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保险索赔欺诈会产生保险人免除赔付责任与解除权产生两个层面的法律后果。但在责任保险的场合,如若保险人愿意承担被保险人故意制造保险事故时的赔付责任,法律可以例外允许,而通过不足额保险等方式控制道德风险。对于实践中的全额免责条款,应通过格式合同的法律规定予以控制。基于索赔欺诈而生的解除权性质是继续性合同基于重大事由而生的解除权,其行使不具有溯及力,应当受到除斥期间的约束。以伪造证据等方式夸大保险损失属于保险索赔欺诈,应当允许保险人行使解除权。欺诈索赔解除权行使后,保险人应当返还相应的保费。
Insurance claims fraud will have two legal consequences for the insurer to dispense with liability for payment and release. However, in the case of liability insurance, if the insurer is willing to assume the liability of the insurer to make the insurance accident deliberately, the law may exceptionally allow and control the moral hazard through insufficiency of insurance. The full exemption clause in practice should be governed by the legal provisions of the format contract. The nature of the right of termination based on the claim fraud is the right of termination of the contract based on material reasons. The exercise of the right of termination is not retroactive and should be subject to the period of exclusion. To exaggerate the insurance losses in the form of forgery evidence, etc. belong to the insurance claim fraud, the insurer should be allowed to exercise the right of cancellation. After the exercise of the right of cancellation of the fraud claim, the insurer shall refund the corresponding premium.