- Email: [email protected]
083019 (M12, B20) Prämienbemessung und Prämiendifferenzierung in der Ruhensversicherung der Privaten Krankenversicherung
Abstracts and Reviews of Komya type approximations for the individual model. From the Poisson exponential example it can be seen that for the solution of the Volterra integral equation, the trapezoidal rule is sufficiently accurate. For the discrete case a local limit theorem for large claim numbers is derived.
Keywords: Total claim distribution, Ruin probability, Integral equation.
M12: MODELLING OF PORTFOLIOS AND
COLLECTIVES
083019 (M12, B20) Primienbemessung und Primiendifferenzierung in der Ruhensversicherung der Privaten Krankenversicherung. Wagner F., Zeitschrift fur die gesamte Versicherungswissenschaft, Volume 84, 1995, pp. 261-290 Any application for a new health insurance contract requires a waiting period because all previous illnesses and an increased age of entry are to be considered in the premium calculation. Considering this fact it is impractical to cancel a temporarily unused insurance policy only to apply for new coverage when need does arise. Suspended insurance coverage was developed to bridge this gap. The purpose of suspended insurance coverage is to ensure that the contractual parties' original rights and obligations are preserved for a determined period -- in particular, without effecting a waiting period, increase in premium level or exclusions from coverage due to increased age or illness in the meantime. In return, the policyholder agrees to pay a premium, significantly lower than that of the original policy, for suspended coverage. The theoretical refunding needs for suspended coverage in private health insurance policies are examined in the basis of a premium-cost-model. Principle statements regarding the level of premium prescribed can be derived from this model. The prevailing principles of practice for the calculation and differentiation of premiums for suspended coverage are presented and evaluated. This review concentrates on the issues of refunding and provisioning for old age. The evaluations are supported by empirical evidence on the average normalized invoice amounts for men and women of all ages for full insurance coverage (i.e., inand out-patient care, dental coverage including replacement) as observed in 1992. The essential conclusions are as follows:
149
1. The data on average invoice amounts show that lower suspended coverage premium levels are indicated for women rather than for men. Insurance practice reflects this through premium differentiation on the basis of gender. 2. As age of entry or the preliminary health insurance period increases, the prescribed premium for suspended coverage decreases. Insurance practice in this area differs. Some health insurers differentiate the suspended coverage premium based on these criteria, whereas others do not. Diverse means are used to achieve this differentiation which depend, in particular, on the degree of categorization according to age group and the preliminary health insurance period respectively. 3. Various types of health insurance coverage demand different levels of suspended coverage premiums. In-patient care prescribes relatively higher premium levels in suspended coverage than does outpatient care. Dental coverage, including replacement, requires, if at all, only very low premium levels for suspended coverage. Once again, some health insurers differentiate the suspended coverage premiums in practice according to the type of original coverage provided, whereas others do not. A technically "correct" suspended insurance coverage premium should he differentiated according to all the criteria mentioned. In practice, a differentiation which fulfills all the theoretical prescriptions cannot be found among health insurers. Differentiation on the basis of gender is commonplace. The methodologies used for further differentiation provide a mixed picture. This evaluation is neither singularly negative nor positive. Suspended insurance coverage premiums which are calculated according to less than the prescribed differentiation lead to a sort of cross-subsidization. The effects are, however, rather limited. Critical instances are: a. those suspended insurance policies where the policyholder is of advanced age or has a long preliminary health insurance period, b. those health insurance policies which exclude certain types of coverage (in-patient, out-patient or dental) for which a respective suspended coverage is unnecessary, and c. those suspended insurance coverage plans which arc not meant to extend to the entire original health insurance policy.
Keywords: Old age, Health insurance.
Keywords: Total claim distribution, Ruin probability, Integral equation.
M12: MODELLING OF PORTFOLIOS AND
COLLECTIVES
083019 (M12, B20) Primienbemessung und Primiendifferenzierung in der Ruhensversicherung der Privaten Krankenversicherung. Wagner F., Zeitschrift fur die gesamte Versicherungswissenschaft, Volume 84, 1995, pp. 261-290 Any application for a new health insurance contract requires a waiting period because all previous illnesses and an increased age of entry are to be considered in the premium calculation. Considering this fact it is impractical to cancel a temporarily unused insurance policy only to apply for new coverage when need does arise. Suspended insurance coverage was developed to bridge this gap. The purpose of suspended insurance coverage is to ensure that the contractual parties' original rights and obligations are preserved for a determined period -- in particular, without effecting a waiting period, increase in premium level or exclusions from coverage due to increased age or illness in the meantime. In return, the policyholder agrees to pay a premium, significantly lower than that of the original policy, for suspended coverage. The theoretical refunding needs for suspended coverage in private health insurance policies are examined in the basis of a premium-cost-model. Principle statements regarding the level of premium prescribed can be derived from this model. The prevailing principles of practice for the calculation and differentiation of premiums for suspended coverage are presented and evaluated. This review concentrates on the issues of refunding and provisioning for old age. The evaluations are supported by empirical evidence on the average normalized invoice amounts for men and women of all ages for full insurance coverage (i.e., inand out-patient care, dental coverage including replacement) as observed in 1992. The essential conclusions are as follows:
149
1. The data on average invoice amounts show that lower suspended coverage premium levels are indicated for women rather than for men. Insurance practice reflects this through premium differentiation on the basis of gender. 2. As age of entry or the preliminary health insurance period increases, the prescribed premium for suspended coverage decreases. Insurance practice in this area differs. Some health insurers differentiate the suspended coverage premium based on these criteria, whereas others do not. Diverse means are used to achieve this differentiation which depend, in particular, on the degree of categorization according to age group and the preliminary health insurance period respectively. 3. Various types of health insurance coverage demand different levels of suspended coverage premiums. In-patient care prescribes relatively higher premium levels in suspended coverage than does outpatient care. Dental coverage, including replacement, requires, if at all, only very low premium levels for suspended coverage. Once again, some health insurers differentiate the suspended coverage premiums in practice according to the type of original coverage provided, whereas others do not. A technically "correct" suspended insurance coverage premium should he differentiated according to all the criteria mentioned. In practice, a differentiation which fulfills all the theoretical prescriptions cannot be found among health insurers. Differentiation on the basis of gender is commonplace. The methodologies used for further differentiation provide a mixed picture. This evaluation is neither singularly negative nor positive. Suspended insurance coverage premiums which are calculated according to less than the prescribed differentiation lead to a sort of cross-subsidization. The effects are, however, rather limited. Critical instances are: a. those suspended insurance policies where the policyholder is of advanced age or has a long preliminary health insurance period, b. those health insurance policies which exclude certain types of coverage (in-patient, out-patient or dental) for which a respective suspended coverage is unnecessary, and c. those suspended insurance coverage plans which arc not meant to extend to the entire original health insurance policy.
Keywords: Old age, Health insurance.