Adverse selection

Disproportionate insurance of risk who are poorer or more prone to suffer loss or make claims than the average risk. It may result from the tendency for poorer risks or less desirable insureds (sick people) to seek or continue insurance to a greater extent than do better risks (healthy people), or from the tendency for the insured to take advantage of favorable options in insurance contracts. Favorable, as compared to adverse, selection, when intentional, is called skimming.


A situation in which patients with greater than average need for medical and hospital care enroll in a prepaid health plan in greater numbers than they occur in a cross-section of the population. A plan which somehow encouraged or allowed people to sign up when they were already ill would suffer from adverse selection.


A situation in which patients with greater than average need for medical and hospital care enroll in a prepaid health care plan in greater numbers than they occur in a cross-section of the population. Aplan which somehow encouraged or allowed people to sign up when they were already ill would suffer from adverse selection.


 


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