A Study on Risk Anti-Selection for health care fraud in life insurance

碩士 === 國立高雄第一科技大學 === 風險管理與保險所 === 92 === Life insurance contract is made according to the utmost principle. In life insurance management orginazation, having two important departments. We usually regard underwriting department as the first defence of the insurance company, and regard claim depart...

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Bibliographic Details
Main Authors: Ying-Hui Lin, 林穎慧
Other Authors: Frank K. Ling
Format: Others
Language:zh-TW
Published: 2004
Online Access:http://ndltd.ncl.edu.tw/handle/35073964801401714955
Description
Summary:碩士 === 國立高雄第一科技大學 === 風險管理與保險所 === 92 === Life insurance contract is made according to the utmost principle. In life insurance management orginazation, having two important departments. We usually regard underwriting department as the first defence of the insurance company, and regard claim department as the last defence. Underwriters and insurance adjusters how to reduce the risk to the lowest, and not against the development department is very important. In practice, underwriter how to judge insured is purposely hide, or is fraud. If insured with intend to hide actually fact, it is difficult to judge. According to empirical data, discussing whether the data are connected with the result is defferent from forerign countries the rule of insureds’anti-declaration obligation in our country. How to decrease this condition is the most important purpose. This study use data from A insurance company are focused on the rescission of contract case due to anti-declaration obligation after two years of policy effect. It is selected six hundred rescission of new business contracts contracts during the time interval between Jan., 2001 and Dec., 2003. Relying on the data collected from Taiwanese insured establishments , multivariate tests and regression analysis results of the study found that, eleven variable factors which have appearent influence on the amount of claim:age of insured , sex of insured, marriage of insured, occupation of insured, medical expense plan , operation expense plan , amount of insured , insured period and area and so on. It comes to the conclusions that: 1. Build up policy’s obligation style. 2. Full of education effect. 3.Take some different grades of payment. 4. Adjust suitable marketing strategy. 5.Build up completed notification system.