Important Points for IC 27 - Health Insurance Exam
Page 17 Of 27
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Pricing is an exercise to determine the right level of premium so that the company makes a desired level of profit after paying the claims and other expenses on a portfolio of policies.
Claim reserving is setting aside a reserve by the claims management department for a claim, the moment it is reported.
The modeling process is used to analyse the data and come up with a formula which can be used to predict the future with as much accuracy as possible.
Pre exiting diseases will be"Any condition, ailment or injury or related condition(s) for which insured had signs or symptoms, and/or were diagnosed, and/or received medical advice/treatment, within 48 months prior to insureds first policy with the insurer.
Regulatory interventions are needed to protect the health insurance market from the effects of imperfection like information asymmetry, adverse selection and moral hazard etc.
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