An application of neural network on underwriting risk of life insurance-Examing the

[[abstract]]目前人壽保險業，雖正面臨有史以來，最大的利差損嚴酷挑戰，但在服務保戶的競爭上，無不以“以客為尊”、“客戶永遠是對的”的策略，提升自家品牌形象。但實務上，一般社會大眾對保險公司，仍存有極大的“核保從寬、理賠從嚴”的認知落差，除了以訛傳訛的錯誤印象之外，最主要還是因極少數的不理賠案件或被解除契約的案件的誤導，而這些誤導，是否可以避免或減到最低？以扭轉社會形象，是保險業者及保險從業人員時時刻刻必須面對，及化解的難題。 本文乃選擇C壽險公司於89年度～91年度的投保件，而於91年度申請理賠，卻被解除契約的案件，以要保書的內容項目，選取12種變數作為分析、統計的依據，藉由類神經網路之學習，建構出理賠風險之聚類，並經由群聚資料中，分析出各聚類特性，再以視覺化工具來協助理賠人員，建立理賠資訊，以研判是否屬於低風險區域而可予以直接理賠﹝以提升理賠時效及保戶滿意度﹞或屬於高風險區域必須進一步詳細醫務調查﹝以了解是否有違反告知義務﹞。另一方面，亦可供壽險業務人員及核保人員，於新契約招攬及核保時，誘導保戶據實告知及如何下核保決策的參考依據。[[abstract]]Although the insurer nowadays confronted by the severe challenge of utmost interest loss than ever before. However, on the competition of customer service , they are all without exception of using the strategy “Regard customer as the honorable guest ” ”Customer is surely right” to promote the self corporate image .In pratice, the ordinary mass population , they got the perception gap from the insurance company ,ie, The process of underwriting is loose ; The insurance claim is strict. Except the wrong imagination of the spreading rumors by rumors, the few un-paying claim case or contract canceled had been misled . Can it be possible to avoid or lower down the misunderstanding? To twist the social wrong imagine, it surely is the insurer and insurance clerk ought to face and settle down the difficult problem time to time . This study is taken and selected the insured cases of the insurance C company as an example during the time interval of year of 2000 and 2002 .Among of the contracts canceled in year of 2002, we tried to analyze and statistic the claim gathering group according to the 12 selected variables from the content items of the application form. by the method of learning S.O.M.. Also, with the analysis of gathering groups traits from the source of the gathering data and visualized tool, it can assist the staff adjuster to build the claim information to judge if claim payment directly or not. It can be helpful to shorten claim time deadline, fulfill the customer satisfactory, and further medical investigation to make sure anti-declaration obligation or not. On the other hand, it can also be the reference to provide the staff adjusters and insurance clerk to induce the potential customer declare the reality when dealing with the new insurance contract