생명보험 유진사(有診査) 및 무진사가입자(無診査加入者)의 사망에 관한 고찰

Abstract

[한글]

一部生命保險 加入者 中 加入後 4次年度까지의 發生하는 死亡者의 特性을 調査하여 有診査加入者와 無診査加入者間에 死亡率의 差異點과 診査選擇效果를 알아보고저 하였다.

調査內容은 年度別 維持狀態 年令別死亡率 및 主要 死因이다. 調査對象者는 서울特別市에 位置한 生命保險會社의 國民福祉保險(保險期間:3年)에 加入한 被保險者 中 1979年 1月 1日부터 同年 12月 31日까지 加入한 總 32,358名으로 定하였다. 診査有無別로 加入者의 死亡分析結果는 다음과 같다.

1. 保險加入者의 經過年度別 失效, 解約 및 死亡에 依한 減少率은 1次年度末에 8.0%, 2次年度末에 25.6%, 3次年度末에 11.6%, 4次年度末에 68.7%였으며, 死亡에 依한 減少率은 1次年度末에 0.03%, 2次年度末에 0.11%, 3次年度末에 0.18%, 4次年度末에 0.09%로서 死亡

에 依한 減少率은 낮았다.

2. 有診査加入者와 無診査加入者의 疾病死亡率水準은 保險加入後 3次年度까지 有意의 差異가 없었으며 4次年度에서는 有診査加入者의 疾病死亡率이 無診査死亡率보다 높았으며 (Z=2.997, P<0.05) 年令區間別로도 有診査加入者와 無診査加入者間에 死亡率의 有意의 差

異가 없었으며 4次年度에서 有診査 疾病死亡率이 �╂�것은 査死에서 檢診除外되는 疾病의 逆選擇加入이 있었던 것으로 고려되었다.

3. 死亡者의 主要 死因은 疾病에 依한 死因의 死亡比率이 73.0% (有診査의 경우 55.6%, 無診査의 경우 74.7%)였고, 事故死亡比率은 27.0%(有診査의 경우 44.4%, 無診査의 경우 25.3%)였으며, 有診査 및 無診査에 있어서 共히 疾病死因中 癌(22.0%)이 가장 높은 死亡率

이었으며 有診査의 경우 癌은 檢査에서 除外되었던 疾病이었다. 高血壓, 腦卒中, 肝疾患, 糖尿病 等에 의한 死亡은 有診査加入者에서 發生되지 않은 것은 有診査의 選擇效果라 할 수 있었다.

4. 保險加入에서 有診査保險의 占有率을 높여 不良契約을 예방하는 것이 바람직 한 것으로 고려되나 有診査와 無診査加入者의 疾病死亡率간에는 차이가 없고 또 검진 진료비으 上昇에 EK라 保險者의 부담을 줄이고 加入者의 service 改善을 爲하여 診査契約의 一部診査를 생략하는 대신 정기건강진단 자료로 代用診査制度의 施行과 훈련된 건강조사원의 모집단계에서 告知事項을 確認하고 外觀觀察로서 피보험자의 건강상태를 확인하여 診査에 대신하는 健康調査員制度(Para-medical examination)의 擴大施行도 바람직한 것으로 사료되었다.

[영문]

In Korea, life insurance policies are sold to the policies holders by insuring either the insureds undergo a medical examination at a clinic or the insureds report their history of diseases ever experienced that replaces the medical examination. This study aimed to measure the level of death rates for the insureds between those who received medical examination and those who did not receive medical examination, and to examine differences of the rates in terms of the insureds' characteristics such as age, sex, cause of death and duration.

A total number of 32.358 insureds were selected for the population of this study from the D. Life Insurance Company located in Seoul City. Out of the 32.358 insureds, 2.997 received medical examination and the rest of 29.381 did not received any medical examination.

Results of analysis are summarized as follows :

1. Death rate per 100,000 insureds for the all was 19.3 in the first year, 96.3 in the second year, 143.8 in the third year 93.4 in the fourth year.

For the group of medical examination received the rate was none in the first year, 41.3 in the second year, 55.4 in the third year and 268.8 in the fourth tear, and for the group of non-medically examined the rate was 21.3 in the first year, 101.9 in the second year, 152.2 in the third year and 76.8 in the fourth year. The levels of death rates between the insureds with medical examination and the insureds without medical examination were non-significant in the differences by duration except the levels of the third year, which indicated the death rate of non-medically examined group was higher than that of the medically examined group.

2. 73.0 percent of the total deaths observed during the insured period were caused by various diseases and the rest of 27.0 per cent deaths were due to accidents.

For the group of medical examination received, 55.6 per cent deaths were caused by diseases, and for the group of non-medically examined, 74.7 per cent of deaths were due to diseases.

3. Death due to cancer was the most frequent cause which accounted for 22.0 per cent of the total deaths.

Proportion of deaths due to cancer from the group of medical examination received was 22.2 per cent, and the corresponding rate for the group of non-medically examined also showed high rate of 22.0 per cent.