机动车辆保险反欺诈的研究

发布时间：2018-02-21 22:18

本文关键词： 机动车辆保险反欺诈研究　出处：《山东大学》2017年硕士论文　论文类型：学位论文

【摘要】：随着我国生产经济的不断增长,我国的机动车数量急剧上升,因机动车发生的交通事故与日增多,造成较大的财产损失和人身伤亡,机动车辆保险发挥着重要的社会保障作用。机动车辆保险逐步影响我国人民的日常生活,且联系非常紧密,该险种为车辆所有者提供在发生保险事故时遭受的经济损失和财产损失的补偿,进而为投保人的生活提供相应的保障,现已成为我国财险保险公司中的支柱险种,是保险公司保费收入的重要来源,占财产保险公司业务收入的70%以上。随着我国机动车辆保险的快速发展,机动车辆保险欺诈案件日渐增多,已经成为了限制车险发展的瓶颈。保险欺诈案件给保险公司的理赔带来较大困难,造成了车险市场"高保费、高赔付、低效益"的经营现状,增加了保险公司的赔付成本和运营管理难度,对整个车险行业的可持续发展产生了极大的消极影响,造成车险赔付率指标逐年上升,部分经营车险的保险公司甚至开始亏损,严重影响了保险行业的健康发展。而保险欺诈案件的形式有很多,有保险方的欺诈,有保险代理方的欺诈,还有第三方和被保险方共同进行的欺诈,想要研究解决该类问题,是一项系统工程。然而,面对我国保险欺诈形势日益严峻的现状,我国保险公司以及监管部门对于保险欺诈的严重危害性还没有深刻的认识,对保险欺诈的研究尚不充分,保险市场化改革也尚不完善。如何通过本次市场化改革的契机,净化保险市场环境,改善经营状况,提升服务质量,解决机动车辆保险欺诈行为这一顽疾已经成为各家保险公司理赔工作的重中之重。本文对保险欺诈做出系统性介绍,并结合案例具体说明了保险欺诈的形式,从风险管理、不完全合约、道德风险以及信息不对称等理论方面多种角度阐述车辆保险欺诈发生的原因,以保证车辆保险反欺诈有坚实的理论基础。通过分析目前山东省机动车辆保险欺诈的现状,揭示欺诈行为对行业的严重影响,明确机动车辆保险反欺诈工作的重要性。结合目前我国财险公司采取的反欺诈措施,明确我国反欺诈的漏洞,并借鉴西方先进的经验,与我国的机动车辆保险反欺诈实际情况相结合,根据山东省机动车辆保险欺诈的实际情况,提出符合实际工作需求的反欺诈机制。本文的实用价值在于设计了一套机动车辆保险反欺诈机制,该机制有利于降低保险行业车险欺诈案件的发生率,在行业内营造有效、快速的理赔环境,在提升客户品质的同时,净化保险市场环境。
[Abstract]:With the continuous growth of our country's production economy, the number of motor vehicles in our country has risen sharply. As a result of the traffic accidents and the increasing number of motor vehicles, great property losses and personal casualties have been caused. Motor vehicle insurance plays an important role in social security. Motor vehicle insurance gradually affects the daily life of our people and is closely linked. This kind of insurance provides vehicle owners with compensation for economic losses and property losses suffered in the event of an insurance accident, and thus provides corresponding protection for the life of policy holders. It has become a pillar of insurance in property insurance companies in China. Insurance company is an important source of insurance premium income, accounting for more than 70% of the business income of property insurance companies. With the rapid development of motor vehicle insurance in China, motor vehicle insurance fraud cases are increasing day by day. It has become a bottleneck restricting the development of auto insurance. Insurance fraud cases bring greater difficulties to the settlement of claims of insurance companies, resulting in the "high premium, high compensation, low benefit" management status quo in the auto insurance market. It increases the indemnity cost of insurance companies and the difficulty of operation management, and has a great negative impact on the sustainable development of the whole auto insurance industry, resulting in an increase in the insurance coverage rate index year by year, and some insurance companies that operate auto insurance even begin to lose money. It has seriously affected the healthy development of the insurance industry. However, there are many forms of insurance fraud cases, including fraud by insurance parties, fraud by insurance agents, and fraud jointly carried out by third parties and insured parties. However, in the face of the increasingly serious situation of insurance fraud in China, there is no deep understanding of the serious harm of insurance fraud in our insurance companies and regulatory departments, and the research on insurance fraud is not sufficient. How to purify the insurance market environment, improve the operating conditions, and improve the service quality through the opportunity of this market-oriented reform, To solve the problem of motor vehicle insurance fraud has become the top priority of the insurance companies. This paper makes a systematic introduction to insurance fraud, and illustrates the form of insurance fraud from the risk management. The reasons of vehicle insurance fraud are expounded from the aspects of incomplete contract, moral hazard and information asymmetry. In order to ensure that the vehicle insurance anti-fraud has a solid theoretical basis. Through the analysis of the current situation of vehicle insurance fraud in Shandong Province, reveals the serious impact of fraud on the industry, Make clear the importance of anti-fraud work in motor vehicle insurance. Combined with the anti-fraud measures taken by property insurance companies in our country at present, make clear the loopholes of anti-fraud in our country, and learn from the advanced experience of the West. Combined with the actual situation of anti-fraud of motor vehicle insurance in China, according to the actual situation of insurance fraud of motor vehicle in Shandong Province, The practical value of this paper lies in the design of a set of anti-fraud mechanism for motor vehicle insurance, which is helpful to reduce the incidence of vehicle insurance fraud cases in insurance industry and to create an effective system in the industry. Fast claim environment, while improving customer quality, purifying insurance market environment.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：D922.284;F842.634

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