保险理论

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《保险理论与实践》2025年第8辑目录
Sou Hu Cai Jing· 2025-08-09 00:39
Group 1 - The article discusses the significant opportunities and challenges faced by commercial health insurance in China due to the multi-dimensional drivers of healthcare reform and high-quality development in the medical and pharmaceutical industries [1] - It identifies the "adverse selection" problem in the personal commercial health insurance market as the root cause of high operational costs, low service efficiency, weak cost control, and limited coverage [1] - The article compares the development experiences of seven typical countries or regions, highlighting that a prosperous commercial health insurance market relies on various forms of government support [1] Group 2 - It emphasizes that a reasonable tax incentive policy and a shared payment model between employers and employees are crucial for the sustainable development of commercial health insurance [1] - The article proposes establishing a shared, account-based funding model to leverage corporate or institutional funding, thereby expanding the coverage and funding scale of commercial supplementary health insurance [1] - It suggests reforming the second pillar of enterprise group supplementary health insurance to provide new theoretical guidance and practical paradigms for the high-quality collaborative development of healthcare, pharmaceuticals, and insurance [1] Group 3 - The article analyzes Australia's high coverage policy for commercial health insurance, which includes various incentives and penalties to maintain coverage rates [3] - It notes that these policies have prevented the Australian commercial health insurance market from falling into a "death spiral," offering valuable insights for the sustainable development of China's health insurance initiatives [3] Group 4 - The article on Mexico's dual healthcare system highlights the disparities in funding and benefits between formal and informal employment populations, leading to sustainability issues [5] - It discusses the failure of the new INSABI system due to funding shortages and centralized management, resulting in a significant drop in coverage rates [5] - The article suggests measures to optimize and integrate the healthcare system, such as including family members of formal employees in the formal healthcare system and implementing regionally differentiated payment mechanisms [5] Group 5 - The article on poultry insurance emphasizes the importance of developing the poultry industry and adjusting breeding structures in China [6] - It identifies a mismatch between the current poultry insurance offerings and the actual risk management needs of poultry farmers [6] - Recommendations include enhancing government support, improving the poultry insurance service system, and aligning insurance products with industry development needs [6] Group 6 - The article on weather index insurance in Zhuhai discusses its role in supporting local aquaculture and stabilizing farmer incomes [7] - It identifies various risks faced by underwriting institutions, including natural disaster unpredictability and basis risk due to mismatches between weather indices and actual losses [7] - The article recommends strengthening meteorological monitoring systems and optimizing insurance product designs to mitigate these risks [7] Group 7 - The article on patent insurance highlights its significance in protecting intellectual property and supporting technological innovation [8] - It identifies challenges such as insufficient recognition of demand and a lack of market mechanisms that hinder the development of patent insurance [8] - Recommendations include building a comprehensive patent risk management platform and enhancing public awareness of patent insurance [8] Group 8 - The article on motor vehicle insurance fraud analyzes the increasing prevalence of fraud in the insurance industry, which disrupts market order and harms economic interests [10] - It identifies systemic issues such as ineffective underwriting processes and lack of supervision in claims handling [10] - The article proposes a multi-faceted approach to combat fraud, including legal reforms, technology integration, and public education [10] Group 9 - The article on exemption clauses in insurance contracts discusses their role in defining the insurer's liability and the disputes that arise from their complexity [11] - It emphasizes the need for clear understanding and application of these clauses to reduce market instability [11] - The article suggests establishing uniform standards for interpreting exemption clauses, especially in the context of internet insurance [11] Group 10 - The article on illegal "agent refund" practices highlights the systemic gaps in the insurance sales process that allow such issues to persist [12] - It calls for a comprehensive regulatory framework to protect consumer interests and enhance the integrity of the insurance market [12] - Recommendations include balancing consumer data protection with its utilization and expanding the obligations of insurance companies during sales [12]
《保险理论与实践》2025年第7辑目录
Sou Hu Cai Jing· 2025-07-12 01:03
Group 1 - Agricultural insurance plays a crucial role in food security, poverty alleviation, and rural revitalization, necessitating the enhancement of its productivity in the context of climate change and agricultural modernization [1] - Precision meteorological services are essential for improving agricultural risk management and production efficiency, but their high costs limit accessibility for small-scale farmers [1] - Combining precision meteorological services with agricultural insurance can significantly reduce agricultural production risks and enhance the effectiveness of the insurance system [1] Group 2 - High-standard farmland construction is vital for national food security and rural revitalization, with post-construction management quality being key to sustaining its functionality [2] - Several provinces have initiated pilot programs for high-standard farmland insurance, exploring market-based solutions for economic compensation and risk management [2] - Key issues in high-standard farmland insurance include insufficient policy support, the need for improved insurance schemes, and a lack of professional capabilities [2] Group 3 - The catastrophe bond market has evolved over nearly 30 years, becoming an integral part of the global reinsurance market, characterized by diversification and digitalization [3] - The paper analyzes the operational mechanisms, development stages, and challenges of catastrophe bonds, offering policy recommendations for the market's growth in China [3] Group 4 - The continuous growth of domestic insurance funds contrasts with the pressure on investment returns, creating opportunities for investment in strategic emerging industries [4][5] - Strategic emerging industries, supported by policies, present new avenues for insurance fund allocation, despite their inherent instability and "light asset" characteristics [5] - The paper discusses strategies for deep integration of insurance funds with emerging industries to enhance investment quality and support economic transformation [5] Group 5 - The integration of health insurance and health management is seen as a promising development, yet challenges such as value misalignment and quantifying health management outcomes persist [6] - Recommendations include incorporating preventive services into insurance claims, implementing guaranteed renewal mechanisms, and developing incentive-based health products [6] Group 6 - The rapid growth of medical insurance fund expenditures necessitates exploring avenues for preserving and increasing fund value [7] - Current limitations on fund interest rates and investment strategies hinder the potential for value growth, prompting suggestions for policy adjustments and investment operations [7] Group 7 - The dual-path model for seafarers' pension insurance faces challenges such as mismatched insurance types and structural imbalances in benefits [8] - The paper advocates for a sustainable contribution mechanism for seafarers within the employee pension insurance framework, addressing legal and practical barriers [8] Group 8 - The paper addresses practical issues surrounding the insurer's disclosure obligations in marine insurance, highlighting deficiencies in current legal regulations [9][10] - It proposes a restructuring of disclosure obligations and the establishment of a tiered disclosure system to enhance fairness and transparency in marine insurance contracts [10] Group 9 - The application of the principle of reasonable expectations in insurance law often leads to inconsistent judicial outcomes, necessitating a reevaluation of its interpretation [11] - The paper argues for a redefinition of the principle's application to improve its effectiveness in promoting economic efficiency and reducing information asymmetry [11] Group 10 - The rise in litigation cases related to professional liability insurance highlights the need for clearer regulations and optimized insurance practices [12] - The paper analyzes contentious points in insurance clauses and suggests improvements to enhance the operational framework of professional liability insurance [12]