【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(jī)動(dòng)車保險(xiǎn)行業(yè)也隨之得到快速發(fā)展,機(jī)動(dòng)車保險(xiǎn)已經(jīng)逐漸成為與國民生活密不可分的險(xiǎn)種。中銀保險(xiǎn)公司是一家主要經(jīng)營車險(xiǎn)業(yè)務(wù)的財(cái)產(chǎn)保險(xiǎn)公司,雖然近幾年來車險(xiǎn)保費(fèi)收入和公司規(guī)模保持著快速增長(zhǎng)的趨勢(shì),但是公司的經(jīng)營效益和利潤(rùn)卻呈現(xiàn)了負(fù)增長(zhǎng)的態(tài)勢(shì)。車險(xiǎn)費(fèi)率的改革導(dǎo)致車險(xiǎn)車損險(xiǎn)費(fèi)率下降明顯,同時(shí)保險(xiǎn)公司住處的賠付成本卻在不斷上升,使中銀保險(xiǎn)公司的車險(xiǎn)業(yè)務(wù)的利潤(rùn)受到雙重?cái)D壓。2015年末中銀保險(xiǎn)車險(xiǎn)的綜合成本率達(dá)到了 103.25% ,較去年上升了 1.62個(gè)百分點(diǎn),車險(xiǎn)業(yè)務(wù)持續(xù)連年虧損走勢(shì)。根據(jù)中銀保險(xiǎn)歷年的數(shù)據(jù)分析來看導(dǎo)致中銀保險(xiǎn)連年虧損局面的因素除了車險(xiǎn)費(fèi)率改革、承保手續(xù)費(fèi)上升、進(jìn)口車輛賠付成本上升、車險(xiǎn)業(yè)務(wù)結(jié)構(gòu)不合理和國家死亡傷殘標(biāo)準(zhǔn)提高外,車險(xiǎn)欺詐案件的持續(xù)增多也是個(gè)主要原因。中銀保險(xiǎn)公司也已經(jīng)開始認(rèn)識(shí)到車險(xiǎn)欺詐的危害性,并針對(duì)車險(xiǎn)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(zhì)、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(xiǎn)欺詐案件的管控機(jī)制,車險(xiǎn)反欺詐工作結(jié)果并不理想。本為旨在結(jié)合歐美、日韓等車險(xiǎn)行業(yè)起步較早的發(fā)達(dá)國家的機(jī)動(dòng)車保險(xiǎn)欺詐的風(fēng)險(xiǎn)管理方法和研究,總結(jié)出一套適合中銀保險(xiǎn)公司的機(jī)動(dòng)車保險(xiǎn)欺詐風(fēng)險(xiǎn)管理方案。首先論述了機(jī)動(dòng)車保險(xiǎn)欺詐的相關(guān)研究理論及學(xué)說,并分析了車險(xiǎn)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(xiǎn)車險(xiǎn)業(yè)務(wù)經(jīng)營現(xiàn)狀及針對(duì)車險(xiǎn)欺詐采取的一系列的管控措施,并分析了中銀保險(xiǎn)車險(xiǎn)欺詐管理中存在的問題和不足。再次,從完善公司架構(gòu)、建立欺詐識(shí)別模型、構(gòu)建車險(xiǎn)欺詐預(yù)警系統(tǒng)、總結(jié)打擊車險(xiǎn)欺詐方法四個(gè)方面設(shè)計(jì)了一套適合中銀保險(xiǎn)公司的車險(xiǎn)欺詐風(fēng)險(xiǎn)管理方案。最后,針對(duì)車險(xiǎn)欺詐管理方案總結(jié)了一系列的保障措施和手段以保證管理方案的順利實(shí)施。車險(xiǎn)欺詐的猖獗不僅擾亂了保險(xiǎn)公司正常的車險(xiǎn)經(jīng)營,同時(shí)也侵害了其他合法投保人的正當(dāng)利益,對(duì)我國車險(xiǎn)行業(yè)的健康穩(wěn)定發(fā)展產(chǎn)生了嚴(yán)重的阻礙。車險(xiǎn)業(yè)務(wù)在中銀保險(xiǎn)的業(yè)務(wù)占比中占有絕對(duì)的份額,所以建立一套行之有效的適合中銀保險(xiǎn)公司的機(jī)動(dòng)車保險(xiǎn)欺詐風(fēng)險(xiǎn)管理方案對(duì)降低中銀保險(xiǎn)的賠付率、綜合成本率進(jìn)而實(shí)現(xiàn)車險(xiǎn)業(yè)務(wù)經(jīng)營利潤(rùn)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(xué)位授予單位】：西安理工大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：D922.284;F842.634

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