CAJ | 학술논문

医疗保险市场中，保险人面临着投保人的逆向选择和道德风险。第三方付费制度缺乏对相关主体有效约束，容易诱导道德风险产生。防范商业医疗险投保人道德风险，应采取以下对策：一是加强合同设计时道德风险的控制；二是加强核保时道德风险的控制；三是加强理赔时道德风险的控制；四是建立诚信制度，加强诚信治理。
의료보험시장중，보험인면림착투보인적역향선택화도덕풍험。제삼방부비제도결핍대상관주체유효약속，용역유도도덕풍험산생。방범상업의료험투보인도덕풍험，응채취이하대책：일시가강합동설계시도덕풍험적공제；이시가강핵보시도덕풍험적공제；삼시가강리배시도덕풍험적공제；사시건립성신제도，가강성신치리。
The insurer is facing adverse selection and moral hazard in medical insurance market because the third party payment lacks effective supervision to related bodies. The following countermeasures should be utilized to prevent the moral hazard from policy holders, i.e. designing insurance contract carefully to prevent policy-holders＇ moral hazard ; strengthening the moral hazard management in underwriting and claiming; and establishing credit system to reinforce credibility management.