- 學位論文
商業保險中失能(殘扶)保險與長照保險定價合理性之分析
Analysis of the rationality of the pricing of disability insurance and long-term care insurance in commercial insurance
摘要
本研究起因於發現壽險商品市場中長看險及失能保險保費及保障範圍存在嚴重失衡之狀態，保險費之制訂乃一財務科學。高發生率對應高保費，低發生率對應低保費始符合保費架構中之收支相等、對價平衡原則。觀察實務上現售之失能險其保障範圍遠大於長看險，可以想見其發生率亦大於長看險，保費應高於長看險但實際上卻洽好相反，長看險之保費竟高於失能險許多，此現象極不合理。故就長看險及失能險之定義、保險範圍做出差異分析。另舉嚴重程度不同之四個實際案例，分析在每月領取相同金額之條件下，長看險及失能險之保費及理賠總金額。得到的結論皆是長看險保費高於失能險保費但理賠總金額卻遠小於失能險。再進一步分析特定傷病類長看與長看險及失能扶助險三者之差異，得知失能扶助險理賠範圍>長看險理賠範圍≒特定傷病型類長看險且失能扶助險保費<長看險保費≒特定傷病型類長看險保費。顯示長看險及失能險之定價明顯不合理，故建議未來保險公司應與醫療及照護機構作進一步的異業合作，由醫療及照護機構之大數據中找出更精準模型，進而發展新型態長看、失能保險造福國人。
並列摘要
The study was based on the discovery that there is a serious imbalance between the long-term-care insurance and disability insurance premiums and coverage in the life insurance commodity market. The formulation of insurance premiums is a financial science. The high incidence rate corresponds to high premiums, and the low incidence rate corresponds to the principle that the balance of income and expenditure in the premium structure is equal to the balance of premiums. Observing the actual disability insurance in the life insurance commodity market, which coverage is far greater than that of long-term-care insurance. It can be imagined that incidence rate is also greater than long-term-care insurance. The premium should be higher than the long-term-care insurance but actually the opposite. It is much higher than the risk of disability. This phenomenon is extremely unreasonable. Therefore, a difference analysis is made on the definition and insurance coverage of long-term-care insurance and disability insurance. In addition, four actual cases with different degrees of severity are analyzed, and the total amount of premiums and claims for long-term-care insurance and disability insurance under the condition of receiving the same amount each month. The conclusions are that the long-term insurance premium is higher than the disability insurance premium but the total amount of the claim is much smaller than the disability insurance. Further analysis of the differences between the specific injuries and long-term-care and long-term-care insurance and disability support insurance, and the scope of the disability support insurance > long-term-care insurance claims, specific injury type long-term insurance and disability support insurance premiums