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市场经济体制下的本位利益诱导与驱使,在不少人的脑海中形成了跑运输赚钱不如到保险公司骗赔的意识,使保险经营中的造假骗赔案时有发生,酿成运工险赔付率的新一轮上扬,1996年娄底地区中保财险公司运工险赔付率高达155％,引起保险经营效益的严重滑坡和保险经济补偿能力的削弱。据调查运工险造假骗赔,涉及保户、政府部门的部分工作人员及社会其它阶层人士合谋私利、相互利用共同犯罪,因此,打假反骗单靠保险公司自身的力量已难以凑效。为此,我们娄底地区财产保险公司与地区纪检部门联手打假反骗,根据群众举报,结合我们在理赔工作及赔案事前审计中掌握的造假疑点,于今年三月份集中对冷水江市的一些赔案开展打假,收到了较好的效果,本文介绍我们调查处理的几桩典型案例,希望给运工险打假反骗提供一些参考意见。
Under the market economy system, the interests of the individual are induced and driven. In the minds of many people, a sense of cheating in running transportation is not as good as that of insurance companies, causing fraud and insurance claims in insurance business from time to time. Payout rate of a new round of rise in Loudi in 1996 the property insurance company transport insurance payout rate as high as 155%, causing a serious decline in the efficiency of insurance business and the insurance financial compensation weakened. According to the investigation, transport insurance fraud fraud, involving policyholders, some government departments and other sectors of the community for personal gain and mutual use of common crimes, therefore, the anti-fraud alone relying on the insurer’s own power has been difficult to make ends meet. To this end, we Loudi regional property insurance companies and discipline inspection departments jointly counterfeiting cheat, according to the masses reported, combined with our work in claims and pre-trial audits to grasp the suspicion of fraud, in March this year, focused on some of the cold water Jiang lost In the case of launching a crackdown, we received good results. This article introduces a few typical cases that we investigated and dealt with, and we hope to provide some reference suggestions for the fraud against fraud by transport insurance.