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0.25CIP Points

新冠长期症状带来的挑战

Lachlan Colquhoun
29 Sep 2022 - Reading time 5 minutes
Claims General Insurance Insurance Broking Life and Retirement Income Reinsurance Risk Management
The challenge of long COVID

虽然新冠正在从“全球大流行病”转为“地方病”,但却出现了新冠症状长期不退的“Long COVID”情况。 

例如,根据英国的国家统计局(Office for National Statistics)统计,2022年4月英国有20万人报告称出现了新冠长期症状,导致英国出现新冠长期症状的患者总人数升至210万,达到了全英国人口的3.1%。

在以色列,马卡比医疗保健服务公司(Maccabi Healthcare Service)研究发现,在报告出现疲劳症状的新冠病毒感染者当中,有一半人的疲劳症状在18个月后仍然存在。医学期刊《柳叶刀》(The Lancet)刊登的一项研究则称,有46%的“Long COVID”患者被迫减少了工作时数。 

到目前为止,全球共累积报告了超过5.44亿新冠确诊病例,预计其中可能高达30%会出现“Long COVID”长期症状。

量化分析

每出现一种新的慢性疾病,都可能会对保险行业造成影响。但对于“Long COVID”,我们目前对其了解远远不足,只知道有疲劳、“脑雾”(记忆力和注意力出现问题)以及关节和肌肉疼痛等症状,这导致我们面临着规模更大的难题。

全球再保险商帕特纳瑞(PartnerRe)首席医学官阿赫姆·雷格纳尔(Achim Regenauer)医生表示,虽然目前累积记录的“Long COVID”症状有超过200种,但仍然没有公认的临床确诊定义,没有实验室或成像诊断工具,也没有有效的治疗方法。他认为,“Long COVID”可能存在多个版本,而非只有一种。 

他还补充道,虽然保险行业知道“Long COVID”会对患病趋势以及寿险、医疗险的承保工作造成影响,但其中仍然存在很大的不确定性,而且这种情况很有可能会在一段时期内得不到改善。
“首先,我们必须对‘Long COVID’在临床医学方面有更深入的理解。”雷格纳尔医生说,“‘Long COVID’现在常常是一个主观疾病,症状都是病人自己描述的。我们如何才能把它变为一个客观的、可测量的现象?”

“如果一个病人说自己无法步行500米以上的距离,全科医生虽然记下了症状,但却无法进行测量,而且也没有胸透X光成像的结果。”

对于这种类型的风险,保险行业过去有应对其他长期健康问题(如肝炎)的经验,因而有一套定价的技巧。慢性疲劳综合征(chronic fatigue syndrome)就是很好的例子。该病在20世纪80年代末首次确定定义,很多患者都有与“Long COVID”类似的长期、使人虚弱的疲劳症状。

“目前我们需要小心应对,因为我们需要在没有全然了解这一疾病的情况下评估其风险。”雷格纳尔医生表示,“虽然医学上逐渐会有新的发现,但这个过程可能需要十年,我们今天做出的风险评估,到时候不会有重新修改的机会。” 

观察并等待

欧洲、英国与美国的保险业正为了迎接“Long COVID”相关问题而做出准备,但澳大利亚和新西兰“Long COVID”的发生几率却低得多。这可能是因为在这一地区奥密克戎(Omicron)比德尔塔(Delta)流行,而且目前来看(根据病人口述情况)“Long COVID”的发生几率也因此较低。

但即便如此,澳新保险行业并没有忽视这一问题。在新西兰,根据政府下属的意外伤害赔偿局(Accident Compensation Corporation)在5月表示,当时累积共有73例新冠相关索赔,只有7例成功通过。 

考虑到新西兰官方记录的约100万新冠确诊人数,这一数字似乎只是一朵微小的浪花,但未来却有可能演变为一场海啸。

澳大利亚金融服务委员会(Financial Services Council of Australia)人寿保险政策主任尼克·科尔文(Nick Kirwan)表示,虽然“Long COVID”目前尚未造成广泛影响,但很明显不会消失。保险行业将能在业界年度数据汇总当中看出“Long COVID”对保险的影响。

“我并不认为‘Long COVID’现在已经成为了我们需要解决的问题,但如果它真的对澳大利亚产生了巨大的影响,那我们收集的数据将会反映出这一情况。”他说道。

“一般来说,如果民众发现自己有某种长期健康问题,而且貌似在短期之内不会痊愈,那根据申请情况,他们有可能会立刻开始索赔。”

兑现收入保障险的承诺

瑞士再保险澳新公司(Swiss Re Australia and New Zealand)的索赔服务经理露西·哈特利(Lucy Hartley)表示,该公司目前为止收到的“Long COVID”索赔要求非常少,但却对精神健康方面的索赔产生了间接影响。

“瑞士再保险最近对一项收入保障精神健康保险组合进行了深入调查。我们发现有68%的索赔都受到了新冠疫情的负面影响。”哈特利表示。 

她指出,在大部分情况下,在满足保单条款与不承保项目的条件下,假如一名客户确诊新冠,然后出现“Long COVID”长期症状并因此无法工作,而且获取了合资格医生的适当治疗,那么这名客户的索赔要求就很有可能成功。

“对于新冠来说,我们制定了相应的承保方针和指导原则,确保对于任何新冠后遗症,尤其是需要强力治疗或住院的情况,我们都有清晰的理解,并将其纳入整体风险评估当中。”  

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