نوع مقاله : مقاله پژوهشی

نویسندگان

• زهرا اسدی ¹
• مدریک پیرصاحب ²

¹ استادیار، گروه حقوق خصوصی و اسلامی، دانشکده حقوق و علوم سیاسی، دانشگاه شیراز، شیراز، ایران.

² دانش آموخته دکتری، گروه حقوق محیط زیست، دانشکده محیط زیست و انرژی، دانشگاه آزاد واحد علوم و تحقیقات، تهران، ایران.

چکیده

پیشینه و اهداف: شورای عالی بیمه در جلسة مورخ 17/07/1398 در اجرای مادة 17 قانون تأسیس بیمه مرکزی ایران و بیمه‌گری، «شرایط عمومی بیمه مسئولیت مدنی کارفرما در قبال کارکنان» را مشتمل بر 24 ماده و 2 تبصره تصویب کرد. این آیین‌نامه با هدف یکسان‌سازی مقررات این بیمه‌نامه تدوین شده‌ است. هرچند آیین‌نامة یادشده سعی بر رفع ابهامات آیین‌نامة شمارة 80 داشته و از تاریخ ابلاغ جایگزین این آیین‌نامه شده است؛ باوجوداین، مستلزم بررسی انتقادی است. هدف از این پژوهش، شناسایی خلأهای موجود در آیین‌نامة ‌شمارة 98 و بیمه‌نامة مرتبط و ارائة راهکارهایی برای رفع آن‌ها، به‌منظور ارتقای عملکرد این رشتة بیمه‌ای است.
روش‌شناسی: این پژوهش به روش توصیفی_– تحلیلی و با بهره‌گیری از منابع کتابخانه‌ای انجام شده است.
یافته‌ها: بیمه‌نامة مسئولیت مدنی کارفرما از حیث شرایط عمومی، تابع مفاد آیین‌نامة ‌شمارة ۹۸ شورای عالی بیمه بوده و درعین‌حال مستند به قوانین و مقررات جاری کشور است. آیین‌نامة مزبور که با هدف رفع ابهامات و اصلاح آیین‌نامة ‌شمارة ۸۰ صادر شده، همچنان در موارد متعددی از جمله تعریف دقیق اصطلاحات کلیدی، فرایند جبران خسارت و ... دارای ابهامات و برداشت‌های تفسیری متفاوت در میان ذی‌نفعان است. این امر در برخی موارد به بروز اختلاف نظر میان بیمه‌گذاران و بیمه‌گران و نیز نارضایتی آن‌ها منجر شده است. ازاین‌رو، شایسته است موارد مزبور در فرایند بازنگری و اصلاح آتی این آیین‌نامه مورد توجه و مداقه قرار گیرد.
نتیجه‌گیری: آیین‌نامة ‌شمارة ۹۸ شورای عالی بیمه، به‌عنوان یک سند کلیدی حاکم بر بیمة مسئولیت کارفرما، مستلزم بازنگری و اصلاح است تا به‌طور جامع‌تر و دقیق‌تر به نیازهای در حال تحول و پیچیدة بازار بیمه پاسخ دهد. بررسی‌های انجام‌شده نشان می‌دهد که برخی بندها و مفاد آیین‌نامه، به‌دلیل ابهام در تعاریف و دامنة پوشش، به تفاسیر متنوع و گاه متناقض بین بیمه‌گذاران و شرکت‌های بیمه منجر شده است. در پاسخ به این چالش‌ها چندین پوشش الحاقی یکسان برای پوشش بهتر ریسک‌ها و نیازهای خاص بیمه‌گذاران و ایجاد رویه‌ای مشابه بین ‌بیمه‌گران معرفی شده است. بااین‌حال، این اقدام به‌تنهایی کافی نیست و بازنگری جامع آیین‌نامه با رویکردی انتقادی و مشارکتی، با در نظر گرفتن نظرات کارشناسان، بیمه‌گذاران و سایر ذی‌نفعان، ضروری به نظر می‌رسد.

کلیدواژه‌ها

• ابهامات آیین نامه شماره98
• شواری عالی بیمه
• بیمه مسئولیت مدنی
• پوشش‌های الحاقی
• کارفرما
• کارکنان

موضوعات

• حقوق بیمه

عنوان مقاله [English]

Regulation 98 of the Supreme Insurance Council and Additional Coverages of Employer’s Liability Insurance: Ambiguities and Solutions

نویسندگان [English]

• Zahra Asadi ¹
• Medrick Pirsaheb ²

¹ Assistant Professor, Department of Private and Islamic Law, Faculty of Law and Political Science, Shiraz University, Shiraz, Iran.

² PhD Graduate, Department of Environmental Law, Faculty of Environment and Energy, Islamic Azad University, Science and Research Branch, Tehran, Iran.

چکیده [English]

BACKGROUNDS AND OBJECTIVES: Employer’s liability insurance, which provides coverage for employers against legal liability for bodily injuries or deaths sustained by employees during the course of employment, is one of the most important fields of liability insurance in Iran’s insurance system. Given its significant role in compensating for work-related injuries and protecting employee rights, the development of clear and comprehensive regulations in this area has consistently been a priority for regulatory bodies. In line with this, the High Council of Insurance, in its meeting dated October 9, 2019 (17 Mehr 1398, Persian calendar), and in accordance with Article 17 of the Law on the Establishment of the Central Insurance of Iran and Insurance Operations, approved the “General Terms and Conditions of Employer’s Liability Insurance” under Regulation No. 98, consisting of 24 articles and 2 notes. This regulation was drafted with the aim of updating, clarifying, and standardizing the previous provisions, and it replaced the former Regulation No. 80, which had faced various criticisms and ambiguities in practice over the years.
Although Regulation No. 98 represents an attempt to address the shortcomings and ambiguities of its predecessor, comparative analyses, expert opinions, and practical experiences in the insurance industry indicate that it still faces conceptual, operational, and legal challenges. These challenges include the lack of precise definitions for key terms, unclear delineation of responsibilities, and legal gaps in the compensation process, which can limit the regulation’s effectiveness in practice. Accordingly, the main objective of this study is to conduct a critical and analytical review of Regulation No. 98 and the insurance policies derived from it, with a focus on identifying the existing gaps, deficiencies, and practical challenges. The study also aims to propose reform strategies and policy recommendations to enhance the technical and legal performance of this branch of liability insurance. Through legal analysis, insurance theory, and empirical observations, this research seeks to contribute to the systematic improvement of current regulations and to support the advancement of employer’s liability insurance services in Iran.
METHODS: This research adopts a descriptive-analytical approach, relying on library resources. First, the provisions of regulation 98 and additional coverages are reviewed. Then, through content analysis of these provisions, the main shortcomings and flaws are identified.
FINDINGS: The employer’s civil liability insurance policy, in terms of its general conditions, is clearly subject to the provisions of Regulation No. 98 of the Supreme Insurance Council, which is recognized as the primary authority for regulating and defining related rules. This regulation, enacted with the aim of resolving ambiguities and amending the deficiencies of Regulation No. 80, despite efforts made to enhance the clarity and effectiveness of the provisions, still contains certain ambiguities and differing interpretations among stakeholders, including policyholders, insurers, and judicial authorities. These ambiguities mainly arise from some vague coverages or imprecise expressions, which have resulted in a lack of uniform and consistent interpretation regarding the rights and obligations of the parties to the insurance contract. This situation has, to some extent, led to legal and technical disputes between the parties and, in certain cases, dissatisfaction and uncertainty concerning the operation of the insurance policy. From this perspective, a more comprehensive and in-depth revision of Regulation No. 98 of the Supreme Insurance Council is increasingly necessary to eliminate ambiguities, facilitate more effective interactions, streamline legal processes, and enhance stakeholder satisfaction. In this revision, it is essential to utilize the expertise of legal, insurance, and industry specialists to not only clarify the provisions more precisely but also establish clear implementation frameworks and dispute resolution mechanisms to prevent recurrence of previous issues
CONCLUSION: Regulation No. 98 of the High Council of Insurance, as a key document governing employer’s liability insurance, requires fundamental revision and reform to more comprehensively and accurately address the evolving and complex needs of the insurance market. The conducted reviews indicate that certain coverages and provisions of the regulation, due to ambiguities in definitions and coverage scope, have led to varied and sometimes contradictory interpretations among policyholders and insurance companies. This situation not only reduces the satisfaction and trust of stakeholders but also has caused legal disputes in some cases. In response to these challenges, several supplementary coverages have been introduced to better cover risks and specific needs of policyholders, however, this measure alone is insufficient. Therefore, a comprehensive revision of the regulation with a critical and participatory approach, incorporating the views of experts, policyholders, and other stakeholders, appears essential. Such a revision can pave the way for improving insurance processes, increasing transparency, and enhancing the quality of services in the field of employer’s liability insurance.

کلیدواژه‌ها [English]

• Ambiguities of regulation No. 98 of the supreme
• Insurance council
• Liability insurance employer
• Employees
• Additional coverages