Actuarial Guidance on Medical Expense Tariffs with on Individual Contribution Dependent Reimbursement
Abstract
In recent years, insurance companies have increasingly offered medical expense tariffs, which allow for an individual contribution dependent premium refund in case no insurance benefits have been received. The characteristics of the calculation of these tariffs have not been actuarially studied in detail yet. Therefore, these special medical expense tariffs should be analysed from an actuarial point of view. In general, the calculation of medical expense tariffs with fixed and guaranteed reimbursement (such as a lump sum payment if no out-patient medical benefits have been received or for an outpatient delivery in case of a stationary tariff) is easier due to its premium independency. There-fore, this shall not be further discussed here.
Professional standards of practice are DAV publications that – together with the rules of professional conduct – set out the fundamental principles for the correct practice of actuarial activities. Professional standards of practice are characterised by their
- treatment of specialist actuarial and professional issues,
- fundamental significance and practical relevance for actuaries,
- professional legitimisation through a implementation process that allows all actuaries to be involved in such implementation,
- correct application, with members being professionally safeguarded by a disciplinary process.
The professional standard of practice „Aktuarielle Betrachtung von Krankheitskostentarifen mit einer vom Zahlbeitrag abhängigen erfolgsunabhängigen Beitragsrückerstattung (euBR) (Actuarial Guidance on Medical Expense Tariffs with on Individual Contribution Dependent Reimbursement) is an advisory note. Advisory notes are professional standards that are to be taken into account in actuarial considerations, the application of which can be freely decided upon in individual cases, however, within the framework of the code of conduct, and which address specific questions.
