단체보험계약에 관한 소고

A Study on the Group Insurance Contracts

Generally, a group insurance policy has been defined as a contract between an insurer and an entity for the benefit of a group of people that has some relationship to the entity. The insurance company saves the cost of soliciting individual policy holders and can thus reduce agents' fees. Also, the employer can save the insurance company some costs of policy administration. These reduced overhead costs allow the insurer to sell a group policy at reduced rates. The legal relationship of a group insurance policy is the same legal relation of a individual insurance. But because of the nature of a group insurance policy, following problems are able to be raised. First, today the pressures of competition and rising costs have produced frequent delegation of administrative detail by the insurer to the employer; and often the insurer has little contact with the insured employee. With the employer carrying out many of the administrative duties traditionally performed by the insurance company, the extent to which an employer's act will bind the insurer has become of significant concern. Secondly, Most group insurance contracts contain provisions that limit the coverage of the employee to the time of employment. Therefore, it is a significant problems what constitutes an effective termination of employment within the meaning of a termination of employment clause in a group insurance policy. Third, When a group insurance plan goes into effect, a group or master policy is customarily issued to the employer or analogous policyholder, and certificate of insurance or other literature, which are prepared by the insurer, the policyholder, or both and which explain the benefits provided by the plan, are issued to the individual employees or other persons. Problems as to the extent of coverage to which the insured are entitled may arise when the master policy contains limitations on or exclusions from coverage which are not contained in the certificates or literature that is furnished to the individual insureds. Fourthly, The matter is whether the insurance company terminates coverage without notice to the insured. If the insurer need not notify the insured of the group policy's termination, the administrative costs of group insurance decrease. However, because an older employee is more likely to be uninsurable, converting group insurance into individual insurance may be an employee's only means of obtaining insurance coverage. Lastly, a contract of property insurance can be made as a contract of insurance between the group and the insurer, but for the benefit of the insured members. This research studied the factors of contract of group insurance as the meaning and of the group, agency relationship of the group, master policy and certificates of participation. That also argued whether the insurer is needed notify the insured of the group policy's termination.