| 關 鍵 詞： |
健康保險；詐欺罪；裝病詐保；精神疾病 |
| 中文摘要： |
裝病詐保的行為主要涉及刑法第 339 條詐欺罪。可以分成健保署負擔醫療費用與保險公司給付保險金兩部分來討論。針對健保署部分，被告不成立詐欺罪，原因在於獲利意圖的主觀要件不成立；就被告詐領保險金部分，則詐欺罪的主、客觀構成要件皆會成立。
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| 英文關鍵詞： |
health care insurance；fraud；fraudulent insurance claim；mental illness |
| 英文摘要： |
It is mainly related to the fraud according to paragraph 339 Criminal Law to claim the insurance fraudulently with pretending to be a patient. It can be divided into two parts: the medical expenses borne by National Health Insurance Administration （MOHW）, and the insurance premiums paid by the insurance company. With respect of the MOHW, the defendant is not guilty of fraud because the subjective element of intent to profit is not fulfilled. However, for the insurance, both of the subjective and objective elements of fraud will be fulfilled.
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| 目 次： |
壹、案例
貳、爭點
參、解析
一、健保署部分
二、保險公司部分
肆、結論
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