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Excluding thyroid cancer, serious illness insurance is expected to cut prices by 15%?
In recent days, the news that the regulatory authorities intend to revise the definition of critical illness disease and the incidence of severe illness experience has aroused widespread concern in the industry. “Removing thyroid cancer from the scope of critical illness insurance” has once again become a hot topic in the industry.
Why should we remove thyroid cancer from the category of serious illness? Because in recent years, the proportion of claims caused by thyroid cancer has risen rapidly, directly pushing up the claims expenses of critical illness insurance. According to the data of the insurance company's claims report in 2018, in the cases of heavy illness insurance, the proportion of thyroid cancer is between 12% and 20%, and the proportion of thyroid cancer is even more in the case of the 500,000 insured policy. Up to 50%.
The high incidence rate and more claims often mean higher product prices. Experts estimate that once thyroid cancer is removed from the critical illness insurance, it is expected to directly boost the price of the critical illness by about 15%.
Thyroid cancer claims increased to 12%-20%
Since 2019, the supervision of the relevant rules for improving critical illness insurance and health insurance has continued. First, the news that the regulatory authorities intend to revise the definition of critical illness insurance has gone away. Then, in March, the issue of "China's personal insurance industry" was issued. The Notice on the Relevant Matters Concerning the Revision of the Major Disease Experience Rate Table, the revision of the episode of the critical illness experience rate is put on the agenda. Recently, the “China Banking Regulatory Commission 2019 Regulation and Legislation Work Plan” published by the regulatory authorities has also shown that the revised The Health Insurance Management Measures are also expected to be officially introduced in 2019.
With the improvement of life expectancy, the change of the incidence of major diseases, and the improvement of medical technology, many of the rules concerning health insurance and critical illness insurance have indeed appeared to be incompatible with the real market. The thyroid cancer claims are heavy. One of the typical performances is the increase in the proportion of illness claims.
In recent years, the incidence of thyroid cancer has become a global trend, and it has also developed rapidly in China. A deputy chief physician of Huashan Hospital affiliated to Fudan University has revealed that the incidence of thyroid cancer in China has increased by about 4.6 times in the past ten years, and the growth rate of Shanghai has reached about 20% per year.
A research report by China Re Life Insurance also showed that more than 80% of the severe illness claims are concentrated on three types of diseases: malignant tumor, sequela of stroke, and acute myocardial infarction. They are mainly concentrated in malignant tumors, but women account for 81%, and men account for 54%. In malignant tumors, thyroid cancer accounts for a considerable proportion, of which the proportion of female thyroid cancer is 25%, and the proportion of male thyroid cancer is 11%.
Because thyroid cancer is one of the diseases that must be protected from severe illness, in recent years, the proportion of claims caused by thyroid cancer has risen rapidly, which directly pushed up the claims expenses of critical illness insurance. From the data of the insurance company's claims report in 2018, the proportion of thyroid cancer in the case of heavy illness is between 12% and 20%. At the same time, the proportion of thyroid cancer in the 500,000 insured policy has been as high as 50%.
Studies have shown that the incidence of thyroid cancer is inseparable from the extensive development of early diagnosis techniques such as ultrasound, CT and fine needle aspiration.The most obvious example is that in 1999 the South Korean government launched a national medical examination program, which included neck ultrasound. The results showed that the incidence of thyroid cancer in Korea increased by 15 times in 16 years. In 2018, the incidence of thyroid cancer in Korea was the highest in the world, and women even reached 18.1%.
The high-frequency and low-loss features of thyroid cancer do not match the knowledge of severe illness
According to the current "Regulations on the Definition of Diseases for Major Sickness Insurance" issued in 2007, thyroid cancer is a kind of malignant tumor, and malignant tumor is one of the six major diseases of insurance company major illness insurance, but with recent years People's understanding of the incidence of various diseases and the trend of heavy illness insurance claims has gradually found that it is not appropriate to continue to treat thyroid cancer as a major disease insurance.
The industry believes that major diseases should guarantee the risk of low frequency and high loss, and thyroid cancer is a risk of high frequency and low loss, which has the characteristics of high prevalence and low treatment cost, and does not meet people's recognition of major diseases. know.
It is worth noting that although thyroid cancer is high, its mortality rate is not high. According to the Global Cancer Report of 2018, the global thyroid cancer mortality rate is about 0.4%.
At the same time, the cost of treatment for thyroid cancer is also low. According to a claim case issued by a company, Ms. Chen, 33, went to the hospital for examination. The pathological diagnosis was the lowest malignant thyroid papillary carcinoma and no metastasis occurred. Chen girls have insured a total of 3 insurances, with a total of 550,000 yuan for critical illness insurance, and the actual medical expenses are only 12.5 million yuan.
According to the Chinese Health Statistics Yearbook, the per capita medical expenses of hospitalized patients with nodular thyroid tumors, the treatment cost per capita is less than 20,000 yuan, and will not cause a major burden on the work and life of patients.
Because the detection rate of thyroid cancer is higher, and after getting a serious illness insurance claim, in addition to a small part for treatment, other parts can also be used to improve life, to some extent, to increase the risk of adverse selection of policyholders, and even some people call it It is "like cancer."
Obviously, thyroid cancer is not in line with people's awareness of the serious illness, high cost of treatment, and long-term rehabilitation after illness. It is precisely because of this understanding that in recent years, around the need to thyroid cancer out of the scope of critical illness insurance, the industry continues to debate.
Actuaries have calculated that, if other variables are not considered, if the staged differentiated thyroid cancer is included in the non-insurance category, according to the disease incidence rate data, the critical illness insurance premium will be reduced by about 3%, the rate There is not much room for decline. However, claims support can be reduced by about 12%, and the effect of control fees is more obvious.
Some people have roughly estimated that after thyroid cancer is removed, the price of heavy illness will be reduced by about 15%; there is even more optimistic expectation that the price reduction of critical illness insurance may reach more than 20%.
In March 2019, the "Notice on the Relevant Matters Concerning the Revision of the Experience Rate Table for the Major Diseases in China's Personal Insurance Industry" has also been issued. It is believed that the overall probability of serious illness has increased in recent years. After the revision of the rate schedule, it will push up the price level of critical illness insurance, but the more mainstream view is that even if the incidence of other major disease experiences has increased, as long as the thyroid cancer is excluded from the critical illness insurance coverage, the overall price of critical illness insurance There is still a large room for decline.
Behind the hot discussion, the critical illness insurance has become an important growth pole in the life insurance market.
It is worth noting that critical illness insurance has become one of the most important growth poles in the personal insurance industry.
The data shows that the premium income of sickness insurance reached 205.3 billion yuan in 2018, accounting for 65.2% of the health insurance business. The disease insurance is mainly based on severe illness insurance. The critical illness insurance accounts for 89.42% of the disease insurance premiums, and the critical illness insurance premium growth rate reaches 41.4%.
The best-selling product data of several listed companies also confirmed this. Xinhua Life Insurance's 2018 annual report disclosed that there are 3 major illness insurances in the top 5 insurance products with premium income, and only health care and worry-free C major illness insurance premiums. It reached 7.382 billion yuan.
The category of critical illness insurance products is also becoming more and more abundant. The 3.5% pre-determined interest rate insurance is comprehensively listed to replace the previous products; the non-dividend insurance-type severe disease has become the mainstream product; the mild extra payment has become the mainstream responsibility, and the mild exemption liability has begun to appear. The products that have been repeatedly paid for severe illness have also begun to increase; the number of diseases has been further increased, and the total number of major and minor diseases has exceeded 100.
For insurance companies, the development of critical illness insurance is undoubtedly the most secure option for health insurance development. Under the current medical insurance payment system, the development of loss-compensated commercial medical insurance requires that insurance companies have strong underwriting, verification and risk control capabilities, and still face strong difficulties and challenges. Critical illness insurance is a fixed-paying business, which is more similar to life insurance. It also has low requirements for risk control capabilities of insurance companies, and its demand for health management is weak. In the short run, critical illness insurance will remain the main product.
For consumers, with the prolongation of life expectancy, the incidence of malignant tumors and cardiovascular and cerebrovascular diseases is gradually increasing. After the tragic encounters caused by various major diseases, when insuring insurance, the first choice of a major illness insurance has become A very natural choice.
In this situation, if the price of critical illness insurance declines, it will undoubtedly further stimulate consumers' enthusiasm for insurance.
It is understood that in many other countries and regions, thyroid cancer has actually been removed from the scope of critical illness insurance. However, is it true that all thyroid cancers need to be removed from critical illness insurance?
It is reported that 90% of thyroid cancer is differentiated thyroid cancer, and its 10-year survival rate is higher than 90%. Among them, the proportion of low- and moderate-risk differentiated thyroid cancers in stage I and stage II is more than 95%; although differentiated thyroid cancer and undifferentiated thyroid cancer in stages III and IV are relatively low, The prognosis is poor, and there is a view that it is not appropriate to remove the disease from the critical illness.
How to eliminate it is another problem. Some people think that it can be directly removed. Some people think that it is possible to put in a mild responsibility. For example, in the definition of serious illness in Hong Kong, thyroid cancer with stage I and below does not include In the case of severe illness, stage I thyroid cancer is a mild range.
From the current point of view, after the revision of the definition of critical illness insurance, the design of critical illness insurance products may have undergone major changes. The more mainstream view is that it will give more choices to insurance companies and may choose to further narrow down. The scope of protection will exclude mild malignant tumors including thyroid cancer, and at the same time give products a lower price; you can also choose to expand the scope of protection according to the regulations, while increasing prices. More flexible product design and pricing for critical illness insurance may be coming.
Editor in charge: Li Limeng RF13188
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