作者：初北平
作者介绍：大连海事大学保险法研究中心教授
出版日期：2020年10月9日
内容提要 我国保险法因果关系判断规则的分歧根源在于对保险法与侵权法中的因果 关系的混同及对合同解释功能的忽略。因果关系规则考察或构建方法论中的不同概念表达， 导致“效果”和“结果”的原因与“纯粹条件”和“背景因素”的概念区分始终没有达成 共识。我国保险司法实践中应采用“原因概念”统一、事实原因发现、合同解释与“实质作 用”标准相结合来发现法律原因的逐级递进的因果关系判断理论，并警惕引入“比例因果 关系”标准的弊端。可在司法解释以及指导性案例中对“实质作用原因”的概念进行诠释， 确立合同解释以及复合原因选择的基本规则，鼓励在保险条款中约定更为详尽的比例因果 关系规则。
关键词 因果关系 实质作用原因 比例因果关系 复合原因 合同解释
Abstract: The divergence in the rules of determination of causation in China’s insurance law is derived from two aspects: the confusion of causation in insurance law with that in tort law and the overlooking of the function of contract interpretation. Due to the different expressions of various concepts in examining the causation rules and establishing the methodologies, there is no unified understanding in China’s academic community to distinguish the concepts of‘results’ and‘effects’,‘pure conditions’and‘background factors’. A progressive theory on determining path of causation should be applied in the judicial practice of insurance in China, which should be a combination with the unification of the causal concepts, the discovery of the factual causes, the contract interpretation and the‘substantial contribution’test, and the vigilance should be kept for the defects of applying the proportional causation. In order to introduce the above paths, it is suggested that the concepts of‘substantial contribution’can be interpreted in the judicial interpretation and guiding cases, and that the basic rules of contract interpretation and concurrent-causes selection should be established. Meanwhile, detailed provisions regarding the proportional causation rule can be provided in the insurance clauses.