A Comparative Research Of Insurance Fraud And Regulation Issues Between China And The U.S.

With the rapid development of our economy and the deepening of reform and opening up,insurance industry is reforming in the mainstream of supply-side structure,showing a good momentum of development in our country.In 2016,the insurance industry continued to grow at a faster pace,with national insurance premiums rising nearly 30 percent year-on-year,and the reform of the supporting system was progressing steadily.But industry risks are exposed,and dishonest insurance practices are flourishing.Insurance fraud phenomenon also becomes more and more serious,insurance regulation has limited effect.Insurance fraud affects the desire of consumer and investor's confidence,reducing the insurance company's profit and solvency,violating the basic principle of insurance law,resulting in adverse consequences ultimately assumed by the market,affecting the healthy development of insurance industry.With the development of financial integration and globalization,insurance fraud presents the characteristics of measures diversification,methods intelligence,influences huge capital and the criminal globalization.Therefore insurance fraud has been paid more and more attention by the international community,research is increasing and deepening.Related researches have shown that the United States in the regulation of insurance fraud has accumulated a wealth of experience,anti-fraud of insurance legislation is relatively perfect.The main task of this paper is how to learn from the experience of American Insurance Regulation,by scientifically analyzing the cause of insurance fraud,points out the deficiency of our country in the aspect of preventing insurance fraud,to improve the level of antiinsurance fraud of Chinese Insurance Regulatory system.First of all,on the basis of combing the domestic and foreign related research results,expounds the definition,category and harm of the insurance fraud,and from the angle of besides moral hazard,adverse selection,uncertain decision and other economics related theory and the basic principle including maximum integrity,loss compensation and insurance benefits of insurance law,carried on the thorough analysis to insurance fraud.Secondly,analyses the reasons of insurance fraud.Including the evaluation and correction of IAIS insurance fraud cause triangle model,using the cost-benefit method,game theory method,questionnaire investigation,etc,reasoning deductively from the legal cost,law enforcement rate and the rationality of insurance fraud,discusses the system reason of insurance fraud.Thirdly,studying fraud risk from insurance dispute and litigation as the starting point of the insurance industry,analyzing the legal theory of typical cases promulgated by Chinese Insurance Industry Association,to extract the factors which may influence the insurance fraud,using statistical induction and regression analysis,to acquire the main factors impact on insurance fraud.Based on the actual situation of China's insurance regulation,compared with the related cases of United States and regulation mechanism,compared the systems of insurance truthfully disclosure,incontestability system and fraud litigation incentive mechanism,evaluating the design of the insurance fraud pattern,the insurance anti-fraud system connotation,finding the problems existing in China's Insurance Regulatory System: "the cost of legal regulation of insurance fraud" and "law enforcement rate is low","the rationality of fraud still exist".Finally,absorbing American experience of the insurance fraud supervision system,put forward specific regulatory strategies and professional path of insurance fraud regulation,to settle the system of insurance fraud regulation of our country,the specific method: Classify the insurance fraud behavior before regulating,establishing incentive system of insurance fraud,control underwriting risk scientifically,refine and increase the costs of law of the insurance fraud,establish and optimize the regulatory system of insurance fraud.