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Research Report on Medical Liability Insurance


									Research Report on Medical Liability Insurance
First, the medical liability insurance market changes and review my business start-up
    The company in May 2002 to the China Insurance Regulatory Commission
completed the first report of medical liability insurance products before, but not in the
market promotion efforts, but to pay close attention to market trends, gather market
information, business strategy cautious pilot, only underwriting business 4 pen,
premiums 1.35 million yuan.

    September 1, 2002 national implementation of "Regulations of Medical
Malpractice", and has issued a series of supporting documents, including:
    "Medical Malpractice Interim Measures";
    "Medical classification standard (for trial implementation)";
    "Major medical negligence and medical malpractice reporting
    "The Ministry of Health, the State Administration of Traditional
Chinese Medicine good implementation of the <Regulations of Medical
Malpractice> the work of the notice";
    "Supreme       People's        Court     on     the   reference
<Regulations of Medical Malpractice> medical malpractice trial in
civil cases," and other.

    The implementation of these laws and regulations to deal with medical
malpractice compensation for the legal environment changed dramatically, including:
medical malpractice Expanding the burden of proof shift, Medical Malpractice way
adjustment, compensation, standards and calculations clear Deng. This change in the
effective protection of vulnerable groups as patients, while the expansion of medical
institutions and medical personnel to practice risk. Before that the slow development
of medical liability insurance instantly ushered in a great life: insurance medical
liability insurance to be transferred around the hospital practice have taken the risk
measures and introduced a local health administrative departments to implement the
work of the medical liability insurance policies, such as the recent Sichuan Provincial
Health Department issued the "On the implementation of the medical
liability insurance in the province to work," which called in the province to
participate in medical institutions of various types of medical liability insurance.

    On the one hand to increase our legal environment and insurance market research
efforts, enhance product development on the other hand, in the October 2003 report
prepared by the introduction of human security, "the medical liability
insurance clause" to replace the original product, while speeding
Marketing pace.

Second, management problems and constraints faced by business development
(A) of the problems facing operations
    1, the lack of empirical data
    Medical liability insurance in China is an emerging insurance, history of shorter
(less than 4 years since 2000), I company is not long, the lack of accumulation of
empirical data, coupled with property insurance actuaries were not in place, and
therefore rate determining are often used to follow the market strategy, more
extensive, only under the hospital beds, the number of medical staff receive premium,
can not be entirely based on the hospital management level, technical level, the
quality of medical staff, different departments, develop different rates in different type
of surgery.

    2, risk diversification difficult
    My small scale of business insurance, reinsurance therefore become the only
choice for risk diversification. However, because of the premium small-scale, so I can
not get reinsurance company to support the reinsurance contract; in the Pro points, the
domestic insurance companies and reinsurance companies are very cautious of such
business, foreign companies is the responsibility of national health dangerous to wait
and see (we think mainly because of different legal environment, compensation
standards and limits are different), so I create a risk the company faces a difficult
situation dispersed.

    3, to attract professional managers
    I know that management of medical liability insurance company need not only to
understand the insurance theory and practice, but also familiar with the medical
expertise, legal knowledge and also acquire a certain amount of specialized
management personnel. We are stepping up to attract such talent to join peace, and
plans to increase our personnel in place of medical liability insurance product
knowledge training and publicity efforts, thereby reducing the operational start-up of

(B) the bottleneck impeding business development
    1, dealing with medical malpractice cases, the law applicable to the
"duality" phenomenon
    Medical malpractice cases, the applicable laws and regulations including the
"Regulations of Medical Malpractice," "The
People's Republic of China misdeed", "Civil
Law", "Contract Law." However, the domestic
application of the law on medical malpractice claims are different, dealing with
medical malpractice law applicable to the case of "dual" of
phenomena, such as:
    (1) "Regulations of Medical Malpractice" fourth 19 second
paragraph states: "does not belong to medical malpractice, medical
institutions are not liable." This provision is clearly ruled out the medical
liability for non-medical, but court trial practice, constitute such incidents, according
to "Regulations of Medical Malpractice" adjustment, does not
constitute medical malpractice tort apply to other "civil law",
this approach will actually be rendered null and void as aforesaid. Insurance Medical
Liability Insurance Underwriting is the practice of medical institutions and medical
negligence, which means not only to bear the liability of medical malpractice, also
cover non-medical malpractice tort risks caused.

    (2) "Medical Malpractice Treatment" in the compensation
standard is higher than before its implementation. However, the recent Supreme
People's Court announced the "Compensation for Personal
Injury cases on the trial a number of problems for the interpretation of the
law", on the scope of personal injury compensation, the standard
introduced new regulations, and the "Regulations of Medical
Malpractice", this judicial interpretation higher standard of compensation
required, which means that if patients in general medical disputes to court, and if not
to does not constitute a general hospital medical malpractice defense, which claims
the damage is caused by medical malpractice (medical institutions and medical staff
account for its reputation, often tend to general medical disputes), then the court will
be in accordance with the personal injury compensation provisions for judicial
interpretation of the amount of compensation, the compensation amount will be
greatly improved, also a corresponding increase in the insurance underwriting risk . It
is reported that a single home or abroad, medical tort claim paid more than 900,000

    2, medical insurance rates the level of demand for services and the dislocation
    "Regulations of Medical Malpractice," The introduction of
the transfer of the burden of proof, making medical malpractice in the hospital as a
head hanging sword of Damocles. Held in Beijing in September last year, the
"2003 Forum and president of the National Hospital PNS"
Medical Malpractice Treatment "implementation of the first anniversary of
the forum", the President had complained bitterly, more representative
view include: the promulgation of the Ordinance make health care disputes will
increase, so that hospitals are struggling with, in order to avoid trouble are often
lightly paid; medical sense of insecurity, see a doctor, to write prescriptions when
patients first thought is not to be complaints, which affected the enthusiasm of such
innovation. From the point of view, to a greater extent reflect the current medical
liability insurance market for medical needs, not simply the transfer of risk, but the
transfer problems: the best insurance claims from patients or their families can be
fully involved from the place of the hospital and patients or their families, in
consultation as soon as possible to resolve disputes. And medical liability insurance
companies do not want to run between the medical dispute process involved different
insurance companies offer at this stage in the process of medical liability insurance
have to be with the local health authorities and medical institutions to set up a
"medical dispute resolution center" to meet medical institutions
out of the various requirements of medical disputes. But this "medical
dispute resolution center" hundreds of million to establish and operate
easily, and to reduce the effect on the insurance claims may not be obvious. Increased
operating costs of medical liability insurance underwriting risk increased, but the
current market rate is still maintained, "Medical Malpractice
Treatment" before the promulgation of the level of increase rate is minimal:
a large hospital in the scale of tens of million annual premium of about Small
hospitals may have only a few million. In the international medical liability insurance
market, in general, a surgical fees to insurance companies to 8% (the reputation of
good doctors can be reduced to 4% had a poor reputation or even medical doctors
may rise to 15%), a doctor per year, usually about 1 / 3 of income for the purchase of
professional insurance and health care in each country only premium ranging from
100 to 400 yuan. Therefore, the level of current market rates can be profitable

    3, the customer needing to be developed
    Parts of the market presence of large hospitals do not want to cover the medical
liability insurance, small hospitals in high-risk insurance company does not welcome
dilemma. When the hospital insurance tend to engage in brain surgery, cardiac
procedures in high-risk insurance departments, pharmacists and nurses are not insured,
but insurance companies are insurance products and not according to different
departments, different charges in different types of surgery for customer behavior is
often difficult to avoid adverse selection. In addition, many medical institutions,
"Medical Malpractice Treatment" and the relevant laws and the
lack of sufficient knowledge of the encounter disputes between patients and insurance
companies would prefer to lose money as soon as possible to resolve disputes,
conciliatory, avoiding patients or their family members went to court and health
department, affect the hospital's reputation and personal future, as to
whether the accident itself, in the end the hospital's negligence, constitutes
medical malpractice, medical institutions, but not seriously. Therefore, the
customer's right to be further nurture the concept of insurance.

    4, insurance companies, risk management can not play
    And business enterprises of different property insurance, domestic insurance
companies for medical liability insurance business a short time, their lack of health
care an effective means of risk prevention, while the market is also very scarce in both
the medical, legal, insurance, knowledge of three people, it can not the insured (health)
to provide medical Loss Prevention Services, difficult insurance company risk
management functions.

Third, the medical liability insurance for the healthy development of the proposal
   1, and further streamline the medical dispute cases to adjust the relationship
between the applicable law, unified handling medical malpractice cases, the measure
of compensation, a clear medical institutions for medical tort damages assumed
responsibility for reducing the amount of compensation between doctors and patients
of the controversy.

    2, the establishment of specialized medical courts or medical disputes tribunal to
resolve medical disputes open up just, fair and speedy resolution channels.

    3, study abroad experience in Hong Kong and the establishment of decentralized
health care risk management mechanisms and improve health care quality, and
effectively avoid medical risks, including the following to establish and improve risk
management system: continuous education and training systems also arrested, clinical
supervision, clinical audit and quality assurance system, accident reporting system,
the system of monitoring and clinical guidelines, clinical supervision and guidelines,
to promote patient-centered service culture, public opinion pooling system

    4, to establish data sharing mechanism: the medical liability insurance, individual
insurance, the lack of historical data, to establish data sharing mechanism is
conducive to rational management, and avoid vicious competition, the medical
liability insurance market to promote healthy development.

Fourth, the development of medical liability insurance company plans
    Hospital in Beijing to consider a higher technical level, the local medical liability
insurance market of the older, relatively more mature, I will promote the medical
liability insurance business focused on the area and choose the first phase and has a
better managed on behalf of and impact of the hospital business development, the
second phase of work in progress under the first phase of the situation and business
Pei Fu, to Beijing, county, district level hospitals to expand. Outside Beijing, then take
a relatively cautious underwriting policy, specific to branch business development
situation. I have plans to achieve premium income in the first half of this year 3
million yuan, annual more than 5 million yuan.

- Tai Ping Insurance Co., Ltd.

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