本研究以財團法人金融消費評議中心公告之申訴與評議統計資料進行分析比較,現今保險申訴管道包括保險公司申訴部門、財團法人金融消費評議中心、直轄市及各縣市政府附設之消費者服務中心、各地方政府消保官、民間消費者保護團體、民意代表及保險申訴掮客等。101年第一季至103年第三季人壽保險理賠類申訴、理賠類評議、非理賠類申訴與非理賠類評議案件分別為4040、2216、3491與1879件,其中經由協調後未進入評議之比例於理賠類及非理賠類分別為45.1%與46.2%。保險爭議消弭須由消費者、保險公司與政府機關共同努力,消費者應提升自身對保險的認知知識;保險公司則應做好員工教育訓練及部門溝通協調;政府機關則須由行政、立法及司法共同配合,以減少保險糾紛,保障國民權益。本研究釐清人壽保險爭議項目及降低保險糾紛之方法,可作為金融服務業及政府相關單位制定更具體化規範參考。
Complaint and ombudsman data announcement from Financial Ombudsman Institution were analyzed and compared, and life insurance appeal channels were discussed in this study. Nowadays life insurance appeal channels, including complaints department of insurance company, Financial Ombudsman Institution, customer service center of governments, consumer ombudsman officer, consumer protection groups, Legislator, brokers of insurance appeal. From first quarter of 101 to third quarter of 103, cases of claims complaint, claims ombudsman, non-claims complaint and non-claims ombudsman of life insurance were 4040, 2216, 3491 and 1879, respectively. Resolved ratios of claims and non-claims complaint cases were 45.1% and 46.2%. Reduce insurance dispute should collaborated by consumers, insurance companies and government agencies. Consumers should enhance their knowledge of the insurance awareness. Insurance companies should provide complete employees education and improve communication and coordination of departments. Executive, legislative and judiciary of government shall cooperate to reduce insurance disputes and protect the rights of the people. This study clarified controversial items of life insurance and offered methods of reducing insurance disputes. Can provide financial services industries and government make more concrete norms.