Commercial health insurance

Author: Zhang Xiao
Publisher:
Publish Date: 2004-07-01
Features: This book is one of the series textbooks for medical insurance majors in higher education institutions. The entire book is divided into ten chapters. Chapter 1 introduces the basic concepts, characteristics, functions, types, development history of commercial health insurance, as well as an overview and development trends of commercial health insurance in China. Chapter 2 focuses on introducing the product forms and classifications of commercial health insurance. Chapter 3 elaborates on the characteristics, elements, forms of commercial health insurance contracts, as well as the establishment, effectiveness, performance, modification, and dispute resolution of contracts. Chapter 4 discusses the influencing factors of the commercial health insurance market, the constituent elements of sales, sales principles, strategies, channels, processes, and techniques. Chapter 5 focuses on discussing the basic knowledge of underwriting for commercial health insurance, the principles, processes, and management of underwriting work, as well as individual health insurance underwriting, group health insurance underwriting, and critical illness underwriting. Chapter 6 introduces the concepts, principles, objectives, claims process, and claims management of commercial health insurance. Chapter 7 introduces the basic knowledge of actuarial science in commercial health insurance, with a focus on product rate setting and pricing, reserve contributions, regulation, and the principles and key considerations of commercial health insurance product design. Chapter 8 introduces the connotation, significance, principles, and policy maintenance of customer service in commercial health insurance. Chapter 9 discusses the organizational system of commercial health insurance and the identification and management control of operational risks. The book finally introduces common medical knowledge related to commercial health insurance in Chapter 10. This book can be used for teaching in medical insurance and related majors in higher education institutions across the country. It can also serve as a training textbook for commercial health insurance companies, insurance intermediaries, and healthcare service providers. Additionally, it can provide research references for other relevant personnel.