Study On Risk Prevention Countermeasures Of Insurance Fraud

Insurance is an industry with economic compensation and mutual assistance.With the development of insurance industry and the coverage of insurance products in every aspect of social life,insurance fraud has become increasingly prominent,and has gradually become a social problem,which directly disturbs the normal operation order of the insurance industry,infringes upon the legitimate rights and interests of the insurance institutions and insurance consumers,and undermines the good faith management environment of the economy and society.At present,China's insurance fraud risk prevention is still in its infancy,and a sound insurance fraud risk prevention system has not been established.In 2012,China Insurance Regulatory Commission issued comments on strengthening insurance anti-fraud which pointed out the direction and planed the route for the insurance fraud risk prevention work throughout the country,and,in particular,put forward requirements for the theory research of strengthening insurance fraud risk management.Therefore,strengthening the prevention of insurance fraud risk is not only an industry problem,but has gradually become an important research topic of risk management in insurance industry.Strengthen the research on the risk prevention of insurance fraud,is conducive to the protection of the interests of insurance consumers,the fighting against insurance fraud crimes,maintaining social stability,establishing a good image of the integrity management of the insurance industry and strengthening the construction of social credit system.In order to explore the practice and countermeasures to guard against insurance fraud risk,suitable for the development of the insurance industry.This paper,from the perspective of concrete practice and case of attack insurance fraud in Shandong insurance industry,by summing up the main practice of preventing insurance fraud risk in foreign countries and in China,then further through economic theory analysis and puts forward some tentative ideas and suggestions for strengthening the risk prevention of insurance fraud in the future.In this paper,the first chapter is the introduction,which mainly expounds the background and meaning of this topic,and summarizes the relevant research literature at home and abroad on the insurance fraud risk,introducing the research methods and contents.The second chapter outlines insurance fraud.This chapter interprets the concepts of insurance,fraud,insurance fraud,insurance anti-fraud and so on,and classifies insurance fraud according to the implementing entity,the true and false,and the fraudulent practices.Then we summarize the characteristics of insurance fraud,such as diversity of form,concealment of behavior and harmfulness.This chapter analyzes the causes of insurance fraud from the aspects of insurance itself,social environment and current laws,and lists ten main forms of insurance fraud,at the same time.The third chapter analyzes the current situation of preventing insurance fraud risk both at home and abroad.In this chapter,not only the mainly practices of the United States,Britain,Japan,Germany,South Korea and other developed countries to prevent the risk of insurance fraud is discussed,but also the basic situation and the main characteristics of risk prevention of insurance fraud in the mainland of China and Taiwan,are analyzed at the same time.By comparing with the main practices of developed countries,this paper points out the main problems existing in the prevention of insurance fraud risks in china.The fourth chapter analyzes the relationship between information asymmetry,adverse selection,moral hazard and insurance fraud in the insurance market.Based on the influence of asymmetric information,we analyzed the game model of insurance fraud,and then several key factors affecting insurance fraud are obtained.The fifth chapter combines the specific case of Shandong province to prevent insurance fraud risk,and makes a practical analysis of the risk of insurance fraud.This chapter focuses on the analysis of the doubtful points of the case and the specific investigation process,and summarizes the relevant experience of preventing fraud risk.The sixth chapter summarizes the first five chapters,and this chapter puts forward prevention countermeasures to strengthen insurance fraud risk.In short,the insurance fraud risk prevention is a systematic project,and cannot solution relying on the insurance industry's own strength.The social departments concerned should attach great importance to it and strengthen research to jointly plug loopholes in insurance fraud.I hope this analysis can help to prevent the risk of insurance fraud in China,and it can be used for reference.