壽險核保作業風險管理之研究

A study on risk management of underwriting operational risk for life insurance

呂秋蓉(Chiu-Jung Lu)

指導教授 ： 何佳玲

淡江大學/商管學院/保險學系保險經營碩士在職專班/碩士(2013年)

https://doi.org/10.6846/TKU.2013.00554

摘要

近幾年來由於保險商品不斷創新及多元化、保險詐欺的盛行、相關法令的變更頻仍，使得核保作業越趨於複雜化。此外，國內外發生公司內部員工舞弊的事件，均使得公司遭受極大的損失、商譽受損甚至倒閉。本研究依據保險業風險管理實務守則中的作業風險分類將壽險核保作業風險分為四大類，並從各種可能的風險因素中，找出關鍵重要的因素。針對個人壽險核保作業流程之重要作業點，所可能產生的風險因素，建立監控機制。
本研究採用德爾菲(Delphi Method )專家問卷調查之方式，進行德爾菲法專家問卷調查及資訊的回饋之後，讓專家的意見達成一致性。
本研究將調查結果依各項核保作業風險因子的發生機率及造成公司營運影響程度建立風險地圖，提供壽險公司核保主管於訂定核保政策與風險評估之參考，並有效避免或降低作業風險，確保保險公司經營安全。

關鍵字

核保 ； 作業風險 ； 核保作業風險 ； 德爾菲法

並列摘要

In recent years, the innovation and diversification of the insurance product, fraud prevalence, and modification of insurance product laws led to the complication in underwriting process. Besides, the occurrence of fraud within the insurance company’s employees resulted in the company’s substantial losses, the damage of the commercial goodwill, and the collapse of the company. This study was based on the classifications of the Code of Practice of Insurance risk Management, and divided the risk life insurance underwriting operations into four categories. Moreover, this study also identified the key significant factors for individual life insurance underwriting processes from the various possible risk factors to establish monitoring mechanism.
This study was based on Expert Delphi survey. After conducting the questionnaire and collecting the feedbacks, the experts’ opinions of the survey would reach the consensus.
The consequence of this study would establish a risk mapping by the probability and the corporation operating influential level of various underwriting risk factors’ occurrence, providing the risk assessments and references for the life insurance company’s underwriting directors to impose the underwriting policies, and to avoid or reduce operational risk to ensure the safety of the insurance company.

並列關鍵字

underwriting ； operational risk ； underwriting operational risk ； Delphi method

參考文獻

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