【摘要】：隨著國(guó)內(nèi)保險(xiǎn)市場(chǎng)的不斷發(fā)展和競(jìng)爭(zhēng)的日漸加劇,保險(xiǎn)理賠作為客戶接觸和感知保險(xiǎn)服務(wù)、履行保險(xiǎn)合同的重要環(huán)節(jié),提高理賠效率、加強(qiáng)和改善理賠服務(wù)質(zhì)量、保障維護(hù)保險(xiǎn)消費(fèi)者權(quán)益一直以來(lái)就是A保險(xiǎn)公司關(guān)注的核心問(wèn)題。理賠垂直管理體制改革是A保險(xiǎn)公司從2010年開(kāi)始進(jìn)行的一項(xiàng)重大的管理模式變革。在近兩年的試點(diǎn)、運(yùn)行過(guò)程中,該模式將基層公司理賠部門(mén)的人、財(cái)、物等方面的權(quán)力收歸上級(jí)公司統(tǒng)一調(diào)配,增強(qiáng)了上級(jí)公司對(duì)基層公司的宏觀調(diào)控和監(jiān)管,維護(hù)了上級(jí)公司的權(quán)威,推動(dòng)和加速了基層公司的經(jīng)營(yíng)意識(shí)與方向的轉(zhuǎn)變,提高了理賠質(zhì)量,也促進(jìn)了理賠業(yè)務(wù)專(zhuān)業(yè)化水平。但這種模式容易引發(fā)“條條矛盾”和“條塊矛盾”,在一定程度上削弱了基層公司完整功能的發(fā)揮,加大了理賠垂直管理部門(mén)違規(guī)、違紀(jì)、腐敗現(xiàn)象發(fā)生的幾率。為此,必須對(duì)該模式進(jìn)行優(yōu)化改革。首先要加強(qiáng)理賠垂直管理部門(mén)的自身建設(shè),完善內(nèi)部激勵(lì)機(jī)制、建立健全管理與監(jiān)督體系；其次,要規(guī)范理賠垂直管理部門(mén)與基層公司之間的關(guān)系,進(jìn)一步合理的劃分上級(jí)公司與基層公司的職責(zé)權(quán)限,建立和健全理賠垂直管理部門(mén)和基層公司的協(xié)調(diào)機(jī)制與爭(zhēng)議解決機(jī)制；最后,可在上級(jí)公司與基層公司合理界定職權(quán)范圍的基礎(chǔ)上,進(jìn)行相應(yīng)的調(diào)整。
[Abstract]:With the increasing development of the domestic insurance market and the increasing competition, the insurance claim is the important part of the customer's contact and perception insurance service, the performance of the insurance contract, the improvement of the settlement efficiency, the enhancement and the improvement of the quality of the settlement of the claim. The protection and maintenance of the consumer's rights and interests has always been a core issue of the company's concern. The system reform of the vertical management of claims is a major change of management mode from the beginning of 2010 to the A-insurance company. In the past two years of pilot and operation, this mode, in the course of operation, will collect the power of people, wealth, and the like in the claim department of the base-level company to the superior company for unified allocation, and enhance the macro-control and supervision of the higher-level company to the base-level company, and maintain the authority of the higher-level company. The transformation of the management consciousness and direction of the grass-roots company is promoted and accelerated, the quality of the settlement is improved, and the professional level of the settlement business is also promoted. But this mode can easily lead to the "the contradictions of the strip" and the "bar-block conflict", which has weakened the full function of the base-base company to a certain extent, and increased the probability of the violation of the vertical management department of the claim, the violation of the law, and the occurrence of corruption. To this end, the model must be optimized for reform. First, we should strengthen the self-construction of the vertical management department of the claims, improve the internal incentive mechanism, establish and improve the management and supervision system, and then standardize the relationship between the vertical management department of the claim and the base-level company, and further reasonably divide the responsibilities of the higher-level company and the base-level company. Establish and perfect the coordination mechanism and dispute settlement mechanism of the vertical management department of the claim and the base-level company; and finally, the corresponding adjustment can be made on the basis of the reasonable definition of the terms of reference between the superior company and the grass-roots company.
【學(xué)位授予單位】：長(zhǎng)沙理工大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：F840.4;F842.3

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