According to surging news reports, the Life Insurance Department of the State Administration of Financial Supervision and Administration recently issued a document to all insurance companies and the Insurance Association of China to solicit opinions from all units on the "Notice on the Smooth and Orderly Development of Urban Customized Commercial Medical Insurance (Draft for Comments)", requiring feedback by email before January 12.
The so-called urban customized commercial medical insurance, commonly known as "Huimin Insurance", is an institutional innovation for commercial insurance to participate in a multi-level medical insurance system. As an inclusive commercial health insurance, Huimin Insurance has covered more than 100 cities across the country with the advantages of low insurance threshold, high insurance amount and affordable price. Moreover, there are also some gaps in the amount insured and the amount insured of the Huimin Insurance products launched in different cities. As little as 100 yuan to cover millions, and as much as 2 or 300 yuan to cover millions. The number of residents participating in Huimin Insurance is also increasing.
Due to the rapid promotion of Huimin Insurance and the great attraction, the vast majority of residents who have purchased Huimin Insurance products do not have a comprehensive understanding of the specific situation of Huimin Insurance, but only see that others have bought it, and the insurance amount given is very large, so they buy it together. As for what exactly can be guaranteed after purchase, it is not known. Therefore, it is not clear whether you can add a safety net to your medical insurance after purchasing Huimin Insurance products. As a result, when there is a real problem, the insurance company cannot fully pay compensation in accordance with the insurance liability, resulting in serious damage to the interests of the policyholder.
In fact, according to the actual situation of Huimin Insurance products, if the insurance company really pays as advertised, it is estimated that few insurance companies can afford it. So, why are insurance companies still going against the wind, knowing that the risks are extremely high, but still willing to take risks? A very important reason is that the insurance liability is ambiguous, and the scope and amount of compensation are very operable, and the policyholder is very likely to not be able to get the protection he deserves as he imagined. Otherwise, Huimin Insurance will become the second universal insurance, which will bring a relatively large risk of compensation to the insurance company.
Not only that, Huimin Insurance products can be accepted by the majority of residents, in addition to the commitment to the insurance amount is very large, very attractive, and the strong participation of government functional departments is inseparable, they use government credit to endorse Huimin Insurance products, so that the majority of residents overly believe in the insurance of Huimin Insurance products. In fact, when there is a contradiction in compensation, the government functional departments cannot give help to the policyholder, and the government's endorsement is only an endorsement, which is for the endorsement of the insurance company, not for the policyholder. It is precisely because of this that insurance companies dare to exaggerate publicity, make improper promises, mislead policyholders, and induce residents.
We said that as a measure to benefit the people, if the insurance company can really fulfill the terms of the commitment, it is indeed very beneficial to the policyholder, and it is also a positive supplement to medical insurance. The key point is that the insurance company has not formed an effective bridge between product promotion and compensation liability, but there is a relatively large gap, and there is a phenomenon that the fulfillment is much less than the promise. At that time, the interests of the policyholder will not be protected.
It is precisely because of this that the State Administration of Financial Supervision and the National Medical Security Administration should issue relevant documents to supervise and standardize Huimin Insurance. In particular, the Draft for Comments points out that "areas with mature conditions can be explored and promoted, and areas with immature conditions should not blindly follow the trend". The meaning is very clear, Huimin Insurance is still in the process of exploration, and has not formed a mature system and system, whether it is an insurance company, a policyholder, or a government regulatory department, they are still feeling the stones to cross the river. At least, it needs to be more rational, scientific and objective, and it is necessary to establish a completely transparent information mechanism between the insurance company and the insurance, rather than the content in the insurance company, the form in the policyholder, what the insurance company thinks, the policyholder is not clear, and what the policyholder hopes is impossible to be reflected in the Huimin Insurance product. Naturally, it is necessary to promote the Huimin Insurance policy more cautiously to avoid blind follow-up and hasty introduction of the Huimin Insurance policy, especially the phenomenon of unlimited expansion of the benefits of Huimin Insurance products.
From the perspective of the areas that have launched Huimin Insurance products, the design of insurance rates is seriously lacking in basic data support. How the data of the medical insurance department can be provided to insurance companies without affecting the information security of residents is also a difficult content to grasp at present. If the basic data is not sound and does not run smoothly, the rate design of Huimin Insurance products will be very different from the actual situation, and insurance companies may use the phenomenon of unlimited high insurance amount in order to promote Huimin Insurance products, and the contradiction of compensation will be greater. Otherwise, the insurance company simply cannot afford it. Therefore, in this regard, it is also necessary for the regulatory authorities to come up with better opinions and methods to avoid insurance companies from designing rates that are completely unrealistic. So, can such a combination be found between the medical insurance department and the insurance company, and how can the regulatory authorities strengthen the supervision of Huimin Insurance?