laws, regulations and administrative provisions relating to the taking-up and pursuit of the business of direct insurance other than life assurance.
326 DIRECTIVE 2002/83/EC OF THE EUROPEAN PARLIAMENT AND OF THE COUNCIL of 5 November 2002 concerning life assurance.
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國 立政
治 大 學
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N ation a l C hengchi y Uitnrsive
95