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💴 | Old age of "one person".What kind of measures do you need?


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Old age of "one person".What kind of measures do you need?

 
If you write the contents roughly
You don't need to have expensive life insurance, but you should consider taking out medical insurance for medical treatment and hospitalization due to illness or injury.
 

There is no clear definition of one person, but mainly those who are reaching the marriageable age ... → Continue reading

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Life insurance

Life insuranceWhat is (seimei hoken)?A humanThe purpose of guaranteeing the loss due to the survival or death ofinsurance.life insuranceAbbreviated as (seiho).

Life insurance theory

Life insurance accidents are life or death[1].. In other words, it is insurance to prepare for the economic burden due to the reduction of income in households due to death of people and the aged[1].

How life insurance works

In the current life insurance, statistical data related to life and death of human beings, that is,Life tableIs always used. That is, an appropriate insurance premium is set based on the life or death prediction of the subscriber based on the life table.

However, since only the data from the past to the present is used for the death statistics, the actual life and death is expected to occur in the future, and thus the prediction may naturally have an error. In such a case, the premium income should not be insufficient, so the mortality rate used for calculating the premium is expected to be safe in advance. The mortality rate at this timeExpected mortalityIs one of the important parameters for calculating premiums.

Basic form of life insurance

Although some life insurance products are complex, they are all variants or mixed forms of death insurance, life insurance, and life-and-death mixed insurance.[2].

Death insurance
Death insurance is insurance that is paid when the insured dies.[2].
Term insurance is a typical example of pure death insurance. Since there is no maturity insurance for term insurance, it is designed to pay all premium income as death insurance by the time of maturity. As a result, policy reserves are zero at maturity and generally do not increase much over the life of the policy.
Survival insurance
Life insurance is insurance that is paid only when the insured is alive after a certain period of time.[2].
Life annuity is a form of life insurance. It can be thought of as a combination of multiple survival insurances, such as the first pension if the person survives one year after the start of pension payment, the second pension if the person survives two years later, and so on.
Life and death mixed insurance
Life and death mixed insurance is a combination of death and survival insurance[2].
Endowment insurance is a one-to-one blend of the above death insurance and survival insurance, and the same amount of insurance is paid when you die during the insurance period and when you are alive at maturity. In addition, whole life insurance extends the insurance period of endowment insurance when the number of survivors on the life table becomes zero. At that time, it depends on the company, and the theoretical maturity is around 1 years old.

Insurance collection method

Natural insurance method and normal insurance method

The insurance premium rate for life insurance is calculated based on the mortality rate for each age, but there are roughly two ways of thinking about it: the "natural insurance premium method" and the "normal insurance premium method."

The "natural insurance premium method" is a method of collecting insurance premiums according to the mortality rate of each age of the subscriber. Generally, the higher the aging rate, the higher the mortality rate. Rises with age.
The “normal insurance premium method” is a method that eliminates the disadvantage that the insurance premium becomes too high in the natural insurance premiums as the elderly gets older, and the policyholder cannot bear the insurance premium burden. Collect insurance premiums that average the mortality rate by age group. For this reason, insurance premiums do not rise even when the insurance period is near the end (that is, elderly).
Level insurance and policy reserve

If the normal insurance method is adopted, the insurance premiums, which should have been paid after becoming old, will be paid in advance when younger.As a result, life insurance companies will collect future insurance premiums in advance and retain them. You are doing it. This reserved fund is called the policy reserve. Since there is a policy reserve for each policyholder of the level insurance premium method, it will be a large amount of money in total, and the life insurance company can operate based on this and make a profit. This is the face of a life insurance company as a financial institution.

Actual insurance premiums are discounted in anticipation of such operational gains. The operating interest rate is planned in advance to calculate this discount. This interest ratePlanned interest rateThis is also an important parameter for calculating insurance premiums.

Cancellation refund

If the standardized premium method is adopted, insurance premiums that are not originally required are collected in advance, so if you cancel your insurance contract for any reason during the insurance period, one of those premiums will be The department is returned to the contractor. This is called a cancellation refund.

The policyholder's creditor may seize the right to request the cancellation and refund and exercise the cancellation right based on the right to collect it before collecting it.[3].. Also creditorsCreditor subrogation rightThe cancellation right may be exercised based on[4].. However, if this is done, it may threaten the insurance recipient's future life.Therefore, in certain cases, there is a system in which the insurance recipient pays the amount equivalent to the cancellation refund to the creditors, etc. to avoid cancellation. It is provided (intervention right, Article 60-62 of the Insurance Law).

In principle, the cancellation refund will be refunded.Temporary incomeIn the case of one-time payment endowment insurance, etc., if the contract is canceled within 5 years from the contract date, it will be treated as a financially similar product and will be subject to a uniform 20% (reconstruction special for 2013 years from January 1). 25% including income tax)Withholding taxIs applied[5].

Three interest sources and dividends

Life insurance premiums consist of net premiums and additional premiums. Net insurance premiums are insurance premiums collected for payment of insurance money, and additional insurance premiums are insurance premiums collected as business expenses of the insurance company. Many insurance companies do not publish a breakdown of net and supplemental premiums,Life net lifeIs one of the few insurance companies that publishes a representative example of these breakdowns.

The amount required as a net insurance premium is determined based on the mortality rate of participants and the operating interest rate of policy reserves as described above, and the planned values ​​used at that time are the planned mortality rate and the planned interest rate, respectively.

Life insurance surcharges are collected under the names of new contract costs, contract maintenance costs, and insurance premium collection costs. For these, the insurance premium is calculated in anticipation of the necessary amount in advance, and the rate at that time is called the planned project cost rate.

Since the planned mortality rate, the planned interest rate, and the planned project cost rate are only estimates, there will be a difference from the amount actually required as insurance premium. Each of themDeath margin,Profit,Cost marginAnd combine these threeThree sourcesCall. Since the actual forecast is set with a considerable margin so that insurance premium shortage does not occur, the difference basically occurs as surplus (for the problem of reverse Zaya (profit loss), refer to the "History" section). .. Since these surpluses are money that did not have to be collected as insurance premiums as a result, the insurance company returns the surpluses to the policyholder. This is called a dividend.

However, in recent years, in order to meet the need to reduce insurance premiums, there is no dividend at all, or only profit margins are returned as dividends, and insurance products of a type in which the insurance premium is reduced in advance are also designed. ing.

Risk selection

In life insurance, it is necessary to form an insured group with the same risk in order to comply with the principle of income and expenditure, etc., but there is always the possibility that an act of unreasonably trying to profit may occur behind it. is there. In other words, it is inherent in the relationship between the life insurance company and the subscriber.Information asymmetrycaused byMoral Hazard,Reverse selectionCan always occur.

Therefore, life insurance companies make risk choices to protect insured groups with the same risk. Specifically, at the time of joiningDoctorMedical checkups, notices, etc. are used to identify subscribers who are considered to be at greater risk than the standard risk. However, that does not mean that such subscribers cannot be insured. If an insured group with the same risk as that of the member can be formed, it is possible to take out insurance with an appropriate premium for the group.

In addition, when payment is made, reassessment is conducted to prevent insurance fraud.

Life insurance products

Personal insurance

Individual insurance refers to a contract in which the insured person is the individual. It is called individual insurance in the following meaning for group insurance. In addition, the insurance contract when the contractor is a corporation may be called corporate insurance (business insurance).

The main purpose is death protection in Japanese private insurance, and the major insurance products currently on sale are described below.

Term insurance
Life insurance that provides benefits for death within a certain period of time. This is a so-called “discard” insurance, which guarantees only death, so there is no maturity insurance when the insurance period expires. Cancellation refunds are generally small if you cancel the contract in the middle (however, if the insurance period is long, such as 60 or 70 years, the amount of cancellation refunds in the latter half of the contract will be reasonably large). Because the insurance premium for the amount of money covered is relatively low, it is used when a large amount of money is needed for a certain period of time, such as a householder until the child grows up. In recent years, in order to respond to the need to reduce insurance premiums and increase the amount of insurance, products that do not have any cancellation refunds have been developed in the case of early termination.
Generally speaking, the term "term insurance" has a fixed amount of insurance during the insurance period, but there are cases where the amount of insurance increases or decreases during the insurance period. These terms are called "increasing term insurance" and "decreasing term insurance", respectively. (Because all future insurance amounts are fixed at the time of contract,Variable insuranceDifferent from).
Life insurance
Insurance that is guaranteed for a lifetime without defining an insurance period. If you die, you will always be paid an insurance premium, so compared to regular insurance, the insurance premium for the amount guaranteed is higher. If you cancel your contract in the middle, you will often get a cancellation refund, but it is usually less than the total amount of premiums paid, and the shorter the number of years elapsed after contracting, the smaller the refund. The increase/decrease in the cancellation refund amount depends on how the payment period is set. If you pay all insurance premiums at the age of 60 (payment period is 60 years), the cancellation refund will generally be higher than the insurance premium paid at around the age of 60. On the other hand, if insurance premiums are paid for a lifetime (whole life payment), there are many cases in which the amount paid is more than the amount paid at the end of the 70s, depending on the time of enrollment.
Endowment insurance
Of course, if you die within the insurance period, you will be paid insurance, but if you are alive at the time of maturity, the same amount as the insurance amount will be paid as a refund for maturity. When the contract expires, the dividend is usually paid in addition to the maturity repayment money, so it is called "savings type" because it can receive more than the paid premium. There may be no savings depending on the age and insurance period at the time of enrollment. This is a combination of life insurance and death insurance in the same amount to reduce the risk associated with insurance benefits and enhance the savings.
Life insurance with term insurance
A combination of life insurance and term insurance. Security can only be increased when large death coverage is needed, as it was before the child grew up. It is the main product in companies that do not sell account type.
There are approximately 1,473 million contracts and approximately 317 trillion yen (as of the end of September 2007) of insurance contracts, and this insurance amount is about 9% of the individual insurance contract of approximately 1,002 trillion yen.

Universal insurance

An insurance product that has been introduced in the United States since the 1970s, it is an insurance that allows you to review insurance premiums and change the content of insurance depending on the life stage. In the United States, it was the mainstream insurance product by the 1990s, but due to various problems such as instability of premium income, most insurance companies in Japan did not introduce it.

Account type insurance
This is a relatively new product, where a certain amount of a certain amount of insurance premiums is allocated to term insurance each time, and the rest is allocated to a fund called an account (account), and after the termination of term insurance, it is a type of insurance that transfers to one-time lifetime insurance or pension ..

It was first developed and introduced by Meiji Yasuda Life in Japan. It is said that the above-mentioned universal insurance was used as a reference during development.

Child insurance (academic insurance)
Insurance that allows you to pay a congratulatory money depending on the age of your child and the entrance time to elementary/junior high school/high school, and receive insurance money at the time of maturity. In addition, when the parent dies, the subsequent payment of insurance premiums may be exempted (the contract lasts until maturity), or the child may be subsidized. In reality, it is an insurance product that combines survival insurance with the insured child and death insurance with the insured parent.
Personal pension insurance
An insurance product that pays insurance premiums for a certain period of time and uses the funds from the insurance premiums as a source of funds to receive the annuity defined by the contract. A type of survival insurance.
Variable insurance
At the rate specified by the contractor during the insurance periodstock-BondAn insurance product in which the amount of death insurance, the amount of surrender and refund, and the amount of maturity insurance change according to the results of investment/operation instructions to such assets (funds). In general insurance, the amount of insurance specified at the time of contract does not change during the contract period (called fixed-rate insurance). General life insurance is poorly adaptable to inflation, and was born as a supplement to fixed rate insurance as an insurance against inflation. In the United States, it has developed in recent years as an insurance product that replaces universal insurance by suppressing the outflow of funds to stock markets such as stocks and bonds.

In addition, there are various types of insurance products, but it can be said that most of them are combined by changing the amount and period of basic death and survival insurance. After 2000Third sector insuranceProvided by a private insurance company in line with the lifting of the banmedical insurance・ ・Disability insuranceIs also a type of life insurance.

Main types of covenants

The special contract is a life insurance option that can be added as a special contract to main contracts such as life insurance and term insurance. In the case of term life insurance, the official name is "life insurance with term insurance," so it is a life insurance term based on the term insurance itself. Of course, the premium will be added to the insurance premium.

Medical treaty
It is common for people to receive a prescribed amount of money when they are hospitalized due to injury or illness (disaster hospitalization/illness hospitalization covenants).
Long-term care insurance special contract
You can receive benefits etc. if you need to receive nursing care. However, there are some cases where the payment conditions are stricter than those of the nationally recognized first-grade persons with disabilities.
Living needs special contract
A treaty that some of the insurance amount will be paid before birth when it is judged that the remaining life will be several months due to cancer. It is also called living benefits.
Nursing needs special contract
A special provision that some of the insurance amount will be paid before birth when a person becomes in need of care.
Disaster surcharge
In addition to the usual insurance premiums, in the event of death from a disaster or accident, a special premium insurance premium will be paid.
The life insurance of Japan Post Insurance is automatically attached.
Insurance exemption special contract
A special treaty to continue insurance after exempting payment of insurance premiums during the period of hospitalization or leave of absence due to a specified illness or accident. It can be called "insurance insurance".

Group insurance

Group insurance is a type of life insurance that guarantees all persons who belong to an organization such as a company or a public office. A contract is signed directly with the group and the life insurance company, and its members are collectively covered by a single contract. Since large-scale processing can save operating costs, insurance can often be obtained at a lower cost than individual insurance.

Group term insurance

A term insurance product for the purpose of employee death protection at companies. The insurance period is one year, and it is automatically renewed after one year.

General welfare group term insurance
It is a group term insurance that a company joins as a financial source such as condolence money. Basically, all the members belong, and the group bears the insurance premium.
Group term insurance (Group B)
It is a term insurance that members can voluntarily join, and it is provided as a benefit of the company. Members are responsible for insurance. It is often cheaper than taking out individual insurance, but if you leave the group due to retirement or other reasons, the guarantee will not continue.

Group credit life insurance

If the repayment person receives a loan and the repayment person dies or is severely disabled during the repayment, the remaining amount of the loan will be repaid with insurance money.Housing loanThe ones that are attached to a loan are typical forms, but some are attached to other loans. Insurance premiums can be paid in a lump sum at the start of the loan or added to the loan interest rate. Recently, there are some products that require insurance payment even if the repayment person suffers from cancer or myocardial infarction.

Group annuity insurance

A product that a company joins to pay an employee retirement pension. Insurance premiums are borne entirely by the company, partially by employees, and fully by employees.

In life insurance contract

  • For what, for whom, and when you need insurance
  • Why insurance should be used instead of other means such as savings
  • Is insurance really necessary for me and my family (bereaved family)?

Necessary guarantees vary depending on each person's values ​​and lifestyle. The amount of compensation required at the time of death is not generally decided only by age, and the same can be said for other guarantees. Even if you don't pay the cost of life insurance, you can simply save money or use the public social security system (Health insurance-Employee pension-Bereaved family basic pensionEtc.) is sometimes sufficient. Not life insuranceNon-life insuranceIn some cases, Also, in some cases, it may be necessary to be prepared for hospitalization or nursing care rather than for death protection.
It is also a good way to utilize life insurance, keeping in mind that if there is a shortage of personal savings or public social security system, it will be supplemented with life insurance. In short, not everyone needs life insurance.

In addition, although there are cases in which it is recommended to join a clause that claims savings, it is not possible to simply compare the expected interest rate, which is an indicator of policy reserve investment yield in insurance, with the deposit interest rate. This is because the insurance premiums include, in addition to the portion (net insurance premiums) that is managed at the expected interest rate in addition to the insurance money, the additional insurance premiums that are the income of the insurance company as expenses of the insurance company. The only way to check the savings is to compare the total amount of premiums paid and the surrender value. There are the following three typical methods of earning a profit margin on a contract that includes death insurance, but all of them can only yield a maximum of long-term bank time deposits. It is important to consider the purpose of insurance in line with the above three purposes, not for savings purposes.

Life insurance tips

  • In the case of life insurance with a contract period of more than one year, basicallycooling offHowever, if you go to the insurance office etc. and make a contract, you cannot cool off.
  • The insurance money may not be paid if there is a false statement in the notification form (which describes your health condition at the time of enrollment) submitted at the time of contract, or omission of notification (violation of notification obligation).
  • Without the consent of the insured, even couples and parents cannot take out insurance.
  • There are two types of life insurance premiums, the same amount for the entire life of the insurance, and a renewal type where the premium increases every certain period
  • The amount of insurance premiums is paid annually rather than monthly, and lump-sum payment (prepayment in full term) is cheaper than annual payment.
  • If you have group insurance (monthly payment) such as the company you work at, the latter will be cheaper than if you join as an individual.
  • Cancellation/reduction can be done at a window such as a call center other than a sales representative or sales office.
  • Even if the insurance premium cannot be paid, if the insurance has a refund, it can be used as a source of funds to continue the insurance (paid insurance that reduces the insurance premium without changing the insurance period, without changing the insurance amount. Extended term insurance, etc. to shorten the period. However, the attached special contract will be automatically canceled)
  • As a general rule, claims such as insurance money, when 3 years have passed since the day after the reason for payment,PrescriptionDisappear by
  • Even if a claim for insurance claims occurs (such as death), the benefits may not be immediately available. Therefore, when a large amount of money is needed (funeral, etc.), there may be a problem that cash cannot be used from insurance. It is necessary to confirm the period, etc. required until the payment of insurance money at the time of enrollment.
  • If it takes days to pay the hospitalization insurance benefits, if the condition recovers by the time of payment, the benefits may be reduced according to the condition. Therefore, the amount of benefits may differ between the insurance for immediate benefits and the insurance for which it takes days to pay benefits (in the case of insurance that is granted on the same day, the amount of benefits will decrease if recovery is made at a later date ( (Refund) is not usually asked). This also causes trouble, so you should check it carefully.
  • If an insurance company goes bankrupt, its insurance would otherwise be void. However, because the impact on policyholders is large, insurance companies spend their money on each other to create a policyholder protection mechanism.In fact, another rescue insurance company or policyholder protection mechanism does the insurance business. I often take over. However, it is said that there is a concern that if the number of insurance companies that collapse due to the bursting of the bubble and the inflow of overseas life insurance companies increases, and there is a large-scale chain bankruptcy again, the policyholder protection mechanism alone will not be able to support it.

Life insurance history

Beginning of life insurance

The form of life insurance contract1400 era OfイタリアAppeared in the beginning,slaveAppeared as a form of marine insurance for transportation[6].

17st centuryThe United KingdomThen, it is said that the pastors of St. Paul's temple put out some of each other's money in order to cover the funeral expenses (Kouen prepayment insurance/Kouen prepayment association). However, this paid the same amount regardless of age, so that the elderly could receive the insurance with relatively low insurance premiums. However, it is said that it has disappeared in about 10 years because the complaints of young people have been gradually bought.

The reason for solving this problem was "Halley's CometFamous astronomerEdmond HarryIs. He actually investigates the life of human beingsstatisticsTurned intoLife tableIt was created. It is statistical data that summarizes the percentage of survivors and deaths by age. Statistics with a large populationLaw of large numbersIt was convenient to derive the number of people dying by each age (mortality rate). Then, once a life table was created, it became possible to estimate the number of people who would pay insurance premiums and the number of people who would die (receive insurance money) at each age. Therefore, it is possible to make a difference in insurance premium according to the mortality rate,18st centuryIn England, there was a system to collect insurance rates based on mortality.

However, the calculation based on this life table is戦 争,EarthquakeIt is not possible to deal with mass deaths due to such large-scale disasters. For this reason, most current life insurance deals with war and disaster.DisclaimerIs provided.

Establishment of modern life insurance

In life insurance, by setting a premium according to the mortality rate for each age based on statistics, the insurance premium received by the insurance company and the insurance payment paid by the insurance company are balanced. The insurance premiums paid by policyholders are generally the total amount of premiums according to the mortality rate for each age leveled over the entire period.

The origin of modern life insurance today is1762Equitable Life established in London, England (en: The Equitable Life Assurance Society). BritishMathematician,(English edition)Used the life table of Edmund Harry to create a theory of life insurance with an appropriate premium according to probability, and intended to establish Equitable Life.

If premiums are collected according to the mortality rate, the premiums will increase year by year. thisNatural insuranceSay. However, the company evens out its insurance premiums according to the contract period.Normalized insurance premiumThe method was adopted. This mechanism prepaid future insurance premiums in the first half of the contract period (this prepaid premium is calledLiability reserveThe amount accumulated in the latter half of the contract period will be used as insurance premiums. This is the mainstream of current life insurance premium calculation.

Originally, life insurance was a mutual aid mechanism, but with the adoption of a level insurance premium, the prepaid insurance premium became a large asset managed by the life insurance company. And as a so-called institutional investor, it became a cornerstone that had a great influence on the financial market.

Establishment of simple insurance

Initially, life insurance was for special people such as property owners and pastors. However, when the number of urban dwellers and salaried workers rapidly increased due to the Industrial Revolution, there were problems such as livelihood security and funeral expenses when the family income earner died. It was in the middle of the 19th century.

There, workers in London were asked by a life insurance company, Prudential Loans & Insurance UnionPrudential), and Prudential accepted this to develop a small-amount, denominated, weekly payment for workers. This brought life insurance to the commoners all at once. It is said that one-third of all British households had contracts with Prudential for some time. It can be said that this is an example of how serious these problems were for workers at that time.

In addition, these problems are becoming a problem in each of the developed countries today.カナダThen, as a national policy, a life insurance company was established. An insurance company that handles life insurance for workers has been established by a Diet decision. This is the currentManulife life insurance.

The peak period of the three major life insurance companies

Underwriting of securities and grouping of companies by holding securities are also performed by life insurance companies. As such, life insurers (in the United States in the late 19th and early 20th centuries) perform the same activities as commercial banks, trust banks, and private bankers. Life insurers purchase securities for sale, not just for investment, and Dai-Life insurers are free to engage in many financial activities by participating in syndicate underwriting activities. To help. (Omitted) Life insurance companies are not limited to the position as a normal financial institution that conducts investment activities appropriate for themselves, are involved in various operations in the financial market, or are owners or business partners of companies. To do. — Armstrong Investigation, Vol.10, pp.385-386, 388.

Life insurance in Japan

Life insurance companies do this in Japan. Also, as a product almost similar to this,Privatization of postal servicesbeforeJapan PostWas goingSimple insuranceAndAgricultural cooperative,Co-opSuch asmutual aidSome businesses are dealt with under the name "Life Mutual Insurance." Life insurance companies also have a wide range of needs, such as savings and protection of old age, in order to meet the needs of “property savings accumulation insurance” andPersonal pension insurance, Etc., but these can be said to be life insurance in a broad sense.

decree

Insurance law(2008May 5th,2010In April 4st), the definition of life insurance contract is "to provide property benefits (...payment of money only ...) on the condition that one of the parties causes a certain event. Contract and the other party pays insurance premiums (...) as a response to the possibility of occurrence of the certain reason." (Article 1 No. 2, partially omitted) Among them, "the one that an insurer promises to carry out a certain insurance benefit for the survival or death of a person (...[7] ). (Article 2, No. 8, partially omitted).

Before the enactment of the insurance law,Commercial law(Article 673 of the Commercial Code) In “Life insurance contract c. one party other party c.[8](A life insurance contract states that one of the parties (an insurer) should pay a certain amount of money regarding the life or death of the other party (the policyholder) or a third party, and that the other party gives the compensation to the other party. The effect is obtained by doing).

Non-life insuranceTreatsAccident insuranceIt is similar to, but different in that it is not bound by the "acute/outpatient" condition that is a requirement for general insurance (however, it may include accident insurance as a special provision). Life insurance is a mechanism for ensuring the risk of illness and death that generally increases with age (except immediately after birth), and guarantees only outpatient accidents.Accident insuranceThe technical basis is fundamentally different from.

History

Until the securities depression

In Japan, in the 3rd year of Keio (1868)Fukuzawa YukichiStarted with the introduction of the modern insurance system (non-life insurance, life insurance) as one of the Western cultures in his book "Western Travel Guide".[9], In 1880Iwakura MissionWas a member ofGiichi WakayamaNitto Hosei Co., Ltd. (Japan's first life insurance company) is opened, but goes bankrupt[10].. In July 1881 (Meiji 14), by Yuzo Abe under Yukichi Fukuzawa, the oldest existing insurance company limitedMeiji LifeThe insurance company was opened. In 1888, Teikoku Life (currently the second insurance company in Japan)Asahi Life), thirdly in 3Nippon LifeWas born. However, at first, there were many criticisms based on the misunderstanding that "do people make money by life or death?"

PrewarAs a characteristic of the life insurance companies up to this point, corporations were the mainstream, not the mutual companies stipulated by the Insurance Business Law as they are today. Also, apart from ordinary life insurance companies,Conscription insuranceThere was a conscription insurance company dealing with insurance called. Among existing insurance companies, Welfare Conscription Insurance (currently Wealthy life), First conscription insurance (former Toho Life,AIG Edison Life Insurance(Inherited to), Daihyaku Mutual Life Insurance (formerly Daihyaku Mutual Life Insurance Company)Manulife lifeJapan inheritance insurance (old) Yamato Life) And so on. It seems that conscription insurance is a type of endowment insurance, and if a child is enrolled while they are still young, the child will receive insurance when the child is conscription. Speaking of modern times, it can be said that it is a product like school insurance. For this reason, until the prewar period, products with high savings properties such as endowment insurance were the mainstream. The family structure, such as parents and children, siblings, and relatives living together or adjoining each other, and the function of supporting each other through ground relationships, company relationships, and blood relationships are fully functioning, and the weight of the role of compensating for the life of the bereaved family required for life insurance It can be said that it was not so expensive.

After the war, Many of these life insurance companiesLtd.からMutual companyI changed clothes to and started again. At this time, recruitment by female sales staff was devised,War widowDue to the abundant supply of jobs, each company has come to adopt this method (sales-ready fleet fleet method of occupational area business). Also, the family structure is such that only parents and children live.Nuclear FamilyAs the number of people in the mainstream became more popular than before, the role of compensating for the bereaved family's life in the unlikely event of becoming an individual has become sought after, and mainstream products have been popular until now. HighlyEndowment insuranceWith a large term of endowment insurance and even a term of insuranceLife insuranceIt gradually shifted to.

High economic growth-Bubble period

The main movement of this era was in 1973Arico(CurrentMetLife Life), in 1974AflacbyCancer insuranceSuch asThird sector insuranceAs a foothold, foreign-affiliated insurance companies begin to enter the market. Major domestic life insurance companies will begin to provide medical insurance centered on the special provision for death protection, which was a conventional product, rather than the third sector insurance as a standalone (main contract). In addition, compared to the sales method of set products by sales lady that has been running for a long time, the United States, which was the world's largest life insurance company in 1981,Prudential FinancialとSonyIs a joint venture company of Sony Prudential Life (currentlySony life) Established. Life insurance specialist with at least college education and relevant knowledge of taxation, law, social security, etc.Life plannerStarted sales by consulting sales by. Appear afterFinancial plannerBring a new channel to the life insurance industry: a proposal style that is the basis for creating a life plan table, income and expenditure analysis, and household consultation, and a professional channel in life insurance. On the other hand, the so-calledBubble economyThe rise in interest rates and soaring real estate prices due to the “bubble period” also had a great impact on life insurance companies that handle “ultra-long-term fixed interest rate” products (flat-rate insurance). In oneBubble burstAfter, highPlanned interest rateWe had a lot of in-force contracts, and the other reason was that the assets we owned and the assets we rented had deteriorated due to investment in real estate as a means of asset management or real estate-related loans. is there. As a result, the profitability of asset management declines andPlanned interest rateThe difference betweenReverse ZayaThe management base became unstable. At that time, there were relatively many companies whose management was deteriorating, with their headquarter near Shibuya.Nissan Life-Chiyoda Life-Toho Life-Japanese group lifeWas sometimes called "Shibuya 4 companies". As a result, out of these four companies, Japan Group Life (AXA Life3 companies)Bankruptcy[11] And othersTaisho Life[12]-Kyoei Life[13]-Tokyo life[14] 3 companies have failed.

On the other hand, as stock investment increased during the bubble period,Variable insuranceWas noticed. General life insurance is called fixed rate insurance, and the amount of insurance at the time of contract does not change. Therefore, economic growth and rising stock prices and prices (inflationAt that time, the asset value (guarantee amount) will decrease substantially. Variable insuranceInflationIt was developed as a solution to the shortcomings of fixed rate insurance, where the insurance money drastically diminished over a long period of time, and it became a focus of attention in insurance contracts during this period. In addition, some life insurance companies have been proactively engaged in sales activities with a bank as a set of financing and sales in the name of inheritance measures using the insurance tax system. However, contrary to expectations, the stock price fell sharply due to the burst of the bubble, and due to this drastically reduced maturity repayment, there was a shortage in repayment of loans, and many asset owners and contractors suffered. Lawsuits against insurance companies and banks continued due to insufficient explanation of the risks when the stock price declined and problems with recruitment activities (banks were actively involved in recruitment, etc.). It is.

Due to this reflection, the current variableInvestment trust), the diversified investment can be voluntarily performed by the contractor, and the minimum amount of the death benefit is guaranteed. By controlling such that most of the assets under management will not be affected even in the event of bankruptcy or business difficulties, the risk is greatly reduced compared to variable insurance during the bubble period.

Life insurance industry after the bubble burst-quarter century

As mentioned above, the life insurance industry after the bubble burst depends on the expected interest rateUpside downAs a result, a number of companies have collapsed, leading to an era in which trust in life insurance itself could fluctuate. For this reason, the life insurance industry and insurance companies were aiming to rebuild the industry in order to restore the trust of policyholders, but one after another in 2005-2007.Non-payment of insurance claimsHas occurred, and various problems in life insurance have come to the forefront.

Also the first Japanese versionFinancial bangAs part of (financial liberalization), policies have been developed to eliminate the “firewall” of industries such as banks, insurance, securities, non-life insurance and life insurance, and to liberalize mutual entry. In line with this, the Insurance Business Law was completely revised in 1995, and the liberalization of insurance premiums andThird sector insuranceComplete liberalization, lifting of bans on joint sales agents, bank over-the-counter sales, online life insurance, etc., which are different from the conventional sales channels by insurance sales representatives, some of the life insurance solicitors who were limited to one company were eased AsInsurance brokerIs recognized. In addition, the spread of the Internet has brought changes such as easier access to information for policyholders to compare and consider insurance companies and insurance products.

following,Boldface indicates industry topics.. Small letters are cases related to bankruptcy, acquisition, absorption, etc.

  • February 1996- Toho LifeDue to business alliance due to poor business performanceGE Capital Edison LifeIs established and preparations for succession are underway.
  • August 1996-Life insurance industry joint agent, ban on mutual participation of life and non-life insurance.
  • February 1997- Nissan LifeWas the first post-war management failure of a life insurance company. Received 2,000 billion yen in financial support from the Contractor Protection Fund (predecessor of the protection mechanism),Aoba lifeWhat.
    • There is concern that the insurance company cannot be rescued by the policyholder protection fund, and a policyholder protection mechanism is established.
  • February 1999- Toho LifeReceived a business suspension order from the Financial Services Agency and went bankrupt.
  • March 2000-Toho Life receives 3 billion yen from Life Insurance Policyholder Protection OrganizationGE Edison LifeComprehensive relocation to.
  • February 2000- XNUMXth lifeIs a bankruptcy. Received Â¥1,450 billion in funding from the Life Insurance Policyholder Protection OrganizationManulife lifeWhat.
  • February 2000- Taisho LifeReceived a financial suspension order from the Financial Services Agency and went bankrupt.
    • Received 262 billion yen in funding from the Life Insurance Policyholders Protection Organization with SoftBank FinanceYamato LifeBy a joint venture ofAzami LifeMoved to.
  • February 2000- Chiyoda LifeIs a bankruptcy.AIGBy the acquisition by the groupAIG Star LifeWhat.
  • February 2000- Kyoei LifeIs a bankruptcy. US without public fundingPrudential FinancialAcquisition by.Gibraltar LifeTo change the company name and rebuild the management.
  • February 2001- Tokyo lifeApplied the Corporate Rehabilitation Law and went bankrupt.
  • April 2001-House credit life insurance in bank over-the-counter (group credit life insurance) is lifted.
  • February 2001- Meiji LifeIs the first time in JapanAccount type insuranceDeveloped Life Account LA (interest-bearing life insurance).
  • February 2001- Solar life-Daido LifeJoined hands to absorb the collapsed Tokyo Life.T & D groupEstablished.
  • April 2002-Lifting of ban on sales of personal annuity insurance and property insurance in bank over-the-counter sales.
  • August 2003-United StatesAIGBy the stock acquisitionGE Edison LifeAcquired.AIG Edison LifeWhat.
  • February 2004- Meiji Yasuda LifeInauguration. Realization of business integration that goes beyond the chaebol of Meiji Life and Yasuda Life.
  • February 2004- Prudential lifeIs under management reconstruction for 200 billion yenAoba lifeAbsorbs.
  • February 2005-In the life and non-life insurance industry, starting with the discovery of unreasonable non-payment of death insurance moneyNon-payment of insurance claimsDeveloped to.
  • December 2005-Ban on sales of one-time whole life insurance, one-time annuity insurance, short maturity level annuity insurance, and savings-type survival insurance in bank over-the-counter sales.
  • February 2006- Small amount short-term insuranceIs lifted.
  • October 2007-Insurance department established as part of postal privatizationJapan Life InsurancePrivatization.
  • In December 2007, bank ban sales were fully lifted. Term insurance, level-paying whole life insurance, long-term level-paying endowment insurance, medical and long-term care insurance, and other insurance products will also be available for sale.
  • February 2008- SBI AXA Life Insuranceas well as the Lifenet life insuranceThe entry of online life insurance companies such as.
  • September 2008-Withdrawn in January 9AIG Star LifeとAIG Edison LifeAIG Life is expected to be born by the merger ofAIGDue to the management crisis, he is looking for a seller.
  • February 2008- Azami Life.. Received the Corporate Rehabilitation Law due to excess debt and started rehabilitation procedures.
  • April 2009-Azami Life in the USPrudential FinancialSubsidiary ofGibraltar LifeMade a wholly owned subsidiary by investing 69 billion yen.
  • 2010- Insurance business lawAmendment (Amendment of Article 300 regarding life insurance recruitment.trustLifting the ban).
    • 新Insurance lawEnforcement (revised for the first time in about 100 years. Notification rules changed from voluntary declaration to obligation to answer questions).
  • February 2010- First lifeThe mutual company is transferred to a stock company and listed.
  • August 2011-United StatesPrudential Financial AIG Edison Life-AIG Star LifeIs a Japanese subsidiaryGibraltar LifeMerged into.
  • August 2012-United StatesAIGArico Japan of the group is the United StatesMet LifeTo MetLife Arico Life (from July 2014MetLife Life).
  • November 2013-Nine major life insurance companies in Japan announced reverse resolution.[15]
  • February 2015- First lifeBecame the industry leader for the first time after the war, surpassing Nippon Life with income such as insurance premiums.
  • February 2015- Nippon Life Mitsui LifeBecame a subsidiary.Regain the top spot with premium income.
  • May 2016-Revision of Insurance Business Law[16].
  • 2016-The suspension of sales of temporary payment whole life insurance is affected by negative interest rates. standardPlanned interest rate2017 revision.

Japanese life insurance company

To run a life insurance business in Japan,Financial Services AgencyYou must obtain a life insurance business license or a foreign life insurance business license from.A foreign life insurance business license is a license required when an overseas insurance company establishes a branch office in Japan and operates an insurance business.If a foreign insurance company establishes a local corporation in Japan and operates a life insurance business, a life insurance business license is required.Therefore, the so-calledForeign-affiliated companiesDo not all operate under a foreign life insurance license.

Insurance business lawAccording to Article 7 and Article 13 paragraph 1 of the Enforcement Regulation of the same law, life insurance companiesCompany nameYou must put the word "life insurance" inside.

As of April 2021, 4, the following companies are engaged in the life insurance business in Japan.42 companiesAnd allLife insurance associationIs a member of.

Life insurance business licensed company

As of April 2021, 4, 1 companies have acquired a life insurance business license (Ltd.37 companies,Mutual company5 companies).

Major domestic life insurance company

Non-life insurance system

Entry from different industries/independent

Department of Foreign Investment

Foreign life insurance licensed company

As of April 2021, 4, there is one foreign life insurance business licensed company.

Problems in Japan

In Japan, about 90% of all households have some kind of life insurance[17] Therefore, it can be said that Japan is a major life insurance power in the world.

Life Insurance Culture CenterAccording to the survey, the average death insurance amount for Japanese life insurance is about 1 million yen per person for ordinary death insurance. In addition, an average of 2400 types of life insurance per household will be incurred and the annual insurance premium will be 3.8 yen on average, and the total amount of insurance premium paid over the lifetime will be 38.5 million yen or more on average.[17].. In other words, life insurance is the next most expensive product after a house, and since it is a long-term contract, carefully consider its necessity and cost when deciding a contract, and consider the life plan and life of each contractor. It is necessary to fully consider the style.

However, it is rare that an actual insurance contract was voluntarily enrolled (the case of voluntary enrollment in the first place may be cautious on the contrary because there is a problem from the perspective of moral hazard for insurance companies). There are many cases where they came in as solicited by diplomats earlier, or joined by introducing or soliciting relatives, friends, or acquaintances. For this reason, there are many cases where the contract is not read, or the content is not understood even after reading it.

On the contractor's side

  • I am indifferent because I rarely get the knowledge about life insurance (especially,インターネットBefore spread).
  • Therefore, I took out insurance at the behest of a diplomat and had little knowledge of the contents of life insurance I contracted for, and the insurance period and amount of insurance, the conditions for receiving insurance money, and the insurance premium going up at a certain age. Sometimes it becomes trouble without knowing.

On the side of the salesman

  • The norm is strict,TurnoverIs also high. Therefore, it is difficult to train a diplomat with proper knowledge.
  • For many yearsGNPI have been soliciting with “sales” (G: lawyer, N: humanity, P: present), and the social status of female diplomats in particular is very low, making it difficult to maintain motivation.

Such problems have been pointed out. Even insurance companies are taking measures to solve this problem, but it is hard to say that the effectiveness is improving. In order to avoid trouble, first understand the types of basic life insurance and the characteristics of each, and consider the "necessity" for yourself, and explain until the diplomats are satisfied. It is necessary to ask.

In addition, in life insurance, recruitment fees paid to solicitors and agents are high, and malicious solicitors and agents are provided with benefits that may be illegal (rebuilding insurance premiums) in order to obtain this. There are actually cases of granting and pressing unnecessary contracts, and if there is no doubt that insurance companies are insured as the recruiter says, eventually the contractor's own head can be strangled. There is a nature. In order to protect yourself from such dangers, it is recommended that you do not swallow the recruiter's story, and use a different method that has nothing to do with the recruiter.

Also, aiming for life insurance claimsInsurance murderSuch ascrimeThere is no end (moral risk). With regard to group term insurance and consumer credit group life insurance, the insured has not been informed of the details of the contract and the recipient, and has become a social problem.

Unjustified nonpayment problem

2005Turned out in FebruaryMeiji Yasuda Life InsuranceIn October 2005, life insurance companies announced the results of a survey on whether or not they had failed to pay their insurance claims and dividends in the past five years in response to the unjustified payment of insurance claims by the company. According to this, it was revealed that as many as 10 life insurance companies did not pay insurance and benefits for inappropriate reasons.

However, before and after the findings were publishedLarge non-payment by non-life insurance companiesIt became clear that unreasonable repayment of life insurance companies was not paid much attention in the form of being swallowed by it, and thereafter, non-life insurance-related scandals in which fraud was found one after another became conspicuous.

In this way, the life insurance industry seemed to have ended a series of scandals,200612 month 22 dayGibraltar Life InsuranceNon-payment found in[18] Starting with the above, a large amount of new insurance claims were uncovered by life insurance companies. For this reason,20072月1日に金融庁が日本の全生命保険会社(38社)に対して、2001年~2005年の過去5年間に行われた保険金不払いの件数や不払い合計金額を調査し、2007年4月13日までにその調査結果を報告するように命令した。その結果、同年4月19日までにCardiff life insuranceIt was revealed that 37 companies excluding the total number of non-payments including individual insurance, group insurance, and refunds amounted to about 44, or about 359 billion yen.[19] However, the results of this survey were, so to speak, halfway through in time for the survey deadline, and this did not mean that the survey was completed.

当初、各生保で調査結果がまとまるのは同年9月末になる見通しであったが、それから遅れることおよそ2ヶ月後の2007年12月8日にようやく調査結果がまとまった。これによると、38社の不払い合計は、件数にして131万件、金額にして964億円に達し、同年4月の中間調査結果と比較しておよそ3倍に膨れ上がった格好となった。[20]

Of the 2008 life insurance companies that were found to have failed to pay their insurance claims on July 7, 3, a large number of 37 life insurance companies (Nippon Life Insurance Company, Dai-ichi Life Insurance Company, Meiji Yasuda Life Insurance Company, Sumitomo Life Insurance Company, Asahi Life Insurance Company) Insurance, Fukukuni Life Insurance, Mitsui Life Insurance, Daido Life Insurance, American Family, and Arico Japan) will be subject to administrative sanctions issued by the Financial Services Agency under a business improvement order.[21]

The status of each life insurance company is as follows (based on the data as of the end of October 2005).

Insurance companyNumber of casesAmount (yen)Document
Meiji Yasuda Life Insurance1053(Insurance: 542)33 billion(Including insurance: 31 billion)[2]
Nippon Life Insurance57(Insurance: 9)-(Including insurance:-)[3]
Asahi Life Insurance45(Insurance: 11)9820 million(Insurance: 9096 million)[4]
American family life insurance45(Including insurance:-)961 million(Including insurance:-)[5]
Arico Japan32(Insurance: 3)7764 million(Insurance: 7000 million)[6]
Sompo Japan DIY Life Insurance30(Insurance: 2)-(Including insurance:-)[7]
Dai-ichi Life Insurance25(Insurance: 6)2327 million(Including insurance:-)[8]
Orix life insurance17(Insurance: 0)184 million(Insurance: 0)[9]
AXA life insurance14(Insurance: 0)278 million(Insurance: 0)[10]
Daido Life Insurance12(Insurance: 0)232 million(Insurance: 0)[11]
AXA Group Life Life Insurance12(Insurance: 0)167 million(Insurance: 0)[12]
Manulife life insurance11(Insurance: 2)2336 million(Insurance: 1952 million)[13]
AIG Star Life Insurance10(Insurance: 0)67(Insurance: 0)[14]
Sompo Japan Himawari Life Insurance9(Including insurance:-)-(Including insurance:-)[15]
Prudential life insurance8(Insurance: 7)-(Including insurance:-)[16]
Mitsui Sumitomo Kirameki Life Insurance8(Insurance: 2)-(Including insurance:-)[17]
Fukoku Life Insurance7(Insurance: 5)6067 million(Insurance: 6062 million)[18]
Mitsui Life Insurance7(Insurance: 1)601 million(Insurance: 500 million)[19]
Sumitomo Life Insurance5(Insurance: 1)1166 million(Insurance: 1000 million)[20]
Tokio Marine & Nichido Life Insurance5(Insurance: 0)724 million(Insurance: 0)[21]
Sony life insurance4(Insurance: 2)6(Including insurance: 6 billion)[22]
AIG Edison Life Insurance3(Insurance: 1)659 million(Insurance: 640 million)[23]
T & D Financial Life Insurance3(Insurance: 0)33 million(Insurance: 0)[24]
Nipponkoa Life Insurance2(Insurance: 0)22(Insurance: 0)[25]
Kyoei Fire Shinrai Life Insurance2(Insurance: 0)10 million(Insurance: 0)[26]
Tokio Marine & Nichido Financial Life Insurance1(Insurance: 1)300 million(Insurance: 300 million)[27]
Aioi Life Insurance1(Insurance: 1)1 million(Including insurance: 1 million)[28]
Fuji Life Insurance1(Insurance: 0)4 million(Insurance: 0)[29]
Total: 28
  • "-" in the table represents non-public or unknown.
  • The amount includes approximate figures.

Problems with clauses

Problems concerning the validity of the clauses on delinquency and forfeiture of insurance premiums[22]

There are many clauses that stipulate that the insurance contract itself will expire without any reminder to the contractor after a certain period of time if the life insurance premium is delinquent. In addition, even if the insurance contract is reinstated due to payment of insurance premiums after expiration while it was in effect, there are many clauses that stipulate that illness and disability cannot be guaranteed during the expiration. Regarding these points, it is pointed out that it may be invalid due to violation of the Consumer Contract Law, and it is being contested in lawsuits. Although there is no Supreme Court case yet, in the High Court ruling, the contractor has won the case (the insurance company has lost).


footnote

[How to use footnotes]
  1. ^ a b Tadao Shibata, "Life Insurance: From its Mechanism to Pension and Nursing Care Insurance," Koyo Shobo, 1995, p. 25
  2. ^ a b c d Tadao Shibata, "Life Insurance: From its Mechanism to Pension and Nursing Care Insurance," Koyo Shobo, 1995, p. 31
  3. ^ Supreme Court September 11, 9, Vol. 9, No. 53, p. 7.
  4. ^ Tokyo District Court April 13, 4 Judgment Times No. 18, p. 1106.
  5. ^ "Pension insurance tax”. Daiwa Securities. 2021th of February 2Browse.
  6. ^ [1]"Slave Insurance and Life Insurance -The World's Oldest Authentic Life Insurance Policy-" Eiichi Kimura (Research Institute for Life Insurance Culture 1966-02)
  7. ^ "Excludes those covered by a straight-line insurance contract. "(Article 2, No. 8, partially omitted)
  8. ^ "A platform for discussion on the compilation of the interim tentative plan for the review of insurance law (3)(Meeting Material 11)- 10th Meeting of Insurance Law Subcommittee of the Legal Council (held on May 19, 5)
  9. ^ Life Insurance Association of Japan "General Course" P.13
  10. ^ [Supervised] Hideki Izumi "Japanese History "First Time" Encyclopedia" PHP Collection
  11. ^ 1997 April Nissan Bankruptcy ⇒ Absorbed by Prudential Life in February 4 after Aoba Life
  12. ^ June 1999 Bankruptcy ⇒ March 6 Azami Life ⇒ April 2001 Yamato Life ⇒ May 3 Subsidiary of Gibraltar Life Prudential Gibraltar Reborn as Financial Life
  13. ^ Bankruptcy in October 2000 ⇒ Regeneration to Gibraltar Life through Prudential Financial
  14. ^ Bankruptcy in March 2001 ⇒ October 3 Merged with T & D Financial Life
  15. ^ “Finally, the cause and lessons that continued to afflict life insurance”. Diamond Online (Diamond Co., Ltd.). (November 2013, 11). オ リ ジ ナ ルArchived as of October 2013, 11.. https://web.archive.org/web/20131129180403/http://diamond.jp/articles/-/45081 
  16. ^ Tightening regulations on joint agents
  17. ^ a b 27 "National Survey on Life Insurance"
  18. ^ http://www.gib-life.co.jp/st/about/news/2006/061222.html[Broken link] About omission of reserve payment According to the “Adult Disease Special Contract” that was sold from March XNUMX to October XNUMX in the former Kyoei Life era, there were XNUMX non-payment of reserve funds (total amount of about XNUMX million yen). Announced. About XNUMX% of them have already paid. It is said that the system is defective.
  19. ^ Non-payment of insurance claims 359 billion yen 38 cases at 44 life insurance companies-Kyodo News April 2007, 4
  20. ^ Non-payment of life insurance companies: 38 companies totaling 964 billion yen -Mainichi Shimbun December 2007, 12
  21. ^ Total of 10/99 billion yen for business improvement orders and non-payment for 791 life insurance companies -Reuters July 2008, 7
  22. ^ Two evening editions of the Chunichi Shimbun, dated January 2011, 1

Literature information

  • "Slave Insurance and Life Insurance -The World's Oldest Authentic Life Insurance Policy-" Eiichi Kimura (Research Institute for Life Insurance Culture 1966-02)[30][31]

Related item

外部 リンク

medical insurance

medical insuranceWhat is (Health Insurance)?Medical institutionSuch as hospitalization costs and surgery costs incurred by the consultationMedical billsInsurer pays part or all of theinsurance.

Due to high medical expensespovertyThe purpose is to prevent illness and stabilize life.In order to avoid the high medical expenses associated with long-term hospitalization and treatment with advanced medical care, which are directly borne by the insured, the insured's upper limit is set, and conversely, insurance claims are paid. In order to prevent the insurer's financial resources from being overwhelmed by the swelling of the amount, the insured's out-of-pocket ratio and out-of-pocket payment are often set, or the coverage is limited in advance.

Type

It can be divided into two types: compulsory public medical insurance and voluntary private (private) medical insurance.

Public medical insurance is a medical insurance system in which the scope of insured persons is set in advance by the government.多くのmanyDeveloped countryHas prepared a public medical insurance system, but the scope of target persons and the financial resources method differ depending on the country.[1]..Even in public medical insurance, the underwriter is not limited to government agencies, and in some countries private companies underwrite (Netherlands, Switzerland, etc.).

On the other hand, private medical insurance is voluntary, and it is possible to select a plan from a menu prepared by multiple insurance companies according to the property and income of the policyholder.The expected role of private health insurance varies greatly from country to country.なお任意加入の医療保険では、自己の健康状態に不安がある人ほど保険加入のインセンティブを持つため、いわゆるWith voluntary medical insurance, people who are worried about their health condition have an incentive to take out insurance, so it is so-called.Reverse selectionMay form an insured group with poor health.This tendency is especially strong with guarantees such as surgical benefits that allow participants to choose to undergo a medical examination.また、保険金Also, insurance moneyscamTo take out insurance for the purpose ofMoral riskThere is also the problem of.

System of each country

  • United States medicalPrivate medical insurance is common.マネージド・ケアは大きく分けてManaged care can be broadly dividedHMO, POS, and PPO.Voluntary subscription in many states,MassachusettsThen, it is obligatory to take out some kind of medical insurance.
  • Dutch medicalSo, short-term medical insurance is compulsory insurance, but it is underwritten by a private insurance company with public risk adjustment.
  • German medicalThe insurance is compulsory insurance, but you can choose between public insurance and private insurance.
  • Singapore medicalInsurance isPay-as-you-go systemNot taken, individual unitFunding method.

Japanese system

Number of Japanese medical insurance subscribers (2013)[3]
InsurerNumber of subscribers (XNUMX)
National Health Insurance3,831
Association Kenpo3,502
Health insurance association, mutual aid, etc.3,869
Medical system for elder senior citizens1,473
(reference) Private medical insurance[4]1,586 million contracts

In Japan, it is called "national insurance"WelfareAll citizens who have an address in Japan except some of the beneficiaries, and have a status of residence of 1 year or moreJapanese foreignerIs required to take out public medical insurance in some way (≠Compulsory insurance).

The first health insurance system in JapanWorld War IAfter1922(TaishoIt was first enacted in 11)1927(ShowaIt was employee insurance for occupations that was enforced in 2 years).This system, which originally started with a union of workers engaged in dangerous businesses such as mining labor, has gradually expanded its scope, and with the development of the national health insurance system operated by municipalities, etc.Universal insuranceWas achieved1961(Showa 36).

Japanese public medical insurance

Japanese national medical expenses(System distinction, FY2016)[5]
Publicly funded medical carePayment3 billion yen (007.5%)
Medical care for the elderlyPayment14 billion yen (033.6%)
medical insuranceEqual payment
19 billion yen
(45.7%)
Employee insurance
9 billion yen
(22.2%)
Association Kenpo5 billion yen (012.1%)
Health insurance association3 billion yen (008.4%)
Seafarers insurance195 billion yen (000.0%)
Mutual aid association1 trillion0583 billion yen (002.6%)
National Health Insurance9 billion yen (022.6%)
OtherLabor accidentな ど3049 billion yen (000.7%)
Patient burden5 billion yen (012.2%)
Special mitigation measures1119 billion yen (000.3%)
the amount42 million yen (1381%)

Employee insurance

Regional insurance

Persons who are not insured by employee insurance (individual business owners, unemployed persons, workers who cannot take out employee insurance, etc.) will join.

  • National Health Insurance(National Health Insurance) --With municipalitiesTokyospecial areaIs going.
  • National Health Insurance Society - self employedEven so, it is legally permitted to form a national health insurance union by coalition of people of the same type.
    • National health insurance generally has a higher premium (insurance tax) than employee insurance, and the method of calculating insurance premiums differs greatly depending on the municipality.
(Reference) Livelihood protection (medical assistance)
WelfareFor those who are not covered by public medical insurance among the beneficiaries, the public assistance system is used regardless of the insurance system.WelfareMedical care is provided as a kind of.Recipients of welfare protection cannot be covered by the National Health Insurance (National Health Insurance ActArticle 6).

Medical system for elder senior citizens

With people over 75 years oldAssociation of Medical Care for the ElderlyIt is a medical insurance system for persons with disabilities aged 65 and over (excluding welfare recipients) certified by the government, 2008 (Heisei 20).May 4It started from.

The insurer is a wide-area federation of medical care for the elderly in the latter half of the year, consisting of all municipalities in each prefecture. It is covered by municipal subsidies and contributions.

Injuries and illnesses caused by third-party acts

In case of a traffic accidentIndustrial accidentUnless it falls under the above, it will be covered by public medical insurance (if it is covered by work-related accidents, the treatment of work-related accidents will be prioritized and public medical insurance will not be applied).In this case, if there is a perpetrator (see below), a third party will be sent to an insurer such as the National Public Health Insurance Division of the municipality, the National Public Health Insurance Association, the Corporate Public Health Insurance Association, or the National Public Health Insurance Association. You must submit a report of injury or illness due to the act without delay.The form is available at each insurer's window.In addition, at the medical institution window, you have to pay the personal contribution once, just like ordinary public medical insurance.

If the traffic accident is not your own accident but a partnerReceiptIt must be stated in the (medical fee bill) that it is a "third party act".Without this statement, the insurer will not be able to charge the perpetrator for the medical expenses incurred according to the accident rate of the traffic accident.

In addition, if you make a settlement without permission, you may not be able to receive benefits from public medical insurance, so it is better to contact the insurer in advance.

Circumstances of medical institutions

Benefits of using public health insurance
Traffic accidents have complicated procedures and complicated interests, and if a patient has trouble, payment may be delayed or delayed depending on the insurance company.In that respect, if you use public medical insurance, you will be paid by the insurer without delay, just like regular medical fees.
Difficulties in using public medical insurance
If you use public medical insurance, the total cost of treatment will be kept low.From the standpoint of running a medical institution, it is natural to want free medical care that can be expected to generate high income.In addition, one of the drawbacks is that it does not generate as much income as the labor required for various procedures, so it deprives medical institutions of their enthusiasm for treatment.

Patient circumstances

Benefits of using public health insurance
Automobile liability insuranceSince the upper limit of (automobile liability) is 120 million yen, it costs treatment costs that exceed the upper limit due to hospitalization costs, etc.If the other party does not have voluntary insurance,When the victim's negligence is largeFor example, using public medical insurance can reduce the burden on the victim.
Difficulties in using public medical insurance
Treatment by free medical treatment has less restrictions on various treatments than treatment by public medical insurance.In addition, since the amount of free medical treatment is high, even if some treatment costs are cut due to the same treatment restrictions as public medical insurance, it is easy to cover the total treatment costs.Patients who are victims will not be able to receive excessive initial medical care, which is a merit of free medical care.

Insurance company circumstances

Benefits of using public health insurance
On the insurance company side, the total amount of compensation can be kept lower than free medical care by using public medical insurance.
Difficulties in using public medical insurance
If the patient's recovery is unsatisfactory, a proceeding may develop between the patient, the medical institution, and the insurance company.This also happens in free medical care, but the possibility increases as much as you cannot receive excessive initial medical treatment.

Insurer circumstances

Benefits of using public health insurance
This will lead to improved services for the insured.
Difficulties in using public medical insurance
Insurers of association-managed insurance / public medical insurance associations and some national public medical insurance may not be able to claim perpetrators who do not have voluntary insurance, or the cost of claiming will be high, so public medical insurance will be used for traffic accidents. I don't want you to use it.

When visiting a medical institution due to illness or injury in a foreign country

Japan's public medical insurance cannot be used in foreign countries, but if you get injured or sick in a foreign country and consult a local medical institution, you will be billed to the insurer who has taken out the medical expenses paid overseas after returning to Japan. Can beOverseas medical expensesThere is a system called.However, the procedure includes a medical statement (a doctor's certificate stating the medical details, disease name, medical condition, etc.), a receipt (a receipt issued by a medical institution with a breakdown), and a Japanese translation of this. In addition, the amount paid by public medical insurance is calculated based on the medical expenses (standard amount) for similar illnesses and injuries in Japan and the foreign exchange conversion rate on the payment decision date, so it costs in foreign countries. If the medical expenses are high, the rate of return from public medical insurance may be low.

In addition, ambulance charges (basically ambulances are charged in foreign countries) are not covered, and medical expenses need to be paid in advance temporarily, so overseas travel accident insurance is contracted (Credit cardDepending on the case, it is often set as standard) so that medical expenses can be billed to the insurance company, and in major countries, local support in Japanese is often available.海外旅行傷害保険から医療費が保険金の形で降りても、公的医療保険の海外療養費の支給額が減額されることはないとのことEven if medical expenses are dropped from overseas travel accident insurance in the form of insurance money, the amount of overseas medical expenses paid by public medical insurance will not be reduced.[6].

Status of private medical insurance in Japan

Private medical insurance in Japan is intended to cover the out-of-pocket medical expenses, miscellaneous expenses such as differential bed charges and transportation expenses, and cash benefits to cover the decrease in income due to leave, that is, to supplement public medical insurance. is there.In addition, there is also a so-called "sympathy money" when a person is diagnosed with a malignant disease.There are many plans in which a fixed amount of benefits is paid according to the diagnosis result, the degree of injury, the type of surgery, and the number of days of hospitalization or hospitalization.民間の保険会社により販売されるものであり、直接の公的助成はないものの、支払った保険料は一定の条件のもとでIt is sold by a private insurance company and there is no direct public subsidy, but the premiums paid are under certain conditions.income taxIt can be recorded in the calculated deduction amount (life insurance premium deduction).

"Third sector insuranceIn this field, small and medium-sized domestic life insurance companies and foreign-affiliated life insurance companies have been the mainstays, and sales of life insurance companies in the United States have increased.結果、一例としてAs a result, as an exampleSpecific illness insuranceIs a representative ofCancer insuranceIn the field,1974Started business in (49)American family life insurance(Currently Aflac Life Insurance Co., Ltd.) launched the first cancer insurance in Japan and has maintained the top position for many years.

2001(13), liberalization of the third sector insurance field was approved based on an agreement with the United States, and in JapanLife insurance company-Non-life insurance companyHas been able to make a full-scale entry into the market, and many insurance companies have since entered this market.2006(18) In November, many insurance companies, including foreign-affiliated companies, were involved in third-sector insurance centered on medical insurance.Unreasonable non-payment of insurance moneyIt came to light that was being done in large numbers.

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注 釈

  1. ^ 1.6% of salary is deducted from salary in advance instead of health insurance premiums paid by civil servants and citizens. There is a burden.なお、自衛官診療証を使用して医療を受給する場合、予め所在If you use the SDF medical certificate to receive medical care, you will be located in advance.Garrison OfBusiness corpsReport to the head of the health department (for garrison where no business unit is set up, the head of an organization equivalent to the department of hygiene in the core unit of the garrison, the person in charge of hygiene, etc.), or report by a certain period after the consultation. There is a rule that if you fail to report after a certain period of time, you will have to refund the medical expenses paid from public expenses.

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References

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