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    Title: 產險理賠績效評量指標之研究
    Other Titles: A study of non-life claims adjustment performance indicators
    Authors: 吳靜宜;Wu, Ching-Yi
    Contributors: 淡江大學保險學系保險經營碩士班
    廖述源
    Keywords: 理賠;理賠績效;理賠理論;理賠程序;理賠處理;Claims Adjustment;Claims Adjustment Performance;Claims Theory;Claims process;Claims Handling
    Date: 2012
    Issue Date: 2013-04-13 11:00:12 (UTC+8)
    Abstract: 保險公司於評估企業經營績效時,往往忽略理賠對於保險公司之重要;理賠可說是保險公司確保利潤之最後一道關卡,亦是維持良好客戶關係不可或缺之重點。保險公司針對理賠,應定期考核其工作績效,並針對缺失加以檢討;然國內尚無一套完善理賠績效考核機制,於考核時,難以發掘理賠真正問題之所在;基此,建構保險公司之理賠績效評量指標,對於保險公司之經營確有其必要性與重要性。

    本文先利用文獻歸納法,將國內外有關理賠之意義、流程、影響因素等,整理並加以論述,旨在探討理賠之重要性;於後,就理賠相關因素,擬定十八項量性理賠績效評量指標,以及四項質性理賠績效評量指標,並詳加說明各項指標之涵義;就由質量並重之評量方式,使理賠績效評量指標之評量更具客觀性。

    最後,本中使用個案分析法,模擬保險公司對於理賠績效評量指標實際使用之情境,並以模擬結果為基準,針對其結果加以分析比較,除使保險公司能瞭解如何運用理賠績效評量指標,更期望保險公司能自我警惕,並提升理賠專業素質。
    Claims’s important is frequently overlooked when insurance companies evaluate business performance. For insurance companies, claims is the last stage to ensure profit and it is the point about customer relationship. Claims adjustment performance should be examined on a regular basis. But in Taiwan, there is no a complete inspection of claims adjustment performance so that insurer hard to find the problem of claims. Based on, making performance indicators of claims for insurance operations is a necessary and importance.
    At first, this thesis used document induction. A survey of significance, procedure, factors, etc.of claims of the related reference papers to claims’ importance. Second, based on claims factors make eighteen quantitative indicators and four qualitative indicators. By quantity and quality both evaluation methods, claims adjustment performance indicators will be more objectivity. Final, this thesis used case analysis method : company, department, adjuster; and analyzing the simulated results.
    Appears in Collections:[保險學系暨研究所] 學位論文

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