Game Analysis Of Insurance Fraud

From the standpoint of the three kinds of participators and the bugs in the process of insurance operation, this paper introduces theories about insurance fraud, and game theory is applied to roundly research the contentions of inner benefits in insurance fraud, in which social medical insurance, vehicle insurance and life insurance are illustrated as they are closely linked with people's living. As a result, this paper educes innovative conclusions, thus prompts some valuable suggestions against insurance fraud.There are six chapters in this paper. The first chapter is to stress the backgrounds and bearing of this paper, and simply introduce the contents and innovations. On the basis of summarization on domestic and overseas theories about insurance fraud, this paper establishes the contents to be researched and possible difficulties and researching means.The second chapter is about insurance fraud and asymmetric information. As the theoretic basis, the chapter roundly expounds fundamental knowledge about insurance fraud, including the concepts, characteristics and inner risk factors. Insurance fraud is classified to be policyholder fraud, agent fraud and insurer fraud. By qualitative explanation of the motivation and forms, the chapter points out that asymmetric information in the insurance markets is an important factor that results in insurance fraud, and as a result, insurance fraud is one of main explicit forms of asymmetric information, which reflects the bugs in the process of insurance operation.The third chapter takes social medical insurance as example to analyze policyholder fraud. Since it easily occurs for violation of maximum credit principle in social medical insurance, the medical insurance market is a typical market in which policyholder fraud occurs.With the presupposition of complete competence in insurance markets and without additional premiums, the premium is composed of three parts: payment for theloss, payment cheated by policyholder and supervision cost for auditing claims for compensation.According to the results of static game analysis of policyholder fraud with complete information, the chapter draws that the insurer consider the policyholder's cost type to be high risk whether he carries out the tell-the-truth obligation or not, so the minimum price acceptable for the insurer is the price of high sick risk. According to the results of dynamic game analysis of policyholder fraud with incomplete information, the chapter draws that the policy price is function of the insurance category, while independent of the insurer's auditing. In the condition of invalid auditing, the chapter adopts state-space map to design equilibrium policies for two kinds of policyholder fraud, in one situation the insurer wouldn't check the fraud for high auditing cost, while in another situation the policyholder manages to make the insurer unaware of the fraud.In the forth chapter, the paper takes vehicle insurance as example for game analysis of agent fraud. Since vehicle insurance is one of the most important property insurance, it directly affects the insurer's profits. In the operation of vehicle insurance, agent insurance is the vital blight so that it becomes typical fraud in insurance markets.By analysis of the game between the agent and the insurer in the operation, the chapter indicates that the most factor resulting in agent fraud is the unreasonablity of the incentive system. Base on mature incentive theories, the chapter reconstruct the commission system by adding time factor to build a incentive model which includes commission timing, explicit factors such as policy amounts and premium income and recessive factors such as the agent's credit and post-sale service quality. As a result, the chapter works out a salary system which prompts the agent to actively work with credit, and improve work quality for his benefit.The fifth chapter is about insurer fraud, where life insurance is analyzed. In China, after exceedingly routine development of life insurance, the solvency risk has become higher and higher be...