也谈保险公司结案率的计算

结案率是评估保险行业、保险公司、理赔部门服务品质的重要指标，目前我国尚没有统一的计算标准。本文在总结国内各种结案率计算公式的基础上，根据不同的考核目的，结合理赔业务流程，提出了基于索赔时点、结案时点和事故时点等考核口径的结案率计算公式。其中，索赔时点结案率在考虑客户索赔时效因素的基础上采评估保险行业结案速度，结案时点结案率在考虑上年逐月转回未决案件，并包含注销和拒赔案件的基础上来评估保险公司的结案速度，事故时点结案率基于出险时间用精算三角流量法来评估理赔部门当期服务质量。

Claim settlement rate is an important indicator of quality of service of the insurance sector, insurance companies and claim settlement departments. However, there is still no uniform calculation formula of it in China. Considering different appraisal purposes and the process of claim settlement,this article puts forth a claim settlement rate formula based on point of time of claim report ,point of time of settlement and point of time of claimed event after summarizing different formulas applied in China. Specifically speaking, settlement rate on point of time of claim report is to assess the speed of claim settlement of the insurance sector after giving consideration of the timeliness of claim report by clients ; settlement rate on point of time of settlement is to assess the speed of claim settlement of insurance companies after giving consideration of unsettled claims of the previous year, including cancelled and rejected claims;settlement rate on point of time of claimed event is to assess quality of service of claim handling departments in the current period by applying the actuarial triangular flow projection method.