The actuarial models for critical illness insurance

The aim of this paper will be analysis of some problems about health and sickness insurance. Therefore we describe the important problems: advantages and limitations of the use sickness function as compared with other methods, subdivide sickness functions into duration of sickness, some problems of health care. The first part will intend to provide a orientation on the present situation and the objectives of health insurance in the Slovak republic. List the main conceptions used in sickness and health insurance: the fundamental qualifying condition for the allocation and payment of benefits, retention of claims for a specified period of time based on a protection peri- od, basic indicators for health care. In part two – a basic probabilistic multistate structure is defined, which provides the possibility of a systematic modeling for sickness insurance (disability annuities and lump sum). There are some specific applications of the actuarial theory in the solution of problems relating to critical illness. Some of the many approaches that can be used for calculations in this paper are multiple- state and decrement models. Their advantage is that they make use of stochastic approach for the transitions between the states. This brings with it a more faithful modeling of the real world than does the deterministic model. In the various chapters of this paper attention is directed not only towards the analysis of the existing theory, but also in particular to extending these models so that they can be used more wi- dely in actuarial work in life, sickness and health insurance. Of course, natural developments lead to recurrent premiums, mathematical reserves, expense loadings and profit testing