重大疾病保险中的逆向选择问题研究
发布时间：2018-07-28 13:23
【摘要】：保险业作为现代社会的一种经济补偿手段,与银行、证券共同构成了现代金融领域的三大支柱,保险业的健康发展对一个国家的社会稳定、经济发展影响深远。重大疾病保险目前在国内比较流行,它是针对某些特定的、较为严重疾病而设计的险种。然而,目前我国重大疾病保险业尚处在起步阶段,发展不完善,各项规章制度不健全,因信息不对称导致的逆向选择问题比较严重。由于逆向选择问题的存在,保险人无法对投保人的风险进行完全有效地辨识,只能依据基础数据以及承保理赔记录分析结果得出经验。但经验分析结果往往与现实存在较大出入,据此计算出的保险费用也不尽合理,这就造成了保险市场上高风险投保人将低风险投保人挤出市场的“劣币驱逐良币”的现象。 本研究首先运用信息经济学的有关理论对重大疾病保险中的逆向选择问题进行理论分析,研究结合中国的实际情况,深入分析了重大疾病保险逆向选择问题的内在特征与规律；梳理和分析了重大疾病保险逆向选择的定义及行为界定；分析了重大疾病保险中逆向选择的危害；在此基础上,对重大疾病保险中的逆向选择问题进行了实证研究,并提出防范逆向选择风险策建议。其中,在实证研究中,本文以重大疾病保险这一具体险种为例,通过考察高保额与损失率之间的因果关系来识别因逆向选择而引引致的欺诈,即运用用多元回归模型和Tobit回归模型研究样本公司参保人投保特种疾病保险保额的高低与罹患特种疾病而产生的给付医疗、死亡理赔费用等变量问的相关关系,得出理赔拟失率与各相关变量间的关系的研究结论。
[Abstract]:As an economic compensation means in modern society, insurance industry, together with banks and securities, constitutes the three pillars of modern financial field. The healthy development of insurance industry has a profound impact on the social stability and economic development of a country. Major disease insurance is currently popular in China, it is designed for some specific, more serious diseases. However, at present, the insurance industry of major diseases in China is still in its infancy. The development is not perfect, the rules and regulations are not perfect, and the problem of adverse selection caused by asymmetric information is serious. Due to the existence of adverse selection problem, the insurer can not identify the risk of the insured completely and effectively, and can only get experience based on the basic data and the analysis results of the insurance claim records. However, the results of empirical analysis often differ from reality, and the calculated insurance costs are not reasonable, which leads to the phenomenon of "Bad money drives out good" in the insurance market where the high-risk policyholders crowd out the low-risk policyholders. In this study, we use the theory of information economics to analyze the problem of adverse selection in the insurance of major diseases. Combining with the actual situation in China, we deeply analyze the inherent characteristics and laws of adverse selection in the insurance of major diseases. The definition and behavior definition of adverse selection in major disease insurance are analyzed, and the harm of adverse selection in major disease insurance is analyzed. On this basis, the reverse selection problem in major disease insurance is studied empirically. It also puts forward some suggestions on how to prevent the risk of adverse selection. Among them, in the empirical study, this paper takes the major disease insurance as an example to identify the fraud caused by adverse selection by examining the causal relationship between the high coverage and the loss rate. That is, using the multivariate regression model and the Tobit regression model to study the correlation between the insured amount of special disease insurance in the sample company and the medical treatment, death claim cost and other variables caused by the special disease. The conclusion is drawn that the relationship between the pseudo loss rate of claim and the relevant variables.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：F842.684
[Abstract]:As an economic compensation means in modern society, insurance industry, together with banks and securities, constitutes the three pillars of modern financial field. The healthy development of insurance industry has a profound impact on the social stability and economic development of a country. Major disease insurance is currently popular in China, it is designed for some specific, more serious diseases. However, at present, the insurance industry of major diseases in China is still in its infancy. The development is not perfect, the rules and regulations are not perfect, and the problem of adverse selection caused by asymmetric information is serious. Due to the existence of adverse selection problem, the insurer can not identify the risk of the insured completely and effectively, and can only get experience based on the basic data and the analysis results of the insurance claim records. However, the results of empirical analysis often differ from reality, and the calculated insurance costs are not reasonable, which leads to the phenomenon of "Bad money drives out good" in the insurance market where the high-risk policyholders crowd out the low-risk policyholders. In this study, we use the theory of information economics to analyze the problem of adverse selection in the insurance of major diseases. Combining with the actual situation in China, we deeply analyze the inherent characteristics and laws of adverse selection in the insurance of major diseases. The definition and behavior definition of adverse selection in major disease insurance are analyzed, and the harm of adverse selection in major disease insurance is analyzed. On this basis, the reverse selection problem in major disease insurance is studied empirically. It also puts forward some suggestions on how to prevent the risk of adverse selection. Among them, in the empirical study, this paper takes the major disease insurance as an example to identify the fraud caused by adverse selection by examining the causal relationship between the high coverage and the loss rate. That is, using the multivariate regression model and the Tobit regression model to study the correlation between the insured amount of special disease insurance in the sample company and the medical treatment, death claim cost and other variables caused by the special disease. The conclusion is drawn that the relationship between the pseudo loss rate of claim and the relevant variables.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：F842.684
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相关期刊论文 前6条
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