The Research of the Characters of Insurance Fraud Insured in Life Insurance Industry—An Example From A Case Company

• Main Authors: Ya-Jen Kao, 高雅珍
• Other Authors: 作者未提供
• Format: Others
• Language: zh-TW
• Published: 2007
• Online Access: http://ndltd.ncl.edu.tw/handle/39vv48

碩士 === 銘傳大學 === 管理學院高階經理碩士學程 === 95 === In Taiwan, there are many insurance fraud cases which had made huge damage for insurance company’s business operation in these years. And they influence social resource allocation and destroy the public’s right seriously. The objectives of this research are to analyze the data and to find out the behavior pattern of insurance fraudster when they apply a new insurance contract. Supply the results to life insurance companies to make whole risk management strategy for the potential insurance fraudster. On the other hand, the life insurance company would accelerate the non-insurance-fraudster underwriting process and reduce the conflict between risk management and business promotion. This research first briefed the current situation, risk management process, and risk management strategy of industry and exampled company. Then it indicated the characters of insurance fraudsters of exampled company and provides risk management suggestion for exampled company. This research indicated that there are some specific patterns in basic information, payment mode, and policy content of insured, especially in four factors, payment period, coverage amount, loading, and policy dividend option. Finally the research suggested exampled company to have special underwriting process for abnormal-premium-amount and payment-frequency policy. And it suggested the exampled company to modify the risk management strategy timely to achieve the risk management goal.