보험판매와 고객보호의 원칙

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6 2 (2012), 5 ㆍ 72 410 140, 2 3 14, 17, 230 30, 25 3 43 2 ㆍ ㆍ, (SIU), (IFAS) 13.4%. 1). 2), ( ). 3),. 4) 5), (, hard fraud) (, soft fraud) 1) 2012. 4. 24 2011. 2),, 19 3 (2006. 9. 30.), 147. 3),, 147. 4),, 111, 142 ; (http://insucop.fss.or.kr/fss/insucop/ define01.jsp),. 5),, 511 (2011. 6.), 58.

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6 2 (2012) < 민영보험부문의사기규모 > (A) (B) (B/A) 1 ( :, %) 1 FY'06 160,298 22,303 13.9 46,020 137,737 FY'10 256,349 31,585 12.3 63,924 184,145 ( ) 274,156 34,105 12.4 69,024 198,837 < 보험사기적발실적 > ( :,, %) 09 10(a) 11(b) (b/a) 54,551 60,109 64,958 8.1 282,169 314,541 358,696 14.0 336,720 374,650 423,654 13.1 3,219 3,290 4,266 29.7 60,141 65,923 68,067 3.3 63,360 69,213 72,333 4.5 < 보험종류별적발금액 > ( :, %, %p) '09 '10 '11 54,551 16.2 60,109 16.1 64,958 15.3 8.1-0.8 50,197 14.9 57,949 15.5 62,905 14.9 8.6-0.6 282,169 83.8 314,541 84.0 358,696 84.7 14.0 0.7 226,086 67.1 229,076 61.1 240,835 56.9 5.1-4.2 44,349 13.2 72,945 19.5 102,893 24.3 41.0 4.8 10,703 3.2 11,327 3.0 7,481 1.8-34.0-1.2 336,720 100 374,650 100 423,654 100 13.1 10) 2012. 4. 24 2011.

< 보험사기유형별적발금액 > ( :, %, %p) '09 '10 '11 82,487 24.5 82,529 22.0 84,144 19.9 1.9-2.1 ( ) 34,694 10.3 29,957 8.0 24,474 5.8-18.3-2.2 3,104 0.9 5,596 1.5 3,466 0.8-38.1-0.7 204,055 60.6 257,016 68.6 298,805 70.5 16.3 1.9 허위 ( 과다 ) 입원 9,804 2.9 22,613 6.0 32,256 7.6 42.6 1.6 허위 ( 과다 ) 진단 826 0.3 3,203 0.9 4,204 1.0 31.2 0.1 사고내용조작 59,327 17.6 81,322 21.7 86,642 20.4 6.5-1.3 24,928 7.4 36,324 9.7 47,373 11.2 30.4 1.5 25,448 7.6 19,300 5.2 20,507 4.8 6.2-0.4 8,636 2.6 7,525 2.0 7,697 1.8 2.3-0.2 3,316 1.0 2,000 0.5 4,067 0.9 103.4 0.4 24,731 7.3 15,805 4.2 20,198 4.8 27.8 0.6 336,720 (100) 374,650 (100) 423,654 (100) 13.1 < 보험종류별관련자 > ( :, %, %p) '09 '10 '11 3,219 5.1 3,290 4.8 4,266 5.9 29.7 1.1 3,109 4.9 3,202 4.6 4,152 5.7 29.7 1.1 60,141 94.9 65,923 95.2 68,067 94.1 3.3-1.1 54,764 86.4 54,322 78.4 54,144 74.9-0.3-3.5 5,181 8.2 11,364 16.5 13,584 18.8 19.5 2.3 136 0.2 144 0.2 172 0.2 19.4 0.0 63,360 100 69,213 100 72,333 100 4.5

6 2 (2012) < 보험사기적발인원 > ( :, %, %p) '09 '10 '11 17,998 28.4 13,395 19.4 9,980 13.8-25.5-5.6 ( ) 15,290 24.1 9,713 14.0 6,616 9.2-31.9-4.8 1,293 2.0 2,160 3.1 1,925 2.7-10.9-0.4 36,296 57.3 48,375 69.9 56,180 77.7 16.1 7.8 허위 ( 과다 ) 입원 1,463 2.3 4,664 6.7 7,821 10.8 67.7 4.1 허위 ( 과다 ) 진단 60 0.1 421 0.6 998 1.4 137.1 0.8 7,885 12 10,578 15 10,336 14-2.3-1.0 7,404 11.7 10,889 15.6 13,571 18.8 24.6 3.2 5,428 8.6 4,924 7.1 3,559 4.9-27.7-2.2 1,673 2.6 1,842 2.7 1,286 1.8-30.2-0.9 917 1.5 703 1.0 1,021 1.4 45.2 0.4 3,638 5.7 2,519 3.6 2,614 3.6 3.8-63,360 100 69,213 100 72,333 100 4.5 < 연령별관련자 > '09 '10 '11 10 * 508 0.8 586 0.9 952 1.3 62.5 0.4 20 11,568 18.3 11,180 16.1 11,166 15.4-0.1-0.7 30 16,628 26.2 18,878 27.2 18,634 25.8-1.3-1.4 40 15,975 25.2 18,505 26.7 20,374 28.2 10.1 1.5 50 13,590 21.5 15,095 21.8 16,092 22.3 6.6 0.5 60 4,072 6.4 4,118 5.9 4,332 6.0 5.2 0.1 70 873 1.4 750 1.1 695 1.0-7.3-0.1 146 0.2 101 0.1 88 0.1-12.9-63,360 100 69,213 100 72,333 100 4.5 * 10 : 09 (90~99 ), 10 (91~00 ), 11 (92~01 ) ( :, %, %p)

< 관련자직업 > ( :, %, %p) '09 '10 '11 5,554 8.8 4,189 6.1 3,683 5.1-12.1-1.0 회사원 9,968 15.7 15,563 22.5 15,357 21.2-1.3-1.2 13,357 21.1 14,360 20.8 14,746 20.4 2.7-0.4 12,376 19.5 6,672 9.6 7,848 10.9 17.6 1.2 ( ) 15,114 23.9 18,745 27.1 21,330 29.5 13.8 2.4, (,, ) FY2010 3.4. 11) FY2006 2.2 1.2 (52.9%). FY2010 27.4 12.4%, 1 20, 1 7. 2011, 4,237, 72,333 2010 13.1%(489 ), 4.5%(3,120 ). 2,408 (56.9%), 1,029 (24.3%), 629 (14.9%) 12), 11) 2012. 4. 24 2011. 12), (,, (2010. 4.), 26 ~ 27 ). (,, 21 2 (2011. 1.), 105 ).

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