南宁生活服务夜网最新资讯Original title: long term medical insurance introduces rate adjustment mechanism, which products can be adjusted and how?
As a kind of health insurance popular with consumers in recent years, all kinds of millions of medical insurance frequently become "Internet red products". However, the head of the life insurance Department of the CIRC said on April 2,
From the current situation, the vast majority of millions of medical insurance products on the market do not contain the responsibility of guarantee renewal, in fact, it is a short-term insurance product
。 In contrast, the long-term medical insurance has a longer guarantee period and more adequate guarantee responsibility.
On April 2, bancassurance issued the notice on Relevant Issues of rate adjustment of long-term medical insurance products (hereinafter referred to as the notice), which solved the institutional barriers to the development of medical insurance by introducing the rate adjustment mechanism, and clearly conveyed the positive signals of encouraging the development of long-term medical insurance.
As early as November 2019, the CBRC issued the measures for the administration of health insurance, which stipulates that insurance companies can agree on the rate adjustment of long-term medical insurance products in insurance products, the main purpose of which is to guide insurance companies to develop and sell long-term medical insurance products, which can effectively solve the problem that short-term medical insurance cannot be renewed due to the suspension of sales of products and other reasons, but also conform to the international standards Common practice. However, it is not clear which long-term medical insurance rates can be adjusted and how.
The notice pointed out that,
The long-term medical insurance products with adjustable design rate developed by insurance companies are only limited to those priced at natural rate, and the insurance period is more than one year, or the insurance period is not more than one year, but the medical insurance products with guarantee renewal clauses are included. The product name of long-term medical insurance with adjustable rate shall contain the words "XX medical insurance (adjustable rate)".
In insurance products, the concepts of natural rate pricing and equilibrium rate pricing often appear. Among them, the natural rate refers to the increasing age of the insured, the declining physical quality and the rising premium; the balanced rate refers to the insurance company's assessment of the risk of the insured at each age and the calculation of the average premium. The insured only needs to pay according to the average premium.
The person in charge of the life insurance Department of the CIRC said,
The long-term medical insurance priced by balanced premium is not included in the range of adjustable rate, which mainly includes several considerations.
First of all, from a scientific point of view, it is difficult to make a long-term judgment on the level of rising medical costs, so if insurance companies adopt the balanced rate pricing, it is difficult to make a long-term scientific measurement on the risk loss rate or incidence rate.
From the operational point of view, if the traditional balanced rate method is adopted, it is difficult for an insurance company to charge the underpriced premium from customers through rate adjustment in the case of insufficient pricing in the early stage, especially for some products with inconsistent payment period and insurance period. For example, some life insurance payment period is 20 years, but the guarantee period is life-long. If the medical insurance adopts the same way, it is also a question whether the policyholders who have stopped paying the premium and still need to pay the premium for the products whose payment period has stopped but the guarantee period still exists once the rate is adjusted.
In addition, under the balanced rate model, policies usually have cash value. If the insurance company adjusts the rate, the cash value statement of the policy will change, and there will be a series of complex adjustments on how to change and the operations of surrender and preservation, which increases the difficulty of operation.
He also pointed out that for consumers, after buying insurance, if the insurance companies take price increase measures and the rate adjustment is very high, it will be difficult to accept. At this time,
If natural rate pricing is adopted, this part of products will have no cash value after a complete policy year. When the policyholder withdraws the insurance at this time, there is no financial loss.
The notice also specifies the basic requirements of the rate adjustment, that is, the insurance company shall formulate the rate adjustment method, and clarify the trigger conditions, internal decision-making mechanism and workflow of the rate adjustment.
The first rate adjustment time shall not be earlier than 3 years from the date of product marketing, and the interval of each rate adjustment shall not be less than 1 year. The insurance company shall not implement the differential rate adjustment policy due to the difference of individual insured's physical condition.
In terms of the product terms and instructions, the notice requires that an insurance company shall provide the applicant with the product instructions for the sale of long-term medical insurance products with adjustable rates. The product terms and product specifications shall give a detailed description of the rate adjustment. At the same time, the product specifications shall demonstrate the guarantee provided by the product in the form of cases, as well as the annual rate adjustment that the applicant may face.
It is worth noting that the notice does not make specific provisions on the specific trigger conditions and upper limit of the rate adjustment, but only makes a principled provision, and requires insurance companies to set up a "long-term medical insurance" sub column under the "special information" column of the "public information disclosure" column on the company's website, to disclose the rate adjustment method and the long-term medical insurance with adjustable rate The name of the insurance product, the date of listing and sales, and the previous rate adjustment information. For each rate adjustment, the insurance company shall notify the applicant in the manner specified in the policy.