本篇論文目錄導航：
【題目】上海車險人傷理賠鑒定問題探究
【導言】車險人傷理賠法律困境探析導言
【1.1 1.2】上海市車險市場人傷理賠率高的原因分析
【1.3】上海市車險人傷理賠司法鑒定中的問題及原因分析
【第二章】司法鑒定的主觀性和客觀性問題分析
【第三章】司法鑒定域外經驗借鑒
【4.1 4.2】制定統一的《司法鑒定法》，嚴格法律規制
【4.3 4.4】加強行政監督管控，完善行業自律機制建設
【結語/參考文獻】車險人傷理賠鑒定制度優化研究結語與參考文獻
摘要
在我國經濟社會持續快速發展的大背景下，作為經濟發展前沿的特大型都市之一的上海，雖然持續多年通過多種積極措施人為控制著機動車的數量，但是機動車的保有量上升勢頭依然難被有效遏制。機動車保有量的快速提升引發交通環境惡化，機動車相關的交通事故總量不斷攀升，導致傷亡人數和傷亡賠付案件雙雙走高。其中，最為突出的問題是，各家保險公司中車險人傷理賠的賠款在車險理賠總賠款中的占比不斷提高。因此，這些案件已成為各家保險公司中車險理賠案件業務的重點和工作難點。
車險人傷案件賠付日漸成為一個關乎民生的問題，因為賠付率高，拉高了車險費率，賠付成本隨經濟發展不斷走高。其中，更因保險欺詐的多發造成大量不正常保險賠付，嚴重侵蝕了保險公司的利益，使得廣大的車主不得不長期背負著高昂的保費負擔，直接影響了廣大車主的權益，實際上已危及了車險市場的持續穩定發展，阻礙了我國和諧社會的建設。
筆者畢業于法醫學專業，曾經在保險公司從事理賠服務工作十年，對上海市車險市場人傷理賠率偏高的問題關注已久。此次，筆者通過對上海市保監會、市保險同業公會、各大財產保險公司及經紀公司等進行的大量調研所獲取的“一手”數據和案例開展針對性分析，圍繞上海市車險人傷理賠中司法鑒定問題及相關的法律對策展開了較為扎實、細致的研究。為此，本文擬從以下三個方面展開論述。
第一、車險人傷理賠司法鑒定中的諸問題點及原因分析
在當今市場競爭和鑒定機構的營利追求等多種因素疊加下，司法鑒定市場亂象層出、“問題鑒定”不斷出現。若對其主要問題進行梳理和成因分析，大致有以下七類問題。
1.評定時間的選擇對鑒定結論影響較大
我國尚無一個權威部門對鑒定的評定時機做出具體的、標準化的釋義。在實際操作時，同一鑒定對象臨床治療終結的認定結論，往往因各鑒定人不同的理解、認知而出現差異。另外，因不同傷者其個體的康復時間和康復結果也存在差異性，由于時間跨度較大，重新鑒定的結論常與初次鑒定的結論不相一致。
2.傷者單方申請鑒定問題所在
依照上海市現行的道路交通事故處理流程，傷者可要求交警事故處理部門出具傷殘委托書或推介書，自行選擇司法鑒定機構申請進行鑒定。然而，這一自由選擇的做法有多種弊端：首先，有的傷者通過對多家鑒定機構“比價”或采取賄賂鑒定人的方式，來謀取高等級的目的。其次，大多鑒定機構是自負盈虧的實體，希望“示好”申請人來擴大客源。再者，“人傷黃?！钡某霈F，更是追求單方委托到相熟的鑒定機構以便謀取高等級的目的。
3.鑒定人員素質參差不一帶來的問題
現行司法鑒定管理規范中，對于鑒定人員的法律素養、道德操守等并無特別具體明確的要求。
例如，一些被之稱為“社會機構”的鑒定部門，大多由醫院或公司開設，具有掛靠或承包經營的特征，所以，日常的鑒定業務技能操作和法律素養、道德操守等只能由鑒定人自行把握，極易出現鑒定人員素質參差不齊的情況。又因為這些機構是完全靠市場吃飯，鑒定意見質量較低、“失真”率較高，是其一大特征。
4.傷殘等級定級標準過于陳舊，有待優化和完善
首先，因為時過境遷和相應的標準釋義不夠細化等原因，我國的《道路交通事故受傷人員傷殘評定》的條款內容已經不能適應當前的新情況。其次，對于傷病關系參與度的司法鑒定意見，大多是由鑒定人以其主觀認知水平來決定傷病參與度的比例，其結果常常出現不同的鑒定人出具的鑒定意見相差甚遠的現象。
5.主觀判斷與客觀事實之間的差距產生的問題
傷殘等級評定或鑒定是具有專業知識的人員依據相應客觀材料做出的鑒別、判斷的主觀認知說明。僅憑鑒定人的經驗、過多依賴鑒定人主觀檢查，結果就是每做一次鑒定都可能出現不同的結論意見，難以分清哪個鑒定人有“過失放水”或“故意放水”可能。
6.鑒定人怠于出庭，申請重新鑒定不易
按現有法律規定和司法實踐，對于司法鑒定意見異議處理的司法救濟手段主要有以下兩種：
一是鑒定人出庭作證或“有專門知識的人”協助出庭質證。但是在司法實踐中，鑒定人愿意出庭參加質證的較少，“有專門知識的人”囿于情面等因素也很少愿意出庭協助。因此，總體上而言當事人或法院更傾向于進行重新鑒定。二是重新鑒定?，F行法律中對哪些情形可啟動重新鑒定程序則沒有明確的規范，與此相關的判斷標準以及如何選擇重新鑒定機構和鑒定人等均無明確的法規依據，易引發對司法鑒定意見或法院判決的公正性的質疑。
7.行政監管和自律管理的缺失
司法鑒定作為專業技術領域的活動，以行政監管手段對其進行監督確有相當的難度，監督管理往往落不到實處，難以對傷殘鑒定意見的質量進行有效地監督，對鑒定機構和鑒定人的行為也難以進行實質性地監督約束。而司法鑒定協會作為行業自律機構，其制定的處罰辦法之法律效力的層級較低，對專業技術領域活動中的問題管控明顯不足。
第二、域外經驗借鑒
1.荷蘭和德國的經驗
我國與荷蘭和德國同屬于大陸法系國家，相較而言，荷蘭和德國在司法鑒定人的考核準入標準上有著較高的標準。
一是荷蘭經驗。首先，荷蘭在司法鑒定人的準入及考核上有較高的要求，培訓內容豐富、時間跨度較長。對于鑒定人除了必備的相關領域的知識以及實施鑒定執業的技能和經驗外，還強調鑒定人應具有一定的相關法律知識素養。其次，資格的期限性。司法鑒定人的資格證書和注冊有效期一般為 4 年，期滿后需重新申請、注冊，意即司法鑒定人的資格并非是終身制的。
二是德國的經驗。按司法鑒定人的公信度由高到低可將鑒定人分級，等級越高對誠信程度和道德品行的要求越高。最高等級的鑒定人標準要求除嚴格專業技術知識和法律法規的考核外，還須考察了解申請人的過往的誠信程度和道德品行。其次，申請人上崗前還須進行公開宣誓。最后，德國訴訟法對于等級高的鑒定人優先選用也作出了具體的規定。
2.韓國經驗
韓國早幾年保險欺詐猖獗的情況與目前我國車險人傷理賠中發生的問題較為相似，因此了解韓國的解決對策，對我國有著現實的借鑒意義。
首先，組織架構上的保障。其成立政府聯合保險犯罪專門活動對策班，集合多部門進行緊密合作。其次，構建保險詐騙認定系統。綜合分析保險合同、事故及保險金支付資料等保險欺詐調查中的信息，做到動向分析和早期預警，能夠有利于追索到嫌疑人之間的共謀關系。再次，建立保險犯罪檢舉中心。廣泛呼吁一般公民提供信息、線索，當檢舉的內容有助于揭發保險犯罪時，各保險協會和保險公司會給予檢舉人獎金。
第三、實現人傷理賠司法鑒定公正的對策研究
1.制定統一的《司法鑒定法》，嚴格法律規制
在當前司法鑒定活動日益受到詬病的情形下，應加快制定統一的《司法鑒定法》或先行通過地方立法的形式，對于以下諸方面進行規制。
首先，應提升司法鑒定人的準入標準，強化對司法鑒定人的基本素質要求。其次，應統一司法鑒定的申請、委托、受理、實施操作標準排除人為因素對司法鑒定意見結論的干擾。再次，應構建多層次的司法鑒定體系。第一將司法鑒定人和機構分級；第二扶持權威鑒定機構，完善重新鑒定復核機制；第三樹立個別“國家隊”級別的鑒定機構在某些鑒定項目上權威性，在某些項目上該鑒定機構只接受重新鑒定或法院的委托。
此外，還應制定司法鑒定意見采信的標準規范，一是應制定司法鑒定意見的采信標準，并由法院與司法行政管理機構等聯合制定司法鑒定人出庭質證準則；二是建立涉醫專業技術官制度；三是建立專項監督管理機制。最后，應明確司法鑒定人責任制、建立錯鑒追究機制。
宣誓制度作為預防鑒定人作偽證的措施，有助于鑒定人主動進行自我提醒和自我約束，有助于維護法律權威。因此，建立司法鑒定人宣誓制度是可行的措施。
2.制定《保險反欺詐法》，建立保險反欺詐體系
首先，應制定統一的《保險反欺詐法》，明確保險欺詐的概念和范圍，有利于各主管部門統一認識，對保險欺詐采取有力的懲治。其次，應建立涉保的司法鑒定反欺詐工作網絡平臺，向相應部門雙向開通信息交流的端口，做到信息共享。再者，設立涉保的司法鑒定檢舉中心，實現有獎舉報，達到群防群治的社會效果。
3.完善司法鑒定行業的自律機制建設，加強行政監督管控機制
制定配套的行政管理辦法，對司法鑒定人和機構進行鑒定前、中、后的全程監督管控，以提升司法鑒定內在的自律機制和外部的監督機制。一是加強行風的建設，倡導完善自律管理機制。二是加強聯動監督管理機制，如建立“鑒定機構和鑒定人員黑名單制度”,對每一個鑒定機構和鑒定人公開進行公信度信用評級的評定 .
4.加強保險行業自身內功建設，探索爭議糾紛處理新機制
建立完善的車險理賠運營體系及糾紛處理機制，配合司法系統工作，減少車險人傷理賠糾紛對司法資源的占用。
首先，可以構建車險人傷案件專項網絡數據平臺，用大數據分析的方式，對司法鑒定實施前、中、后的全程覆蓋監督，增進司法鑒定的透明度，以提升鑒定應有的客觀公正性。其次，創設新型的保險合同糾紛快速處理機制，從時效性、公正性、權威性、合法性的多維度考量，設置涉保專業仲裁庭不失為一種好的解決途徑。
本文主要采用根源分析和實證分析等方法，借鑒荷蘭和德國的司法鑒定人制度、韓國的反保險欺詐舉措的等經驗，對于完善本市車險人傷理賠司法鑒定制度的思路和對策進行了細致地探討和分析，從體制、制度及技術多個層面提出了相應的法律對策和建議，以期提高司法鑒定的公正性與權威性、促進車險理賠反欺詐工作的推進及車險市場的穩定發展，進一步實現司法鑒定應有的價值，維護我國司法的公平公正，有力推動我國社會的誠信建設與和諧建設。
[關鍵詞]車險人傷理賠；司法鑒定；法律規制；機制建設
Abstract
Under the background of sustained and high-speed development of China'seconomic development, as one of the metropolitans who sits at the front line ofChina's economic development, although Shanghai has actively and intentionallytook measures to control the number of motor vehicles, the uptrend of motor vehiclesquantity seems difficult to be effectively curbed. The swift increase of motor vehiclequantity leads to a deterioration of transportation conditions, a continuous increasingof motor-related transport accidents and a continuous large number of death andpersonal injuries cases. The most prominent problem is the increasing proportionaccount by the claims for personal injuries in the total claims under motor insuranceof various insurance companies. These accidents and claims are of importance anddifficulties in motor insurance claims of various insurance companies.
The indemnity of personal injuries of motor insurance is becoming a problem ofsocial well-being. The high loss ratio in this regard has raised the premium rate ofmotor insurance. The cost of claims is growing with the economic development. Also,the frequent fraudulent claims caused a lot of undue indemnities which seriouslyinfringe the insurance company's profit and the vehicle owner's interest who shall besubject to the burden of high premium rate. This fact is actually endangering the sustainable and stable development of the motor insurance industry and thereforehampered the construction of China's harmonious society.
The author is graduated in the major of forensic medicine and has ten yearsclaims service work experiences in insurance company circle, and has focused on therelatively high loss ratio of Shanghai motor insurance personal injuries claim in a longterm manner. Through analyzing abundant “first-hand” data and precedents whichcollected from CIRC Shanghai, Shanghai Insurance Association, property andcasualty insurance companies and brokers, together with the author's personalpractical experiences, the author has carried out a relatively solid and meticulousresearch for judicial identification of personal injury and related legalcountermeasures about the indemnity of personal injuries of motor insurance.Therefore this paper intends to start from the following three aspects.
Section one, analyze the problems and reasons of the judicial identification of themotor insurance claims.
Current market competition and identification of institutions who pursuit theprofit and other factors leads to the judicial identification of market chaos layer andthe problem identification continues to appear. To analysis the main reasons, there arethe following seven aspects.
1.the choice of assessment time has a greater impact on the identificationconclusions.
There is no authoritative department in our country to make a specific,standardized interpretation of the evaluation time. In actual operation, theidentification of the end of clinical treatment for the same object was always differentconclusion by expert witness' different understanding and cognition. In addition, thedifferences of the rehabilitation time and rehabilitation results of different patientswere also different, and due to the large time span, the conclusion of the re appraisalis not consistent with the conclusion of the initial identification.
2. unilateral application by the injured person.
In accordance with the existing road traffic accident process in Shanghai, theinjured could require traffic accident treatment department to issue a disability letter of authorization or recommendation and he can choose the judicial identificationinstitution by himself. However, this free choice of practice has many drawbacks.Firstly, some injured compare the number of identification institutions conclusion, ortake a bride to the expert witness to get the higher grade identification. Secondly,most of the identification institutions are self financing entries and they would like toshow good to the application to get more clients. Thirdly, “personal injury scalpers”will pursue the familiar judicial identification to see for higher grade identification.
3.the problem of different the expert witness' qualities.
In the current judicial appraisal management standard, there is no specificrequirement for the expert witness' legal literacy and ethics of the personnel.
For example, for some identification institution which usually is called as socialinstitution, mostly they are operated by hospitals or companies with the characteristicsof anchored or contracted operation. So the daily identification skills and legalliteracy and ethics are controlled by the expert witness himself, and this is easy toappear different expert witness' qualities situation. In addition, these institutionscompletely rely on the market, they usually provide the lower identification and withhigh rate of distortion.
4. the evaluation criteria of degree of disability are too old to be optimized andimproved.
Firstly, because of the passage of time and the corresponding interpretationstandard are not detailed enough and other reasons, the content of assessment ofdisability for road traffic accidents in our country could not be adapted to the currentsituation. Secondly, for the judicial expertise opinion about the injury mostly will bedecided by the expert witness' subjective cognitive level for the injury participationrate. The result is often quite different from the different expert witness' judicialexpertise opinion.
5. the problem of the difference between subjective judgment and objectivefacts.
The disability degree assessment or identification is a professional knowledgeof personnel based on the corresponding objective material to make the identification, the subjective cognitive explanation. Only by the experience of the expert, too muchdependence on the identification of the subjective examination, the result is that eachof the identification of a different conclusions. It is hard to find if the expert witnessnegligence or intentional concession.
6. the expert witness disdains to appear in court, it is not easy to apply for there-identification.
According to the existing legal provisions and judicial practice, the judicialrelief measures for the judicial identification of the views are mainly the followingtwo:
The first one is the confrontation of the expert witness appearing in court orwith the assistant of the professional expert. But in the judicial practice, the expertwitness seldom appears in court, and the professional expert wouldn't like to appearin court either. So in generally, the parties or the courts are more inclined tore-identify. The other one is about re-identification. In current law, there are no clearrules about what kind of situations can be re-start the process of identification, and noclear legal basis about the related judging standard and how to choose theidentification institution and expert. This is easy to bring the doubt for the judicialidentification opinion and the justice of court decision.
7.the absence of administrative supervision and self-discipline management.
As a professional technical field of activity, it is quite difficult for judicialexpertise to supervise the administrative supervision. Supervision and managementare often not implemented. It is difficult to effectively monitor the quality of thedisability appraisal. It is also difficult to carry out substantive supervision andrestraint to the identification of institutions and the identification of human behavior.And the judicial authentication Association, as the industry self regulatory body, thelegal effect of the punishment circular is lower, and the problem of the professionaltechnical field is obviously insufficient.
Section two, foreign experience for reference.
1.the experience in Holland and Germany.
China is a country of continental legal system which is the same with Hollandand Germany, compared the judicial identification of people's assessment of accessstandards, Holland and Germany have a higher standard.
The first one is Holland experience. Firstly, in Holland, the judicialidentification of the access and assessment has the higher requirements, the richertraining content and longer time span. Beside the necessary areas of knowledge andexperience in the implementation of the identification of the practice, the expertwitness is also required a certain knowledge of the relevant laws. Secondly, it isqualification period. Generally, the judicial expert witness qualification certificate andregistration is valid for 4 years, after the expiration, they need to re apply forregistration. This means that qualification is not is for life.
The second one is Germany experience. The judicial expert witness should bedivided into different levels according to public trust from high to low, the higher thelevel, the higher the requirement on integrity and moral conduct to the expert witness.For the highest level expert witness, who is not only strictly required the professionaltechnical knowledge and legal regulations of the assessment, but also investigated theintegrity of the applicant's past and moral conduct. Secondly, the applicant must makea public oath before the applicant. Finally, the German litigation law also gives thespecific provisions of the priority to choose the high level expert witness.
2.the experience in South Korea.
In the early years, the situation of insurance fraud in South Korea is similarwith our current situation. Therefore, it is realistic significance to understand thesolution of South Korea.
Firstly, it is organizational structure security. They establish the department ofthe special event of joint insurance policy, different departments cooperate together.
Secondly, they establish the insurance fraud identification system to analyze theinvestigation information for insurance fraud comprehensively, such as insurancecontract, accident and insurance payment. It can realize trending analysis and earlywarning, and search for the collusion between the suspects. Furthermore, theyestablish the insurance crime reporting center. General publish is widely appeal to provide information and clues, if the information is helpful to expose the suspects, allof insurance association and companies will provide reward.
Section third, realize the countermeasures research for the judicial identificationof the claims.
1.the unified Judicial Identification Law should be formulated to realize strictlegal regulation.
In the case of the current judicial appraisal activities, we should speed up theestablishment of a unified Judicial Identification Law or approve the local legislationin advance, and the following aspects of regulation,
Firstly, we should improve the judicial identification of the access standards,and strengthen the judicial identification of people's basic quality requirements.Secondly, we should unify the application of forensic identification, commissioning,acceptance, the implementation of the standard of operation to exclude theinterference of human factors on the judicial appraisal conclusion. Thirdly, we shouldconstruct multi levels of judicial appraisal system: （1） to classify the judicial expertiseand institution; （2） To support the authority of the identification of institutions,improve the mechanism of re appraisal review; （3） To establish the authority of theindividual “national team” rating agencies in certain appraisal projects, in someprojects, the identification of the institution is only accepted by the re appraisal or thecourt's commission.
In addition, we should also develop a standard specification for collectingopinions for judicial identification. （1） We should make the collecting opinionstandard for judicial identification and also make the expert witness appearing in courtrules by the courts and judicial administrative agencies together. （2） We shouldestablishment of medical professional and technical officer system. （3） We shouldestablish special supervision and management mechanism. （4） We should establish aclear judicial expert responsibility system, and the wrong identification and correctionmechanism.
The oath method is helpful to remind and bind the expert and is able to upholdthe law's authority. Therefore, it is feasible to build an oath measure for judicialexpert.
2.make Anti Insurance Fraud Laws, and establish anti insurance fraud system.
First of all, we should formulate a unified Anti Insurance Fraud Laws, clear theconcept and scope of the insurance fraud, which is good for the competent departmentunified understanding of the insurance fraud and take effectively action. Secondly, weshould establish a network platform for the anti fraud work of the judicialidentification, and shear the exchange information to the corresponding department.Thirdly, establish the reporting center of the judicial identification to realize prizereport to achieve the social effects of prevention and treatment.
3.improve the self regulatory mechanism of the judicial identification industryand strengthen the administrative supervision and control mechanism.
To develop a complete set of administrative measures to improve thesupervision and control of the whole course of the judicial expert witness and theinstitution, in order to improve the internal self-discipline mechanism and externalsupervision mechanism: （1） To strengthen the construction of morals, advocatingperfect self-discipline management mechanism. （2） To strengthen the linkagesupervision and management mechanism, such as the establishment for theidentification system and the identification of the black list system to assess eachidentification mechanism and expert witness publicly.
4.strengthen the internal construction of the insurance industry and explore newmechanisms for dealing with disputes.
Establish a complete insurance claims operation system and dispute settlementmechanism, and cooperate with the judicial system to reduce the judicial resourcesoccupation from motor insurance claims.
Firstly, we can build a special network data platform for motor insurance injurycases, with the way of big data analysis, supervise the whole judicial process, toenhance the transparency of judicial identification and improve the objective justice.Secondly, we can establish a new type of quick handing mechanism for insurance contract disputes, and considering from the timeliness, impartiality, authority,legitimacy of the multi dimension considerations, it is a good way to set up a specialarbitration court.
This paper mainly focus on the detailed discussion and analysis of improvingthe thinking and strategies of judicial identification of personal injuries claims undermotor insurance by using the methods of original analysis and empirical analysis,learning from the judicial identification systems of Holland and Germany, the Koreaninsurance anti-fraud measures. This paper also provides relevant legal strategies andsuggestions from multiple aspects of system, policies and techniques to the aforesaidissues to improve the jurisprudence and authority of judicial identification andpromote the advancement of anti-fraud business in motor insurance claims and thesteady growth of motor insurance for further realization of the value of judicialidentification, the maintenance of China's justice and the construction of a trusty andharmonious society.
[Keywords]Personal Injuries claims of Motor Insurance;JudicialIdentification of Personal Injury; Supervision and Regulation;Construction of Mechanism
目 錄
導 言
一、問題的提出
二、研究價值及意義
三、文獻綜述
四、主要研究方法
五、論文結構
六、論文的主要創新及不足
第一章 上海市車險人傷理賠現狀分析
第一節上海市車險人傷理賠現狀
一、機動車保有量急增、車險人傷事故驟升
二、人傷事故賠款占比畸高
第二節上海市車險市場人傷理賠率高的原因分析
一、保險產品費率設置不合理，無法遏制高賠付率
二、保險人對傷者、肇事方（投保方）的控制力較弱
三、立法和司法過于保護傷者
四、人傷理賠賠償標準升幅快
五、傷殘等級評定或鑒定虛高
第三節上海市車險人傷理賠司法鑒定中的問題及原因分析
一、評定時機對鑒定意見結論影響較大
二、傷者單方申請鑒定問題所在
三、鑒定人員素質參差不一
四、傷殘等級定級標準有待優化和完善
五、鑒定人的主觀判斷與客觀事實之間的差距
六、鑒定人怠于出庭，申請重新鑒定困難重重
七、行政監管和自律管理的缺失
第二章 司法鑒定的主觀性和客觀性問題分析
一、司法鑒定的主觀性
二、司法鑒定的客觀性
三、司法鑒定主觀性與客觀性統一的目標與方法
第三章 域外經驗借鑒
第一節荷蘭和德國的經驗
一、荷蘭的經驗
二、德國的經驗
第二節韓國經驗
一、組織架構上的保障
二、構建保險詐騙認定系統
三、建立保險犯罪檢舉中心
第三節臺灣地區經驗
一、設立中立、獨立的爭議糾紛處理機構
二、爭議糾紛處理的法定效力
第四章 實現上海市人傷理賠司法鑒定公正的對策研究
第一節制定統一的《司法鑒定法》，嚴格法律規制
一、提升司法鑒定人的準入標準
二、統一司法鑒定的申請、委托、受理、操作標準
三、構建多層次的司法鑒定體系
四、制定司法鑒定意見采信的標準規范
五、明確司法鑒定人責任制，建立錯鑒追究機制
六、建立司法鑒定人宣誓制度
第二節制定統一的《保險欺詐法》，健全保險反欺詐體系
一、明確保險欺詐的概念和范圍
二、建立涉保的司法鑒定反欺詐工作網絡平臺
三、設立涉保的司法鑒定檢舉中心
第三節加強行政監督管控，完善行業自律機制建設
一、加強行風的建設，倡導完善自律管理機制
二、加強聯動監督管理機制
第四節加強保險行業“自身內功”建設，探索爭議糾紛處理新機制
一、構建車險人傷案件專項網絡數據平臺
二、創設新型的保險合同糾紛快速處理機制
結 語
參考文獻
【題目】上海車險人傷理賠鑒定問題探究
【導言】車險人傷理賠法律困境探析導言
【1.1 1.2】上海市車險市場人傷理賠率高的原因分析
【1.3】上海市車險人傷理賠司法鑒定中的問題及原因分析
【第二章】司法鑒定的主觀性和客觀性問題分析
【第三章】司法鑒定域外經驗借鑒
【4.1 4.2】制定統一的《司法鑒定法》，嚴格法律規制
【4.3 4.4】加強行政監督管控，完善行業自律機制建設
【結語/參考文獻】車險人傷理賠鑒定制度優化研究結語與參考文獻
摘要
在我國經濟社會持續快速發展的大背景下，作為經濟發展前沿的特大型都市之一的上海，雖然持續多年通過多種積極措施人為控制著機動車的數量，但是機動車的保有量上升勢頭依然難被有效遏制。機動車保有量的快速提升引發交通環境惡化，機動車相關的交通事故總量不斷攀升，導致傷亡人數和傷亡賠付案件雙雙走高。其中，最為突出的問題是，各家保險公司中車險人傷理賠的賠款在車險理賠總賠款中的占比不斷提高。因此，這些案件已成為各家保險公司中車險理賠案件業務的重點和工作難點。
車險人傷案件賠付日漸成為一個關乎民生的問題，因為賠付率高，拉高了車險費率，賠付成本隨經濟發展不斷走高。其中，更因保險欺詐的多發造成大量不正常保險賠付，嚴重侵蝕了保險公司的利益，使得廣大的車主不得不長期背負著高昂的保費負擔，直接影響了廣大車主的權益，實際上已危及了車險市場的持續穩定發展，阻礙了我國和諧社會的建設。
筆者畢業于法醫學專業，曾經在保險公司從事理賠服務工作十年，對上海市車險市場人傷理賠率偏高的問題關注已久。此次，筆者通過對上海市保監會、市保險同業公會、各大財產保險公司及經紀公司等進行的大量調研所獲取的“一手”數據和案例開展針對性分析，圍繞上海市車險人傷理賠中司法鑒定問題及相關的法律對策展開了較為扎實、細致的研究。為此，本文擬從以下三個方面展開論述。
第一、車險人傷理賠司法鑒定中的諸問題點及原因分析
在當今市場競爭和鑒定機構的營利追求等多種因素疊加下，司法鑒定市場亂象層出、“問題鑒定”不斷出現。若對其主要問題進行梳理和成因分析，大致有以下七類問題。
1.評定時間的選擇對鑒定結論影響較大
我國尚無一個權威部門對鑒定的評定時機做出具體的、標準化的釋義。在實際操作時，同一鑒定對象臨床治療終結的認定結論，往往因各鑒定人不同的理解、認知而出現差異。另外，因不同傷者其個體的康復時間和康復結果也存在差異性，由于時間跨度較大，重新鑒定的結論常與初次鑒定的結論不相一致。
2.傷者單方申請鑒定問題所在
依照上海市現行的道路交通事故處理流程，傷者可要求交警事故處理部門出具傷殘委托書或推介書，自行選擇司法鑒定機構申請進行鑒定。然而，這一自由選擇的做法有多種弊端：首先，有的傷者通過對多家鑒定機構“比價”或采取賄賂鑒定人的方式，來謀取高等級的目的。其次，大多鑒定機構是自負盈虧的實體，希望“示好”申請人來擴大客源。再者，“人傷黃?！钡某霈F，更是追求單方委托到相熟的鑒定機構以便謀取高等級的目的。
3.鑒定人員素質參差不一帶來的問題
現行司法鑒定管理規范中，對于鑒定人員的法律素養、道德操守等并無特別具體明確的要求。
例如，一些被之稱為“社會機構”的鑒定部門，大多由醫院或公司開設，具有掛靠或承包經營的特征，所以，日常的鑒定業務技能操作和法律素養、道德操守等只能由鑒定人自行把握，極易出現鑒定人員素質參差不齊的情況。又因為這些機構是完全靠市場吃飯，鑒定意見質量較低、“失真”率較高，是其一大特征。
4.傷殘等級定級標準過于陳舊，有待優化和完善
首先，因為時過境遷和相應的標準釋義不夠細化等原因，我國的《道路交通事故受傷人員傷殘評定》的條款內容已經不能適應當前的新情況。其次，對于傷病關系參與度的司法鑒定意見，大多是由鑒定人以其主觀認知水平來決定傷病參與度的比例，其結果常常出現不同的鑒定人出具的鑒定意見相差甚遠的現象。
5.主觀判斷與客觀事實之間的差距產生的問題
傷殘等級評定或鑒定是具有專業知識的人員依據相應客觀材料做出的鑒別、判斷的主觀認知說明。僅憑鑒定人的經驗、過多依賴鑒定人主觀檢查，結果就是每做一次鑒定都可能出現不同的結論意見，難以分清哪個鑒定人有“過失放水”或“故意放水”可能。
6.鑒定人怠于出庭，申請重新鑒定不易
按現有法律規定和司法實踐，對于司法鑒定意見異議處理的司法救濟手段主要有以下兩種：
一是鑒定人出庭作證或“有專門知識的人”協助出庭質證。但是在司法實踐中，鑒定人愿意出庭參加質證的較少，“有專門知識的人”囿于情面等因素也很少愿意出庭協助。因此，總體上而言當事人或法院更傾向于進行重新鑒定。二是重新鑒定?，F行法律中對哪些情形可啟動重新鑒定程序則沒有明確的規范，與此相關的判斷標準以及如何選擇重新鑒定機構和鑒定人等均無明確的法規依據，易引發對司法鑒定意見或法院判決的公正性的質疑。
7.行政監管和自律管理的缺失
司法鑒定作為專業技術領域的活動，以行政監管手段對其進行監督確有相當的難度，監督管理往往落不到實處，難以對傷殘鑒定意見的質量進行有效地監督，對鑒定機構和鑒定人的行為也難以進行實質性地監督約束。而司法鑒定協會作為行業自律機構，其制定的處罰辦法之法律效力的層級較低，對專業技術領域活動中的問題管控明顯不足。
第二、域外經驗借鑒
1.荷蘭和德國的經驗
我國與荷蘭和德國同屬于大陸法系國家，相較而言，荷蘭和德國在司法鑒定人的考核準入標準上有著較高的標準。
一是荷蘭經驗。首先，荷蘭在司法鑒定人的準入及考核上有較高的要求，培訓內容豐富、時間跨度較長。對于鑒定人除了必備的相關領域的知識以及實施鑒定執業的技能和經驗外，還強調鑒定人應具有一定的相關法律知識素養。其次，資格的期限性。司法鑒定人的資格證書和注冊有效期一般為 4 年，期滿后需重新申請、注冊，意即司法鑒定人的資格并非是終身制的。
二是德國的經驗。按司法鑒定人的公信度由高到低可將鑒定人分級，等級越高對誠信程度和道德品行的要求越高。最高等級的鑒定人標準要求除嚴格專業技術知識和法律法規的考核外，還須考察了解申請人的過往的誠信程度和道德品行。其次，申請人上崗前還須進行公開宣誓。最后，德國訴訟法對于等級高的鑒定人優先選用也作出了具體的規定。
2.韓國經驗
韓國早幾年保險欺詐猖獗的情況與目前我國車險人傷理賠中發生的問題較為相似，因此了解韓國的解決對策，對我國有著現實的借鑒意義。
首先，組織架構上的保障。其成立政府聯合保險犯罪專門活動對策班，集合多部門進行緊密合作。其次，構建保險詐騙認定系統。綜合分析保險合同、事故及保險金支付資料等保險欺詐調查中的信息，做到動向分析和早期預警，能夠有利于追索到嫌疑人之間的共謀關系。再次，建立保險犯罪檢舉中心。廣泛呼吁一般公民提供信息、線索，當檢舉的內容有助于揭發保險犯罪時，各保險協會和保險公司會給予檢舉人獎金。
第三、實現人傷理賠司法鑒定公正的對策研究
1.制定統一的《司法鑒定法》，嚴格法律規制
在當前司法鑒定活動日益受到詬病的情形下，應加快制定統一的《司法鑒定法》或先行通過地方立法的形式，對于以下諸方面進行規制。
首先，應提升司法鑒定人的準入標準，強化對司法鑒定人的基本素質要求。其次，應統一司法鑒定的申請、委托、受理、實施操作標準排除人為因素對司法鑒定意見結論的干擾。再次，應構建多層次的司法鑒定體系。第一將司法鑒定人和機構分級；第二扶持權威鑒定機構，完善重新鑒定復核機制；第三樹立個別“國家隊”級別的鑒定機構在某些鑒定項目上權威性，在某些項目上該鑒定機構只接受重新鑒定或法院的委托。
此外，還應制定司法鑒定意見采信的標準規范，一是應制定司法鑒定意見的采信標準，并由法院與司法行政管理機構等聯合制定司法鑒定人出庭質證準則；二是建立涉醫專業技術官制度；三是建立專項監督管理機制。最后，應明確司法鑒定人責任制、建立錯鑒追究機制。
宣誓制度作為預防鑒定人作偽證的措施，有助于鑒定人主動進行自我提醒和自我約束，有助于維護法律權威。因此，建立司法鑒定人宣誓制度是可行的措施。
2.制定《保險反欺詐法》，建立保險反欺詐體系
首先，應制定統一的《保險反欺詐法》，明確保險欺詐的概念和范圍，有利于各主管部門統一認識，對保險欺詐采取有力的懲治。其次，應建立涉保的司法鑒定反欺詐工作網絡平臺，向相應部門雙向開通信息交流的端口，做到信息共享。再者，設立涉保的司法鑒定檢舉中心，實現有獎舉報，達到群防群治的社會效果。
3.完善司法鑒定行業的自律機制建設，加強行政監督管控機制
制定配套的行政管理辦法，對司法鑒定人和機構進行鑒定前、中、后的全程監督管控，以提升司法鑒定內在的自律機制和外部的監督機制。一是加強行風的建設，倡導完善自律管理機制。二是加強聯動監督管理機制，如建立“鑒定機構和鑒定人員黑名單制度”,對每一個鑒定機構和鑒定人公開進行公信度信用評級的評定 .
4.加強保險行業自身內功建設，探索爭議糾紛處理新機制
建立完善的車險理賠運營體系及糾紛處理機制，配合司法系統工作，減少車險人傷理賠糾紛對司法資源的占用。
首先，可以構建車險人傷案件專項網絡數據平臺，用大數據分析的方式，對司法鑒定實施前、中、后的全程覆蓋監督，增進司法鑒定的透明度，以提升鑒定應有的客觀公正性。其次，創設新型的保險合同糾紛快速處理機制，從時效性、公正性、權威性、合法性的多維度考量，設置涉保專業仲裁庭不失為一種好的解決途徑。
本文主要采用根源分析和實證分析等方法，借鑒荷蘭和德國的司法鑒定人制度、韓國的反保險欺詐舉措的等經驗，對于完善本市車險人傷理賠司法鑒定制度的思路和對策進行了細致地探討和分析，從體制、制度及技術多個層面提出了相應的法律對策和建議，以期提高司法鑒定的公正性與權威性、促進車險理賠反欺詐工作的推進及車險市場的穩定發展，進一步實現司法鑒定應有的價值，維護我國司法的公平公正，有力推動我國社會的誠信建設與和諧建設。
[關鍵詞]車險人傷理賠；司法鑒定；法律規制；機制建設
Abstract
Under the background of sustained and high-speed development of China'seconomic development, as one of the metropolitans who sits at the front line ofChina's economic development, although Shanghai has actively and intentionallytook measures to control the number of motor vehicles, the uptrend of motor vehiclesquantity seems difficult to be effectively curbed. The swift increase of motor vehiclequantity leads to a deterioration of transportation conditions, a continuous increasingof motor-related transport accidents and a continuous large number of death andpersonal injuries cases. The most prominent problem is the increasing proportionaccount by the claims for personal injuries in the total claims under motor insuranceof various insurance companies. These accidents and claims are of importance anddifficulties in motor insurance claims of various insurance companies.
The indemnity of personal injuries of motor insurance is becoming a problem ofsocial well-being. The high loss ratio in this regard has raised the premium rate ofmotor insurance. The cost of claims is growing with the economic development. Also,the frequent fraudulent claims caused a lot of undue indemnities which seriouslyinfringe the insurance company's profit and the vehicle owner's interest who shall besubject to the burden of high premium rate. This fact is actually endangering the sustainable and stable development of the motor insurance industry and thereforehampered the construction of China's harmonious society.
The author is graduated in the major of forensic medicine and has ten yearsclaims service work experiences in insurance company circle, and has focused on therelatively high loss ratio of Shanghai motor insurance personal injuries claim in a longterm manner. Through analyzing abundant “first-hand” data and precedents whichcollected from CIRC Shanghai, Shanghai Insurance Association, property andcasualty insurance companies and brokers, together with the author's personalpractical experiences, the author has carried out a relatively solid and meticulousresearch for judicial identification of personal injury and related legalcountermeasures about the indemnity of personal injuries of motor insurance.Therefore this paper intends to start from the following three aspects.
Section one, analyze the problems and reasons of the judicial identification of themotor insurance claims.
Current market competition and identification of institutions who pursuit theprofit and other factors leads to the judicial identification of market chaos layer andthe problem identification continues to appear. To analysis the main reasons, there arethe following seven aspects.
1.the choice of assessment time has a greater impact on the identificationconclusions.
There is no authoritative department in our country to make a specific,standardized interpretation of the evaluation time. In actual operation, theidentification of the end of clinical treatment for the same object was always differentconclusion by expert witness' different understanding and cognition. In addition, thedifferences of the rehabilitation time and rehabilitation results of different patientswere also different, and due to the large time span, the conclusion of the re appraisalis not consistent with the conclusion of the initial identification.
2. unilateral application by the injured person.
In accordance with the existing road traffic accident process in Shanghai, theinjured could require traffic accident treatment department to issue a disability letter of authorization or recommendation and he can choose the judicial identificationinstitution by himself. However, this free choice of practice has many drawbacks.Firstly, some injured compare the number of identification institutions conclusion, ortake a bride to the expert witness to get the higher grade identification. Secondly,most of the identification institutions are self financing entries and they would like toshow good to the application to get more clients. Thirdly, “personal injury scalpers”will pursue the familiar judicial identification to see for higher grade identification.
3.the problem of different the expert witness' qualities.
In the current judicial appraisal management standard, there is no specificrequirement for the expert witness' legal literacy and ethics of the personnel.
For example, for some identification institution which usually is called as socialinstitution, mostly they are operated by hospitals or companies with the characteristicsof anchored or contracted operation. So the daily identification skills and legalliteracy and ethics are controlled by the expert witness himself, and this is easy toappear different expert witness' qualities situation. In addition, these institutionscompletely rely on the market, they usually provide the lower identification and withhigh rate of distortion.
4. the evaluation criteria of degree of disability are too old to be optimized andimproved.
Firstly, because of the passage of time and the corresponding interpretationstandard are not detailed enough and other reasons, the content of assessment ofdisability for road traffic accidents in our country could not be adapted to the currentsituation. Secondly, for the judicial expertise opinion about the injury mostly will bedecided by the expert witness' subjective cognitive level for the injury participationrate. The result is often quite different from the different expert witness' judicialexpertise opinion.
5. the problem of the difference between subjective judgment and objectivefacts.
The disability degree assessment or identification is a professional knowledgeof personnel based on the corresponding objective material to make the identification, the subjective cognitive explanation. Only by the experience of the expert, too muchdependence on the identification of the subjective examination, the result is that eachof the identification of a different conclusions. It is hard to find if the expert witnessnegligence or intentional concession.
6. the expert witness disdains to appear in court, it is not easy to apply for there-identification.
According to the existing legal provisions and judicial practice, the judicialrelief measures for the judicial identification of the views are mainly the followingtwo:
The first one is the confrontation of the expert witness appearing in court orwith the assistant of the professional expert. But in the judicial practice, the expertwitness seldom appears in court, and the professional expert wouldn't like to appearin court either. So in generally, the parties or the courts are more inclined tore-identify. The other one is about re-identification. In current law, there are no clearrules about what kind of situations can be re-start the process of identification, and noclear legal basis about the related judging standard and how to choose theidentification institution and expert. This is easy to bring the doubt for the judicialidentification opinion and the justice of court decision.
7.the absence of administrative supervision and self-discipline management.
As a professional technical field of activity, it is quite difficult for judicialexpertise to supervise the administrative supervision. Supervision and managementare often not implemented. It is difficult to effectively monitor the quality of thedisability appraisal. It is also difficult to carry out substantive supervision andrestraint to the identification of institutions and the identification of human behavior.And the judicial authentication Association, as the industry self regulatory body, thelegal effect of the punishment circular is lower, and the problem of the professionaltechnical field is obviously insufficient.
Section two, foreign experience for reference.
1.the experience in Holland and Germany.
China is a country of continental legal system which is the same with Hollandand Germany, compared the judicial identification of people's assessment of accessstandards, Holland and Germany have a higher standard.
The first one is Holland experience. Firstly, in Holland, the judicialidentification of the access and assessment has the higher requirements, the richertraining content and longer time span. Beside the necessary areas of knowledge andexperience in the implementation of the identification of the practice, the expertwitness is also required a certain knowledge of the relevant laws. Secondly, it isqualification period. Generally, the judicial expert witness qualification certificate andregistration is valid for 4 years, after the expiration, they need to re apply forregistration. This means that qualification is not is for life.
The second one is Germany experience. The judicial expert witness should bedivided into different levels according to public trust from high to low, the higher thelevel, the higher the requirement on integrity and moral conduct to the expert witness.For the highest level expert witness, who is not only strictly required the professionaltechnical knowledge and legal regulations of the assessment, but also investigated theintegrity of the applicant's past and moral conduct. Secondly, the applicant must makea public oath before the applicant. Finally, the German litigation law also gives thespecific provisions of the priority to choose the high level expert witness.
2.the experience in South Korea.
In the early years, the situation of insurance fraud in South Korea is similarwith our current situation. Therefore, it is realistic significance to understand thesolution of South Korea.
Firstly, it is organizational structure security. They establish the department ofthe special event of joint insurance policy, different departments cooperate together.
Secondly, they establish the insurance fraud identification system to analyze theinvestigation information for insurance fraud comprehensively, such as insurancecontract, accident and insurance payment. It can realize trending analysis and earlywarning, and search for the collusion between the suspects. Furthermore, theyestablish the insurance crime reporting center. General publish is widely appeal to provide information and clues, if the information is helpful to expose the suspects, allof insurance association and companies will provide reward.
Section third, realize the countermeasures research for the judicial identificationof the claims.
1.the unified Judicial Identification Law should be formulated to realize strictlegal regulation.
In the case of the current judicial appraisal activities, we should speed up theestablishment of a unified Judicial Identification Law or approve the local legislationin advance, and the following aspects of regulation,
Firstly, we should improve the judicial identification of the access standards,and strengthen the judicial identification of people's basic quality requirements.Secondly, we should unify the application of forensic identification, commissioning,acceptance, the implementation of the standard of operation to exclude theinterference of human factors on the judicial appraisal conclusion. Thirdly, we shouldconstruct multi levels of judicial appraisal system: （1） to classify the judicial expertiseand institution; （2） To support the authority of the identification of institutions,improve the mechanism of re appraisal review; （3） To establish the authority of theindividual “national team” rating agencies in certain appraisal projects, in someprojects, the identification of the institution is only accepted by the re appraisal or thecourt's commission.
In addition, we should also develop a standard specification for collectingopinions for judicial identification. （1） We should make the collecting opinionstandard for judicial identification and also make the expert witness appearing in courtrules by the courts and judicial administrative agencies together. （2） We shouldestablishment of medical professional and technical officer system. （3） We shouldestablish special supervision and management mechanism. （4） We should establish aclear judicial expert responsibility system, and the wrong identification and correctionmechanism.
The oath method is helpful to remind and bind the expert and is able to upholdthe law's authority. Therefore, it is feasible to build an oath measure for judicialexpert.
2.make Anti Insurance Fraud Laws, and establish anti insurance fraud system.
First of all, we should formulate a unified Anti Insurance Fraud Laws, clear theconcept and scope of the insurance fraud, which is good for the competent departmentunified understanding of the insurance fraud and take effectively action. Secondly, weshould establish a network platform for the anti fraud work of the judicialidentification, and shear the exchange information to the corresponding department.Thirdly, establish the reporting center of the judicial identification to realize prizereport to achieve the social effects of prevention and treatment.
3.improve the self regulatory mechanism of the judicial identification industryand strengthen the administrative supervision and control mechanism.
To develop a complete set of administrative measures to improve thesupervision and control of the whole course of the judicial expert witness and theinstitution, in order to improve the internal self-discipline mechanism and externalsupervision mechanism: （1） To strengthen the construction of morals, advocatingperfect self-discipline management mechanism. （2） To strengthen the linkagesupervision and management mechanism, such as the establishment for theidentification system and the identification of the black list system to assess eachidentification mechanism and expert witness publicly.
4.strengthen the internal construction of the insurance industry and explore newmechanisms for dealing with disputes.
Establish a complete insurance claims operation system and dispute settlementmechanism, and cooperate with the judicial system to reduce the judicial resourcesoccupation from motor insurance claims.
Firstly, we can build a special network data platform for motor insurance injurycases, with the way of big data analysis, supervise the whole judicial process, toenhance the transparency of judicial identification and improve the objective justice.Secondly, we can establish a new type of quick handing mechanism for insurance contract disputes, and considering from the timeliness, impartiality, authority,legitimacy of the multi dimension considerations, it is a good way to set up a specialarbitration court.
This paper mainly focus on the detailed discussion and analysis of improvingthe thinking and strategies of judicial identification of personal injuries claims undermotor insurance by using the methods of original analysis and empirical analysis,learning from the judicial identification systems of Holland and Germany, the Koreaninsurance anti-fraud measures. This paper also provides relevant legal strategies andsuggestions from multiple aspects of system, policies and techniques to the aforesaidissues to improve the jurisprudence and authority of judicial identification andpromote the advancement of anti-fraud business in motor insurance claims and thesteady growth of motor insurance for further realization of the value of judicialidentification, the maintenance of China's justice and the construction of a trusty andharmonious society.
[Keywords]Personal Injuries claims of Motor Insurance;JudicialIdentification of Personal Injury; Supervision and Regulation;Construction of Mechanism
目 錄
導 言
一、問題的提出
二、研究價值及意義
三、文獻綜述
四、主要研究方法
五、論文結構
六、論文的主要創新及不足
第一章 上海市車險人傷理賠現狀分析
第一節上海市車險人傷理賠現狀
一、機動車保有量急增、車險人傷事故驟升
二、人傷事故賠款占比畸高
第二節上海市車險市場人傷理賠率高的原因分析
一、保險產品費率設置不合理，無法遏制高賠付率
二、保險人對傷者、肇事方（投保方）的控制力較弱
三、立法和司法過于保護傷者
四、人傷理賠賠償標準升幅快
五、傷殘等級評定或鑒定虛高
第三節上海市車險人傷理賠司法鑒定中的問題及原因分析
一、評定時機對鑒定意見結論影響較大
二、傷者單方申請鑒定問題所在
三、鑒定人員素質參差不一
四、傷殘等級定級標準有待優化和完善
五、鑒定人的主觀判斷與客觀事實之間的差距
六、鑒定人怠于出庭，申請重新鑒定困難重重
七、行政監管和自律管理的缺失
第二章 司法鑒定的主觀性和客觀性問題分析
一、司法鑒定的主觀性
二、司法鑒定的客觀性
三、司法鑒定主觀性與客觀性統一的目標與方法
第三章 域外經驗借鑒
第一節荷蘭和德國的經驗
一、荷蘭的經驗
二、德國的經驗
第二節韓國經驗
一、組織架構上的保障
二、構建保險詐騙認定系統
三、建立保險犯罪檢舉中心
第三節臺灣地區經驗
一、設立中立、獨立的爭議糾紛處理機構
二、爭議糾紛處理的法定效力
第四章 實現上海市人傷理賠司法鑒定公正的對策研究
第一節制定統一的《司法鑒定法》，嚴格法律規制
一、提升司法鑒定人的準入標準
二、統一司法鑒定的申請、委托、受理、操作標準
三、構建多層次的司法鑒定體系
四、制定司法鑒定意見采信的標準規范
五、明確司法鑒定人責任制，建立錯鑒追究機制
六、建立司法鑒定人宣誓制度
第二節制定統一的《保險欺詐法》，健全保險反欺詐體系
一、明確保險欺詐的概念和范圍
二、建立涉保的司法鑒定反欺詐工作網絡平臺
三、設立涉保的司法鑒定檢舉中心
第三節加強行政監督管控，完善行業自律機制建設
一、加強行風的建設，倡導完善自律管理機制
二、加強聯動監督管理機制
第四節加強保險行業“自身內功”建設，探索爭議糾紛處理新機制
一、構建車險人傷案件專項網絡數據平臺
二、創設新型的保險合同糾紛快速處理機制
結 語
參考文獻
