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題名 以紮根理論探討壽險有效保額與實際給付金額的差距
The Gap Between In-Force Sum Assured and Actual Benefit Payments in Life Insurance : A Grounded Theory Study作者 林智鏞
Lin, Chih-Yung貢獻者 許永明
Shiu, Yung-Ming
林智鏞
Lin, Chih-Yung關鍵詞 人壽保險
有效保額
實際理賠給付
保障差距
三重落差模型
生命週期假說
紮根理論
Life insurance
In-force sum assured
Actual benefit payments
Coverage gap
Triple-gap model
Life Cycle Hypothesis (LCH)
Grounded theory日期 2026 上傳時間 2-Feb-2026 12:16:08 (UTC+8) 摘要 本研究探討台灣壽險市場中一個長期存在且關鍵的現象：為何保戶在投保初期規劃較高的人壽保險（有效保額），但在數十年後不幸身故時，受益人實際獲得的理賠金（實際給付金額）卻往往產生巨大落差。 本研究採取質性研究中的紮根理論（Grounded Theory）作為研究方法，對14組（共17人次）資深保戶進行深度訪談，結合文獻探討與實務觀察，進行三級編碼分析。研究發現保額落差並非單一決策因素，而是保戶在生命歷程中，因應經濟效益追求、生命週期推移與制度環境互動後產生的動態演變結果。 本研究最終建構出「壽險保額衰退的三重落差模型（Triple-Gap Model of Life Insurance Coverage Decay）」： 1.主動性落差：保戶基於金融知識提升與經濟理性覺醒，主動將資金從低效率壽險轉移至高效益投資工具或生前享受與醫療長照保障 。 2.被動性落差：受通膨侵蝕、定期險自然到期、家庭階段性責任解除，以及高齡與體況導致的投保限制，使壽險保額呈現不可逆的自然衰退。 3.制度性落差：因人情銷售脆弱性、孤兒保單與服務斷層，導致保戶對保險制度信任斷裂，進而引發脫退行為。 研究結論指出，壽險保額衰退本質上是保戶在生命週期中的資源優化配置。本研究建議保險業者應強化「服務鏈結」與「數位賦能」，並開發能彈性轉換，抗通膨的產品，或結合保單投資收益轉入購買躉繳型終身壽險機制，以協助保戶填補保障缺口，落實壽險的長期價值。
This study investigates a critical and persistent phenomenon within Taiwan’s life insurance market : the significant discrepancy between high initial coverage (In-force Sum Assured) and the actual death benefit payments received by beneficiaries decades later. Adopting「Grounded Theory」as the primary methodology, this research conducted in-depth interviews with 14 groups (total 17 participants) of long-term policyholders. Through a three-stage coding process - open, axial, and selective coding - combined with literature reviews and practical observations, the study identifies that this coverage gap is a dynamic evolution resulting from policyholders’ pursuit of economic efficiency, transitions through the life cycle, and interactions with the institutional environment. The research develops the construction of the "Triple-Gap Model of Life Insurance Coverage Decay": 1.Active Gap : Driven by enhanced financial literacy and economic rationality, policyholders actively shift funds from traditional life insurance to high-efficiency investment vehicles or pre-death benefits such as self-enjoyment, medical and long-term care. 2.Passive Gap : Resulting from irreversible factors such as inflationary erosion, expiration of term insurance, fulfillment of family responsibilities, and age or health-related barriers to increasing coverage. 3.Institutional Gap : Due to the fragility of relationship-based selling, orphan policies, and service disruptions, those factors lead to a breakdown of trust in the insurance system and subsequent policy lapses. The study concludes that coverage decay essentially represents a strategic reallocation of resources across an individual's life cycle. 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GENEVA PAPERS ON RISK AND INSURANCE-ISSUES AND PRACTICE, 44(4), 653-678. https://doi.org/10.1057/s41288-018-0104-5 描述 碩士
國立政治大學
國際金融碩士學位學程
113ZB1042資料來源 http://thesis.lib.nccu.edu.tw/record/#G0113ZB1042 資料類型 thesis dc.contributor.advisor 許永明 zh_TW dc.contributor.advisor Shiu, Yung-Ming en_US dc.contributor.author (Authors) 林智鏞 zh_TW dc.contributor.author (Authors) Lin, Chih-Yung en_US dc.creator (作者) 林智鏞 zh_TW dc.creator (作者) Lin, Chih-Yung en_US dc.date (日期) 2026 en_US dc.date.accessioned 2-Feb-2026 12:16:08 (UTC+8) - dc.date.available 2-Feb-2026 12:16:08 (UTC+8) - dc.date.issued (上傳時間) 2-Feb-2026 12:16:08 (UTC+8) - dc.identifier (Other Identifiers) G0113ZB1042 en_US dc.identifier.uri (URI) https://nccur.lib.nccu.edu.tw/handle/140.119/161381 - dc.description (描述) 碩士 zh_TW dc.description (描述) 國立政治大學 zh_TW dc.description (描述) 國際金融碩士學位學程 zh_TW dc.description (描述) 113ZB1042 zh_TW dc.description.abstract (摘要) 本研究探討台灣壽險市場中一個長期存在且關鍵的現象：為何保戶在投保初期規劃較高的人壽保險（有效保額），但在數十年後不幸身故時，受益人實際獲得的理賠金（實際給付金額）卻往往產生巨大落差。 本研究採取質性研究中的紮根理論（Grounded Theory）作為研究方法，對14組（共17人次）資深保戶進行深度訪談，結合文獻探討與實務觀察，進行三級編碼分析。研究發現保額落差並非單一決策因素，而是保戶在生命歷程中，因應經濟效益追求、生命週期推移與制度環境互動後產生的動態演變結果。 本研究最終建構出「壽險保額衰退的三重落差模型（Triple-Gap Model of Life Insurance Coverage Decay）」： 1.主動性落差：保戶基於金融知識提升與經濟理性覺醒，主動將資金從低效率壽險轉移至高效益投資工具或生前享受與醫療長照保障 。 2.被動性落差：受通膨侵蝕、定期險自然到期、家庭階段性責任解除，以及高齡與體況導致的投保限制，使壽險保額呈現不可逆的自然衰退。 3.制度性落差：因人情銷售脆弱性、孤兒保單與服務斷層，導致保戶對保險制度信任斷裂，進而引發脫退行為。 研究結論指出，壽險保額衰退本質上是保戶在生命週期中的資源優化配置。本研究建議保險業者應強化「服務鏈結」與「數位賦能」，並開發能彈性轉換，抗通膨的產品，或結合保單投資收益轉入購買躉繳型終身壽險機制，以協助保戶填補保障缺口，落實壽險的長期價值。 zh_TW dc.description.abstract (摘要) This study investigates a critical and persistent phenomenon within Taiwan’s life insurance market : the significant discrepancy between high initial coverage (In-force Sum Assured) and the actual death benefit payments received by beneficiaries decades later. Adopting「Grounded Theory」as the primary methodology, this research conducted in-depth interviews with 14 groups (total 17 participants) of long-term policyholders. Through a three-stage coding process - open, axial, and selective coding - combined with literature reviews and practical observations, the study identifies that this coverage gap is a dynamic evolution resulting from policyholders’ pursuit of economic efficiency, transitions through the life cycle, and interactions with the institutional environment. The research develops the construction of the "Triple-Gap Model of Life Insurance Coverage Decay": 1.Active Gap : Driven by enhanced financial literacy and economic rationality, policyholders actively shift funds from traditional life insurance to high-efficiency investment vehicles or pre-death benefits such as self-enjoyment, medical and long-term care. 2.Passive Gap : Resulting from irreversible factors such as inflationary erosion, expiration of term insurance, fulfillment of family responsibilities, and age or health-related barriers to increasing coverage. 3.Institutional Gap : Due to the fragility of relationship-based selling, orphan policies, and service disruptions, those factors lead to a breakdown of trust in the insurance system and subsequent policy lapses. The study concludes that coverage decay essentially represents a strategic reallocation of resources across an individual's life cycle. It recommends that insurers strengthen service connectivity and digital empowerment, while developing flexible, inflation-adjusted products, or a mechanism integrating policy investment returns into the purchase of a single-premium whole life insurance policy to bridge the coverage gap and fulfill the long-term value of life insurance. en_US dc.description.tableofcontents 第一章 緒論 8 第一節 研究背景與動機 8 第二節 研究問題與目的 11 第三節 研究重要性與貢獻 11 第二章 文獻探討 13 第一節 壽險的身故保障需求與生命週期假說 13 第二節 壽險有效保額與實際死亡給付不同 14 第三節 影響壽險給付的因素與限制 15 第四節 資訊不對稱與保戶行為的影響 16 第五節 建全保險保障的期待 17 第六節 台灣人壽保險有效保額與給付之現況分析 18 第一項 有效保額與實際給付金額的定義 18 第二項 歷年有效契約平均保額與新契約平均保額增加顯著 19 第三項 門檻法則政策有效提高新契約平均保額 21 第四項 歷年實際理賠給付金額卻未有同等幅度增加 22 第七節 人壽保險重要比率指標的意涵 22 第一項 保險密度與保險滲透度 22 第二項 保險投保率與保險普及率 24 第三項 台灣保險業在世界上的位置 26 第八節 有效保額與實際理賠金額落差原因探討 28 第一項 產品構面 28 第二項 契約構面 29 第三項 信念與行為構面 30 第四項 售後服務構面 31 第五項 社會與人口現實構面 33 第三章 研究方法與設計 34 第一節 研究主體與範圍 34 第二節 研究方法 36 第一項 紮根理論簡介 36 第二項 深度訪談 38 第三項 研究對象 38 第四項 訪談大綱 39 第五項 信實度檢定 42 第四章 資料分析 44 第一節 開放式編碼 44 第二節 主軸編碼 47 第三節 選擇性編碼 54 第四節 族群間異同分析 57 第五章 結論與建議 61 第一節 研究結論 61 第二節 研究貢獻 62 第三節 研究建議 63 第四節 研究限制 64 第五節 未來研究方向 64 參考文獻 68 zh_TW dc.format.extent 9131649 bytes - dc.format.mimetype application/pdf - dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0113ZB1042 en_US dc.subject (關鍵詞) 人壽保險 zh_TW dc.subject (關鍵詞) 有效保額 zh_TW dc.subject (關鍵詞) 實際理賠給付 zh_TW dc.subject (關鍵詞) 保障差距 zh_TW dc.subject (關鍵詞) 三重落差模型 zh_TW dc.subject (關鍵詞) 生命週期假說 zh_TW dc.subject (關鍵詞) 紮根理論 zh_TW dc.subject (關鍵詞) Life insurance en_US dc.subject (關鍵詞) In-force sum assured en_US dc.subject (關鍵詞) Actual benefit payments en_US dc.subject (關鍵詞) Coverage gap en_US dc.subject (關鍵詞) Triple-gap model en_US dc.subject (關鍵詞) Life Cycle Hypothesis (LCH) en_US dc.subject (關鍵詞) Grounded theory en_US dc.title (題名) 以紮根理論探討壽險有效保額與實際給付金額的差距 zh_TW dc.title (題名) The Gap Between In-Force Sum Assured and Actual Benefit Payments in Life Insurance : A Grounded Theory Study en_US dc.type (資料類型) thesis en_US dc.relation.reference (參考文獻) 中文文獻 于雲真. 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