| In recent years, in the insurance industry, the newly established insurance subjectrapid increase, the insurance market competition is becoming increasingly fierce, manyinsurance companies own operation ability will face a severe test. In case of thepresence of growth in the limited market size, The insurance company will maintaintheir profitability to a certain level by put forward higher requirements on riskmanagement, including risk management of insurance claims will be the priority amongpriorities.Motor vehicle insurance as a property insurance company’s main businesscategories, its scale is more than70%of total business scale, so the industry attachesgreat importance to the motor vehicle insurance claim real supervision. This paper is toexplore how the insurance industry are focused on the trend of insurance fraud, basedon a municipal branch of insurance group--CP insurance company as a platform,using the risk index method, to study the specific risk index to identify fraudulentclaims. And use the false claim case which investigated by CP insurance company in2012to further validation of those summarized risk indicators, discusses the scope andlimitations of the risk indicators effectively early warned.The significance of Establish an insurance fraud risk warning index is to provideclaims data accumulation and risk indicators research experience for the future.On thatcase China’s insurance industry can construct an insurance fraud claim system in ourcountry, by emulate the advanced experience of foreign insurance industry and establishthe insurance anti-fraud League. And hope to use these risk early warning index toestablish data model, embedded into each insurance company claims system, realize thesystem can automatic filtering screening identification of claim risk coefficient. Finallyrealized in favor of technical means to improve the recognition rate of insurance fraudclaims, to help insurance companies to improve the level of risk managementobjectives. |
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