Health insurance is divided into sickness insurance, medical insurance and income security insurance according to insurance liability. Compared with other insurances, health insurance has the following characteristics:
(1) Insurance period: Except for major diseases, most health insurance, especially medical expenses insurance, is usually a one-year short-term contract.
(II) Actuarial technology: The pricing of health insurance products mainly considers the disease rate, disability rate and duration of disease (disability). The calculation of health insurance rate is based on the loss rate of insured amount, and the unexpired liability reserve at the end of the year is generally paid according to a certain proportion of the premium income of the current year. In addition, waiting period, deductible, deductible, * * payment ratio, payment method and payment limit will also affect the final rate.
(3) Payment of health insurance: The question of whether the principle of payment is applicable to health insurance cannot be generalized, but this principle is applicable to expense health insurance and belongs to compensatory payment; However, the fixed payment of health insurance is not applicable, and the payment of insurance benefits has nothing to do with actual losses.
(D) Particularity of operational risk: Health insurance deals with injury risk, and its influencing factors are far more complicated than life insurance, and adverse selection and moral hazard are more serious. In addition, the risk of health insurance also comes from medical service providers, and the quantity and price of medical services are largely determined by them, which is difficult for insurance companies to control as payers. How about China Life? I just sorted out the relevant contents, hoping to help you: How about China Life? Top Ten Life Insurance Products Ranking List!
(V) Cost sharing: Because health insurance is risky, difficult to control and unpredictable, there are often many restrictions or restrictive clauses on the insurer's medical insurance payment responsibility for diseases in health insurance.
(VI) Particularity of contract terms: health insurance does not need to designate a beneficiary, and the insured and beneficiary are often the same person.
In the health insurance contract, besides the incontestable clauses, grace period clauses and no loss clauses of general life insurance, there are also some unique clauses, such as existing conditions clauses, conversion clauses, cooperative payment clauses, medical examination clauses, deductible clauses and waiting period clauses. I just sorted out the relevant contents about buying insurance physical examination, hoping to help you: ten precautions for buying insurance physical examination!
(7) Excluded liability of health insurance: The excluded liability of health insurance generally includes diseases, deaths and disabilities caused by war or military action, intentional suicide or attempted suicide, and diseases, disabilities, miscarriages and deaths caused by abortion.
Bao Ge Tip: What are the characteristics of commercial health insurance? To sum up, compared with other insurance, commercial health insurance mainly has the characteristics of insurance period, actuarial technology and cost sharing. In addition, there are three types of commercial health insurance, namely sickness insurance, medical insurance and income security insurance.