保险人与服务提供商的关联模式与共谋型保险欺诈研究

被保险人和服务提供商共谋型保险欺诈是保险人面临的重要课题。过往的研究一般是通过优化保险人的审计战略和设计最优保险合同来解决。由于维修或者保健服务具有软信息的特征,保险合同往往难以实现次优。本文通过构造保险人和服务提供商的关联模型,分别从静态框架下保险合同的特征和动态框架关联模式的演化及排他性关联对共谋型保险欺诈的阻止作用,提出保险人实行上游垂直一体化能够部分缓解共谋型保险欺诈问题。文章最后针对中国保险市场提出建议。

Research of Affiliation of Insurer and Provider, and Collusive Insurance Fraud

The collusion between the insured and providers is a severe problem in insurance market. The literatures argue to design optimal insurance contract and optimize audit strategies to solve this problem. The attribute of soft information of collusion makes it hard to achieve second-best equilibrium. This paper argues that to employ dynamic exclusive affiliation is way to alleviate collusive insurance fraud. Suggestions to China insurance market are given at the end of the paper.