Securities Times reporter Liu Jingyuan
Health notification has always been an important part of insurance companies' underwriting and risk control of critical illness insurance business, which objectively blocks many unhealthy people, making it difficult to obtain critical illness protection.
How to make critical illness insurance cover the sick people, the industry is trying to break through.
Recently, there is a newly launched one-year critical illness insurance, which eliminates the link of health notification. People under the age of 60 can apply for insurance, and the threshold for insurance is greatly reduced.
For this innovative product, there are different voices in the insurance industry.
Breaking the "rules" of critical illness insurance
The recently listed critical illness insurance exempt from "health notification" is the Shuidi Blue Ocean series of critical illness insurance, jointly launched by Shuidi Insurance Brokers Co., Ltd., China Property Insurance and Yongan Insurance.
The "no health notification" in the insurance process is the biggest innovation.
The parties who launched the product all said that this simplifies the insurance process, and not only protects healthy people, but also people with sick people.
At present, people with sick people have an urgent need for insurance protection and are not effectively covered.
In recent years, medical insurance has shifted from healthy people to non-healthy people. In particular, Huimin Insurance no longer distinguishes whether customers are healthy or not, so that its coverage of sick people has been significantly improved. However, critical illness insurance is still struggling to protect people with sick people. .
Since critical illness insurance is a type of insurance that pays out upon confirmation of critical illness during the guarantee period, insurance companies tend to cover healthy people and try to exclude people at risk of illness through "health notification".
At present, the critical illness insurance products available for people with sick people either focus on specific disease groups, or only relax some of the insurance conditions.
"There is a huge market demand for sick people. This is the blue ocean market in the future. Everyone has a solid understanding of how to target people with sick people. The industry usually thinks that people with sick people are not insurable or have high risks." Teng Hui, chief actuary of Shuidi Company Said that the market already has some insurance for sick people, but the protection is not enough.
He said that since we want to provide insurance for people with sick people, why not release health notices and allow everyone to be insured?
Under this line of thinking, the water drop blue ocean series of critical illness insurance products are completely exempt from health notices, and only have certain restrictions on the age of insurance.
The insured age is from 30 days to 60 years old, and the maximum renewal period is 80 years old. The guarantee period is 1 year.
In addition, this series of products is as comprehensive as possible in terms of protection responsibilities, covering hundreds of diseases including mild, moderate and severe diseases. Among them, severe diseases can be compensated for up to two times in the first year, and some extended responsibilities, such as ICU hospitalization allowances, are also included.
Industry: potential disputes
Actuaries in the insurance industry have both positive comments and conservative attitudes towards critical illness insurance exempt from health notices.
Among them, how to manage and control risks is a common concern.
A reinsurance product designer said that the feasible way to control the risk of this product is to make the "denominator" bigger, so that there are as many insured people as possible, so as to offset the risk of adverse selection.
"Although there is no health notification, there is an exemption from liability for pre-existing conditions, and the theoretical effect is the same." wind control ideas.
The reporter noticed that the water drop blue ocean series of critical illness insurance products displayed on the insurance page that "only new diseases are covered, and all pre-existing diseases and their complications are not covered".
Waterdrop also stated that when making claims, the compensation standards for this series of critical illness insurance are consistent with the critical illness insurance products that require health notification.
There are also different voices in the industry.
According to the analysis of the above-mentioned reinsurers, the design of this product is to "underwrite claims", which is close to a theoretical model and is difficult to operate.
"How to define new diseases, and how to prove the connection between complications? Medically it is difficult to prove or cannot trace the source of the cause, and insurance must trace the source, otherwise it will pay full compensation."
In fact, excluding these potential hidden diseases that are difficult to prove is one of the reasons why insurance companies have strict health notification requirements for critical illness insurance customers.
Generally speaking, critical illness insurance advocates "strict entry and lenient exit", that is, strict underwriting, and loose claims after underwriting.
An actuary of a life insurance company believes that Shuidrop Blue Ocean Critical Illness Insurance does not have a "health notice", "only covers new diseases, not all pre-existing diseases and their complications", which is equivalent to "wide entry and strict exit", which may cause more serious illnesses. Multiple claims disputes.
Some actuaries also pointed out that "pre-existing illness exemptions are generally used in medical insurance, and critical illness insurance generally does not use such exemptions." Article 10 of the water drop blue ocean series of serious illness product liability exemptions is "pre-existing conditions suffered by the insured before the insured". Exceeds the specification for the use of the new definition of serious illness issued by the Insurance Industry Association.
The actuarial director of another medium-sized life insurance company believes that the design of this critical illness insurance is innovative and "friendly" to customers.
However, compared with general critical illness insurance products, it is more risky to insurance companies. However, this critical illness insurance has limits on the amount of insurance and risks in terms of rates (the price is relatively higher), "hoping for a win-win situation."