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正修學報

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中文摘要

看護市場,提供各種型態的長期看護保險,我國全民健康保險雖有提供居家看護的相關保障內容,但仍無法抵補長期看護各項費用支出,因此,商業性長期看護保險相關產品之推出,可以彌補此一保障缺口。但我國並未針對長期看護保險之相關特性,妥適規劃一獨立而完整的長期看護保險保單。反觀美國商業性長期看護保險在美國保險市場已不是新產品也訂頒有長期看護保險示範條款,該示範條款之規範相當完整,足可供我國設計商業性長期看護保險之參酌。職是,本文擬以美國長期看護保險示範條款之規定內容,比較檢討我國商業性長期看護保險之相關問題,並提出改進之道,俾我國長期看護保險市場得有進一步發展的空間。

英文摘要

Long-term care (LTC) is in ever higher in demand due to fast growing elderly population and increasing bed-ridden patients from accidents. It has been the responsibility of insurers at fulfilling the gap between the basic assistance provided from the government and the market need. Hence, the insurer is expected to produce various forms of policies to cover the rising long-term care needs. It is obviously that the protection is unsatisfactory and the market is severely limited. Our paper is trying to identify key issues addressed in LTC model policy from National Association of Insurance Commisioners (NAIC), such as incontestability, payment schedules, group definition, etc., to see if they can be adopted into the coming domestic LTC model policy.

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