The Analysis And Control Research Of Personal Insurance Compensation Risk

Since the reform and opening up,along with the vigorous development of China's market economy,the people's material life has been significantly improved,the income level has also been significantly improved.In recent years,with the people living the most appropriate personal accident insurance market has also undergone a very significant change.The insured amount of personal accident insurance for different occupations and insurance is increasing year by year,especially after the promulgation of the new work injury insurance regulations,it has accelerated the growth rate of personal accident insurance.Faced with such changes in the market situation,various insurance companies in personal accident risk control have taken a positive response.However,compared with foreign developed country insurance companies,China's insurance companies to develop a short time,the lack of a scientific and reasonable risk control response methods,which is currently the academic and insurance industry common focus.This article focuses on the necessity of risk management and control in the personal accident insurance market facing high compensation risks.Through the analysis of personal accident insurance claims of TPY insurance company in recent years,the company has identified various types of risks in the whole process of personal accident insurance.Combining with the specific operating conditions of Personal Accident Insurance of TPY insurance company of Shandong,various types of compensation risks were specifically proposed:the fraud risk of the insured,the risk of personal value increasing year by year,the risk of legal proceedings,the risk of increasing medical expenses year by year,the risk of personnel management,business decision-making risk,compliance management risk control and the risk of product design.Then,using fuzzy comprehensive evaluation method(FAHP)to quantitatively evaluate the personal accident insurance risk of TPY insurance company of Shandong,a comprehensive score was obtained,in which the risk management of the insured fraudulently insured,the insured fraudulent claims and business decision-making risk are in a failing state;the risk management of claim staff responsibility,underwriting personnel skills,underwriting personnel responsibility,management manpower shortage and management process design risk are in passing status;the risk management of legal litigation risk,claims staff skills,compliance and product design is in a medium state;the management of the risks of the insured person's personal growth year by year and the risk of medical expenses increasing year by year are in good condition.Finally,the corresponding countermeasures and suggestions are put forward from the following aspects:insured fraud risk,business decision-making risk,personnel management risk,product design risk and external risk.