壽險(xiǎn)調(diào)查

目 錄

總論篇
第一章　壽險(xiǎn)調(diào)查概述 // 003
一、調(diào)查的定義..................................................................................................003
二、調(diào)查的類(lèi)型..................................................................................................003
三、調(diào)查的形式..................................................................................................004
四、調(diào)查的主要方法..........................................................................................006
五、調(diào)查的提調(diào)標(biāo)準(zhǔn)..........................................................................................008
六、調(diào)查的基本流程..........................................................................................009
第二章壽險(xiǎn)調(diào)查人員基本要求 // 012
一、工作原則......................................................................................................012
二、素質(zhì)要求......................................................................................................014
三、技能要求......................................................................................................015
四、風(fēng)險(xiǎn)管控能力..............................................................................................017
五、行為規(guī)范要求..............................................................................................018
第三章　壽險(xiǎn)調(diào)查管理 // 020
一、風(fēng)險(xiǎn)管理......................................................................................................020
二、專業(yè)管理......................................................................................................021
三、績(jī)效管理......................................................................................................024
理論篇
第四章　實(shí)施前的準(zhǔn)備 // 029
一、案情分析與信息收集..................................................................................029
二、查勘計(jì)劃制訂..............................................................................................032
三、應(yīng)對(duì)策略準(zhǔn)備..............................................................................................032
四、約訪查勘準(zhǔn)備..............................................................................................034
第五章　過(guò)程與證據(jù)管理 // 036
一、人員訪談?lì)?.................................................................................................036
二、現(xiàn)場(chǎng)查勘類(lèi)..................................................................................................043
三、合作鑒定類(lèi)..................................................................................................061
四、外部書(shū)證的調(diào)取..........................................................................................077
五、理賠協(xié)談及拒付解釋..................................................................................104
第六章　調(diào)查結(jié)果反饋 // 109
一、調(diào)查報(bào)告撰寫(xiě)..............................................................................................109
二、調(diào)查日志錄入..............................................................................................113
三、調(diào)查材料歸檔..............................................................................................118
第七章　固定渠道合作管理 // 120
一、基礎(chǔ)概述......................................................................................................120
二、管理原則......................................................................................................120
三、管理流程......................................................................................................121
實(shí)戰(zhàn)篇
第八章　契約生存調(diào)查 // 125
一、基礎(chǔ)概述......................................................................................................125
二、財(cái)務(wù)調(diào)查......................................................................................................126
三、契約生存調(diào)查的實(shí)施..................................................................................130
四、經(jīng)典案例借鑒..............................................................................................132
第九章　保全生存調(diào)查 // 138
一、基礎(chǔ)概述......................................................................................................138
二、保全生存調(diào)查方式......................................................................................139
三、經(jīng)典案例借鑒..............................................................................................139
第十章　基礎(chǔ)查勘 // 142
一、基礎(chǔ)概述......................................................................................................142
二、實(shí)務(wù)要點(diǎn)......................................................................................................143
三、具體項(xiàng)目......................................................................................................146
四、實(shí)戰(zhàn)案例......................................................................................................152
第十一章　正面查勘 // 154
一、基礎(chǔ)概述......................................................................................................154
二、實(shí)務(wù)要點(diǎn)......................................................................................................155
三、實(shí)戰(zhàn)案例......................................................................................................161
第十二章　醫(yī)療查勘 // 167
一、基礎(chǔ)概述......................................................................................................167
二、基礎(chǔ)知識(shí)......................................................................................................167
三、實(shí)務(wù)要點(diǎn)（重點(diǎn)調(diào)查內(nèi)容）......................................................................171
四、查勘內(nèi)容與方式..........................................................................................174
第十三章　事故查勘 // 194
一、查勘要點(diǎn)......................................................................................................194
二、查勘方式與內(nèi)容..........................................................................................195
第十四章　醫(yī)療鑒定查勘 // 233
一、醫(yī)療鑒定流程及查勘要點(diǎn)..........................................................................233
二、傷殘鑒定查勘實(shí)踐與案例分析..................................................................237
第十五章　理賠調(diào)查新技術(shù) // 245
一、基因檢測(cè)技術(shù)..............................................................................................245
二、人像對(duì)比技術(shù)..............................................................................................248
三、GPS定位技術(shù)..............................................................................................250
四、3S技術(shù)..........................................................................................................253
五、移動(dòng)理賠技術(shù)..............................................................................................254
六、互聯(lián)網(wǎng)平臺(tái)與理賠調(diào)查..............................................................................255
七、新科技設(shè)備在理賠調(diào)查中的應(yīng)用..............................................................257
風(fēng)險(xiǎn)管理篇
第十六章　壽險(xiǎn)公司的經(jīng)營(yíng)風(fēng)險(xiǎn)管理 // 263
一、壽險(xiǎn)公司的經(jīng)營(yíng)模式..................................................................................263
二、壽險(xiǎn)公司的經(jīng)營(yíng)風(fēng)險(xiǎn)..................................................................................264
三、壽險(xiǎn)公司風(fēng)險(xiǎn)管理的目標(biāo)..........................................................................266
四、壽險(xiǎn)公司風(fēng)險(xiǎn)管理建議..............................................................................266
第十七章　壽險(xiǎn)公司反欺詐風(fēng)險(xiǎn)管理 // 269
一、反欺詐管理的定義......................................................................................269
二、壽險(xiǎn)公司面臨的欺詐風(fēng)險(xiǎn)..........................................................................269
三、反欺詐風(fēng)險(xiǎn)管理的意義..............................................................................273
四、壽險(xiǎn)公司反欺詐管理的問(wèn)題......................................................................274
五、壽險(xiǎn)公司理賠風(fēng)險(xiǎn)的防控與應(yīng)對(duì)..............................................................276
六、壽險(xiǎn)反欺詐案例分析..................................................................................283
第十八章　壽險(xiǎn)反欺詐管理對(duì)策 // 289
一、壽險(xiǎn)反欺詐內(nèi)部管理對(duì)策..........................................................................289
二、壽險(xiǎn)反欺詐外部管理對(duì)策..........................................................................290
三、大數(shù)據(jù)與壽險(xiǎn)反欺詐系統(tǒng)平臺(tái)建設(shè).........................................................292
四、典型壽險(xiǎn)反欺詐經(jīng)驗(yàn)分析..........................................................................300
五、保險(xiǎn)銷(xiāo)售行為可回溯管理..........................................................................305
六、保單逆選擇風(fēng)險(xiǎn)排查..................................................................................308
第十九章　國(guó)際壽險(xiǎn)公司反欺詐的舉措與經(jīng)驗(yàn) // 323
一、保險(xiǎn)欺詐的環(huán)球趨勢(shì)..................................................................................323
二、國(guó)際壽險(xiǎn)業(yè)反欺詐舉措..............................................................................324
三、國(guó)際壽險(xiǎn)反欺詐經(jīng)驗(yàn)對(duì)我國(guó)的啟示.........................................................328
參考書(shū)目 // 330