【摘要】：隨著國民收入的不斷提高,我國汽車保有量逐年上升,機動車保險行業(yè)也隨之得到快速發(fā)展,機動車保險已經(jīng)逐漸成為與國民生活密不可分的險種。中銀保險公司是一家主要經(jīng)營車險業(yè)務的財產保險公司,雖然近幾年來車險保費收入和公司規(guī)模保持著快速增長的趨勢,但是公司的經(jīng)營效益和利潤卻呈現(xiàn)了負增長的態(tài)勢。車險費率的改革導致車險車損險費率下降明顯,同時保險公司住處的賠付成本卻在不斷上升,使中銀保險公司的車險業(yè)務的利潤受到雙重擠壓。2015年末中銀保險車險的綜合成本率達到了 103.25% ,較去年上升了 1.62個百分點,車險業(yè)務持續(xù)連年虧損走勢。根據(jù)中銀保險歷年的數(shù)據(jù)分析來看導致中銀保險連年虧損局面的因素除了車險費率改革、承保手續(xù)費上升、進口車輛賠付成本上升、車險業(yè)務結構不合理和國家死亡傷殘標準提高外,車險欺詐案件的持續(xù)增多也是個主要原因。中銀保險公司也已經(jīng)開始認識到車險欺詐的危害性,并針對車險欺詐采取了一系列的管控措施,但受制于公司規(guī)模、人員素質、重視程度等多重因素并沒有建立起一套完整和行之有效的車險欺詐案件的管控機制,車險反欺詐工作結果并不理想。本為旨在結合歐美、日韓等車險行業(yè)起步較早的發(fā)達國家的機動車保險欺詐的風險管理方法和研究,總結出一套適合中銀保險公司的機動車保險欺詐風險管理方案。首先論述了機動車保險欺詐的相關研究理論及學說,并分析了車險欺詐的形成原因、表現(xiàn)方式和危害。其次闡述了目前中銀保險車險業(yè)務經(jīng)營現(xiàn)狀及針對車險欺詐采取的一系列的管控措施,并分析了中銀保險車險欺詐管理中存在的問題和不足。再次,從完善公司架構、建立欺詐識別模型、構建車險欺詐預警系統(tǒng)、總結打擊車險欺詐方法四個方面設計了一套適合中銀保險公司的車險欺詐風險管理方案。最后,針對車險欺詐管理方案總結了一系列的保障措施和手段以保證管理方案的順利實施。車險欺詐的猖獗不僅擾亂了保險公司正常的車險經(jīng)營,同時也侵害了其他合法投保人的正當利益,對我國車險行業(yè)的健康穩(wěn)定發(fā)展產生了嚴重的阻礙。車險業(yè)務在中銀保險的業(yè)務占比中占有絕對的份額,所以建立一套行之有效的適合中銀保險公司的機動車保險欺詐風險管理方案對降低中銀保險的賠付率、綜合成本率進而實現(xiàn)車險業(yè)務經(jīng)營利潤意義重大。
[Abstract]:With the continuous improvement of national income, the amount of automobile ownership in China has increased year by year, and the motor vehicle insurance industry has also developed rapidly. The motor vehicle insurance has gradually become an inseparable danger to the national life. The company's scale is growing fast, but the company's profit and profit show a negative growth trend. The reform of the car insurance rate has led to the decrease of the rate of vehicle insurance and the cost of the insurance company's settlement, which makes the profit of the insurance company's car insurance business double squeezed.2015 At the end of the year, the comprehensive cost rate of China silver insurance car insurance reached 103.25%, up 1.62 percentage points from last year, and the car insurance business continued to lose the trend in successive years. According to the data analysis of China silver insurance over the years, the factors that lead to the continuous loss situation of China silver insurance are in addition to the reform of the car insurance rate, the increase of the insurance fee and the cost of the import vehicles. In addition, the increasing number of car insurance fraud cases is also the main reason. China bank insurance company has also begun to recognize the harmfulness of car insurance fraud, and take a series of control measures against car insurance fraud, but it is subject to the scale of the company, the quality of personnel, and the degree of attention. Multiple factors do not set up a complete and effective control mechanism for car insurance fraud cases, and the results of auto insurance against fraud are not ideal. This is a risk management method and Research on motor vehicle insurance fraud in developed countries, which are aimed at the earlier developed countries, such as Europe and America, Japan and South Korea. The company's motor vehicle insurance fraud risk management scheme first discusses the related research theory and theory of motor vehicle insurance fraud, and analyzes the causes of the formation, expression and harm of car insurance fraud. Secondly, it expounds the current situation of the business operation of the insurance car insurance and a series of measures and control measures for the vehicle insurance fraud. The problems and shortcomings exist in the insurance fraud management of China silver insurance. Thirdly, from the improvement of the company structure, the establishment of fraud identification model, the construction of the car insurance fraud early warning system, and the four aspects of the method of combating the car insurance fraud, a set of risk management scheme is designed suitable for the insurance company of China silver insurance company. A series of safeguard measures and means are put forward to ensure the smooth implementation of the management scheme. The rampant fraud of vehicle insurance not only disrupts the normal operation of insurance companies, but also infringes on the legitimate interests of other legal insurers, and has seriously hindered the healthy and stable development of the car insurance industry in China. It is of great significance to establish a set of effective risk management scheme for the insurance fraud of China silver insurance company to reduce the rate of indemnity of China silver insurance and the comprehensive cost rate and then realize the operation profit of car insurance business.
【學位授予單位】：西安理工大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：D922.284;F842.634

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