2003-1 2003. 3.
,, -.,.,..,.,,,..,. 2003 3
1. 8 1. 8 2. 10. 12 1. 12 2. 18 3. 34 4. 38. 40 1. 40 2. 44 3. : MIB(Medical Inform ation Bureau) 73 4. 81. 84 1. 84 2. 85 3. 116. 124 1. 124 2. 127 3. 135. 152 155 < > 158
< -1> 13 < -2> 14 < -3> 15 < -4> 16 < -5> (, FY2001) 19 < -6> (, FY2001) 20 < -7> (, FY2001) 21 < -8> (, FY2001) 22 < -9> ( ) 23 < -10> ( ) 24 < -11> ( ) 26 < -12> ( ) 28 < -13> 29 < -14> ( ) 31 < -15> 32 < -16> ( ) 33 < -17> 35 < -1> 41 < -2> 49 < -3> (Su n Life Fin ancial) 51 < -4> ( ) (Sun Life Financial) 52 < -5> (Su n Life Financial) 53 < -6> (Sun Life Financial) 54 < -7> (Su n Life Fin ancial) 56 < -8> ( ) 58 < -9> (Sun Life Financial) 58
< -10> ( ) 61 < -11> (all or nothing, Su n Life Financial) 62 < -12> (Sun Life Financial) 62 < -13> ( ) 63 < -14> ( : ) 65 < -15> ( : ) 66 < -1> (2002.4 10) 85 < -2> KoreanRe ( 1, ) 94 < -3> KoreanRe ( 2, ) 95 < -4> KoreanRe (, ) 95 < -5> KoreanRe ( ) 96 < -6> (1, 2 ) 104 < -7> (3 ) 105 < -8> (4, ) 106 < -9> ( ) 107 < -10> (1 ) 107 < -1> ( ) 125 < -2> ICPS 143 < -3> 145 < -4> 146 < -5> 149 < -6> 149
< -1> ( ) 24 < -2> ( ) 25 < -3> ( ) 27 < -4> ( ) 29 < -5> 30 < -6> ( ) 31 < -7> 32 < -8> ( ) 33 < -9> 39 < -1> 43 < -2> MIB ( ) 75 < -1> 86 < -2> 88 < -3> 89 < -4> 90 < -5> 91 < -6> 91 < -7> 92 < -8> 96 < -9> 97 < -10> (risk factors) 98 < -11> 99 < -12> (board lin e) 101 < -13> (m aximu m lim it) 101 < -14> 102 < -15> 109
< -16> 110 < -17> 110 < -18> 111 < -19> 112 < -20> 113 < -21>, 114 < -22> 115 < -23> (p aram edical examination) 116 < -1> 129
1 1. ( ),..,,,,,. 2.,,. 10.
2,. FY2000 100%.,,.,,.,,,..,,.,,.
3 3. ( ). (Fair Credit Reporting Act)..,..,.,,,,..
4,,.,,.,.,. 6 9,. 500.. 10,. LOMA, ALU,..,
5. 4., 3, 5.,.,,.,,.,, 3,.,. 150 (2 300 ).
6, 2000. MIB,,,. 5,. 5.,.,...
7.,,,.,.. ( ),.,,,..,.,,,.
8. 1..,. 50%.., 5 26%.,,.,.,., 1). 1)
9,.....,.,.., 10 30,.
10 2.,.,,.. ( ),.,., 2).,. 2),,.
11 11.,,,. 5.,.,. ( ), ( ),,,,. 6 5,.,,,...
12.,,.,,. (disease insurance) 3) (accident insurance) 4),, (long-term care insurance) 5), (disability incom e insurance). 1. 1970,,, 1980. 1990,,, 1997 7 3 ( ) 3), ( ). 4). 5).
13. 2000..,. 1) 1,,,,,. 60, 70, 80,. 90. < -1> ( 91 ), 1, 1, 1
14 2), (3, 7 ) 6).,,,.,,,,.,,,,. < -2> 1, 1, 1 2002 (Critical Illness: CI),,, (50 100%). 6), 3,,, 7,,,,,,.
15,,. 3),. MRI,,, 7), (, 70%) (, 500 ). 3,, 8), 3, 5, 10. < -3>,,,,, MRI,,,,, : 7). 8).
16.,.,,.. < -4>, (180 ). 9), 10)., 9),. 10). 1. ( ), ( ) ( ) 2
17,,,, 3 11). 2001,, 3. 180..,.,, 12). 2.,, ( ) ( ) 2 ( ) ( ) ( ) ( ) ( ) 11) 200 20, 300 10 12),, 55 65%, 75% 80%.
18 2. 13). 1990,, 2000.,.. 20% 14), 15). 1) 2000. FY2001 13),,. 2002 4 10 5.0%. 14) (2001), p. 48. 15) 2001 12.
19 2 714 87.7%. 1 1,716 56.6%, 8,967 43.3%, 32 (0.2%) 16). < -5> (, FY2001) ( :, %) 2 :, 649 (5.5) 502 (5.6) 20 (63.5) 10,452 7,677 32 (89.2) (85.6) (100.0) 1,264 1,290 - (10.8) (14.4) (0.0) 11,716 8,967 32 (100.0) (100.0) (100.0),. 1,170 (5.7) 18,160 (87.7) 2,554 (12.3) 20,714 (100.0) 2) 2002 3, 1 30.5%, 1 3 46.3%, 3 5 16.4%, 93.2% 5. 1 31.3%, 1 3 52.5%, 3 5 16.2%, 5, 1. 3 15, 2000 16) 2002. 4 10 24.3%, 75.7%.
20. < -6> (, FY2001) ( :, %) 1 1 3 3 5 5 7 7 :, 3,476 (29.7) 2,805 (31.3) 32 (100.0) 4,877 4,709 - (41.6) (52.5) (0.0) 1,951 1,453 - (16.7) (16.2) (0.0) 1,095 - - (9.3) (0.0) (0.0) 316 - - (2.7) (0.0) (0.0) 11,715 8,966 32 (100.0) (100.0) (100.0),. 6,312 (30.5) 9,585 (46.3) 3,404 (16.4) 1,095 (5.3) 316 (1.5) 20,713 (100.0) 3) 2002 3, 1 5 35.5%, 5 1 26.6%. 65.6% 1, 1 34.4%. 1 5 46.7%, 1 3.0% 17). 59.0% 1 5, 5 41%. 17)., 3 5.
21 < -7> (, FY2001) ( :, %) 1 44,943 23,203-68,146 (1.7) (0.9) (0.0) (1.3) 1 5 19,989 (0.8) 10,821 (0.4) - (0.0) 30,810 (0.6) 5 1 35,195 (1.3) 42,104 (1.7) 1 (0.0) 77,300 (1.5) 1 5 665,163 (25.0) 1,151,019 (46.7) 14,930 (59.0) 1,831,112 (35.5) 5 1 719,014 (27.0) 646,914 (26.2) 6,612 (26.1) 1,372,540 (26.6) 1 1,178,903 590,551 3,757 1,773,211 (44.3) (24.0) (14.8) (34.4) 2,663,207 2,464,612 25,300 5,153,119 (100.0) (100.0) (100.0) (100.0) :,,. 4) FY2001, 10 42.2%, 7 10 37.9%, 3 5 9.5%, 3 9.4 %. 10 54.9%, 7 10 35.6%, 10 99%. 10, 18). 18) mis-estimation of the trend in m ortality
22 < -8> (, FY200 1) ( :, %) 3 3 5 5 7 7 10 10 :, 174,627 (15.6) 13,126 (1.5) - (0.0) 123,689 65,682 - (11.1) (7.7) (0.0) 18,611 2,235 1 (1.7) (0.3) (0.0) 451,597 304,620 225 (40.4) (35.6) (0.9) 348,119 469,225 25,075 (31.2) (54.9) (99.1) 1,116,643 854,888 25,300 (100.0) (100.0) (100.0),. 187,753 (9.4) 189,371 (9.5) 20,846 (1.0) 756,442 (37.9) 842,419 (42.2) 1,996,831 (100.0).,, FY1997 FY2001 5,. 1) FY2000 2,841 FY2001 5,300 1.87, 197 409 2.08. FY1997 46%, FY1999
23 88% FY2001 113%,.,., 2001 134 9.7%, 5 5.7% 19). 20) 2001 25 10. < -9> ( ) ( :, ) FY1997 1,023,083 9,118,796 684 4,229,282 46% FY1998 2,190,639 9,248,430 1,274 7,790,838 84% FY1999 3,288,916 14,758,004 2,296 12,920,448 88% FY2000 5,132,997 24,757,447 2,841 19,703,069 80% FY2001 7,759,357 36,058,647 5,300 40,878,870 113% : = / :,,. 19) 1997 9.0%, 1998 1.6%, 1999 6.9%, 2000 1.4%. 1990 70, (24.1%), (16.0%), (160.0%), (10.5%) (http :/ / www.ncc.re.kr). 20) 2002 11 14. 2001,, MRI,, 8,764, 73% 6,414.
24 < -1> ( ) 2) FY2000 1,068 FY2001 1,697 1.59, 37 58 1.56. FY1998 94% FY2000 111%, FY2001 124 %. < -10> ( ) ( :, ) FY1997 171,124 114,940 - - - FY1998 797,985 865,370 181 815,855 94% FY1999 1,283,204 1,966,243 535 1,902,269 97% FY2000 1,799,069 3,366,916 1,068 3,735,681 111% FY2001 2,340,194 4,723,441 1,697 5,833,778 124% : = / :,,.
25,.. < -2> ( ) 3),,. FY2000 36%, FY2001 40%, 66%, 70% 21). 21)..,
26 FY1998 182%, FY2000 190%, FY2001, 120%.. < -11> ( ) ( :, ) FY1997 680,554 913,927 - - 0% FY1998 3,078,286 1,177,749 276 539,262 46% FY1999 4,466,196 2,758,360 885 1,813,038 66% FY2000 5,730,142 4,672,889 1,671 3,100,366 66% FY2001 6,820,221 6,410,158 2,690 4,466,330 70% FY1997 111,543 1,195,554 1,694 180,178 15% FY1998 185,207 1,970,362 4,211 569,605 29% FY1999 439,292 6,133,153 19,061 4,083,200 67% FY2000 838,448 13,331,878 28,225 4,820,608 36% FY2001 1,402,643 23,138,921 49,912 9,335,680 40% FY1997 1,541,356 15,298,295 42,278 26,262,010 172% FY1998 2,080,116 21,946,501 74,400 39,915,551 182% FY1999 2,799,915 30,024,910 122,875 56,212,092 187% FY2000 3,779,825 43,275,608 195,164 82,059,257 190% FY2001 4,522,424 64,496,777 226,012 77,153,609 120% : = / :,,..
27 < -3> ( ) 4) 22),,. FY1999 37%, FY2000 39%, FY2001 40%,. FY2000 42%, FY2001 33%, 23) 22) 39,, ( ).,. 23) 1, 1.
28 FY1998 66% FY2000, FY2001 63%, 56%.,., 5. < -12> ( ) ( :, ) FY1997 206,319 894,243 1 40,000 4% FY1998 961,778 3,018,032 57 584,504 19% FY1999 1,303,739 5,462,717 170 2,036,063 37% FY2000 1,527,911 9,071,222 281 3,532,783 39% FY2001 1,638,883 11,483,899 290 4,607,539 40% FY1997 173,253 2,863,785 199 908,042 32% FY1998 241,614 2,487,585 160 943,800 38% FY1999 479,071 10,409,358 307 1,867,766 18% FY2000 821,749 9,317,701 562 3,880,373 42% FY2001 1,352,675 20,078,667 805 6,528,534 33% FY1997 26,047,080 152,083,612 13,022 140,738,303 93% FY1998 33,316,319 186,717,931 14,113 123,247,137 66% FY1999 41,038,491 222,640,185 17,074 144,990,507 65% FY2000 49,104,579 270,094,779 19,626 169,148,076 63% FY2001 62,950,374 293,146,737 26,084 163,400,308 56% : = / :,,.
29 < -4> ( ) 5), FY1997 171% FY1999, FY2000 192%, 218%, FY2001 176%,. < -13> ( :, ) FY1997 4,776,275 49,669,953 138,443 84,976,353 171% FY1998 6,533,648 63,626,976 199,087 108,286,747 170% FY1999 8,040,965 85,192,796 311,169 163,399,935 192% FY2000 10,071,033 110,897,491 458,713 241,750,010 218% FY2001 12,224,480 132,158,434 482,051 232,202,727 176% : = / :,,.
30 < -5> 6),. FY2000 60% FY2001 70%,,,,. 24),. 24) mis-estimation of the mortality level
31 < -14> ( ) ( :, ) FY1997 2,365,876 15,101,245 2,578 5,357,502 35% FY1998 7,455,491 18,767,528 6,159 11,243,864 60% FY1999 11,260,418 41,487,835 23,254 24,622,784 59% FY2000 15,850,316 64,518,053 34,648 38,772,880 60% FY2001 21,313,973 101,893,733 60,694 71,650,731 70% : 1) = / 2) + + + + + :,,. < -6> ( ) FY1997 116% FY2001 92%,,.
32 < -15> ( :, ) FY1997 32,442,366 219,517,476 196,939 254,009,575 116% FY1998 42,095,015 275,909,401 295,762 275,372,447 100% FY1999 52,465,076 347,189,653 482,642 375,129,986 108% FY2000 64,378,078 452,970,102 771,557 518,653,910 115% FY2001 82,056,183 568,474,462 905,738 523,257,417 92% : 1) = / 2) + + :,,. < -7> FY1999, FY2000 103%, 108%, FY2001 89%.,
33,,,.,,,. < -16> ( ) ( :, ) FY1997 34,808,242 234,618,721 199,517 259,367,077 111% FY1998 49,550,506 294,676,929 301,921 286,616,311 97% FY1999 63,725,494 388,677,488 505,896 399,752,770 103% FY2000 80,228,394 517,488,155 806,205 557,426,790 108% FY2001 103,370,156 670,368,195 966,432 594,908,148 89% : = / :,,. < -8> ( )
34 3.., (proposed insured) (mortality) (morbidity) 25).,.,. 26)..., ( -1 ).,.,,., 25) Bailey, Richard (eds.) (1990), p. 1. 26) Bailey, Richard (eds.) (1990), p. 208.
35.. < -17> - - 1 - - - - - - - - - - - - : (2000), p. 13., (w aiting p eriod) 27).,..,. (renew al provision), 28). 27). (2000), p. 14. 28),,,
36.,, 29)... 30).,., 31). 32).,,. Bailey Richard (eds.) (1990), p. 221. 29) (1994), p. 237. 30) Bailey, Richard (eds.) (1990), p. 208. 31). 32),,.
37.,,, ( ),,, (, ),,,,,,,,,.,,,,.,,,... 1,. 2,., ( ). 3 1 2.,,. 4. 5 33). 33).
38 4.,,.,,.,,....,., ( ).,..,,,. (2000), p. 17.
39,.,..,.,.,.. < -9>
40. 1.,., 1)., (em ployer-sp onsored p lan),,., 72.4%, 14.2%, 17.5%. 92%, 9%.. 1),,,. LIMRA International(2001) (CI) 2000 21,000, 35, 500 6..
41 < -1> ( :, %) 1998 1999 174,145,130 72.4 170,317,241 71.4 160,472,373 66.7 157,058,238 65.8 15,780,576 6.6 15,525,423 6.5 34,086,514 14.2 34,188,078 14.3 42,131,483 17.5 43,920,458 18.4 240,688,167 100.0 238,609,671 100.0 : 100%. : Cu ster an d Ketsche(2000), p. 5.. (group hea lth pla n),, 2) (n ondiscrimination).,,., (,, )., (large group),, 50 (sm all grou p),., (pre-existing condition) 2),.
42, 20 (minimu m p articip ation rate).. (individua l he a lth ins urna ce) 3), 4)..,,. 5).,,,. 3),,,. 4),,. 5) ( ) MIB(medical information bureau),,,.
43 < -1>,,.,, 6).,. ( ),.. 6) Terms & Conditions".
44 2.. 1) 1 : ( ).,,,,,,,., (m aterial facts) 7). 2) 2 :,,,, (progn osis),, (clarify), 8)., (medical report), (hospital report), (medical examination), (medical records). ( 7). 8),.
45 ) MIB 9),. 3) 3 :,., (m edical advisor)., (CI). (m ajor risk factors) ( ),,,,,, (minor risk factors), ( ), ( ) ( ), ( ),,,. 4) 4 :,,,,.., 9) 3.
46.,.,, CI, CI, 10).. (information source s) 1),.,. ( ) Part Part. Part,,,,,,,,. Part,, 10),,,,,,,,.
47. ( ),,,, ( / / / / ),,,,,,, (2 ),,,,. ( ),, Sun Life Financial.,,,,,,,,,,,,,,,,,,,,,,,,,,,, ( ),,,
48,,,,,,,,,, ( ), (AIDS), AIDS 5,, 5, X,, (diagnostic test).,,. 5,, 5, ( ) (Life Style),. 12 (
49? / cigarette/ ), 1,,,, 1 ( ) 3 ( ),.,,,,,,,,. < -2>? / ( ).,,,,
50 sentin el effect.,. ( ),,,,,,, (con sum er rep orting agencies),.. MIB MIB. 2),,., ( ),,,,.,,,
51 < -3>.,, 24, 12 12. < -3> (S un Life Fina ncia l) 1. : [ ] [ ] * [ ] [ ] [ ] [ ] 2. a)? [ ] [ ] 3.,,? [ ] [ ]. 4.? [ ] [ ]. 5. 6. (FAA)** 7. 8.. 9.? [ ] [ ]. 24 12 12 ( ) (, TV, ) : *) VFR=Visu al Flight Ru les **) FAA =Federal Aviation Ad m inistration
52,,,,, < -4>. < -4> ( ) (S un Life Fina ncia l) 1?? [ ] [ ] [ ] [ ] a)?( ) b)?( ) c) d)?(,, ) a)?( ) b),,,? c)?(,,, ) d) a),,,,? b)?(,,?) c)
53 < -5> 5,,,. < -5> (S un Life Fina ncia l) 1.. (hashish, cannabis) (crack, ice) Amphetamines(Benzedrine, Dexed rin e, Methedrine) Barbiturates(Amytal, Seconal, Nembutal, Phenobarnital) 5 2.,,? [ ] [ ],,,. 3.? [ ] [ ]. 4.,?. 5.,,?. (, 1 ) (agent's rep ort), (confidential financial statem ent).,
54 11)., (,,, ),,. < -6> (S un Life Fina ncia l) : [ ] [ ] [ ] [ ] / / / (p ersonal prop erty) ( - ) 11),,,
55 3),.,. (vend or). 2 4,. $25 $200 12).,, < -7>. 13),.,,. 12) Bergstrom & Schmidt(2000), p. 13. 13) Allianz Private Krankenversicherung 20 40 EURO.
56 < -7> (S un Life Fina ncia l) :. 1.?. 2. : : 3.. 140/ 90, 4. (a)? (b). (1) (2) (3) 5 7. 5. (a),,,? (b),? (c),,? (d)? (e)? 6. (a)? (b)? (, / ) (c)? (d)?. (e)? (, ) (f),? 7. (a),,,. a. (b) : b. ( ) :. :, : $ ( )
57 4) (eligibility),.,,, AIDS,,,,,,,,,,.., (full m edical exam), (param edical exam).,,,,,,,,,.,,,.,,,,,,.,. 5,, 5.,., $70 $80, $75 $125, $175 $180.
58 < -8> ( ) (, ) (, ) (board certified M.D.) $70 $80 $75 $125 $175 $180 : Rich ard L. Bergstrom, Lif e Insurance Underwriting Tools: A n Overview of the Purpose, Costs, and Benef its of Current Risk Selection Tools, Ju ly 2000., Sun Life Financial 16 < -9>. < -9> (S un Life Fina ncia l) $0 $99,999 $100,000 $249,999 $250,000 $5,000,000 $1,000,001 $5,000,001 $7,000,001 $5,000,000 $7,000,000 0 14 A A F F F F 15 19 B B B D G G 20 39 B C D D H H 40 50 B C E E H H 51 60 D E E E H H 61 75 E H H H H H 76 85 H H H H H H : A=, B=,, C=, (HGT,WGT BP), D=,, E=,,, F= APS, G=,, H=,,
59 20 39 25 5,, 20 5 (, ), 61 10.,,. 5),,,,. (, ),,,,,,.. 1),, (risk factors). (judgement method of rating) (numerical rating system). ( ),
60.,. ( ) 100,., (debit p oints),.,.,,. 2),.,,,,,, 6 9 < -10>., 500.
61 < -10> ( ) 0 29 100 129 30 50 A 130 150 51 75 B 151 175 76 100 C 176 200 101 150 D 201 250 151 200 E 251 300 201 250 F 301 350 251 300 G 351 400 301 400 H 401 500 : (2001), p. 66. 1980..,,.,. (all or n othing ),. 1990,, < -11> < -12>.
62 < -11> (a ll or nothing, S un Life Fina ncia l), 140/ 90 240 < -12> (S un Life Fina ncia l) (cm) (kg) (cm ) (kg) 154.9 71.7 180.3 98.4 157.5 73.9 182.9 100.7 160.0 76.7 185.4 103.4 162.6 78.9 188.0 106.1 165.1 81.6 190.5 108.9 167.6 86.2 193.0 111.6 170.2 88.5 195.6 114.3 172.7 90.3 198.1 117.5 175.3 93.0 200.7 120.2 177.8 95.3 203.2 123.4 < -13>,,,.
63 < -13> ( ) / -20% 5-10% 2 0% 1 10 +20% 1 10 +30% -7.5% -2.5% 0% +2.5% +7.5% 60-2.5% 0% 1 +20% (BMI) 20 25-5.0% 10% 0% 10 20% +2.5% 20% +5.0% : BMI=Body Mass In dex :, (http :/ / ww w.un derw riter.or.kr),,,,.,..
64 3),., (m edical risk assessm ent) (h ealth un derw ritin g).,,,.,.,,,,, (,,, ).,.,, < -14>, < -15>. 29. 1.
65 < -14> ( : ) 29... 30 H b A1c 8.0%, 2.6mm ol/ L, 160mg/ dl( 8.8mmol/ L)......, 1 ( ) 10... 11 19 *... $7.50** 20 29... $5.00 30 39... +100 40 49... +75 50... +50 2 ( ): 10... 11 19 *... $7.50 20 29... $5.00 30 39... +100 40 49... +75 +100 50 60... +50 +75 > 60... +50 +50 2 : 10... 11 19 *... 20 29... +75 30 39... +50 40 49... +25 +100 50 60... +25 +75 > 60... +25 +50 IGT 10... 11 19 *... $5.0 20 29... +75 30 39... +50 40 49... +50 50 60... +100 > 60... +50... +75 3,... : * 1, ** $1,000 $7.5
66 < -15> ( : ) : 1, 2 ( ) 150% (excellent)... 25 50 (good)... (fair)... 50 100 (poor)... 100 1, 2 ( )... 2.5 ( 50) 2 ( )... distinct pricing... +25 aggregate pricing... +50 CI 60, 60... 25 60 2... 50 60 3... 75 60 &... 25 40 & 3... 50,... 75... 75... 55... 2, 55..., 2... +50... +100............ :,,.
67,.. 1) ( ),,,,.,,.. ( ),,,,,,.,,
68.. 14).,. (concept),,,,,.., (underwriting actuaries),. 2) 14),,,.
69,.,., (, )., ( ) 15).. 10,.. 3, 6 9 16). LOMA (Life Office 15) Sun Life Financial.,. 16).
70 Man agem ent Association), (Un derw riter Training Manu al).,,, 17) ALU (Academ y of Life Un derw ritin g). ALU. LOMA CLU (Ch artered Life Und erwriter) ALU ALU, ALU, ALU. ( ) ALU ALU ALU LOMA FLMI 3 18). ( ) ALU ALU, ALU LOMA FLMI 2 19), CLU, (planning for bu siness owner and professional). 17) (2001), pp. 56 60. 18),, 19),
71 ( ) ALU,,,, LOMA FLMI 1 20), CLU. 3),. 10.,. 1, MIB. 15%, 150 21). 4),,,. 20) 21) (2001), p. 44.
72 ( ) (deductible),,., $200, $400, $500,. ( ) (coins ura nce),,. 80%, 20%,. ( ) (wa iting pe riod). 3,,,, 8. ( ) (exclus ion), (total p erm an ent disability) (w aiver of premium ),,.
73. (,, 1 ),. 3. : MIB(Medical Info rmatio n Bureau).,. 1902 MIB. MIB, 600,.. 1) MIB. MIB, MIB 1 230. /,,, (laboratory test
74 results) (insu rability) (non-m edical),, (aviation).,, 22) MIB,. 7. MIB MIB, MIB.,, MIB MIB, MIB MIB., X-ray,, MIB X-ray,,. X-ray,., MIB (red flag)., < -2> 22) 100 15 20 MIB.
75, MIB (cod e translator) 23). 340, MRN. < -2> MIB ( ) MIB MIB MIB 23),, MIB 3 2, 1 3.
76., MIB (requ est for details) MIB 24),. 2) MIB, (Checking Services),. (1) (Follow-up Se rvice s) 2 (contestable p eriod)., 2 MIB, MIB. (2) (Ins ura nce Activity Index) 1988, 24) MIB.
77., 2 MIB. ( ). (3) (Dis a bility Ins ura nce Re cord Se rvice : DIRS),. 25) 5 (,, ).,. (4) (Health Claims Index Service: HCI) 1988 H CI, (,, ). (clearinghou se),,. 25) 36%.
78 3) ( ),.,, (risk m is-classification).,.,.. 1) (Fed eral Trade Comm ission) (Fair Credit Rep orting Act). 604 (consum er rep orting agency),., ( ).
79 2) MIB,, MIB. MIB. CEO, Chief Un derw riter, Medical Un derw riter MIB,, MIB. MIB,,. ) (Pre -Notice),,. 1 (sentinel effect).,., MIB,,,.
80 ) (Post-Notice) MIB., MIB,, MIB,,. ), MIB,,. (m edical director),,.. ) MIB, MIB, MIB
81 (Requ est for Disclosure).,, MIB. MIB 26). 100, 27). 4...,,, ( ). 26) 13 8, 0.4% 550. 27) Human Services Administration Health Insurance Portability and Accountability Act. MIB,.
82 1) 1.,,. 2),,,.,,. 3),..
83 4), MIB,.,,..,,,., 6 9,,...,,,,.
84. 1.,., 1)., 3. 2002 10,. 2002 4 10 3 91.7%, 3 75.0% 2).. 1% 6, 7% 5 11.,,. 1),. 2).
85 < -1> (2002.4 10) ( :, %) 1 711,373 48.2 104,523 44.8 2 545,080 37.0 35,678 15.3 3 96,702 6.6 34,885 14.9 4 34,176 2.3 19,745 8.5 5 33,364 2.3 17,173 7.4 6 27,280 1.8 6,250 2.7 7 8,565 0.6 5,136 2.2 8 5,186 0.4 4,794 2.1 9 5,042 0.3 3,118 1.3 10 2,093 0.1 2,198 0.9 :,,. 2.. 1) 3), 3),.., 1 2 ( 1 ), ( ), (
86 3. < -1> ),.,,, 3,,, 4) 5., ( ),,, (,, + ),,,. ) 4),,,,,,, (, ),, (AIDS) HIV
87, (,, ). (,, ),,. (,,,, ) (,,,,, ), (,,,,,,,,,, ).,,,, ( / / ),, ( ), (, ), ( / ), ( ) (,, ). ). (,, ),, (,,,,,, ). (, ), 5 ( ) ( ), 3, 5.
88 ( ).,,.,. < -2> ).,.,.,. 11 20
89,.,.,., 3.,,,. < -3> 2)
90 9, 6, 5..,. < -4 > :. 3, 8.
91 < -5> 11., 1.. < -6>
92,,,., 10, 6. < -7> : 3),. 90 180.
93 (, 5 ), 50%., 1. 1998,,,,,,,,.,.. 1), 3, 3,... 6, 4 3.,
94. KoreanRe 2002 11.,,,.,., 1 2 < -2>, < -3> < -4>. 1 34, 5 125 125%., 150% (125+25),. < -2> Kore a nre ( 1, ) 20 5 6 10 11 15 15 25 200 250 30 175 200 250 35 125 150 175 40 100 125 150 41 75 100 125 (+25), (+25) ( )
95 < -3> Kore a nre ( 2, ) 30 7 7 10 15 1 ( ) 35 100 150 40 85 135 45 70 120 50 55 105 55 40 90 55 25 75 (+25) ( ) 1 ( ) 150 1, 15 1 250 2, 151. < -4> KoreanRe (, ) 50 1 1 50 100 1 1.5 101 150 1 2 151 200 2 201 250 2 250,, 201 250, 2 251 280 50 100, Hb A1C 6% 25, 12%
96. < -5> Korea nre ( ) (FBS) 2 (PP2) 180 200 180 250 25 50 201 250 251 280 50 100 250 280 H b A1C 6% 25 9 12 % 25 50 12 % 2) 5, 4. 2,, 1. < -8>
97,. 6 3, 5 4. 5.,. < -9>
98. 11. ( / ) 6, 2. 5 2,. 4 2, 3 1, 3, 2.,,,,,,. < -10> (ris k factors) 2,
99,.,.,,, 5 15 80%..,. < -11>
100 3).,,,,. 5). 45 1, 45 50 5 6, 50 1. 45 1 2, 45 50 5 6 1, 50 1 3 5. 45 2, 45 50 1, 50 5.,, 2. 5 135 (board lin e) 6). 125 1, 130 2, 135 5, 150 1, 130, 135, 150. 5) 6) 100.
101 < -12> (boa rd line) (m axim um limit) 6 150, 135 1, 300 2., 500. < -13> (maximum limit)
102 6 2, 6, 5,. < -14> :, 5,., 4. 1.,,,,,,,,,,,,,,.,,, 36. 2,
103,,,,,,, 35. 3,,,,,,,, ( ),,, ( ), (2.5 ). 4,, ( ),,,,,, (25 ).,, (< -6> < -8> )., 1. 1 4 ( ), ( ), 1,,,,., 1 2 1 20, 10, 1 1, 10,,, (< -9> < -10> ).
104 < -6> (1, 2 ),,,,,,,,,,,,,,,,,,, ( ), 1,,,,,,,,,,,,,,,,,,,, (, ), (16 60 ) (36 ), ( ),,,,,,,,,,,,, 2,,,,,,,,, ( ),, ( ),, ( ),,,,,,,,,,,, ( ),,,,,,,,,, ( ),, (35 )
105 < -7> (3 ),,,, 3,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ( ), (2.5 ), (26 ),,,,, (2.5,, ),,,,,,,,,,,,,,, ( ), (26 ), (2.5 ),, (2.5 )
106 < -8> (4, ) 4 ( ),,,,,,,,,,,,,,, ( ),,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ( ) (25 ),,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, (, ) (25 ),,,
107 < -9> ( ) 1 1 5 3 5 1 5 2 2 5 7 1 5 4 1 3 4 10 2 7 4 4 7 12 3 10 7 : 1) ( ) :, 2) (, ) 1. < -10> (1 ) 1 1 1 10 20 10 2 1 2 20 3 1 5 3 30 20 50 4 3 5 : 1),, 2),..
108. 1).,. (, ), (, ),,,,,, 2000. 2) 4,, 5.,,., (trend),,.
109 3) ( MIB ) 11. < -15> 7) 1 10. 7) < > 35,.,,,,,,,..
110 < -16>,,. 7, 4. < -17> :
111 4) 10 75.8% 5, 6 10 19.6%, 10 4.6%.,, IMF.,,,. < -18> 9 17.3%, 82.7%, 0%.
112 < -19> 9. 19.6% ALU1, ALU2 ALU3 5.2%, 2.1%, CKLU 8) 45.4%. 2 ALU1, ALU2, ALU3, 5 CKLU.,, 8) 1 2002. CKLU(Certificate of Korea Life Underwriter), AKLU(Associate of Korea Life Underwriter), FKLU(Fellow of Korea Life Underwriter). CKLU, AKLU, FKLU.
113 1 2. < -20>,,. 1,. 10. 5),
114. 3 1, 3 4,.,,.,. < -21>, 5) 2 1, 4 4
115.... < -22> 4, 2.,,,.
116 < -23> (paramedical examination) 3.. 1)., 9).,, ( ),,, (, ),,,,,,,,,. 9).,,,.
117.. 10),., (1994. 1), (1995. 1), (1997. 12) 11), (1999.2) 12), (2001. 1), (1973. 2).,,,... 2), 10) 17. 11) (1993. 8). 12) (1986. 5).
118. 10, 5, 3..,,,,. 3),,,, 13)., 1.,.. 1999 1,, 13) 1 2, 3.
119.,,.. 3. < -11> ( ) 1 ( ) 1 ( ) 1 1 1 2 2 15 15, 30 - : 2002 10 1. : (2001), p. 86...,.
120,,.,..,.,..,.,.,.. 1)..,
121... 2),,.,, 3,. 500, 300., (, ).....
122,..,..., 5, 10..,.,..,
123. 14).,,., 71 57, 9,., 15 732,.,.. 5 15),.. 14),,, 2003. 2. 17. 15),,,,.
124. 1..,,,.,.,,,, 1). (< -1> ),.,.,. 1).
125 < -1> ( ) 176 ( ) 1. 1. 2. 24 1 3. 4. 9 10 11. 177 ( ) 176 9.,.,.,,,.,,.,.
126,,, 3,,.,.,,,,,.,.,,..,.,.
127,,, 2)..,.,. 2.. 1) 3.,. 3), 2) Browne, Mark J.(1992), p. 595. 3),.
128...... 2).,. ( ) ( -1 ).
129 < -1> 3)., ( ) ( ) 4).,. ).,,,..., ( / 4), ( ).
130 ), ( ), ( ), ( ), ( ),,,,,,, (, ),, / ( ),,,,,. ),..,,,,,..... MIB.. 1
131. MIB. 1) MIB..,,,..,. MIB 5)....,. 5) MIB.
132 2) )..,...,.,.. ),,.. 6)
133 ( ) (, ) /, 6).
134 7) (,, ) ) MIB,,,,.,,,,. ),,,. 7) MIB 230.
135, 8).,... 3....,,,. 1) 8) MIB chief underwriter medical underwriter MIB.
136 9).,.,,.. 10)... 2),. 9) ( 17 1 ) 11 ( ). 10) ( 17 1 ) 11 2..
137. 11)..,,,, 12)... 3).,,.,. 11) ( 17 1 ),,. 12) (2002), p. 20.
138 ).,.,,,.... ).. (appointed physician), (family physician)..,.
139.. 1).,, 13)..,.,..,... 13) (1994), p. 237.
140. 2) (m edical u nd erwriting).. 14)....,.,,.. 14),.
141.. 3) (occup ation al u nd erwriting).,.,.,..,.. 4) (financial un derw ritin g) 15). 15) (2001), p. 88.
142,..,... 16).,?? (need),? 5)..,. (ICPS),,,, (< -2> ). MIB ICPS 16) (2001), p. 89.
143. < -2> ICPS,,,,,, ( ), ( ),, ( ) ( ), ( ) ( ),,,,,, /,,,, ( ),,,,,,, ( ), ( ),,, : 1). 2).,., H IV,, 17). 17) (2001), p. 13.
144 6).,...,,,,. 7)....,..
145.,.. 1),. CKLU, AKLU, FKLU 3 18). < -3> CKLU AKLU FKLU Certificate Associate Fellow + + + 3 + 1 4 / 4 / 2 / ( ) ( ) / & / CKLU AKLU : (2001), p. 36. 18) ALU(Academy of Life Underwriting) ALU, ALU, ALU., ALU.
146 3.. ALU. ALU Exam 15 1, Exam 15, Exam 23,, < -4> FLMI280: / Level1 - FLMI290: 2 FLMI LOMA FLMI310: / Level1 Level2 FLMI371: / 2 : / FLMI Exam 1 : / 1 Exam2 / Exam 1 ALU ALU 1 CLU JII CLU JII Exam3 1 : / CoP CIP ACII FCII section1: / section2: section3: ( / ) section4: : / : : / Exam 2 - CoP : / / : CIP * 11 ( ) ACII : (http :/ / www.underwriter.or.kr) 1 2 2 2-1
147,,,....,..., 19). 2). 19),, 1, MIB (Vendors). 2001 15%, 150 $. (2001).
148 20)..,..,. 3),.,., 7 (< -5> ). 20) CI,.
149 < -5> Und erwriting Trainee ~ $100,000 Ju nior Und erwriter $100,000 ~ $1m illion ~ table D Senior Und erwriter $1million ~ $2.5m illion ~ Lead Senior Un derw riter ~ $5m illion ~ Assistant Director ~ $10m illion ~ Director ~ $30m illion ~ Chief Und erwriter ~ : (2001), p. 46., (< -6> ).,. < -6> ( : %) 5 5 ~ 10 10 16.0 28.0 56.0 75.8 19.6 4.6 :,. : (2001), p. 36. 4)
150..,.,,...,,,......
151,,,,.,..,.,,,.,.,..
152.,. 4,.....,.,..
153.,., 10,.,,.,.,..,.,..,.,. MIB,
154,,,,,.,,.,,,,,,,,...,,....,.
155 (1994),,,, 4. (1995), Privacy,,, 1995 8. (1996), (PRIVACY),,,. (2003),,,, 2003 2. (1996),,,, 1996 11 ( 214 ).,, 2002. 11. 11. (2002),, 2. (2000),,,, 2000 9., (http :/ / w ww.un derw riter.or.kr) (2001),,. (2001),.,,.,,.,, 2002.,, 2002. KoreanRe,, 2002. (1995),,,, 1995 3, pp. 119~148. (1996),,,, 1996 11 ( 214 ).
156 Bailey, Rich ard (ed s.)(1990), Underwriting in the Lif e and Health Insurance Companies, LOMA. Bergstrom, L. R. an d B. D. Schm id t(2000), Lif e Insurance Underw riting Tools: A n Overview of the Purpose, Costs, and Benef its of Curren t Risk Selection Tools, Ju ly 2000. Brow n e, Mark J.(1992), "State Restriction on H ealth In su rance Un d erw ritin g Criteria: The Effect on th e Unin sured Population ", Journal of Insurance Regulation, Vol. 10, N o. 4, Su mm er, 1992, p. 595. Cu ster, S. W. an d P. Ketsch e(2000), Employment-Based Health Insurance Coverage, H ealth In su rance Association of Am erica. Cu ster, S. W. an d P. Ketsch e(2000), The Changing Sources of Health Insurance, H ealth In su ran ce Association of Am erica. Eggleston, Karen (2000), "Risk Selection and Optim al Health In su rance- Provid er Paym en t System s", The Journal of Risk and Insurance, Vol. 67, N o. 2, p p. 173~196. LIMRA Intern ation al, Critical Illness Insurance Products in the United States, 2001. LIMRA Intern ation al, Group Lif e Underwritering Guidelines, 2001. LIMRA Intern ation al, Group M edical Practices, 2002. LIMRA Intern ation al, U.S. Group Disability Insurance, Third Qu arter 2002. Mu nich Re, Critical Illness Insurance(http :/ / w w w.m u nich re.com) Pollitz, K., S. Lewis, R. Im es and E. Ban git(2001), A Consumer's Guide to Getting and Keeping Health Insurance in Calif ornia, Georgetown University, Institute for Health Care Research an d Policy, Jun e 2001. Pollitz, K., S. Lewis, M. Kofm an, E. Bangit, E. and K. Lucia(2002), A Consumer's Guide to Getting and Keeping Health Insurance in M assachusetts, Georgetow n Un iv ersity, In stitu te for H ealth Care Research an d Policy, Ju ly 2002.
157 Pollitz, K., S. Lew is, R. Im es an d E. Ban git(2001), A Consumer's Guide to Getting and Keeping Health Insurance in M issouri, Georgetown University, Institute for Health Care Research and Policy, Febru ary 2001. Pollitz, K., S. Lewis, M. Kofm an, E. Ban git and K. Lu cia(2000), A Consumer's Guide to Getting and Keeping Health Insurance in N ew York, Georgetown University, Institute for Health Care Research an d Policy, Decem b er 2000. Pollitz, K., S. Lewis, M. Kofm an, E. Ban git and K. Lu cia(2000), A Consumer's Guide to Getting and Keeping Health Insurance in Pennsylvania, Georgetown University, Institute for Health Care Research an d Policy, Decem b er 2000. http :/ / ww w.healthinsu ranceinfo.n et. http :/ / ww w.hiaa.org. http :/ / ww w.hnic.or.kr. http :/ / ww w.lom a.org. http :/ / ww w.mib.com. http :/ / www.ncc.re.kr. http :/ / www.underwriter.or.kr.
158 < >., 3. (i n f o r ma t i o n s ou r c e ) 1.?( ) ( ) ( ) (Disability Incom e) ( ) 2., 3? 2-1.?(.( ) ( ) 3.?.
159 / ( / ) ( ) 4.? ( ) ( ) 5.? ( ) ( ) 6.? ( ) ( ) 7.,?( ) ( )
160 8.? (d eductible) (co-in surance) (w aitin g p eriod) (p re-existin g condition) ( ) 9.?. 1.. 1-1. (m edical un d erw riting m anu al)? 1-1-1.... ( ) 1-2. 3?
161 1-2-1.... ( ) 1-3.,? 1-3-1.... ( ) 2.? (Ju d gem ent Meth od of Ratin g) (N um erical Ratin g System) + ( ) 3. (board lin e)? ( ) 4. (m axim um lim it)? ( )
162 5.?. 5-1. (risk factors)?( ) ( ) 6.? ( ) 7.? 5% 5 10% 10 15% 15 20% ( )
163 8.? 35 ( ) ( ) ( ) 36 40 ( ) ( ) ( ) 41 45 ( ) ( ) ( ) 46 50 ( ) ( ) ( ) 51 55 ( ) ( ) ( ) 56 60 ( ) ( ) ( ) 61 ( ) ( ) ( ) :,,, : 9.? ( )% 10.? ( ) 10-1.? 1 ( ) ( ) ( )% 2 ( ) ( ) ( )% 3 ( ) ( ) ( )% 4 ( ) ( ) ( )%
164. 1.,? 0,. ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) 1 ( ) ( ) ( ) 2 ( ) ( ) ( ) 3 ( ) ( ) ( ) 2. (un d erw riting actu aries)? 3., ( )? ( )
165 4. (paramedical examination)? 5.?( : Medical Inform ation Bu reau) 5-1.? 5-2. (5-1 )? ( ) 6.? : : 6-1.? ( ) 7.? 5 6 10 10 ( ) ( ) ( ) ( )
166 8.? ALU ( ) ( )% ALU ( ) ( )% ALU ( ) ( )% CKLU ( ) ( )% ( ) ( ) ( )% ( ) ( ) ( )% 9. ( )?, ( ) ( ) ( ) ( ) ( ) 10.? ( ) ( ) ( ) ( ) ( )
167 11. ( )? 5 ( ) 6 10 ( ) 10 ( ) ( ) ( ) ( ) 12. 1 1? 50 50 100 100 150 150 200 200 250 250 300 ( ) 13. (Exp ert Und erw ritin g System )? 14.,?
(KID I) 96-1 /, 1996.4 96-2 /, 1997.2 96-3 : /,, 1997.3 96-4 /,,, 1997.3 96-5, /,,, 1997.3 96-6 /,,, 1997.3 96-7 (I) : /,,, 1997.3 96-8 : /, 1997.3,, 96-9 /,,, 1997.3. 97-1 /,,,, 1997.5. 97-2 98-1 : /,,, 1997.11 M&A : M&A /, 1998.1, 98-2 /,,, 1998.2 98-3 /,,, 1998.2 98-4 98-5 ( ) : / 1998.3 /, 1998.3 98-6 : /,, 1998.3,,,, 98-7 /,, 1998.6 98-8 /,,, 1998.10 99-1 ( ) : /, 1999.2 99-2 /,,, 1999.3,
99-3 99-4,, 1999.3 / 1999.3 : /,,,, 99-5 (Survival Analysis) /,, 1999.3 99-6 : /,, 1999.7 99-7 /,, 1999.12 99-8 /,, 1999.12 2000-1 /,, 2000.3 2000-2 ART /, 2000.3 2000-3 /, 2000.3 2000-4 /,. 2000.3 2000-5 /,,, 2000.3 2000-6 /, 2000.6 2000-7 /,. 2000.8 2000-8 /,. 2000.9 2000-9 10 /. 2000.11 2000-10 /. 2000.12 2001-1 /,, 20001.1 2001-2 OECD /,,, 2001.1 2001-3 /,, 2001.1 2001-4 /,, 2001.3 2001-5 /,,,, 2001.3 2001-6 /,, 2001.4 2001-7 CRM : CRM /, 2001.8 2001-8 /,, 2001.10 2001-9 /,, 2001.10
2001-10 /, 2001.12 2001-11 /, 2001.12 2002-1 /,,, 2002. 3 2002-2 /,, 2002. 3 2002-3 /,,, 2002. 5 2002-4 /,, 2002. 5 2002-5 RBC /,,, 2002. 10 2002-6 /,, 2002. 10 2002-7 /,,, 2002. 12 2002-8 /,,, 2002. 12 96-1 /,,,, 1996.2 96-2, 1996.2 96-3 /,,, 1996.10 96-4 /,,,, 1996.12 96-5 /, 1997.3 97-1 (IIS) ( 33 ), 1997.7 97-2 (PIC) ( 18 ), 1997.9 98-1 ( I ) /,, 1998.2 98-2 /,,, 1998.3 98-3 / 1998.3, 98-4 M&A /,,, 1998.8
98-5 MAI /,, 1998.8 98-6 /,,, 1998.10 98-7 ( ) : /,, 1998.11 99-3 /, 1999.3 99-4 /, 1999.6 99-5 : /,, 1999.7 99-6 /,,,, 1999.7 99-7 : /, 1999.7 99-8 /,, 1999.8 99-9 (Underwriting) /, 1999.11 99-10 /, 2000.2 2000-1 /, 2000.3 2000-2 /, 2000.3 2001-1 /, 2001.1 2001-2 / 2, 2001.1 2001-3 /,, 2001.3 2001-4 /, 2001.3 2001-5 /,,, 2001.6 2001-6 (I) / 1, 2001.11 2001-7 (II) /, 2001.11 2002-1 /, 2002.3 2002-2 /,,, 2002.9 2003-1 2003 /, 2003.3
97-1 /,,, 1997.10 97-2 '98, 1997.11 98-1 '99, 1998.11 99-1 2000, 1999.11 99-2 : - /, 1999.12 2000-1 2001, 2000.10 2001-1 /,, 2001.1 2001-2 2002, 2001.11 2001-3 /,, 2001.12 2002-1 2003, 2002.11 1 / F. Grace, 1997.6 Harold D. Skipper, Robert W. Klein, Martin 2 / D. Farny,, J. E. Johnson,, 1998.3 3 1, 1998.11 4 2, 1999.12 Insurance Business Report 1, 1997.5 2 OECD /,, 1997.10 3 /,, 1997.11 4 /, 1997.12 5 IMF /, 1998.3 6 /, 1998.3
7 /,, 1998.5 :,,, 8 /,,, 1999.2 9 (IT) : /, 1999.3 10 /, 1999.3 11 IMF /,, 1999.3 12 /,, 1999.10 13 21 / 1999.12 14 WTO /, 2002.4 15 5 /, 2002. 9,,, 1 Environment Changes in the Korean Insurance Industry in Recent Years / Hokyung Kim, Sangho Park, 1995.5. 2 Korean Insurance Industry 2000 / Insurance Research Center, 2001.4 3 Korean Insurance Industry 2001 / Insurance Research Center, 2002.2 4 Korean Insurance Industry 2002 / Insurance Research Center, 2003.2 CEO Report 2000-1 /,, 2000.5 2000-2 /, 2000.6 2000-3 /, 2000.10 2000-4 /, 2000.11 2001-1 /,, 2001.8 2001-2 /,, 2001.8 2001-3 /,, 2001.10 2002-1 /, 2002.4 2002-2 PL PL /, 2002.6
2002-3 /, 2002.6 2002-4 5 /, 2002.9 2002-5 CI(Critical Illness) /, 2002.10 2002-6 /, 2002.10 2003-1 /, 2003.2 2003-2 2003 /, 2003.3
300,000 150,000 150,000 - (10~15 / ) (5~10 / ) (3~5 / ) - (3-4 ) ( ) - - - - - (10~15 / ) (5~10 / ) (3~5 / ) - (3-4 ) ( ) - - ( 3 4 30,000) ( 50,000) ( 20,000) : : 368-4230,4047 : 368-4099 - : (067-25-0014-382) / (110-55016-257) : - : 6937009 1. ;,,,, Yes 24,
ysoh @kidi.or.kr khlee@kidi.or.kr 2003-1 2003 3 35-4 (02) 368-4000 (02) 2268-0676 ISBN 89-88001- 79-6 93320 10,000