健康险委托管理型业务探讨

对国内健康险市场来说,委托管理型业务是个新生事物。保险委托管理型业务,是提供保险服务的主体为降低成本将管理工作委托给另一保险人的管理方式,从本质上来说,它已经属于非保险业务,无异于一般的委托管理业务。委托管理型业务在政府主导型医疗保险格局中,主要以商业补充医疗险为生存环境。根据委托管理型业务的特点,委托管理型业务市场相当有限。因为该类业务以供方利益为中心,而对于需求方利益则考虑较少,委托方的需求将会大量萎缩;保险公司风险控制技术低,无法满足委托方的风险控制需求;社保机构将大额补充医疗险作为委托管理型业务的可能性不大;委托管理型业务极有可能只是个过渡性业务形式。

To domestic health insurance market, entrusted business management is a new concept. The business management entrustment refers to the practice that the insurance service principal entrust the business to another insurer in order to lower cost. Essentially speaking, it is a non-insurance business, and is similar to ordinary entrusted business. In a government-led medical insurance framework, entrusted business management is mainly applied to complementary commercial medical insurance business. Its inherent features determine that entrusted management business has a limited market, because it is oriented to maximize supplier＇s interest while the consumer＇s interests are less considered. This will result in a shrinking of demands for consignors. The low risk control level on the part of insurers cannot satisfy the risk control demands of consignors. There is a small possibility that the social security organization will entrust management of the large-sum complementary medical insurance to third party. Therefore, this type of business will most likely be a transitional business.