A new trend is emerging in health insurance: premium increases based on claims. It is common practice in the auto insurance industry, for example, for insurers to revisit your premium each year and adjust it based on factors such as your driving record or number of accidents. However, health insurers have generally evaluated their insured’s health only once, at the outset, when issuing a policy. The reevaluation of health and premiums was a practice that ended in the 1950s because the insurers feared regulators would impose limitations on premiums. At least one health insurer, however, has begun to evaluate the health of its insureds annually and to adjust policy premiums accordingly. Even without examination of insureds, some insurers have increased the insureds’ premiums based simply on the nature of their claims for the year and the possibility that more claims will arise.
Those who are healthy are in favor of this annual review. Perceiving themselves as the equivalent of good drivers, they want to pay less when they stay healthy. The health discount is, in their minds, the equivalent of the safe driver discount. However, those who are less healthy argue that people buy insurance so that it will be there when they need it, and the coverage should apply without regard to claims. Consider the ethical issues in this type of pricing for health insurance.
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