人身意外伤害险相关医学问题的研究

发布时间：2018-06-22 02:23

本文选题：保险医学 + 意外伤害保险　；参考：《中国医科大学》2006年硕士论文

【摘要】：前言意外伤害保险(Accident Insurance,AI)是人身保险的重要险种之一。所谓“意外伤害保险”是指投保人向保险人交纳一定的保费,在保险期限内,投保人由于遭受意外事故导致死亡、残疾的,保险人按照合同约定给付受益人全部或部分保险金。意外伤害保险的给付责任分为死亡给付和伤残给付。1982年以来,随着我国人身保险业的恢复,意外伤害保险也得到了充分的发展,业务量不断增加,服务领域不断扩大,以中国人寿保险公司保费收入为例,1985年意外伤害险的保费收入仅为14816万元,而1993年就激增至252082万元。然而,在意外伤害险投保数量增加的同时,意外伤害险中的一些医学问题也逐渐显露出来。在险种设计上,保险金额偏低,不能应对实际发生的伤害情况;伤残理赔标准单一,对于各种不同的意外伤害险种,未能充分考虑不同意外伤害的出险率、出险后果以及投保的具体情况。在核保中,忽视职业风险,轻视投保人的逆向选择和道德风险,带病投保或伪造保险事故的发生率增加。在理赔中,由于缺乏医学相关知识,理赔人员仅能局限于对各种单据的真实性进行审核,对投保人所从事职业的常见病、多发病的了解甚少,因而无法正确运用近因原则判断保险事故的责任。因此,本研究根据医学与保险学的相关理论,通过对沈阳某人寿保险公司2005年8月～12月意外伤害险理赔案例进行统计分析,为意外伤害险的险种设计、核保及理赔的完善提供的科学依据。对象与方法 1.对象收集沈阳某人寿保险公司2005年8月至2005年12月意外伤害险赔付案例共2042件。根据投保群体和承保内容的不同,将意外伤害险分为两
[Abstract]:Preface Accident Insurance Insurance (AI) is one of the important types of life insurance. So-called "accident injury insurance" is to point to policy-holder pays certain premium to underwriter, inside insurance period, policy-holder because suffer accident to cause death, disability, underwriter gives beneficiary whole or partial insurance gold according to contract agreement. The liability of accidental injury insurance is divided into death and disability benefits. Since 1982, with the recovery of the personal insurance industry in China, the accidental injury insurance has also been fully developed, the volume of business continues to increase, and the service fields continue to expand. Take the premium income of Chinese life insurance companies as an example. In 1985 the premium income for accident and injury insurance was only 148.16 million yuan, but in 1993 it soared to 2.52082 billion yuan. However, as the number of accidental injury insurance increases, some medical problems in accidental injury insurance gradually emerge. In the design of insurance, the amount of insurance is too low to cope with the actual injury situation. The standard of disability compensation is single, and the risk rate of different accidental injury can not be fully considered for all kinds of accidental injury insurance. The consequences of insurance and the details of the insurance. In the process of insurance, the occupational risk is ignored, the adverse selection and moral hazard of the policy holder are despised, and the incidence of diseased or forged insurance accidents increases. In the settlement of claims, due to the lack of medical relevant knowledge, claim settlement personnel can only be limited to the examination of the authenticity of various documents, and have little knowledge of the common diseases of the profession in which the policy holder is engaged. Therefore, it is impossible to use the principle of proximal cause correctly to judge the liability of insurance accident. Therefore, according to the relevant theories of medicine and insurance, this study analyzed the accident injury insurance cases of a life insurance company in Shenyang from August to December, 2005, and designed the accident injury insurance. The scientific basis provided by the perfection of insurance and claim settlement. Object and method 1. Participants collected 2042 cases from August 2005 to December 2005 of a life insurance company in Shenyang. According to the difference between the insured group and the coverage content, the accident injury insurance is divided into two parts
【学位授予单位】：中国医科大学
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：F842.6;D919

【相似文献】