Volume 8, Issue 4 (Winter 2026)
Iran J Health Insur 2026, 8(4): 285-296 |
Back to browse issues page
Research code: 192
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Safarzadeh E, Ebrahimnezhad K, Ghanbarzadeh M, Hozarmoghadam N. Designing a Risk Profile Framework for Supplementary Health Insurance in Iran: An Analysis of Institutional, Data, and Technological Requirements. Iran J Health Insur 2026; 8 (4) :285-296
URL: http://journal.ihio.gov.ir/article-1-386-en.html
URL: http://journal.ihio.gov.ir/article-1-386-en.html
1- Department of Economics, Faculty of Social Sciences and Economics, Alzahra University, Tehran, Iran , e.safarzadeh@alzahra.ac.ir
2- Department of Economics, Faculty of Social Sciences and Economics, Alzahra University, Tehran, Iran
3- Department of Personal Insurance, Insurance Research Center, Tehran, Iran
2- Department of Economics, Faculty of Social Sciences and Economics, Alzahra University, Tehran, Iran
3- Department of Personal Insurance, Insurance Research Center, Tehran, Iran
Abstract: (1651 Views)
This study aims to design a localized and practical framework for developing a risk profile for supplementary health insurance in Iran. The framework is intended to systematically identify, assess, and manage financial, operational, and legal risks, with the goal of enhancing insurers’ resilience, improving decision-making, and supporting the development of more efficient insurance products. The research was carried out in three stages: (1) extraction of risk profile components from specialized literature, (2) a comparative study of experiences from leading countries and international indicators, and (3) analysis of the current status of Iran’s insurance industry in terms of human, technological, legal, and institutional infrastructure to provide a locally adaptable and practical risk profile. The findings indicate that the risk profile can serve as a strategic tool for effective insurance risk management. The proposed framework consists of seven steps: defining objectives and scope, gathering key stakeholders, environmental scanning, risk identification, risk assessment and measurement, development of risk responses, and monitoring and reporting. This structure facilitates the identification and forecasting of high-cost medical risks, prioritization of threats, and targeted allocation of resources. Furthermore, international experiences highlight the critical role of advanced technologies and robust legal frameworks in enhancing the efficiency of risk management systems. Implementing a systematic risk profile in supplementary health insurance can promote fair pricing, strengthen financial resilience, and improve the quality of insurance services. However, challenges such as the lack of structured data, weak technological infrastructure, shortage of specialized personnel, and absence of comprehensive legal frameworks require simultaneous development of data, legal, human, and technological infrastructures, along with improved coordination among insurers and regulatory bodies.
Type of Study: Review Article |
Subject:
Special
Received: 2025/09/28 | Revised: 2026/05/17 | Accepted: 2026/01/20 | ePublished: 2026/02/8
Received: 2025/09/28 | Revised: 2026/05/17 | Accepted: 2026/01/20 | ePublished: 2026/02/8
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
