本文選題：財險市場 + 保險欺詐　； 參考：《山東大學》2014年碩士論文

【摘要】：近年來隨著山東財產(chǎn)保險行業(yè)的發(fā)展,其社會價值得到了政府部門和監(jiān)管機構(gòu)的肯定和認可。與此同時,財產(chǎn)保險欺詐案件呈上升趨勢,它擾亂了正常的保險經(jīng)營活動,而且使保險公司的社會威信和信譽度受到嚴重挑釁和質(zhì)疑。 本文的重要特點就是對保險欺詐與反欺詐做系統(tǒng)性的介紹,目的是要曲突徙薪,防患于未然。山東財險市場上保險欺詐案件形成的原因,既有客觀性又有主觀性,例如：社會的某些不良習氣的存在；某些被保險人法律意識的淡薄進而置法律于不顧,鋌而走險；還有保險人自身內(nèi)部管控制度不嚴格或者本身就從事欺詐活動等。因此,研究該類問題,是一項系統(tǒng)工程。監(jiān)管部門和立法機構(gòu)制定切實可行措施,消除各類保險欺詐案件形成的要素,把案發(fā)量降到最低。這對維護保險公司社會保障功能、保護消費者的合法權(quán)益具有重大的現(xiàn)實意義。 本文由以下幾個章節(jié)組成： 第一章介紹選題背景和現(xiàn)實意義。首先介紹了現(xiàn)在保險欺詐出現(xiàn)的新的表現(xiàn)形式,保險公司打擊保險欺詐的重要性。本文的整體研究框架結(jié)構(gòu)和研究方法,特別是介紹本文的創(chuàng)新之處以及下步需要改進的地方。 第二章介紹了國內(nèi)外關(guān)于保險欺詐理論的研究成果。對文章參考的文獻分類進行介紹以及對本文進行的理論指導。 第三章介紹國外的反欺詐的組織和法律保障,回歸國內(nèi)保險欺詐案件的發(fā)展趨勢和反欺詐的現(xiàn)狀。再對山東財產(chǎn)保險公司保險欺詐與反欺詐情況進行重點分析介紹。 第四章結(jié)合作者本人在工作崗位中參與的山東地區(qū)保險欺詐調(diào)查,運用微證尋案案例分析方法對欺詐風險點和應(yīng)對措施進行詳細介紹,區(qū)別了普通保險欺詐案件。 第五章從具體操作可行性為出發(fā)點,對山東財產(chǎn)保險公司下一步如何提升全程各個環(huán)節(jié)反欺詐能力提出了思考和對策。 第六章進一步強調(diào)保險欺詐和反欺詐是個系統(tǒng)的、長期的、博弈的過程。只有整個社會的共同參與,才能達到保險反欺詐理想的效果。 總之,本文對于保險欺詐理論和現(xiàn)狀進行系統(tǒng)介紹和分析,結(jié)合具體欺詐案例表現(xiàn)形式和解決方法,從可操作性、簡便性等貼近實戰(zhàn)的角度來分析,從而有針對性的提出保險反欺詐的對策,本文研究對山東財產(chǎn)保險準確地識別欺詐行為,增強防范,維護正常市場秩序有著重要的意義。本文實用價值有利于不斷增強和嚴格財產(chǎn)保險公司內(nèi)部的管控制度,強化責任追究。無論是保險機構(gòu)的管理人員,還是在一線的案件調(diào)查人員都有非常大的幫助作用。
[Abstract]:In recent years, with the development of Shandong property insurance industry, its social value has been affirmed and recognized by government departments and regulators.At the same time, the property insurance fraud cases are on the rise, which disturbs the normal insurance business activities, and makes the social prestige and credibility of the insurance companies seriously challenged and questioned.The important feature of this paper is to introduce insurance fraud and anti-fraud systematically.The reasons for the formation of insurance fraud cases in Shandong property insurance market are both objective and subjective, such as: the existence of some bad social habits;There is also the insurer's own internal control system is not strict or itself engaged in fraudulent activities and so on.Therefore, it is a system engineering to study this kind of problem.Regulators and legislatures have worked out practical measures to eliminate the elements of various insurance fraud cases and to minimize the number of cases.It is of great practical significance to safeguard the social security function of insurance companies and protect the legitimate rights and interests of consumers.This article consists of the following chapters:The first chapter introduces the background and practical significance of the topic.Firstly, the paper introduces the new manifestation of insurance fraud and the importance of insurance company to combat insurance fraud.The whole research frame structure and research method of this paper are introduced, especially the innovation of this paper and the next step need to be improved.The second chapter introduces the research results of insurance fraud theory at home and abroad.This paper introduces the literature classification and the theoretical guidance of this paper.The third chapter introduces the organization and legal protection of foreign anti-fraud, return to the development trend of domestic insurance fraud cases and the current situation of anti-fraud.Then the Shandong property insurance company insurance fraud and anti-fraud are analyzed and introduced.The fourth chapter combines the investigation of insurance fraud in Shandong area in which the author participates in the work station, and introduces the fraud risk point and countermeasures in detail by using the case analysis method of micro-proof seeking case, and distinguishes the common insurance fraud case.The fifth chapter from the concrete operation feasibility as the starting point, proposed the thought and the countermeasure to the Shandong property insurance company next how to enhance the whole course each link anti-fraud ability.Chapter 6 further emphasizes that insurance fraud and anti-fraud are systematic, long-term and game-based processes.Only the participation of the whole society can achieve the ideal effect of anti-fraud insurance.In a word, this paper systematically introduces and analyzes the theory and current situation of insurance fraud, combining with the manifestation and solution of specific fraud cases, from the point of view of maneuverability, simplicity and so on close to the actual combat.Therefore, it is of great significance for Shandong property insurance to identify fraud accurately, strengthen prevention and maintain normal market order.The practical value of this paper is conducive to strengthening and tightening the internal control system of the property insurance company and strengthening the accountability.Both insurance executives and investigators in front-line cases are of great help.
【學位授予單位】：山東大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：D922.284;F842.65

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