A Study On The Legal Standard Of Long-term Disability In Long-term Care Insurance

Long-Term Care Insurance,as the "sixth insurance" in the social insurance system of our country,corresponds to the care and care of citizens who are disabled for a long time due to old age,illness,disability and other reasons.Since 2016,when Ministry of Human Resources and Social Security issued < Guidance on the pilot implementation of the Long-Term Care Insurance system >,announcing the pilot program of Long-Term Care Insurance,nearly 40 cities have launched the exploration of Long-Term Care Insurance system.It can be said that China has entered the comprehensive pilot stage of Long-Term Care Insurance system.However,neither the< pilot opinions>nor local practices clearly define the scope and composition of "long-term disability",one of the basic things of Long-Term Care Insurance."Long-term disability" as a Long-Term Care Insurance of insurance accident,connecting the insurant ginseng and enjoy treatment of insurance of the "bridge".On the one hand,the reasonable setting of its legal standard can help the insurer objectively determine whether the insurance accident of long-term care insurance occurs,and then fulfill the obligation of long-term care insurance payment.On the other hand,it is a tool for the insured to safeguard his long term care insurance interests.This paper focuses on the theme of "the legal standard of ’long-term disability’",takes the problem as the guidance,and takes "the status quo and problems--jurisprudential analysis--overseas reference--China’s improvement" as the thinking.The main contents are as follows:Through normative analysis of the current legal documents concerning Long-Term Care Insurance in China,the first part summarizes the existing problems of the legal standard of "long-term disability".These include limiting the scope of disability to severe physical disability,blurring the lines between disability and disease,ambiguity about the timing of the "long term",and ignoring mental and social factors in assessing disability.The second part makes a jurisprudential analysis of the legal standard of "long-term disability".Under the rule of law,"long-term disability" as an insurance accident of the Long-Term Care Insurance,a new type of social insurance,needs to be clearly defined by law in terms of its scope and composition standard.However,when setting relevant standards,the law is not designed out of nothing,but needs to follow a certain legal basis--including the social risk types and characteristics that the insured need to transfer,as well as the particularity of insurance risk allocation in this way.Its specific setting should be determined by the function and purpose of the Long-Term Care Insurance system.In this part,the present "long-term disability" standard in Germany and Japan is discussed in detail.The third part is outside reference.Under the background of aging,providing socialized solutions to the long-term care needs of the chronically disabled is the future trend worldwide.Germany and Japan,as the early countries to implement the Long-Term Care Insurance,have a reference to China in their legal setting of "long term disability".The fourth part,on the basis of the summary,analysis and reference of the first three parts,puts forward some suggestions for the perfection of the legal standard of "long-term disability" in China.First,the legal system of long term care insurance should be improved to provide a basis for the legal standard of long-term disability.Second,the definition of "long-term disability" should be expanded to cover mental disability and moderate to mild disability,with long-term care needs at its core.Thirdly,the relationship between "long-term disability" and disease should be made clear,and treatment should not be taken as a prerequisite for identifying disability.Fourth,the minimum duration of care needs should be defined,that is,the time node represented by the "long-term".Fifth,comprehensive and operational assessment tools for "long-term disability" should be established.