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痛并快乐着!一个保险调查员的酸甜苦辣!     

Image最近有部名叫《守护神之保险调查》的电视剧在网络上热播,剧情是讲述有关保险调查员的故事,这里所有棘手、危险、离奇的保险事故交到他们的手中,总能抽丝剥茧,找出真相。


  电视剧的热播也把“保险调查员”这份职业推向公众的视野,令不少人充满好奇。其实这个职业并不神秘,也不冰冷,这一特殊的群体同样是拥有七情六欲的平常人。日前,记者走近一个普通的保险调查员张远,就让我们来了解一下他的酸甜苦辣吧!


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酸 不寻常的选择


  8年前,很多人还觉得医生是个“金饭碗”,可以救死扶伤,挽救生命。不过对于张远来说,他却抛下了这个“金饭碗”,做出了一个“不寻常”的选择。


  医学院毕业后,张远从医6年,而后转行成为保险调查员,这一干就是8年。


  见到张远时,已经是晚上8点,他刚从宝坻区的一个村子里结束理赔调查赶回公司,带着一身寒气。“这个时间没下班其实挺正常的。”张远一边说话,一边脱下两件羽绒服,又撕去贴在身上的三个暖贴。“这都是老婆让贴的。”张远笑着说。


  在张远看来,很多人不理解他的选择,也不理解他的工作,这让他时常有些酸楚。尤其是参加同学聚会时,昔日的同窗中已经有人成为医学领域的专家。“我不后悔这样的选择。”张远说,医生的工作是挖掘病因,而保险调查员的工作则是追求真相。


  “或许是跟我性格有关系吧。”张远说。他自认为自己是个爱较真的人,喜欢追根究底。“其实我所接触的寿险类保险调查员,包括我的同事们,多数都是医学专业毕业,从事过医生或者法医的工作。”


  保险调查员的工作不是想象中的那样简单,甚至对从业者也有一定的要求。


  “作为保险调查员,除了需要掌握医学、保险、法律方面的知识,还得懂得察言观色。”有了相应的专业知识,才能了解被保险人描述发病症状、就诊过程和事故经过是否符合医学常识。学会察言观色,才能初步判断被保险人是否隐瞒真相。这些对准确判断案件的真实性来说,缺一不可。


  在针对不同调查对象的调查取证中,张远总会听到这样的声音:“人家都生病了,怪可怜的,有什么好调查的?”“保险公司这么有钱还不赶紧赔偿,调查肯定是为了省钱!”面对这些不理解,张远说:“其实我们的调查也无非是了解真相,还原事实。同时尽快核实情况让绝大多数善良保险客户尽早拿到保险理赔金,让极少数骗保人无可乘之机。”


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 “辣手神探”追求真相


  我国的保险业发展迅猛,其中寿险已成为世界第二大市场,占据了全球市场份额的12%。人身保险保费收入更是迅速发展。保险业的巨变,带来了逐渐规范化的行业条例与逐步完善的法律法规,使得保险行业得以更有序高效的发展,保险行业正呈现出一片繁荣的景象。


  但是,在保险行业逐渐发展壮大的背后,伴随的“阴影”也随之逐渐扩大。


  面对保险行业的痛点,保险调查员在此刻显得格外重要。为了避免出现恶性保险欺诈行为、确保投保人与保险公司的合法利益得到保障,需要保险调查员坚持平衡保险利益,为保险企业以和保险消费者之间树立公平交易的桥梁。查处保险欺诈,使极少数欺诈者阴谋不能得逞,并震慑、阻遏有保险欺诈意图的人,这也是理赔调查的目的。


  说起保险调查员的工作,让张远印象深刻的是一场密谋的杀夫案,那一次他真的仿佛是“辣手神探”。


  事情发生在3年前,投保人赵红报案称丈夫刘某意外身故。就在刘某身故前的不到一个月,赵红刚为刘某投保了高额意外伤害险。保险受益人就是赵红。得知这一情况,张远和同事立即前往事发地进行调查。


  据张远回忆,当时赵红称刘某是从3米高的平房房顶上摔下致死,正如赵红所说,张远在现场看到了一个倒下的梯子和一些破碎的砖头。“从现场看上去,似乎很‘正常’。”不过,细心的张远在检查过程中发现,刘某四肢等部位没有明显外伤、骨折,脖子处却有一道很浅的痕迹。“多年的经验告诉我,这道颈前平行痕迹可能并不是‘意外’这么简单。”张远向赵红提出报警尸检,而赵红的反应更加印证了张远的猜想。


  “赵红对报警一事格外反感,坚持不同意报警。”张远说。“在有些人看来,我们要报警似乎是为了躲避保险赔偿。但实际上,我们要做的,是要追求事实真相。”最终张远还是决定报警,经过警方调查,证实了赵红杀害丈夫刘某的事实。赵红最终也受到了法律的制裁。


  “这是一个让我很心痛同时又很庆幸的案例。”张远说。“一半是天使,一半是恶魔。在巨额保险金的诱惑下,将黑手伸向自己的至亲家人。为诈取保险金杀人,也严重背离了保险的社会功能。”


  “我不会让一单应该得到理赔的被拒赔,也不会容忍一个以骗保为目的的不法分子。”守护好每一位当事人的合法利益,正是他一直的坚持。


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 感受绝望 收获感动


  在外人眼里这份工作是一个既轻松又自在的活,不需要天天坐办公室,查案还可以四处走。殊不知,从事保险调查员这份工作真的会遇到千千万万种困难与危险。车子陷入泥地,只能是自己想办法把车弄上来;不管刮风下雨,天气多么恶劣,有需要时都要第一时间出现在现场……有时客户不配合,态度强硬,甚至恶言威胁,还需要作耐心的说服工作,最终达成双方满意结果。


  “体验过无数次的绝望也收获无数次的感动。”张远说。“我是个很感性的人,会因当事人的喜怒哀乐而感同身受。”


  张远讲述了他印象深刻的一个案例。3岁的晓蓉患骨髓炎后下肢瘫痪。庆幸的是,在晓蓉出生不久,父母就为她上了重疾险。而张远登门的任务,就是核查晓蓉是否已经达到重疾的标准。


  “这是我们日常工作中比例很大的一部分,就是还原保险事故真实面目,使良质客户得到快速理赔,使保险公司按照保险合约兑现保障承诺。”张远说:“恶意骗保的终究是少数,没有那么多的‘人心险恶’。”


  当然,晓蓉确实符合理赔标准,张远也在第一时间完成了核查工作,希望能尽快对晓蓉做出理赔。“但是,那天晚上我离开晓蓉家后哭了。”张远说:“她和我女儿一样大,很天真。”他能感受到晓蓉父母的无助,以及对未来的迷茫。但是在疾病面前,每个人都太渺小了。“我能做的就是完成核查工作,陈述事实,让晓蓉能够尽快得到理赔。”


  张远说,每当遇到身故理赔的客户,他的心也跟着沉重起来——他们中有的是家中顶梁柱却因为意外轰然倒下,有的是人过中年痛失独子……一个生命的逝去,留下的是家人的无限悲凉。“我所能做的,也只有尽力去安慰生者,尽快协助完成理赔手续,希望那笔理赔款能让他们在接下来的岁月中不至于太过艰难。”


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 “多”赔偿 带去希望


  不过,张远说,理赔工作中也不都是沉重,“有一次,我们甚至还多赔偿了一部分。”


  被保险人刘某因摔伤导致胸部和上肢挫伤,之后向保险公司申请赔偿住院治疗费。按照流程张远到刘某家进行核查。张远在刘某众多片子和报告中发现,刘某曾在门诊拍摄过CT片,CT报告显示其有四根肋骨骨折。“他的情况已经符合保险伤残10级,而他的险种都买了,最终除了医疗费用的赔偿,保险公司又一并赔偿10%意外伤残保额。”张远说,这让刘某和家人都很意外。“他们只以为能赔偿住院治疗费。”


  “有些人得到理赔款而解除了沉重经济负担,还有对我们的工作感激不已的,对我们的服务赞不绝口的客户……这些对于我们来说,也是一份肯定。”张远说。


  有人说,保险调查员是一份看尽人间百态的工作:有人因“保险金”杀人,有人因“保险金”获得一份保障。在现实生活中,“保险调查员”的工作由于某些原因经常处于保密状态,所以他们很少公开出现在大众的视线里,这无疑又为这些调查员蒙上了一层神秘的面纱。


  实际上,保险调查员也是伴随保险业而存在的一项普通职业。只不过,他们品尝到了更多的酸甜苦辣。


(来源:北方网)

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 173  已被阅读了1267619次  楼主 2019-08-08 10:10:36
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