The 《 Securities Daily recently learned that on January 6, the CBRC issued a notice on issues related to the regulation of short-term health insurance business to all personal insurance companies, property insurance companies and the China Insurance Industry Association.
Reporters found that the insurance industry and policy-holders concerned that the draft regulation of short-term health insurance (also known as \"net red million medical insurance \") sales and renewal requirements, explicitly mentioned that the insurance companies developed\" short-term health insurance products should be clearly stated in the insurance clause as'non-insurance renewal' clause,\" as well as \"insurance companies may not arbitrarily stop selling short-term health insurance products to infringe the rights and interests of insurance consumers.
Health insurance consists of four major types of insurance: heavy health insurance, medical insurance, long-term care insurance and disability insurance.
Short-term health insurance is a health insurance product that is sold to individuals for a period of one year or less and does not contain a guaranteed renewal. This kind of insurance is mainly short-term medical insurance on the market, because it has the characteristics of low premium, high coverage (more than 1 million yuan or more), easy to buy online, etc., once launched, it is quickly sought after by consumers, becoming the \"network red person\" in insurance products.
Among them, on the issue of renewal of insurance, the draft opinion is clear, insurance companies developed short-term health insurance products including insurance liability, should be clearly stated in the insurance clause as \"non-guaranteed renewal\" clause.
The term of this product insurance shall be one year (or not more than one year). At the end of the insurance period, the applicant needs to reapply to the insurance company to insure the product, pay the insurance premium, and obtain a new insurance contract. Insurance companies are not allowed to use words such as \"continuous insurance \",\" automatic renewal \",\" promise renewal \",\" lifetime limit\" and other words that are easily confused with long-term health insurance in short-term health insurance product terms, publicity materials.
On the policy-holder's concern to stop the sale of the crux of the issue, the draft notes that insurance companies are not allowed to stop the sale of short-term health insurance products, infringement of the rights and interests of insurance consumers. Where an insurance company stops selling short-term health insurance products, it shall inform the insured consumers through the company's official website, sales channels, newspapers and periodicals, instant messaging and other convenient means of disclosure, and provide the insured consumers of the purchased products with the necessary and reasonable reinsurance services upon expiration of the insurance period.
In addition, the draft also stressed that if an insurance company voluntarily stops selling insurance products, it shall disclose relevant information at least 15 days prior to the suspension of the sale of the products, and if the regulatory body orders it to stop because of the existence of illegal or illegal design of the products, it shall disclose the relevant information within 3 days from the date of the suspension of the supervision.
In terms of pricing, the draft opinion requires that insurance companies should scientifically and reasonably determine the price of short-term health insurance products. The actuarial assumptions used in product pricing shall be based on empirical data and shall not be arbitrarily agreed upon or deviated from the actual operation. Insurance companies may determine differentiated product rates according to different risk factors and sell short-term personal health insurance products in strict accordance with the approved or recorded product rates.
In terms of the insured amount and deductible amount, the draft is clear, and the insurance company should reasonably determine the rate, deductible amount, indemnity ratio and insurance amount of the short-term health insurance products according to the actual level of medical expenses and the data of claim settlement experience. An insurance company shall not set a false and high amount of insurance which deviates from the empirical data base of claims.
In recent years, due to pricing, insurance coverage, deductible setting unreasonable reasons, some insurance companies short-term health insurance losses. Data show that in 2018, four domestic professional Internet property insurance companies health insurance all suffered underwriting losses, underwriting profits totaling -billion yuan. Short-term health insurance earnings are expected to improve as comments follow.
A number of insurers told the securities daily that some insurance companies'health insurance product underwriting profit losses are related to their unreasonable pricing of products, homogeneity and fierce competition resulting in low rate setting and weak risk management.
For example, a vice president of a property-insurance company previously told the securities daily that the company's previous investment in short-term health insurance, including spending on a large amount of advertising costs, has not been fully shared among insurers and between insurers and hospitals, raising the cost of claims. As the company strengthens the application of big data and risk management, health insurance and other types of insurance are expected to turn losses and achieve underwriting profits.
Hua Jin Securities researcher Cui Xiaoyan pointed out that short-term health insurance industry development space does not represent competition detente. Short-term health insurance products are highly competitive. Compared with the complete personal health big data support of life insurance companies, the lack of data on property insurance companies that mainly push \"millions of medical insurance\" products puts them at a disadvantage in pricing. In addition, the high homogeneity of the product and behind the life insurance companies on the life insurance compensation process control, resulting in a high amount of compensation. According to the data, the proportion of compensation paid by personal insurance companies is stable at about 25%, while that of property insurance companies is already more than 75%.
In addition to the above-mentioned key points, the draft also strengthens the protection of consumers: the insurance company should guide the insured consumers to read the insurance terms in a reasonable manner, so that the insured person can fully understand the information of the insurance products and services.