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終身癌症保險費率之釐定 / The Actuarial Pricing for the Whole Life Cancer Insurance連宏銘, Michael Lien, Hung-Ming Unknown Date (has links)
自從民國七十一年起惡性腫瘤(俗稱癌症)開始躍昇為國人十大死因之第一位,而且癌症死亡率有逐年攀升的趨勢。另外,根據衛生署公佈的「民國八十五年癌症登記報告」中,發現國人罹患癌症的情況不僅有集中特定癌症而且亦有逐年遞增的現象,由此可知癌症一直威脅著國人的健康。
由於政府在民國八十四年開辦全民健康保險,提供大部份國民基本的醫療保障,然而健保的給付項目以及金額仍然有限,因此壽險業者為了補足全民健保的缺口,陸續推出終身癌症保險以提供國人更完整的保障。然而國內終身癌症保險仍屬初期階段,缺乏完整的統計經驗資料,大部份採用國外再保險公司所提供的癌症經驗資料,並未參酌國內醫院所作的癌症統計;壽險業最近因損失率過高,也將終身癌症保險的給付內容重新修訂,以作為調整保費的依據,因此其終身癌症保險之保費適足性值得探討。
本研究限定在定額型個人終身癌症保險,主要探討在國人癌症發生率逐年上升情況下,如何去建立一套終身癌症保險費率釐定模型,並且參考國內醫院的癌症統計資料,在合理的精算假設下,使用S-Plus統計軟體計算出終身癌症保險之保費,進一步探討壽險業之費率適足性。
在本文實證分析中,列舉國內三家壽險公司,就其給付內容比較保費,並探討其保費適足性,發現其相同處在於國內三家壽險公司的年繳保費明顯不足,而且其年繳保費差額隨著年齡呈直線遞增。其兩者年繳保費之比率方面,本實證分析的年繳保費皆高出三家壽險公司二至四倍左右,因此在長期之下保費的不足會導致壽險公司虧損,進而可能影響到壽險公司的清償能力,此結果可提供壽險業者及監理機關參考。 / With the increasing of cancer incidence rate, the insurers provide completely and thoughtfully designed planning in order to meet the requirements of the public, supplemental to the national health insurance program enforced by the government of R.O.C. in 1995. However, many domestic insurers have faced the problem of the experience loss ratio beyond the expected. Since the whole life cancer insurance policies have been issued on the market a few years ago, the empirical data from the insurance are insufficient for the pricing. In addition, only a fewer researches have focused on the actuarial model of this type of insurance. In this paper, we will investigate the premium calculation of the whole life cancer insurance under the influence of specified factors, and outline the appropriate model construction procedures.
The data we use are not only from Department of Health of the Executive Yuan but also from domestic hospital, such as National Taiwan University Hospital and Veterans General Hospital. Moreover, we make reference to medical studies and make use of rational actuarial assumptions, i.e., the trend of cancer incidence rate, cancer survival rate, cancer outpatient rate, average cancer outpatient treatment days, cancer inpatient rate, cancer surgical rates, cancer radiotherapy or chemotherapy rates, average cancer radiotherapy or chemotherapy treatment days, cancer bone marrow transplantation rates, cancer mortality rates, and other cancer rates, available to the premium calculation in empirical analysis.
Finally, we examine the premiums of three whole life insurance policies to compare to our results in empirical analysis and discuss whether premiums are adequate. We hope that this paper could be beneficial to the actuaries and also provide suggestions for the government surveillance.
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