A保险公司理赔垂直管理模式优化研究
发布时间：2019-05-16 10:50
【摘要】：随着国内保险市场的不断发展和竞争的日渐加剧,保险理赔作为客户接触和感知保险服务、履行保险合同的重要环节,提高理赔效率、加强和改善理赔服务质量、保障维护保险消费者权益一直以来就是A保险公司关注的核心问题。理赔垂直管理体制改革是A保险公司从2010年开始进行的一项重大的管理模式变革。在近两年的试点、运行过程中,该模式将基层公司理赔部门的人、财、物等方面的权力收归上级公司统一调配,增强了上级公司对基层公司的宏观调控和监管,维护了上级公司的权威,推动和加速了基层公司的经营意识与方向的转变,提高了理赔质量,也促进了理赔业务专业化水平。但这种模式容易引发“条条矛盾”和“条块矛盾”,在一定程度上削弱了基层公司完整功能的发挥,加大了理赔垂直管理部门违规、违纪、腐败现象发生的几率。为此,必须对该模式进行优化改革。首先要加强理赔垂直管理部门的自身建设,完善内部激励机制、建立健全管理与监督体系；其次,要规范理赔垂直管理部门与基层公司之间的关系,进一步合理的划分上级公司与基层公司的职责权限,建立和健全理赔垂直管理部门和基层公司的协调机制与争议解决机制；最后,可在上级公司与基层公司合理界定职权范围的基础上,进行相应的调整。
[Abstract]:With the increasing development of the domestic insurance market and the increasing competition, the insurance claim is the important part of the customer's contact and perception insurance service, the performance of the insurance contract, the improvement of the settlement efficiency, the enhancement and the improvement of the quality of the settlement of the claim. The protection and maintenance of the consumer's rights and interests has always been a core issue of the company's concern. The system reform of the vertical management of claims is a major change of management mode from the beginning of 2010 to the A-insurance company. In the past two years of pilot and operation, this mode, in the course of operation, will collect the power of people, wealth, and the like in the claim department of the base-level company to the superior company for unified allocation, and enhance the macro-control and supervision of the higher-level company to the base-level company, and maintain the authority of the higher-level company. The transformation of the management consciousness and direction of the grass-roots company is promoted and accelerated, the quality of the settlement is improved, and the professional level of the settlement business is also promoted. But this mode can easily lead to the "the contradictions of the strip" and the "bar-block conflict", which has weakened the full function of the base-base company to a certain extent, and increased the probability of the violation of the vertical management department of the claim, the violation of the law, and the occurrence of corruption. To this end, the model must be optimized for reform. First, we should strengthen the self-construction of the vertical management department of the claims, improve the internal incentive mechanism, establish and improve the management and supervision system, and then standardize the relationship between the vertical management department of the claim and the base-level company, and further reasonably divide the responsibilities of the higher-level company and the base-level company. Establish and perfect the coordination mechanism and dispute settlement mechanism of the vertical management department of the claim and the base-level company; and finally, the corresponding adjustment can be made on the basis of the reasonable definition of the terms of reference between the superior company and the grass-roots company.
【学位授予单位】：长沙理工大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：F840.4;F842.3
本文编号：2478235
[Abstract]:With the increasing development of the domestic insurance market and the increasing competition, the insurance claim is the important part of the customer's contact and perception insurance service, the performance of the insurance contract, the improvement of the settlement efficiency, the enhancement and the improvement of the quality of the settlement of the claim. The protection and maintenance of the consumer's rights and interests has always been a core issue of the company's concern. The system reform of the vertical management of claims is a major change of management mode from the beginning of 2010 to the A-insurance company. In the past two years of pilot and operation, this mode, in the course of operation, will collect the power of people, wealth, and the like in the claim department of the base-level company to the superior company for unified allocation, and enhance the macro-control and supervision of the higher-level company to the base-level company, and maintain the authority of the higher-level company. The transformation of the management consciousness and direction of the grass-roots company is promoted and accelerated, the quality of the settlement is improved, and the professional level of the settlement business is also promoted. But this mode can easily lead to the "the contradictions of the strip" and the "bar-block conflict", which has weakened the full function of the base-base company to a certain extent, and increased the probability of the violation of the vertical management department of the claim, the violation of the law, and the occurrence of corruption. To this end, the model must be optimized for reform. First, we should strengthen the self-construction of the vertical management department of the claims, improve the internal incentive mechanism, establish and improve the management and supervision system, and then standardize the relationship between the vertical management department of the claim and the base-level company, and further reasonably divide the responsibilities of the higher-level company and the base-level company. Establish and perfect the coordination mechanism and dispute settlement mechanism of the vertical management department of the claim and the base-level company; and finally, the corresponding adjustment can be made on the basis of the reasonable definition of the terms of reference between the superior company and the grass-roots company.
【学位授予单位】：长沙理工大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：F840.4;F842.3
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