Limitsiz sağlık sigortaları genel bir yaklaşım

Abstract

Today Health insurance is favoured by a great portion of the population in the developed countries where the history of insurance business leads far back to the older ages. In United States of America where private health insurance has reached its climax point, out of 199 millions of insurable people under age 65, 188 millions of people have health insurance. That means that 95 % of the insurable people is insured. On the other hand in Turkey the number of the people having health insurance is under 1 million. Considering the USA example, it is worthwhile to think about the horizons of private health insurance. In essence, Unlimited health insurance covers the greatest risks and expensive treatments that may effect the life of the insured and cause him to lose a fortune in trying to recover. In this study basicly the technical aspects of the health insurance is examined. The aim of the study is to show the recent health insurance applications with examples from foreign countries where health insurance is far more developed than Turkey, to help the development of health insurance by showing scientific methods to be adopted in order that the insurer can bear greater risks. In the first section the factors used to limit the risk is explained. In the second section the underwriting procedures and reinsuring the health insurance is concerned. In the third section the basic concepts about health insurance mathematics and the models used in premium calculation are considered. Fourth section consists of the detailed explanations of the factors effecting the claims according to the benefit groups. Also this section includes the introduction of comprehensive health insurances in USA and the comparison of the likewise products in Turkey among themselves. Fifth section covers the examples of the policy wordings from USA and Turkey. Finally in the sixth section the precautions that should be taken by the insurer in order to be free of his liability are explained.