我国重大疾病保险保费调整机制研究

Analysis on Premium Adjustment Mechanism of Critical Illness Insurance in China

目的:通过构建现金流量模型提出我国重大疾病保险保费调整机制。方法:采用中国重大疾病保险实践数据,建立恰当的精算假设与现金流量模型,对中国重大疾病保险的保费调整进行模拟分析。结果:(1)由于重大疾病发生率的恶化及市场利率的变化,重大疾病保险保证保费通常存在定价不足风险,表现为保险期内当年现金流出现负值,部分情景下累积现金流出现负值;(2)在保费调整的准则上,建议当损失率达到70%以上时,可允许保险公司进行保费调整,若损失率达到80%以上时,必需强制保险公司进行保费调整。结论:本研究提出了重大疾病保险保费调整的机制,为实践提供指导。

Objective： By constructing the cash flow model, it proposed the premium adjustment mechanism of critical illness insurance（CII）. Methods： Based on the practical data of critical illness insurance in China, it established some actuarial assumptions and cash flow model to simulate and analyze premium adjustment mechanism of CII. Results： （1） Because of the deterioration of critical illness incidence rate and the change of market interest rates , CII guaranteed premium usually resents pricing risk, which showed that the cash flow is negative, sometimes accumulated cash is negative; （2） based on the criteria of insurance cost adjustment, it is suggested that when the loss rate reached more than 70%, which could permit the insurance company adjust the premium, if the loss rate reached more than 80%, it needs to compulsory the insurance companies to adjust premium. Conclusion： The study proposes the mechanism of CII premium adjustment, provides guidance for practice.