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神秘夫妇投保一亿 短期内在多家保险公司突击投保

2019-02-26 08:16:36   北青网 

原标题:神秘夫妇投保一亿

本报讯(记者 蔺丽爽)近日,一家寿险公司核保负责人将1969年出生的李明(化名)列入了投保关注名单,同时列入关注名单的还有李明的妻子,二人投保的金额令人咋舌:1亿元!

据券商中国报道,该核保人掌握的一份截至2月15日的行业统计显示,李明自2018年12月底起,2个月来已在26家保险公司连续投保超26份保险,除了少数几份定期寿险,其余多为高额意外险、驾乘险,单人累计保额超6000万元。

多位保险行业人士告诉北京青年报记者,由于是夫妻共同投保,李明夫妻合计意外险保额约1亿元。投保人短期在多家保险公司突击投保如此高额意外险相当罕见,该行为已经引起保险行业高度重视。

李明最近一次投保是2019年2月8日在上海一家寿险公司投保的意外险,保额10万元。有保险行业人士告诉北青报记者,该投保人在2月8日之后仍尝试继续投保,但一些保险公司设置了“黑名单”,投保没能成功。

据了解,高额意外保险是保险道德风险的高发区域。保险承保环节的难点是:在百万保额保单频出的大背景下,如何在承保环节就成功判断,投保人是真需要保险的保障,还是打算以生命为代价进行骗保?

保险公司核保的核心目的主要是两个:防止逆选择和防止道德风险。例如已经患病的人投保健康险;购买高额意外险出险案例,被保险人故意发生伤残死亡索赔等。这些都违反大数法则,令保险公司蒙受损失。

一位资深核保人士告诉北青报记者,车险方面中国保信有个车险反欺诈查询的平台,仅仅2018年中国保信车险反欺诈系统就为行业挽损1.65亿元。而健康保险企业与医保、医院等部门联网,获得投保者的信息,已经在很大程度上能够控制“逆选择风险”。

但目前国内尚缺乏为险企核保寿险和意外险统一提供服务的“风控”平台。各家寿险、财产险公司只能各显神通,有些通过结盟共享数据库的方式筛选出高风险投保人。如果被保险人风险过高,超出了保险公司的承保范围,可能会被列入“黑名单”。

业内呼吁

尽快利用大数据筛出“骗保”人

去年,曾发生“男子伪造车祸坠河假象骗保,其妻以为丈夫身亡携一双儿女自杀”的悲剧。近期,“天津男子泰国杀妻案”也已进入诉讼流程,根据最新证人口供记录和相关证据,警方最终以蓄意谋杀、残忍伤害他人致死罪控告嫌疑犯张某。受害人生前被投保十多份保单,保险金额达2600多万。

多位业内人士呼吁,行业应尽快建立供保险公司核保使用的共享大数据平台,从核保环节筛出“潜在骗保人”,既能减少保险公司的风险,甚至还能挽救可能出现的伤害事件。

实际上,在法律制度上,《刑法》专门设置了保险诈骗罪,包含投保人、被保险人故意造成财产损失的保险事故,骗取保险金的;投保人、受益人故意造成被保险人死亡、伤残或者疾病,骗取保险金的等五种情形。“骗保”不仅不会一夜暴富,还会因此被起诉和承担相应的法律后果。

责任编辑:周晶晶 CN032
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