I. Models and characteristics of auto insurance claims service in the international mature insurance market
There are a large number of foreign institutions specializing in auto insurance claims service, and the division of labor is very fine. Based on their own interests, insurance companies and external institutions pay special attention to their cooperation in order to satisfy customers. They not only perform their respective duties, but also pay special attention to the enjoyment of information and resources, mainly in the following aspects:
(1) Cooperation in investigation and damage assessment.
As the first link of claims service, survey and loss determination is actually the first step of insurance company's claims, which is directly related to the number of claims, the speed of claims, social impact, crystal card effect and many other aspects. Therefore, insurance companies attach great importance to this link. In order to cope with a large number of tedious survey and damage assessment work, insurance companies in developed countries and regions generally adopt the mode of cooperation with external professional institutions.
(b) information technology development cooperation
1. Improve the rationality and timeliness of survey and dispatch. Progressive Company, the fourth largest auto insurance company in the United States, uses GPS positioning technology to determine the position of surveyors. Through the intelligent dispatching system, surveyors were sent to the scene of the accident in a short time. In addition, through the computer network, you can query the scheduling situation of repair shops and provide customers with timely repair services.
2. Improve the accuracy of survey and damage determination. Allianz Group of Germany has been using Audatex system (now belonging to ADP Company of the United States), and recently used Glassmatix loss estimation system to ensure the standardization and transparency of auto insurance claims.
3. Improve the timeliness and convenience of receiving reports. An Tian Fire and Marine Insurance Company uses the 24-hour accident acceptance reporting system in automobile insurance claims. This system corresponds to the national 14 claims center and the remote computer system of 252 claims terminals. Customers can get the processing results of the insurance company from any claim terminal and get the payment within 7 days.
4. Improve the efficiency of survey and damage determination. In Taiwan Province Province, China, auto insurance claims have begun to use the remote loss-determining system, which can be transmitted through the Internet, so that the loss-determining personnel of insurance companies can not only determine the loss on site, but also remotely determine the loss online. Customers and repair shops can also inquire about the loss-determining results and the price of accessories, and even buy accessories online.
(3) Cooperate to provide diversified service links.
Providing customers with all-round and multi-level services is a major feature of modern auto insurance claims, in which derivative services have become the main means of competition. The United States has done the best in this regard. As the largest insurance market in the world, the cooperation between American insurance companies and external institutions such as banks, telecommunications, hospitals, police stations, repair shops, glass shops, rescue companies and emergency centers is very common. Since the early 1990s, companies specializing in dealing with the losses of auto insurance companies have also appeared in the United States. The existence of a large number of professional organizations not only improves the overall level of the insurance industry, but also promotes the improvement of the quality of insurance protection and the reduction of the cost of insurance services.
Second, the current automobile claims service model in China's insurance market and its advantages and disadvantages.
Auto insurance is the largest single insurance business in China's domestic insurance market and the backbone of China's property insurance business. Its business volume accounts for more than half of property insurance. In 2003, the national property insurance premium income reached 89.24 billion yuan, of which 54.46 billion yuan came from auto insurance. In 2003, among the property insurance companies in China, the number of auto insurance claims reached more than 7.66 million, and that in payout ratio reached 60.87%. The survey and claim settlement of auto insurance has a large workload and high cost. The current insurance market in China is characterized by high fees, high expense ratio and low capital utilization rate. In 2003, the auto insurance business faced a severe situation of loss in the whole industry. Effectively changing the current service mode of auto insurance claims in China, squeezing out the water of claims and reducing the cost of claims services has become one of the major topics to change the current situation of auto insurance operating losses in China.
(A) China claims service model
Due to the mobility of motor vehicles, insurance companies are required to establish and improve a service system or service mechanism suitable for the characteristics of motor vehicles, especially in providing services, and do a good job in handling motor vehicles after they are out of danger. This service system or mechanism mainly focuses on timely rescue, survey, damage assessment and repair of insured vehicles after accidents, and also includes handling cases involving third party liability. At present, China's more mature and popular model is the insurance company's independent claims service model, which is characterized by:
1. Establish its own service hotline to provide all-weather and all-round services for the insured, and receive reports through the hotline.
2. Establish your own survey team, equipped with your own survey vehicle and corresponding equipment, and accept the dispatch of your own customer service center and site survey to determine the damage.
3. Establish your own auto parts quotation center. In view of the high proportion of auto insurance compensation items, which has a great impact on auto insurance payout ratio and operating profit, and is also the easiest to generate huge profits, all insurance companies attach great importance to it and organize special personnel to engage in the collection, quotation and verification of auto parts prices.
4. A certain link of the survey and assessment or a certain field where the service cannot radiate shall be handed over to external institutions such as the assessment company, the price department, the repair shop and the survey company.
(B) Analysis of the advantages and disadvantages of China's current automobile insurance claims service model.
1. Independent claims. That is, the claims department of the insurance company is responsible for accident investigation and damage assessment. This way has played a positive role in the early development of China insurance industry, and it is also obviously branded with a series of specific historical periods. With the reform and opening up of China society and the development and changes of the market, especially after China joined the WTO, global economic integration has had a great impact on China. The international advanced claims evaluation methods and concepts are continuously spread to the domestic I-insurance population, and the awareness of insurance consumption is continuously improved. The disadvantages of this model are increasingly prominent, mainly in the following aspects:
(1) Large capital investment, low work efficiency and poor economic benefits. For the insurance company itself, from exhibition industry to underwriting, from fixed loss to compensation, every link is in its own hands, and the large and comprehensive model causes inefficiency. The huge claims team, the corresponding survey vehicles and equipment, and a large amount of manpower and material resources to deal with the cumbersome loss-fixing claims have led to poor economic benefits in its internal management and business accounting, and there are often abnormal phenomena that business personnel can't see the survey, estimate the damage and deliver the materials. This unreasonable allocation of resources does not meet the requirements of China's insurance companies to become bigger and stronger, participate in international competition, cultivate core competitiveness and take the road of specialized management.
(2) The claim settlement business is opaque and unfair. Auto insurance claims are different from other social production projects, involving a wide range of interests, strong professionalism and many types of adjustments, which require the claims business to be open and transparent. Insurance companies decide their own losses, just as insurance companies are both "athletes" and "referees", which means that the results of determining losses violate the basic principles and requirements of fairness to the insured. For this contradiction, even if the insurance company's fixed loss conclusion is reasonable, it is often difficult to convince the insured, which will lead to claims disputes. Especially in the market with asymmetric information, this disadvantage is more and more prominent.
2. Price evaluation. That is, the public security traffic management department entrusts the price department to compensate. This method is rarely used, because both sides of the insurance don't recognize it and don't welcome it. The China Insurance Regulatory Commission also issued a document to boycott.
3. Insurance evaluation. That is to say, it is an international practice that the insurance parties entrust a professional insurance loss-fixing company to be responsible for the investigation and adjustment of automobile losses. The advantages of this method are:
(1) can reduce claims disputes. It can better reflect the characteristics of the fairness of insurance companies' contracts, make the settlement process open and transparent, avoid possible disputes and disputes, and prevent abuse of power for personal gain.
(2) Improve the insurance market structure. Professional companies are responsible for survey and loss assessment, which can better reflect the specialization of social division of labor, promote the development of insurance loss assessment industry and further improve the insurance market structure.
(3) It can promote insurance companies to optimize their internal structure and save a lot of manpower, material resources and financial resources. Because the insurance company pays the inspection fee to the evaluation company according to the actual inspection workload, it can more truly reflect the real business situation and avoid unnecessary expenses and increased fixed operating costs that may be brought by the insurance company's fixed inspectors and related equipment.
Thirdly, the change of the insurance market environment in China requires the change of the service mode of auto insurance claims.
Changes in policy and legal environment
1. The regulatory authorities have intensified the development of the insurance market, which is unprecedentedly active. With China's entry into WTO, China's insurance market is facing the pressure of full opening. In order to meet this challenge, achieve comprehensive, coordinated and sustainable development, and make China's insurance industry bigger and stronger, the China Insurance Regulatory Commission has taken a series of positive measures, and the insurance market has undergone unprecedented changes. The number of insurance subjects has increased rapidly, the business fields of insurance companies have also been fully opened, the reform of auto insurance clause rate system has been fully promoted throughout the country, and insurance intermediaries have sprung up like mushrooms after rain. It is the only way for China insurance industry to improve its competitiveness to learn from international experience and strengthen the business cooperation between insurance companies and professional insurance intermediaries at a higher level.
2. Opportunities and challenges brought by the implementation of the new road traffic safety law. The Road Traffic Safety Law, which came into effect on May 1 2004, puts forward newer and higher requirements for auto insurance claims service. The law stipulates the implementation of compulsory motor vehicle third-party liability insurance system, emphasizing people-oriented and respecting life, and the compensation standard for traffic accident victims will be greatly improved; The scene of the accident should be dealt with quickly, and a traffic accident occurred on the road without causing personal injury or death. If the parties have no dispute about the cause of the accident, they can immediately evacuate the scene, resume traffic and negotiate for damages. It can be predicted that with the implementation of statutory insurance, the number of insured vehicles will increase substantially and the number of accident cases will also increase; At the same time, the implementation of the new law will greatly improve the requirements and skills of on-site survey; The investigation workload in 2004 will definitely increase substantially. How to adapt to the auto insurance claims service under the new legal conditions has become a problem that every property insurance company must face.
(B) changes in the competitive environment
1. The supply subject of insurance companies has increased unprecedentedly, and the competitive pressure has increased. In 2004, there was a very prominent change in the insurance market, that is, the number of insurance suppliers increased greatly. With the cancellation of regional operation of insurance companies and the relaxation of branch approval, insurance companies that were originally limited to a certain region have set up institutions in major and medium-sized cities across the country, and the competition in the insurance market has become fierce. Rates have dropped sharply, profits have dropped sharply, and large-scale losses have occurred in auto insurance operations.
2. The claims service of insurance companies obviously lags behind underwriting, and most insurance companies advocate cooperation with intermediaries. With the increase of suppliers in the insurance market, there will be such a situation: both newly established insurance companies and newly entered branches of foreign-funded insurance companies are unable to have professional claim adjusters corresponding to their underwriting objects in the initial stage of operation due to hard constraints such as cost; Due to the increase of new suppliers, the profits of the original insurance companies have declined, so it is not cost-effective to have or reserve more claim settlement personnel; The new supplier will make the already insufficient qualified applicants more scarce, the cost of using and storing the applicants will rise, and the mobility of the applicants will increase. When the underwriting business is developing rapidly, the mismatch of claims will often affect the development of the insurance industry. Practice has proved that it is no longer possible to meet the needs of the growing claims work only by relying on the internal claims personnel of insurance companies as in the past. The unsynchronized development of claim settlement and underwriting has become an important issue for insurance companies to improve their economic benefits. Drawing lessons from the experience of developed insurance countries and strengthening mutual cooperation with intermediaries have increasingly become the institutional arrangements of many insurance companies.
3. Customers' increasing demand for services. China has entered the era of automobile industry, and automobiles have become an indispensable part of social economy and people's life. People's consumption of cars is becoming more and more common, and the requirements for services are getting higher and higher. For the development of auto insurance business, insurance companies will also meet the service needs of policyholders as an important means of competition. Only by providing better insurance services than competitors at the same cost can we be in a favorable position in the competition. The increasingly specialized 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 assessment industry countermeasures
(A) actively seek government support
Using government resources to promote the development of industries and enterprises is a subject worthy of attention and research for every industry and enterprise. Professional evaluation institutions should urge the CIRC to clearly evaluate the legal status of the company as soon as possible, so that it can perform its duties independently as a professional institution without interference from administrative law enforcement departments such as traffic police and prices.
(2) Comply with market changes and meet market demand.
Compared with other insurance losses, motor vehicle losses are relatively small, so from the operational point of view, the inspection fees that insurance companies can pay are limited. Fixed loss companies should not be "lion's mouth" in charging, but should obtain a lot of business with professional and high-quality services and reduce costs and expenses through a lot of business. Otherwise, the result will only force the insurance company to use internal strength to test.
(3) Improve the service level and broaden the service areas.
In order to better expand the market, the loss assessment company should pay attention to strengthening cooperation and exchange, and provide professional technical support for insurance companies in the following aspects:
1. Study how to reduce the maintenance cost. The damage company should make statistics, classification and research on the accident probability, loss and repair cost of several leading vehicles widely used in China through daily damage assessment, determine the damage degree and repairability of vehicles through repairing various collision test vehicles and vehicles damaged by actual accidents, find out the most suitable maintenance methods, and then provide these research results to repair shops and make them public to customers.
2. Form a quotation system for maintenance spare parts. At present, in China's automobile maintenance market, the price of automobile spare parts is chaotic, and the price difference between the original parts and the auxiliary parts is several times. It is difficult for insurance companies and car owners to accurately distinguish the grades of various spare parts, so that the quality of car maintenance can not be guaranteed. Therefore, the fixed loss company should strengthen the contact and communication with various automobile manufacturers and their spare parts suppliers, collect and sort out the prices of spare parts and spare parts suppliers, and promulgate them in time to form an efficient and accurate spare parts quotation system.
3. Work out the man-hour quota of the repair fee. After the price of spare parts is determined, how to accurately determine the labor cost will directly affect the maintenance cost. The loss-fixing company should contact and communicate with the local automobile maintenance association, and work out the man-hour quota of the repair fee in combination with the local wage level, expense level and repair shop level, so as to provide a price basis for determining the labor cost of automobile repair.
(D) training professionals, pay attention to professional ethics
Auto insurance assessment is a highly professional job, and the assessors should have the necessary professional knowledge of motor vehicle maintenance, insurance, law, medicine, etc., have considerable expression skills and negotiation skills, and should also have good professional ethics. In our country, a prominent problem in the field of auto insurance claims is the lack of a good social credit environment, and it often happens that claimants are bought by repair shops or the insured, colluding with them and harming the interests of insurance companies. Therefore, whether jurors can establish good credit is another key factor, even a decisive factor, for the existence and development of the jury system.
(5) Pay attention to technical support and build professional brands.
Auto insurance assessment is different from other property insurance assessments. The subject matter of auto insurance assessment is single, but there are many brands, the verification of vehicle losses and spare parts prices is complicated, the accident rate is high, the mobility is strong, the accident location is uncertain, the third-party liability accidents occur frequently, the accident medical expenses are audited, and the disability level is determined, which leads to heavy workload, high investment and high operating cost, making motor vehicle insurance claims become a test field for the insurance industry to use high-tech means. At present, the advanced technology of using IC card and its technical support system for risk management and risk assessment, and using computer for remote underwriting and compensation has been popularized in China. Auto insurance assessment companies should strive to popularize and improve these new technical means, improve the technical content of auto insurance assessment, ensure the professional quality of insurance assessment, and enhance the competitiveness of the assessment industry.
(six) improve the management level, so as to pay equal attention to efficiency and benefit.
Auto insurance is refined management insurance, with small risk, relative stability and strong controllability. We must constantly strengthen management, reduce costs and improve efficiency in order to achieve good benefits. Evaluation companies should make more summaries and exchanges in the management of auto insurance claims to form their own management characteristics and advantages.
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