天安车险查勘操作规范及要点

天安车险查勘操作及要点 现场查勘的定义: 用科学的方法和现代技术手段，对交通事故现场进行实地验证和查询，将所得的结果完整而准确地记录下来的工作过程 现场查勘的目的: 查明事故原因，判定事故性质 确定保险责任，确认事故损失 现场查勘的意义: 收集证据的基本措施 事故处理的起点 把好理赔出口关的重要环节 一、查勘前的准备工作: 1、仪容、仪表。(穿着公司统一配发的司服、配戴胸卡、不准留长胡须、蓄长发)，查勘车辆干净整洁。 2索赔单证(索赔、查勘报告、定损单、询问笔录、书等) 、 签字笔、印油。 3相机、录音笔(手机有录音功能也可)、卷尺、施救工具(拖车绳、千斤顶等) 、安全警示装置(反光背心、三角架等)。 二、接受调度: 准确、完整地记录好调度提供的案件信息，了解出险车辆的承保及出险情况。 the needs of future rehabilitation centre. facilitates future expansion of the hospital-wide voice communications, reducing costs due to expansion. Taking into account the special nature of public hospital, from a security point of view, the internal network of centres for the rehabilitation of the project system and Internet construction independently. to protect data within medical rehabilitation center from influence of external network, ensure safe and reliable medical information. Intranet for the hospital's internal network and not the hospital external link external network and an external network and data Association, two independent sets of network equipment. Medical network to four-room for 2 large Gigabit switches at the core, double-machine 三、联系客户: 1、联系时间: 3分内电话联系，之后每10分钟左右联系一次 2、联系内容:使用标准服务话术，自我介绍:您好～我是天安保险查勘员XXX，请问你的车。。。。。。说明来意。确认事故情况及地点，简要指引处理现场，告知自己所处位置和大概到达时间，安抚客户情绪，提醒客户注意安全，说服客户等现场。 3、态度:礼貌、耐心，文明用语。 现场查勘 一、到达现场后的首要工作 1、到达查勘地点后，使用标准服务话术(同时递上名片)向事故当事人进行自我介绍:您好～我是天安保险查勘员XXX，很高兴为您服务。对于未按要求或约定的时间到达现场的必须致歉:不好意思，因XX原因让您久等了。 2、如果保险标的或受伤人员尚处于危险中，应立即协助客户采取有效的施救、保护措施，避免损失扩大。 3、指导标的车的事故当事人正确填写《机动车辆保险索赔申请书》，并要求客户签字确认。对客户不明白的事项进行详细解释。 4、对于车辆损失超过5000元或涉及人员伤亡的案件，应提醒事故当事人向交通管理部门报案。 the needs of future rehabilitation centre. facilitates future expansion of the hospital-wide voice communications, reducing costs due to expansion. Taking into account the special nature of public hospital, from a security point of view, the internal network of centres for the rehabilitation of the project system and Internet construction independently. to protect data within medical rehabilitation center from influence of external network, ensure safe and reliable medical information. Intranet for the hospital's internal network and not the hospital external link external network and an external network and data Association, two independent sets of network equipment. Medical network to four-room for 2 large Gigabit switches at the core, double-machine 二、查勘现场 1、查明肇事驾驶员和报案人情况 (1)确认肇事驾驶员和报案人身份，核实其与被保险人关系。 (2)查验肇事驾驶员的驾驶证。确认驾驶证是否有效;驾驶的车辆是否与准驾车型相符;驾驶人员是否是被保险人或其允许的驾驶员;驾驶人员是否为保险中约定的驾驶员;特种车驾驶员是否具备国家有关部门核发的有效操作证;营业性客车的驾驶员是否具有国家有关行政管理部门核发的有效资格证书。若前述证件有不合格的应当用数码相机拍照，取得证据 (3)若发现标的车驾驶员有酒后或醉酒以及有吸食或注射毒品、被药物麻醉嫌疑且当时未向交管部门报案的，应主动要求肇事驾驶员和报案人立即向交管部门报案(若标的当事人不配合报交管部门需说明利害关系，必要的时候代为报案)并做好询问及取证工作。 (4)准确记录被保险人或驾驶员的联系方式 2、查验出险车辆情况 A、查验保险车辆信息 (1)查验车型、车牌号码、发动机号、VIN 码、车辆颜色等信息，并与保险单(手机查勘定损系统中的保单信息)以及行驶证内容进行核对。 the needs of future rehabilitation centre. facilitates future expansion of the hospital-wide voice communications, reducing costs due to expansion. Taking into account the special nature of public hospital, from a security point of view, the internal network of centres for the rehabilitation of the project system and Internet construction independently. to protect data within medical rehabilitation center from influence of external network, ensure safe and reliable medical information. Intranet for the hospital's internal network and not the hospital external link external network and an external network and data Association, two independent sets of network equipment. Medical network to four-room for 2 large Gigabit switches at the core, double-machine (2)查验标的车辆保险期限是否有效(手机查勘定损系统中的保单信息); (3)标的车辆出险时的使用性质与保单载明的是否相符; (4)车辆结构有无改装或加装;是否有车辆标准配置以外的新增设备; (5)是否运载危险品; (6)是否有超载情况。 B、查验第三方车辆信息 (1)查验并记录第三方车辆的车牌号码、车型，查验第三方交强险和商业险承保内容及承保公司。 (2)记录第三方驾驶员姓名、联系方式等信息，核对交强险标志与保单内容是否相符并拍照。 3、查明出险经过 A、核实出险时间 (1)对出险时间接近保险起讫期出险的案件，应特别引起注意，认真查实。 (2)了解车辆启程或返回的时间、行驶路线、委托运输单位的装卸货物时间、伤者住院治疗的时间等，以核实出险时间。 (3)核对报案时间是否超过出险时间48 小时以上。 B、核实出险地点 (1)查验出险地点与保险单约定的行驶区域范围是否相符。 the needs of future rehabilitation centre. facilitates future expansion of the hospital-wide voice communications, reducing costs due to expansion. Taking into account the special nature of public hospital, from a security point of view, the internal network of centres for the rehabilitation of the project system and Internet construction independently. to protect data within medical rehabilitation center from influence of external network, ensure safe and reliable medical information. Intranet for the hospital's internal network and not the hospital external link external network and an external network and data Association, two independent sets of network equipment. Medical network to four-room for 2 large Gigabit switches at the core, double-machine (2)对擅自移动现场或谎报出险地点的，需进一步深入调查。 (3)查验事故现场是否存在碰撞散落物、碰撞痕迹是否吻合等，以此判断是否为事故第一现场。 (4)盗抢险案应在车辆被盗地点周围进行调查询问，以确定出险时间内车辆是否被真实停放过。 C、查明出险原因 出险的真实原因是判断保险责任的关键，对原因的确定应采取深入调查，切忌主观武断、先入为主。对于事故原因的认定应有足够的事实依据，通过必要的推理，得出科学的结论，应具体分析说明是客观因素，还是人为因素，是车辆自身因素还是受外界影响;是严重违章，还是故意行为或违法行为等，尤其对于保险责任的查勘，应注意确定是外部原因引起、是损伤形成后没有进行正常维修而继续使用造成损失扩大所致，还是车辆故障导致事故。 对损失原因错综复杂的，应运用近因原则进行分析，通过对一系列原因的分析，确定导致损失的近因，从而得出结论。凡是与案情有关的重要情节都要尽量收集、记载，以反映事故全貌，同时，应获取证明材料，收集证据。对可能存在酒后驾车或无照驾驶，执照的准驾车型与实际车型不符等情况，应立即同公安交警部门获取相应证人证言和检验证明 。 4、判断保险责任 the needs of future rehabilitation centre. facilitates future expansion of the hospital-wide voice communications, reducing costs due to expansion. Taking into account the special nature of public hospital, from a security point of view, the internal network of centres for the rehabilitation of the project system and Internet construction independently. to protect data within medical rehabilitation center from influence of external network, ensure safe and reliable medical information. Intranet for the hospital's internal network and not the hospital external link external network and an external network and data Association, two independent sets of network equipment. Medical network to four-room for 2 large Gigabit switches at the core, double-machine (1)、对事故是否属于保险责任进行初步判断应结合承保情况和查勘情况，分别判断事故是否属于机动车交通事故责任强制保险或商业机动车辆保险的保险责任，对是否立案提出建议。 (2)、对不属于保险责任或存在条款列明的责任免除、加扣免赔情形的，应收集好相关证据。 (3)、暂时不能对保险责任进行判断的，应在查勘记录中写明理由。 (4)、查勘人员应根据事故所涉及的损失情况和损失金额，初步判断事故涉及的责任险别. (5)、对本次查勘案件在系统内有历史赔付记录的，必须调出历史赔付记录，核对历史记录中的损失照片及定损资料，确认是否与本次损失有联系。如存在同一损失重复索赔的，应剔除该损失或予以拒赔。 (6)、初步判断责任划分情况 a、交警部门介入事故处理的，依据交警部门的认定; b、交警部门未介入事故处理的，可指导当事人根据《中华人民共和国道路交通安全法》及实施条例、《交通事故处理程序规定》和当地有关交通事故处理法规，协助事故双方协商确定事故责任并填写《协议书》。 c、当事人自行协商处理的交通事故，应根据协议书内容，结合有关交通事故处理法规核实事故责任。发现明显与实际the needs of future rehabilitation centre. facilitates future expansion of the hospital-wide voice communications, reducing costs due to expansion. Taking into account the special nature of public hospital, from a security point of view, the internal network of centres for the rehabilitation of the project system and Internet construction independently. to protect data within medical rehabilitation center from influence of external network, ensure safe and reliable medical information. Intranet for the hospital's internal network and not the hospital external link external network and an external network and data Association, two independent sets of network equipment. Medical network to four-room for 2 large Gigabit switches at the core, double-machine 情况不符的，应要求被保险人重新协商或由交警出具交通事故认定书。 5、对于损失金额超5000元的案件缮制查勘记录 a、根据查勘情况，认真、详尽地填写《查勘报告》，肇事司机或报案人应在《查勘报告》上签字确认。 b、涉及人员伤亡的，要分别登记保险车辆车上人员和三者车辆、车外人员的死亡、受伤人数。 c、对于多车互碰的案件，应对所有三者车辆的基本情况逐车进行记录。 d、对事故中受损的财产，详尽记录受损物的名称、类型、规格、数量、重量等; e、重大、复杂或有疑点的案件，应在询问有关当事人、证明人后，在《车险事故查勘询问笔录》中记录，并由被询问人签字确认，并及时上报公司相关负责人。 f、对查勘中发现的问题，需提醒下一步理赔环节注意的问题，应在《查勘报告》中详细注明。 g、绘制现场草图，现场草图应基本能够反映事故现场的道路、方位、车辆位置、肇事各方行驶路线、外界因素等情况; 现场拍照 意义: 现场照相是用拍照的方法把现场记录下来，照片信息形象真实，能弥补文字、绘图难以描绘的情景。 (一)照相内容: the needs of future rehabilitation centre. facilitates future expansion of the hospital-wide voice communications, reducing costs due to expansion. Taking into account the special nature of public hospital, from a security point of view, the internal network of centres for the rehabilitation of the project system and Internet construction independently. to protect data within medical rehabilitation center from influence of external network, ensure safe and reliable medical information. Intranet for the hospital's internal network and not the hospital external link external network and an external network and data Association, two independent sets of network equipment. Medical network to four-room for 2 large Gigabit switches at the core, double-machine 1、现场方位、概览、中心(重点)、细目照相; 2、现场环境、痕迹勘验、人体(伤痕)照相; 3、道路及交通设施、地形、地物照相; 4、分离痕迹、表面痕迹、路面痕迹、衣着痕迹、遗留物;受损物规格 、编码照相; 5、车辆检验 (车架号、发动机号)、两证检验照相。 (二)照相步骤: 现场方位 ? 现场概貌,含牌照的标的损失全貌 ? 重点部位 ? 损失细目这四个步骤的照片，要彼此联系、相互印证。 (三)查勘定损照相原则 1、先拍摄原始状况，后拍摄变动状况; 2、先拍摄现场路面痕迹，后拍摄车辆上的痕迹; 3、先拍摄易破坏易消失的，后拍摄不易破坏和消失的。 总之，要根据定损核价实际情况要求，既能说明事故的保险责任，又能详细反映事故损失，灵活运用、采取交叉拍摄的方法 (四)查勘拍照要求 1、准确全面地反映保险责任及事故车的受损范围和程度; 2、拍照保险车辆特征。包括车牌号，车架号/铭牌/发动机号照片; 3、拍摄保险车辆的行驶证、驾驶员的驾驶证(驾驶客运车the needs of future rehabilitation centre. facilitates future expansion of the hospital-wide voice communications, reducing costs due to expansion. Taking into account the special nature of public hospital, from a security point of view, the internal network of centres for the rehabilitation of the project system and Internet construction independently. to protect data within medical rehabilitation center from influence of external network, ensure safe and reliable medical information. Intranet for the hospital's internal network and not the hospital external link external network and an external network and data Association, two independent sets of network equipment. Medical network to four-room for 2 large Gigabit switches at the core, double-machine 辆驾驶员准驾证，特种车辆驾驶员操作资格证)。 4、双方或多方事故，应拍摄三者车辆的“交强险标志”――正面及背面均需拍摄。条件允许的应拍摄三者车辆交强险保单。 5、必要时可要求相关证人或肇事司机与受损车辆拍摄合影照片。查勘人员必须要与出险车辆合影。 6、夜间拍摄时，可使用照明工具(车辆大灯、手灯等)，提高现场的亮度，保证照片清晰可辨。 7、第一现场照片能够反映出事故现场的全貌，有明显的参照标志物，如道路全貌(交叉路口情况、道路宽度)、路标、建筑物等，以便于确定大致地位;顺车辆运动方向(包括刹车痕迹)，拍摄事故撞击点; 8、理赔系统上传照片的顺序、照片按先远后近、先外后内、先全貌后配件顺序上传; 9、在车场或现场对事故车定损拍照时，先拍整车(能反映车牌号码45?度四方向拍摄)，以判断标的出险行驶方向和碰撞着力点和碰撞走向;车牌脱离车体时，需复位拍照，严禁单独拍摄车牌及损失部位，尤其要注意对隐损部位的拍照; 10、对受损部位整体相向拍照，以确定碰撞痕迹和损失范围; 11、凡需要更换或修理的部件、部位均必须进行局部特写拍照; the needs of future rehabilitation centre. facilitates future expansion of the hospital-wide voice communications, reducing costs due to expansion. Taking into account the special nature of public hospital, from a security point of view, the internal network of centres for the rehabilitation of the project system and Internet construction independently. to protect data within medical rehabilitation center from influence of external network, ensure safe and reliable medical information. Intranet for the hospital's internal network and not the hospital external link external network and an external network and data Association, two independent sets of network equipment. Medical network to four-room for 2 large Gigabit switches at the core, double-machine 12、内部损失解体后，必须对事故部位补拍照片，并能反映事故损伤原因; 13、对照片不能反映出的裂纹、变形，要用手指向损坏部位拍照或对比拍照或标识拍照，并能反映损伤原因，尤其对事故造成轴、孔损伤拍摄的，一定要有实测尺寸照片; 14、拍摄玻璃照片时注意玻璃的光线反光，玻璃单独破碎险中玻璃损坏不严重，先拍一张照片，再击打玻璃受损处使损伤扩大明显后，再拍一张照片; 15、一张照片已能反映出多个部件、部位受损真实情况的不需单个或重复拍照，但重大配件或价格较贵的配件必须有能反映损伤、型号规格或配件编码的单独照片; 16、局部拍照时，需持稳相机，同时相机要聚焦，照片要求清晰并有辅助照片反映所处部位; 17、受损货物、路产照片。照片应能够反映出财产损失的全貌及损失部位，多处受损应分别拍摄;带包装的物品受损应将包装拆下后拍摄，并注意拍摄包装物上的数量、类型、型号、重量等;价值较高的货物在分类后单独编号拍摄。 18、相机的日期顺序调整为年、月、日、小时、分钟、秒;且显示日期必须与拍摄日期一致，严禁以各种理由调整相机日期; 19、数码相机象素调整为480×640，照片大小不超过150k。 20、为了提高系统资源使用效率，应避免同类型照片的重复the needs of future rehabilitation centre. facilitates future expansion of the hospital-wide voice communications, reducing costs due to expansion. Taking into account the special nature of public hospital, from a security point of view, the internal network of centres for the rehabilitation of the project system and Internet construction independently. to protect data within medical rehabilitation center from influence of external network, ensure safe and reliable medical information. Intranet for the hospital's internal network and not the hospital external link external network and an external network and data Association, two independent sets of network equipment. Medical network to four-room for 2 large Gigabit switches at the core, double-machine 录入。 现场定损 1、根据公司规定，符合现场定损条件(如事故真实，损失较小，符合“一纸快赔”权限的。单证齐全有效。客户同意定损金额等)要现场完成手机定损，开具损失确认单。对于手机定损的案件按月量化考核，并在部门的周例上通报，对好的给予表扬差的点名批评。 2、对于涉及人员伤亡的事故，要按人伤案件受理的规定和要求及时通知、上报医疗调查岗，以便医调人员及时进一步的查勘。对于涉及轻微伤人的案件，如头部、面部、颈部、胸背部、臀部、腰部，手腕部、腿部、足部轻微软组织伤或者皮擦伤，不影响日常行为活动的，对伤者受伤部位拍照后，应积极主动的与伤者调解协商一次性赔偿结案;查勘岗现场不能把握的，应及时与人伤调查岗沟通，由人伤调查岗负责指导完成。 3、人伤闪赔沟通技巧 第一时间内到达事故现场。 了解事故经过，确定基本损失的基础上，进行引导性调解。 标的全责时: 对客户:您好，我是天安保险事故查勘员XXX，事故我已经基本查看完毕，伤者伤情应该不算严重，休养一段即可，为了节省您的时间，尽早处理好本次事故，我们公司对于此类the needs of future rehabilitation centre. facilitates future expansion of the hospital-wide voice communications, reducing costs due to expansion. Taking into account the special nature of public hospital, from a security point of view, the internal network of centres for the rehabilitation of the project system and Internet construction independently. to protect data within medical rehabilitation center from influence of external network, ensure safe and reliable medical information. Intranet for the hospital's internal network and not the hospital external link external network and an external network and data Association, two independent sets of network equipment. Medical network to four-room for 2 large Gigabit switches at the core, double-machine 案件双方可以尝试当场和解，您先和对方了解一下意向吧，我这边也和公司专业人士了解一下标准。当客户提出要求超查勘员权限标准时可以说:我和我们医疗核损/专业人士沟通了一下，可以处理的费用是。。。，他这种伤情休息一下就好了/如果不放心就去医院检查一下，确定没问题我们就走一下快速处理流程。 双方都有责任时: 则可以说:都是意外，我们公司对小额案件可以。。。，双方都有责任，各自让一步，你们商量商量，我这边也和公司请示一下，尽量让你们减少损失。。。 查勘员可自行发挥自身的语言组织能力，总体原则是把我们的快速处理人伤案件的优势和给双方提供的方便讲清楚。实施过程中应先了解双方意向，同时明确告知客户我司的赔偿金额。 如果达成协议，则指导双方签订赔偿协议。 如果伤者执意要去医院检查或者不能达成调解协议，则由人伤调查后续跟进。 重大案件上报及三者物损案件的处理 1、损失金额预估超1万元的，要做重大案件及时上报核赔人;损失金额预估超5万元的，3个工作日内重大案件上报核赔人及分公司。 2、对于涉及三者物损的案件，如:路灯杆、电线杆、信号the needs of future rehabilitation centre. facilitates future expansion of the hospital-wide voice communications, reducing costs due to expansion. Taking into account the special nature of public hospital, from a security point of view, the internal network of centres for the rehabilitation of the project system and Internet construction independently. to protect data within medical rehabilitation center from influence of external network, ensure safe and reliable medical information. Intranet for the hospital's internal network and not the hospital external link external network and an external network and data Association, two independent sets of network equipment. Medical network to four-room for 2 large Gigabit switches at the core, double-machine 灯杆、绿化带、树木、电线、光缆、通信设施等损坏的应现场第一时间电话上报核赔人，以便核赔人第一时间给出合理的处理，防止损失扩大。 资料上传 查勘员回到公司，应立即将事故现场照片和单证资料存档，并将照片、查勘报告在规定时效内上传理赔系统，防止影像资料、照片丢失。符合一纸快赔的案件应及时完成资料上传工作，完成自动核价，以保证案件在24小时内结案支付赔款。对于不能及时完成定损核价的案件，应保证实务案卷中的资料完整齐全，并根据案件的处理进度时时跟进完成核价、核损工作。 the needs of future rehabilitation centre. facilitates future expansion of the hospital-wide voice communications, reducing costs due to expansion. Taking into account the special nature of public hospital, from a security point of view, the internal network of centres for the rehabilitation of the project system and Internet construction independently. to protect data within medical rehabilitation center from influence of external network, ensure safe and reliable medical information. Intranet for the hospital's internal network and not the hospital external link external network and an external network and data Association, two independent sets of network equipment. Medical network to four-room for 2 large Gigabit switches at the core, double-machine the needs of future rehabilitation centre. facilitates future expansion of the hospital-wide voice communications, reducing costs due to expansion. Taking into account the special nature of public hospital, from a security point of view, the internal network of centres for the rehabilitation of the project system and Internet construction independently. to protect data within medical rehabilitation center from influence of external network, ensure safe and reliable medical information. Intranet for the hospital's internal network and not the hospital external link external network and an external network and data Association, two independent sets of network equipment. Medical network to four-room for 2 large Gigabit switches at the core, double-machine