- 學位論文
終身醫療健康保險最適需求保障之研究
The Research into the Benefit of Reform for Permanent Hospital Indemnity Insurance
摘要
我國自民國84年起開辦全民健康保險，提供國人基本必要的醫療保健照護保障，同時興起社會大眾對商業健康保險之需求。壽險業也正視到逐漸興起的健康保險市場，在民國85年首張終身醫療險保單上市後，多家壽險公司也紛紛推出終身型的醫療保險。民國91年部分壽險公司將終身醫療健康保險由「無理賠上限型」調整為「限額型」。民國96年9月1日起為配合「人身保險商品審查應注意事項」規定，壽險公司多採取停售無理賠上限型終身醫療健康保險，而改銷售限額型終身醫療健康保險因應。 本研究是以壽險公司的立場去探討消費者的醫療保障需求，並從全民健康保險的給付統計資料進行分析，再由其給付缺口去探究與終身醫療健康保險間可能的互補關係，期能提供壽險公司商品設計之參考，開發更多元之終身醫療健康保險商品。 研究結果，限額型終身醫療健康保險在健康保險市場中具未來發展性，惟建議強化終身醫療健康保險與全民健康保險之互補，並增加限額型終身醫療健康保險之給付項目及額度，同時開發新型態的健康保險商品，提供投保大眾更適足的醫療保障，以繼續拓展與經營健康保險市場。
並列摘要
In 1995, Taiwan government established the National Health Insurance scheme in order to provide necessary health care to citizens. At the same time, this gave rise to the public need for commercial health care. Life insurance companies realized this huge market and the first policy for permanent medical insurance appeared in 1996. This product attracted other companies to enter the market and provide similar types of policy for customers. In 2002, insurance companies adjusted the product of permanent medical insurance from “unlimited amends” to “limited amends”. According to the rule of inspection points on life insurance products, the insurance companies stopped selling unlimited amends type of products instead of limited amends health care from September 1 2007. From the insurance companies’ point of view, my research is focused on the needs of medical protection of the customers. By analyzing the statistical material collected from the Bureau of National Health Insurance, I would like to study the relationship between the deficiency of those medical protection and permanent medical insurance and provide the insurance companies with necessary information for designing diversified insurance products. The result of my research is : there is a niche market for the limited amends type of permanent medical insurance. For the purpose of expanding and managing the health insurance market, my research suggests to strengthen the function of the permanent medical insurance to compensate for the deficiency of national health insurance. The final goal is to provide the public with sufficient medical protection by way of developing diversified products and providing more items and limit of limited amends of medical insurance for the entire life.