The insurance fraud is frequent type of criminality at the present time. The perpetrators of this crime cause heavy economic damages to insurance companies. Objective of the thesis called "The insurance fraud in the Czech Republic" is to evaluate the current state of the problem of insurance fraud in the Czech Republic from the perspective of insurance companies, law enforcement authorities and new legislation. As well to describe the way of detection and investigation, characterize the offender, analyze the most frequent cases, typical methods of committing insurance fraud and to evaluate the statistics and trends from previous years. In the thesis are explained the principles of detecting insurance fraud in insurance companies and the preventive measures. Part of the thesis is to identify weaknesses in the fight against the insurance fraud.

The main target of this Master thesis is to find out health insurance company's possibilities in creating marketing plans and their implementation. The health insurance company is a specific subject which has different marketing tools as well as other responsibilities and legislative limitations. First part describes theoretical principles, methods and tools of marketing. Those are later applied to the field of public health insurance. Basic information about health insurance, its creation, formation and development concludes this passage. Second section deals with analysis of particular health insurance company, its marketing plan, budget, strategy, etc. An evaluation survey which depicts general public awareness of health insurance companies and their activities is also included in this part.

European insurance currently stands in front of phase of structural changes. Transforming of currently conservative and strongly regulated insurance area will be different from transformations done in other industries. For insurance of 21st century will be typical change of currently calmful insurance market into strongly competitive enviroment requesting significant changes in organizational structure of insurance companies. Effort of whole disertation is to support top management of insurance companies in creation of complicated models of organization structures of insurance companies. The work creates simple theoretical structure explaining changes in organizational structures of insurance companies. Special focus is being put on outsourcing of value chain in claims handling of motor vehicle insurance. Motivation of insurance management to implement described changes is mainly price fight, which strongly emphasizes need of efficiency. Optimizing of insurance company value chain might support increase in profitability of insurance technical result, compared to competition.

過去二十年以來，美國金融機構的財務狀況不斷遭遇挑戰，許多同業或相關行業紛紛發生財務危機甚至破產，其間不乏一些知名大公司，探究原因發現利率是大元凶，因在一九七Ｏ年代末至一九八Ｏ年代利率產生劇烈變化，面對利率如此驟變，對其業務與利率有息息相關的金融保險機構而言，無疑是極大考驗，為此各種金融創新的商品亦陸續出籠，但亦產生新風WP在未尋求避險工具下暴露出金融機構對於利率風險的管理仍有所欠缺。且在金融自由化、國際化施政方針之下，利率自由化及金融商品創新之陸續推展，利率顯得較具變動性，主管機關為維持保險公司之清償能力，對此一風險勢必應加以注意，以免保險業因利率風險變動造成巨額虧損影響保戶權益甚或影響其清償能力。 而資產負債管理係維持現金流入與現金流出量相等Cash Flow Matching，避免利率風險、流動性風險及再投資風險；資產負債管理有別於傳統財務管理方法，其具有下列特色：□重視資產負債表資產與負債二方面的關連性；□在達成可接受的投資報酬之際，同時兼顧利率風險；□促使資產管理人員(投資部門)及保險商品管理人員(精算及行銷部門)的連繫協調，進而使投資策略及商品策略之運作能相互配合；□有益於新產品開發及管理；□最終可促使獲利能力提昇，進而穩定獲利模式並促使公司穩定成長。 資產負債管理方法，包括獲利力分析(Profitability Analysis)、利率分析(Rate / Volume Analysis)、期間分析(Duration Analysis)、Gap Analysis 等，其中較廣為使用者為：□平均存續期間(Duration) ；□利率期貨（Interest RateFutures)；□股價指數期貨（Stock Index Futures）；□息票內化法（Internal Coupon Stripping）；□利率交換（ Interest Rate Swaps ）；□資產負債的區隔(Segmentation of Assets/Liabilities)；□現金流量情境分析（Cash Flow Projection under Multiple Economic Scenarios）。以監理立場考量，選擇採用的資產負債管理方□k除須顧及壽險公司之利率風險外，尚須考慮其流動性及收益性，在我國正漸漸鬆綁金融政策及邁進國際化之際，不宜對壽險公司之監理政策採取過於嚴謹手段，而平均存續期間之方法除可包融其他資產負債管理方法並可加以綜合運用，故便針對平均存續期間方法詳加介紹。 經上述之分析討論後，若要此資產負債管理分析落實及在不對壽險公司予以過多限制下，在壽險監理上應如何規範呢？歸納結果如下：□對於模擬之利率設定，採用一綜合式規定，每期依市場狀況指定2至3種利率，其餘數種由各公司視情況選用；□避免壽險公司過多困擾及考量我國目前尚無採用市價會計之實力下，仍以法定會計原則作為衡量標準，惟對於預期交易量將日益增多之衍生性金融商品，應要求於財務報表中揭露交易活動之質與量，且當實際結果有損失部分應於報表內表達；□要求壽險公司作區隔化，便於作預測及現金流量管理，且因應我國未來人口結構老齡化之年金。 商品開始販售之年金保險，其性質不同於一般之壽險商品區隔化更有其必要。有關免疫化的分析報告於利率環境變動不大時，每季提出並須經由會計師、精算師複核簽證及每月提出資產變動情況報告；若利率產生遽烈變動(如3%)時應於一個月內再作調整及編製免疫化分析報告，以避免影響壽險公司之穩定性；□對於壽險公司平均存續期間差距情況作一評等，列入經營風險評估及稽核抽檢之考量；有關平均存續期間之分析報告採不對外公開形式。

壽險利用國外股價指數期貨來規避國內股票投資組合的特定市場風險，其 可行性為何，則是本研究的重點。本研究目的主要乃基於壽險業在欲達成 某目標報酬率的前提下，為了避免因股票投資組合價值下跌，而須利用股 價指數期貨來規避其溢額風險。首先經由文獻探討來得知壽險業股票投資 組合的特性，並針對台灣與美國、日本、香港股市相關性作實證上研究結 果的比較，然後再將股票指數期貨避險理論與運用做彙整，最後則將過去 有關股價指數期貨實證研究節果做一回顧。本研究結果發現 ：(1)壽險業 在選擇國外股價指數期貨為避險工具時，以香港□生指數期貨為最佳 。(2)避險期間不宜過短， 以四週為宜。 (3)因本研究發現避險期間越 長，則避險比例越高， 且其避險績效亦越高，因此若在考慮交易成本的 情況下，則應以較長的避險期間為佳。 (4)迴模模型大致上皆能符合適合 度與假設檢定，故毋須再作修正。

台灣壽險業自1987年開放美商進入市場，及1993年開放國人設立保險公司後，產業蓬勃發展，截至今年止，已有逾30家壽險公司，競爭激烈。在此競爭的情況下，如何開創公司的藍海，避免在紅海裡廝殺，公司的營運模式策略將會影響公司未來的發展；且因壽險商品本就屬不具專利權的金融商品，同業間商品的模仿甚易，再加上金融產業疆界日益模糊，跨業交叉銷售成為一新趨勢，故壽險公司之競爭大部份決定於公司的營運模式的選擇與發展。另，就以LIMRA在2003年對美國壽險公司CEO的調查中顯示 ，該調查的最高管理階層認為，其未來工作中面臨四項最大的挑戰，其中營運模式、通路發展即為其中之一，可見該要素對現今公司策略的重要性。 因此，各家公司採取何種營運策略、模式，實就影響該公司的營運績效與未來成就；並且從該公司的營運模式策略，可以觀之是否能永續經營。尤其，壽險產業是確保客戶人生的風險保障，提供客戶長期承諾的行業，經由所提供的服務，使保戶能獲得財務上的安全，並且得到心靈上的平和。壽險公司能如何能信守對客戶的長期承諾，而不是短線經營，短期獲取利益，實值得好好深思與探討。 本研究將透過國內壽險市場的發展與現況分析，試歸納出目前壽險產業的營運模式，並藉由個案公司保德信人壽的研究，分析其營運模式策略與該公司之經營績效。且透過個案公司與其他公司-全球、紐約人壽的經營指標比較，及金融海嘯對其影響之因素，來探討在不同營運模式策略下，各自的營運成效，並試著從中研究、探尋壽險業較適之營運模式。 另經由此研究對個案公司及對壽險業，提出個人的淺見與建議，以供個案公司、業界做為日後的參考，並亟盼未來我國壽險市場運作能更加健全與蓬勃發展。 關鍵字：保德信人壽、壽險顧問、營運模式、策略 / Since its opening up to American insurers in 1987 and then to private domestic insurers in 1993, the Taiwan life insurance industry has thrived and now consists of more than 30 firms engaged in fierce competition. Given such a competitive market, it is crucial to develop blue ocean strategies and avoid price wars. Business strategies and corresponding business models will have an important impact on the future of a firm. As life insurance is not a patented financial product, it is very vulnerable to imitation by other firms. Moreover, the boundaries of the financial sector are becoming less defined and cross-industry selling is the latest trend. As a result, competition among life insurers is mainly determined by the selection and development of business models. According to a 2003 survey conducted by LIMRA on CEOs of American life insurers, management at the highest level believed that business models and distribution channel development would be the greatest challenges for them in the future, highlighting the importance of these factors on companies’ strategy. Therefore, the selection of business strategies and models has a real impact on the current and future performance of a firm and reflect its potential for sustainable development. The life insurance industry is in the business of offering long-term risk protection, providing the insured with financial security and peace of mind. How life insurance companies can focus on keeping their promises to clients over the long term, as opposed to simply seeking short terms gains, is a subject worth considering. This study will analyze the current state and development of the domestic life insurance market and summarize the business models presently employed. A case study of Prudential Life Insurance Company of Taiwan will further provide an analysis of its business model and performance. A comparison is made between the case study and other firms, including TransGlobe and New York Life Insurance Taiwan, and with respect to the impact of the financial crisis in order to discuss individual performance under different business models and propose optimal business models for life insurers. Keywords: Prudential Life Insurance Company of Taiwan, Lifeplanner, Business model, Strategy

近年來台灣的市場利率持續下滑，可能造成保險公司無法實現對被保險人之高預定利率的保單給付承諾，利率風險已經成為壽險公司是否能繼續經營之重要關鍵。壽險公司如未能衡量利率變動風險而貿然推出保單，將對財務造成極大的負擔，不但會影響公司清償能力，亦會對社會造成衝擊，因此壽險公司應先衡量現在及未來將面臨多大的利率風險，做適當資產負債管理，以避免將來失卻清償能力。 　　本研究利用財務上平均存續期間（duration）觀念與Barney（1997）所提出之K值來衡量利率風險，以民國87-89年財務報表資料，實證研究利率風險會對那些經營指標產生影響，以喚起業界對於利率風險之重視。研究結果發現： 　　1.利率風險對於壽險公司之投資報酬率、股東權益報酬率有顯著的影響，並且呈負相關。 　　2.利率風險對於壽險公司之流動比率無顯著相關；與負債比率有顯著之正相關。 　　3.利率風險對於新契約保費成長率、保單繼續率無顯著影響，顯示國內並無明顯之逆中介情況。 　　4.壽險公司可藉由投資較長期之公債、公司債及減少保單貸款、不動產投資與固定資產項目之利率敏感度，以增加壽險公司之獲利性。 / The interest rates have been decreasing recently. Under this circumstance, it might be difficult for insurance companies to gain sufficient investment returns to fulfill the commitment of insurance policies. The interest-rate risk has become one of the critical factors for the solvency of life insurance companies. Therefore, life insurance companies should evaluate the impact of interest-rate risk and perform asset-liability management to prevent insolvency. 　　This study applies the concept of duration and K value (Barney 1997) to measure interest-rate risk and its impact on the operations of life insurance companies in Taiwan. The empirical analysis is conducted based on the financial data of life insurance companies in Taiwan during the period of 1998-2000. The empirical findings are listed as follows: 　　1.Interest-rate risk has a significantly negative impact on both investment return and ROE.. 　　2.Interest-rate risk does not have significant impact on current ratio of the life insurance companies, but it is positively related to debt ratio. 　　3.Interest-rate risk does not have significant impact on either new contract growth rate or policy renewal rate, which indicates that the process of disintermediation does not happen in life insurance industry in Taiwan. 　　4.By investing in the long-term government bonds and corporate bonds and reducing the interest-rate sensitivity of policy loans、investment on real estates and fixed assets , life insurance companies may be able to increase their profits.

隨著金融市場的整合、金融控股公司的成立，保險公司、銀行與證券機構等的經營不再只是各自為政，其經營變化皆會影響到整體的經營成敗。子公司的經營應不再只是注重經營績效，還應納入各項經營風險的考量，在報酬與風險之間取得一個平衡點。 本研究主要是透過風險調整資本報酬(RAROC)，來測量在金控旗下產物保險公司經營績效之優劣。本文利用民國73年至93年的產物保險年鑑的財報資料，以RAROC及傳統財務比率，比較富邦公司與本國老公司經營績效之差異。 本文之實證研究結果發現如下： 1. 在傳統財務比率之下，富邦產物保險公司的經營能力與本國老公司大致相同，但獲利能力明顯優於本國老公司。 2. 在風險調整資本報酬比率下，營運部分之績效比較結果為： (1) 在全部業務之下，富邦產物保險公司與本國老公司大致相同。 (2) 在扣除分保業務之後，富邦產物明顯優於本國老公司 3. 在風險調整資本報酬比率下，富邦產物之投資方面的經營績效明顯優於本國老公司。 / After the renovation of financial market and the establishment of financial holding company in Taiwan, insurance companies, banks and security institutes will not operate independently, and their efficiency on operation will affect themselves. Subsidiary companies not only focus on efficiency on operation, but also measure variation of risk on operation to achieve a balance between risk and return. This study applies the concept of Risk-Adjusted Return on Capital (RAROC) to measure efficiency on operation of non-life insurance company in financial holding company. The empirical analysis is conducted based on the financial data of non-life insurance companies in Taiwan during the period of 1984-2003. The empirical results are summarized as follow. 1. Base on traditional financial ratios, the underwriting efficiency of Fubon is the same as the other companies, but in the part of investment, Fubon is more efficient than other companies. 2. Based on Risk-Adjusted Return on Capital for measuring underwriting efficiency: (1) Fubon and old local companies are the same efficient for total business. (2) Fubon is significantly more efficient than other companies for the retained business. 3. Based on Risk-Adjusted Return on Capital for measuring investment efficiency, Fubon is better than other companies.

När nya politiska regleringar införs på en marknad kan det få konsekvenser för alla aktörer på marknaden. Det kan påverka både deras verksamhet och deras relationer. Syftet med denna uppsats är att få en ökad förståelse för hur relationen mellan företag på försäkringsmarknaden förändras inför en större politisk förändring och vilka faktorer som kan spela in. För att undersöka detta intervjuas företrädare för försäkringsbolag och försäkringsförmedlare inför det kommande direktivet om försäkringsdistribution (IDD). För att undersöka hur relationerna förändrats används en modell av relationen som grundar sig i bland annat Anderson och Narus (1990) forskning om relationens beståndsdelar och hur dessa hänger ihop. För att undersöka vilka faktorer som påverkar hur förändringen går till används en modell av Hadjikhani, Thilenius och Pourmand (2009) som förklarar hur politiska förändringar kan påverka företag, både direkt genom lagstiftning och indirekt via andra företag. Slutsatserna som dras är att: Relationerna mellan försäkringsbolag och försäkringsförmedlare påverkas av regleringar såsom direktivet om försäkringsdistribution (IDD) och att relationen börjar förändras redan innan regleringen trätt i kraft. Vilken relation två företag har till varandra influerar till vilken grad företagen utsätts för direkt och indirekt påverkan inför förändringar i politiska regleringar. Graden av indirekt påverkan de olika företagen utsätts för kan påverka relationen mellan företagen. En politisk förändring kan innehålla både stödjande och tvingande element. / When new political regulations are introduced to a market, they can have consequences for all market players. This can affect both the activities and relationships between them. The purpose of this paper is to gain a better understanding of how the relationship between companies in the insurance market is changing as a consequence of a major political change and which factors can be relevant to this change. To investigate this, representatives from insurance companies and insurance brokers are interviewed about the forthcoming Insurance Distribution Directive (IDD). To investigate how the relationships changed, a model of the relationship, based in, among others, Anderson and Narus (1990) model, which deals with the constituents of a relationship and how they relate to each other. To investigate the factors which influence how the relationship changes, a model of Hadjikhani, Thilenius and Pourmand (2009) is used, which explains how political changes can affect companies, both directly through legislation and indirectly through other companies. The conclusions drawn are that: Relationships between insurance companies and insurance brokers are affected by regulations such as the Insurance Distribution Directive (IDD) and that the relationship begins to change even before the regulation is implemented. The relationship between the companies influences the extent to which companies are exposed to direct and indirect influence as a result of political regulations. The degree of indirect impact on the various companies can affect the relationship between the companies. A political change can contain both supporting and compelling elements.

The main aim of my dissertation Factors influencing the management of health insurance in 2004 2012 in the context of health insurance in The Czech Republic - was to identify and categorize the factors that affect the management of the chosen health insurance in 2004 2012 with the respect to existing system of health insurance. The first assessed year was 2007 because of unavailability of data in 2004 - 2007. My dissertation is divided into two parts, theoretical and practical. The theoretical part is devoted to the principles of health insurance, the legal relations of health insurance, the current system of public health insurance and the effects influencing the health insurance balance. The practical part deals with designated health insurance and its organizational structure, its management methods, the income side of the balance sheet, the expediture side of the balance and finally the ratings balance of the specific health insurance. The factors which affect this side of the balance were analysed in detail at the income side. Among these factors were included: trends in the number of policyholders, the development of receivables, the problems of "state policyholders", macroeconomic index and the redistribution system. The expediture balance was mainly focused on the cost of health care and preventive care. In conclusion the balance of one of the health insurance companies was evaluated in the selected years.