실손의료보험 소비자의 불평처리경험과 만족도에 관한 연구

Abstract

The purpose of this study is to investigate the path and complaint behavior of consumers who have complaints of consumers who have suffered from health insurance. The main conclusion from the results of the analysis of the complaints process step by step is as follows: First, out of the 279 consumers who performed the first stage complaint process, 96.8% of the consumers finished the first stage, 64.2% 32.6% did not go to step 2 despite the fact that the problem was not solved, and the main reason was the distrust of the solution (because it was hard to expect the desired result anyway). The consumer who performed the complaint process up to the second stage mainly uses the designer and the customer center of the insurance company at the time of the subscription at the first stage and uses the place other than the one at the first stage due to the complaint at the first stage at the second stage. These results show that insurance consumers do not express insurance claims in many cases externally and complaints are being banned. In particular, it is very important that the main contacts appear at the first stage as insurance companies and designers at the time of enrollment because the first-tier contact can be a critical moment for consumers to recover their grievances. Insurance companies are suggesting that at this point they need to develop a variety of strategies to restore consumer dissatisfaction. Second, the complainants experienced mainly complaints related to claims (34.5%), which is a representative service factor related to insurance products. Considering the insurance planners' complaints about the guarantee contents, the proportion of the problem makers is close to 50%. This is a results is replaced by a relatively underestimated part as a service failure factor, but it is obvious that the strict selection, training and ongoing management of the insurance planner is important. Third, when we look at the result of the complaint process by channel, the problem solving rate of insurance designers and customer centers selected mainly for accessibility is 60 ~ 75%, and the abandonment rate of consumers who did not solve the problem was as high as 80 ~ 90%. Forth, in the process of complaint processing, the complainants experienced normal level of satisfaction with the time they received the response from the person in charge, and they want to receive the reply within a shorter time than the actual reply time. Also, the attitude, integrity, professionalism and kindness of the insurance planner and satisfaction with the staff of the customer center were found to be important factors in the customer satisfaction.