本發明係有關於一種金融電子商務領域之健康及傷害保險，特別有關於在運用網路科技來創造擁有資金競標機制的投資型健康及傷害保險。The present invention relates to health and injury insurance in the field of financial e-commerce, and in particular to the use of network technology to create investment-type health and injury insurance with a capital bidding mechanism.
保險業提供健康及傷害保險的目的在於提供被保險人因疾病、意外事件所造成之經濟損失(包含醫療費用及因死亡殘疾所致之所得中斷)，而予以彌補該損失。健康保險(Health Insurance)的概念最早是由英國人Hugh the Elder Chamberien於1694年提出，認為可藉由保險手段來補償被保險人的人身所受到的損害。但這項概念直到十九世紀末因工業革命所帶動的社會型態改變，保險公司才開始推出健康保險商品。The purpose of the health and injury insurance provided by the insurance industry is to compensate the insured for the economic losses caused by illnesses and accidents (including medical expenses and interruption of income due to death disability). The concept of Health Insurance was first proposed by British Hugh the Elder Chamberien in 1694, and it is believed that insurance can be used to compensate the insured person for damage. But this concept did not begin until the end of the 19th century due to changes in the social pattern driven by the industrial revolution, and insurance companies began to introduce health insurance products.
然而初期健康保險僅限於殘疾保險(Disability Insurance)，保險所保障的範圍多侷限於因殘疾死亡所導致經濟來源的損失。直到二十世紀中期以後，歐美工業化國家的社會結構發展趨於成熟，健康保險的功能及定義也逐漸產生變化。However, initial health insurance is limited to Disability Insurance, and the scope of insurance coverage is limited to the loss of economic resources caused by death from disability. Until the middle of the twentieth century, the social structure of industrialized countries in Europe and the United States has matured, and the functions and definitions of health insurance have gradually changed.
健康保險開始納入醫療保險項目，提供被保險人醫療費用保障(Medical Expense Coverage)；而既有之殘疾保險，則從意外(Accident)觀念延伸，且與產物保險中之責任保險(Liability Insurance)相結合，藉此承保被保險人因人身傷害事件所生風險。Health insurance begins to be included in the medical insurance program, providing the Medical Expense Coverage for the insured; while the existing disability insurance extends from the Accident concept and is related to Liability Insurance in the product insurance. Combine, thereby insuring the insured person’s life due to personal injuryrisk.
時至今日，健康保險不再僅是壽險公司所提供的保險服務項目，許多產險公司亦有提供健康保險服務。由於健康保險在某種程度上屬於一種概括式的概念，一些類似或由其衍生的險種，包含醫療保險、傷害保險、意外保險等項目，其分類也由於保險服務內容彼此相互重疊，而無一定明確區分，為求名稱定義一致，本專利申請案對於保障人身因疾病及意外所生損害保險，依當地國家之保險法定義方式加以定名，故以健康及傷害保險稱之。Today, health insurance is no longer just an insurance service provided by life insurance companies, and many property insurance companies also provide health insurance services. Since health insurance is to some extent a generalized concept, some similar or derived types of insurance, including medical insurance, injury insurance, accident insurance and other items, are also classified because the insurance service contents overlap each other, and there is no certain Clearly distinguishing, in order to define the definition of the name, this patent application is to protect the personal injury caused by diseases and accidents, and is named according to the definition of the insurance law of the local country, so it is called health and injury insurance.
由於健康及傷害保險所承保標的係為人身所承受之疾病、意外風險，故健康及傷害保險之發展與一經濟社會對人身價值衡量有關，也因此其保險滲透狀況可作為衡量一個國家人民生活的水平以及經濟發展程度的指標。以保險業高度發展的美國為例，依據美國人口統計局(United States Census Bureau)2006年統計，84%美國民眾投保健康險(美國健康險同時包含醫療及傷害險)，其中60%的健康險係由雇主代為投保，9%為受雇者自己購買保險，其他約有27%由政府參與資助(由於部分被保民眾可能同時自行購買或接受政府資助，故總比率加總超過84%)。至於台灣的醫療傷害保險，最重要來源係來自於由雇主及要保人自付之全民健康保險，2007年8月總投保人數達到2,253萬人，投保比率達到全部人口97%以上。由於全民健康保險僅提供基礎醫療給付，許多民眾亦藉由加入商業健康及傷害保險彌補其不足，依據保險事業發展中心(Taiwan Insurance Institute)統計，2006年健康及傷害保險總保費達到2,216億元，佔當年度總保險費用之13.76%。Since the subject of health and injury insurance is the risk of accidents and accidents, the development of health and injury insurance is related to the measurement of personal value in an economic society, and therefore its insurance penetration can be used as a measure of the lives of people in a country. Level and indicators of economic development. In the United States, where the insurance industry is highly developed, according to the 2006 statistics of the United States Census Bureau, 84% of Americans are insured for health insurance (US health insurance includes both medical and injury insurance), of which 60% are health insurance. The employer is insured on behalf of the employer, 9% of the employees purchase insurance themselves, and about 27% of the other are funded by the government (the total ratio is more than 84% because some of the insured people may purchase or receive government subsidies at the same time). As for Taiwan's medical injury insurance, the most important source comes from the universal health insurance paid by the employer and the insured. In August 2007, the total number of insured persons reached 22.53 million, and the insurance coverage reached 97% of the total population. Since universal health insurance only provides basic medical benefits, many people also make up for their shortcomings by joining commercial health and injury insurance. According to the Insurance Insurance Development Center (Taiwan Insurance Institute), the total health and injury insurance premiums in 2006 reached 221.6 billion yuan. Accounting for 13.76% of the total annual insurance costs.
由於健康及傷害保險為保險業重要險種，為滿足不同消費者需求，商品種類及區分方式也相當多變。依據保險人身份，可區分為由公營健康及傷害保險(例如我國之全民健保及勞工保險之傷害給付部分)、保險公司辦理之商業健康保險；又依據保費資金來源可區分為政府贊助型(Government Sponsored)、雇主贊助型(Employer Sponsored)、個人購買型(Individual Purchased)。但就保險商品設計觀點，目前保險業所推出之健康及傷害保險種類包括以下幾類普遍險種：As health and injury insurance is an important insurance industry, the types of goods and the way they are differentiated are quite varied to meet the needs of different consumers. According to the identity of the insurer, it can be divided into public health and injury insurance (such as the injury payment part of China's universal health insurance and labor insurance), commercial health insurance for insurance companies, and can be divided into government-sponsored types according to the source of premium funds. Sponsored), Employer Sponsored, and Individual Purchased. However, regarding the design of insurance products, the types of health and injury insurance introduced by the insurance industry include the following types of general insurance:
1.傳統式健康及傷害保險：提供被保險人於保險期間(一定期間或終身)的醫療及傷害保障，並依據保險理賠條款，依據給予定額或實際支出額之保險給付。1. Traditional Health and Injury Insurance: Provides medical and injury protection for the insured during the insurance period (for a certain period of time or for life), and based on the insurance claims, based on the insurance premium given to the fixed amount or actual expenditure.
2.帳戶式健康及傷害保險：本質上屬於一種儲蓄型健康及傷害保險，客戶定期繳交保險費於個人保險儲蓄帳戶，保險理賠則依據被保險人出險狀況進行給付，若保險期間結束帳戶仍有餘額，則依據保險契約內容退還帳戶內剩餘之保費。2. Account-based health and injury insurance: essentially a kind of savings-type health and injury insurance, the customer pays the insurance premium regularly in the personal insurance savings account, and the insurance claims are paid according to the insured's risk situation. If there is a balance, the remaining premium in the account will be refunded according to the contents of the insurance contract.
3.個人/團體式健康及傷害保險：依據要保人為個人或團體(通常為企業或機構)所投保的健康傷害險，對團體保險而言，該項保險往往屬於員工福利計畫一部份。個人式健康及傷害保險往往結合人壽保險，以附約型態存在。3. Personal/group health and injury insurance: According to the health insurance that the insured person is insured for an individual or group (usually a business or institution), for group insurance, the insurance is often part of the employee benefit plan. . Personal health and injury insurance often combines life insurance with a contractual form.
美國專利公告號US 4,491,725「Medical insurance verification and processing system」揭露對公共或私人醫療保險在申請及理賠的繁複過程所可能造成的錯誤及時間成本的浪費問題而提出一套解決方案。該專利案所稱之醫療保險之驗證及處理系統即是將要保人的醫療卡內所記載有關該要保人投保所需的資訊儲存於主機中，並透過資料的讀取及驗算(驗證)以快速且精準地算出購買保險的保費，將可確保要保人之保險申請的便利、提高費用收取的正確性，以並加速理賠處理程序。US Patent Publication No. 4,491,725 "Medical insurance verification and processing system" discloses a solution to the problem of the erroneous and time-consuming waste of public or private medical insurance in the complicated process of application and claims. The medical insurance verification and processing system referred to in the patent case is required to be insured by the insured person in the medical card of the insured person.The information is stored in the host computer, and the data is read and verified (verified) to quickly and accurately calculate the insurance premium for purchase, which will ensure the convenience of the insurance applicant's insurance application and improve the correctness of the fee collection. Speed up claims processing.
美國專利公告號US 5,070,452「Computerized medical insurance system including means to automatically update member eligibility files at pre-established intervals」係揭露對前項專利(US 4,491,725)的缺失所提出專利案。由於前項專利案雖然可更有效率處理要保人(病患)的醫療卡訊息，但未提出要保人卡片中資料是如何地輸入、儲存、更新。若缺乏具體解決方式，那麼仍會產生很多在醫療保險之申請成本、費用計算上的謬誤，以及錯誤給付醫療理賠狀況，特別是當舊有資料與現實狀況不符時，如該要保人已離職，理應不享有該就業團體的醫療保險福利，卻仍顯示投保就業團體醫療保險或未即時更新訊息等，便會產生許多的問題，所以該專利案即從前述專利案缺失出發。藉由資料庫連結及要保人定期更新作法，加速保險申請及費用計算正確性，並不致發生實際應給付情況與資料記載狀態不符之情事。U.S. Patent Publication No. 5,070,452, "Computerized medical insurance system including means to automatically update member eligibility files at pre-established intervals" discloses a patent filed for the absence of the prior patent (US 4,491,725). Although the patent application in the preceding paragraph can more effectively process the medical card information of the person (patient), it does not propose how to input, store and update the information in the card. If there is no specific solution, there will still be a lot of delays in the application cost and cost calculation of medical insurance, as well as the wrong payment of medical claims, especially when the old information does not match the actual situation, if the insured has left If the medical insurance benefits of the employment group are not available, but it still shows that the medical insurance for the insured employment group or the information is not updated immediately, many problems will arise. Therefore, the patent case is based on the lack of the aforementioned patent case. Accelerate the correctness of the insurance application and the cost calculation by linking the database and the person to be updated regularly, without causing the actual payment situation to be inconsistent with the status of the data.
前述兩項專利之目的仍在於以電腦系統改善健康保險作業流程，但基本上仍是在傳統健康保險之保費繳交、出險理賠的邏輯下運作，無法就傳統健康保險運作模式提出一套有效創新想法。雖然近年來有帳戶式健康及傷害保險商品的提出，可以在無重大理賠情況下，退回要保人帳戶中未使用保費，以降低要保人保費支出並減少被保險人醫療浪費，但其所購買之健康及傷害保險仍是標準化商品，無法滿足保險界所追求商品客製化需求。此外，現有傳統健康及傷害保險多僅有損失填補功能，並無法發揮擴大信用、結合投資儲蓄效用，侷限保險費用的運用。因此本發明之投資型健康及傷害保險之方法與系統的發明動機在於將資金競標機制融入傳統健康及傷害保險中，讓要保人能在平台運作下，除獲得人身保障外，亦可依據市場利率變化及自身理財需求，靈活運用所繳保險費用。而保險業界亦可藉由本發明方法，擴大保險資金基礎，不僅滿足客戶需求，亦可擴大保險業務規模，強化保險財務品質。The purpose of the above two patents is still to improve the health insurance operation process by computer system, but basically still operate under the logic of traditional health insurance premium payment and insurance claims, and it is impossible to propose an effective innovation on the traditional health insurance operation mode. idea. Although in recent years there are account-based health and injury insurance products, you can return the unused premiums in the insured account without major claims, in order to reduce the insurance premiums and reduce the medical waste of the insured, but The purchased health and injury insurance is still a standardized product and cannot meet the demand for customized products in the insurance industry. In addition, existingTraditional health and injury insurance has only lost the function of filling, and it is unable to play the role of expanding credit, combining investment savings, and limiting the use of insurance fees. Therefore, the invention of the method and system for investment-type health and injury insurance of the present invention is to integrate the capital bidding mechanism into the traditional health and injury insurance, so that the insurer can operate under the platform, in addition to obtaining personal protection, according to the market. The interest rate changes and their own financial needs, flexible use of the insurance premiums paid. The insurance industry can also expand the insurance fund base by the method of the present invention, not only to meet the needs of customers, but also to expand the scale of insurance business and strengthen the financial quality of insurance.
綜上所述，本發明提出一種投資型健康及傷害保險之方法與系統，以解決以上問題。本發明之發明目的如下：In summary, the present invention proposes a method and system for investing in health and injury insurance to solve the above problems. The object of the invention is as follows:
1.本發明架構一資金競標機制，讓健康及傷害保險的繳費方式，從既有平準式或階梯式繳費模式，成為變動的、可自我主張利率的繳費方式，使傳統健康及傷害保險轉型為投資型健康及傷害保險。1. The framework of the invention is a fund bidding mechanism, which allows the payment method of health and injury insurance to be changed from the existing leveling or tiered payment mode to a changeable self-claimed interest rate payment method, so that the traditional health and injury insurance is transformed into Investment health and injury insurance.
2.本發明架構的資金競標機制，使用者的競標標金可以反映市場利率和市場資金水位。當市場資金需求活絡時，投資商品暢旺，利率上揚；市場資金需求趨緩時，投資標的少，利率下跌；當市場利率直接反映在資金競標平台上時，客戶所參與的投資型健康及傷害保險產品，便成為具為資訊對稱性的直接金融理財商品。2. The capital bidding mechanism of the framework of the invention, the user's bidding standard can reflect the market interest rate and the market fund level. When the market capital demand is active, investment products are booming, interest rates rise; when market capital demand slows down, investment targets are low, interest rates fall; when market interest rates are directly reflected in the fund bidding platform, the investment-type health and injury insurance that customers participate in Products become direct financial wealth management products with information symmetry.
3.確保保險契約之安定：保險契約之安定，乃影響保險公司能否健全的因素之一。由於健康保險保費隨著被保險人年齡、健康狀況進行調整，逐步調高費率往往阻礙了要保人的續保意願，造成保險公司很大的困擾。特別是傳統健康及傷害保險商品，其制式化商品設計及缺乏彈性的契約內容，無法貼近市場，確實地反映網路時代資訊的對稱性，造成保險契約不安定。本發明資金競標機制所發揮的資訊對稱性一舉解決這些問題，以確保契約的安定。3. Ensuring the stability of the insurance contract: The stability of the insurance contract is one of the factors that affect the integrity of the insurance company. As health insurance premiums are adjusted with the age and health of the insured, gradually increasing the rate often hinders the willingness of the insured to renew, resulting inInsurance companies are very troubled. In particular, the traditional health and injury insurance products, the design of the product and the lack of flexible contract content, can not be close to the market, and truly reflect the symmetry of the information in the Internet age, resulting in the insurance contract is not stable. The information symmetry played by the fund bidding mechanism of the present invention solves these problems in one fell swoop to ensure the stability of the contract.
4.創造現金流量。投資型健康及傷害保險的競標機制之推出，必能增加保險人之現金流量，增加保險人之信用能力，有助於資金之投資運用。4. Create cash flow. The introduction of the competitive bidding mechanism for investment-type health and injury insurance will certainly increase the cash flow of the insurer, increase the credit ability of the insurer, and contribute to the investment and use of funds.
5.提高投保意願：由於目前健康及傷害保險僅提供醫療、意外給付，缺乏理財功能，影響部分要保人的參與意願。因此，投資型健康及傷害保險的競標機制之推出，可將理財、保障功能結合，擴大客戶的投保意願。5. Increase the willingness to insured: Since the current health and injury insurance only provides medical care, accidental payment, and lack of financial management functions, it affects the willingness of some insured persons to participate. Therefore, the introduction of the competitive bidding mechanism for investment-type health and injury insurance can combine financial management and security functions to expand customers' willingness to insure.
6.提供被保險人更佳保障：既有健康及傷害保險係以損失填補原則進行設計，特別是發生重大傷害或疾病事件時，雖然被保險人(或其受益人)可獲得一定程度補償，但保險契約往往就此終止。本發明在導入資金交易平台及資金投資功能，使被保險人不僅可獲得出險補償，亦可享有投資報酬，維繫其出險失能後之所得收入，對於確保被保險人後續生活品質有更積極助益。6. Provide better protection for the insured: both health and injury insurance are designed with the principle of loss of filling, especially in the event of a major injury or illness, although the insured (or his beneficiary) can receive a certain level of compensation, But the insurance contract often ends here. The invention introduces the capital transaction platform and the capital investment function, so that the insured can not only obtain the insurance compensation, but also enjoy the investment remuneration, and maintain the income after the disability is disabled, which is more helpful for ensuring the insured's subsequent quality of life. beneficial.
為達成上述目的，本發明提供一種投資型健康及傷害保險之方法，其應用於一該投資型健康及傷害保險系統，該方法包含下列步驟：由該投資型健康及傷害保險系統之一投資型健康及傷害保險接收作業模組接收並審核一要保人之一基本資料，由該投資型健康及傷害保險接收作業模組提供一投資型健康及傷害保險保單以供該要保人購買，該投資型健康及傷害保險保單包含一競標交易組合；由該投資型健康及傷害保險系統之一資金競標模組判斷參與競該標交易組合之該要保人之人數是否額滿，該人數與該競標交易組合之一競標期數相同；若參與該競標交易組合之該要保人之人數額滿時，則在該競標期數的每一會期由該投資型健康及傷害保險系統之一資金競標模組接收未曾得標之該要保人所輸入之一投標金額，該資金競標模組根據所輸入之該投標金額來決定一得標金額與得標者；由該投資型健康及傷害保險系統之一金流處理模組根據該得標金額結算一總得標金、存款金額與一還款金額；在該要保人未得標時，由該理賠作業模組判斷一被保險人是否出險；在該要保人未得標時，若該被保險人出險，在該要保人未得標時，若該被保險人未出險，則進行由該資金競標模組接收未曾得標之該要保人所輸入之該投標金額之步驟；則由該金流處理模組結算該投資型健康及傷害保險保單之一理賠金及該要保人之該個人帳戶之所有該存款金額的現值；在該要保人已得標時，由該理賠作業模組判斷該投資型健康及傷害保險保單是否到期；以及在該要保人已得標時，若該投資型健康及傷害保險保單到期，則由該金流處理模組結算該要保人所繳納之一保費的總額及一結算餘額，該結算餘額係為該要保人之該個人帳戶經投資之該總得標金之一資產淨值扣除剩餘會期之一總還款金額；在該要保人已得標時，若該投資型健康及傷害保險保單未到期，則由該理賠作業模組判斷該被保險人是否出險；以及在該要保人已得標時，若該被保險人出險，則由該金流處理模組結算該投資型健康及傷害保險保單之該理賠金及該結算餘額，該結算餘額係為該要保人之該個人帳戶經投資之該總得標金之該資產淨值扣除剩餘會期之一總還款金額。To achieve the above object, the present invention provides an investment-type health and injury insurance method for use in an investment-type health and injury insurance system, the method comprising the steps of: investing in one of the investment-type health and injury insurance systems The Health and Injury Insurance Receiving Module receives and reviews one of the essential information of the insured, from the investment health andThe injury insurance receiving operation module provides an investment-type health and injury insurance policy for the insured person to purchase. The investment-type health and injury insurance policy includes a bidding transaction portfolio; the bidding of one of the investment-type health and injury insurance systems The module determines whether the number of the insured persons participating in the bidding transaction combination is full, and the number of bidding periods is the same as the bidding period of the bidding transaction combination; if the amount of the insured person participating in the bidding transaction combination is full At each session of the bidding period, one of the investment type health and injury insurance system funds bidding module receives one bid amount that has not been awarded by the insured person, and the fund bidding module is based on Entering the bid amount to determine the winning amount and the winner; the gold flow processing module of the investment health and injury insurance system settles a total amount of the deposit, the deposit amount and the repayment amount according to the winning amount. When the insured person fails to obtain the bid, the claim operation module determines whether the insured person is in danger; if the insured person fails to obtain the bid, if the insured person is in danger, the insured person is insured When the bid is obtained, if the insured is not in danger, the step of receiving the bid amount input by the bidder that has not been awarded by the fund bidding module is performed; and the investment type is settled by the gold stream processing module The current value of the health insurance and injury insurance policy and all the deposit amount of the personal account of the insured person; when the insured person has obtained the bid, the claim operation module judges the investment type health and injury Whether the insurance policy expires; and when the insured person has obtained the bid, if the investment health and injury insurance policy expires, the gold flow processing module settles the total amount of one of the premiums paid by the insured and a settlement balance, which is the net asset value of the total amount of the investment of the individual account of the insured person minus one of the remaining repayment amount;When the insured person has obtained the bid, if the investment type health and injury insurance policy has not expired, the claim operation module determines whether the insured person is in danger; and if the insured person has obtained the bid, if If the insured person is in danger, the gold flow processing module settles the claim and the settlement balance of the investment type health and injury insurance policy, and the settlement balance is the total investment of the personal account of the insured person. The net asset value of the standard deposit is deducted from the total repayment amount of one of the remaining periods.
本發明提供一種投資型健康及傷害保險系統，包含：一投資型健康及傷害保險接收作業模組，用以根據一要保人之基本資料進行審核，提供一投資型健康及傷害保險保單以供該要保人選擇購買；一資金競標模組，用以在該競標交易組合之一競標期數的每一會期根據根據該要保人所輸入之一投標金額，來決定一得標金額與得標者；一理賠作業模組，用以判斷該投資型健康及傷害保險保單是否到期，及判斷一被保險人是否出險與出險程度；以及一金流處理模組，用以根據該得標金額結算該總得標金、一存款金額與一還款金額；其中，根據該投資型健康及傷害保險保單是否到期及該被保險人是否出險與出險程度，由該金流處理模組來結算一理賠金及該個人帳戶之所有該存款金額的現值、或所繳納之一保費的總額及一結算餘額、或部分該理賠金，該結算餘額係為該個人帳戶經投資之該總得標金之該資產淨值扣除剩餘會期之一總還款金額。The invention provides an investment-type health and injury insurance system, comprising: an investment-type health and injury insurance receiving operation module, which is used for reviewing basic information of an insured person and providing an investment-type health and injury insurance policy for providing The insured person chooses to purchase; a fund bidding module is used to determine a winning amount according to one bid amount according to the insured person in each meeting period of one of the bidding period of the bidding transaction combination. a successful bidder; a claim operation module for judging whether the investment health and injury insurance policy expires, and determining whether an insured person is in danger or risk; and a gold flow processing module for The standard amount is settled by the total amount of the deposit, the amount of the deposit and the amount of the repayment; wherein, according to whether the investment-type health and injury insurance policy expires and whether the insured is in danger or risk, the gold flow processing module Settlement of the present value of the claim and all the deposit amount of the personal account, or the total amount of one of the premiums paid and a settlement balance, or part of the claim, the settlement balance Department for individual accounts by the net asset value of the gold standard gotta investment deduction total repayment amount will be one of the remaining period.
一種投資型健康及傷害保險之方法，其應用於一投資型健康及傷害保險系統，該方法包含下列步驟：由該投資型健康及傷害保險系統之一投資型健康及傷害保險接收作業模組接收並審核一要保人之一基本資料，由該投資型健康及傷害保險接收作業模組提供一投資型健康及傷害保險保單以供該要保人購買，該投資型健康及傷害保險保單包含一競標交易組合；由該投資型健康及傷害保險系統之一資金競標模組判斷參與該競標交易組合之該要保人之人數是否額滿，該人數與該競標交易組合之一競標期數相同；若參與該競標交易組合之該要保人之人數額滿時，則在該競標期數的每一會期由該投資型健康及傷害保險系統之一資金競標模組接收未曾得標之該要保人所輸入之一投標金額，該資金競標模組根據所輸入之該投標金額來決定一得標金額與得標者；由該投資型健康及傷害保險系統之一金流處理模組根據該得標金額結算一總得標金、一存款金額與一還款金額；在該要保人未得標時，由該理賠作業模組判斷一被保險人是否出險；在該要保人未得標時，若該被保險人出險，則由該金流處理模組結算該投資型健康及傷害保險保單之一理賠金及該要保人之一個人帳戶之所有該存款金額的現值；在該要保人未得標時，若該被保險人未出險，則進行由該資金競標模組接收未曾得標之該要保人所輸入之該投標金額之步驟；在該要保人已得標時，由該理賠作業模組判斷該投資型健康及傷害保險保單是否到期；在該要保人已得標時，若該投資型健康及傷害保險保單到期，則由該金流處理模組結算該要保人所繳納之保費的總額及一結算餘額，該結算餘額係為該要保人之該個人帳戶經投資之該總得標金之一資產淨值扣除剩餘會期之一總還款金額；在該要保人已得標時，若該投資型健康及傷害保險保單未到期，則由該理賠作業模組判斷該被保險人是否出險；以及在該要保人已得標時，若該被保險人出險，則由該金流處理模組結算該投資型健康及傷害保險保單之該理賠金及該結算餘額，該結算餘額係為該要保人之該個人帳戶經投資之該總得標金之該資產淨值扣除剩餘會期之該總還款金額。進一步包含下列步驟：由該要保人向一電子憑證核發機構提供該基本資料以申請一電子憑證；由該要保人以該電子憑證進入該投資型健康及傷害保險系統，該投資型健康及傷害保險接收作業模組從該電子憑證核發機構獲得對應該電子憑證之該要保人之該基本資料；由該金流處理模組收取該要保人所繳納之該保費，並由該投資型健康及傷害保險接收作業模組核發該投資型健康及傷害保險保單之一電子保單給該要保人；由該金流處理模組交割已存入未得標之該要保人之該個人帳戶之該存款金額；由該金流處理模組交割已得標之該要保人之該還款金額；由該金流處理模組交割該總得標金以存入當會期得標之該要保人之該個人帳戶；由該投資型健康及傷害保險系統之一投資管理模組提供各種投資標的以供該要保人之該個人帳戶之該總得標金進行投資，並公佈對應該總得標金所投資之一投資標的、一投資損益及該資產淨值；在該要保人已得標時，若該被保險人未出險，則進行由該理賠作業模組判斷該投資型健康及傷害保險保單是否到期之步驟；以及當由該受益人或該要保人領取該理賠金及該個人帳戶之所有該存款金額的現值、或領取所繳納之該保費的總額及該結算餘額、或領取該理賠金及該結算餘額時，由該投資型健康及傷害保險接收作業模組終止該投資型健康及傷害保險保單之契約。An investment-based health and injury insurance method for an investment-type health and injury insurance system, the method comprising the following steps:The investment-type health and injury insurance receiving operation module of the investment-type health and injury insurance system receives and reviews one of the basic information of the insured person, and provides an investment-type health by the investment-type health and injury insurance receiving operation module. And an injury insurance policy for the purchaser to purchase, the investment-type health and injury insurance policy includes a bidding transaction combination; the investment bidding module of one of the investment-type health and injury insurance systems determines the participation in the bidding transaction portfolio Whether the number of the insured person is full, the number of bids is the same as the bidding period of one of the bidding transaction combinations; if the amount of the insured person participating in the bidding transaction combination is full, then each period of the bidding period Receiving, by the fund bidding module of the investment type health and injury insurance system, a bid amount input by the insured person who has not obtained the bid, the fund bidding module determines a winning amount according to the bid amount input. Winning bidder; the gold flow processing module of one of the investment-type health and injury insurance systems settles a total winning amount, a deposit amount and a repayment according to the winning amount When the insured person fails to obtain the bid, the claim operation module judges whether the insured person is in danger; if the insured person fails to obtain the bid, if the insured person is in danger, the gold flow processing module The group settles the present value of one of the investment health and injury insurance policy claims and the amount of the deposit in one of the insured persons; if the insured does not obtain the bid, if the insured is not in danger, then And the step of receiving, by the fund bidding module, the bid amount input by the insured person who has not obtained the bid; and determining the investment type health and injury insurance policy by the claim operation module when the insured person has obtained the bid Whether the expiration date; if the insured person has obtained the bid, if the investment health and injury insurance policy expires, the gold flow processing module will settle the total amount of the premium paid by the insured and a settlement balance.The balance of the settlement is the net asset value of the total amount of the investment in the personal account of the insured, minus the total repayment amount of one of the remaining periods; if the insured has obtained the bid, if the investment If the health insurance and injury insurance policy has not expired, the claim operation module determines whether the insured person is in danger; and when the insured person has obtained the bid, if the insured person is in danger, the gold flow processing module The group settles the claim and the settlement balance of the investment health and injury insurance policy, and the settlement balance is the net asset value of the total amount of the investment in the personal account of the insured, minus the total duration of the remaining period Repayment Amount. The method further includes the following steps: the insured person provides the basic information to an electronic voucher issuing institution to apply for an electronic voucher; and the insured person enters the investment type health and injury insurance system with the electronic voucher, the investment type health and The injury insurance receiving operation module obtains, from the electronic voucher issuing institution, the basic data of the insured corresponding to the electronic voucher; the gold flow processing module receives the premium paid by the insured, and the investment type The health and injury insurance receiving operation module issues an electronic policy of the investment type health and injury insurance policy to the insured person; the gold flow processing module delivers the personal account that has been deposited in the unclaimed insured person The deposit amount; the amount of the repayment of the insured person who has been awarded by the gold stream processing module; the gold stream processing module delivers the total bid amount to deposit the required amount of the meeting period The personal account of the insured person; the investment management module of the investment health and injury insurance system provides various investment targets for the total amount of the personal account of the insured person to invest, and It will have to be labeled one of gold investment investment targets, a net investment gains and losses and the asset;When the insured has obtained the bid, if the insured is not in danger, the step of judging whether the investment type health and injury insurance policy expires is performed by the claim operation module; and when the beneficiary or the The insured person receives the current value of the claim and all the deposit amount of the personal account, or receives the total amount of the premium paid and the settlement balance, or receives the claim and the balance of the settlement, The injury insurance receiving operation module terminates the contract for the investment-type health and injury insurance policy.
其中，在該要保人未得標時，若該被保險人出險，則由該金流處理模組結算該投資型健康及傷害保險保單之該理賠金及該要保人之該個人帳戶之所有該存款金額的現值之步驟更包含下列步驟：在該要保人未得標時，若該被保險人出險，則由該理賠作業模組判斷該被保險人是否為嚴重出險；在該要保人未得標時，若該被保險人為嚴重出險，則由該金流處理模組結算及給付該投資型健康及傷害保險保單之該理賠金及該要保人之該個人帳戶之所有該存款金額的現值給該受益人或該要保人；以及在該要保人未得標時，若該被保險人不為嚴重出險，則由該金流處理模組給付該投資型健康及傷害保險保單之契約條款所定之部分該理賠金給該要保人，之後進行由該資金競標模組接收未曾得標之該要保人所輸入之該投標金額之步驟。Wherein, when the insured person fails to obtain the bid, if the insured person is in danger, the gold flow processing module settles the claim of the investment type health and injury insurance policy and the personal account of the insured person The step of present value of the deposit amount further includes the following steps: when the insured person fails to obtain the bid, if the insured person is in danger, the claim operation module determines whether the insured person is seriously in danger; If the insured is in a serious risk, if the insured is seriously in danger, the gold flow processing module will settle and pay the claim for the investment health and injury insurance policy and all the personal account of the insured person. The present value of the deposit amount is given to the beneficiary or the insured person; and when the insured person fails to obtain the bid, if the insured is not seriously in danger, the gold flow processing module pays the investment type health And the portion of the claim specified in the contractual clause of the injury insurance policy is given to the insured, and then the step of receiving the bid amount input by the insured who has not obtained the bid by the fund bidding module is performed.
其中，在該要保人已得標時，若該被保險人出險，則由該金流處理模組結算該投資型健康及傷害保險保單之該理賠金及該結算餘額之步驟更包含下列步驟：在該要保人已得標時，若該被保險人出險，則由該理賠作業模組判斷該被保險人是否為嚴重出險；在該要保人已得標時，若該被保險人為嚴重出險，則由該金流處理模組結算及給付該投資型健康及傷害保險保單之該理賠金及該結算餘額給該受益人或該要保人；以及在該要保人已得標時，若該被保險人不為嚴重出險，則由該金流處理模組給付該投資型健康及傷害保險保單之契約條款所訂之部分該理賠金給該要保人，之後進行由該理賠作業模組判斷該投資型健康及傷害保險保單是否到期之步驟。Wherein, when the insured person has obtained the bid, if the insured person is in danger, the step of clearing the claim and the settlement balance of the investment type health and injury insurance policy by the gold flow processing module further comprises the following steps: : When the insured person has obtained the bid, if the insured person is in danger, the claim operation module determines whether the insured is seriously in danger;When the insured person has obtained the bid, if the insured is seriously in danger, the gold flow processing module settles and pays the claim and the settlement balance of the investment type health and injury insurance policy to the beneficiary or The insured person; and when the insured person has obtained the bid, if the insured is not in serious risk, the gold flow processing module pays the part of the contractual terms of the investment health and injury insurance policy The claim is given to the insured person, and then the step of determining whether the investment type health and injury insurance policy expires is determined by the claim operation module.
其中，該被保險人之嚴重出險係指身故或全殘之出險情況，而該被保險人為非嚴重出險係指非身故及非全殘之出險情況。Among them, the serious insured of the insured refers to the risk of death or total disability, and the insured is a non-severe risk refers to the non-death and non-disabled risk.
其中，當該要保人為非嚴重出險而獲得部分該理賠金時，在該投資型健康及傷害保險保單到期時，由該金流處理模組依該投資型健康及傷害保險保單所訂之退費標準退還已繳保費之總額的部份金額給該要保人。Wherein, when the insured person obtains part of the claim for non-severe risk insurance, when the investment type health and injury insurance policy expires, the gold flow processing module is determined according to the investment type health and injury insurance policy The refund standard refunds part of the total amount of the premium paid to the insured.
其中，該電子保單之核保項目包含一要保書之內容填寫是否完整及真實、該要保人之資格、該要保人與該被保險人之關係、該被保險人之資格、該被保險人是否書面同意該保險契約、該要保人所參與之該投資型健康及傷害保險保單之該競標交易組合之一總會款、該被保險人之實際經濟需求與保額之間的比例、以及該要保人之個人條件、就業狀況、年收入是否能使其長期持續穩定地繳交保費。The underwriting item of the electronic policy includes whether the content of the insured is complete and true, the qualification of the insured, the relationship between the insured and the insured, the qualification of the insured, and the Whether the insurer agrees in writing to the insurance contract, the total amount of the bidding transaction portfolio of the investment-type health and injury insurance policy in which the insured person participates, and the ratio between the actual economic demand and the insured amount of the insured And whether the personal conditions, employment status, and annual income of the insured person will enable them to pay premiums in a long-term and stable manner.
其中，在該被保險人出險時，經理賠申請判定核可後，由該金流處理模組依據該投資型健康及傷害保險保單所載明之內容來給付理賠金，包含：若該投資型健康及傷害保險保單為健康項目保險，則該理賠金為健康項目出險之理賠金；若該投資型健康及傷害保險保單為傷害項目保險，則該理賠金為傷害項目出險之理賠金；以及若該投資型健康及傷害保險保單為健康及傷害綜合項目保險，則該理賠金為健康項目出險之理賠金與傷害項目出險之理賠金至少其一。Wherein, when the insured person is in danger, after the manager claims to approve the application, the gold flow processing module pays the claim according to the contents stated in the investment type health and injury insurance policy, including: if the investment type The health and injury insurance policy is for health insurance, then the claim isIf the investment health and injury insurance policy is injury insurance, the claim is the claim for the injury project; and if the investment health and injury insurance policy is the health and injury comprehensive project insurance The claim is at least one of the claims for the health insurance project and the damages for the injury project.
其中，當該要保人在該投資型健康及傷害保險接收作業模組選擇投保該投資型健康及傷害保險保單之綜合項目保險時，其健康項目部份的有效期間可與傷害項目部份的有效期間相同或不同。Wherein, when the insured person chooses to insure the comprehensive project insurance of the investment type health and injury insurance policy in the investment type health and injury insurance receiving operation module, the effective period of the health item part may be related to the injury item part Valid periods are the same or different.
其中，當健康項目部份的有效期間與傷害項目部份的有效期間不同時，以兩者之中有效期間較長者作為整份保險之該最終有效期間之基準並以之決定該要保人參與該投資型健康及傷害保險系統之一競標期間。Wherein, when the effective period of the health project component is different from the effective period of the injury project component, the longer of the effective period of the two is used as the benchmark for the final effective period of the entire insurance and the insured person is determined to participate. One of the investment-type health and injury insurance systems during the bidding period.
其中，在該要保人已得標時，若該投資型健康及傷害保險保單到期，則由該金流處理模組給付該要保人所繳納之保費的總額及該結算餘額給該要保人。Wherein, when the insured person has obtained the bid, if the investment type health and injury insurance policy expires, the gold flow processing module pays the total amount of the premium paid by the insured and the settlement balance to the Protector.
其中，由該金流處理模組所結算之該結算餘額若為負值，則由所繳納之該保費的總額或該理賠金抵繳該結算餘額之負值的部分。Wherein, if the settlement balance settled by the gold stream processing module is a negative value, the total amount of the premium paid or the portion of the settlement amount that the negative balance of the settlement balance is paid.
其中，由該投資型健康及傷害保險系統藉由網路、有線及無線通訊方式與一終端機進行通訊，而與該要保人做一即時安全之訊息交換。Among them, the investment-type health and injury insurance system communicates with a terminal by means of network, wired and wireless communication, and exchanges an instant and secure message with the insured person.
其中，由該資金競標模組根據所輸入之該投標金額以最高的投標金額來決定該得標金額與得標者；當有數個相同之最高的投標金額時，由該資金競標模組以抽籤方式抽出最高的投標金額之該等要保人的其中一者為得標者，該得標金額為最高的投標金額；以及當無人投標時，由該資金競標模組以抽籤方式抽出未曾得標之該等要保人的其中一者為得標者，此抽籤方式之該得標金額為該資金競標模組所規定之一基本標金。Wherein, the fund bidding module uses the highest bid amount according to the bid amount input.Determining the amount of the winning bid and the winner; when there are several identical bid amounts, one of the insured persons who draws the highest bid amount by the fund bidding module is the winner. The winning bid amount is the highest bid amount; and when no one bids, the bidding module extracts one of the insured persons who have not obtained the bid as the winning bidder by the lottery method, and the lottery method is obtained. The target amount is one of the basic deposits stipulated by the fund bidding module.
其中，由該金流處理模組將該要保人得標時之該總得標金導入該個人帳戶後，將該總得標金轉換成作為投資用途之資金並由該投資管理模組進行投資管理。Wherein, the gold flow processing module introduces the total winning fund when the insured person obtains the bid into the personal account, converts the total winning fund into funds for investment purposes, and invests management by the investment management module. .
其中，由一保險公司將該投資型健康及傷害保險保單之資料傳送至該電子憑證核發機構以加密、數位簽章、存證後，由該電子憑證核發機構將該投資型健康及傷害保險保單傳送至該保險公司，該保險公司再將其傳送至該要保人。Wherein, after an insurance company transmits the information of the investment-type health and injury insurance policy to the electronic voucher issuing institution to encrypt, digitally sign, and deposit the certificate, the electronic voucher issuing institution may apply the investment type health and injury insurance policy Transferred to the insurance company, which then transmits it to the insured.
其中，由該理賠作業模組接收由該投資型健康及傷害保險系統外部之一保險公司理賠作業系統所傳送之理賠申請結果，該理賠申請結果係在該被保險人出險時，由一保險公司接收理賠申請，進行保險事故認定，以及判斷是否符合理賠標準。Wherein, the claim operation module receives the result of the claim application transmitted by the insurance company's claims operation system outside the investment type health and injury insurance system, and the claim application result is an insurance company when the insured person is in danger. Receive claims, make insurance accidents, and determine whether they meet the claim criteria.
其中，該競標交易組合包含一競標期限、該競標期數及一總會款。The bidding transaction portfolio includes a bidding period, the number of bidding periods, and a total meeting amount.
其中，在由該金流處理模組根據該得標金額結算該總得標金、該存款金額與該還款金額之步驟係由下列方程式所結算：結算該總得標金：利息先支付：An=(U-In)×((N-n))+(U×(n-1))Wherein, the step of clearing the total amount of the winning bid, the deposit amount and the repayment amount according to the winning amount by the gold stream processing module is settled by the following equation: settlement of the total bid: the interest is paid first:An = (U -In ) × ((N -n )) + (U × (n -1))
利息後支付：
結算該還款金額：利息先支付：USettlement of the repayment amount: interest paid first: U
利息後支付：U+InPayment after interest: U+In
結算該存款金額：利息先支付：U-InSettlement of the deposit amount: interest paid first: U-In
利息後支付：UPayment after interest: U
其中，An係為得標要保人於第n期得標之總得標金；U係為一競標上限；N係為競標期數；n係為一現行期數，且n≦N；In係為得標要保人於第n期之得標金額；Ii係為得標要保人於第i之得標金額，且i<n。Among them, An is the total winning bid for the winner in the nth period; U is the upper limit of bidding; N is the number of bidding periods; n is the current period, and n≦N; In order to obtain the bid, the amount of the winning bid in the nth period is required; Ii is the winning amount of the i-guarantee in the i-th, and i<n.
一種投資型健康及傷害保險系統，包含有：一投資型健康及傷害保險接收作業模組，用以根據一要保人之一基本資料進行審核，提供一投資型健康及傷害保險保單以供該要保人選擇購買，該投資型健康及傷害保險保單包含一競標交易組合；一資金競標模組，用以在該競標交易組合之一競標期數的每一會期根據該要保人所輸入之一投標金額，來決定一得標金額與得標者；一理賠作業模組，用以判斷該投資型健康及傷害保險保單是否到期，及判斷一被保險人是否出險與出險程度；以及一金流處理模組，用以根據該得標金額結算一總得標金、一存款金額與一還款金額；其中，根據該投資型健康及傷害保險保單是否到期及該被保險人是否出險與出險程度，由該金流處理模組來結算一理賠金及一個人帳戶之所有該存款金額的現值、或所繳納之一保費的總額及一結算餘額、或部分該理賠金，該結算餘額係為該個人帳戶經投資之該總得標金之該資產淨值扣除剩餘會期之一總還款金額。An investment-type health and injury insurance system comprising: an investment-type health and injury insurance receiving operation module for reviewing basic information of one of the insured persons, providing an investment-type health and injury insurance policy for the To ensure that the purchaser chooses to purchase, the investment-type health and injury insurance policy includes a bidding transaction portfolio;a fund bidding module for determining a winning amount and a winning bid according to a bid amount input by the insured person in each meeting period of one of the bidding period of the bidding transaction combination; a group for judging whether the investment-type health and injury insurance policy is expired, and determining whether an insured person is in danger or risk; and a gold flow processing module for clearing a total winning amount according to the winning amount, a deposit amount and a repayment amount; wherein, according to whether the investment type health and injury insurance policy expires and whether the insured person is in danger or risk, the gold flow processing module settles a claim and a personal account The current value of the deposit amount, or the total amount of one premium paid and a settlement balance, or part of the claim balance, which is the net asset value of the total amount of the investment in the individual account minus the remaining period One of the total repayment amount.
進一步包含：該投資型健康及傷害保險接收作業模組，用以根據該要保人之一電子憑證從該投資型健康及傷害保險系統外部之一電子憑證核發機構取得該要保人之該基本資料，由該金流處理模組收取該要保人所繳納之該保費，以核發該投資型健康及傷害保險保單之一電子保單給該要保人；一投資管理模組，用以提供各種投資標的以供該要保人之該個人帳戶之一總得標金進行投資，並公佈對應該個人帳戶之該總得標金所投資之一投資標的、一投資損益及該資產淨值；該金流處理模組，用以交割該總得標金以存入該個人帳戶、已存入該個人帳戶之該存款金額、及在每一會期所繳納之該還款金額，給付該理賠金及該個人帳戶之所有該存款金額的現值、或所繳納之該保費的總額及該結算餘額、或部分該理賠金給該要保人或一受益人；以及一資料庫，用以由該投資型健康及傷害保險接收作業模組存取該要保人之該基本資料及該投資型健康及傷害保險保單之資料，由該資金競標模組存取該投標金額、最高的投標金額該得標金額與得標者之資料，由該投資管理模組存取該投資標的、該投資損益及該資產淨值之資料，由該理賠作業模組存取該被保險人之出險資料、該投資型健康及傷害保險保單之資料，及由該金流處理模組存取該得標金額、該總得標金、該還款金額、該存款金額、該理賠金、該結算餘額、及該個人帳戶之資料。Further comprising: the investment type health and injury insurance receiving operation module, configured to obtain the basic of the insured person from an electronic voucher issuing institution outside the investment type health and injury insurance system according to the electronic voucher of the insured person Information, the gold flow processing module receives the premium paid by the insured person to issue an electronic insurance policy for the investment health and injury insurance policy to the insured; an investment management module for providing various The investment target is to invest in one of the personal accounts of the insured person, and to announce the investment target, one investment profit and loss and the net asset value of the investment in the total amount of the individual account; the gold flow processing a module for delivering the total amount of the deposit to deposit the personal account, the deposit amount deposited in the personal account, and the amount of the payment paid in each session, to pay the claim and the personal account The present value of all the deposit amount, or the amount paidThe total amount of the premium and the balance of the settlement, or part of the claim to the insured or a beneficiary; and a database for accessing the insurance module by the investment health and injury insurance receiving module The basic information of the person and the information of the investment-type health and injury insurance policy, the fund bidding module accesses the bid amount, the highest bid amount, the bid amount and the bidder's information, and the investment management module Accessing the investment target, the investment profit and loss and the net asset value, the claim operation module accesses the insured's insurance information, the investment health and injury insurance policy information, and the processing of the gold flow processing module The group accesses the winning amount, the total winning amount, the repayment amount, the deposit amount, the claim, the settlement balance, and the personal account information.
其中，該電子保單之核保項目包含一要保書之內容填寫是否完整及真實、該要保人之資格、該要保人與該被保險人之關係、該被保險人之資格、該被保險人是否書面同意該保險契約、該要保人所參與之該投資型健康及傷害保險保單之該競標交易組合之一總會款、該被保險人之實際經濟需求與保額之間的比例、以及該要保人之個人條件、就業狀況、年收入是否能使其長期持續穩定地繳交保費。The underwriting item of the electronic policy includes whether the content of the insured is complete and true, the qualification of the insured, the relationship between the insured and the insured, the qualification of the insured, and the Whether the insurer agrees in writing to the insurance contract, the total amount of the bidding transaction portfolio of the investment-type health and injury insurance policy in which the insured person participates, and the ratio between the actual economic demand and the insured amount of the insured And whether the personal conditions, employment status, and annual income of the insured person will enable them to pay premiums in a long-term and stable manner.
其中，該電子憑證核發機構接收由一保險公司所傳送之該投資型健康及傷害保險保單之資料，在加密、數位簽章、存證後，該電子憑證核發機構將該投資型健康及傷害保險保單傳送至該保險公司，而該保險公司再將其傳送至該要保人。The electronic voucher issuing institution receives the information of the investment type health and injury insurance policy transmitted by an insurance company, and after the encryption, digital signature, and deposit, the electronic voucher issuing institution inputs the investment type health and injury insurance The policy is transmitted to the insurance company, which in turn transmits it to the insured.
其中，該金流處理模組將該總得標金轉換成作為投資用途之資金，而該投資管理模組將該總得標金進行投資管理。The gold flow processing module converts the total awarded gold into funds for investment purposes, and the investment management module manages the total winning funds.
其中，該投資型健康及傷害保險系統藉由網路、有線及無線通訊方式與一終端機者進行通訊，而與該要保人做一即時安全之訊息交換。Among them, the investment-type health and injury insurance system communicates with a terminal by means of network, wired and wireless communication, and exchanges an instant and secure message with the insured person.
其中，該理賠作業模組接收由該投資型健康及傷害保險系統外部之一保險公司理賠作業系統所傳送之理賠申請結果，該理賠申請結果係在該被保險人出險時，由一保險公司接收理賠申請，進行保險事故認定，以及判斷是否符合理賠標準。Wherein, the claim operation module receives the result of the claim application transmitted by the insurance company's claim operation system outside the investment type health and injury insurance system, and the claim application result is received by an insurance company when the insured person is in danger Claim application, identification of insurance accidents, and judgment of compliance with claims.
其中，該競標交易組合包含一競標期限、該競標期數及一總會款。The bidding transaction portfolio includes a bidding period, the number of bidding periods, and a total meeting amount.
其中，該資金競標模組執行下列步驟：根據所有輸入之該投標金以最高的投標金額來決定該得標金額與得標者；在當有數個相同之最高投標金額時，以抽籤方式抽出最高的投標金額之該等要保人的其中一者為得標者，該得標金額為最高的投標金額；以及當無人投標時，以抽籤方式抽出未曾得標之該等要保人的其中一者為得標者，此抽籤方式之該得標金額為該資金競標模組所規定之一基本標金。The fund bidding module performs the following steps: determining the bid amount and the winner according to the highest bid amount according to all the bids input; and extracting the highest amount by lot when there are several identical bid amounts One of the insured persons of the bid amount is the winner, the winning amount is the highest bid amount; and when no one bids, one of the insured persons who have not won the bid is drawn by lottery. If the winner is the winner, the winning amount of the lottery method is one of the basic deposits stipulated by the fund bidding module.
其中，該金流處理模組所結算之該結算餘額若為負值，則由所繳納之該保費的總額或該理賠金抵繳該結算餘額之負值的部分。Wherein, if the settlement balance settled by the gold flow processing module is a negative value, the total amount of the premium paid or the portion of the settlement amount that the negative balance of the settlement balance is paid.
其中，當該要保人在該投資型健康及傷害保險接收作業模組選擇投保該投資型健康及傷害保險保單之綜合項目保險時，其健康項目部份的有效期間可與傷害項目部份的有效期間相同或不同。Wherein, when the insured person chooses to insure the comprehensive project insurance of the investment type health and injury insurance policy in the investment type health and injury insurance receiving operation module, the effective period of the health item part may be related to the injury item part Valid periods are the same or different.
其中，當健康項目部份的有效期間與傷害項目部份的有效期間不同時，以兩者之中有效期間較長者作為整份保險之最終有效期間之基準並以之決定該要保人參與該投資型健康及傷害保險系統之一競標期間。Wherein, when the effective period of the health project component is different from the effective period of the injury project component, the longer of the effective period of the two is used as the benchmark for the final effective period of the entire insurance and the insured person is required to participate in the One of the investment health and injury insurance systems during the bidding period.
其中，當該被保險人為非嚴重出險而獲得部分該理賠金時，在該投資型健康及傷害保險保單到期時，該金流處理模組依該投資型健康及傷害保險保單所訂之退費標準退還已繳保費之總額的部分金額給該要保人。Wherein, when the insured obtains part of the claim for non-severe risk insurance, the gold flow processing module is refunded according to the investment health and injury insurance policy when the investment health and injury insurance policy expires The fee standard refunds part of the total amount of the premium paid to the insured.
其中，在該被保險人出險時，經理賠申請判定核可後，該金流處理模組依據該投資型健康及傷害保險保單所載明之內容而給付的方式包含：若該投資型健康及傷害保險保單為健康項目保險，則該理賠金為健康項目出險之理賠金；若該投資型健康及傷害保險保單為傷害項目保險，則該理賠金為傷害項目出險之理賠金；以及若該投資型健康及傷害保險保單為健康及傷害綜合項目保險，則該理賠金為健康項目出險之理賠金與傷害項目出險之理賠金至少其一。Wherein, when the insured person is in danger, after the manager claims the application for approval, the payment method of the gold flow processing module according to the contents of the investment health and injury insurance policy includes: if the investment type is healthy and If the injury insurance policy is a health insurance item, the claim is a claim for a health project; if the investment health and injury insurance policy is an injury insurance, the claim is a claim for the injury project; and if the investment is The Health and Injury Insurance Policy is a health and injury comprehensive project insurance, and the claim is at least one of the claims for the health insurance project and the damages for the injury project.
其中，該被保險人之出險為身故或全殘之出險情況係為嚴重出險，而該被保險人之出險為非身故及非全殘之出險情況係為非嚴重出險。Among them, the insured's risk of death or total disability is a serious risk, and the insured's risk of non-death and non-disabled is a non-serious risk.
401‧‧‧終端機401‧‧‧ Terminal
402‧‧‧投資型健康及傷害保險系統402‧‧‧Investment Health and Injury Insurance System
403‧‧‧電子憑證核發機構403‧‧‧Electronic voucher issuing agency
404‧‧‧保險公司理賠作業系統404‧‧‧Insurance Company Claims Operating System
405‧‧‧投資型健康及傷害保險接收作業模組405‧‧‧Investment Health and Injury Insurance Receiving Module
407‧‧‧資金競標模組407‧‧‧Capital bidding module
408‧‧‧投資管理模組408‧‧‧Investment Management Module
409‧‧‧理賠作業模組409‧‧‧ Claims Operation Module
410‧‧‧金流處理模組410‧‧‧Gold Stream Processing Module
411‧‧‧資料庫411‧‧‧Database
圖一係本發明之投資型健康及傷害保險系統之方塊圖；以及圖二係本發明之投資型健康及傷害保險方法之流程圖。Figure 1 is a block diagram of the investment-type health and injury insurance system of the present invention;Figure 2 is a flow chart of the investment type health and injury insurance method of the present invention.
以下特將本發明具體實施方式詳細描述，並列舉較佳之具體實施例說明如下：圖一係本發明之投資型健康及傷害保險系統之方塊圖。在圖一中，投資型健康及傷害保險系統402藉由網路、有線及無線通訊方式與要保人所使用之投資型健康及傷害保險系統402外部之一終端機401(如電腦、手機、PDA等裝置)進行通訊，而與要保人做一即時安全之訊息交換。由要保人藉由終端機401向投資型健康及傷害保險系統402購買投資型健康及傷害保險保單、參與投資型健康及傷害保險系統402之競標、及從投資型健康及傷害保險系統402獲知競標的結果與收付款項。DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS The following is a detailed description of the embodiments of the present invention, and the preferred embodiments are illustrated as follows: Figure 1 is a block diagram of the investment-type health and injury insurance system of the present invention. In Figure 1, the investment-type health and injury insurance system 402 is connected to a terminal 401 (such as a computer or mobile phone) external to the investment-type health and injury insurance system 402 used by the insurer by means of network, wired and wireless communication. A device such as a PDA communicates with the insured person to make an instant and secure message exchange. The insured person purchases the investment-type health and injury insurance policy from the investment-type health and injury insurance system 402 by the terminal 401, participates in the bidding of the investment-type health and injury insurance system 402, and learns from the investment-type health and injury insurance system 402. The result of the bidding and the payment.
下文中將描述投資型健康及傷害保險系統402所包含之一投資型健康及傷害保險接收作業模組405、一資金競標模組407、一投資管理模組408、一理賠作業模組409、一金流處理模組410及一資料庫411等各模組之操作。An investment-type health and injury insurance receiving operation module 405, a fund bidding module 407, an investment management module 408, a claim operation module 409, and an investment health and injury insurance system 402 are described below. The operation of each module such as the gold stream processing module 410 and a database 411.
投資型健康及傷害保險接收作業模組405根據要保人之一電子憑證從投資型健康及傷害保險系統402外部之一電子憑證核發機構403取得要保人之一基本資料，並審核該要保人之基本資料，投資型健康及傷害保險接收作業模組405提供一投資型健康及傷害保險保單以供要保人選擇購買。其中，投資型健康及傷害保險保單包含有競標交易組合，該競標交易組合包含一競標期限、一競標期數及一總會款。The investment type health and injury insurance receiving operation module 405 obtains basic information of one of the insured persons from one of the electronic voucher issuing institutions 403 outside the investment type health and injury insurance system 402 according to one of the electronic documents of the insured person, and reviews the insured person. The basic information of the person, the investment-type health and injury insurance receiving operation module 405 provides an investment-type health and injury insurance policy for the insurer to choose to purchase. The investment-type health and injury insurance policy includes a bidding transaction portfolio, and the bidding transaction portfolio includes a bidding period, a bidding period, and a general meeting amount.
當要保人在投資型健康及傷害保險接收作業模組405選擇投保投資型健康及傷害保險保單之綜合項目保險時，其健康項目部份的有效期間可與傷害項目部份的有效期間可為相同或不同。當健康項目部份的有效期間與傷害項目部份的有效期間不同時，以兩者之中有效期間較長者作為整份保險之最終有效期間之基準並以之決定要保人參與投資型健康及傷害保險系統402之競標期間。When the insured person selects the comprehensive project insurance for the investment-type health and injury insurance policy in the investment-type health and injury insurance receiving operation module 405, the effective period of the health item portion and the effective period of the injury item portion may be Same or different. When the effective period of the health project component is different from the effective period of the injury project component, the longer of the effective period of the two is used as the benchmark for the final effective period of the entire insurance and it is decided to participate in the investment health and During the bidding period of the injury insurance system 402.
在金流處理模組410收取要保人所繳納之保費後，投資型健康及傷害保險接收作業模組405核發投資型健康及傷害保險保單之一電子保單給要保人。After the gold flow processing module 410 receives the premium paid by the insured person, the investment type health and injury insurance receiving operation module 405 issues an electronic policy of the investment type health and injury insurance policy to the insured.
其中，電子保單之核保項目包含一要保書之內容填寫是否完整及真實、要保人購買投資型健康及傷害保險保單之資格、要保人與被保險人之關係、被保險人投保之資格、被保險人是否書面同意保險契約、要保人所參與之投資型健康及傷害保險保單之競標交易組合之總會款、被保險人之實際經濟需求與保額之間的比例、以及要保人之個人條件、就業狀況、年收入是否能使其長期持續穩定地繳交保費。Among them, the underwriting policy of the electronic policy includes whether the content of the required insurance book is complete and true, the qualification of the insured person to purchase the investment-type health and injury insurance policy, the relationship between the insured and the insured, and the insured’s insurance. Qualification, whether the insured agrees in writing the insurance contract, the total amount of the bidding transaction portfolio of the investment-type health and injury insurance policy in which the insured person participates, the ratio between the actual economic needs of the insured and the insured amount, and Whether the personal conditions, employment status, and annual income of the guarantor can enable them to pay premiums in a long-term and stable manner.
電子憑證核發機構403接收由保險公司所傳送之投資型健康及傷害保險保單之資料，在加密、數位簽章、存證後，電子憑證核發機構403將投資型健康及傷害保險保單傳送至保險公司，而保險公司再將其傳送至要保人。The electronic voucher issuing institution 403 receives the information of the investment-type health and injury insurance policy transmitted by the insurance company. After the encryption, digital signature, and deposit, the electronic voucher issuing institution 403 transmits the investment-type health and injury insurance policy to the insurance company. And the insurance company will send it to the insured.
在參與競標交易組合之要保人的人數(該人數與競標交易組合中的競標期數相同)額滿時，在競標期數的每一會期中，要保人藉由終端機401輸入一投標金額至投資型健康及傷害保險系統402，資金競標模組407根據所有輸入的投標金額以最高的投標金額作為一得標金額並決定得標者。資金競標模組407將開標結果經由終端機401傳送至要保人。資金競標模組407將前述各項資料存入資料庫411。When the number of insured persons participating in the bidding transaction combination (the number of bidding periods is the same as the number of bidding periods in the bidding transaction combination) is full, in each period of the bidding period, the insurer enters a bid by the terminal machine 401. Amount to the investment health and injury insurance system 402,The fund bidding module 407 uses the highest bid amount as the winning amount based on all the entered bid amounts and determines the winning bidder. The fund bidding module 407 transmits the bid opening result to the insured person via the terminal 401. The fund bidding module 407 stores the foregoing items in the database 411.
當有數個相同之最高的投標金額時，資金競標模組407以抽籤方式抽出最高的投標金額之該等要保人的其中一者為得標者，得標金額即為此最高的投標金額；當無人投標時，資金競標模組407以抽籤方式抽出未曾得標之該等要保人的其中一者為得標者，此抽籤方式之得標金額係資金競標模組407所規定之一基本標金。When there are a plurality of identical bid amounts, the fund bidding module 407 extracts one of the insured persons of the highest bid amount by lottery as the winner, and the bid amount is the highest bid amount; When there is no bidding, the fund bidding module 407 extracts one of the insured persons who have not obtained the bid as a successful bidder by means of lottery, and the winning amount of the lottery method is one of the basic requirements specified by the fund bidding module 407. The standard gold.
投資管理模組408提供各種投資標的以供要保人之一個人帳戶之一總得標金進行投資，並經由終端機401公佈對應個人帳戶之總得標金所投資之一投資標的、一投資損益及一資產淨值給要保人。其中，投資標的包含共同基金、有價證券及衍生性金融商品至少一者之金融商品。The investment management module 408 provides various investment targets for one of the personal accounts of one of the insured persons to be invested in the total amount of the investment fund, and announces one of the investment targets, one investment profit and loss and one of the investment funds corresponding to the individual account of the personal account via the terminal 401. The net asset value is given to the insured. Among them, the investment target includes financial products of at least one of mutual funds, marketable securities and derivative financial products.
理賠作業模組409判斷投資型健康及傷害保險保單是否到期，及判斷被保險人是否出險與出險程度。理賠作業模組409接收由投資型健康及傷害保險系統402外部之一保險公司理賠作業系統404所傳送之理賠申請結果，該理賠申請結果係在被保險人出險時，由保險公司接收理賠申請，進行保險事故認定，以及判斷是否符合理賠標準。The claim operation module 409 determines whether the investment type health and injury insurance policy is expired, and determines whether the insured person is in danger or risk. The claim operation module 409 receives the claim application result transmitted by the insurance company claims operation system 404 outside the investment type health and injury insurance system 402, and the claim application result is received by the insurance company when the insured is in danger, Conduct insurance accident identification and determine whether it meets the claim standard.
金流處理模組410根據得標金額結算總得標金、一存款金額與一還款金額，金流處理模組410交割總得標金以存入個人帳戶、交割已存入個人帳戶之存款金額、及交割在每一會期所繳納之還款金額，金流處理模組410給付一理賠金及個人帳戶之所有存款金額的現值、或給付所繳納之保費的總額及一結算餘額、或給付理賠金及結算餘額，或給付部分理賠金給要保人或受益人。其中，結算餘額係為個人帳戶經投資之總得標金之資產淨值扣除剩餘會期之一總還款金額的餘額。由金流處理模組410所結算之結算餘額若為負值，則由要保人所繳納之保費的總額或理賠金抵繳結算餘額之負值的部分。The gold stream processing module 410 settles the total amount of the deposit, the amount of the deposit and the amount of the repayment according to the winning amount, and the gold stream processing module 410 delivers the total amount of the deposit to deposit into the personal account, and the deposit amount deposited into the personal account, And delivery of the repayments paid during each sessionThe amount, the gold flow processing module 410 pays the current value of all the deposit amount of the claim and the personal account, or the total amount of the premium paid and the settlement balance, or the payment of the settlement and settlement balance, or the payment of part of the claim To protect or beneficiary. The settlement balance is the balance of the net asset value of the total amount of the investment in the individual account minus the total repayment amount of one of the remaining sessions. If the settlement balance settled by the gold stream processing module 410 is a negative value, the total amount of the premium paid by the insured person or the claim amount is offset by the negative value of the settlement balance.
金流處理模組410將未得標之要保人之存款金額及已得標之要保人之還款金額分別轉換成該會期得標之要保人之總得標金的一部分。The gold flow processing module 410 converts the amount of the deposit of the unguaranteed insured person and the repayment amount of the insured person who has obtained the standard into a part of the total winning amount of the insured person of the meeting period.
金流處理模組410接收由投資型健康及傷害保險系統402外部之一保險公司理賠作業系統404所傳送之理賠申請結果，該理賠申請結果係在被保險人出險時，由保險公司接收理賠申請，進行保險事故認定，以及判斷是否符合理賠標準。The gold flow processing module 410 receives the claim application result transmitted by the insurance company claims operation system 404 outside the investment type health and injury insurance system 402, and the claim application result is received by the insurance company when the insured is in danger. , to determine the insurance accident, and to determine whether it meets the standard of claims.
在被保險人出險時，經保險公司理賠作業系統404的理賠申請判定核可後，金流處理模組410依據投資型健康及傷害保險保單所載明之內容所給付的方式如下：(1)若投資型健康及傷害保險保單為健康項目保險，則理賠金為健康項目出險之理賠金；(2)若投資型健康及傷害保險保單為傷害項目保險，則理賠金為傷害項目出險之理賠金；以及(3)若投資型健康及傷害保險保單為健康及傷害綜合項目保險，則理賠金為健康項目出險之理賠金與傷害項目出險之理賠金至少其一。When the insured person is in danger, after the claim of the insurance company claims operation system 404 is approved, the gold flow processing module 410 pays according to the contents stated in the investment health and injury insurance policy as follows: (1) If the investment-type health and injury insurance policy is for health insurance, the claim is the claim for the health project; (2) if the investment-type health and injury insurance policy is the injury insurance, the claim is the damage for the injury project. And (3) if the investment-type health and injury insurance policy is a health and injury comprehensive project insurance, the claim is at least one of the claims for the health project's claims and damages.
被保險人為嚴重出險係指身故或全殘之出險情況，而被保險人為非嚴重出險係指非身故及非全殘之出險情況。The insured is a serious accident that refers to the death or total disability, and the insured is a non-severe risk refers to the non-death and non-disabled risk.
當被保險人為非嚴重出險而獲得部分理賠金時，在投資型健康及傷害保險保單到期時，金流處理模組410依投資型健康及傷害保險保單所訂之退費標準退還已繳保費之總額的部分金額給要保人。When the insured obtains part of the claim for non-severe insurance, when the investment-type health and injury insurance policy expires, the gold flow processing module 410 refunds the paid premium according to the refund standard set by the investment-type health and injury insurance policy. A portion of the total amount is given to the insured.
資料庫411用以由投資型健康及傷害保險接收作業模組405存取要保人之基本資料及投資型健康及傷害保險保單之資料，由資金競標模組407存取投標金額、最高的投標金額、得標金額與得標者之資料，由投資管理模組408存取投資標的、投資損益及資產淨值之資料，由理賠作業模組409存取被保險人之出險資料、投資型健康及傷害保險保單之資料，及由金流處理模組410存取得標金額、總得標金、還款金額、最高投標金額、存款金額、理賠金、結算餘額、個人帳戶之資料。The database 411 is used for accessing the basic data of the insured person and the information of the investment type health and injury insurance policy by the investment type health and injury insurance receiving operation module 405, and the bidding amount and the highest bid are accessed by the fund bidding module 407. The amount of the amount, the amount of the winning bid and the information of the successful bidder, the investment management module 408 accesses the information of the investment target, the investment profit and loss and the net asset value, and the claim operation module 409 accesses the insured's insurance information, investment health and The information of the injury insurance policy, and the information obtained by the gold flow processing module 410, the total amount of the bid, the repayment amount, the highest bid amount, the deposit amount, the claim, the settlement balance, and the personal account.
對於得標之要保人而言，金流處理模組410依照利息給付的先後來結算總得標金有以下兩種計算式：利息先支付：An=(U-In)×((N-n))+(U×(n-1)……(1)For the winners, the gold stream processing module 410 settles the total amount of the standard in accordance with the interest payment. There are two calculation formulas: interest payment:An = (U -In ) × ((N -n ))+(U ×(n -1)......(1)
利息後支付：
其中，An係為得標要保人於第n期得標之總得標金；U係為一競標上限；N係為競標期數；n係為一現行期數，且n≦N；In係為得標要保人於第n期之得標金額；Ii係為得標要保人於第i之得標金額，且i<n。Among them, An is the total winning bid for the winner in the nth period; U is the upper limit of bidding; N is the number of bidding periods; n is the current period, and n≦N; In order to obtain the bid, the amount of the winning bid in the nth period is required; Ii is the winning amount of the i-guarantee in the i-th, and i<n.
上述前得標要保人需在往後期數進行還款，還款金額的計算方式如下：利息先支付：U……(3)The above-mentioned winning bidders need to repay the amount in the later period. The repayment amount is calculated as follows: interest is paid first: U...(3)
利息後支付：U+In……(4)Payment after interest: U+In......(4)
其中，U係為一競標上限；In係為得標要保人於第n期之得標金額；金流處理模組410結算未得標要保人之存款金額係依照利息先後支付有兩種計算方式：利息先支付：U-In……(5)Among them, U is the upper limit of bidding; In is the winning amount of the winner in the nth period; the gold flow processing module 410 settles the unsuccessful deposit amount of the insured in accordance with the interest payment. Calculation method: interest paid first: U-In......(5)
利息後支付：U……(6)Payment after interest: U...(6)
其中，U係為一競標上限；In係為得標要保人於第n期之得標金額；圖二係本發明之投資型健康及傷害保險方法之流程圖。在描述圖二之流程的同時，請一併參考圖一之各組件。Among them, U is the upper limit of bidding; In is the winning amount of the winner in the nth period; Figure 2 is the flow chart of the investment health and injury insurance method of the present invention. While describing the flow of Figure 2, please refer to the components of Figure 1.
首先，由要保人向電子憑證核發機構403提供基本資料以申請電子憑證(步驟S101)，保險公司與網路認證之電子憑證核發機構403合作並審核要保人的基本資料後，核發保險電子憑證給予該要保人。First, the insured person provides the basic information to the electronic voucher issuing institution 403 to apply for the electronic voucher (step S101), and the insurance company cooperates with the electronic credential issuing institution 403 of the network authentication and reviews the basic information of the insured person, and then issues the insurance electronic The voucher is given to the insured.
接著，由要保人藉由終端機401以一電子憑證進入投資型健康及傷害保險系統402。投資型健康及傷害保險系統402之投資型健康及傷害保險接收作業模組405從電子憑證核發機構403獲得並審核對應該電子憑證之要保人的基本資料。投資型健康及傷害保險接收作業模組405提供各種投資型健康及傷害保險保單之形式以供要保人選擇購買(步驟S102)。投資型健康及傷害保險接收作業模組405將要保人的基本資料、投資型健康及傷害保險保單等儲存於資料庫411。投資型健康及傷害保險保單包含有競標交易組合，而該競標交易組合包含一競標期限、一競標期數及一總會款。Next, the insured person enters the investment type health and injury insurance system 402 with an electronic voucher via the terminal 401. The investment-type health and injury insurance receiving operation module 405 of the investment-type health and injury insurance system 402 obtains and reviews basic information corresponding to the insured person corresponding to the electronic certificate from the electronic voucher issuing institution 403. The investment type health and injury insurance receiving operation module 405 provides various forms of investment-type health and injury insurance policies for the insured to purchase (step S102). The investment type health and injury insurance receiving operation module 405 stores the basic information of the insured person, the investment type health and injury insurance policy, and the like in the database 411. The investment-type health and injury insurance policy includes a bidding transaction portfolio, and the bidding transaction portfolio includes a bidding period, a bidding period, and a general meeting amount.
當要保人在投資型健康及傷害保險接收作業模組405選擇投保投資型健康及傷害保險保單之綜合項目保險時，其健康項目部份的有效期間可與傷害項目部份的有效期間可為相同或不同。當健康項目部份的有效期間與傷害項目部份的有效期間不同時，以兩者之中有效期間較長者作為整份保險之最終有效期間之基準並以之決定要保人參與投資型健康及傷害保險系統402之競標期間。When the insured person selects the comprehensive project insurance for the investment-type health and injury insurance policy in the investment-type health and injury insurance receiving operation module 405, the effective period of the health item portion and the effective period of the injury item portion may be Same or different. When the effective period of the health project component is different from the effective period of the injury project component, the longer of the effective period of the two is used as the benchmark for the final effective period of the entire insurance and it is decided to participate in the investment health and During the bidding period of the injury insurance system 402.
其中，要保人之電子憑證係向電子憑證核發機構403申請，在要保人提供基本資料給電子憑證核發機構403並經審核後，電子憑證核發機構403給予要保人之電子憑證。The electronic voucher to be insured is applied to the electronic voucher issuing institution 403. After the insurer provides the basic information to the electronic voucher issuing institution 403 and is audited, the electronic voucher issuing institution 403 gives the electronic voucher of the insured.
由金流處理模組410收取要保人所繳納之投資型健康及傷害保險保單之保費，並由投資型健康及傷害保險接收作業模組405核發投資型健康及傷害保險保單之一電子保單給要保人(步驟S103)。而電子保單之核保項目如上所述。The gold flow processing module 410 collects the premium of the investment-type health and injury insurance policy to be paid by the insured, and is issued by the investment-type health and injury insurance receiving operation module 405.An electronic insurance policy for one of the investment type health and injury insurance policies is given to the insured (step S103). The underwriting of the electronic policy is as described above.
由保險公司將投資型健康及傷害保險保單之資料傳送至電子憑證核發機構403以加密、數位簽章、存證後，由電子憑證核發機構403將投資型健康及傷害保險保單傳送至保險公司，保險公司再將其傳送至要保人。After the insurance company transmits the information of the investment-type health and injury insurance policy to the electronic voucher issuing institution 403 to encrypt, digitally sign, and deposit the certificate, the electronic voucher issuing institution 403 transmits the investment-type health and injury insurance policy to the insurance company. The insurance company then transmits it to the insured.
其中，投資型健康及傷害保險保單規定所要繳納的費用包含保險期間的保費及投資型健康及傷害保險系統402在競標期間之存款金額或還款金額。Among them, the investment-type health and injury insurance policy requires that the fees to be paid include the premium during the insurance period and the deposit amount or repayment amount of the investment-type health and injury insurance system 402 during the bidding period.
接著，由資金競標模組407判斷參與競標交易組合之要保人之人數是否額滿，該人數與競標交易組合之競標期數相同(步驟S104)。Next, the fund bidding module 407 judges whether the number of the insured persons participating in the bidding transaction combination is full, and the number of bids is the same as the number of bidding periods of the bidding transaction combination (step S104).
若參與競標交易組合之要保人的人數未額滿時，則進行步驟S104；若參與競標交易組合之要保人的人數額滿時，則在競標期數的每一會期中，未曾得標之要保人藉由終端機401進入投資型健康及傷害保險系統402並輸入一投標金額以參與競標。資金競標模組407根據所輸入之投標金額以最高的投標金額作為一得標金額並決定得標者(步驟S105)。資金競標模組407將該等資料儲存於資料庫411。If the number of persons to be insured in the bidding transaction portfolio is not full, proceed to step S104; if the amount of the insured person participating in the bidding transaction combination is full, then no bid is obtained in each session of the bidding period The insurer enters the investment health and injury insurance system 402 via the terminal 401 and enters a bid amount to participate in the bidding. The fund bidding module 407 determines the winner by using the highest bid amount as the winning amount based on the entered bid amount (step S105). The funds bidding module 407 stores the data in the database 411.
其中，在當有數個相同之最高的投標金額時，資金競標模組407以抽籤方式抽出最高的投標金額之該等要保人的其中一者為得標者，得標金額即為此最高的投標金額；當無人投標時，資金競標模組407以抽籤方式抽出未曾得標之該等要保人的其中一者為得標者，此抽籤方式之得標金額係資金競標模組407所規定之一基本標金。Wherein, when there are several identical highest bid amounts, the fund bidding module 407 extracts one of the insured persons with the highest bid amount by lottery as the winner, and the winning amount is the highest. The bid amount; when no one bids, the fund bidding module 407 draws out one of the insured persons who have not won the bid by drawing lots.The bidder, the winning amount of the lottery method is one of the basic standard funds stipulated by the fund bidding module 407.
由金流處理模組410根據從資料庫411所取得之得標金額結算得標之要保人之一總得標金(如上述計算式(1)或(2))、未得標之要保人所要繳交之一存款金額(如上述計算式(5)或(6))、及已得標之要保人之一還款金額(如上述計算式(3)或(4))(步驟S107)。金流處理模組410將總得標金、存款金額及還款金額等資料儲存於資料庫411。The gold stream processing module 410 settles the winning bid of one of the insured persons according to the winning amount obtained from the database 411 (such as the above formula (1) or (2)), and the unqualified one is guaranteed. The amount of deposit to be paid by a person (such as the above formula (5) or (6)), and the amount of repayment of one of the insured persons (such as the above formula (3) or (4)) (step S107). The gold stream processing module 410 stores the total amount of the gold, the deposit amount, and the repayment amount in the database 411.
其中，由金流處理模組410將未得標之要保人之存款金額轉換成當會期得標之要保人之總得標金的一部分，並將已得標之要保人之還款金額轉換成當會期得標之要保人之總得標金的一部分。Wherein, the gold flow processing module 410 converts the undeposited deposit amount of the insured person into a part of the total winning amount of the insured person who is entitled to the bidding period, and repays the claimed insured person's repayment amount. The amount is converted into a part of the total winning amount of the insured person who is entitled to the meeting.
接著，由金流處理模組410交割已存入未得標之要保人的個人帳戶之存款金額(步驟S109)。在要保人未得標時，由理賠作業模組409判斷被保險人在投資型健康及傷害保險保單到期前是否出險(步驟S111)。若被保險人未出險時，則進行步驟S105；若被保險人出險時，則由理賠作業模組409判斷被保險人是否為嚴重出險(步驟S113)。Next, the deposit amount of the personal account that has been deposited in the unclaimed insured person is delivered by the gold stream processing module 410 (step S109). When the insured person fails to obtain the bid, the claim operation module 409 judges whether the insured person is in danger before the investment type health and injury insurance policy expires (step S111). If the insured is not in danger, proceed to step S105; if the insured is in danger, the claim operation module 409 determines whether the insured is in serious risk (step S113).
若被保險人為嚴重出險時，則由金流處理模組410結算及給付理賠金及要保人之個人帳戶之所有存款金額的現值給受益人或要保人(步驟S115)。若被保險人為非嚴重出險時，則由金流處理模組410給付投資型健康及傷害保險保單之契約條款所訂之部分理賠金給要保人(步驟S117)，之後進行步驟S105。If the insured is in serious risk, the cash flow processing module 410 settles and pays the present value of the deposit amount and all deposit amounts of the personal account of the insured to the beneficiary or the insured (step S115). If the insured is not in serious risk, the gold flow processing module 410 pays part of the claim amount of the contractual clause of the investment type health and injury insurance policy to the insured (step S117), and then proceeds to step S105.
保險公司在接收出險理賠之申請時，進行被保險人之保險事故的認定，以及判斷是否符合嚴重出險之理賠標準，保險公司藉由保險公司理賠作業系統404將理賠申請結果傳送至投資型健康及傷害保險系統402之理賠作業模組409。The insurance company carries out the insurance accident of the insured when receiving the application for the insurance claimThe insurance company transmits the claim application result to the claim operation module 409 of the investment-type health and injury insurance system 402 by the insurance company claims operation system 404 by determining and judging whether it meets the claim criteria for serious insurance.
在被保險人出險時，經保險公司理賠作業系統404的理賠申請判定核可後，金流處理模組410依據投資型健康及傷害保險保單所載明之內容所給付的方式如下：(1)若投資型健康及傷害保險保單為健康項目保險，則理賠金為健康項目出險之理賠金；(2)若投資型健康及傷害保險保單為傷害項目保險，則理賠金為傷害項目出險之理賠金；以及(3)若投資型健康及傷害保險保單為健康及傷害綜合項目保險，則理賠金為健康項目出險之理賠金與傷害項目出險之理賠金至少其一。When the insured person is in danger, after the claim of the insurance company claims operation system 404 is approved, the gold flow processing module 410 pays according to the contents stated in the investment health and injury insurance policy as follows: (1) If the investment-type health and injury insurance policy is for health insurance, the claim is the claim for the health project; (2) if the investment-type health and injury insurance policy is the injury insurance, the claim is the damage for the injury project. And (3) if the investment-type health and injury insurance policy is a health and injury comprehensive project insurance, the claim is at least one of the claims for the health project's claims and damages.
被保險人為嚴重出險係指身故或全殘之出險情況，而被保險人為非嚴重出險係指非身故及非全殘之出險情況。The insured is a serious accident that refers to the death or total disability, and the insured is a non-severe risk refers to the non-death and non-disabled risk.
其次，由金流處理模組410交割總得標金以存入當會期得標之要保人之個人帳戶(步驟S119)。投資管理模組408提供各種投資標的以供要保人之個人帳戶的總得標金進行投資，並經由終端機401公佈對應該總得標金所投資之一投資標的、一投資損益及一資產淨值給要保人，投資管理模組408將該等資料儲存至資料庫411(步驟S121)。然後，由金流處理模組410交割已得標之要保人之還款金額(步驟S123)。其中，投資標的包含共同基金、有價證券及衍生性金融商品至少一者之金融商品。Next, the gold stream processing module 410 delivers the total amount of the deposit to deposit the personal account of the insured person who is entitled to the session (step S119). The investment management module 408 provides various investment targets for investment in the total amount of the personal account of the insured person, and announces, via the terminal 401, an investment target, an investment profit and a net asset value corresponding to the investment of the total winning fund. To protect the person, the investment management module 408 stores the data in the database 411 (step S121). Then, the reimbursement amount of the insured person who has obtained the bid is delivered by the gold stream processing module 410 (step S123). Among them, the investment target includes financial products of at least one of mutual funds, marketable securities and derivative financial products.
在要保人已得標時，由理賠作業模組409判斷投資型健康及傷害保險保單是否到期(步驟S125)。當該投資型健康及傷害保險保單到期時，保險公司藉由保險公司理賠作業系統404通知理賠作業模組409。When the insured person has obtained the bid, the claim operation module 409 determines whether the investment type health and injury insurance policy has expired (step S125). When the investment-type health and injury insurance policy expires, the insurance company notifies the claims operation module 409 by the insurance company claims operation system 404.
在要保人已得標時，若投資型健康及傷害保險保單到期，則由金流處理模組410結算及給付要保人所繳納之一保費的總額及一結算餘額給要保人，該結算餘額係為要保人之個人帳戶經投資的總得標金之資產淨值扣除剩餘會期之一總還款金額的餘額(步驟S127)。由金流處理模組410所結算之結算餘額若為負值，則由要保人所繳納之保費的總額抵繳結算餘額之負值的部分。When the insured person has obtained the bid, if the investment type health and injury insurance policy expires, the gold flow processing module 410 settles and pays the total amount of one premium paid by the insured and a settlement balance to the insured person. The settlement balance is the balance of the net asset value of the total amount of the invested capital of the insured personal account minus one of the remaining repayment amount of the remaining session (step S127). If the settlement balance settled by the gold flow processing module 410 is a negative value, the total amount of the premium paid by the insured person is offset against the negative value of the settlement balance.
當被保險人在投資型健康及傷害保險保單到期前曾經為非嚴重出險而獲得部分理賠金時，在投資型健康及傷害保險保單到期時，金流處理模組410依投資型健康及傷害保險保單所訂之退費標準退還已繳保費之總額的部分金額給要保人。When the insured obtains part of the claim for non-severe insurance before the expiration of the investment health and injury insurance policy, the gold flow processing module 410 is based on investment health and when the investment health and injury insurance policy expires. The refund standard set by the injury insurance policy refunds part of the total amount of the premium paid to the insured.
在要保人已得標時，若投資型健康及傷害保險保單未到期，則由理賠作業模組409判斷被保險人是否出險(步驟S129)。若被保險人未出險，則進行步驟S125；若被保險人出險，則由理賠作業模組409判斷被保險人是否為嚴重出險(步驟S131)。When the insured person has obtained the bid, if the investment type health and injury insurance policy has not expired, the claim operation module 409 determines whether the insured person is in danger (step S129). If the insured is not in danger, step S125 is performed; if the insured is in danger, the claim operation module 409 determines whether the insured is in serious risk (step S131).
保險公司在接收出險理賠之申請時，進行被保險人之保險事故的認定，以及判斷是否符合嚴重出險之理賠標準，保險公司藉由保險公司理賠作業系統404將理賠申請結果傳送至投資型健康及傷害保險系統402之理賠作業模組409。When the insurance company receives the application for the insurance claim, the insurance company determines the insured's insurance accident and determines whether it meets the claim standard for serious insurance. The insurance company transmits the claim application result to the investment health through the insurance company claims operation system 404. The claims operation module 409 of the injury insurance system 402.
在要保人已得標時，若被保險人為嚴重出險，則由金流處理模組410結算及給付投資型健康及傷害保險保單之理賠金及結算餘額給受益人或要保人，該結算餘額係為要保人之個人帳戶經投資的總得標金之資產淨值扣除剩餘會期之總還款金額的餘額(步驟S133)。由金流處理模組410所結算之結算餘額若為負值，則由理賠金抵繳結算餘額之負值的部分。When the insured person has obtained the bid, if the insured is seriously in danger, the gold flow processing module410 settlement and payment of the investment-type health and injury insurance policy claims and settlement balance to the beneficiary or the insured, the settlement balance is the net asset value of the total amount of the investment in the individual account of the insured person minus the remaining period The balance of the total repayment amount (step S133). If the settlement balance settled by the gold stream processing module 410 is a negative value, the portion of the negative balance of the settlement balance is offset by the claims.
若被保險人不為嚴重出險，則由金流處理模組410給付投資型健康及傷害保險保單之契約條款所訂之部分理賠金給要保人(步驟S135)。If the insured is not seriously in danger, the gold flow processing module 410 pays part of the claim amount of the contractual terms of the investment type health and injury insurance policy to the insured (step S135).
當由受益人或要保人領取理賠金及個人帳戶之所有存款金額的現值、或領取所繳納之保費的總額及結算餘額、或領取理賠金及結算餘額時，由投資型健康及傷害保險接收作業模組405終止投資型健康及傷害保險保單之契約(步驟S137)。Investment-type health and injury insurance when the beneficiary or the insured person receives the current value of the deposit amount and all the deposit amount of the personal account, or the total amount of the premium paid and the settlement balance, or the settlement of the claim and settlement balance The receiving operation module 405 terminates the contract of the investment type health and injury insurance policy (step S137).
下文說明一實施例，同時參考圖一及二，以說明本發明之投資型健康及傷害保險之方法與系統的實施方式。An embodiment will now be described with reference to Figures 1 and 2 to illustrate embodiments of the method and system for investment-type health and injury insurance of the present invention.
李君為了加強自身健康及傷害的保障，於是李君向電子憑證核發機構403提供基本資料以申請電子憑證(步驟S101)。接著，以其電子憑證經由終端機401向投資型健康及傷害保險系統402購買投資型健康及傷害保險保單(步驟S102)，李君在繳交保費後收到由投資型健康及傷害保險接收作業模組405所核發之投資型健康及傷害保險保單的電子保單(步驟S103)。其中，該投資型健康及傷害保險保單包含一具有一競標期限、一競標期數及一總會款之競標交易組合。In order to strengthen his health and injury protection, Li Jun provided basic information to the electronic voucher issuing agency 403 to apply for electronic voucher (step S101). Next, the investment-type health and injury insurance policy is purchased from the investment-type health and injury insurance system 402 via the terminal 401 with the electronic voucher (step S102), and Li Jun receives the investment-type health and injury insurance after receiving the premium. The electronic policy of the investment-type health and injury insurance policy issued by the module 405 (step S103). The investment-type health and injury insurance policy includes a bidding transaction portfolio having a bidding period, a bidding period, and a general meeting.
接著，由資金競標模組407判斷參與競標交易組合之要保人之人數是否額滿，該人數與競標交易組合之競標期數相同(步驟S104)。Next, the fund bidding module 407 judges whether the number of the insured persons participating in the bidding transaction combination is full, and the number of bids is the same as the number of bidding periods of the bidding transaction combination (step S104).
李君為自己投保一投資型健康及傷害保險，保單條件如下：Li Jun insured an investment-type health and injury insurance for himself. The policy conditions are as follows:
●保險種類：五年期健康項目保險，以及三年期傷害項目保險●Type of insurance: five-year health insurance, and three-year injury insurance
●保額：健康項目保險保額100萬元，傷害項目保險保額200萬元●Insured amount: the insurance coverage of the health project is 1 million yuan, and the insurance coverage of the injury project is 2 million yuan.
●要保人：李○○●To protect people: Li ○○
●被保險人：李○○●Insured: Li ○○
●繳費期間：期初一次繳清●Payment period: payable once at the beginning of the period
應繳保費：健康項目保險保費6,810元，傷害項目保險保費1731元Premiums payable: health insurance premiums of 6,810 yuan, injury insurance premiums of 1,731 yuan
●競標期間：四年，每月一次，共四十九期● During the bidding period: four years, once a month, forty-nine periods
●競標上限：新台幣一萬元整●Maximum bidding: NT$10,000
●底標：隨郵政儲金一年期浮動利率調整(目前為2.48%)●Bottom standard: With the one-year floating rate adjustment of the postal deposit (currently 2.48%)
●其他：●Other:
1.要保人在本公司所提供的投資商品中任意選擇操作1. To ensure that the arbitrarily choose to operate in the investment products provided by the company
2.若出險事件屬重度損害，則可提前撥付平台交割帳戶之個人帳戶經結算的餘額；出險損害之輕重程度，由合格醫療機構認定之。2. If the accident is a serious injury, the balance of the individual account of the platform delivery account can be paid in advance; the severity of the damage is determined by the qualified medical institution.
若參與競標交易組合之要保人之人數額滿時，當李君在這四年中皆不參與投資型健康及傷害保險系統402之競標時(步驟S105)，李君得依資金競標機制各會期所公布之得標金額進行存款，如第一期公布之得標金額為650元，則李君除了會期初一次繳清保費8,541元(6,810元+1,731元)外，需另存入9,350元(10,000元-650元)的存款金額(如上述計算式(5))(步驟S107、S109)，而這筆第一會期的存款金額之現值將在李君得標時或是四年之後成為10,000元，如第二會期公布之得標金額為660元，則第二會期李君應存入9,340元(10,000元-660元)的存款金額(如上述計算式(5))(步驟S107、S109)，第二會期的存款金額之現值亦在李君得標時或是三年十一個月之後成為10,000元，以下各會期皆依此類推，則李君各會期所存入的存款金額的現值將在四年後達到四十八萬元之總額(如上述計算式(1)的總得標金)，在投資型健康及傷害保險保單到期時(步驟S125)，由金流處理模組410結算及給付李君所存之所有存款金額的現值(即四十八萬元)與所繳納之保費的總額而一次領取完畢(步驟S127)。之後，由投資型健康及傷害保險接收作業模組405終止投資型健康及傷害保險保單之契約(步驟S137)。If the amount of the person who participates in the bidding transaction portfolio is full, when Li Jun does not participate in the bidding for the investment-type health and injury insurance system 402 in the past four years (step S105), Li Jun will follow the fund bidding mechanism. During the session, the winning amount will be deposited. If the winning amount announced in the first period is 650 yuan, then Li Jun will pay a deposit of 8,540 yuan (6,810 yuan + 1,731 yuan) in addition to the initial payment. The deposit amount of (10,000 yuan - 650 yuan) (such as the above formula (5)) (steps S107, S109), and the present value of the deposit amount of the first session will be at the time of Li Jun's bid or four years After that, it will become 10,000 yuan. If the winning amount announced in the second session is 660 yuan, then the second session of Li Jun should deposit the deposit amount of 9,340 yuan (10,000 yuan - 660 yuan) (such as the above formula (5)) (step S107, S109), the present value of the deposit amount of the second session is also 10,000 yuan when Li Jun wins the bid or three years and eleven months. The following sessions are all the same, then Li Jun will meet each other. The present value of the deposit amount deposited will reach a total of 480,000 yuan in four years (such as the total awarded amount of the above formula (1)). When the investment-type health and injury insurance policy expires (step S125), the cash flow processing module 410 settles and pays the present value of all deposit amounts deposited by Li Jun (ie, 480,000 yuan) and the total amount of premiums paid. The collection is completed once (step S127). Thereafter, the investment type health and injury insurance receiving operation module 405 terminates the contract of the investment type health and injury insurance policy (step S137).
未曾得標之李君在持續繳費即將滿二年之時，決定參與投資型健康及傷害保險系統402之競標以取得總得標金來進行投資，藉此提升報酬率。李君於第24會期以標金1,000元下標，資金競標模組407根據所輸入之投標金額判斷出李君的標金為最高的投標金額，因此資金競標模組407決定李君得標(步驟S105)，李君由金流處理模組410交割取得共455,000元(10,000元x23期+9,000元x25期)之總得標金(如上述計算式(1))(步驟S119)，投資型健康及傷害保險系統402逕行將此總得標金導入李君之平台交割帳戶之個人帳戶以進行投資操作，而根據李君由投資管理模組408所選擇的投資標的進行投資(步驟S121)，盈虧由李君自負，而李君在接下來的25會期之各會期需繳還10,000元的還款金額給金流處理模組410(如上述計算式(3))(步驟S123)，以償還資金競標中產生的貸款。Li Jun, who has not won the bid, will decide to participate in the bidding for the investment-type health and injury insurance system 402 at the time of the continuous payment for two years, in order to obtain the total prize money to invest, thereby increasing the rate of return. Li Jun was subscripted at the 24th session with a standard amount of 1,000 yuan. The fund bidding module 407 judged that Li Jun’s bid was the highest bid amount based on the bid amount entered. Therefore, the fund bidding module 407 decided that Li Jun won the bid. (Step S105), Li Jun delivered a total of 455,000 yuan (10,000 yuan x 23 periods + 9 thousand yuan) from the gold stream processing module 410.The total awarded amount of the x25 period (such as the above formula (1)) (step S119), the investment-type health and injury insurance system 402 will import the total winnings into the personal account of the Li Jun platform delivery account for investment operation, and according to Li Jun invests in the investment target selected by the investment management module 408 (step S121), the profit and loss is borne by Li Jun, and Li Jun pays the repayment amount of 10,000 yuan for each of the next 25 sessions. The gold stream processing module 410 (such as the above formula (3)) (step S123) to repay the loan generated in the fund bidding.
假設未來該總得標金所投資的二年中(25期)，年化報酬率為7%，則資金競標期間期滿時，亦即第四年結束時，累積平台交割帳戶之個人帳戶經投資的總得標金之資產淨值將達到523,968元，相較於不競標之純粹存款者多了43,968元(523,968元-480,000元)。Assume that in the next two years (25 periods) of the total investment, the annualized return rate is 7%. When the capital bidding period expires, that is, at the end of the fourth year, the individual account of the cumulative platform delivery account is invested. The net asset value of the total awarded gold will reach 523,968 yuan, which is 43,968 yuan (523,968 yuan - 480,000 yuan) compared with the pure depositors who do not bid.
但由於李君之健康項目保險有效期達五年，因此，雖然傷害項目保險於第三年結束時到期，而資金競標期間於第四年結束時期滿，李君之個人帳戶仍將存續至第五年結束(即投資型健康及傷害保險保單到期時)，亦即該帳戶款項之投資持續至第五年才結束。However, since Li Junzhi's health insurance is valid for five years, although the injury insurance expires at the end of the third year, and the capital bidding period expires at the end of the fourth year, Li Junzhi's personal account will survive until the end of the fifth year ( That is, when the investment-type health and injury insurance policy expires, that is, the investment in the account is not completed until the fifth year.
第三年結束時，李君之傷害險到期，第三年半時，李君因盲腸炎開刀(步驟S129、S131)，向保險公司申請健康項目出險之部分理賠金(步驟S135)，至第五年結束(即投資型健康及傷害保險保單到期)時，健康項目保險到期(步驟S127)，李君領回由金流處理模組410所結算及給付之個人帳戶的資產淨值557,394元及部分所繳納之保費的總額(步驟S127)。之後，由投資型健康及傷害保險接收作業模組405終止投資型健康及傷害保險保單之契約(步驟S137)。At the end of the third year, Li Junzhi’s injury insurance expired. In the third year and a half, Li Jun opened the knife for cecalitis (steps S129 and S131) and applied to the insurance company for part of the compensation for the health project (step S135), to the fifth year. At the end (ie, the investment-type health and injury insurance policy expires), the health insurance item expires (step S127), and Li Jun receives the net asset value of 557,394 yuan and part of the personal account settled and paid by the gold flow processing module 410. The total amount of the premium paid (step S127). Thereafter, the investment-type health and injury insurance receiving operation module 405 terminates the contract for the investment-type health and injury insurance policy (steps)S137).
雖然本發明已參照較佳實施例及舉例性附圖敘述如上，惟其應不被視為係限制性者。熟悉本技藝者對其形態及實施例之內容做各種修改、省略及變化，均不離開本發明之範圍。The present invention has been described above with reference to the preferred embodiments and the accompanying drawings, and should not be considered as limiting. It will be apparent to those skilled in the art that various modifications, omissions and changes may be made without departing from the scope of the invention.
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| TW097146860ATWI451350B (en) | 2008-12-03 | 2008-12-03 | Investment-based health and injury insurance |
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| TW097146860ATWI451350B (en) | 2008-12-03 | 2008-12-03 | Investment-based health and injury insurance |
| Publication Number | Publication Date |
|---|---|
| TW201023077A TW201023077A (en) | 2010-06-16 |
| TWI451350Btrue TWI451350B (en) | 2014-09-01 |
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| TW097146860ATWI451350B (en) | 2008-12-03 | 2008-12-03 | Investment-based health and injury insurance |
| Country | Link |
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| TW (1) | TWI451350B (en) |
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