中国太平洋保险公司风险管控中的核保核赔系统改造和流程再造研究

上海交通大学硕士学位论文中国太平洋保险公司风险管控中的核保核赔系统改造和流程再造研究姓名：唐靖渭申请学位级别：硕士专业：工商管理（MBA）指导教师：周朝民20040606CPICUNDERWRITING&CLAIMSSYSTEMUPDATEFORTHEBETTERRISKMANAGEMENTANDCONTROLSTUDYOFPROCEDUREEVALUATIONANDIMPLEMENTATIONABSTRACTChineseinsuranceindustryisinit’scubhood.Althoughrapidprogresshastakenplaceintherecentyears,ChineseinsuranceCo.isfacingabigchallenge.VariousrisksandproblemsarecausedbytheweaknessoftheChineseinsurancesystemitselfandexternalmarketchange,especiallyforChina’sentrytoWTO.ToensurethehealthandstabledevelopmentofInsuranceBusiness,it’sessentialtosetupaneffectiveinternalcontrolsystemtostrengthentheoperationadministrationofthecommercialinsurancecompany.InParticular,weshouldsetupasetofcorrectandeffectiveprocesswithscientificmethodtocompliancethekeypointsoftheUnderwriting&Claimsprocess.TofocusoninternalcontrolofthekeypointsduringtheprocessoftheUnderwriting&Claims,weshouldcombinetheelectricalmanagementfollowedbythecheckreport.Meanwhile,weshouldimprovethestatisticsystemandpost-auditpolicy.Toavoidanyriskinbusinessoperation,weshouldcopywiththenationalmacro-preventionmeasuresforbetterexecutionofthemicro-businessoperation.Weshouldintegratetheriskpreventionmeasuresintotheinterestexpansiontoreachourtargetatlast.CPICauditreportexploretherisksexistedinbusinessoperationin2003.IttookanegativeeffectonUnderwriting&Claimsoperationininsurancecompanyduetotheincorrectinformationcausedbytherisksofthemoralhazardandadverseselectioninsociety.Tosolvetheproblemsasabovementioned,weshouldupdatetheUnderwriting&ClaimsSystemundertheriskpreventionadministrationandcontrol.Weshouldchangetheoperationmodulefromsalesfocustothecustomerfocusunderthenewbusinessoperationguideline.Weshouldapplythee-commercialsolutiontoimplementtheriskmanagementonthebasisofthehealthandstandardUnderwriting&Claimssystemmeanwhile,tostrengthentheprocessdevelopment.Asaninsurancecompany,thefunctionofUnderwriting&Claimsmanagementsystemplananimportantroleonthemodernizationofthebusinessadministration.Itiscriticalforinsuranceenterprisetocompletethecentralizedmanagementonthebasisofcustomerfocus.ThecurrentUnderwriting&ClaimssystemofCPICplayanimportantroletounifythebusinessstandard.However,thereisstillsomeweakpointsinprocessdesigningthatsomeriskscannotbepreventedduetothemanualinputandmodification.It’snecessaryforustoevaluatethewholeprocess,presentthenewplanandimplementtheprocesscorrectly.Thenewsystemisincludedthevoucherimagemanagementsystem,centralizedbillingsystem,businesssystemandUnderwriting&Claimssystem.Thedataandimageinformationinputsimultaneouslymakethevouchermanagementonahigherlevel.Theapplicationofthetheinternettechnologyinthissystemmaketheremoteoperationpossible.CPICapplythenewsystemthroughoutthewholecompanywiththeadvancedexperienceandtechnologyfromtheforeigncompanies.Weovercometheweakpointwiththeoptimismsolution.Comparedwiththeoldsystem,itimprovetheeffectiveofthedocumentscirculation,completetheelectric-filemanagement,supportingsystem,personalizedinsurancesheetwithhighefficiency,informationshareacrossfunctionsandgrandofauthorityandsoon.TheCPICnewsystemis“spider”promotedandtestedbytheCPICbranchesalloverthecountry.Wereceivedgoodfeedbackandreachtheresultasweexpectedthroughadetailedimplementationplan.Duringthetestperiod,theworkvolumeishigherthanbefore,butthenewsystemmeettherequirementofthefocalmanagementofUnderwriting&Claimsdivisionwiththesuperioradvantagesofthetimeefficiencyandreasonableprocessandgrandofauthoritysetting.ThemostimportantistoimprovetheriskcontrollevelandqualityoftheUnderwriting&Claimsoperation.KeyWords:RiskManagementandControl,Underwriting&Claims,System,ProcedureEvaluationandNewSystemImplementation200406091231234567891011121314151617181920212223242526272829303132YN33343536373839404142MBA200466313MBA200466中国太平洋保险公司风险管控中的核保核赔系统改造和流程再造研究作者：唐靖渭学位授予单位：上海交通大学相似文献(1条)1.学位论文唐琨保险远程定损模型及其应用研究2005本文结合中国太平洋保险公司远程定损系统的设计与实现，对远程定损模型进行了深入的研究。本系统主要是完成保险公司理赔从查勘员调度、现场损失情况回传及定损情况重新返回到查勘员的过程，利用先进的通讯和计算机技术对理赔查勘和定损的全过程进行控制管理，既能节省大量人工劳动，又能有效的提高工作效率，同时也避免了在中间环节可能产生的不必要的问题。这套系统的应用集中体现了保险公司风险管控的水平，具有很高的应用价值。引证文献(1条)1.李强A保险公司发展战略研究[学位论文]硕士2006本文链接：授权使用：上海海事大学(wflshyxy)，授权号：6aee21dd-240f-4b91-b446-9e09015e21fe下载时间：2010年10月8日