• 무역상무연구
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• 제17권
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• pp.93-125
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• 2002

This paper aims to find a reasonable solvency margin system in non-life insurance industry and also to evaluate the appropriateness of the current solvency margin regulation system in Korea. The current solvency margin system in Korea, based on EU's solvency margin model, was introduced during the 1997 financial crisis. The solvency requirement is not based on non-life insurer's risk, but simply on written premiums. The current solvency margin for general insurance, such as fire, marine, and automobile insurance, is determined by the greater between a premium-based amount and a claim-based amount, where the premium-based solvency margin is calculated by multiplying the net written premium for the preceding year by the premium based solvency margin ratio. Also, the amount of solvency margin for long term insurance is set at 4% of the policy reserve of the long term insurance. Still, there exist many differences between the current solvency margin regulation system in Korea and EU's model. This paper focuses on the rationality of the solvency margin regulation system, and compares the current system in Korea with EU's model and the RBC(Risk Based Capital) system in U.S. and Japan. Finally, this paper suggests a more specific and reasonable solvency margin system to be developed in Korea.

• 보험의학회지
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• 제26권
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• pp.31-39
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• 2007

Background and main issue: In the Korean insurance market, an outstanding issue is the decrease of margin of risk ratio. This affects the solvency and profitability of insurance companies. Insurance medicine, which has been developed in Western countries, is so-called medical risk selection or medical underwriting. Medical risk selection is based on clinical follow-up study and mortality analysis methodology. Unfortunately, there have been few clinical follow-up studies, and no intercompany disease analysis system is available in the Korean insurance market. In practice, we use underwriting guidelines, which were developed by some global reinsurance companies. However, these guidelines were developed under clinical follow-up studies performed abroad. So, we cannot rule out underestimation of excess mortality factors such as mortality ratio, excess death rate, and life expectancy. It is necessary to perform medical assessment in claims administration. Comparing the insured's statement by medical records with products' benefit according to this procedure, we can make sound claim decisions and participate in the role of sound underwriting. We can call this scientific procedure as the verification of medical claims review. Another area of medical claims review is medical counsel for claims staff. Result: There is another insurance medicine in addition to medical risk selection. Independent medical assessment by medical records of insured is medical claims review. Medical claims review is composed of verification and counsel.