本文關(guān)鍵詞： 機(jī)動(dòng)車(chē)輛 保險(xiǎn) 反欺詐 研究　出處：《山東大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：隨著我國(guó)生產(chǎn)經(jīng)濟(jì)的不斷增長(zhǎng),我國(guó)的機(jī)動(dòng)車(chē)數(shù)量急劇上升,因機(jī)動(dòng)車(chē)發(fā)生的交通事故與日增多,造成較大的財(cái)產(chǎn)損失和人身傷亡,機(jī)動(dòng)車(chē)輛保險(xiǎn)發(fā)揮著重要的社會(huì)保障作用。機(jī)動(dòng)車(chē)輛保險(xiǎn)逐步影響我國(guó)人民的日常生活,且聯(lián)系非常緊密,該險(xiǎn)種為車(chē)輛所有者提供在發(fā)生保險(xiǎn)事故時(shí)遭受的經(jīng)濟(jì)損失和財(cái)產(chǎn)損失的補(bǔ)償,進(jìn)而為投保人的生活提供相應(yīng)的保障,現(xiàn)已成為我國(guó)財(cái)險(xiǎn)保險(xiǎn)公司中的支柱險(xiǎn)種,是保險(xiǎn)公司保費(fèi)收入的重要來(lái)源,占財(cái)產(chǎn)保險(xiǎn)公司業(yè)務(wù)收入的70%以上。隨著我國(guó)機(jī)動(dòng)車(chē)輛保險(xiǎn)的快速發(fā)展,機(jī)動(dòng)車(chē)輛保險(xiǎn)欺詐案件日漸增多,已經(jīng)成為了限制車(chē)險(xiǎn)發(fā)展的瓶頸。保險(xiǎn)欺詐案件給保險(xiǎn)公司的理賠帶來(lái)較大困難,造成了車(chē)險(xiǎn)市場(chǎng)"高保費(fèi)、高賠付、低效益"的經(jīng)營(yíng)現(xiàn)狀,增加了保險(xiǎn)公司的賠付成本和運(yùn)營(yíng)管理難度,對(duì)整個(gè)車(chē)險(xiǎn)行業(yè)的可持續(xù)發(fā)展產(chǎn)生了極大的消極影響,造成車(chē)險(xiǎn)賠付率指標(biāo)逐年上升,部分經(jīng)營(yíng)車(chē)險(xiǎn)的保險(xiǎn)公司甚至開(kāi)始虧損,嚴(yán)重影響了保險(xiǎn)行業(yè)的健康發(fā)展。而保險(xiǎn)欺詐案件的形式有很多,有保險(xiǎn)方的欺詐,有保險(xiǎn)代理方的欺詐,還有第三方和被保險(xiǎn)方共同進(jìn)行的欺詐,想要研究解決該類(lèi)問(wèn)題,是一項(xiàng)系統(tǒng)工程。然而,面對(duì)我國(guó)保險(xiǎn)欺詐形勢(shì)日益嚴(yán)峻的現(xiàn)狀,我國(guó)保險(xiǎn)公司以及監(jiān)管部門(mén)對(duì)于保險(xiǎn)欺詐的嚴(yán)重危害性還沒(méi)有深刻的認(rèn)識(shí),對(duì)保險(xiǎn)欺詐的研究尚不充分,保險(xiǎn)市場(chǎng)化改革也尚不完善。如何通過(guò)本次市場(chǎng)化改革的契機(jī),凈化保險(xiǎn)市場(chǎng)環(huán)境,改善經(jīng)營(yíng)狀況,提升服務(wù)質(zhì)量,解決機(jī)動(dòng)車(chē)輛保險(xiǎn)欺詐行為這一頑疾已經(jīng)成為各家保險(xiǎn)公司理賠工作的重中之重。本文對(duì)保險(xiǎn)欺詐做出系統(tǒng)性介紹,并結(jié)合案例具體說(shuō)明了保險(xiǎn)欺詐的形式,從風(fēng)險(xiǎn)管理、不完全合約、道德風(fēng)險(xiǎn)以及信息不對(duì)稱等理論方面多種角度闡述車(chē)輛保險(xiǎn)欺詐發(fā)生的原因,以保證車(chē)輛保險(xiǎn)反欺詐有堅(jiān)實(shí)的理論基礎(chǔ)。通過(guò)分析目前山東省機(jī)動(dòng)車(chē)輛保險(xiǎn)欺詐的現(xiàn)狀,揭示欺詐行為對(duì)行業(yè)的嚴(yán)重影響,明確機(jī)動(dòng)車(chē)輛保險(xiǎn)反欺詐工作的重要性。結(jié)合目前我國(guó)財(cái)險(xiǎn)公司采取的反欺詐措施,明確我國(guó)反欺詐的漏洞,并借鑒西方先進(jìn)的經(jīng)驗(yàn),與我國(guó)的機(jī)動(dòng)車(chē)輛保險(xiǎn)反欺詐實(shí)際情況相結(jié)合,根據(jù)山東省機(jī)動(dòng)車(chē)輛保險(xiǎn)欺詐的實(shí)際情況,提出符合實(shí)際工作需求的反欺詐機(jī)制。本文的實(shí)用價(jià)值在于設(shè)計(jì)了一套機(jī)動(dòng)車(chē)輛保險(xiǎn)反欺詐機(jī)制,該機(jī)制有利于降低保險(xiǎn)行業(yè)車(chē)險(xiǎn)欺詐案件的發(fā)生率,在行業(yè)內(nèi)營(yíng)造有效、快速的理賠環(huán)境,在提升客戶品質(zhì)的同時(shí),凈化保險(xiǎn)市場(chǎng)環(huán)境。
[Abstract]:With the continuous growth of our country's production economy, the number of motor vehicles in our country has risen sharply. As a result of the traffic accidents and the increasing number of motor vehicles, great property losses and personal casualties have been caused. Motor vehicle insurance plays an important role in social security. Motor vehicle insurance gradually affects the daily life of our people and is closely linked. This kind of insurance provides vehicle owners with compensation for economic losses and property losses suffered in the event of an insurance accident, and thus provides corresponding protection for the life of policy holders. It has become a pillar of insurance in property insurance companies in China. Insurance company is an important source of insurance premium income, accounting for more than 70% of the business income of property insurance companies. With the rapid development of motor vehicle insurance in China, motor vehicle insurance fraud cases are increasing day by day. It has become a bottleneck restricting the development of auto insurance. Insurance fraud cases bring greater difficulties to the settlement of claims of insurance companies, resulting in the "high premium, high compensation, low benefit" management status quo in the auto insurance market. It increases the indemnity cost of insurance companies and the difficulty of operation management, and has a great negative impact on the sustainable development of the whole auto insurance industry, resulting in an increase in the insurance coverage rate index year by year, and some insurance companies that operate auto insurance even begin to lose money. It has seriously affected the healthy development of the insurance industry. However, there are many forms of insurance fraud cases, including fraud by insurance parties, fraud by insurance agents, and fraud jointly carried out by third parties and insured parties. However, in the face of the increasingly serious situation of insurance fraud in China, there is no deep understanding of the serious harm of insurance fraud in our insurance companies and regulatory departments, and the research on insurance fraud is not sufficient. How to purify the insurance market environment, improve the operating conditions, and improve the service quality through the opportunity of this market-oriented reform, To solve the problem of motor vehicle insurance fraud has become the top priority of the insurance companies. This paper makes a systematic introduction to insurance fraud, and illustrates the form of insurance fraud from the risk management. The reasons of vehicle insurance fraud are expounded from the aspects of incomplete contract, moral hazard and information asymmetry. In order to ensure that the vehicle insurance anti-fraud has a solid theoretical basis. Through the analysis of the current situation of vehicle insurance fraud in Shandong Province, reveals the serious impact of fraud on the industry, Make clear the importance of anti-fraud work in motor vehicle insurance. Combined with the anti-fraud measures taken by property insurance companies in our country at present, make clear the loopholes of anti-fraud in our country, and learn from the advanced experience of the West. Combined with the actual situation of anti-fraud of motor vehicle insurance in China, according to the actual situation of insurance fraud of motor vehicle in Shandong Province, The practical value of this paper lies in the design of a set of anti-fraud mechanism for motor vehicle insurance, which is helpful to reduce the incidence of vehicle insurance fraud cases in insurance industry and to create an effective system in the industry. Fast claim environment, while improving customer quality, purifying insurance market environment.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：D922.284;F842.634

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