A财险山东分公司车险理赔减损研究

发布时间：2018-04-02 18:47

本文选题：车险理赔　切入点：减损　出处：《西安科技大学》2014年硕士论文

【摘要】：山东省财产险保险市场规模在2012年依然呈现了较快的增长趋势，截至2012年12月，全省（不含青岛计划单列市）实现保费收入314.21亿元，同比增长18.31%，其中机动车辆保险实现保费收入256.42亿元，同比增长15.34%，车险业务占产险公司全部业务的比重达到了81.61%。然而，各保险公司的车险业务均出现了不同程度的亏损，截至2012年12月，，全省车险业务亏损达19.10%，实际亏损10.56亿元。A财险山东分公司的车险业务同样陷入了“高保费，高赔付，低效益”的经营困境，截至2012年12月，A财险山东分公司车险保费收入占总保费的74%，车险亏损额却占公司亏损险种总亏损额的96%。本文结合A财险山东分公司车险理赔现状，研究造成当前车险经营困境的深层次原因，通过对影响经营利润的各项因素包括保费收入、综合赔付率和综合费用率的分析，由于综合费用率维持在正常水准上，本文认为在高保费收入的现实条件下，综合赔付率高是导致亏损的主要原因，因此采取有效措施降低综合赔付率的水准是实现车险经营良性发展的关键。将影响我国车辆保险市场上综合赔付率的各种因素分成人为风险因素和自然风险因素两类，进一步地把人为风险因素分成道德风险因素和非道德风险因素两类，并按类别分因素进行了详细分析；以此为基础，结合A财险山东分公司的理赔流程和现状，提出了几个当前公司存在的导致综合赔付率居高不下并急需解决的问题，包括道德风险的控制、理赔资源的最优配置、理赔人员业务技能的提高、业务承保品质的提高等；针对存在的各种问题，运用了犯罪经济学理论、运筹学的排队理论和头脑风暴法作为分析工具依次提出解决对策。本文结合笔者自身从事财产保险的工作经历，提出了以提高道德风险的各项成本的措施和通过理赔品质审计提高虚假案件的侦破率等为基础，结合KPI指标体系考核、短信平台与远端视频定损系统等措施来降低A财险山东分公司的综合赔付率水准，最终实现车险经营的盈利以带动整个公司经营效益的提高，指明了A财险山东分公司车险理赔服务的目标和方向。
[Abstract]:The scale of property insurance market in Shandong Province still showed a rapid growth trend in 2012. As of December 2012, the insurance premium income of the whole province (excluding Qingdao plan separately listed city) was 31.421 billion yuan.The insurance premium income of motor vehicle insurance increased by 25.642 billion yuan from the same period last year, an increase of 15.34 yuan, and the proportion of vehicle insurance business in the total business of the property insurance company reached 81.61%.However, the auto insurance business of all insurance companies has suffered losses of varying degrees. As of December 2012, the losses in the auto insurance business of the whole province amounted to 19.10 million yuan. The actual losses of the vehicle insurance business of the Shandong Branch of property Insurance, Shandong Branch, were also "high premiums, high compensation payments,"As of December 2012, the premium income of automobile insurance in Shandong branch accounts for 74% of the total premium, but the loss amount of auto insurance accounts for 96% of the total loss of the company.Combined with the current situation of auto insurance claims in A property Insurance Shandong Branch, this paper studies the deep-seated causes of the current vehicle insurance business dilemma, through the analysis of the factors that affect the operating profit, including premium income, comprehensive compensation rate and comprehensive cost rate.Because the comprehensive cost rate is maintained at the normal level, this paper thinks that under the realistic condition of the high premium income, the high comprehensive compensation rate is the main reason leading to the loss.Therefore, to take effective measures to reduce the level of comprehensive compensation rate is the key to the benign development of auto insurance management.The factors that affect the comprehensive compensation rate in the vehicle insurance market of our country are divided into two categories: artificial risk factor and natural risk factor, and the man-made risk factor is further divided into two categories: moral hazard factor and non-moral hazard factor.On the basis of this, combined with the process and current situation of A property insurance Shandong branch, the paper puts forward some problems that cause the high comprehensive compensation rate and need to be solved urgently.It includes the control of moral hazard, the optimal allocation of claim resources, the improvement of claim personnel's business skills, the improvement of business underwriting quality and so on.The queuing theory and brainstorming method of operational research are used as analytical tools to solve the problem.Based on the author's working experience in property insurance, this paper puts forward some measures to improve the cost of moral hazard and improve the detection rate of false cases through the quality audit of claims, combined with the assessment of KPI index system.Short message platform and remote video fixed loss system, etc., to reduce the comprehensive compensation rate level of A property Insurance Shandong Branch, and finally realize the profit of auto insurance operation so as to promote the whole company's operating efficiency.Pointed out A property insurance Shandong branch auto insurance settlement service goal and direction.
【学位授予单位】：西安科技大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：F842.3

【参考文献】