長期看護保險核保制度比較研究

Comparative Study of the Underwriting Institution of Long term care Insurance

葉進鋒(Chin-Feng Yeh)

指導教授 ： 郝充仁 ； 李雅婷

淡江大學/商管學院/保險學系保險經營碩士在職專班/碩士(2015年)

https://doi.org/10.6846/TKU.2015.00452

摘要

國內老年人口比例逐年上升、生育率下降，且傳統家庭養老觀念日漸式微，對於老年所面臨的生活及保障，已逐漸衍生為社會問題。台灣高齡化、少子化的情形日益嚴重，也因此衍生高扶養比與長期看護等相關問題。目前台灣長期看護系統尚未整合，對於老年人無法提供連續且完整性之長期看護服務。
由於長期看護需求增加以及一般社會大眾對於長期看護觀念也日益增長，各壽險公司面對著龐大的市場需求正積極推出及銷售各類型長期看護保險相關商品，由於陸續推出不同種類之長期看護保險商品，長期看護保險之核保也更顯重要。由於國內長期看護保險研究也鮮有探討長期看護保險商品的核保，故本研究將探討長期看護保險之核保，期為長期看護保險之核保投注一份心力。
本文研究範圍摘要如下：
1.介紹國內長期看護保險制度與商業長看保險現況及核保制度。
2.研究國外長看保險制度與老年人常見疾病之風險因素。
3.以國外長期看護保險核保經驗探討長期看護保險核保制度。
4.探討商業長期看護保險之未來發展趨勢。
5.最後以商業長看保險核保案例做個案研究

關鍵字

長期看護保險 ； 家庭照護 ； 需要長期看護狀態 ； 道德風險

並列摘要

The domestic aging population ratio in Taiwan has been on the rise in recent years, and with the concomitant birthrate decline, traditional concepts of raising a family and then being cared for by them in retirement are on the decline as well. This means that for the elderly they are faced with social problems arising from their lives and long term care. As aging of population and the birthrate falls precipitously over time in Taiwan, there has also arisen issues relating to the large number of elderly requiring care and long-term care services. Currently Taiwan’s long-term eldercare network is incomplete, and is unable to provide the elderly with continuous and comprehensive eldercare services.
With the ever growing demands for long term eldercare and the common public growing understanding of eldercare concepts, insurance companies are faced with a large market demand and have been assiduously introducing and promoting a variety of long-term care insurance offerings, and given the variety of such long-term care insurance products, the underwriting of such long-term care insurance becomes all the more important. Since our domestic long-term care insurance studies have only begun to explore long-term care policy underwriting, this study will investigate long-term care insurance, in the hope of making a contribution to long-term care insurance underwriting efforts.
This study includes the following aspects:
1.Introducing the domestic long-term care insurance system and the status quo of commercial long-term care insurance and underwriting systems.
2.Study of international long-term care insurance systems and elucidating risk factors for common geriatric disorders and diseases among the elderly.
3.Discussing international long-term care insurance underwriting experiences and their contribution to the long-term care insurance underwriting system.
4.Discuss future development trends in commercial long-term care insurance.
5.Conclude by considering case analyses of commercial long-term care insurance underwriting.

並列關鍵字

Long term Care Insurance ； Home Care ； Long term Care Assistance ； Moral Risk

參考文獻

15.吳淑瓊(2005)，人口老化與長期看護政策，國家政策季刊，第4卷第4期，頁5-24。

1.鄭清霞等(2014)，制度性因素對長期看護保險費用影響程度之初探—以 ADLs 功能障礙者為例。

5.林士聘(2010)，長看看護保險商品及消費者購買須知之探討，國立政治大學經營管理碩士學程風險管理與保險組碩士論文。

4.梁亞文、劉立凡、 林育秀(2010)，英日兩國長期看護制度對推動我國長期看護制度之意涵，長期看護雜誌，第14期。

4.肝病防治基金會全球資訊網，B型肝炎http：//liver.org.tw/index.php?option