Head damage
As a head injury , sometimes in the plural as head injury commonly are referred to in the Actuarial an accounting basis in the field of the type of life insurance calculated health insurance .
background
Head injuries indicate the amount that a health insurer has to provide annually in terms of financial benefits. Head injuries are usually determined separately for each age of the insured, since older insureds generally require higher financial resources per year than younger members. This estimated expected value is the quotient of benefits per age for one year.
The expected future performance obligations of the insurer determined in this way flow into the determination of the premium to be paid by the policyholder. This applies to both the initial premium and the contributions as a result of premium adjustments. These adjustments are carried out as the actual head damage deviates significantly from the originally estimated head damage if the head damage has increased by a defined percentage point and an independent trustee agrees to an adjustment based on a deviation and the new head damage profiles. These new profiles form the basis for determining the follow-up contributions.
In the case of strong new business, the premium adjustment procedure can be distorted, as numerous new customers who have carried out a health check and therefore tend to have low head damage profiles are gained in a relatively sick insurance portfolio and, as a result, the head damage falls below the actual adjustment limit. This can result in stronger premium adjustments at a later point in time.
In Germany, the determination of premiums in private health insurance is subject to the general regulations of the Insurance Supervision Act and the special regulations of the Health Insurance Supervision Ordinance . This applies in particular to §6 requirements for determining head damage per age and insured subgroup.