河北经贸大学学报
河北經貿大學學報
하북경무대학학보
Journal Of Hebei University Of Economics and Trade
2014年
2期
115~120
,共null页
周建涛 周建波 秦炳山 徐迎迎
週建濤 週建波 秦炳山 徐迎迎
주건도 주건파 진병산 서영영
欺诈金额 惜赔金额 投保方特征 保险公司类型 机会欺诈 保险理赔 新《保险法》
欺詐金額 惜賠金額 投保方特徵 保險公司類型 機會欺詐 保險理賠 新《保險法》
기사금액 석배금액 투보방특정 보험공사류형 궤회기사 보험리배 신《보험법》
fraud amount; underpayment amount; the policy-holder's characteristics; types of insurance company; chance cheat; settlement of insurance claim; new insurance law
保险理赔诉讼涉及投保方、保险公司、法院三方,到底是投保方欺诈,还是保险公司惜赔,法院判决具有客观公信力。对2000-2011年170个人身意外伤害保险理赔诉讼样本进行实证分析发现:投保方索赔金额远大于保险公司愿赔金额,法院判决金额介于索赔金额与愿赔金额之间,惜赔金额大于欺诈金额;投保方欺诈金额与索赔金额、保险费正相关,北京甚于外地,残疾甚于其他伤害,年龄61~70岁弱于其他年龄段,新法实施后弱于新法实施前;保险公司惜赔金额与愿赔金额负相关,但与保险金额正相关,北京弱于外地,地市分公司弱于区县支公司,死亡甚于其他伤害,中毒、溺水甚于其他事故,年龄51~60岁甚于其他年龄段,新法实施后甚于新法实施前。
保險理賠訴訟涉及投保方、保險公司、法院三方,到底是投保方欺詐,還是保險公司惜賠,法院判決具有客觀公信力。對2000-2011年170箇人身意外傷害保險理賠訴訟樣本進行實證分析髮現:投保方索賠金額遠大于保險公司願賠金額,法院判決金額介于索賠金額與願賠金額之間,惜賠金額大于欺詐金額;投保方欺詐金額與索賠金額、保險費正相關,北京甚于外地,殘疾甚于其他傷害,年齡61~70歲弱于其他年齡段,新法實施後弱于新法實施前;保險公司惜賠金額與願賠金額負相關,但與保險金額正相關,北京弱于外地,地市分公司弱于區縣支公司,死亡甚于其他傷害,中毒、溺水甚于其他事故,年齡51~60歲甚于其他年齡段,新法實施後甚于新法實施前。
보험리배소송섭급투보방、보험공사、법원삼방,도저시투보방기사,환시보험공사석배,법원판결구유객관공신력。대2000-2011년170개인신의외상해보험리배소송양본진행실증분석발현:투보방색배금액원대우보험공사원배금액,법원판결금액개우색배금액여원배금액지간,석배금액대우기사금액;투보방기사금액여색배금액、보험비정상관,북경심우외지,잔질심우기타상해,년령61~70세약우기타년령단,신법실시후약우신법실시전;보험공사석배금액여원배금액부상관,단여보험금액정상관,북경약우외지,지시분공사약우구현지공사,사망심우기타상해,중독、닉수심우기타사고,년령51~60세심우기타년령단,신법실시후심우신법실시전。
Insurance claim suit is involved with three parties, the insured, the insurance company, and the court, is it the insured fraudulent or the insurance company underpaid? The court's judgment is objectively impartial. This article describes and regresses the 170 accident insurance sample data of claiming litigations between 2000 and 2011, finding that the insured's offer is far larger than the insurance company's accept, the court's judgment is between the insured's offer and the insurance company's accepted, fraud amount is lower than underpayment amount, fraudulent claim is proportional to insured fee, Beijing is worse than other districts, disability is worse than other hurts, age 61-70 is weaker than other age groups, fraud in new insurance law is weaker than before; the insurance company underpayment is proportional to insured amount, Beijing is weaker than other districts, city division company is weaker than county branch company, death is worse than other hurts, poisoning and near-drowning are worse than other accidents, age 51-60 is worse than other age groups, underpayment in new Insurance law is worse than before.