입원, 수술 무사고기간에 따른 주요질병 위험도의 예측모형 연구

As the market for Simplified Issue (SI) insurance continues to grow, there has been active development of ‘3.N.5’ type products, which segment the insured pool by diversifying the period without hospitalization and surgery (N). Consequently, the importance of rational ratemaking and risk assessment based on this accident-free period has become increasingly significant. This study aims to analyze the changing patterns of incidence rates for major diseases according to the length of the period free of hospitalization and surgery, and to propose a prediction model that quantitatively explains these patterns. Using the National Health Insurance Service-National Sample Cohort (NHIS-NSC) 2.2 DB, the study subjects were classified into Simplified Issue (SI) and Standard groups. An exponential regression model was applied to investigate the relationship between the accident-free period and the incidence of health-related events. Furthermore, this study suggests a method to obtain reasonable estimate of incidence rates for lifetime accident-free subjects, overcoming the temporal limitations of observed data. The findings indicate that the history of hospitalization and surgery is a significant indicator for explaining individual health risks. The proposed prediction model and methodology are expected to contribute to the establishment of sophisticated underwriting and rate differentiation strategies for segmented Simplified Issue insurance products