First, strengthen leadership and plan systematically. Anti-insurance fraud involves all aspects inside and outside the industry, and all units should make overall plans and strengthen organizational leadership. The regulatory authorities should give full play to the leading role of anti-insurance fraud, further improve the anti-fraud system, and organize relevant work in a planned and step-by-step manner. Insurance institutions should bear the main responsibility of anti-insurance fraud, incorporate anti-insurance fraud into the overall risk management and control system for planning, strengthen the sense of responsibility from the corporate governance level, improve the system and mechanism, upgrade technical means and optimize resource allocation. Trade associations should play the role of organization and coordination, and build anti-fraud platforms through joint meetings and professional committees to improve the efficiency of anti-fraud; The society should organize the industry to actively carry out theoretical research on anti-insurance fraud and explore the law of anti-insurance fraud.
The second is to highlight key points and advance step by step. At present, there are many insurance fraud cases with various forms, so we should emphasize the principle of giving priority to punishment, and list insurance fraud behaviors such as "fake institutions, fake insurance policies and fake compensation cases" which are harmful to society and strongly reflected by the people as the focus of anti-fraud. The regulatory authorities should intensify the investigation and supervision of major fraud cases, and investigate the responsibilities of relevant personnel in strict accordance with the Guiding Opinions of the CIRC on Investigating the Responsibility of Insurance Institutions. Insurance institutions should take the prevention of fraud risks as the guide, highlight key points and actively cooperate, resolutely hand over fraudulent acts suspected of illegal crimes to public security and judicial organs, seriously investigate the responsibilities of relevant personnel for internal fraudulent acts that have not yet constituted a crime, and at the same time, improve the internal control system in time and actively carry out fraud risk warning education. Industry associations should explore the underwriting and claims information sharing mechanism of key insurance products, and timely develop anti-fraud information sharing platforms. All units should, in accordance with the requirements of the Guiding Opinions, promote the "three-step" anti-fraud work step by step according to their priorities: this year, we should start with a solid foundation, establish rules and regulations, improve the system and strengthen publicity; Next year, we will focus on information sharing and law enforcement cooperation and strive to create a good external environment; By 20 14, a four-in-one anti-fraud work system of "government-led, law enforcement linkage, company-led, industry cooperation" will be initially established. There are still more than three months this year, and there are many anti-insurance fraud tasks. All units must pay close attention to implementation.
The third is to pay attention to methods and strive for practical results. Different types of fraud have different characteristics and causes, so all units should strengthen analysis and research and carry out anti-fraud work in a targeted manner. Prevention is the key to control speculative fraud, insurance institutions should explore the implementation of insurance, claims anti-fraud tips and other systems, industry organizations should increase publicity and education for consumers to effectively prevent speculative insurance fraud; The main way to control professional fraud is to crack down. The regulatory authorities should strengthen the cooperation between the industry and the public security and judicial organs, jointly investigate and deal with criminal gangs of insurance fraud, effectively deter criminals and optimize the external environment for the development of the industry. In the implementation of the "Guiding Opinions", it is necessary to distinguish responsibilities and implement them at all levels to avoid going through the motions. Those who have outstanding work performance should be given appropriate rewards. Those who are not serious about their work, delay job opportunities and cause serious consequences should be dealt with severely in accordance with relevant regulations.
Fourth, actively explore and be good at summing up. There are many aspects of anti-insurance fraud, and the anti-fraud situation and tasks faced by various companies and regions are different. In the previous stage, the industry has made useful explorations in improving the anti-fraud organization system, strengthening regional cooperation, strengthening the application of anti-fraud technology and information sharing. In the next stage, on the basis of thoroughly implementing the Guiding Opinions, we will continue to intensify innovation, sum up and popularize good experiences and practices in a timely manner, and actively explore a new anti-insurance fraud mechanism suitable for China's national conditions and industry reality.
If you want to know more about insurance, you can go to >> "Raise more fish and talk about insurance" for free consultation!