保险理赔是公众与舆论关注的焦点,也是立法与监管的重点,从投诉情况来看,保险人的理赔义务并没有在实践中很好地得到履行,制定立法技术更高的法律规范进一步严格约束保险人的行为准则很有必要。本文梳理中国台湾地区保险理赔法律规制及监管情况,从理赔程序、法律后果、行政监管等方面与大陆展开对比,分析影响保险理赔立法与监管水平的深层次问题,并提出进一步完善的建议。 Insurance claims are the focus of the public and public opinion, as well as the focus of legislation and supervision. From the point of view of complaints, the insurers’ obligation to settle claims has not been satisfactorily fulfilled in practice, and legislation and legislation with higher technical standards are further tightened. The insurer’s code of conduct is necessary. This article combs the legal regulation and regulation of insurance claims in Taiwan of China, compares the claims settlement procedures, legal consequences and administrative supervision with the Mainland to analyze the deep-seated problems that affect the legislation and supervision level of insurance claims and proposes further improvements.