免赔额与医疗保险索赔额关系分析

使用Group Medical Insurance Claims Database数据库的数据对免赔额与索赔额和每次索赔的超额费用进行了实证分析.结果表明,随着免赔额的增加,医疗保险的索赔额会逐渐降低,而每次索赔的超额费用会逐渐增加.同时,还利用多目标规划方法,并结合实证结果,构建多目标模型以确定医疗保险的最优免赔额.

A Study on the Relationship between Deductible and Medical Insurance's Claim

This paper makes use of Group Medical Insurance Claims Database to research relationship between claims and deductible, and deductible and excess charges. The empirical shows, with deductible increasing, medical insurance's claims will decrease and excess charges per claims will increase. And, on the base of empirical result, this paper makes use of multi-objective programming to build model in order to give the deductible.