One, the international mature insurance market auto insurance claims service mode and characteristics
Foreign organizations specializing in auto insurance claims service is more, and the division of labor is very fine. Insurance companies and external organizations based on their respective interests, in order to achieve customer satisfaction this *** with the purpose, pay special attention to the cooperation between each other. They not only their respective duties, but also pay special attention to information, resources *** enjoy, mainly reflected in the following aspects:
(a) survey, determination of the link of cooperation
Survey, determination of the work of the first ring as a claims service, in fact, is also the insurance company on the case of whether the compensation, the compensation of how much of the first pass, which directly relates to the insurance company to settle the number of claims cases, the closure of cases, speed, social impact, crystal brand effect. It is directly related to the number of claims, the speed of settlement, the social impact, the crystal effect and so on, so the insurance company attaches great importance to this link. In order to cope with a large number of cumbersome survey, loss determination work, developed countries and regions of the insurance companies generally adopted the mode of cooperation with external professional organizations.
(II) Cooperation in Information Technology Development
1. Improve the rationality and timeliness of survey scheduling. Progressive, the fourth largest auto insurance operating company in the United States, uses GPS positioning technology to determine the location of surveyors. Through the intelligent scheduling system, surveyors are dispatched to the scene of an insurance accident within a very short period of time, and in addition, through the computer network, they can inquire about the scheduling situation of the repair shops and provide timely delivery and repair services to customers.
2. Improve the accuracy of surveying and loss determination. Allianz Deutschland has been using Audatex system (now belonging to ADP) and recently Glassmatix estimation system to ensure the standardization and transparency of auto insurance claims.
3. Improve the timeliness and convenience of receiving and reporting cases. Yasuda Fire & Marine Insurance Company of Japan uses a 24-hour working accident receiving and reporting system in auto insurance claims, which corresponds to the remote computer system of 14 claim centers across the country and 252 claim terminals nationwide, so that customers can get the result of the insurance company's processing from any claim terminal and get the compensation within 7 days.
4. Improve the efficiency of survey and damage determination. In China's Taiwan, auto insurance claims have begun to use the remote loss determination system, through the Internet transmission, to realize the insurance company loss adjuster can both on-site loss determination, but also can carry out online remote loss determination, the customer and the garage can also go online to inquire about the results of the loss determination and the price of spare parts, and even the purchase of spare parts and other functions.
(C) provide diversified service links in the cooperation
Provide customers with a full range of multi-level services is a major feature of modern auto insurance claims, in which derivative services have become the main means of competition. The best in this regard is the United States. As the world's largest insurance market, the U.S. insurance companies and banks, telecommunications, hospitals, police departments, repair shops, glass stores, rescue companies, emergency centers and other external organizations are very common. Since the early 1990s, the United States has also seen the emergence of a company specializing in loss balance processing for auto insurance companies. The existence of a large number of specialized institutions not only improves the overall level of the insurance industry, but also promotes the improvement of the quality of insurance coverage and the reduction of the cost of insurance services.
Two, the current insurance market in China, the mode of automobile claims service and its advantages and disadvantages
Automobile insurance is China's largest single-insurance business in the domestic insurance market, is the backbone of China's property insurance business. Its business volume accounts for more than half of the property insurance. 2003, the national insurance premium income amounted to 89.24 billion yuan, 54.46 billion yuan from the auto insurance. 2003, China's general insurance companies, auto insurance has decided the number of cases of compensation up to more than 7.66 million, the claims rate of up to 60.87%, auto insurance survey, the amount of accounting work, high cost. In China's current insurance market, high handling fees, high cost rate, low capital utilization, auto insurance in the operation of 2003 has appeared in the whole industry loss of the grim situation. Effectively change the current auto insurance claims service model, squeeze the moisture of claims, reduce the cost of claims service, has become one of the major issues to change the current situation of China's auto insurance operating losses.
(a) China's claims service model
Since the motor vehicle has the characteristics of mobility, the insurance company in the operation, especially in the provision of services to establish and improve the characteristics of motor vehicles with the establishment of a service system or service mechanism, to do a good job in the motor vehicle after the insurance work. This service system or mechanism is mainly centered on timely rescue, investigation, loss determination and repair of insurance vehicles after insurance, at the same time, also includes the handling of cases involving third-party liability. At present, China's more mature and popular model is the claims service model dominated by the insurance company's autonomous claims handling, which is characterized by:
1. Each establishes its own service hotline, which provides round-the-clock and all-around services to the insured, and accepts case reports through the hotline.
2. Each company establishes its own survey team, which is fully equipped with survey vehicles and corresponding equipment, and accepts the scheduling and on-site survey and damage determination of its own customer service center.
3. Each of them establishes its own vehicle spare parts quotation center, for the high proportion of auto insurance claims, auto insurance claims and operating profits have a great impact on the rate of claims, and at the same time is the most likely to generate profiteering in the spare parts claims, the insurance companies attach great importance to organizing people engaged in the collection of auto parts prices, quotations and price verification work.
4. A certain part of the survey and loss determination or a certain area of the service radiation can not be handed over to the public appraisal companies, price departments, repair shops, survey companies and other external organizations to complete.
(B) the current auto insurance claims service model of China's pros and cons
1. Autonomous claims. That is, the insurance company's claims department is responsible for the inspection of the accident and loss settlement. This approach has played a positive role in the early development of China's insurance industry, but also obviously with a series of specific historical period of branding. With the reform and opening up of Chinese society and the development of the market, especially after the accession to the WTO, the global economic integration of China has had a great impact on the international advanced claims estimation methods and concepts continue to be transmitted to the domestic i insured's awareness of insurance consumption is also increasing, the drawbacks of this model will increasingly come to the forefront, mainly manifested in:
(1) large capital investment, low efficiency, poor economic efficiency. For the insurance company itself, from the exhibition to underwriting, from loss determination to underwriting claims, each link in the hands of the large and comprehensive model resulting in inefficiency. Huge claims team, coupled with the survey vehicles, equipment, the corresponding configuration, a large number of human and material resources to deal with the cumbersome loss adjusting and claims matters, resulting in its internal management and operation of poor economic efficiency, but also often appear in the business staff survey can not see over, assess the loss of fixed over, the material can not be handed over to the abnormal phenomenon. This irrational allocation of resources and China's insurance companies to become bigger and stronger, to participate in international competition, to develop core competitiveness, take the road of specialization, compared to the requirements of the operation, is not compatible.
(2) Poor transparency and unfairness in claims handling. Auto insurance loss adjusting is different from other social production projects, which involves a wide range of interests, professionalism, accounting for more categories, which requires claims business open and transparent. The insurance company's own loss determination is like the insurance company doing both "athlete" and "referee", which means that the loss determination results are contrary to the basic principles and requirements of justice for the insured. For this kind of contradiction, even if the conclusion of the insurance company is reasonable, it is often difficult to convince the insured, which leads to disputes in the claim settlement work. Especially in the asymmetric information market, this disadvantage is more prominent.
2. Price assessment. That is, the public security traffic management department entrusted the price department to force the development of the loss. This approach is used less, because the insurance parties are not recognized, not welcome. The China Insurance Regulatory Commission (CIRC) has also issued a document to resist.
3. Insurance public appraisal. That is, the professional insurance adjuster company accepts the commission of the insurance party, is responsible for the loss of automobile inspection and adjusting work, which is a common practice in the international arena. The benefits of this practice are:
(1) can reduce claims disputes. The public adjuster who has no interest is responsible for the inspection and loss adjustment work, which can better reflect the fairness of the insurance company's contract, and make the claims process open and transparent, avoiding possible disputes and disputes, and preventing the use of power for personal gain.
(2) Improving the structure of the insurance market. Having a professional company responsible for survey and loss determination can better reflect the specialization of the social division of labor, and at the same time, it can promote the development of the insurance public appraisal industry and further improve the structure of the insurance market.
(3) It can promote insurance companies to optimize their internal structure and save a lot of human, material and financial resources. Since the insurance company is based on the actual inspection workload to pay inspection fees to the public appraisal company, so it can more faithfully reflect the real situation of the operation, to avoid the insurance company equipped with fixed inspection personnel and related equipment may incur unnecessary expenses and increase the fixed operating costs.
Three, the changes in China's insurance market environment on the auto insurance claims service model of the change requirements
(a) changes in the policy and legal environment
1. Regulatory authorities to increase the development of the insurance market, the insurance market has never been more active. With China's accession to the WTO, China's insurance market has been under pressure to fully liberalize. In order to meet this challenge, implement comprehensive, coordinated and sustainable development, and make China's insurance industry bigger and stronger, the CIRC has taken a series of positive measures, and the insurance market has seen unprecedented changes. There has been a rapid increase in the number of insurance entities, a full liberalization of the operating areas of insurance companies, a nationwide reform of the auto insurance terms and rates system, and the emergence of insurance intermediaries. Drawing on international experience, it has become a must for China's insurance industry to improve its competitiveness by strengthening the business partnership between insurance companies and professional insurance intermediaries at a higher level.
2. The implementation of the new Road Traffic Safety Law brings opportunities and challenges. The Road Traffic Safety Law, which came into effect on May 1, 2004, has put forward newer and higher requirements for auto insurance claims service. The Law provides for the implementation of a compulsory third-party liability insurance system for motor vehicles, emphasizing people-oriented and respect for life, and the compensation standard for people injured in traffic accidents will be substantially increased; the implementation of rapid treatment of the accident scene, and the immediate evacuation of the scene, the restoration of traffic, and the negotiation of damages on their own, in the event of a traffic accident on the road that does not result in injury or death and the parties concerned do not have any disputes over the causes of the facts. It is foreseeable that, with the implementation of statutory insurance, the number of vehicles insured will increase significantly, and the number of insurance cases will also rise; at the same time, the implementation of the new law, the requirements and skills for on-site investigation will also be greatly improved; the workload of investigation is bound to be substantially increased in 2004. How to adapt to the new legal conditions of automobile insurance claims service has become a problem that every general insurance company must face.
(2) Changes in the competitive environment
1. Unprecedented increase in the main body of the insurer's supply, and increase in the pressure of competition. 2004, there is a very prominent change in the insurance market, that is, the main body of the supply of insurance has increased greatly. The abolition of regional operation of insurance companies and the relaxation of branch approvals have made the insurance companies, which were originally restricted to operate in a certain region, to set up institutions in large and medium-sized cities across the country, and the competition in the insurance market has reached a white-hot level. The competition in the insurance market has reached a white-hot level. Rates have dropped sharply, profits have plummeted, and auto insurance operations have suffered large losses.
2. Claims service of insurance companies obviously lags behind underwriting, and most insurance companies internally advocate cooperation with intermediaries. With the increase in the number of supplying entities in the insurance market, there will be a situation where both the newly established insurance companies and the newly entered branches of foreign insurance companies will not be able to equip themselves with professional claims adjusters corresponding to the subject matter of their underwriting due to the hard constraints of cost in the early stage of their operation; and due to the increase in the number of new supplying entities, the profits of the original insurance companies will drop, thus making their owned or reserved claims adjusters become unaffordable. Due to the increase of new supplying entities, the profits of the original insurance companies will decrease, thus making it uneconomical for them to have or reserve more claims adjusters; the new supplying entities will make the already insufficient qualified claims adjusters even more scarce, and the cost of using and reserving claims adjusters will increase, thus increasing the mobility of the claims adjusters. When the underwriting business develops rapidly, the mismatch of claims work tends to affect the development of the insurance industry. It has been proved that relying solely on insurance companies' in-house claims staff to handle claims cases as in the past can no longer meet the needs of the growing claims work. The unsynchronized development of claims handling and underwriting has become an important problem for insurance companies to solve in order to improve economic efficiency. Drawing on the experience of developed insurance countries, strengthening mutual cooperation with intermediary organizations has increasingly become an institutional arrangement for many insurance companies.
3. Customers' increasing demand for services. China has begun to enter the era of automobile industry, the car has become an indispensable part of the social economy and people's life, people's consumption of automobiles is becoming more and more common, and the service requirements are getting higher and higher. Insurance companies, for the sake of the development of auto insurance business, also take meeting the service demands of the policyholders as an important means of competition. Only by providing better insurance services than their competitors under the same cost conditions can they be in a favorable position in the competition. The increasing specialization of social division of labor provides a good opportunity for insurance companies to reduce transaction and service costs.
Four, the development of China's auto insurance public appraisal industry countermeasures
(a) actively seek government support
Using government resources to promote the development of the industry and enterprises is a topic worthy of attention and research in every industry and enterprise. Professional public appraisal organizations should press the CIRC to clarify the legal status of public appraisal companies as soon as possible, so that they can perform their duties independently as professional organizations without interference from traffic police, prices and other administrative law enforcement departments.
(II) Conform to market changes and meet market needs
Motor vehicle losses are characterized by relatively small amounts compared with other insurance losses, so, from an operational point of view, insurance companies are able to pay limited inspection costs. Public appraisal company in the charge should not be "big mouth", and should be professional and quality service to obtain a larger volume of business, through a larger volume of business to reduce costs and charges. Otherwise, the result will only force the insurance company to have to use the company's internal strength to test.
(C) Improve service level and broaden service area
In order to better expand the market, public adjusting companies should pay attention to strengthening cooperation and communication among themselves, and they should provide professional technical support for insurance companies in the following aspects:
1. Research on how to reduce the cost of repair. The public appraisal companies should, through the daily public appraisal and determination of losses, make statistics, classification and research on the probability of accidents, losses and repair costs of several dominant car models which are widely used in our country, and determine the degree of damage and repairability of automobiles by repairing various collision test vehicles and vehicles damaged in actual accidents, find out the most appropriate repair methods from them, and then provide the results of these researches to the various garages and make them available to the The results of these studies are then made available to the repair shops and disclosed to the client.
2. Formation of repair spare parts quotation system. At present, China's auto repair market, auto parts prices are more chaotic, the price difference between genuine parts and sub-factory parts several times, insurance companies and car owners are difficult to accurately distinguish between various types of spare parts level, so that the quality of car repair is not guaranteed. For this reason, the public estimation company should strengthen the contact and communication with each automobile dealer and its spare parts dealers, collect and organize the price of spare parts and the relevant situation of spare parts suppliers, and promulgate them in time, so as to form an efficient and accurate spare parts quotation system.
3. Formulate the labor hour quota for repair cost. After the price of spare parts is determined, how to accurately determine the labor cost will be directly related to the repair cost. The company should contact and communicate with the local automobile repair association, combined with the local wage level, cost level and the level of repair shop, *** with the development of repair cost of labor hour quota, to determine the cost of automobile repair labor to provide a price basis.
(D) training professionals, focusing on professional ethics
Auto insurance public appraisal is a strong professional work, public appraisal staff should have the necessary motor vehicle maintenance expertise, insurance expertise, legal knowledge, medical knowledge, considerable expression ability, negotiation skills, while more should have good professional ethics. In China, a prominent problem in the field of auto insurance claims is the lack of a good social credit environment, which often leads to the phenomenon that adjusters are bribed by repair shops or insured persons to collude with them and harm the interests of insurance companies. Therefore, whether the public adjuster can establish a good credit is another key factor in the existence and development of the public adjuster system, and can even be said to be the decisive factor.
(E) Focus on technical support to build a professional brand
Automobile insurance public appraisal is different from other property insurance public appraisal. The subject matter of auto insurance public appraisal is single, but there are many brands, the vehicle loss approval and spare parts prices are complex, the insurance rate is high, mobility is strong, the location of the insurance is uncertain, the third-party liability accidents are frequent, the audit of the accident medical expenses, the determination of the disability level of the matter is many, resulting in auto insurance claims workload, investing more money, high operating costs, so that motor vehicle insurance claims become a testing ground for the insurance industry to use high-tech means. At present, the advanced technology of utilizing IC cards and their technical support systems for risk management and risk assessment, as well as computerized remote underwriting and claims handling, has begun to be promoted in China. Auto insurance appraisal companies should make efforts to promote and improve these new technological means to enhance the technological content of auto insurance appraisal, ensure the professional quality of insurance appraisal and enhance the competitiveness of the appraisal industry.
(F) Enhance the level of management, so that the efficiency and effectiveness of both
Auto insurance is a fine management of insurance, the risk is small and relatively stable, controllable. It is necessary to continuously strengthen management, reduce costs and improve efficiency in order to achieve good results. The company should summarize and communicate more in the auto insurance claims management, to form their own management characteristics and advantages.