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MBA毕业论文_财产保险公司枣庄分公司机动车保险理赔风险管控研究PDF

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更新时间:2022/2/3(发布于山东)

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I 摘要 当前,我国各大财产保险企业比较头疼的问题是机动车保险理赔(以下简称车险 理赔)问题,包括A财产保险公司枣庄分公司(以下简称枣庄A公司)在内的国内 很多财产保险企业,都出现了因车险理赔风险管控不力而导致公司严重亏损的现象。 车险理赔风险管控是否得力,成为制约各大险企可持续发展的关键因素,其重要性不 言而喻。 本文主要通过分析枣庄A公司车险理赔大数据,总结其规律,掌握发案较高的车 型及险种,对其特征予以分析,努力探究出科学的管控方式,同时以枣庄A公司为例 进行积极探索,总结提炼出当前车险理赔管控的几大风险点:车型、赔付率、理赔流 程、监管投诉、法律诉讼、恶意欺诈等,以此为重点,对其进行梳理、剖析,提出解 决思路。 基于分析得出,枣庄A公司销售端带来的事前风险与理赔端带来的事中风险是其 车险理赔风险的主要来源。结合实际情况,本文从销售结构、理赔流程、反欺诈、投 诉和诉讼方面入手,剖析管控风险不力的原因,提出调整考核方式、优化人员薪资结 构、改善理赔流程、设立反欺诈共享平台等优化方案,建议利用组织建设、制度建设、 意识提升、企业文化等保障对策确保方案实施。以此为枣庄A公司车险理赔风险管控 提供理论依据,从而提升其抗御车险理赔风险的能力,为企业盈利创造良好条件。 关键词:车险理赔;风险管控;优化方案;保障对策 西北农林科技大学硕士学位论文 II ABSTRACT At present, the major insurance companies in our country are facing a headache problem of Vehicle Insurance Claims (hereinafter referred to as car insurance claims) . Many domestic insurance companies, including the Zaozhuang branch of A Property Insurance Company (hereinafter referred to as Zaozhuang A company) , all appeared because the automobile insurance claims risk management control is ineffective and causes the company the serious loss the phenomenon. Whether the auto insurance claims risk management is effective or not has become the key factor that restricts the sustainable development of the major insurance enterprises, its importance is self-evident. This article mainly through the analysis Zaozhuang A company automobile insurance claims big data, summarizes its rule, grasps the occurrence high vehicle type and the insurance type, analyzes to its characteristic, diligently explores the scientific management control way, simultaneously takes Zaozhuang A company as the example to carry on the active exploration, this paper summarizes and summarizes several risks of the current vehicle insurance claims management, such as vehicle type, claims rate, claims process, regulatory complaints, legal proceedings, malicious fraud, etc. . Based on the related research, we can draw a conclusion that the main sources of Zaozhuang A company's Auto Insurance claim risk are the ex ante risk brought by the sales end and the medium risk brought by the claim end. Combining with the actual situation, this paper analyzes the reasons for the ineffective risk management from the aspects of sales structure, claim process, anti-fraud, complaint and lawsuit, put forward to adjust the assessment method, optimize the personnel salary structure, improve the claim process, set up anti-fraud sharing platform and other optimization programs, it is suggested that organization construction, system construction, consciousness promotion and enterprise culture should be used to ensure the implementation of the plan. This provides a theoretical basis for the risk management of Zaozhuang A company's car insurance claims, so as to improve its ability to resist the risk of car insurance claims and create good conditions for enterprise profits. KEY WORDS: Car Insurance claims; Risk Management and control; Optimization Scheme; Safeguard countermeasures 目 录 I 目 录 摘要 ........................................................................................................................................... I ABSTRACT .............................................................................................................................II 第一章 绪论 .......................................................................................................................... 1 1.1 研究的背景 ................................................................................................................... 1 1.2 研究的目的与意义 ....................................................................................................... 1 1.2.1 研究的目的 ............................................................................................................ 1 1.2.2 研究的意义 ............................................................................................................ 2 1.3 国内外研究综述 ........................................................................................................... 2 1.3.1 国外研究综述 ........................................................................................................ 2 1.3.2 国内研究综述 ........................................................................................................ 3 1.3.3 国内外研究综述评述 ............................................................................................ 4 1.4 研究思路与研究方法 ................................................................................................... 4 1.4.1 研究思路 ................................................................................................................ 4 1.4.2 研究方法 ................................................................................................................ 6 1.5 论文可能的创新之处 ................................................................................................... 7 第二章 研究的理论基础 ...................................................................................................... 8 2.1 车险理赔风险的理论 ................................................................................................... 8 2.1.1 风险的定义和分类 ................................................................................................ 8 2.1.2 机动车辆保险的定义和分类 ................................................................................ 8 2.1.3 车险理赔风险的概念和特征 ................................................................................ 9 2.1.4 车险理赔风险的来源 .......................................................................................... 10 2.1.5 车险理赔风险发生后的结果 .............................................................................. 11 2.2 车险理赔流程 ............................................................................................................. 12 2.2.1 传统车险理赔流程 .............................................................................................. 12 2.2.2 现代车险理赔流程 .............................................................................................. 13 2.2.3 其他特殊理赔情况 .............................................................................................. 14 2.3 车险理赔风险理论总结 ............................................................................................. 15 第三章 枣庄A公司车险理赔现状 .................................................................................... 16 3.1 公司基本概况 ............................................................................................................. 16 西北农林科技大学硕士学位论文 II 3.2 车险理赔数据情况 ..................................................................................................... 16 3.2.1 车险理赔总体数据 .............................................................................................. 16 3.2.2 车辆不同使用性质的理赔数据 .......................................................................... 17 3.2.3 营业货运类各车型的相关数据 .......................................................................... 18 3.3 车险理赔问卷调查 ..................................................................................................... 19 3.3.1 调查样本及方式 .................................................................................................. 19 3.3.2 问卷得分情况分析 ....................................................