本研究參酌我國保險業健康保險要保書中的詢問事項、過去相關研究以及德菲法訪問專家之意見，探討保證續保之健康保險的核保因子。本研究將保證續保健康保險之核保因子，歸類為兩大構面及十三項核保因子；十三項核保因子包括年齡、性別、罹病率、生活習慣、健康告知事項、體檢報告書、職業類別、財務狀況、理賠記錄、長尾風險、同業競爭性、道德危險、再保險等。本研究接著再以層級分析法找出核保因子的相關權重，研究結果發現，保證續保健康保險的核保因子構面，健康因子之重要性大於非健康因子。而十三項核保因子依重要性排列順序，最重要為體檢報告書，其次依序為健康告知事項、罹病率、年齡、理賠紀錄、生活習慣、道德危險、性別、職業類別、長尾風險、財務狀況、再保險、同業競爭性。本研究並認為找出各核保因子間之重要性順位關係，可供產險業健康保險核保人員做為決策之參考。 The purpose of this paper is, by employing Delphy and AHP method, to identify and structure underwriting factors under guaranteed renewable health insurance. After survey, this paper identified two main underwriting dimensions and thirteen sub-underwriting factors on guaranteed renewable health insurance. This paper finds that health dimension is more important than non-health dimension. This paper also finds the most importance sub-underwriting factors under two dimensions are the medical report, then are the health disclosure matter, morbidity, age, claims record, habits, moral hazard, sex, occupation, long tail risk, financial condition, reinsurance, industry competition respectively. This study also suggests that the priority among respective underwriting factors is helpful to health insurance underwriting activity.
