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從風險管理與犯罪預防觀點論保險詐欺之防制林秉耀 Unknown Date (has links)
保險詐欺是自有保險制度以來就有的問題,世界各國都被這個問題所困擾。因為沒有受到廣泛的宣傳及討論,加上執法機關的忽視、抗拒提供調查機能及加強追訴,所以在1980年代以前沒有被當作重大問題予以重視,一般民眾完全不知它的嚴重性,把它當作「沒有被害人的犯罪(victimless crime)」。然而保險詐欺隨時都在發生,而且範圍及程度日益擴大,已堪稱為「溫和的巨災(quiet catastrophe)」,不但影響個人經濟負擔,且破壞社會安定,因此本文就如何防制保險詐欺加以探討。
保險詐欺直接衝擊的是保險公司的經營穩定性與安全性,對保險公司而言是經營上的風險,因此從風險管理的角度,分析保險公司的實務運作,探討運用各種風險管理對策防制保險詐欺的可行性。經本文研究發覺以風險管理模式可以防制保險詐欺或減輕保險詐欺的損失,各種風險管理對策運用如下:
(一) 風險自承原則:對規模小、影響層面小的保險詐欺案件,列為「堪忍的詐欺」,予以承受,以節省相關的查證經費。
(二) 風險規避原則:建立「防範保險詐欺查核表」,在進行核保、理賠作業時嚴格查核,積極避開保險詐欺風險。
(三) 風險分散原則:針對損失頻率低、損失幅度大的案件採取同業共保的方式;對損失頻率高、損失幅度小的案件採取約定自負額方式承保,以分散風險。
(四) 風險轉嫁原則:約集保險同業成立相互保險組織,把保險詐欺所帶來的風險移轉給相互保險組織。
保險詐欺基本上是犯罪行為,要消弭犯罪行為可以藉由對犯罪環境加以有效管理、設計或操作,以及降低犯罪機會達到目的。本文研究發現推動「詐欺管理生命週期理論」的嚇阻、預防、察覺、緩和、分析、政策、偵查、追溯等措施,及「情境犯罪預防理論」的增加犯罪困難度、提升犯罪風險、降低犯罪報酬、削弱犯罪動機等措施,喚起全民共同防制保險詐欺的意念,可以壓制保險詐欺之發生。
嚴謹的法令規範是防制犯罪的根本,經由本文的探討發覺保險詐欺的盛行,除了民眾法治觀念差以外,現行法令不周全,讓歹徒有機可乘及執法單位強制力不足,亦是原因之一。修訂保險法及刑法,對於防制保險詐欺有很大的效益。 / “Insurance Fraud” has been an issue, by which the countries all over the world are perplexed, since there exists the system of insurance. By 1980’s, not much attention has been paid to this issue which deemed a victimless crime and the public does not realize how serious the problem is due to the lake of broad propaganda and the ignorance, being rejected to offer the function, and being refused to strengthen prosecution by the law enforcement agency.
Nevertheless, insurance fraud happens all the time and has already been called the “quiet catastrophe” because the range and severity caused keep expanding day by day. Resulting from, not only the financial burden of the individual is influenced, but the social stability is destroyed as well. Therefore, this paper probed into “how to prevent Insurance Fraud”.
Since Insurance Fraud would strike the financial stability and security of an insurance company, it becomes kind of risk on company’s management. This paper would be analyzing the practical operation of an insurance company and trying to find out the feasibility of Insurance Fraud Prevention by using various kinds of risk management countermeasures. By which, this paper discovers the losses caused by insurance fraud could be prevented and/ or reduced. The followings are those risk management countermeasures studied and applied:
A. The principle of “Risk Retention & Reduction”:
Sorting out those cases by loss amount scale. Smaller ones are classified & named as “Admitted Fraud”, and settled without verification in order to save the related expenses for investigation.
B. The principle of “Risk Avoidance or Hedging”:
Setting up “Checking List of Insurance Fraud”, by using which to actively avoid the risk of insurance fraud while carrying on the operations of underwriting and claim handling.
C. The principle of “Risk Sharing & Diversification”:
Co-insuring with peer companies for those accounts with the characteristic of low frequency & high severity in terms of loss exposure. As to other accounts, appointing an appropriate policy deductible level to disperse the risk of Insurance Fraud.
D. The principle of “Risk Transference or Shift”:
Establishing the pooling system or organization to transfer the risk of Insurance Fraud to the peer companies.
Basically, Insurance Fraud is a criminal offence, which could be eliminated and / or reduced by way of methods of management, design, and operation on the crime environment. It is found that the occurrence of Insurance Fraud could be depressed by:
A. Promoting measures of “The Fraud Management Lifecycle Theory”, such as deterrence, prevention, detection, mitigation, analysis, policy, investigation, prosecution etc., and
B. Executing the countermeasures of “The Situational Crime Prevention Theory” such as increasing perceived efforts, increasing perceived risks, reducing anticipated reward, removing excuses etc., and
C. Arousing the public the thought of fighting Insurance Fraud mutually.
A rigorous legal system is the base of preventing criminal offence. As discovered and presented by this paper, reasons why the Insurance Fraud has been prevailing are not only because of a poor sense of legal compliance of the public, but also the un-thoroughness of the current legal system resulting in offering ruffians opportunities to take advantages from Insurance Fraud and the in-sufficient power of prosecution of the law enforcement agency. Therefore, to revise the insurance law and criminal law would be greatly workable for preventing Insurance Fruad.
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The application of a technique for enhancing recall to improve learning in the science classroomParsons, Darryl C January 2007 (has links)
There has existed for many years a memory enhancement technique ("memory pegs") that although having dramatic demonstrable success in some individual cases has not been generally applied in education. The emergence of constructivist epistemology has emphasised the notion that learning occurs as a result of connecting new material with previously learnt concepts. There is, therefore, the implication that effective learning requires some previous knowledge upon which to attach new concepts - and thus realisation of the importance of learning with respect to acquiring factual information as a prerequisite to learning new processes and/or skills. This issue has focussed my attention on the need to ensure that the more physiological skills of accessing 'memory', both for learning and recall, are optimised for maximum learning. Further, there are some indications that the physiological skills of memory access (storage and retrieval) may respond favourably to training and 'exercise'. This study was designed to find out whether or not a repeated 'exercise' using a simple memory enhancement technique would lead to a determinable and statistically significant increase in overall performance in a range of cognitive skills (as indicated by science and mathematics examination results), whether learning such a technique would affect a student's attitudes towards science, whether there was a relationship between the amount of time spent practicing the technique and the degree of effect, and whether the memory technique did actually improve the ability to recall lists of objects.
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Nouvelles perspectives sur la clinique du cancer : le corps, la psychothérapie, et les états crépusculaires dans la maladie grave / New perspectives on clinical cancer : body, psychothérapies and crepuscular states in serious diseaseMilleur, Yannick 01 December 2015 (has links)
Les patients atteints de cancer traversent des conditions d’existence extrêmes demandant un cadre spécifique de prise en charge psychothérapique. Le cancer et les soins anticancéreux indispensables, forment pourtant la situation cancéreuse envahie par les logiques processuelles du cancer, violentes. Cette situation peut être un raz de marrée dans la vie d’un sujet, emportant les convictions les plus établies et les bases narcissiques-identitaires et du caractère les plus ancrées. Le sujet présente un risque majeur d’effondrement. De plus, la puissance du traumatisme actuel puise ses racines dans la reviviscence de traumatismes primaires restés jusque là éteints. Leur retour a lieu sous la forme de sensations hallucinatoires induisant des états de corps et des états de perception du monde extérieur psychiquement irreprésentables. Le sujet se vit et s’éprouve alors passivement, sans pouvoir s’affecter véritablement. Mortifères, la pesanteur, l’inertie et la douleur dominent ou au contraire, le sujet se sent à vif, hypersensible, envahi, persécuté, au risque de l’éclatement. Le monde s’articule alors essentiellement sur cette bipolarité que vient recouvrir la défense opératoire radicale de la blancheur. Elle jette son dévolu sur le monde, les relations, les objets, les affects, le corps du sujet. Parfois, rien ne touche ce dernier dont la psyché s’est resserrée autour de son noyau archaïque aux limites psyché-soma. Le cancer éradique la subjectivité, subtilisant le principe actif des logiques de l’originaire. Cet état de mélancolie blanche parfois durable, n’est que l’une des phases d’une processualité mélancolique polymorphe. Cette dynamique domine la vie du sujet selon deux tendances à la proto-mélancolie et à la proto-manie, qui remplacent le monde affectif par une propension à l’inertie ou à la psychomotricité. Le travail de mélancolie vise la relance des capacités d’identification en impasse. Nous allons étudier les modalités spécifiques du transfert et en particulier la mobilisation essentielle d’un transfert formel de base. Il fonctionne à partir de l’activation originaire en double de signifiants formels alors partagés par le thérapeute et son patient. Des mouvements de léthargie et d’excitations psychocorporelles peuvent gagner le clinicien et plonger la relation thérapeutique dans des états crépusculaires, relatifs au cancer et au retour des traumatiques primaires. Nous verrons comment le but premier de la psychothérapie vise l’utilisation psychique – et non l’éradication – de l’objet-cancer, comme moyen de forger les conditions de viabilité du cadre : permettre la mise en représentation des états de corps, rétablir la symbolisation, l’imagination et le recours aux fantasmes inconscients. Ce sont là les bases indispensables d’une psychothérapie auprès des patients atteints de cancer. / Cancer patients experience extreme conditions of existence requiring a specific form of psychotherapy. The cancer and essential anticancer treatments together form the cancerous situation, invaded by the cancer’s violent, processual logic. This situation can constitute a sea change in the subject’s life, sweeping away their most firmly held convictions and the most deeply rooted foundations of their narcissistic identity and character. The subject is at major risk of suffering a breakdown. In addition, the ‘actual’ trauma draws strength from the revival of primary traumas up until now extinguished. Their return takes the form of hallucinatory sensations producing states of body and perception of the external world psychologically unrepresentable. The subject sees and experiences themself passively, without really being capable of feeling affected. Deadly dullness, inertia and pain dominate or, on the contrary, the subject feels vividly alive, hypersensitive, invaded and persecuted, at the risk of bursting. The world essentially revolves around this bipolarity, which the radical operational defence system covers in whiteness. It throws its mantle over the world, relationships, objects, affects and the subject’s body. Sometimes nothing can touch the subject at all, and their psyche is reduced to its archaic core, at the edge of psyche-soma. The cancer eradicates subjectivity, steeling away the active principle of primal logic. This sometimes lasting state of white melancholy is but one phase in a polymorphic melancholic processuality. This force dominates the subject’s life, with a tendency either to proto-melancholy or proto-mania, which replace the affective world by a propensity to inertia or psychomotricity. The aim of melancholy work is to revive the deadlocked capacity for identification. We will examine the specific use of transference and, in particular, the key implementation of a basic formal transference. This works based on the dual primal activation of formal signifiers shared by the therapist and their patient. The therapist may be subject to motions of lethargy and psychocorporal excitations, plunging the therapeutic relationship into crepuscular states, relative to the cancer and to the return of primary traumas. We will look at how the principle aim of psychotherapy is the psychological use, and not eradication, of the cancer object, as a means of forging the conditions rendering the therapeutic context feasible: allow the representation of states of body, restore symbolisation, imagination and recourse to unconscious fantasy. Together, these form the essential basis of psychotherapy for cancer patients.
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