目 錄
模塊一 風(fēng)險(xiǎn)與保險(xiǎn) ....................................................................................... 1
任務(wù)一 風(fēng)險(xiǎn)識(shí)別 ................................................................................................................. 3
一、風(fēng)險(xiǎn)的含義 ..................................................................................................... 3
二、風(fēng)險(xiǎn)的特征 ..................................................................................................... 4
三、風(fēng)險(xiǎn)的構(gòu)成要素 ............................................................................................. 5
四、風(fēng)險(xiǎn)的分類 ..................................................................................................... 6
任務(wù)二 風(fēng)險(xiǎn)管理 ................................................................................................................. 8
一、風(fēng)險(xiǎn)管理的含義與目標(biāo) ................................................................................. 8
二、風(fēng)險(xiǎn)管理的步驟 ............................................................................................. 9
三、風(fēng)險(xiǎn)管理的方法 ........................................................................................... 10
任務(wù)三 風(fēng)險(xiǎn)管理與保險(xiǎn) ................................................................................................... 12
一、風(fēng)險(xiǎn)與保險(xiǎn)的關(guān)系 ....................................................................................... 12
二、風(fēng)險(xiǎn)管理與保險(xiǎn)的關(guān)系 ............................................................................... 12
三、可保風(fēng)險(xiǎn)的條件 ........................................................................................... 13
模塊二 認(rèn)識(shí)保險(xiǎn) ......................................................................................... 18
任務(wù)一 保險(xiǎn)的產(chǎn)生與發(fā)展 ............................................................................................... 20
一、保險(xiǎn)的起源與發(fā)展 ....................................................................................... 20
二、保險(xiǎn)產(chǎn)生與發(fā)展的條件 ............................................................................... 23
任務(wù)二 保險(xiǎn)的含義、特征與保險(xiǎn)要素 ........................................................................... 25
一、保險(xiǎn)的含義 ................................................................................................... 25
二、保險(xiǎn)的特征 ................................................................................................... 25
三、保險(xiǎn)要素 ....................................................................................................... 26
任務(wù)三 保險(xiǎn)的種類 ........................................................................................................... 28
一、按保險(xiǎn)標(biāo)的分類 ........................................................................................... 28
二、按保險(xiǎn)性質(zhì)分類 ........................................................................................... 29
三、按保險(xiǎn)實(shí)施方式分類 ................................................................................... 30
四、按風(fēng)險(xiǎn)轉(zhuǎn)嫁的次數(shù)分類 ............................................................................... 31
五、按保險(xiǎn)承保方式分類 ................................................................................... 31
任務(wù)四 保險(xiǎn)的職能 ........................................................................................................... 33
一、經(jīng)濟(jì)補(bǔ)償職能 ............................................................................................... 33
二、資金融通職能 ............................................................................................... 34
三、社會(huì)管理職能 ............................................................................................... 34 保 險(xiǎn) 學(xué)
— VI —
模塊三 認(rèn)識(shí)保險(xiǎn)行業(yè) ................................................................................. 40
任務(wù)一 保險(xiǎn)市場(chǎng)的組織形式 ........................................................................................... 41
一、保險(xiǎn)市場(chǎng)的含義 ........................................................................................... 41
二、保險(xiǎn)市場(chǎng)的構(gòu)成要素 ................................................................................... 41
三、保險(xiǎn)市場(chǎng)的組織形式 ................................................................................... 43
任務(wù)二 保險(xiǎn)市場(chǎng)的供給與需求 ....................................................................................... 44
一、保險(xiǎn)市場(chǎng)的供給 ........................................................................................... 44
二、保險(xiǎn)市場(chǎng)的需求 ........................................................................................... 46
三、保險(xiǎn)市場(chǎng)的供需平衡 ................................................................................... 49
任務(wù)三 保險(xiǎn)監(jiān)管 ............................................................................................................... 50
一、保險(xiǎn)監(jiān)管的含義 ........................................................................................... 50
二、保險(xiǎn)監(jiān)管的目標(biāo)與原則 ............................................................................... 50
三、保險(xiǎn)監(jiān)管的方式 ........................................................................................... 53
四、保險(xiǎn)監(jiān)管的內(nèi)容 ........................................................................................... 54
五、保險(xiǎn)監(jiān)管體系 ............................................................................................... 58
模塊四 保險(xiǎn)營(yíng)銷與服務(wù) .............................................................................. 66
任務(wù)一 保險(xiǎn)營(yíng)銷 ............................................................................................................... 68
一、保險(xiǎn)營(yíng)銷的含義 ........................................................................................... 68
二、保險(xiǎn)營(yíng)銷的基本原則 ................................................................................... 68
三、保險(xiǎn)營(yíng)銷的基本要素 ................................................................................... 69
四、保險(xiǎn)營(yíng)銷渠道 ............................................................................................... 70
五、保險(xiǎn)營(yíng)銷策略 ............................................................................................... 72
任務(wù)二 保險(xiǎn)服務(wù) ............................................................................................................... 75
一、保險(xiǎn)服務(wù)的含義 ........................................................................................... 75
二、保險(xiǎn)服務(wù)的內(nèi)容 ........................................................................................... 76
模塊五 保險(xiǎn)合同 ......................................................................................... 84
任務(wù)一 保險(xiǎn)合同的概念與特點(diǎn) ....................................................................................... 86
一、保險(xiǎn)合同的概念 ........................................................................................... 86
二、保險(xiǎn)合同的特點(diǎn) ........................................................................................... 87
任務(wù)二 保險(xiǎn)合同的構(gòu)成要素 ........................................................................................... 89
一、保險(xiǎn)合同的主體 ........................................................................................... 89
二、保險(xiǎn)合同的客體 ........................................................................................... 92
三、保險(xiǎn)合同的內(nèi)容 ........................................................................................... 92
四、保險(xiǎn)合同的形式 ........................................................................................... 94
任務(wù)三 保險(xiǎn)合同的訂立、成立、生效與履行 ............................................................... 97
一、保險(xiǎn)合同的訂立 ........................................................................................... 97
二、保險(xiǎn)合同的成立與生效 ............................................................................... 97
三、保險(xiǎn)合同的履行 ........................................................................................... 98
任務(wù)四 保險(xiǎn)合同的變更、中止、復(fù)效及終止 ............................................................. 102 模塊一 風(fēng)險(xiǎn)與保險(xiǎn)
— VII —
一、保險(xiǎn)合同的變更 ......................................................................................... 102
二、保險(xiǎn)合同的中止與復(fù)效 ............................................................................. 104
三、保險(xiǎn)合同的終止 ......................................................................................... 105
任務(wù)五 保險(xiǎn)合同的解釋與爭(zhēng)議處理 ............................................................................. 106
一、保險(xiǎn)合同的解釋原則 ................................................................................. 107
二、保險(xiǎn)合同爭(zhēng)議的處理 ................................................................................. 109
模塊六 保險(xiǎn)產(chǎn)品設(shè)計(jì) ................................................................................115
任務(wù)一 人身保險(xiǎn)的設(shè)計(jì) ................................................................................................. 116
子任務(wù)一 人身保險(xiǎn)概述 ....................................................................................... 117
一、人身保險(xiǎn)的概念與特點(diǎn) ............................................................................. 117
二、人身保險(xiǎn)的分類 ......................................................................................... 119
三、人身保險(xiǎn)合同的常見(jiàn)條款 ......................................................................... 120
子任務(wù)二 人壽保險(xiǎn) ............................................................................................... 124
一、傳統(tǒng)人壽保險(xiǎn) ............................................................................................. 124
二、創(chuàng)新型人壽保險(xiǎn) ......................................................................................... 127
三、人壽保險(xiǎn)保險(xiǎn)費(fèi)的計(jì)算 ............................................................................. 129
子任務(wù)三 健康保險(xiǎn) ............................................................................................... 130
一、健康保險(xiǎn)的含義 ......................................................................................... 130
二、健康保險(xiǎn)的特殊條款 ................................................................................. 130
三、健康保險(xiǎn)的基本類型 ................................................................................. 131
子任務(wù)四 意外傷害保險(xiǎn) ....................................................................................... 135
一、意外傷害保險(xiǎn)的含義及特征 ..................................................................... 135
二、意外傷害保險(xiǎn)的主要內(nèi)容 ......................................................................... 136
三、意外傷害保險(xiǎn)的分類 ................................................................................. 138
任務(wù)二 財(cái)產(chǎn)損失保險(xiǎn)的設(shè)計(jì) ......................................................................................... 139
子任務(wù)一 火災(zāi)保險(xiǎn) ............................................................................................... 139
一、火災(zāi)保險(xiǎn)的概念及特征 ............................................................................. 139
二、火災(zāi)保險(xiǎn)的一般內(nèi)容 ................................................................................. 140
三、團(tuán)體火災(zāi)保險(xiǎn) ............................................................................................. 141
子任務(wù)二 工程保險(xiǎn) ............................................................................................... 146
一、工程保險(xiǎn)的概念 ......................................................................................... 146
二、建筑工程保險(xiǎn) ............................................................................................. 147
三、安裝工程保險(xiǎn) ............................................................................................. 151
四、科技工程保險(xiǎn) ............................................................................................. 152
子任務(wù)三 機(jī)動(dòng)車輛保險(xiǎn) ....................................................................................... 154
一、機(jī)動(dòng)車輛保險(xiǎn)的含義 ................................................................................. 154
二、機(jī)動(dòng)車交通事故責(zé)任強(qiáng)制保險(xiǎn) ................................................................. 154
三、機(jī)動(dòng)車輛損失險(xiǎn) ......................................................................................... 156
四、第三者責(zé)任險(xiǎn) ............................................................................................. 157
五、機(jī)動(dòng)車交通事故責(zé)任強(qiáng)制保險(xiǎn) ................................................................. 158 保 險(xiǎn) 學(xué)
— VIII —
子任務(wù)四 家庭財(cái)產(chǎn)保險(xiǎn) ....................................................................................... 160
一、家庭財(cái)產(chǎn)保險(xiǎn)的主要險(xiǎn)種 ......................................................................... 160
二、家庭財(cái)產(chǎn)保險(xiǎn)的保險(xiǎn)標(biāo)的范圍 ................................................................. 161
三、家庭財(cái)產(chǎn)保險(xiǎn)的責(zé)任范圍 ......................................................................... 162
四、家庭財(cái)產(chǎn)保險(xiǎn)的保險(xiǎn)金額與保險(xiǎn)價(jià)值 ..................................................... 162
任務(wù)三 責(zé)任保險(xiǎn) ............................................................................................................. 163
一、產(chǎn)品責(zé)任保險(xiǎn) ............................................................................................. 164
二、公眾責(zé)任保險(xiǎn) ............................................................................................. 166
三、雇主責(zé)任保險(xiǎn) ............................................................................................. 169
四、職業(yè)責(zé)任保險(xiǎn) ............................................................................................. 172
模塊七 承保與理賠 ................................................................................... 180
任務(wù)一 保險(xiǎn)承保 ............................................................................................................. 182
子任務(wù)一 保險(xiǎn)核保與承保 ................................................................................... 182
一、保險(xiǎn)核保的概念 ......................................................................................... 182
二、保險(xiǎn)核保的程序 ......................................................................................... 183
子任務(wù)二 保險(xiǎn)承保 ............................................................................................... 183
一、保險(xiǎn)承保的概念 ......................................................................................... 183
二、保險(xiǎn)承保的主要環(huán)節(jié)與程序 ..................................................................... 184
子任務(wù)三 保險(xiǎn)利益原則 ....................................................................................... 185
一、保險(xiǎn)利益及成立要件 ................................................................................. 186
二、保險(xiǎn)利益原則的概念 ................................................................................. 186
三、人身保險(xiǎn)的保險(xiǎn)利益 ................................................................................. 187
四、財(cái)產(chǎn)保險(xiǎn)的保險(xiǎn)利益 ................................................................................. 188
子任務(wù)三 最大誠(chéng)信原則 ....................................................................................... 189
一、最大誠(chéng)信原則的含義 ................................................................................. 189
二、最大誠(chéng)信原則的主要內(nèi)容 ......................................................................... 190
任務(wù)二 保險(xiǎn)理賠 ............................................................................................................. 193
子任務(wù)一 保險(xiǎn)理賠概述 ....................................................................................... 193
一、保險(xiǎn)理賠的含義 ......................................................................................... 193
二、保險(xiǎn)理賠的基本原則 ................................................................................. 194
三、理賠的一般程序 ......................................................................................... 194
子任務(wù)二 近因原則 ............................................................................................... 195
一、近因原則的含義 ......................................................................................... 196
二、認(rèn)定近因的基本方法 ................................................................................. 196
三、近因原則的判定及應(yīng)用 ............................................................................. 196
子任務(wù)三 損失補(bǔ)償原則 ....................................................................................... 198
一、損失補(bǔ)償原則的含義 ................................................................................. 198
二、損失補(bǔ)償原則的基本內(nèi)容 ......................................................................... 198
三、損失補(bǔ)償原則的派生原則 ......................................................................... 200
子任務(wù)四 財(cái)產(chǎn)保險(xiǎn)理賠業(yè)務(wù) ............................................................................... 203 模塊一 風(fēng)險(xiǎn)與保險(xiǎn)
— IX —
一、火災(zāi)保險(xiǎn)的賠償處理 ................................................................................. 203
二、家庭財(cái)產(chǎn)保險(xiǎn)賠償?shù)奶幚?......................................................................... 205
三、機(jī)動(dòng)車輛保險(xiǎn)的賠償處理 ......................................................................... 206
子任務(wù)五 人身保險(xiǎn)理賠業(yè)務(wù) ............................................................................... 210
一、人壽保險(xiǎn)的理賠 ......................................................................................... 210
二、健康保險(xiǎn)的理賠 ......................................................................................... 211
三、人身意外傷害保險(xiǎn)的理賠 ......................................................................... 212
模塊八 再保險(xiǎn) .......................................................................................... 221
任務(wù)一 再保險(xiǎn)的組織形式 ............................................................................................. 223
一、再保險(xiǎn)的基本概念 ..................................................................................... 223
二、危險(xiǎn)單位、自留額和分保額 ..................................................................... 224
三、再保險(xiǎn)與原保險(xiǎn)的關(guān)系 ............................................................................. 225
任務(wù)二 再保險(xiǎn)合同 ......................................................................................................... 226
一、比例再保險(xiǎn) ................................................................................................. 226
二、非比例再保險(xiǎn) ............................................................................................. 229
任務(wù)三 再保險(xiǎn)的經(jīng)營(yíng)管理 ............................................................................................. 231
一、分出業(yè)務(wù)的運(yùn)營(yíng)管理 ................................................................................. 231
二、分入業(yè)務(wù)的運(yùn)營(yíng)管理 ................................................................................. 234
模塊九 保險(xiǎn)費(fèi)率與產(chǎn)品定價(jià) ..................................................................... 241
任務(wù)一 保險(xiǎn)費(fèi)率的厘定 ................................................................................................. 243
一、保險(xiǎn)費(fèi)率概述 ............................................................................................. 243
二、保險(xiǎn)費(fèi)率的構(gòu)成 ......................................................................................... 244
三、非人壽保險(xiǎn)保險(xiǎn)費(fèi)率的厘定 ..................................................................... 244
四、人壽保險(xiǎn)費(fèi)率的厘定 ................................................................................. 246
任務(wù)二 保險(xiǎn)產(chǎn)品定價(jià) ..................................................................................................... 248
一、保險(xiǎn)產(chǎn)品定價(jià)的概念 ................................................................................. 248
二、保險(xiǎn)產(chǎn)品定價(jià)的方法 ................................................................................. 248
模塊十 保險(xiǎn)準(zhǔn)備金與保險(xiǎn)資金運(yùn)用 .......................................................... 254
任務(wù)一 保險(xiǎn)準(zhǔn)備金 ......................................................................................................... 256
一、保險(xiǎn)準(zhǔn)備金的含義及分類 ......................................................................... 256
二、保險(xiǎn)準(zhǔn)備金的提取 ..................................................................................... 257
任務(wù)二 保險(xiǎn)資金運(yùn)用 ..................................................................................................... 258
一、保險(xiǎn)資金的來(lái)源 ......................................................................................... 259
二、保險(xiǎn)資金的運(yùn)用原則 ................................................................................. 260
三、保險(xiǎn)資金運(yùn)用的組織模式 ......................................................................... 261
四、保險(xiǎn)資金運(yùn)用的形式 ................................................................................. 263