| 健康保险欺诈与反欺诈探析 |
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| 引用本文： | 童元松. 健康保险欺诈与反欺诈探析[J]. 长春金融高等专科学校学报, 2007, 0(3): 15-18 |
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| 作者姓名： | 童元松 |
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| 作者单位： | 无锡市广播电视大学,江苏,无锡,214021 |
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| 摘 要： | 健康保险欺诈手段包括投保人故意隐瞒既往病史及现有病症,或故意制造保险事故,或谎报投保条件,或医患勾结骗取保险金.保险公司迫切需要加强内控制度建设,提高业务人员综合素质,识别欺诈,建立完整的反欺诈体系以促进健康保险的发展.
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| 关 键 词： | 健康保险 骗保 反欺诈 内控制度 健康保险 保险欺诈 反欺诈 Insurance 发展 体系 识别 综合素质 业务人员 内控制度建设 加强 保险金 医患 条件 投保人 保险事故 制造 病症 病史 欺诈手段 |
| 文章编号： | 1671-6671（2007）03-0015-04 |
| 修稿时间： | 2007-06-23 |
On the Fraud and Counter-fraud of Health Insurance |
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| TONG Yuan-song. On the Fraud and Counter-fraud of Health Insurance[J]. Journal of Changchun Finance College, 2007, 0(3): 15-18 |
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| Authors: | TONG Yuan-song |
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| Affiliation: | Wuxi Radio and TV University, Wuxi 214021, China |
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| Abstract: | The fraudulent means of health insurance include intentionally concealing past disease history and current disease, or deliberately creating insurance accident, or telling lies about insurance conditions, or the collusion of doctors and patients so as to get insurance compensation. Insurance companies need to strengthen the institution establishment of internal control, improve the comprehensive quality of operational staff, identify fraud and establish a complete counter-fraud system to promote the development of health insurance. |
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| Keywords: | health insurance fraud counter-fraud institution of internal control |
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