甘肃省新型农村合作医疗引入商业保险建立意外伤害保险的探析

Analysis on the Establishing Accident Insurance by Introducing Commercial Insurance into New Rural Cooperative Medical System in Gansu

目的:探讨在西部经济欠发达农村地区,将商业保险引入新型农村合作医疗建立意外伤害保险的必要性、可行性和可能产生的社会意义。方法:对新型农村合作医疗意外伤害保险项目基线调查数据及4个试点县报表资料进行对比和综合分析。结果:试点地区共为1 332 785名参合农民整体投保,从新型农村合作医疗基金中支付意外伤害保费1 066.08万元,截至2012年11月,4个试点县区共受理意外伤害案件3 518件,已理赔案件1 976件,赔付金额1 564.42万元,大大减轻了遭受意外伤害家庭的负担。结论:通过引入商业保险机制,建立新型农村合作医疗意外伤害保险,是当前在西部欠发达农村地区实现意外伤害保障的最佳选择。

Objective： To discuss the necessity, feasibility and the possible social significance of establishing accident insurance system by introducing commercial insurance pattern into new rural cooperative medical system（NCMS）in the western underdeveloped rural areas. Methods： The baseline survey data of the accident insurance system and the data report of the four pilots in Gansu are compared and analyzed. Results： The pilot areas pay the whole insurance for a total 0f 1 332 785 enrollees and 10 660 800 yuan for the accidental injury insurance premium. The four pilot countries have received 3 518 accidental cases up to the November of 2012, 1 976 cases have been solved, and the compensation expense are 15.6 442 million yuan, which greatly reduced the heavy burdens of these families. Conclusion： The best choice to achieve the accidental injury protection in the western underdeveloped rural areas is establishing an accident insurance system by introducing commercial insurance pattern into NCMS.