Studi pengalaman tabel morbiditas berdasarkan pengalaman salah satu perusahaan asuransi Indonesia = Morbidity Table Experience Study Based On an Indonesian Private Insurance Company Data

Sofian, Felicia (2018) Studi pengalaman tabel morbiditas berdasarkan pengalaman salah satu perusahaan asuransi Indonesia = Morbidity Table Experience Study Based On an Indonesian Private Insurance Company Data. Bachelor thesis, Universitas Pelita Harapan.

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Abstract

Morbiditas adalah tingkat yang sakit dan yang sehat dalam suatu populasi. Dalam membentuk produk asuransi kesehatan, salah satu asumsi utama yang diperlukan adalah tingkat morbiditas. Asumsi ini disajikan dalam bentuk tabel yang dapat ditambahkan dengan informasi krusial lainnya, yang disebut tabel morbiditas. Penelitian ini menawarkan suatu metode dalam mengembangkan tabel morbiditas menggunakan studi pengalaman berdasarkan data riil dari perusahaan asuransi swasta Indonesia. Tabel ini mencakup tingkat kejadian klaim (yang dihitung menggunakan metode eksposur individual), jangka waktu rawat inap dan jumlah klaim terbayarkan harian (yang dihitung menggunakan metode rata-rata sederhana). Tabel ini dievaluasi berdasarkan 3 parameter: tahun kalender, tahun polis, dan kelompok umur. Kemudian, dilakukan analisis terhadap perilaku klaim pada ketiga parameter dengan mempertimbangkan kredibilitas data dan standar deviasi dari tiga variabel di atas. Hasil akhir dari penelitian ini adalah sebuah tabel morbiditas serta analisis perilaku klaim yang dapat digunakan oleh perusahaan asuransi swasta Indonesia. / Morbidity is the rate of disease in a population. It is one of the main assumptions in making a health insurance product. This assumption is presented in a table called the morbidity table, which can be expanded with other crucial information. This research offers a method in developing a new morbidity table using experience study based on real data from an Indonesian private health insurance company. This table consists of claim incidence rate (which is calculated using individual exposure method), length of stay and daily amount paid (calculated using simple average method). The table is evaluated using three parameters: calendar year, policy year, and age parameter band. Afterwards, an analysis on claim behaviour is conducted for each parameter, taking into account the credibility of the data and the standard deviation of the three variables. The final result of this research is a morbidity table and claim behaviour analysis usable by Indonesian private insurance companies.

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