互联网保险欺诈及反欺诈研究.pdf-资料库

eshangui-12147876-051f2352bdaa54301cbb08c0cb5c369b.pdf-第1页.png

第1页 / 共47页

eshangui-12147876-051f2352bdaa54301cbb08c0cb5c369b.pdf-第2页.png

第2页 / 共47页

eshangui-12147876-051f2352bdaa54301cbb08c0cb5c369b.pdf-第3页.png

第3页 / 共47页

eshangui-12147876-051f2352bdaa54301cbb08c0cb5c369b.pdf-第4页.png

第4页 / 共47页

eshangui-12147876-051f2352bdaa54301cbb08c0cb5c369b.pdf-第5页.png

第5页 / 共47页

eshangui-12147876-051f2352bdaa54301cbb08c0cb5c369b.pdf-第6页.png

第6页 / 共47页

eshangui-12147876-051f2352bdaa54301cbb08c0cb5c369b.pdf-第7页.png

第7页 / 共47页

eshangui-12147876-051f2352bdaa54301cbb08c0cb5c369b.pdf-第8页.png

第8页 / 共47页

代码：１００３６ 互联网保险欺诈及反欺诈研究 学位类型：同等学力 论文作者：刘慧君 培养学院：保险学院 专业名称：金融学 指导教师：王国军教授 ２０１８年９月

The Research on Internet Insurance Fraud and Anti-fraud

摘要保险欺诈行为一直存在于保险行业中，随着我国保险行业的不断发展，保险欺诈问题日趋严重。2000 年以后，互联网保险逐渐兴起，通过互联网形式销售保险产品已在保险业务销售中占有一席之地。与此同时，互联网保险的保险欺诈问题也已逐步显现，其严重程度不容小觑。保险产品通过互联网形式销售与通过传统形式销售，其销售模式、风控模式有着很大的差别，传统的反保险欺诈手段不能完全适用于互联网保险的反欺诈。那么，剖析出互联网保险欺诈的特点以及建立反欺诈风控体系尤为重要。本文首先从微观角度出发，分析了国内四家互联网保险公司的经营情况，四家公司均存在着在保费收入大幅提升的同时赔付逐渐升高的情况，在赔付率升高的同时，势必存在着一定程度的保险欺诈行为。其次，举例说明保险公司面临的互联网保险欺诈现状，列举出新型互联网保险欺诈的案例，以互联网保险与传统保险在业务流程上的差异为切入点，进而剖析此类型的互联网保险欺诈出现的根本原因。再次，分析了国外反保险欺诈先进经验和国内反保险欺诈现状，借助完全信息静态博弈模型分析影响互联网保险欺诈的因素。最后，针对互联网保险特有的欺诈风险点，分别从政府层面、行业协会层面、保险公司层面就建立反互联网保险欺诈的风控体系给出意见。关键词：互联网保险欺诈，保险欺诈，反欺诈措施

Abstract Insurance fraud has always existed in the insurance industry. With the continuous development of China's insurance industry, the problem of insurance fraud has become increasingly serious. After 2000, Internet insurance gradually emerged. The sale of insurance products through the Internet has already occupied a place in the sales of insurance business. At the same time, the problem of insurance fraud of Internet insurance has gradually emerged, and its severity cannot be underestimated. Insurance products are sold through the Internet and sold through traditional forms. The sales model and risk control model are very different. The traditional anti-insurance fraud method cannot be fully applied to the anti-fraud of Internet insurance. Then, it is especially important to analyze the characteristics of Internet insurance fraud and establish an anti-fraud risk control system. first analyzes the operation of four domestic Internet This paper insurance companies from the microscopic point of view. All four companies have a situation in which the premium income is greatly increased while the claims are gradually increasing. As the loss ratio increases, there is bound to be a certain degree. Insurance fraud. Secondly, it gives an example of the current situation of Internet insurance fraud faced by insurance companies, lists the cases of new Internet insurance fraud, and takes the difference between Internet insurance and traditional insurance as the starting point, and then analyzes the root causes of this type of Internet insurance fraud. . Thirdly, it analyzes the foreign advanced experience and the status quo of domestic anti-insurance fraud, and analyzes the factors affecting Internet insurance fraud by means of the complete information static game model. Finally, in view of the fraud risk points peculiar to Internet insurance, opinions were given on establishing a risk control system against Internet level, industry association level, and insurance company level. insurance fraud from the government Keywords: Internet insurance fraud, insurance fraud, anti-fraud measures

目录第 1 章引言..............................................................................................1 1.1 研究背景和意义............................................................................................. 1 1.1.1 研究背景..................................................................................................................1 1.1.2 研究意义..................................................................................................................1 1.2 文献综述......................................................................................................... 3 1.2.1 国内文献综述..........................................................................................................3 1.2.2 国外文献综述..........................................................................................................4 1.3 研究方法、研究思路及创新点..................................................................... 5 1.3.1 研究方法.................................................................................................................5 1.3.2 研究思路.................................................................................................................5 1.3.3 创新点及不足.........................................................................................................6 第 2 章互联网保险欺诈的现状及成因分析.........................................7 2.1 国内四家互联网保险公司经营数据.............................................................. 7 2.1.1 经营现状分析..........................................................................................................7 2.1.1.1 众安保险经营数据..............................................................................................7 2.1.1.2 泰康在线经营数据..............................................................................................9 2.1.1.3 安心保险经营数据............................................................................................10 2.1.1.4 易安保险经营数据............................................................................................11 2.1.2 A 保险公司的互联网保险反保险欺诈的情况................................................... 12 2.2 互联网保险欺诈的成因................................................................................ 13 2.2.1 互联网保险与传统保险在承保流程上的差异导致的保险欺诈差异...............13 2.2.2 互联网保险与传统保险在理赔流程上的差异导致的保险欺诈差异...............17 第 3 章反互联网保险欺诈的国际和国内经验...................................20 3.1 国外反欺诈成功经验借鉴............................................................................ 20 3.1.1 美国........................................................................................................................20 3.1.2 英国........................................................................................................................21 3.1.3 日本........................................................................................................................21 1

3.2 我国反保险欺诈现状.................................................................................... 22 第 4 章互联网保险欺诈完全信息静态博弈分析.................................25 4.1 假设前提........................................................................................................ 25 4.2 模型假设........................................................................................................ 25 4.3 博弈均衡分析................................................................................................ 26 第 5 章建立反互联网保险欺诈的风控体系.........................................28 5.1 从政府层面建立风控体系............................................................................ 28 5.1.1 法律层面................................................................................................................28 5.1.2 监管层面................................................................................................................29 5.2 从行业层面建立风控体系............................................................................ 29 5.2.1 行业规范层面........................................................................................................29 5.2.2 行业技术层面........................................................................................................30 5.3 从公司层面建立风控体系............................................................................ 31 5.3.1 公司制度层面........................................................................................................31 5.3.2 公司技术层面........................................................................................................32 5.3.2.1 从投保端防范保险欺诈措施........................................................................... 32 5.3.2.2 从理赔端防范保险欺诈措施........................................................................... 33 结束语........................................................................................................34 参考文献....................................................................................................35 致谢............................................................................................................37 个人简历在读期间发表的学术论文与研究成果.................................38 2

资料库

互联网保险欺诈及反欺诈研究.pdf

相关推荐

开发技术

热门标签

最新资料