机动车车险理赔诈骗防范的对策研究

发布时间：2018-06-26 19:05

本文选题：机动车保险 + 道德风险　；参考：《山东师范大学》2017年硕士论文

【摘要】：机动车辆保险是财产保险的一种,又可称为汽车保险。在我国,随着汽车保有量的逐年快速增加,汽车保险已经成为中国非寿险市场中最重要的组成部分,更是财产保险中的第一大险种。当前,在国内保险公司中,汽车保险业务保费收入已占到其财产保险业务总保费收入的50%以上,部分公司的汽车保险业务保费收入比例甚至占其财产保险业务总保费收入的60%以上。因此,汽车保险业务经营的盈亏,直接影响到财产保险行业的经济效益。但是,在汽车保险业务蓬勃爆发的过程中,也存在着诸多问题,其中盈利能力较弱、赔付比例较高一直是影响我国产险公司发展的一大问题。虽然由于汽车保险本身具有出险概率高、赔付额度大、赔付率较高等特点,但是从实际案例分析来看,保险理赔诈骗现象是导致我国汽车保险业务赔付率居高不下、盈利能力表现不佳的一个重要原因。近年来国内外关于汽车保险理赔诈骗防范对策的研究可以说是著述颇多,但大多文献分析理论支撑较弱,给出的建设性意见不够实际明确,针对这一研究现状,本文针对我国汽车保险业务赔付率居高不下、盈利能力表现不佳这一热点问题,通过引入大量实际案例,对汽车保险理赔诈骗的理论基础、现象和成因进行了深入、系统的研究和分析。以此为基础,分别从保险产品的设计和降低道德风险策略两个方面出发给出了我国汽车保险业务理赔诈骗防范的对策和建议。这也是本论文研究的最大现实意义之所在。本文第一章为绪论部分,指明了本文工作的研究背景和意义,分析了国内外的研究现状,进而点出了本文的主要研究内容和创新点。第二章为本文研究工作的理论基础,主要包括信息不对称理论和委托代理理论,分别对这两种理论的理论背景、理论意义、建立方法以及主要内容进行了介绍。第三章为汽车保险理赔诈骗的现状分析,首先对车险诈骗的定义、界定方法以及特点给出了介绍,进而引出道德风险是引发汽车保险诈骗的一个主要因素,通过实例分析了道德风险在汽车保险理赔诈骗中的两种常见的形式,从实例的背后,可以看到保险的相关主体方诚信缺失是导致目前这些诈骗行为产生的最根本的原因。另外,通过数据分析,本文发现目前汽车保险诈骗的职业化和团伙化愈发明显,这些现象应该及时引起相关部门的重视。第四章,本文研究了汽车保险理赔诈骗产生的深层次原因,这些原因进行归类,大体上分为五个方面:保险种类本身的原因、投保人方面的问题、保险人方面的问题、保险代理人方面的问题、保险法律法规建设以及执行方面的问题,对每个方面的问题给出了相应的方法建议。第五章,在第三章和第四章分析结果的基础上,本文从保险产品的设计、降低道德风险概率和用户自身防范这三个角度出发,给出了一些防止汽车保险理赔诈骗事件发生的具体措施,从而希望能够相关管理部门在制定管理办法和法律法规时提供有意义的参考。
[Abstract]:Motor vehicle insurance is a kind of property insurance, and it can also be called automobile insurance. In China, with the rapid increase of car ownership, automobile insurance has become the most important part of China's non life insurance market. It is also the first major insurance in property insurance. At present, in domestic insurance companies, the insurance revenue of automobile insurance has already been paid. It accounts for more than 50% of the total insurance premium income of its property insurance business, and the proportion of the insurance premium income of some companies is even more than 60% of the total insurance premium income of its property insurance business. Therefore, the profit and loss of the auto insurance business directly affects the economic benefits of the property insurance industry. However, the car insurance business is booming. In the process, there are also a number of problems, among which the profitability is weak and the proportion of compensation is always a big problem that affects the development of China's domestic insurance companies. Although automobile insurance itself has high probability of risk, the amount of compensation is large and the rate of compensation is high, the insurance compensation fraud is caused by the actual case analysis. There is an important reason for the high compensation rate of automobile insurance business and the poor performance of profitability. In recent years, the research on the Countermeasures of auto insurance compensation fraud can be said to be a lot, but most of the literature analysis theory is weak and the constructive suggestions are not clear enough. By introducing a large number of practical cases, the theoretical basis, phenomena and causes of auto insurance claim fraud are deeply studied and analyzed by introducing a large number of practical cases, which are based on the design of insurance products and the reduction of moral risk strategy two by introducing a large number of practical cases. The first chapter is the introduction part of this paper, which points out the research background and significance of this work, analyzes the research status at home and abroad, and then points out the main research content and creation of this paper. The second chapter is the theoretical basis of this study, mainly including information asymmetry theory and principal-agent theory. The theoretical background, theoretical significance, establishment method and main content of the two theories are introduced respectively. The third chapter is the analysis of the status of auto insurance fraud fraud, first of all, definition and definition of car insurance fraud. The article introduces the law and the characteristics, and then leads to the moral hazard is a major factor that triggering the automobile insurance fraud. Through an example, it analyzes two common forms of the moral risk in the fraud of the auto insurance claims. From the example, we can see that the lack of the related parties in the insurance is the result of the present fraud. In addition, through data analysis, this paper finds that the professionalization and gangs of automobile insurance fraud are becoming more and more obvious at present, and these phenomena should be paid more attention to the relevant departments in time. In the fourth chapter, this paper studies the deep reasons of auto insurance compensation fraud, and these reasons are classified into five aspects in general. The fifth chapter, on the basis of the analysis results in the third and the fourth chapters, is based on the results of the analysis of the third and the fourth chapters. The design, the three angles of reducing the probability of moral hazard and the prevention of the users themselves, give some specific measures to prevent the fraud of the auto insurance claims, so as to hope that the relevant administrative departments can provide meaningful reference when formulating the management methods and laws and regulations.
【学位授予单位】：山东师范大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：D922.284;F842.634

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