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|其它题名: ||A study on claim dispute regarding commerical health insurance in Taiwan market|
|作者: ||陳偉弘;Chen, Wei-Hung|
郝充仁;李雅婷;Hao, Chung-Jen;Lee, Ya-Ting
|关键词: ||商業健康保險;理賠爭;爭議類型;commerical health insurance;Claim dispute;type of claims disputes|
|上传时间: ||2012-06-21 06:36:35 (UTC+8)|
Taiwan has launched commercial health insurance products for
more than 40 years. As consumer awareness has gradually risen, insurance disputes have also increased.
According to the statistics released by the authorities, the life insurance industry had a total of 3,092 complaints in 2010, with 1,339 claim cases, and health insurance accounting for up to 58.87%, which held the highest rank among all insurances and was necessary to be reviewed and improved.
Claim service is one of important indicators for policyholders to evaluate an insurance company because insurance products are invisible and the values can be sensed by the insured only when incurring loss. Moreover, insurance claims emphasize promptness and accuracy for the purpose of which once the insured event occurs, the insured can receive financial compensation quickly instead of plunging into a deep crisis.
This research mainly discusses issues regarding health insurance claims, and analyzes and reviews the disputed cases, expecting to offer the information as reference not only to insurance companies for handling disputes or improving, but also to the authorities and relevant units (such as judicial inspection unit and Bureau of Health Insurance, etc.) for amending the Insurance Act or regulating clauses.