JP2011165220A - Insurance system, insurance method, insurance program, and computer-readable recording medium with the same program recorded thereon - Google Patents
Insurance system, insurance method, insurance program, and computer-readable recording medium with the same program recorded thereon Download PDFInfo
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Abstract
Description
本発明は被保険者、殊に糖尿病（高血糖症）罹患者に対する契約保険料の決定を行う保険システムと保険方法並びに保険プログラムと当該プログラムを記録したコンピュータ読み取り可能な記録媒体に関するものである。 The present invention relates to an insurance system and an insurance method for determining a contract premium for an insured person, particularly a person suffering from diabetes (hyperglycemia), an insurance program, and a computer-readable recording medium on which the program is recorded.
生命保険（終身保険）においては、被保険者の性別や年齢や職種等に応じて、つまりは保険リスクに応じて契約保険料が決定されているが、高血圧・糖尿病（高血糖症）・慢性肝炎・緑内障などの既往症を有している被保険者の場合、保険会社側では保険リスクの算出が困難であるために、保険契約が断られたり、契約できたとしても、契約保険料がきわめて高かったりしている。 In life insurance (life insurance), contract premiums are determined according to the insured's gender, age, occupation, etc., that is, according to the insurance risk, but are subject to hypertension, diabetes (hyperglycemia), chronic For insured persons with a history of hepatitis, glaucoma, etc., it is difficult for the insurance company to calculate the insurance risk, so even if the insurance contract is refused or contracted, the contract premium is extremely high. It is expensive.
一方、上記の既往症のうち、糖尿病（高血糖症）に関しては、近年罹患者が非常に多くなっており、保険会社にしてみれば、糖尿病（高血糖症）の重さに応じた保険リスクを算定できれば、糖尿病（高血糖症）患者との保険契約によって売り上げを増大させることができ、また、糖尿病（高血糖症）患者にしてみれば、糖尿病（高血糖症）を軽くすることができれば契約保険料を低くすることができるために、糖尿病（高血糖症）克服のモチベーションを高めて健康状態の維持を図ることができる。 On the other hand, among the above-mentioned pre-existing diseases, diabetes (hyperglycemia) has been affected by a large number of people in recent years. For insurance companies, the insurance risk corresponding to the severity of diabetes (hyperglycemia) If it can be calculated, sales can be increased through insurance contracts with diabetic (hyperglycemic) patients, and if diabetic (hyperglycemic) patients, diabetes (hyperglycemic) contracts can be reduced. Since the insurance premium can be lowered, the motivation for overcoming diabetes (hyperglycemia) can be increased and the health condition can be maintained.
ここにおいて、糖尿病（高血糖症）は血糖値が増えるほど重症であると言えるが、血糖コントロールの指標とされている空腹時静脈血漿糖値（fasting plasmaglucose：ＦＰＣ）や経口ブドウ糖負荷試験（ＯＧＴＴ）における２時間血漿糖値（２ｈ−ＰＧ）は、食事摂取量の調節、薬剤の使用、インスリン注射などによって患者が比較的自在に値をコントロールすることができたために、保険会社にしてみれば、上記の値を基に契約対象者の保険リスクを算定することはできず、このために保険契約を断るか、きわめて高い契約保険料を設定するほかはなかった。 Here, it can be said that diabetes (hyperglycemia) becomes more severe as the blood glucose level increases, but fasting plasma glucose (FPC) or oral glucose tolerance test (OGTT), which is an index of blood glucose control. The 2 hour plasma sugar level (2h-PG) in the patient was able to control the value relatively freely by adjusting the food intake, use of drugs, insulin injection, etc. Based on the above values, the insurance risk of the policyholders could not be calculated, and for this purpose, there was no choice but to refuse the insurance contract or set a very high policy premium.
本発明はこのような点に鑑みなされたものであって、その目的とするところは被保険者の糖尿病（高血糖症）に関する保険リスクを適切に算定して契約保険料を決定することができる保険システムと保険方法並びに保険プログラムと当該プログラムを記録したコンピュータ読み取り可能な記録媒体を提供するにある。 The present invention has been made in view of these points, and the object of the present invention is to appropriately calculate insurance risk related to diabetes (hyperglycemia) of the insured person and determine the contract premium. The present invention provides an insurance system, an insurance method, an insurance program, and a computer-readable recording medium in which the program is recorded.
しかして本発明に係る保険システムは、通信ネットワークを介して被保険者の端末とサーバを接続して構成され、被保険者からの要求と被保険者の個人データに基づいてサーバが被保険者との保険契約のための契約保険料を決定する保険システムであって、被保険者の個人データを通信ネットワークを介して受け付ける保険契約受付部と、被保険者が受診した医療機関からの被保険者についての長期血糖コントロール指標を医療機関から受信する医療機関用受信部と、被保険者の食事管理を請け負う食事管理支援者から入手した被保険者の食事管理実績データを受信するデータ受信部と、上記受付部及び受信部から得られた個人データと長期血糖コントロール指標と食事管理実績データに応じて予め設定された料率で被保険者に対する契約保険料を決定する計算部とを上記サーバが備えることに特徴を有している。被保険者の長期血糖コントロール指標及び食事管理実績を保険リスクの算定材料として契約保険料を決定するものである。 The insurance system according to the present invention is configured by connecting a terminal of an insured person and a server via a communication network, and the server is insured based on a request from the insured person and personal data of the insured person. An insurance system that determines contract premiums for insurance contracts with the insurance contract reception unit that receives personal data of the insured person via a communication network, and insurance from the medical institution that the insured person has received A receiving unit for a medical institution that receives a long-term blood glucose control index for a person from a medical institution, and a data receiving unit for receiving meal management performance data of the insured obtained from a meal management supporter who undertakes meal management of the insured; and Contract maintenance for the insured person at a rate set in advance according to the personal data, long-term blood glucose control index, and meal management performance data obtained from the reception unit and reception unit. And a calculation unit for determining a fee is characterized in that provided in said server. Contract insurance premiums are determined by using the insured's long-term blood glucose control index and dietary management results as a basis for calculating insurance risk.
そして本発明に係る保険方法は、通信ネットワークを介してサーバにアクセスする被保険者に対して契約保険料の決定を行う保険方法であって、上記サーバが被保険者の個人データを通信ネットワークを介して受け付ける保険契約受付部と、被保険者が受診した医療機関からの被保険者についての長期血糖コントロール指標を医療機関から受信する医療機関用受信部と、被保険者の食事管理を請け負う食事管理支援者から入手した被保険者の食事管理実績データを受信するデータ受信部と、上記受付部及び受信部から得られた個人データと長期血糖コントロール指標とに応じて予め設定された料率で被保険者に対する契約保険料を決定する計算部とを備え、上記サーバがその保険契約受付部にて被保険者からの個人データを受け付ける個人データ入力ステップ、上記サーバがその医療機関用受信部にて被保険者が受診した医療機関からの被保険者についての長期血糖コントロール指標を受信するコントロール指標入力ステップ、上記サーバがそのデータ受信部にて被保険者の食事管理を請け負う食事管理支援者から入手した被保険者の食事管理実績データを受信する食事管理実績データ入力ステップ、上記サーバがその計算部にて、得られた個人データと長期血糖コントロール指標ステップと食事管理実績データに基づいて被保険者に対する契約保険料を決定する契約保険料決定ステップとからなることに特徴を有している。 The insurance method according to the present invention is an insurance method for determining a contract premium for an insured person who accesses a server via a communication network, wherein the server transmits personal data of the insured person to the communication network. Through the insurance contract reception unit, the medical institution receiving the long-term blood glucose control index for the insured from the medical institution that the insured consulted, and the meal undertaken by the insured's meal management A data receiving unit that receives the insured's meal management performance data obtained from the management supporter, the personal data obtained from the receiving unit and the receiving unit, and a rate set in advance according to the long-term blood glucose control index A calculation unit for determining a contract premium for the insurer, and the server accepts personal data from the insured by the insurance contract reception unit. Input step, the server receives a long-term blood glucose control index for the insured person from the medical institution that the insured person has received at the receiving part for the medical institution, and the server receives the data in the data receiving part. The meal management result data input step for receiving the insured person's meal management result data obtained from the meal management supporter who undertakes the insured's meal management; It is characterized by comprising a blood glucose control index step and a contract premium determination step for determining a contract premium for the insured based on the meal management result data.
そして、上記の長期血糖コントロール指標としてＨｂＡ１ｃ（ヘモグロビンＡ１ｃ）の値を用いることに他の特徴を有している。このＨｂＡ１ｃは、過去１，２ヶ月の平均血糖値の動きを見ることができるものであり、血糖量検査の直前の食事摂取量の調節や薬剤の使用やインスリン注射などではコントロールすることができない値であり、保険リスクの算定にきわめて有効に使用することができる。 And it has another characteristic in using the value of HbA1c (hemoglobin A1c) as said long-term blood glucose control index. This HbA1c is a value that can see the movement of the average blood glucose level in the past 1 to 2 months, and cannot be controlled by adjusting the food intake immediately before the blood glucose level test, use of drugs, insulin injection, etc. It can be used very effectively for insurance risk calculation.
さらに医療機関から入手した被保険者の新たな長期血糖コントロール指標に基づいて契約保険料を変更するステップを備えることに第４の特徴を有している。 Furthermore, it has the 4th characteristic in providing the step which changes a contract premium based on the insured person's new long-term blood glucose control parameter | index acquired from the medical institution.
また、本発明に係る保険プログラム及び該プログラムを記録したコンピュータ読み取り可能な記録媒体は、上記の保険方法を実行させるためのものであることに特徴を有している。 An insurance program according to the present invention and a computer-readable recording medium on which the program is recorded are characterized in that the insurance method is executed.
本発明においては、被保険者が受診した医療機関から受信した被保険者についての信頼性のある長期血糖コントロール指標と、被保険者の食事管理を請け負う食事管理支援者から入手した被保険者の食事管理実績を被保険者に対する契約保険料の決定に際して利用するものであり、ある程度の期間の被保険者の血糖コントロールの努力結果を見ることができるために、保険会社にしてみれば、保険リスクを適切に判定して契約保険料を決定することができ、この結果、既往症を有する被保険者に対しても高額とならない契約保険料で保険契約を行うことができることになり、被保険者にとってはこれまで契約できなかったり高額の契約保険料を支払わなくてはならなかった保険の契約を行うことができ、保険会社にしてみれば、保険契約対象者の範囲を広げることができるために、顧客を拡大することができる。また、長期血糖コントロール指標の値に応じて契約保険料が定まることから、被保険者は自身の長期血糖コントロール指標の値を下げることに努めることになり、被保険者の健康維持や医療費の低減にも有効である。 In the present invention, a reliable long-term blood glucose control index for an insured person received from a medical institution that the insured has consulted, and the insured person obtained from a meal management supporter who undertakes insured meal management. The meal management results are used when determining the contract premium for the insured, and the insurer's blood glucose control efforts can be seen for a certain period. As a result, it is possible to make an insurance contract with a contract premium that does not increase even for insured persons with a past medical condition. Can make insurance contracts that could not be contracted until now or had to pay high contract insurance premiums, and if it is an insurance company, it is eligible for insurance contracts In order to be able to widen the range of, it is possible to expand the customer. In addition, since the contract insurance premium is determined according to the value of the long-term blood glucose control index, the insured endeavors to lower the value of his / her long-term blood glucose control index. It is also effective for reduction.
そして、上記長期血糖コントロール指標として、ＨｂＡ１ｃの値を用いる時、現時点では最も信頼性のあるデータであるために、保険リスクを適切に設定して契約保険料を求めることができる。 When the value of HbA1c is used as the long-term blood glucose control index, since it is the most reliable data at present, the insurance premium can be set appropriately and the contract premium can be obtained.
また、医療機関から入手した被保険者の新たな長期血糖コントロール指標に基づいて契約保険料を変更するならば、被保険者はより一層健康管理に努めることになり、被保険者の健康維持や医療費の低減効果が大きくなる。 In addition, if the contract premium is changed based on the insured's new long-term blood glucose control index obtained from a medical institution, the insured will make further efforts to manage his / her health. The effect of reducing medical costs is increased.
以下本発明を実施の形態の一例に基づいて詳述すると、被保険者（保険契約希望者）と、この被保険者が保険契約を申し込む保険会社の他に、被保険者の長期血糖コントロール指標（ここではＨｂＡ１ｃを利用）の検査を行う医療機関に加えて、被保険者の食事管理支援を行うサービス運用会社が加わっている場合の４者の関係を図１に示す。 Hereinafter, the present invention will be described in detail based on an example of an embodiment. In addition to an insured (insurance applicant) and an insurance company to which the insured applies for an insurance contract, a long-term blood glucose control index of the insured FIG. 1 shows the relationship between the four parties in the case where a service management company that provides meal management support for the insured is added in addition to the medical institution performing the examination (here, using HbA1c).
ここでのサービス運用会社が実施する食事管理支援は、たとえば被保険者にデジタル画像撮影機能を備えた携帯端末を貸与し、該携帯端末で被保険者が摂取する朝や昼の食事を撮影してその画像データをサービス運用会社のサーバに送れば、栄養士が摂取栄養分析をし、夕方に摂取エネルギー情報として被保険者に知らせるとともに、管理栄養士などの専門家が、１週間及び１ヶ月間のデータに基づき、被保険者自身の食事に関する反省や感想を加味した上で、週間及び月間摂取エネルギーの変動・総合栄養バランス等のアドバイスをするものであり、また、血糖、血圧、体重、歩数の生体情報を記録して月間レポートでトレンドグラフで表示したり、携帯端末での料理のカロリーデータの検索や、糖尿病生活支援のための各種生活支援情報コンテンツの配信等を行うものであって、ここでは上記食事管理支援サービスは、保険会社を通じて被保険者と契約して有料で実施される。なお、ここでの食事管理支援サービスは一例であり、上記のサービス全てが実施されることは必須ではなく、要は被保険者の食事の管理を支援するものであればよいものであり、たとえば、被保険者が摂取する食事そのものを被保険者の症状に応じて提供するサービスであってもよい。 The meal management support provided by the service management company here is, for example, renting a portable terminal equipped with a digital image photographing function to the insured person and photographing the morning or noon meal taken by the insured person with the portable terminal. If the image data is sent to the server of the service management company, the nutritionist analyzes the intake nutrition and informs the insured person as intake energy information in the evening. Based on the data, it gives advice on changes in energy intake and total nutritional balance during the week and month, taking into account reflections and impressions of the insured's own diet, and also provides information on blood sugar, blood pressure, weight, and number of steps. Record biological information and display it as a trend graph in a monthly report, search for calorie data of dishes on mobile devices, and various life support information for diabetes life support A performs the delivery or the like of the content, the dietary management support services here is carried out for a fee contract with the insured through the insurance company. It should be noted that the meal management support service here is an example, and it is not essential that all of the above services be implemented. The point is that any service that supports the management of the insured person's meal may be used. A service that provides the meal itself taken by the insured according to the symptoms of the insured may be used.
図３は、上記サービス運用会社で稼働しているサーバソフトウェアのモジュール構成を示しており、被保険者である顧客のデータを収容した顧客データ部の他に、上記サービスのための患者（被保険者）用サービス利用契約受け付け部と患者用サービス利用時情報受信部を備え、また保険会社との間のデータ送受用として、保険会社用サービス申し込み通知受信部、保険会社用サービス利用開始通知送信部、保険会社用サービス利用率データ送信部を備え、さらに被保険者のサービス利用料の決済のためのクレジット会社用サービス利用料申請部、クレジット会社用顧客データ届出部、クレジット会社用カードチェック依頼部を備えている。 FIG. 3 shows the module configuration of the server software operating in the service management company. In addition to the customer data section containing the data of the customer who is the insured, the patient for the service (insured) A service use contract reception unit for patients and a service use information reception unit for patients, and for data transmission / reception with an insurance company, a service application notification reception unit for insurance companies and a service use start notification transmission unit for insurance companies , A service usage rate data transmission unit for insurance companies, a service usage fee application unit for credit companies for settlement of service usage fees for insured persons, a customer data reporting unit for credit companies, and a card check request unit for credit companies It has.
一方、保険会社で稼働しているサーバソフトウェアは、図２に示すように、顧客データ部の他に、患者（被保険者）用保険契約受け付け部、本発明の主体となる患者用契約保険料見積もり額計算部、患者用契約保険料見積もり額提示部を備えるほか、上記サービス運用会社とのデータ送受のための支援システムサービス運用会社用サービス申し込み通知送信部、サービス利用開始通知受信部、サービス利用率データ受信部を備え、また、提携している医療機関からのデータ受信のための医療機関用ＨｂＡ１ｃデータ受信部、医療機関への金融機関を通じた検査料支払いのための検査料支払額送信部及び検査料支払依頼部を備え、さらに被保険者の契約保険料決済のためのクレジット会社用サービス利用料申請部、クレジット会社用顧客データ届出部、クレジット会社用カードチェック依頼部を備えている。 On the other hand, as shown in FIG. 2, the server software operating in the insurance company includes, in addition to the customer data section, a patient (insured person) insurance contract acceptance section, and a patient contract insurance premium that is the subject of the present invention. In addition to providing an estimated amount calculation unit and patient contract insurance fee estimated amount presenting unit, support system for operating system service companies to send / receive data to / from the service management company Service application notification sending unit, service use start notification receiving unit, service usage HbA1c data receiving unit for medical institutions for receiving data from medical institutions affiliated with medical institutions, and an inspection fee payment transmitting unit for paying inspection fees through financial institutions to medical institutions And an inspection fee payment requesting unit, a credit company service usage fee application unit, and credit company customer data for the insured's contract insurance payment Out section, is equipped with a card check request unit for the credit company.
医療機関は、被保険者の長期血糖コントロール指標の検査データの保険会社への提供契約を保険会社との間で予め締結しており、該医療機関には図４に示すＨｂＡ１ｃデータ入力部、ＨｂＡ１ｃデータ送信部、検査料受取額確認部を備えた端末ソフトウェアが稼働する端末が設置されている。 The medical institution has previously concluded a contract with the insurance company to provide the insurer's long-term blood glucose control index test data to the insurance company, and the medical institution has an HbA1c data input unit, HbA1c shown in FIG. A terminal on which terminal software including a data transmission unit and an inspection fee receipt confirmation unit operates is installed.
被保険者（保険契約希望者）がインターネット等の通信ネットワークを介して保険会社のサーバにアクセスして保険契約を申し込む場合、被保険者が通信端末を通じて保険会社のサーバに住所氏名や年齢、性別、既往症等の個人データを入力すれば、この個人データは保険会社サーバの患者用保険契約受付部で受け付けられ、既往症が無い場合はサーバは契約保険料見積もり額計算部において算定した契約保険料を被保険者の通信端末側に提示し、被保険者（保険契約希望者）が契約を申し込めば、確定された契約保険料がクレジットカード会社を通じて被保険者に請求される。 When an insured person (applicant for an insurance contract) applies for an insurance contract by accessing the insurance company's server via a communication network such as the Internet, the insured person's name, age, and gender are sent to the insurance company's server through a communication terminal. If you enter personal data such as a previous medical condition, this personal data will be accepted by the patient insurance policy acceptance section of the insurance company server, and if there is no previous medical condition, the server will receive the contract premium calculated by the contract premium estimate calculation section. When the insured person (insurance applicant) applies for a contract, the confirmed insurance premium is charged to the insured person through the credit card company.
そして、上記被保険者が糖尿病（高血糖症）を患っており、これを既往症として個人データに含めた場合、保険会社のサーバは提携している医療機関を通信端末側に提示して長期血糖コントロール指標の検査を要請するとともに、食事管理支援サービスを受けた場合には、契約保険料の割引があることを提示する。 When the insured suffers from diabetes (hyperglycemia) and is included in the personal data as a past illness, the insurance company's server presents the affiliated medical institution to the communication terminal side for long-term blood glucose When requesting inspection of control indicators and receiving a meal management support service, present that there is a discount on the contract premium.
そして被保険者が上記医療機関において長期血糖コントロール指標の検査を受けたならば、その被保険者の長期血糖コントロール指標のデータは、医療機関の端末から保険会社のサーバに送信され、該長期血糖コントロール指標データは、顧客データ部の該当顧客データに検査日とともに記録される。 Then, if the insured person has been tested for the long-term blood glucose control index in the medical institution, the data of the insured long-term blood glucose control index is transmitted from the terminal of the medical institution to the server of the insurance company, and the long-term blood glucose control index The control index data is recorded together with the inspection date in the corresponding customer data in the customer data section.
そして、被保険者が再度保険会社のサーバにアクセスして保険契約を進める時、保険会社のサーバは、被保険者の個人データに加えて、上記長期血糖コントロール指標のデータも参照して契約保険料の算出を行う。この算出は、長期血糖コントロール指標の値を基にした予め用意した算出式によって行ったり、あるいは予め用意した算出用テーブルを用いて行うが、いずれにしても、長期血糖コントロール指標として過去１，２ヶ月の平均血糖値の動きを示すことになる上述のＨｂＡ１ｃの値を用いる時、ＨｂＡ１ｃの値が高いほど契約保険料が高くなるようにしてある。 When the insured accesses the insurance company's server again and advances the insurance contract, the insurance company's server refers to the long-term blood glucose control index data in addition to the insured's personal data. Calculate the fee. This calculation is performed using a calculation formula prepared in advance based on the value of the long-term blood glucose control index, or using a calculation table prepared in advance. When the above-described HbA1c value, which indicates the movement of the average blood glucose level of the month, is used, the higher the value of HbA1c, the higher the insurance premium.
また、被保険者が食事管理支援システムサービスを受けることを希望した場合には、保険会社のサーバはその申し込み通知があったことをサービス運用会社のサーバに通知するとともに、被保険者の端末の通信先をサービス運用会社のサーバへ切り換えさせる。そして被保険者が食事管理支援システムサービスの利用契約をサービス運用会社側との間で行ったならば、サービス運用会社のサーバはサービス利用開始通知を保険会社のサーバに送る。 In addition, when the insured person wishes to receive the meal management support system service, the insurance company server notifies the service management company server that there has been an application notification, and the insured person's terminal Switch the communication destination to the server of the service management company. If the insured makes a use contract for the meal management support system service with the service management company, the server of the service management company sends a service use start notification to the server of the insurance company.
この時、保険会社のサーバは、保険契約の完了前であれば、上記の契約保険料の決定に際して、食事管理支援システムサービスの利用者であることを鑑みた割引を行う。また、既に保険契約が完了している場合は、その保険契約更新時もしくは予め定めた契約保険料見直し時に提示する契約保険料の見積もり額の算出にあたって、上記割引を適用する。 At this time, if the insurance company's server is before the completion of the insurance contract, the insurance company server performs a discount in consideration of being a user of the meal management support system service when determining the contract insurance premium. If the insurance contract has already been completed, the above discount is applied when calculating the estimated amount of the contract premium to be presented when the insurance contract is renewed or when a predetermined contract premium is reviewed.
また、サービス運用会社は、被保険者のサービス利用状況に基づく利用率データを定期的に、あるいは所要の時期に保険会社のサーバに送信する。この利用率データをサーバは顧客データ部の該当顧客データに加えて、保険契約更新時もしくは予め定めた契約保険料見直し時に提示する契約保険料の見積もり額の算出にあたり、利用率が高いほど割引率または割引額を大きくして見積もり額を算出する。ここでの利用率は、たとえば摂取カロリー量が目標としたカロリー量以下に保たれた日数などに基づく達成率を加味したものであってもよい。もちろん、達成率が高いほど割引額を大きくする。 In addition, the service management company transmits utilization rate data based on the service usage status of the insured person to the server of the insurance company periodically or at a required time. In addition to the corresponding customer data in the customer data section, the server uses this usage rate data to calculate the estimated amount of contract premiums to be presented when renewing an insurance contract or when revising a predetermined contract premium. Alternatively, the estimated amount is calculated by increasing the discount amount. The utilization rate here may be a value that takes into account the achievement rate based on, for example, the number of days that the calorie intake amount is kept below the target calorie amount. Of course, the higher the achievement rate, the larger the discount amount.
保険契約更新時には、保険会社のサーバは新たな長期血糖コントロール指標のデータを医療機関を通じて提出することを被保険者に求める。契約更新時の長期血糖コントロール指標の値が前回の値より低くなっておれば、年齢が増えているにもかかわらず、契約保険料が低下する場合も生じることから、被保険者は自身の健康管理に努めることになり、これは被保険者の健康を維持することになって医療費の負担が小さくなるほか、保険会社にしてみれば保険金支払いのリスクの低減となり、さらには健康保険組合にとっては医療費負担の削減となる。 When the insurance contract is renewed, the insurance company server requests the insured to submit new long-term blood glucose control index data through the medical institution. If the value of the long-term blood glucose control index at the time of contract renewal is lower than the previous value, the insurance premium may decrease even though the age is increasing. In addition to maintaining the health of the insured person, the burden of medical expenses will be reduced, and if it is considered as an insurance company, the risk of insurance payment will be reduced. This will reduce the burden of medical expenses.
なお、該保険の場合、契約更新はたとえば１年毎として、その都度、長期血糖コントロール指標を参照した契約保険料の算出を行うのが好ましいが、さらに短期の周期で長期血糖コントロール指標の変化に応じて契約保険料の見直しを行うことができるようにしておいてもよい。 In the case of the insurance, it is preferable to calculate the contract insurance fee by referring to the long-term blood glucose control index every time, for example, every year. However, the long-term blood glucose control index changes in a shorter cycle. You may be able to review contract insurance premiums accordingly.
図５は被保険者が保険会社と保険契約を行った後に食事管理支援システムサービスを申し込んだ場合の流れを示している。 FIG. 5 shows the flow when the insured applies for a meal management support system service after making an insurance contract with an insurance company.
以上の説明では、被保険者の食事管理支援サービスを行うサービス運用会社も登場する例を示したが、被保険者と保険会社に長期血糖コントロール指標の検査を行う医療機関の３者のみが登場するものであってもよい。これは上記の例において、食事管理支援サービスを申し込まなかった場合に相当する。 In the above explanation, an example of a service management company that provides a meal management support service for the insured has been shown, but only three of the medical institutions that perform long-term blood glucose control index tests appear for the insured and the insurance company. You may do. This corresponds to the case where the meal management support service is not applied in the above example.
長期血糖コントロール指標としては、現時点ではＨｂＡ１ｃの値が最も適切であるが、これに代わるコントロール指標があれば、それを用いてもよいのはもちろんである。 As a long-term blood glucose control index, the value of HbA1c is most appropriate at the present time, but it is needless to say that if there is an alternative control index, it can be used.
Claims (6)
被保険者の個人データを通信ネットワークを介して受け付ける保険契約受付部と、
被保険者が受診した医療機関からの被保険者についての長期血糖コントロール指標を医療機関から受信する医療機関用受信部と、
被保険者の食事管理を請け負う食事管理支援者から入手した被保険者の食事管理実績データを受信するデータ受信部と、
上記受付部及び受信部から得られた個人データと長期血糖コントロール指標と食事管理実績データに応じて予め設定された料率で被保険者に対する契約保険料を決定する計算部と
を上記サーバが備えることを特徴とする保険システム。 A contract premium for an insurance contract with an insured person based on a request from the insured person and personal data of the insured person, configured by connecting the insured's terminal and the server via a communication network An insurance system for determining
An insurance contract reception unit that receives personal data of the insured person via a communication network;
A medical institution receiving unit that receives from the medical institution a long-term blood glucose control index for the insured from the medical institution that the insured has consulted;
A data receiving unit for receiving insured meal management result data obtained from a meal management supporter who undertakes insured meal management; and
The server includes a calculation unit that determines a contract premium for the insured at a rate set in advance according to the personal data, the long-term blood glucose control index, and the meal management performance data obtained from the reception unit and the reception unit. An insurance system characterized by
上記サーバが被保険者の個人データを通信ネットワークを介して受け付ける保険契約受付部と、
被保険者が受診した医療機関からの被保険者についての長期血糖コントロール指標を医療機関から受信する医療機関用受信部と、
被保険者の食事管理を請け負う食事管理支援者から入手した被保険者の食事管理実績データを受信するデータ受信部と、
上記受付部及び受信部から得られた個人データと長期血糖コントロール指標とに応じて予め設定された料率で被保険者に対する契約保険料を決定する計算部とを備え、
上記サーバがその保険契約受付部にて被保険者からの個人データを受け付ける個人データ入力ステップ、
上記サーバがその医療機関用受信部にて被保険者が受診した医療機関からの被保険者についての長期血糖コントロール指標を受信するコントロール指標入力ステップ、
上記サーバがそのデータ受信部にて被保険者の食事管理を請け負う食事管理支援者から入手した被保険者の食事管理実績データを受信する食事管理実績データ入力ステップ、
上記サーバがその計算部にて、得られた個人データと長期血糖コントロール指標ステップと食事管理実績データに基づいて被保険者に対する契約保険料を決定する契約保険料決定ステップとからなる
保険方法。 An insurance method for determining a contract premium for an insured person who accesses a server via a communication network,
An insurance contract acceptance unit for accepting personal data of the insured person via a communication network;
A medical institution receiving unit that receives from the medical institution a long-term blood glucose control index for the insured from the medical institution that the insured has consulted;
A data receiving unit for receiving insured meal management result data obtained from a meal management supporter who undertakes insured meal management; and
A calculation unit for determining a contract premium for the insured at a rate set in advance according to the personal data obtained from the reception unit and the reception unit and the long-term blood glucose control index;
A personal data input step in which the server receives personal data from the insured person at the insurance contract reception unit;
A control index input step in which the server receives a long-term blood glucose control index for the insured person from the medical institution that the insured person consulted at the medical institution receiving unit;
Meal management result data input step for receiving the insured's meal management result data obtained from the meal management supporter who undertakes the insured's meal management in the data receiving unit of the server,
An insurance method in which the server comprises a contract premium determining step for determining a contract premium for an insured person based on the obtained personal data, long-term blood glucose control index step and meal management performance data in the calculation unit.
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