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费用补偿型医疗保险是当前商业健康保险的重要组成部分,也是最受消费者欢迎的产品之一,《司法解释三》的执行对保险公司经营该产品的赔付风险和市场竞争有重大影响。本文首先介绍了《司法解释三》中影响该产品的相关规定,然后分析了《司法解释三》下商业保险公司面临的赔付风险增加、产品设计挑战和市场竞争出现新形态,最后对保险公司经营该产品从风险管理、产品开发、运营管理等提出相应的建议。
Expense compensation medical insurance is an important part of the current commercial health insurance and is also one of the products most popular with consumers. The execution of Judicial Interpretation III has a significant impact on the insurance company’s risk of payment and market competition. This paper first introduces the relevant provisions in Judicial Interpretation 3 which affect the product, and then analyzes the increasing risk of the commercial insurance companies facing the payment risks under the “Judicial Interpretation III”, the product design challenge and the new form of market competition. Finally, The product from the risk management, product development, operations management, etc. made the appropriate recommendations.