Comparison On Insurance Anti-fraud Mechanisms Of China And The U.S. And Countermeasures

Since the insurance generated, insurance fraud has always been its constant companion, with people’s insurance awareness improve in recent years, the insurance industry has undergone tremendous development, but insurance fraud is also increasing, and invisibility increasing, the way of insurance fraud become more and more, insurance fraud has become one of the main obstacles to hinder the healthy development of the insurance industry, Even the insurers have to consider the costs due to fraud when calculate the premium, hence, Insurance fraud has been hailed as the silent catastrophe of insurance industry.With the development of china’s economic in recent years, the insurance industry has been also developed rapidly, Since restore the insurance industry in the1980s, The number of insurance companies and premium income keep growing, Premium income in2011has reached1.4trillion Yuan, has become an important part of the national economy that cannot be ignored, but insurance fraud keep growing accompany with the development of insurance, According to China’s insurance regulatory authorities estimate about20percent of China’s insurance claims caused by the fraud, can cause hundreds of billions loss. However, China is still not realized the seriousness of the hazard of insurance fraud, has not established the anti-fraud system yet, and has just beginning the study of insurance anti-fraud; there are many deficiencies in many places. Insurance fraud is a worldwide problem not just unique to our country, The United States as one of the most developed insurance industry countries; there is also a serious insurance fraud, The United States insurance industry has developed many years, so does its study of insurance anti-fraud, Therefore, in order to detect the problems in the insurance anti-fraud, This article specifically compare the insurance anti-fraud mechanism of China and the U.S. with each other, Then found the shortcomings of China’s insurance anti-fraud process, and make recommendations.This paper based on comparative analysis, defined the concept of insurance fraud first, then analyze the causes of insurance fraud with game theory from the perspective of information asymmetry, found three factors that have impact on the probability of insurance fraud:check probability, punishment, cost, then analyze the current situation of China’s insurance fraud from the view of these three factors, make an overview of the insurance anti-fraud mechanism of china and the U.S. and compare with each other, found deficiencies in China’s insurance anti-fraud mechanism, make recommendations in the end.Based on the above ideas, the structure of this paper is divided into five parts:The first part, make an overview of the contents of the insurance fraud, can be divided into two sections, the first section defines the concept of insurance fraud, the second section analyzes the causes of insurance fraud with game theory from the perspective of information asymmetry, and found three factors that have impact on the probability of insurance fraud:check probability, punishment, cost.The second part describes the status of China’s insurance fraud, and estimate the amount of insurance fraud use premiums and insurance claims data of the past decade, found the trend of insurance fraud has been increasing in recently years,The third part describes China’s insurance anti-fraud mechanism. Found four reference systems:the relevant legislation of the insurance anti-fraud, insurance anti-fraud agency, Insurance anti-fraud technology and anti-fraud information platform, publicize the insurance anti-fraud knowledge and training of professionals, introduce China’s insurance anti-fraud legislation, information platform construction and other related content from these four parts.The fourth part mainly describe the insurance anti-fraud mechanism, First described the status of insurance fraud in America, then introduce the relevant legislation of the insurance anti-fraud, insurance anti-fraud agency, Insurance anti-fraud technology and anti-fraud information platform, publicize the insurance anti-fraud knowledge and training of professionals of America. Then compare the insurance anti-fraud mechanism of China and America with reference systems, find the defects of China, Such as in China there is no specific legislation on insurance fraud prevention and specific agencies for anti-fraud, provide the direction for the future conduct of the insurance anti-fraud work.The fifth part mainly makes recommendations on China’s insurance anti-fraud mechanism, compare with insurance anti-fraud mechanism of America, make recommendations to national legislation departments, insurance regulators and insurers. Such as accelerate the special legislation on the insurance anti-fraud, establish a unified national insurance anti-fraud database, study insurance fraud recognition technology of Western scholars, promote independent investigation system etc.In short, this paper intend to find the defects of China’s insurance anti-fraud mechanism through the comparison of China and America, introduce the advanced experience of America, especially the insurance fraud recognition model, So that we recognize the insufficient, then establish a sound insurance anti-fraud mechanism.