《保险研究》20230702-《机动车三责险人伤索赔经济、非经济损失夸大程度估计——基于理赔诉讼样本》（周建涛、杜景龙、周建波、徐白凡、张睿）

［摘   要］近些年，机动车保险欺诈愈演愈烈，案件频发，现有文献大多聚焦于识别车损险硬欺诈，针对机动车三责险人伤索赔夸大的识别研究较少。本文基于索赔夸大程度估计模型，引入法官识别法，将经济、非经济损失索赔均纳入模型，在理论上丰富了原有模型。在实证上，基于北京法院判决金额客观识别了夸大索赔，估计了二者夸大程度差异，为索赔夸大程度估计提供了现实依据。研究发现，精神损害抚慰金索赔夸大额远大于所有经济损失索赔子项，且死亡/伤残赔偿金索赔会显著诱发非经济损失和误工损失、住院护理费等其他经济损失的夸大索赔。与保险理赔专家识别法相比，本文提出的法官识别法更加客观，且能够准确区分各索赔子项夸大程度差异。最后，基于本文研究提出应对夸大索赔人“不诚信名单”声誉惩罚对策。

［关键词］夸大索赔程度；精神损害抚慰金；死亡/伤残赔偿金；声誉惩罚

［基金项目］教育部规划基金课题(18YJA790119)；2021年北京航空航天大学教改项目（4302126）。

［作者简介］周建涛，北京航空航天大学经济管理学院副教授；杜景龙，北京航空航天大学经济管理学院硕士研究生；周建波，北京大学经济学院教授；徐白凡，中航证券有限公司证券承销与保荐分公司高级经理；张睿(通讯作者)，北京航空航天大学经济管理学院硕士研究生。

Estimation of the Overstated Extent for Economic and Non-economic Losses Claimed for Bodily Injury in Automobile Third-party Liability Insurance Based on Claims Suit Samples

ZHOU Jian-tao,DU Jing-long,ZHOU Jian-bo,XU Bai-fan,ZHANG Rui

Abstract：In recent years,frauds in motor vehicle insurance has become increasingly severe with frequent cases.Existing literatures mostly focus on identifying hard frauds in vehicle damage insurance,and there is relatively few research on identifying exaggerated claims for personal injury in motor vehicle third-liability insurance.Based on the estimation model of claim exaggeration,this paper introduces the judge identification method,and incorporates both economic and non-economic loss claims into the model,enriching the original model in theory.Empirically,based on the judgment amount of the Beijing court,exaggerated claims are objectively identified,and the difference in the extent of exaggeration between the two is accurately estimated,providing a practical basis for estimating the degree of exaggeration in claims.Our research has found that claims for general damages far exceed all claims for economic losses,and claims for death/disability damages can significantly induce exaggerated claims for non-economic loss and other economic losses such as wage loss and hospitalization care expenses.Compared with the expert identification method for insurance claims,the judge identification method proposed in this paper is more objective and can accurately distinguish the exaggeration degree differences of each claim sub-item.Finally,"dishonest list" reputation penalty is proposed for exaggerated claimants.

Key words：extent of the exaggerated claims;general damages;death/disability damages;reputation penalty