While highlighting the role of security, but the development of commercial health insurance is facing embarrassment. In the first three quarters of this year, Shanghai health insurance payments 740,000,000 yuan, representing a 23% increase over the same period last year. Focus on the protection of the one-year health insurance premium income fell 18 percent year-on-year, insured by the time of 5,800,000 over the same period last year, dropped to 830,000.
Pay increase profits under pressure
The health insurance business has been suffering from health insurance to pay high rates. Data show that in the first three quarters of this year, the Shanghai one-year health insurance paid 12.5 percent growth, year over payment of health insurance grew 75%, and a similar rate of growth in compensation has been here for three years. Rui Fude health insurance products, said a Department of Actuarial, from the nearly 3-year statistics, if the count is not due reserve duty, short-term rate of health insurance payments has reached 88%, the profit pressure.
Sub-health of the population increase in the incidence of the disease were to increase health insurance payments increase. However, as there are only to customers and insurance companies of the two sides of life insurance products, health insurance claims involve third-party hospitals, which are often the insurance companies to control the rate of payment difficulties.
Experts point out that a longer period of protection of health insurance, insurance companies, the lack of insured health tracking mechanism; and medical institutions from their own interests, tend to use more expensive drugs, over-the-art equipment and beyond the reasonable scope of treatment , The insurance payment will increase spending.
Inadequate protection of the lack of products to attract
Pacific Life Product Development Department said a health risk from time to time there will be a product for sale for some time after the suspension of the sale, which is mainly based on two conditions: First, the actuarial allowed, leading to high operating costs, poor profitability. Second, the sales lead to overheating in the future to pay too much risk concentrated suspension of the sale must be improved. The improvement is often the result of "the expansion of a number of small incidence of the disease into the insurance liability while reducing the individual claims limit of the disease."
A survey shows that the treatment of major diseases has been estimated cost of more than 150,000 yuan, the insurance risk of major diseases, surgery and hospitalization cost of insurance consumers, the actual amount of capital is also far from enough to pay for major diseases. At present, consumers were suffering from the flu in health care costs have more than hundred dollars. In the first three quarters, the Shanghai-cost health insurance cases are paid 504 yuan for, but it's obviously difficult to pay the amount to meet consumer demand for health care.
In order to reduce the amount of insurance payments "improved" products, but its security can not meet demand, will make the product cold reception encountered. So far this year, short-term health insurance policy holders at 830,000, only one-sixth of the same period last year, a significant risk of the disease was only 15% of the insured.
Added emphasis on the role of product change
Shanghai University of Finance and Economics Institute of Finance Su-fang said that the current health insurance as a whole there is a low degree of specialization, product homogenization, medical insurance weak risk control and other issues, compared to the actual needs of consumers and there is a wide gap between the health of the market The acceptance of low risk.
In the past a single health insurance products has been difficult to the thirst of the market, its development challenges. To consumer health insurance, for example, although lower premiums, subject to renewal every year, the troublesome and more expensive the premiums of older, and age insurance is also restricted; claims in connection with social security by linking payment than the standard limit And more. To solve these problems, insurance companies try to seek a breakthrough in product design: China Life raised re-disease risk, "the second payment," the Great Wall to launch the insured amount of insurance, the responsibility of the variable heavy disease plus health insurance, Prudential Life Insurance launched the "Healthy life "," In a timely manner to "such as insurance, the main" advance payment ", in De-linked" Yi-sheng well-being "will be re-disabled and old-age planning to carry out ... ...
Experts believe that health insurance companies to operate first of all to clear to become the social security health insurance to add such a position in product innovation so as to whether or not to carry out sub-limit for social security, resolving the source of premium and compensation paid to avoid health risks Insurance business has become "chicken."
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