Research On The Mechanism Of Risk Management Of Commercial Health Insurance

The article made a primary and holistic design on the mechanism of risk management ofcommercial health insurance after researching overseas theories and experience and realisticinstance of our country. I hope it can offer a reference for professional health insurance company.The first part discussed overseas theories and experience on risk management of commercialhealth insurance, including game theory and information economics, managed care theory, newdevelopment in the field of information technology and some domestic research.The second part analyzed present status of risk of domestic health insurance. Subsequently, thethird part in the article use the method of flow analysis to analyze health insurance, and dividedits operational flow into three parts, which are operation, reinsurance and capital management,and expounded their risk and management. Among other things operation includes productdevelopment, marketing, underwrite, customer service(claims settlement and health control).Finally, the article analyzed impersonal condition of perfecting the mechanism of riskmanagement of our commercial health insurance.Risk of commercial health insurance is important not only to benefit of insurance company but tosocial stability and economic advance. So we should perfect the mechanism and externalenvironment ceaselessly and add fuel to the fire for the development of commercial healthinsurance.