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查脉:保险医疗总监角色演变的全球调查

Checking the Pulse: A Global Survey on the Evolving Roles of the Insurance Medical Director.

机构信息

Sheetal S Salgaonkar, VP Global Medical Director, Reinsurance Group of America, Incorporated (RGA).

Leigh Allen, AVP, Global Strategic Research, RGA International.

出版信息

J Insur Med. 2022 Jul 1;49(3):189-199. doi: 10.17849/insm-49-3-1-11.1.

Abstract

BACKGROUND AND OBJECTIVE

-The traditional role of the insurance medical director is evolving. RGA surveyed insurance medical directors to provide an overview of their roles, skill sets, future trends, and their increasing and changing contributions to the insurance industry in recent years and throughout the current pandemic.

METHOD

-RGA conducted a first-of-a-kind global survey of medical directors in the insurance industry. The online survey took place from April to June 2021 and had seven key sections: medical experience and qualifications, roles and responsibilities, underwriting and claims capabilities, adapting to change, disease and product trends in insurance, challenges, and future opportunities. Globally, 124 insurance medical directors from 84 companies participated in the survey.

RESULTS

-Respondents are an experienced group of medical directors, with 88% active in the medical profession for 10 years or more. Eighty-seven respondents (70%) dedicate the majority of their time to providing technical medical expertise. Forty-eight percent of medical directors were involved in medical issue briefings prior to the pandemic, and that number increased to 63% during the pandemic. Three of every five respondents (60%) reported a shift in underwriting to an emphasis on more competitive decisions, e-underwriting, and data analytics, while for claims practices, 35% reported a shift to more decisions being challenged and increasing complexity of claims and products. In addition, 31% of insurance medical directors are involved in product development on a regular basis. Only 50% of respondents reported a high or moderate level of investment from employers for training and development with their companies. Forty-three percent of survey respondents are interested in a change of role, especially those with less than 15 years of experience in the insurance industry. Medical directors see data and analytics (50%) as the largest area of development for future growth. Eighty-eight percent of participants surveyed believe that the future role of the medical director in the life and health insurance industry is promising.

CONCLUSION

-The future of the medical director role will require more strategic responsibilities, greater product development expertise, and stronger data and analytics skills to support insurer needs. It will be important for insurance medical directors to engage in conversations with their employers to discuss their current and emerging roles.

摘要

背景与目的

  • 保险医学主任的传统角色正在演变。RGA 调查了保险医学主任,以提供他们的角色、技能集、未来趋势的概述,以及近年来和整个当前大流行期间他们对保险业日益增加和不断变化的贡献。

方法

  • RGA 对保险行业的医学主任进行了首次全球调查。在线调查于 2021 年 4 月至 6 月进行,有七个关键部分:医疗经验和资格、角色和责任、承保和理赔能力、适应变化、保险中的疾病和产品趋势、挑战和未来机会。全球共有 84 家公司的 124 名保险医学主任参与了调查。

结果

  • 受访者是一群经验丰富的医学主任,其中 88% 的人从事医疗行业已有 10 年或更长时间。87 名受访者(70%)将大部分时间用于提供技术医疗专业知识。48%的医学主任在大流行前参与了医疗问题简报,这一数字在大流行期间增加到 63%。每五名受访者中有三名(60%)报告说,承保工作重点已转向更具竞争力的决策、电子承保和数据分析,而理赔业务方面,35%的人报告说,更多的理赔决定受到质疑,理赔和产品的复杂性增加。此外,31%的保险医学主任定期参与产品开发。只有 50%的受访者报告说,雇主对与公司的培训和发展进行了大量或中等程度的投资。43%的调查受访者对角色的改变感兴趣,尤其是那些在保险行业工作经验不足 15 年的人。医学主任认为数据和分析(50%)是未来发展的最大领域。88%的受访者认为,未来医疗主任在人寿和健康保险行业的角色是有前途的。

结论

  • 医学主任角色的未来将需要更多的战略责任、更强的产品开发专业知识和更强大的数据和分析技能,以满足保险公司的需求。保险医学主任与雇主进行对话,讨论他们当前和新兴的角色将非常重要。

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