本文選題：拒賠金額 + 減賠金額　； 參考：《云南財經(jīng)大學(xué)學(xué)報》2014年05期

【摘要】：保險理賠難已引起社會的高度關(guān)注。對2000~2012年162個健康保險理賠訴訟樣本進行實證分析,發(fā)現(xiàn)惜賠99例,惜賠率61.1%,其中拒賠72例,拒賠占惜賠的72.7%。保險惜賠深受索賠人談判能力、保險金額、理賠人員素質(zhì)的影響。保險公司對投保人拒賠金額甚于被保險人,對職工減賠金額弱于農(nóng)民。無論拒賠金額還是減賠金額,均與保險金額正相關(guān)。保險公司對重大疾病拒賠金額甚于一般疾病,對住院超過15日的減賠金額甚于住院少于15日的金額。區(qū)縣支公司拒賠金額甚于地市分公司,中西部地區(qū)拒賠金額和減賠金額均甚于東部地區(qū)。
[Abstract]:The difficulty of insurance claims has aroused great concern of the society.Based on the empirical analysis of 162 cases of health insurance claims from 2000 to 2012, 99 cases of compensation were found, including 72 cases of negative compensation and 72.7% of the total of 72.7% of the total.The insurance indemnity is affected by the claimant's negotiation ability, insurance amount and the quality of the claim personnel.The insurance company claims more to the insured than the insured, and less to the workers than the farmers.No matter how much you refuse to pay or how much you reduce your claim, it is positively related to the amount of insurance.The insurance company refuses to pay more for major illness than for general illness, and for more than 15 days of hospitalization, more than 15 days of hospitalization.The district and county branch company refused to compensate more than the prefectural branch, and the central and western regions refused to pay more than the eastern region.
【作者單位】： 北京航空航天大學(xué)經(jīng)濟管理學(xué)院;北京大學(xué)經(jīng)濟學(xué)院;
【基金】：國家社會科學(xué)基金項目“基于惜賠視角的保險消費者權(quán)益保護機制設(shè)計”(13BJY181) 教育部規(guī)劃基金項目“中國健康、意外保險欺詐的識別及預(yù)警研究”(11YJA790223)
【分類號】：F842.684

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1 周建濤;秦炳山;迪麗;王泉涌;;健康、意外保險惜賠識別[J];新疆社會科學(xué);2013年03期

【二級參考文獻】

中國期刊全文數(shù)據(jù)庫 前1條

1 周建濤;巨s，

本文編號：1764143