本論文主要在探討產險公司如何建立一個有效且完整的品質管理系統。以結構方程發展出核保及費率制定的核心變數並分別驗證汽車車體損失險及團體傷害保險兩個屬性不同的險種。就汽車車體損失保險而言，驗證結果得知，核保因素之未婚者、地區仍存在逆選擇的現象。未有充分證據顯示事前道德風險的存在。就團體傷害保險而言，費率因素中之團體人數對於實支實付平均保額及住院日額平均保額仍存在逆選擇的現象。住院日額平均保額對於損失率存在事前道德風險的現象。 This dissertation explores the development of an effective and complete quality management system by insurance companies. Using structural equation model to develop the core variables of underwriting and ratemaking. To verify these assumptions, this study examines auto physical damage insurance and group injury insurance, which are two different policies with varying features. In the case of auto physical damage insurance, the risk factors are claims, human, auto, road environment, and place factors. The results indicate that the variables in underwriting factors such as single, region imply the existence of adverse selection. There is no significant evidence to imply the presence of ex-ante moral hazard. For group injury insurance, the risk factors are underwriting, rates, and business factors. The number of groups in the rates of factors support for insured amounts for daily hospitalization indemnity indicate the presence of ex-ante moral hazard.
