本文選題：風(fēng)險(xiǎn)管理 + 車險(xiǎn)欺詐��； 參考：《電子科技大學(xué)》2013年碩士論文

【摘要】：近年來(lái)在保險(xiǎn)行業(yè)，由于新成立的保險(xiǎn)主體迅猛增多，保險(xiǎn)市場(chǎng)競(jìng)爭(zhēng)日趨激烈，各家保險(xiǎn)公司自身的經(jīng)營(yíng)能力將面臨嚴(yán)峻考驗(yàn)。在有限的市場(chǎng)規(guī)模增長(zhǎng)面前，各家保險(xiǎn)公司為將自身的盈利能力保持到一定水平，就需要對(duì)風(fēng)險(xiǎn)管理提出更高要求，其中對(duì)理賠工作的風(fēng)險(xiǎn)管理將是重中之重。 機(jī)動(dòng)車輛保險(xiǎn)作為財(cái)產(chǎn)保險(xiǎn)公司的主營(yíng)業(yè)務(wù)險(xiǎn)種，其規(guī)模占總業(yè)務(wù)規(guī)模的75%以上，所以業(yè)內(nèi)十分重視對(duì)車險(xiǎn)業(yè)務(wù)的賠案真實(shí)性督察工作。本文就是順應(yīng)保險(xiǎn)業(yè)目前關(guān)注探討如何反車險(xiǎn)欺詐工作這一趨勢(shì)，以一家市級(jí)保險(xiǎn)公司——CP保險(xiǎn)公司為平臺(tái)，運(yùn)用風(fēng)險(xiǎn)指標(biāo)法，總結(jié)研究了識(shí)別欺詐賠案的具體風(fēng)險(xiǎn)指標(biāo)。并運(yùn)用CP保險(xiǎn)公司2012年度查實(shí)的虛假賠案，對(duì)總結(jié)出的風(fēng)險(xiǎn)指標(biāo)做進(jìn)一步有效性論證，探討了目前的風(fēng)險(xiǎn)指標(biāo)有效預(yù)警的范圍和局限性。 反車險(xiǎn)欺詐風(fēng)險(xiǎn)預(yù)警指標(biāo)的建立其意義是為今后我國(guó)保險(xiǎn)行業(yè)建設(shè)反車險(xiǎn)欺詐理賠系統(tǒng)提供理賠數(shù)據(jù)積累和風(fēng)險(xiǎn)指標(biāo)研究經(jīng)驗(yàn)，以實(shí)現(xiàn)我國(guó)效仿國(guó)外保險(xiǎn)行業(yè)先進(jìn)經(jīng)驗(yàn)，建立跨保險(xiǎn)公司的反欺詐聯(lián)盟的目標(biāo)。并希望運(yùn)用這些風(fēng)險(xiǎn)預(yù)警指標(biāo)建立數(shù)據(jù)模型，嵌入到各家保險(xiǎn)公司理賠系統(tǒng)中，，實(shí)現(xiàn)系統(tǒng)能自動(dòng)過(guò)濾篩查識(shí)別賠案的風(fēng)險(xiǎn)系數(shù)。最終實(shí)現(xiàn)利用技術(shù)手段提高對(duì)車險(xiǎn)欺詐賠案的識(shí)別率，幫助保險(xiǎn)公司提高風(fēng)險(xiǎn)管理水平的目標(biāo)。
[Abstract]:In recent years, the insurance industry, due to the rapid increase of newly established insurance bodies, insurance market competition is becoming increasingly fierce, each insurance company will face a severe test of its own business ability. In the face of the limited market growth, in order to maintain their profitability to a certain level, insurance companies need to put forward higher requirements for risk management, in which the risk management of claims management will be the most important. As the main business insurance of property insurance company, motor vehicle insurance accounts for more than 75% of the total business scale. In accordance with the current trend of the insurance industry to pay close attention to how to deal with the fraud in automobile insurance, this paper takes a municipal insurance company, CP insurance company, as the platform, and uses the risk index method to summarize and study the specific risk indicators for identifying fraud and compensation cases. By using the false compensation case verified by CP Insurance Company in 2012, the paper further demonstrates the validity of the risk index summarized, and discusses the scope and limitation of effective early warning of the current risk index. The significance of establishing early warning index of anti-vehicle insurance fraud risk is to provide the accumulation of claim data and research experience of risk index for the construction of anti-vehicle insurance fraud settlement system in our country in the future, so as to realize our country emulate the advanced experience of foreign insurance industry. The goal of establishing an anti-fraud alliance across insurance companies. It is hoped that the data model can be established by using these risk early warning indexes and embedded in the claim system of insurance companies so that the system can automatically filter and screen the risk coefficient of identifying compensation cases. Finally, the goal of using technical means to improve the recognition rate of vehicle insurance fraud and compensation cases and to help insurance companies improve their risk management level is realized.
【學(xué)位授予單位】：電子科技大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：F842.3

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