China's insurance regulator has rejected scepticism about health
insurance sold in the country, calling for a proper understanding
of insurance products.
The China Insurance Regulatory Commission (CIRC) also on Friday
pledged to introduce measures to better regulate and standardize
health insurance, a sector with huge market potential given the
rising medical costs faced by Chinese people.
This was the first official response from the regulator
following media reports about a legal dispute over illness
insurance.
This has fuelled scepticism among consumers that health
insurance policies, particularly those covering major illnesses
such as hepatitis and cancer, do not cover what they promise
to.
A widespread anonymous email, which claimed that major illness
insurance policies being sold in China covered only death instead
of illnesses, added to the public's worries.
"This is not true, or at least inaccurate," Wang Zhichao, a
director at the CIRC, told reporters.
China Life Insurance Co, the largest Chinese life insurer, has
paid out 5.3 billion yuan (US$654 million) in claims for just two
major illness over the last few years, accounting for 23.24 percent
of its total claims for that period, the official said.
Other sources said some 90 percent of illness insurance payouts
by a number of insurers were paid out because of illnesses rather
than because of death.
"The basis for the pricing of major illness insurance is still
based on the number of illnesses, not on the mortality rate," Wang
said.
Health insurers around the world face the challenge of balancing
the rising demand for medical care and keeping costs under control,
the official said.
In China, health insurers face the task of making a profit under
the added threat of fraud, which analysts say is difficult to avoid
given a lack of monitoring systems.
More than 90 Chinese insurers, including four specialized health
insurers, sell health insurance.
They have marketed nearly 800 health insurance products, including
199 designed for major illnesses.
But losses at some Chinese insurance companies have been as high as
200 percent in recent years, meaning they paid out 2 yuan (24 US
cents) over every 1 yuan (12 US cents) of premiums they
collected.
"In the future we need to make an effort to more clearly define
major illness insurance, the types of illnesses and remedies that
are covered," Wang said. "This is something the entire industry
needs to do."
(China Daily March 18, 2006)