壽險業應用大數據核保實務淺談

Underwriting Practices Based on Big Data: An Application for Life Insurance

最近幾年以來，大數據應用被視為提升產業競爭力的關鍵技術，在網路、科技及銀行產業均有深入的應用，但對保險業而言，大數據在最重要的風險管理上並無顯著的進展。本文針對核保結果與理賠關聯性進行大數據分析，結合核保實務經驗，篩選真正高風險客群，降低保險公司的理賠風險；並且分析核保人員的行為，將其核保規則系統化及自動化，以提升核保人員的作業效率。本文為國內壽險業大數據核保風險管理之實際開發案例，以低成本高效益之開發方式，提供業界作為大數據內部應用之施行參考。

In recent years, the application of big data is a key technology to provide competitive advantage in the industry, and has been widely utilized in the Internet, and banking industries. However, there is no significant progress in the field of risk management which is the most important issue in insurance industry. By using the big data analysis and integrating with practical experience, this study investigates the association between underwriting and claims to identify the potential high-risk customers in order to reduce the claim risk of the insured. We also analyze the behavior of insurance underwriters to institutionalize the procedures of underwriting and to improve the operational efficiency. This study is a real application case of life insurance big data on risk management of underwriting. It can be a reference for the insurers to understand the practical issue about big data.