The regulator issued a document again
Regulate short-term health insurance business
(1) Stop "0 yuan in the first month"
and "drug transfer", standardize the "Rubik's Cube" business
(2) It is strictly forbidden to have a "0" rate
It is not allowed to be changed through the endorsement in violation of regulations
(3) The surrender portal should be provided in a conspicuous manner
Retrospective adjustment of pricing to ensure business sustainability
1
Short-term health insurance that continues to evolve rapidly
Supervise the continuous issuance of documents to regulate business within three years
1. The "Golden 8 Years" of Short-term Health Insurance: Premiums Doubled by 5 Times, with a CAGR of 32%!
In 2016, with the characteristics of "high insurance amount and low premium", "million medical" insurance exploded out of the circle, and subsequently, the low-threshold Huimin Insurance landed in more than 100 cities.
Suddenly, this type of short-term health insurance has become one of the most familiar insurance products for consumers, and it is also the first product that many people buy.
As a result, short-term health insurance has also entered a golden period of development.
Judging from the health insurance business data of property insurance companies, the premium growth rate has been maintained in double digits in the past eight years, and the growth rate has continued to exceed 25% in the first five years.
In 2020, short-term health insurance has become the second largest insurance type in the property and casualty insurance industry, and its market share has also increased from 3% in 2016 to 10.6% in 2022.
2. The fastest innovation, and there are many controversies: guaranteed renewal, 0 yuan in the first month, alienation as "selling drugs"...
With the rapid development of short-term health insurance, the innovation and iteration of related products are also accelerating, such as the addition of special medical treatment, overseas medical treatment, outpatient and emergency care, and family sharing deductibles.
However, in the process, a lot of problems were also exposed...
For example, the "guaranteed renewal" of short-term health insurance is not compliant, 0 yuan in the first month involves gimmick marketing, and medical insurance for specific drug costs does not meet the design principles of insurance products.
Therefore, in order to regulate the development of the industry, the supervision has also issued a number of documents since 2021.
The first is to standardize the terms and conditions of short-term health insurance, making it clear that it shall not contain "automatic renewal", etc., and the second is to suspend some "drug insurance" business.
2
Regulatory documents are issued to regulate the "Rubik's Cube" business
It is strictly forbidden to have a "0" rate and not to change it in violation of regulations
Today, the State Administration of Financial Supervision issued the "Notice on Further Improving Matters Related to Short-term Health Insurance Business", once again regulating the development of short-term health insurance, and pointing to the "Rubik's Cube" business, as shown in the figure below.
1. The regulator once again issued a document emphasizing that the "0" rate is strictly prohibited!
At present, since the sales of many short-term health insurance products are mainly based on Internet platforms, the related sales disputes surrounding this product are also exposed more quickly.
For example, in the early days, gimmick marketing methods such as 0 yuan in the first month, with the cooperation of some insurance companies and Internet platforms, quickly helped companies to expand the scale of premiums.
However, because many consumers do not know that this is a monthly payment product with automatic deduction, it has also caused a lot of consumer disputes.
In this regard, the regulator has also issued risk reminders many times, pointing out that the so-called "0 yuan in the first month" is actually a premium spread to the later stage, which is not really beneficial.
In order to regulate this problem, in the previous "New Regulations on Internet Life Insurance", it was also clearly pointed out that the amount of each installment should be the same for installment payment products.
At the same time, because of routine marketing problems such as "0 yuan in the first month", two insurance brokers were punished.
In the new regulations, the regulator once again emphasizes that the pricing of short-term health insurance should be scientific and reasonable, and the rate structure of the product shall not be changed by arbitrarily adjusting actuarial assumptions, etc., and it is strictly forbidden to have various situations that obviously do not conform to actuarial principles, such as "0" rates.
2. "0 yuan in the first month" was stopped, and the "Rubik's Cube" business started again?
Although the previous supervision has stopped the "0 yuan in the first month" business, a new sales model has emerged in the market, which is called the "Rubik's Cube" business by industry insiders.
To put it simply, it is to first acquire customers through medical insurance with low premiums, low insurance amounts, and high deductibles such as "1 yuan in the first month".
Then, guide it to "upgrade" to purchase conventional medical insurance and other products.
In this way, regulatory requirements such as "0 yuan in the first month" can be circumvented.
This is also the reason why when you sweep a shared bicycle, share a charging treasure, or watch a short video, you will still see promotions such as "1 yuan in the first month" to buy insurance.
Recently, there have been many consumer complaints that the elderly at home mistakenly believed in the "1 yuan in the first month" discount, and then were continuously deducted, and applied for surrender only to find that the purchased products were inexplicably upgraded...
3
The surrender portal should be provided in a conspicuous manner
Retrospective adjustment of pricing to ensure business sustainability
1. Do not change through endorsement in violation of regulations! The surrender entrance should be provided in a conspicuous manner!
Therefore, in order to standardize the development of short-term health insurance business in all aspects, the notice regulates product design, sales management, customer service and other aspects.
For the problem of inexplicable product upgrades, the regulator requires that insurance companies shall not make changes at will through approval and other means in violation of regulations.
At the same time, if the content of the contract changes, it is necessary to remind consumers of the work.
In addition, in response to many people's feedback, after scanning the code and riding, the insurance purchased inexplicably deducted every month, but they don't know where to unbind.
The new regulations require insurance companies to fully online access to services such as claims settlement and complaint complaints for products sold through online platforms.
Moreover, these entrances such as surrender and online preservation should be provided in a conspicuous way!
2. Quality is related to sales expenses, and pricing is adjusted retrospectively to ensure sustainable operation!
In addition, in recent years, although the short-term health insurance business has brought a large amount of premiums to property insurance companies, it has been losing money year after year in terms of profitability.
Taking 2022 as an example, 49 property and casualty insurance companies that disclosed health insurance business data will have a cumulative loss of 1.05 billion.
At the same time, according to the disclosed data on the loss ratio of individual short-term health insurance, the loss ratio of many companies is low.
This has also led many people to question the problem of "high compensation and low fees" in the health insurance business.
For details, see "139 Insurance Companies' Individual Short-term Health Insurance Loss Ratio! Low payout ratio? These are questions to consider..."
In this regard, the new regulations also emphasize that insurance companies should establish and improve the linkage mechanism between quality and sales expenses.
At the same time, insurers need to retrospectively adjust actuarial assumptions such as product pricing incidence to ensure the sustainability of business operations.
Finally, the regulatory authorities also said that they will continue to pay attention to and monitor the operation of the short-term health insurance market, and seriously deal with relevant institutions and responsible persons with obvious loopholes in product design and more complaints in accordance with laws and regulations.