我国保险消费者权益保护研究

发布时间：2018-01-20 14:25

本文关键词： 保险消费者消费者权益保护服务承诺保险服务　出处：《西南财经大学》2013年硕士论文　论文类型：学位论文

【摘要】：近年来,我国保险业快速发展,市场组织不断完善,保费收入稳步增长,与此同时,保险消费者权益受到侵害的现象屡见不鲜,保险消费领域“销售误导”、“理赔难”等问题普遍引起了民众和社会对保险行业的不满,削弱了保险业赖以生存的信用基础,严重制约了我国保险业的进一步发展。鉴于此,我国保险监管部门采取了一系列的措施,以规范保险业秩序,维护消费者合法权益。2011年10月,中国保监会保险消费者权益保护局正式成立,日前,中国保监会还相继下发了《关于改进服务质量落实服务承诺有关问题的通知》、《中国保监会关于加强和改进财产保险理赔服务质量的意见》、《关于做好保险消费者权益保护工作的通知》以及《机动车辆保险理赔管理指引》等一系列规章制度。此后,开展保险教育、畅通投诉渠道、完善调处机制、解决积压赔案、提高信息、透明度、加大监管惩处力度等一系列保护消费者权益的新政密集出台。可以说,对保险消费者权益保护工作的重视程度达到了前所未有的高度。为进一步规范保险业服务,提高服务质量,切实保护消费者合法权益,2012年3月保监会下发了《关于开展“3.15”保险服务承诺活动的通知》(保监厅发[2012]10号)要求各保险公司在国际消费者权益日到来之际,开展保险服务承诺活动,集中公开自己的服务承诺。截止至2012年7月9日,在中国保险行业协会网站上共公布了119家保险公司的服务承诺,其中财险主体有58家。公开保险服务承诺对保护保险消费者合法权益来说无疑是一次有益的尝试,有利于规范行业服务,纠正行业不正之风,推动行业服务水平的提升和扭转行业不良形象。与此同时,保险公司的服务承诺在其内容和具体落实的过程中也存在着不少问题,比如承诺内容空泛,将一般性工作要求当成对消费者的承诺；服务承诺表述不明确容易引起争议,缺少对违诺责任的规定和相应的惩戒机制；理赔服务落实质量差等问题。理论上也缺乏对服务承诺所具有的法律性质和应承担的法律责任的明确界定。这些问题严重制约了保险服务承诺在维护消费者权益方面作用的有效发挥。在此背景下,本文尝试通过对财产保险公司现行服务承诺进行分析,发现其中存在的问题和不足,进而从改进和落实财产保险服务承诺的角度就加强我国保险消费者权益保护相关问题提出几点建议。文章具体内容如下：第一部分是绪论,简要介绍了文章的研究背景与意义,对研究现状进行了综述,并指出了本文的创新与不足之处。第二部分首先对保险消费者权益保护问题作了简要概括,初步界定了保险消费者的概念,对保险消费者权益保护的现实必要性进行了阐述,并就保险服务承诺的法律性质及其在保险消费者权益保护方面的作用进行了初步探讨。指出保险公司的服务承诺具有契约的性质,其实质构成法律意义上的要约,服务承诺的内容应属于合同的一部分。第三部分是对我国财产保险公司现行服务承诺的整理和分析。本章以中国保险行业协会网站中公布的各财产保险公司服务承诺为资料来源,对其中17家财险公司服务承诺的详细内容分别在理赔服务、增值服务和维护客户权益机制三个方面作了列表对比和分析。通过上文对财险服务承诺的分析,再结合我国财险服务的实际落实情况,文章第四部分指出了目前财险服务承诺在内容上和落实质量上存在的问题,包括服务承诺宣传不到位、服务条款表述不明易引起争议、服务承诺内容有待规范、理赔服务承诺落实质量不高等方面。第五部分,针对财险公司现行服务承诺存在的问题,提出了改进落实服务承诺,加强保险消费者权益保护的几点建议,分别从保险公司的角度、行业自律的角度以及保险监管的角度进行了阐述。文章建议保险公司应充分评估自己的践诺能力,并规范服务承诺的内容,完善理赔服务,从根本上提高服务水平；行业协会作为行业的自律组织应对各承诺主体的执行情况做定期的监督检查,制定相应的自律惩戒措施并探索建立行业服务标准；保险监管部门应进一步畅通投诉渠道,完善投诉机制,并引入第三方评价披露机制,建立社会监督制度。
[Abstract]:In recent years, the rapid development of China's insurance industry, and constantly improve the market organization, premium income increased steadily, at the same time, the insurance consumer rights have been infringed It is often seen. consumption, insurance sales misleading "," claims difficult "problems aroused people and social discontent of the insurance industry, the insurance industry's weakened credit to survive, seriously restrict the further development of China's insurance industry. In view of this, China's Insurance Regulatory Department has adopted a series of measures to regulate the insurance industry order, safeguard the legitimate rights and interests of consumers.2011 in October, Chinese CIRC Insurance Consumer Protection Bureau was formally established, before the China CIRC have been issued" on the improvement of service quality to implement service commitment issues related to notice >, < China CIRC on strengthening and improving the quality of property insurance claims service advice >, < A Good insurance consumer protection work notice > and < the motor vehicle insurance claims management guidelines and a series of rules and regulations. Since then, carry out the insurance education, smooth channels for complaints, improve the mediation mechanism, solve the backlog of claims, improve information transparency, strengthen supervision, punishment and a series of consumer protection intensive introduction of the new deal. Say, the degree of attention to the insurance consumer protection work reached a hitherto unknown height.
In order to further standardize the insurance service, improve service quality, and effectively protect the legitimate rights and interests of consumers in March 2012, the CIRC issued "on the" 3.15 "insurance service commitment activities notice > (No. [2012]10 CIRC office) requires insurance companies in the international consumer rights day, to carry out the insurance service commitment, centralized public our service commitment. As of July 9, 2012, in the China Insurance Industry Association website released a total of 119 insurance companies in the service commitment, which has 58 main insurance insurance services. Public commitment to protect the legitimate rights and interests of insurance consumers is undoubtedly a useful attempt to standardize the services industry, correct industry unwholesome tendencies. To promote the industry to improve service level and change the industry bad image. At the same time, the insurance company's service commitment in its content and specific implementation process There are also many problems, such as commitment to empty the contents of the general requirements, working as a commitment to consumers; service commitment is ambiguous and controversial, lack of provisions on the liability break and the corresponding punishment mechanism; claims service implementation issues such as the poor quality. The theory also lacks the legal nature of the service commitment the clear definition and legal responsibility. These problems seriously restrict the insurance service commitment play an effective role in safeguarding the interests of consumers.
Under this background, this paper attempts to present the property insurance company service commitment analysis, find out the existing problems and shortcomings, and from the improvement and implementation of property insurance service commitment perspective on strengthening the rights and interests of insurance consumers protection in China related issues put forward some suggestions on the specific content of the article is as follows:
The first part is the introduction, which briefly introduces the background and significance of the research, summarizes the current research status, and points out the innovation and shortcomings of this article.
The second part of the first brief summary of insurance consumer protection issues, preliminary definition of insurance consumers, the necessity of insurance consumer protection are expounded, and the legal nature of the insurance service commitment and the role of nurse Quan Yibao insurance consumers are discussed. It is pointed out that the nature of the insurance company's service commitment have a contract, which constitute the legal sense of the offer, commitment to service content should be part of the contract.
The third part is the collation and analysis of the property insurance company of our country current service commitment. Published in this chapter China Insurance Association website in the property insurance company service commitment as the data source, the details of which 17 property insurance companies pledge respectively in settlement services, three aspects of value-added services and safeguard the interests of customers mechanism the list of comparison and analysis.
Through the theoretical analysis of insurance service commitment, combined with the actual implementation of the insurance service of our country, the fourth part of the article pointed out that the current insurance service commitment in the content and implementation of quality problems, including service commitment publicity is not in place, service provision of unknown controversial content needs to be standardized, service commitment, claims service commitment the implementation of the quality is not high.
The fifth part, aiming at the existing problems of current insurance company service commitment, proposed to improve the implementation of the service commitment, some suggestions on strengthening the insurance consumer protection, respectively from the point of view of insurance companies, the insurance supervision and self-discipline angle angle are discussed. The article suggests that the insurance company should fully assess their practice ability, and specification service commitment, perfect settlement services, fundamentally improve the level of service; Industry Association as the implementation of industry self-discipline organization with the main commitment to do regular supervision and inspection, making appropriate self disciplinary measures and explore the establishment of industry service standards; insurance supervision departments should further smooth channels for complaints, complaints and improve the mechanism. The introduction of third party evaluation disclosure mechanism, establish social supervision system.

【学位授予单位】：西南财经大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：F842.3;D922.284

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