商業火災保險詐欺案件關聯性研究

The Study on Relationship of Commercial Fire Insurance Fraud Cases

邱書啟(Shu-Chi Chiu)

指導教授 ： 廖述源

淡江大學/商管學院/保險學系保險經營碩士在職專班/碩士(2016年)

https://doi.org/10.6846/TKU.2016.00798

摘要

商業火險詐欺已轉為集團組織化犯罪，而綜觀商業火險詐欺個案，可歸納其共同關聯性為以下七項：(一)火災原因以人為縱火因素為主。(二)以國內經營不善公司或廠房作為掩飾。(三)承租收購後即偽裝經營，並向保險公司投保高額火災保險。(四)火災時間多為夜深無人之際。(五)火災地點位處郊外偏僻之處。(六)保險公司承保後即於短時間內通報出險。(七)不當外力介入脅迫保險公司理賠。
本研究希冀藉由商業火險保險犯罪及縱火案例分析後，謹此對於保險業者、主管與監理機關提出建議事項如下：
一、對保險業者之建議
(一)落實商業火險查勘作業
(二)加強核保及理賠部門資訊交流
(三)加強核保及理賠同業聯繫
(四)重視反詐欺專業人才培訓
(五)加強保險公司與消防、警察與檢調單位聯防機制
(六)加強宣導保戶正確觀念
二、對主管與監理機關之建議
(一)強化保險犯罪防制中心功能
(二)成立專責反保險詐欺調查單位
(三)提高保險詐欺懲罰
(四)設置保險詐欺資料庫
(五)加強保險犯罪防制宣導

關鍵字

保險詐欺 ； 保險犯罪 ； 縱火

並列摘要

Commercial fire insurance deceptions have become a group organized crime. Making an overview of commercial fire insurance deceptions, their common correlation could be concluded as the following: (1) The occurrence of fire are mainly caused by deliberately arson. (2) Conceal their actions by bad managed companies or plants at home. (3) After tenanting or purchase, they disguise the place as the business office and cover expensive fire insurance with the insurance company. (4) Most of fire disaster occurs late in night when there is no one around. (5) Fire disasters occur at desolate suburb. (6) After the insurance company accepts insurance, notice of loss will be made in a short period. (7) Improper external forces intervene and coerce the insurance company to settle claims.
By analyzing commercial fire insurance crimes and cases of arson, the study proposes the following suggestions for the insurers, competent authorities and supervision authorities:
1.Suggestions for insurers:
(1)Carry out the survey operation of commercial fire insurance.
(2)Reinforce the information exchange between the insurance department and the claims department.
(3)Reinforce the connection among persons in the insurance check and claim field.
(4)Attach attention to the training of professional anti-fraud talents.
(5)Reinforce the joint defense system among insurance companies, fire protection departments, police offices and survey units.
(6)Reinforce the publicity concerning correct concepts of the insured.
2.Suggestions for competent authorities and supervision authorities:
(1)Reinforce functions of the insurance crime control center.
(2)Set up the specific survey units of insurance fraud.
(3)Improve the punishment of insurance deceptions.
(4)Set the data base of insurance deceptions.
(5)Reinforce the publicity concerning the prevention and control of insurance deceptions.

並列關鍵字

Insurance Fraud ； Insurance Crime ； Arson

參考文獻

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