一、研究目的：本論文研究動機在探討現有釐定產物保險之保險費架構下 ，加入市場報酬率與風險來獲得產物保險保險費新的評價模型（pric- ing model）。並證明產物保險採取此種保險費評價模型之可行性。二、 研究方法：本論文係以產物保險公司承保面所生之收入與成本之外加入資 金運用面，作為其保險費評價模型之建立，並佐以假設的資料來分析。三 、研究結果：以購買產物保險消費者而言，雖保險公司顯少變動費率，但 在資本市場報酬率高時，消費者常認為保險公司利用了這些資金所得之利 潤並無回饋保戶，如降低保費，而認為所收保險費過高，甚至可能導致降 低投保意願。若產物保險公司依本篇論文”產物保險之評價模型”以公開 之資訊，如市場報酬率與風險來釐訂保險費，將可減少大眾對保險費過高 或過低之疑慮。

我國汽車保險於產物保險業務結構中占約百分之五十，其業務消長與品質關係著保險公司經營績效。而業績消長與品質好壞又跟行銷通路息息相關。掌握通路即掌握業務雖對，但如何選擇好的通路及經營，就牽涉到保險公司自身之定位與優勢所在。金融控股公司法於2001年6月27日經立法院三讀通過，並於同年11月1日實施，自此金融相關產業正式邁入戰國時代，各大金融控股公司相繼成立。金控業者借由自身銀行、證券、壽險、產險等行業在資源整合、交叉行銷、One-Stop Shopping、與成本管控運用下，期待能正面積極發揮綜效（Synergy）以達成效益極大化之經營模式。非金控業者為求生存發展，也紛紛與其他異業合作，或尋求其他新興行銷營運模式，形成多元行銷契機。 　　汽車險業務經營傳統上受車商保代之影響很大，自2005下半年起因受銀行雙卡壞帳緊縮消費金融影響下，2006年汽車經銷商新車銷售大幅衰退，直接衝擊著汽車險保費的收入，因此若依賴車商業務較重之業者將承受相同衰退命運。但若業者能經營多元行銷通路，相對的可能影響就較輕微。因此產險公司如何開拓與壽險、銀行之異業合作，以提升汽車險及其他保險業務，對本身保險業務之成長就非常重要。 　　本研究以個案公司經營壽險及銀行通路為對象分析，確發現產險公司若能有效發揮自身優勢，提供附加價值，積極爭取異業合作，尤其是壽險與銀行業之互利合作，藉由他們廣大之人力與據點通路，對汽車險業務之成長有很大之幫助。另外因為多元通路的經營，風險分散，也較不會因為不利事件或經濟環境不佳，而造成業務成長的瓶頸。 / Motor insurance business has played a dominant role in the Taiwanese non-life insurance industry. The written premium incomes from the motor insurance accounts for nearly 50% of the overall incomes of the domestic market. The underwriting quality of the motor insurance business is highly related to the profit result and is closely depending on the marketing channels. Therefore, the selection of appropriate marketing channels will have predominant influence in the performance of a non-life insurance company. In 2001, the financial holding regulation went into effect and all financial sectors, including banking industry, life insurance industry, non-life insurance industry, and security industry, had made efforts to integrate internal resources in order to lower operating costs, to develop cross-selling strategy, and to provide better customer service in order to achieve the synergy from financial holdings. At the same time, those financial sectors without joining financial holding group also look for new marketing strategy through strategic alliance and or innovative market channels. 　　The marketing channels of the motor insurance business in Taiwan are traditionally dominated by car dealers. However, since the new car sales in 2006 were seriously impacted by the irrecoverable loans or credits of the credit cards in 2005 and by the depression, decreasing almost 30% than that of previous year, of new-motor market in 2006. Nevertheless, the non-life insurance company might reduce the mentioned impacts if it can conduct multi-channels with good quality except for car dealers. Therefore, to cooperate with other industries, including life insurance and banking fields, to establish a strategic alliance will be very important for the development of the property insurance company in all aspects at present and the near future. 　　The model of the research is focusing on the case studies of the two channels, life insurance business and banking business, for the operation of the non-life insurance company. With the detailed analysis, we discovered that non-life insurance company can effectively increase growth of the written motor insurance premium by the approaches of developing self-advantages, providing additional values, and co-operating with the salesmen and the resources of the life insurance industry and banking industries. Furthermore, to run the multi-channels for the property insurance companies will be extremely contributive to disperse risks and will avoid the bottleneck of sales growth under the circumstances of the unfavorable events and of the recession.

競爭之主要經濟價值在於經由市場機能的運作，使資源作最有效的配置，並確保市場 競爭的公平性和和平等性，但如自由競爭的經濟價值已非任由私人 企業所叮能達成時，即有賴國家以法理手段來維持市場競爭秩序，因此各國反托拉斯 法莫不以維護競爭及防止限制競爭行為為目的。 就保險業而言，保險事業係依賴多數被保險人所線納之保費而為經營，其營運之良莠 與否和公眾經濟生活有密切關係，為確保業者的清償能力，各國無不對保險業加以管 理，藉以維護公共利益，以保險監理之核心一費率來說，費率是否不足夠、合理及公 平和保險人、被保險人休戚相關，因此有賴主管機關加以管理，然而何種管理方式方 符合最大公共利益，則有許多不同的觀念，例如美國自十九世紀以來，對保險費率究 應採行自由競爭或管制方式即爭論不已，且因保費率釐定過程之特殊需要，反托拉斯 法應否適用於保險業亦引起一番爭議。本文即擬就美國產物保險費率監理製定作一介 紹，並以美國立法及聯邦最高法判例，探討美國聯邦反托拉斯法對保險業除外適用的 原因及範圍。 雖然我國尚未有反托拉斯法，但研擬中之公平交易將保險業之行為排除公平六易法的 適用，其並未經過審慎的評估，因此吾人欲以美國之經驗作為我國保險業應否適用公 平交易法的參考。

首先針對目前國內產物保險公司有關作業險管理尚未有完整之監理規範或管理實務，但是，因作業風險所導致之損失金額卻與日俱增，實為不可忽視之風險，故藉由探討產物保險公司建構作業風險管理機制，同時分析其中理論與實務之運作，盼能有助於國內產物保險公司在未來不論是主管機關的監理制度，或是與全世界風險管理趨勢的結合上，提供具有參考性之建議及方向作為研究的目的設定。 本研究透過文獻回顧及探討，對於國內外金融機構作業風險管理執行情況，可知作業風險管理與內部控制之關係應是互補的概念，不能單以內部控制取代作業風險控管，而唯有作業風險與內部控制相互充實，才能更能提昇作業風險管理之功能及能力。另對於產物保險相關之作業風險損失事件之收集彙整，瞭解作業風險損失可能產生重大的財務損失，或是影響公司之正常業務營運，由於作業風險與產險公司日常營運活動息息相關，且作業風險管理並非一全新之風險管理觀念，面對產險市場瞬息萬變，主管機關監理強度趨於嚴格，包括頒布保險業之風險管理實務守則，內容規範即可看出作業風險以結構化之管理，已成為潮流。如何透過管理流程，及輔以各項管理工具，與現行之內控、法令遵循等機制加以整合，將過去的被動轉換為主動的管理，不論是發生頻率低、損失幅度高的事件，或是發生頻率高、損失幅度低的事件，皆應平等重視。 個案研究則以作業風險管理之理論為基礎，逐一探討研究之標竿保險公司作業風險管理執行情形，可以得到下列四個結論：(一)落實風險管理之企業文化是關鍵成功因素、（二）作業風險管理專責單位或人員的建立應是有必要性、（三）建立完整之作業風險管理架構、（四）作業風險管理與內部控制制度是互補的、（五）無缺失不代表無風險。本研究最後提出以下建議：（一）師法目前Basel II銀行之作業風險管理經驗、（二）積極專業人才培訓是作業風險管理之成功要件、 (三)保險業者應儘速建立內、外部損失資料庫、(四)應設置隸屬董事會之風險管理委員會、(五)法令遵循自行評估之調整。以作為未來台灣產險業如何建制作業風險管理機制及有效控管作業風險之參考。 / Despite of the increasing exposure and loss due to operational risk to Taiwanese Non-Life insurance companies, an intergrated coorporate self-regulation or practical guidelines for operational risk management within financial institutions have not yet been developed. Therefore, through seriously study, discuss, and analyze the mechnisms on how to implement a thorough corporate operational risk management guidelines and a balanced operational point between theory and practice, I hope that this paper could give our local non-life financial institutes, regulators, and compliances some aspects on the regulatory governence development. Numerous articles and literature reviews on foreign and domestic businsses and financial institutions regarding operational risk management operations stated that interal control and operational risk management have substitutional effect. Therefore, only if both interal control and operational risk management simutaneously develop, will operational risk management’s functionality and ability be most effective. Massive information on opertaional risk loss event have been collected and compiled to study its impact to Non-life insurance companies, including the loss it may bring to the financial institution or the effect on daily business operation. Driven by legal changes and forever-changing business market, the local goverment have becoming tougher on regulatory governance, including promulgate the code of practice for operational risk management guildance, which we would see that structured operation risk management is the newfound trend. The intergration of current compliance, internal control and other mechanisms through management process in order for operational risk management corresponds to a much wider trend of “responsive” or “active”, not “passive” management is what we ought to act on. Also, we should treat low-frequency, high-magnitude events and high-frequency, how-magnitude events equally. This paper came up with five conclusions 1. implementing the enterprise culture of operational risk management is the key to success. 2. developing operational risk management response team is an ought to do 3. implementing thorough operational risk management structure 4. substitutional effect among operational risk management and internal control system 5. no merit does not mean no risk. At last, this conceptual paper gives some recommendations for future operational risk management development 1. take operational risk management experiences by Basel II as a model 2. cultivate ORM professionals actively is the key to success 3. develop internal and external risk loss database 4. The risk management committee should be subordinate to the board of director 5. adjustment of compliance’s interal accessment.

本文主要探討產物保險公司如何以自身的風險管理及內部的流程控制來達到有效的控管和預測，進而創造更高的業主權益報酬率，確保被保險人的權益，以維繫公司的永續經營發展為研究的目的。 身為風險管理工具之一的保險公司，必須瞭解自身於經營上面對的風險所在。首先論述如何建立保險公司風險管理程序，並從風險中深入分析，得知不適當的定價是造成保險公司喪失清償能力最主要的原因，建立完善的核保風險機制據以發展保險公司本身的核心價值，特以火險為例詳細說明其建制的過程與細節。 除介紹如何利用核保財務分析模型（Underwriting Financial Model）來解決適當訂價的問題，並配合運用風險資本額的公式求出各險種之風險資本額、各險種之業主權益分配額、各險種之可運用資金、各險種之自留綜合率、各險種業主權益報酬率、以預測來年之營運績效，另外尚討論信用風險與風險累積的控制，運用創新的觀念及技術來管理公司的業務量。 最後建議保險公司應設立風險管理專責單位，對於風險管理的流程與運作提早規劃準備，保險公司應有意願提昇風險管理的專業能力並嚴格自律及確實執行，俾強化公司自身風險觀念瞭解到公司真正有此需求。 關鍵字：風險管理、業主權益報酬、風險資本額、核保、產物保險經營 / The main theme of this research is to explore the issues related to the ways of risk management and internal operation control for insurance companies. The insurance companies could be efficiently controlled and projected to create higher return on equity, to guarantee the insured’s benefit, and to maintain the company’s long-term operation by implementing risk management process. Insurance companies, as one of the tools for risk management, are required to realize their own risks in operation. Firstly they must explore how to build up a process of risk management and to recognize that inadequate price is one of the main reasons to cause insurance company’s insolvency. Secondly they should explore how to build up an adequate underwriting risk mechanism to develop the core value of insurance companies, and to illustrate its process and detail of the building-up with Fire insurance business. Insurance companies are also required to know how to solve inadequate price by using Underwriting Financial Model, and how to calculate Risk Base Capital, Capital Allocation, Asset Allocation, Combined Ratio, Return on Equity for each line of business to predict business results for the coming year. This paper also discusses the importance of credit risk and risk accumulation in order that insurance companies can manage their own business by using innovating concept and technique. Finally Insurance companies are recommended to set up a risk management unit that should plan and prepare for the process of risk management. They ought to show their high wiliness to increase the capability of risk management, and to exercise high discipline and put into work in order to enhance the concept and need of risk management. Key Words： Risk Management, Return on Equity, Risk Base Capital, Underwriting, Insurance Operation.

本研究係以企業保險為研究主體，企業的保險需求涵蓋產物保險及團體保險，以解決企業經營所面臨的財產、責任及人身上之風險，故本研究包含產物保險及團體保險，經由對企業投保產物保險及團體保險的分析，瞭解企業投保保險的現況，依此找出企業購買保險的需求所在，並藉此擬訂有效的行銷策略。 本研究以國內保險經紀人的目標客戶群為觀點來挑選研究對象，研究問卷之抽樣方法係採取非隨機抽樣法中的便利抽樣法，選擇之地區僅限於台北縣市、基隆市之企業。因考量企業體與一般消費者不同，主要決策者業務繁忙，訪問不易，故先以電話詢問有無接受問卷調查之意願，電話詢問的企業家數約有550家，其中表示有意願接受問卷調查的有285家，有意願者再利用E-mail、傳真、郵寄，或直接在電話線上接受訪談，願意接受問卷調查的285家中，回收141份問卷，回收率49%，其中2份為無效問卷，有效問卷為139份。 研究結果顯示：企業會選擇目前保險公司投保，及續保時「更換過保險公司」的原因，無論產險或團體保險，「保費較低」均佔所有原因之冠，可見價格仍是企業選擇保險公司最關鍵的考慮因素。 120家有投保團體保險的企業，有97.5%的企業有投保團體意外險，有45%的企業有投保團體定期險，顯示有超過一半的企業僅投保團體意外險而沒有投保團體定期險，目前產險公司所銷售之傷害保險較壽險公司便宜許多，在費率上有絕對競爭優勢，因此，對產險業及保險經紀人而言，團體傷害保險商機仍大。 本研究顯示，近七成的企業直接找產險公司投保，有三成是透過保險經紀人安排保險，資本額越大者，透過保險經紀人投保的比率有越高的趨勢，資本額5000萬以下的企業有27.6%係透過保險經紀人投保，資本額20億以上的企業有63.6%係透過保險經紀人投保，可見大企業業委由保險經紀人投保者較普遍，而中小企業仍習慣直接找保險公司投保。另外，企業會選擇目前保險公司投保的最重要原因中，資本額5000萬以下的企業，無論產險或是團體保險，以選取「與業務員有認識」的比率最高，產險為31%，團險為39.1%；而資本額20億以上的企業，無論產險或是團體保險，以選取「保費較低」的比率最高，產險為54.5%，團險為36.7%，可見大企業選擇保險公司以保費高低為最主要考量，而中小企業則是人情掛帥，所以經營中小企業應保持跟客戶有良好的互動，培養良好的人際關係。