【摘要】：保險(xiǎn)業(yè)作為現(xiàn)代社會的一種經(jīng)濟(jì)補(bǔ)償手段,與銀行、證券共同構(gòu)成了現(xiàn)代金融領(lǐng)域的三大支柱,保險(xiǎn)業(yè)的健康發(fā)展對一個(gè)國家的社會穩(wěn)定、經(jīng)濟(jì)發(fā)展影響深遠(yuǎn)。重大疾病保險(xiǎn)目前在國內(nèi)比較流行,它是針對某些特定的、較為嚴(yán)重疾病而設(shè)計(jì)的險(xiǎn)種。然而,目前我國重大疾病保險(xiǎn)業(yè)尚處在起步階段,發(fā)展不完善,各項(xiàng)規(guī)章制度不健全,因信息不對稱導(dǎo)致的逆向選擇問題比較嚴(yán)重。由于逆向選擇問題的存在,保險(xiǎn)人無法對投保人的風(fēng)險(xiǎn)進(jìn)行完全有效地辨識,只能依據(jù)基礎(chǔ)數(shù)據(jù)以及承保理賠記錄分析結(jié)果得出經(jīng)驗(yàn)。但經(jīng)驗(yàn)分析結(jié)果往往與現(xiàn)實(shí)存在較大出入,據(jù)此計(jì)算出的保險(xiǎn)費(fèi)用也不盡合理,這就造成了保險(xiǎn)市場上高風(fēng)險(xiǎn)投保人將低風(fēng)險(xiǎn)投保人擠出市場的“劣幣驅(qū)逐良幣”的現(xiàn)象。 本研究首先運(yùn)用信息經(jīng)濟(jì)學(xué)的有關(guān)理論對重大疾病保險(xiǎn)中的逆向選擇問題進(jìn)行理論分析,研究結(jié)合中國的實(shí)際情況,深入分析了重大疾病保險(xiǎn)逆向選擇問題的內(nèi)在特征與規(guī)律；梳理和分析了重大疾病保險(xiǎn)逆向選擇的定義及行為界定；分析了重大疾病保險(xiǎn)中逆向選擇的危害；在此基礎(chǔ)上,對重大疾病保險(xiǎn)中的逆向選擇問題進(jìn)行了實(shí)證研究,并提出防范逆向選擇風(fēng)險(xiǎn)策建議。其中,在實(shí)證研究中,本文以重大疾病保險(xiǎn)這一具體險(xiǎn)種為例,通過考察高保額與損失率之間的因果關(guān)系來識別因逆向選擇而引引致的欺詐,即運(yùn)用用多元回歸模型和Tobit回歸模型研究樣本公司參保人投保特種疾病保險(xiǎn)保額的高低與罹患特種疾病而產(chǎn)生的給付醫(yī)療、死亡理賠費(fèi)用等變量問的相關(guān)關(guān)系,得出理賠擬失率與各相關(guān)變量間的關(guān)系的研究結(jié)論。
[Abstract]:As an economic compensation means in modern society, insurance industry, together with banks and securities, constitutes the three pillars of modern financial field. The healthy development of insurance industry has a profound impact on the social stability and economic development of a country. Major disease insurance is currently popular in China, it is designed for some specific, more serious diseases. However, at present, the insurance industry of major diseases in China is still in its infancy. The development is not perfect, the rules and regulations are not perfect, and the problem of adverse selection caused by asymmetric information is serious. Due to the existence of adverse selection problem, the insurer can not identify the risk of the insured completely and effectively, and can only get experience based on the basic data and the analysis results of the insurance claim records. However, the results of empirical analysis often differ from reality, and the calculated insurance costs are not reasonable, which leads to the phenomenon of "Bad money drives out good" in the insurance market where the high-risk policyholders crowd out the low-risk policyholders. In this study, we use the theory of information economics to analyze the problem of adverse selection in the insurance of major diseases. Combining with the actual situation in China, we deeply analyze the inherent characteristics and laws of adverse selection in the insurance of major diseases. The definition and behavior definition of adverse selection in major disease insurance are analyzed, and the harm of adverse selection in major disease insurance is analyzed. On this basis, the reverse selection problem in major disease insurance is studied empirically. It also puts forward some suggestions on how to prevent the risk of adverse selection. Among them, in the empirical study, this paper takes the major disease insurance as an example to identify the fraud caused by adverse selection by examining the causal relationship between the high coverage and the loss rate. That is, using the multivariate regression model and the Tobit regression model to study the correlation between the insured amount of special disease insurance in the sample company and the medical treatment, death claim cost and other variables caused by the special disease. The conclusion is drawn that the relationship between the pseudo loss rate of claim and the relevant variables.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：F842.684

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本文編號：2150289