我國保險詐欺相關問題之研究

保險詐欺乃當今新興之全球性金融犯罪問題，我國保險制度行之有年，同樣無法避免，保險詐欺日漸猖獗除了造成業者損失外，隨之而來的殺人、偽造文書、蓄意製造車禍等行徑更是造成了社會善良風俗的淪喪。　　本研究以「保險詐欺防治制度」和「我國不同類型之保險詐欺案例特性」為主要之研究方向，以文獻分析法為研究方法，先由國內外相關文獻中進行保險詐欺之定義，列出常見的保險詐欺表徵，並列出由不同標準劃分之保險詐欺類型並簡述其特性，於第三章再從法律層面、制度層面歸納出我國與其餘國家之間防制制度的差異，並藉由司法院判決案例中進行統計分析，總結出我國近年來保險詐欺案件的特性與發展方向。　　研究結果說明我國目前保險詐欺以偽造文書為最常見之保險詐欺類型，且整體數據顯示保險詐欺犯罪有高度集團化之趨勢，鑒於我國目前保險法與刑法中均沒有對保險詐欺做出明確罰則與規範，本研究提出之研究建議: 一、將保險詐欺相關立法、修法排入日程。二、我國專責之機構應完整發揮其功效。三、加強對社會大眾對於保險詐欺之認識與警覺。

關鍵字

保險；保險詐欺；保險犯罪

並列摘要

Insurance fraud is an emerging global financial crime issue. The insurance system has been around in Taiwan for years, and the problem is also unavoidable. Nowadays Insurance fraud is increasingly rampant; aside from causing losses to the industry, the subsequent acts include murder, forgery of documents, and deliberate accidents. All these lead to the loss of good traditions. The direction of this study is to explore the issues of "common types of insurance fraud" and "characteristics of insurance fraud in Taiwan", adopting literature analysis as the research method. First, it lists the definition of insurance fraud in the domestic and foreign relevant literature, as well as the common features of insurance fraud. Next, it lists the types of insurance fraud classified by different standards, briefly describing their characteristics. In Chapter 3, the legal and institutional levels are summarized and the differences in the prevention systems between Taiwan and other countries are analyzed. Statistical analysis is carried out from the cases of Judicial Yuan to generalize the traits and development direction of insurance fraud cases in Taiwan in recent years. The findings of the study indicate that forged documents is currently the most common type of insurance fraud in Taiwan, and the overall data shows that insurance fraud tends to be highly grouped. Given that there are no clear penalties and regulations for insurance fraud in Taiwan’s current insurance law and criminal law, the research recommendations are proposed in this study: 1. Put insurance fraud-related legislation and amendments on the agenda. 2. The specialized agency in our country should fully exert its functions. 3. Strengthen the awareness and alertness of the public regarding insurance fraud.