Health Insurance Product Innovation and Sales Practices: Guide to Health Management Clause Design and Sub-health Assessment Scripts

II. Application of the Sub-health Concept in Health Insurance and Disease Prevention The sub-health concept advocates early detection and early treatment, using interventional therapy to transform a sub-healthy state into a healthy state or delay the onset of disease. Early detection means promoting health checkups to identify existing health problems early, allowing for targeted treatment and intervention. Interventional therapy is a comprehensive treatment plan that includes a balanced and scientific diet, appropriate food quantity, scientific behavioral habits, adequate and effective sleep, reasonable outdoor activities, abstaining from smoking and limiting alcohol consumption, maintaining a normal mental state, self-regulation, orderly work arrangements, efforts to reduce unnecessary stress, and the scientific use of medication for diseases requiring it. Interventional therapy combines the best treatment results from both traditional Chinese medicine and Western medicine to comprehensively and thoroughly treat sub-health. The concept of early detection and early treatment of sub-health aims to: 1) enable sub-healthy patients to recover their health, which is what people most desire; and 2) delay the onset of disease, generally by 6-10 years, meaning that life will be delayed by 6-10 years. Once this situation occurs, let alone the sub-healthy patient recovering their health and no longer developing illness, even if the onset of illness is delayed by 6-10 years, the benefit of health insurance critical illness insurance payouts will be delayed by 6-10 years, and the efficiency of fund utilization is self-evident. For death insurance, the benefit of death insurance payouts will be even more significantly delayed by 6-10 years. III. Application of the Sub-health Concept in Health Insurance Product Innovation The "Health Insurance Management Measures" formulated by the China Insurance Regulatory Commission (CIRC) clearly stipulates several management regulations for health insurance, serving as a guide and requirement for the design and development of health insurance. Currently, in accordance with the CIRC's "Health Insurance Management Measures," life insurance companies have generally launched long-term and short-term health insurance. Long-term health insurance is underwritten as a fixed-benefit medical insurance, while short-term health insurance has fixed-fee reimbursement clauses, mostly underwritten as supplementary insurance. Disability income loss insurance and long-term care insurance are almost non-existent; even if they are developed and designed, they cannot be widely promoted and sold to prevent operational risks. As for managed health insurance, it is currently still a forbidden area. China has 700 million sub-healthy people, representing a huge life insurance market. The sub-health concept advocates early detection and early treatment. Health education is severely lacking in China, and health knowledge is generally scarce. Early detection and treatment of sub-healthy individuals-that is, interventional treatment-would lead to some recovering their health and others delaying the onset of disease. This is not only good news for sub-healthy patients but also very beneficial for insurance companies. Article 6 of the China Insurance Regulatory Commission's "Administrative Measures for Health Insurance" stipulates that this measure does not apply to insurance companies providing entrusted management services without assuming insurance risk. Imagine that life insurance companies, when designing and developing health insurance terms, incorporate their management functions, adding health management features. The costs of health management could be appropriately included in the product pricing. From an actuarial perspective, the insurance company could allocate a significant portion of the increased benefits from the customer's recovery or delayed disease to subsidize the health management costs. While such terms would be priced higher than ordinary terms, and the insurance company would incur higher costs, have a greater workload, and require a higher level of professional service, overall it would be beneficial to the insurance company and would certainly be welcomed by customers, contributing to the sound operation of life insurance companies. At the same time, it is also possible to add health management clauses to health insurance, guarantee the health management function of the insurance company in the form of supplementary clauses, and clarify the responsibilities and obligations of the insurance company and the customer in the clauses. Through this kind of health management of customers, health education is carried out in a planned manner to solve the sub-health problem of customers and give full play to the dual functions of insurance company protection and social management. IV. Application of the sub-health concept in the development of health insurance business. By applying the sub-health concept, a set of effective sales visit scripts can be compiled in business development. (I) Contact scripts (1) Contact script one: Mr. Zhang, there is a hot topic in society now called sub-health phenomenon. We have just received training on the sub-health concept and were quite inspired. I don't know if you know, but I would like to talk to you about sub-health. (2) Contact script two: Ms. Wang, I have been feeling a little unwell recently. I just went to the hospital. The doctor who saw me told me about my condition and said that there was no disease, but that I was under a lot of work pressure and was in a sub-health phenomenon. I went to Xinhua Bookstore as he asked and bought a few books about sub-health. I would like to study the sub-health problem with you. (II) Scripts for Promoting the Concept of Sub-health: Discover clients' sub-health issues through health tests, thereby introducing the concept of sub-health. 1. Script One: Starting with a Sub-health Test: Mr. Zhang, let's take a sub-health test. Compare yourself to the following symptoms to see if you have sub-health or to what extent. If your total score exceeds 50 points, you need to sit down and reflect on your lifestyle, strengthen exercise and nutrition, etc. If your total score exceeds 80 points, you should go to the hospital to see a doctor, adjust your mindset, or apply for leave to rest properly. (Specific test items are as follows: hair loss, depression, poor memory, fear of the office, tendency towards social withdrawal, decreased efficiency, fatigue and shortness of breath, unexplained irritability, decreased appetite, a sense of escape, environmental sensitivity, social obligations, insomnia and excessive dreaming, aging appearance, decreased immunity, decreased sexual function). If the score is below 50 points, it means the client is healthy. Congratulations on your good health. If the score is 50 or above, it indicates the client has reached a sub-healthy state. First, congratulate them on their relatively good health, but acknowledge some minor issues they need to pay attention to. Help them analyze the problems and then transition to promoting the concept of sub-health. If the score is 80 or above, it indicates a more serious sub-healthy state. First, help them analyze the problems, congratulate them on identifying these issues early, and explain that the core of the sub-health concept is early detection and early treatment. Remind them to schedule a comprehensive health check-up at the hospital. After accompanying the client through the check-up, analyze their health condition and then transition to promoting the concept of sub-health. 2. Script Two: Starting with a Dietary Quality Test Ms. Wang: Research on sub-health issues has found a link between dietary quality and sub-health. How is the quality of our daily diet? Is it nutritious? This determines whether we can maintain our health. Recently, the World Cancer Research Fund posed the following questions to many families. Let's test together to see if our daily diet is reasonable. (Specific items include: eating fruit after meals, eating leafy green vegetables, eating tomatoes, eating dried fruit snacks, eating whole grains, eating yellow and red vegetables, eating beans, using onions and garlic for seasoning, eating deep-sea fish, eating citrus fruits, eating dried fruit for lunch, using soybeans for iron supplementation, consuming low-fat milk, adding vegetables to meals, using vegetable oil, and drinking fruit and vegetable juices). If the score is between 0 and 10: This indicates that the customer's food choices are problematic, indicating a serious problem with unbalanced diets. Therefore, we need to help them carefully examine their diet. At this point, we should shift to the concept of sub-health, explaining the role of the three major nutrients in human health, emphasizing the idea that "health comes from a refined lifestyle," and requesting that they choose foods with high scores in the questions. Tell the customer that this measure should not be rushed and should be changed gradually. If the score is between 11 and 21: This indicates that the client's food choices are generally correct, but there's room for improvement. Ideally, they should choose or primarily consume the highest-scoring food categories daily. At this point, transition to the concept of sub-health, explaining the role of the three major nutrients in human health, and emphasizing that health comes from a refined lifestyle, continuously reinforcing this concept. If the score is between 22 and 32: This indicates that the client's diet already provides a good amount of nutrients, and generally, there's no need for vitamin or health supplements. Congratulations on their excellent eating habits; we hope they maintain them.