【摘要】：隨著國內(nèi)保險市場的不斷發(fā)展和競爭的日漸加劇,保險理賠作為客戶接觸和感知保險服務(wù)、履行保險合同的重要環(huán)節(jié),提高理賠效率、加強和改善理賠服務(wù)質(zhì)量、保障維護保險消費者權(quán)益一直以來就是A保險公司關(guān)注的核心問題。理賠垂直管理體制改革是A保險公司從2010年開始進行的一項重大的管理模式變革。在近兩年的試點、運行過程中,該模式將基層公司理賠部門的人、財、物等方面的權(quán)力收歸上級公司統(tǒng)一調(diào)配,增強了上級公司對基層公司的宏觀調(diào)控和監(jiān)管,維護了上級公司的權(quán)威,推動和加速了基層公司的經(jīng)營意識與方向的轉(zhuǎn)變,提高了理賠質(zhì)量,也促進了理賠業(yè)務(wù)專業(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違規(guī)、違紀、腐敗現(xiàn)象發(fā)生的幾率。為此,必須對該模式進行優(yōu)化改革。首先要加強理賠垂直管理部門的自身建設(shè),完善內(nèi)部激勵機制、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與基層公司之間的關(guān)系,進一步合理的劃分上級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和基層公司的協(xié)調(diào)機制與爭議解決機制；最后,可在上級公司與基層公司合理界定職權(quán)范圍的基礎(chǔ)上,進行相應(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】：長沙理工大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：F840.4;F842.3

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