人身保險詐欺相關問題之探討

A study on the Personal Insurance Fraud.

魏雅珣(Ya-Hsun Wei)

指導教授 ： 施懿純

朝陽科技大學/管理學院/保險金融管理系/碩士(2017年)

摘要

隨著經濟起飛保險觀念的強化，保險已成為現在不可或缺的經濟產物，因保險導致的詐欺犯罪案件也會越來越多，藉由投保高額保險後，故意導致保險事故、意外來詐領保險金，甚至更有為了保險金進而謀害被保險人的行為，不當手法越來越多造成許多嚴重的後果。本研究藉由說明保險詐欺之意義、法律性質與各國立法例，配合我國司法案例分析結果，來探討如何降低此種情形。
本研究採文獻分析法及法院個案判例研究法，從司法判決案例中，分析這些案件發生的原因及特徵，針對全國各地方法院2011~2016年間一審判決保險詐欺案有罪之個案做研究分析，內容包括人身保險詐欺相關之類型與模式，再以實際案例驗證保險詐欺，提出保險詐欺相關建議與防制之缺失，以減少保險詐欺案件之發生。根據上述研究結果對於保險詐欺防制的工作提出相關可行性之建議，以期降低未來保險詐欺案之發生率。

關鍵字

保險 ； 人身保險 ； 保險詐欺

並列摘要

The economic boom in Taiwan and the idea of having insurance is generally accepted bypublic. Nowadays insurance has become the necessity of commercial product.This is due to the increased number of insurance frauds which means the insurer or beneficiary would pay for the higher premium with the intent to obtain a fraudulent outcome by creating accidents on propose or even severe event, such as murder.This study explores how to reduce this situation by explaining the meaning, legal nature and national legislation of the insurance fraud, and then puts forward some suggestions on the existing Taiwan Insurance Law.
Thisstudy is based on document analysis and case study method.It would analyse the root causes, such as, the reasons of why the events were taken place and features, from each case. The study is concerned the cases which are related to personal insurance fraud from 2011 to 2016 and the decisions were made by nationwide courtyards at the first trial. Suggestions and comments about how to avoid the fraud can be raised via reviewing and verifying the actual cases of insurance fraud. Therefore, we may reduce the number of insurance fraud. Finally, the study will list implementable suggestions based on the search result in order to reduce the incidence of insurance fraud in future.

並列關鍵字

Insruance ； Personal Insurance ； Insurance Fraud

參考文獻

2.柯政昌(2014)。台灣健保詐欺量刑標準之實證研究。國立交通大學管理

之研究。台北。行政院金融監督管理委員會保險局。

3.行政院金融監督管理委員會保險局

一、書籍

1.月足一清原著，吳崇權譯(1988)。人壽保險犯罪及其防止對策。台北：