摘要
保险理赔过程中时常发生投保方欺诈现象,通过对实证调研的2000—2011年度258个意外、健康保险理赔诉讼样本进行描述性统计和Logistic回归,发现年龄41~60岁欺诈概率甚于其他年龄段,年龄41~50岁欺诈频次最高,年龄51~60岁欺诈概率最大,工人欺诈概率甚于其他职业,北京欺诈概率甚于外地,北京郊区县欺诈概率甚于北京市区;保险金额与欺诈概率正相关,疾病身故保险欺诈金额最大,保险期间与欺诈概率负相关,意外伤害住院医疗保险欺诈频次最高,健康险欺诈概率甚于意外险;摔扭伤欺诈概率甚于其他伤害,交通事故机动车司机欺诈概率甚于交通事故非机动车伤害,被保险人索赔欺诈概率甚于投保人索赔,非律师参与欺诈概率甚于律师参与。
The insurance claim process is often accompanied by the claimant exaggerated claims. This article regresses the 258 accident and health insurance sample data of claiming litigations between 2000 and 2011 with descriptive statistics and Logistic model, finding that the 41-50 and 51-60 year-old is worse than the other year-old, and the 41-50 with the highest fraud frequency and the 51-60 with the highest fraud probability; the worker fraud is worse than the others＇; Beijing is worse than other areas, and Beijing suburb worse than Beijing city; fraud is significantly positive with insurance amount, the death insurance from illness with the largest fraud amounts, fraud is significantly negative with insurance term, casualty hospitalization insurance with the highest fraud frequency, health insurance worse than accident; strain/sprain fraud is worse than trauma, troublemaker in a traffic accident worse than the injured, the insured fraud worse than the insurant, fraud with non-lawyer worse than that with lawyer.
出处
《河北经贸大学学报》
CSSCI
北大核心
2014年第6期138-142,共5页
Journal of Hebei University of Economics and Business
关键词
欺诈概率
索赔人特征
保单信息
案件情况
健康保险
统计分析
保险金额
律师
fraud probability, the insured characteristics, policy information, the case circumstances, health insurance, statisti-cal analysis, insurance amount, lawyer
