人壽保險業申訴率與評議率決定因子

The Determinants of Complaint and Ombudsman Ratios: Evidence from the Life Insurance Industry

本文的目的在於：找出人壽保險業申訴率與評議率的決定因子。我們採用2012年至2021年臺灣人壽保險業資料，實證結果發現：較佳清償能力與規模較小的業者，會收到較多的申訴；在評議率方面，當監理預算的攀升，銷售較多投資型保險、較佳清償能力的公司，會有較高的評議率。至於健康保險賣越多的公司以及公股公司，則有較低的評議率。我們進一步利用「成功調解之申訴案件、占申訴案件的比率」作為被解釋變數，發現健康險銷售較多、規模較小、獲利能力較佳、與屬於金控的公司，有申訴案件較容易被調解的現象。

The purpose of this paper is to identify the determinants of complaint and ombudsman ratios in the life insurance industry. Using complaint and ombudsman data on life insurers in Taiwan from 2012 to 2021, we find that insurers with higher solvency and smaller size have more complaints; when regulatory budget expenses rise, insurers that sell more investment-linked products and have higher solvency experience higher ombudsmen ratios, while state-owned insurers with a higher level of health insurance premiums have lower ombudsman ratios. We further find that complaint cases from smaller insurers that sell more health insurance and more profitable insurers that belong to financial holding companies have the characteristic of being relatively easy to settle.