CP保险公司车险反欺诈预警指标研究

发布时间：2018-05-08 20:23

本文选题：风险管理 + 车险欺诈　；参考：《电子科技大学》2013年硕士论文

【摘要】：近年来在保险行业，由于新成立的保险主体迅猛增多，保险市场竞争日趋激烈，各家保险公司自身的经营能力将面临严峻考验。在有限的市场规模增长面前，各家保险公司为将自身的盈利能力保持到一定水平，就需要对风险管理提出更高要求，其中对理赔工作的风险管理将是重中之重。机动车辆保险作为财产保险公司的主营业务险种，其规模占总业务规模的75%以上，所以业内十分重视对车险业务的赔案真实性督察工作。本文就是顺应保险业目前关注探讨如何反车险欺诈工作这一趋势，以一家市级保险公司——CP保险公司为平台，运用风险指标法，总结研究了识别欺诈赔案的具体风险指标。并运用CP保险公司2012年度查实的虚假赔案，对总结出的风险指标做进一步有效性论证，探讨了目前的风险指标有效预警的范围和局限性。反车险欺诈风险预警指标的建立其意义是为今后我国保险行业建设反车险欺诈理赔系统提供理赔数据积累和风险指标研究经验，以实现我国效仿国外保险行业先进经验，建立跨保险公司的反欺诈联盟的目标。并希望运用这些风险预警指标建立数据模型，嵌入到各家保险公司理赔系统中，，实现系统能自动过滤筛查识别赔案的风险系数。最终实现利用技术手段提高对车险欺诈赔案的识别率，帮助保险公司提高风险管理水平的目标。
[Abstract]:In recent years, the insurance industry, due to the rapid increase of newly established insurance bodies, insurance market competition is becoming increasingly fierce, each insurance company will face a severe test of its own business ability. In the face of the limited market growth, in order to maintain their profitability to a certain level, insurance companies need to put forward higher requirements for risk management, in which the risk management of claims management will be the most important. As the main business insurance of property insurance company, motor vehicle insurance accounts for more than 75% of the total business scale. In accordance with the current trend of the insurance industry to pay close attention to how to deal with the fraud in automobile insurance, this paper takes a municipal insurance company, CP insurance company, as the platform, and uses the risk index method to summarize and study the specific risk indicators for identifying fraud and compensation cases. By using the false compensation case verified by CP Insurance Company in 2012, the paper further demonstrates the validity of the risk index summarized, and discusses the scope and limitation of effective early warning of the current risk index. The significance of establishing early warning index of anti-vehicle insurance fraud risk is to provide the accumulation of claim data and research experience of risk index for the construction of anti-vehicle insurance fraud settlement system in our country in the future, so as to realize our country emulate the advanced experience of foreign insurance industry. The goal of establishing an anti-fraud alliance across insurance companies. It is hoped that the data model can be established by using these risk early warning indexes and embedded in the claim system of insurance companies so that the system can automatically filter and screen the risk coefficient of identifying compensation cases. Finally, the goal of using technical means to improve the recognition rate of vehicle insurance fraud and compensation cases and to help insurance companies improve their risk management level is realized.
【学位授予单位】：电子科技大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：F842.3

【参考文献】