【摘要】：現(xiàn)代保險(xiǎn)是由古代的巴比倫和腓尼基的船貨抵押借貸思想逐漸演化而來(lái)的。1384年在佛羅倫薩誕生了世界第一份具有現(xiàn)代意義的保險(xiǎn)單。在這張保單中有明確的保險(xiǎn)標(biāo)的、明確的保險(xiǎn)責(zé)任,如海難事故,其中包括船舶破損、擱淺、火災(zāi)、或沉沒(méi)造成的損失或傷害事故。保險(xiǎn)是人類(lèi)運(yùn)用科學(xué)原理由大多數(shù)人分?jǐn)偵贁?shù)人損失的一種風(fēng)險(xiǎn)轉(zhuǎn)移機(jī)制,風(fēng)險(xiǎn)共擔(dān)、損失共攤、互利互惠是保險(xiǎn)制度的基石。保險(xiǎn)的這種風(fēng)險(xiǎn)轉(zhuǎn)移機(jī)制從整體上提高了人們對(duì)于風(fēng)險(xiǎn)事故的承受能力,對(duì)于保障社會(huì)經(jīng)濟(jì)穩(wěn)定運(yùn)行以及人民生活安定發(fā)揮了重大作用。但是保險(xiǎn)業(yè)的發(fā)展并不是一帆風(fēng)順的,伴隨著保險(xiǎn)業(yè)的壯大而一路發(fā)展起來(lái)的保險(xiǎn)欺詐,已經(jīng)給保險(xiǎn)業(yè)的生存帶來(lái)了嚴(yán)重的威脅。我國(guó)《刑法》與《保險(xiǎn)法》等相關(guān)法律規(guī)范中雖然對(duì)于保險(xiǎn)欺詐行為進(jìn)行了一系列的立法規(guī)定,但法律本身的滯后性以及法律規(guī)范設(shè)計(jì)上所存在的漏洞,使得這些法律法規(guī)根本無(wú)法發(fā)揮其作用,也無(wú)法從根本上杜絕保險(xiǎn)欺詐。本文著重研究了歐美反保險(xiǎn)欺詐立法與運(yùn)行機(jī)制的特征,并進(jìn)行了分析和歸納得出反保險(xiǎn)欺詐的啟示,他山之石可以擊玉,這些啟示對(duì)我國(guó)保險(xiǎn)業(yè)反欺詐起到了借鑒的作用并提出了相應(yīng)的完善建議。 本文主要分為三個(gè)部分,文章的第一部分集中分析了保險(xiǎn)欺詐與反欺詐的概念,涉及到保險(xiǎn)欺詐的基本特征、主要形式和保險(xiǎn)欺詐的危害。第二部分重點(diǎn)分析了歐美反保險(xiǎn)欺詐立法與運(yùn)行機(jī)制的特征及啟示,其中側(cè)重分析了美、英兩國(guó)的立法和司法特征；剖析了澳大利亞的司法與執(zhí)法體系；同時(shí)歸納了國(guó)際組織在國(guó)際反保險(xiǎn)欺詐方面的作用。文章的第三部分也是最后章節(jié)提出了我國(guó)反保險(xiǎn)欺詐存在的問(wèn)題和完善我國(guó)保險(xiǎn)業(yè)反欺詐的建議。以期從完善相關(guān)立法,為反保險(xiǎn)欺詐提供法制保障；充分發(fā)揮監(jiān)管部門(mén)在反保險(xiǎn)欺詐中的作用；建立健全的保險(xiǎn)機(jī)構(gòu)內(nèi)控體系；成立特殊的反保險(xiǎn)欺詐調(diào)查機(jī)構(gòu)；搭建保險(xiǎn)欺詐信息平臺(tái)；加強(qiáng)國(guó)際合作,共同打擊保險(xiǎn)欺詐犯罪等多個(gè)方面著手,在我國(guó)建立起一整套系統(tǒng)完善的針對(duì)保險(xiǎn)欺詐行為的防范措施,從而在根本上達(dá)到遏制保險(xiǎn)欺詐目的。
[Abstract]:Modern insurance evolved from the ancient Babylonian and Phoenician mortgage lending ideas. In 1384, the world's first insurance policy of modern significance was born in Florence. In this policy there is a clear subject matter of insurance, a clear liability for insurance, such as a maritime accident, which includes damage to a ship, grounding, fire, or sunken loss or injury. Insurance is a kind of risk transfer mechanism in which most people share the losses of a few people by using the scientific principle, the risk is shared and the losses are shared, and mutual benefit is the cornerstone of the insurance system. The risk transfer mechanism of insurance improves people's ability to bear risks and accidents, and plays an important role in ensuring the stable operation of social economy and people's life. However, the development of the insurance industry is not smooth, along with the expansion of the insurance industry and the development of insurance fraud, has brought a serious threat to the survival of the insurance industry. Although there are a series of legislative provisions on insurance fraud in the relevant legal norms such as the Criminal Law and the Insurance Law in China, the lag of the law itself and the loopholes in the design of the legal norms exist. These laws and regulations simply can not play its role, can not fundamentally eliminate insurance fraud. This paper focuses on the characteristics of legislation and operation mechanism of anti-insurance fraud in Europe and America, and analyzes and summarizes the enlightenment of anti-insurance fraud. These revelations have played a reference role in anti-fraud of insurance industry of our country and put forward the corresponding consummation suggestion. This paper is divided into three parts. The first part focuses on the analysis of the concept of insurance fraud and anti-fraud, involving the basic characteristics of insurance fraud, the main forms and the harm of insurance fraud. The second part focuses on the analysis of the characteristics and implications of the legislation and operation mechanism of anti-insurance fraud in Europe and the United States, including the legislative and judicial characteristics of the United States and the United Kingdom, and the judicial and law enforcement system of Australia. At the same time, the role of international organizations in international anti-insurance fraud is summarized. The third part is the last chapter and puts forward the problems of anti-insurance fraud in our country and the suggestions to perfect the anti-fraud of insurance industry in our country. In order to improve the relevant legislation, provide legal protection for anti-insurance fraud; give full play to the role of regulatory authorities in anti-insurance fraud; establish a sound internal control system of insurance institutions; set up a special anti-insurance fraud investigation body; Build insurance fraud information platform; Strengthening international cooperation, cracking down on insurance fraud crime and other aspects, we have established a set of systematic and perfect preventive measures against insurance fraud in our country, so as to achieve the goal of curbing insurance fraud fundamentally.
【學(xué)位授予單位】：上海社會(huì)科學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：D922.284;D924.3

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