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医责险综合成本率居高不下 保费增长靠“吃政策饭”

2017-08-11 11:42:49   中国经济网

在和谐医患关系、化解医患纠纷方面,医责险被寄予了厚望。

从最近几年的发展来看,我国医责险保险市场规模在不断扩大,但业内人士指出,其发展离不开外在力量的推动,尤其是相关半强制性政策的推动。

相关数据显示,2014年,我国医责险实现保费收入18.8亿元,为各级医疗机构提供风险保障338亿元。2015年,我国医疗责任保险保费收入23.64亿元,为各级医疗机构提供风险保障506.1亿元。2016年,医责险的保费收入约为28.02亿元。今年上半年,尽管目前没有公开医责险的单方面数据,但保监会的数据显示,责任险保障总金额96.81万亿元,同比增长76.49%,较去年同期上升43.52个百分点;赔款支出85.73亿元,同比增长20.13%,医责险、环责险、食品安全责任险等都是主要的责任险产品。

从各地来看,山东、广东等地方也都在大力推进医责险的发展。参与方包括卫计委、医生协会、医疗机构等。“对三甲等公立医院的强制投保是医责险实现较快发展的重要原因。”一位业内人士表示。但从目前来看,这一市场还存在“挤牙膏”现象,就是政府推一下,市场就往前走一下,不推则不动。

究其原因,一方面,大型医疗机构存在风险大、保费高的特点,部分医疗机构购买意愿不强,宁愿自担风险;另一方面,级别较低的医疗机构和民营医疗机构尽管有市场需求,但保险公司的积极性又不强,供需还存在错位的情况。

同时,记者了解到,目前保险公司开展医责险的综合成本率依然处于较高的水平。“情况不好的结果是赔穿了,情况好一些的也只能做到微利。”海绵保总裁陈明光表示,由于医责险业务具有一定特殊性,其赔付结果不仅和技术相关,还混合了很多社会因素,因此,该项业务也比较复杂。

(以上信息摘自《中国证券报》《证券日报》)

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