從保險詐欺探究我國保險中介人監理制度

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Title:	從保險詐欺探究我國保險中介人監理制度
Other Titles:	A study of intermediaries regulation controlfrom the perspective of insurance fraud
Authors:	薛名揚;Hsueh, Ming-yang
Contributors:	淡江大學保險學系保險經營碩士在職專班陳瑞;Chen, Ray
Keywords:	保險中介人;保險詐欺;保險監理;Insurance Intermediaries;Insurance Fraud;Insureance Regulation
Date:	2009
Issue Date:	2010-01-11 02:01:12 (UTC+8)
Abstract:	一個完整的保險市場，是由保險公司、要保人和保險中介人三方面所組成，缺一不可。以行銷通路的策略而言，保險公司除了利用傳統的業務人員體系販售保單之外，有助於降低銷售成本之保險中介人更是不容小覷的行銷通路。台灣的保險業一直以來都在政府的管制與保護下發展，在加入世界貿易組織(WTO)後，更是面臨自由化與全球化的挑戰，保險公司以往單純依賴傳統的銷售通路已不符合時代的趨勢，保險中介人從過去只銷售產品的角色，轉變為金融保險的專業顧問，且行銷通路逐漸成為保險公司兵家必爭之地。保險業者為了搶攻通路，無不極力開拓以增加業務來源，然而，在搶攻行銷通路的背後卻也發生產生不少的問題。本篇論文乃以文獻分析，參酌國際保險詐欺防制準則，及美、英、日、中等國保險詐欺防制措施、歸納及比較，發現我國在實施防制保險詐欺的運作實務過程中，仍僅著眼於外部保險詐欺；忽略保險產品和保險交易行為的特性，仍可為內部保險詐欺者利用之平台，另保險中介人未納入保險詐欺防制體系中，將造成防制工作一大缺漏。建議修正相關法令規定，明確訂定保險中介人保險詐欺的責任；由主管機關提供詳細指引內容、可疑交易識別指標、保險詐欺相關案例等，以供保險人及保險中介人遵循；並落實保險詐欺防制教育訓練及完善回饋制度，以強化保險監理。 A complete insurance market consists of insurers, policy holders, and intermediaries. Without any of those three parties, this market would not be possible. As far as the marketing strategy is concerned, aside from traditional selling channel like agents, the intermediary is also a cost-saving channel we can not ignore. Furthermore, business alignment, database marketing and direct marketing are also mixing selling channels for helping insurers to take the lead in this competition. Insurance business in Taiwan has been developed under the government’s control and protection for a long time. Since Taiwan joined WTO, the insurers have been facing the challenges from market open and globalization. The old-fashioned tradition channels which the insurers reply on are not able to meet the needs of this new era. From consumers’ point of view, the role of the intermediary has been changed from a product distributor to a professional financial consultant. This channel has become so crucial to all insurers. Every insurer tries its best to develop this channel to bring in more new business. However, more problems caused due to such keen competition. Documents analysis is the main research method in my paper. I also refer to insurance fraud prevention principles and actual prevention actions taken by United States, United Kingdom, Japan and China. Afterwards, I found that Taiwan simply focused on external insurance fraud when implementing insurance fraud prevention. However, ignorance of insurance products and trading behavior would also become the warm bed for internal fraud. Particularly once the intermediary is not controlled by the fraud prevention systems, such leak will result in serious drawbacks. To modify regulations is strongly suggested. It is necessary to define the responsibilities of intermediaries in insurance fraud. The authority concerned should provide distinct guide about fraud indicators and fraud cases for insurers and intermediaries to follow. As well, it is a must to implement insurance fraud prevention training and reporting system. The above which were mentioned will strengthen our insurance operation monitoring and management.
Appears in Collections:	[Graduate Institute & Department of Insurance Insurance] Thesis

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