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The probability of ruin of an insurance company is one of the main risk measures considered in risk theory, and the problems of its calculation and approximation have attracted much attention. Statistical estimations have been developed on the ruin probability in infinite time for insurance loses from heavy-tailed distributions. However, these estimation suffer heavily from under-coverage or have a robustness problem. We therefore need another method for estimating the probability of ruin in infinite time for heavy-tailed losses. In this paper, we introduce a robust estimator of the infinite-time probability of ruin for such distributions. Our methodology is based on extreme value theory, which offers adequate statistical results for such distributions. Our approach is based on a sensitive distribution known as the t-Hill estimator (t-score or score moment estimation) for the index of any tail distribution and introduced in Fabiáan and Stehlík. We establish their asymptotic normality, and through a simulation study, illustrate their behaviour in terms of absolute bias and mean squared error. The simulation results show that our estimators perform well and that they are fairly robust to outliers. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The annual mean spending measures typically used to study longitudinal trends mask distributional and seasonal variation that is relevant to patients' perceptions of health care affordability and, in turn, provider collections. This study describes shifts in the distribution and seasonality of plan and patient out-of-pocket spending from 2012 through 2021. STUDY DESIGN: Analysis of multipayer commercial claims.data. METHODS: Medical spending per enrollee was calculated by summing inpatient, outpatient, and professional services, which comprised plan payments and out-of-pocket payments (deductible, coinsurance, co-payment). To account for the long right tail of the spending distribution, enrollees were stratified by their decile of annual medical spending, and annual mean spending estimates were calculated overall and by decile. Mean spending estimates were also calculated by quarter-year. RESULTS: Inflation-adjusted medical spending grew most quickly among the highest decile of spenders, without proportional growth in their out-of-pocket expenses. Out-of-pocket spending increased for the majority of enrollees in our sample prior to the COVID-19 pandemic, in real dollars and as a share of total medical spending. Out-of-pocket spending was increasingly concentrated in the early months of the calendar year, driven by deductible spending, and was lower in 2020 and 2021, plausibly due to policies limiting cost sharing for COVID-19--related services. CONCLUSIONS: Insurance is working well to protect the highest spenders at the cost of reduced insurance generosity among spenders elsewhere in the distribution. The increasing cross-subsidization among enrollees through cost-sharing design--vs premiums--is a trend to watch among rising public concerns about underinsurance and medical debt. [ABSTRACT FROM AUTHOR]

Comprehensive computerized gait analysis (CGA) alters orthopedic surgical plans and improves outcomes. Despite these documented benefits, CGA is not widely available to all patients who could be helped by it. Research Question: Do social determinants of health impact access to CGA? Retrospective review of patients seen for CGA from 2021 to 2022. Dates of referral, insurance approval and completion of CGA, demographics and insurance type were extracted from patient records. Zip codes were used to determine the neighborhood socioeconomic status (SES). Data were analyzed using non-parametric statistics. Insurance type affected time to authorization (private insurance/self-pay: median 9 days; HMO insurance: median 51.5 days; public insurance: median 27 days; p=0.0004). Once authorized, insurance type did not affect time to schedule and complete CGA (p=0.76). Lower neighborhood SES was associated with longer time to authorization but shorter time to complete CGA once authorized. Rescheduling was associated with longer time to complete CGA once authorized (median 29.5 vs. 16 days, p<0.0001). White, non-Hispanic families tended to reschedule more often than non-white or Hispanic families (35 % vs. 18 %, p=0.07). Knowledge of barriers to CGA is necessary in order to design and implement effective strategies to widen its availability to all whom it could benefit. Social determinants of health and insurance type are associated with delays in authorization for CGA. Families with public insurance and HMO coverage experience delays in obtaining insurance authorization compared to PPO/self-pay patients, whose tests did not require prior authorization. However, there can also be delays in scheduling and completing CGA once authorized. This is a multi-faceted issue that requires further research. • Low neighborhood SES and public or HMO insurance delayed authorization for CGA. • Low neighborhood SES and public or HMO insurance did not delay CGA once authorized. • White, non-Hispanic patients had high neighborhood SES and rescheduled more often. • Primary language and race/ethnicity did not impact access to CGA. [ABSTRACT FROM AUTHOR]

The insurance industry is one of the largest financial areas that due to its service nature, customers can create different values, and the marketing efforts of insurance companies in attracting and retaining different groups of customers have led them to implement various loyalty programs, in which one of the criteria for grouping customers is the customer lifetime value (CLV). In this regard, this research has been conducted with the aim of designing and evaluating the loyalty program of insurance industry customers based on their lifetime value as an applied mixed exploratory, and cross-sectional research. The statistical population of the classification stage was 800 customers registered in the database of Shiraz insurance branches in 2018, and the statistical sample for prioritizing loyalty programs was 40 customers who were randomly selected using the Morgan table and based on access and willingness to participate in the study, the sample was completed. In the first stage, through systematic review, 28 loyalty programs were identified, and 15 valid programs were extracted using the content validity ratio (CVR), and these programs were categorized, and the Kappa index was used to assess categorization reliability. Therefore, in the second stage, the weights of LRFM indexes were determined with the analytic hierarchy process (AHP) and then the customers were classified into four groups of keys, intermittent, prodigal, and uncertain clusters customers using their data in insurance branches databank. Finally, the customers' priority of identified programs in each group was determined using the fuzzy best–worst method (FBWM). The findings show that from the perspective of customers, intangible and long-term programs are more attractive to key customers, while for intermittent customers, long-term tangible loyalty programs, for uncertain customers, immediate loyalty programs, and for prodigal customers, intangible loyalty programs are more attractive. The results of this study can be used in the formulation of loyalty programs in the insurance industry, in such a way that suitable loyalty programs are considered for each group of customers depending on the customers' CLV. Such as in designing loyalty programs, the tangibility and time horizon must be considered. Also, each group of programs must be suitable to customers' CLV. [ABSTRACT FROM AUTHOR]

Despite the growing demand for long‐term care (LTC), the uptake of private LTC insurance (LTCI) is low and even declining in the United States. One reason is the complexity of LTCI decisions. Researchers have therefore suggested to support decision‐making abilities. This paper shows, however, that such support would not unambiguously enhance functioning of the LTCI market. We analyze whether selection arises from two correlated but different decision‐making abilities at old age, education and numeracy, and interactions thereof with private information. Using historical data from the Health and Retirement Survey we find that education generates adverse selection, which is only partially offset by advantageous selection due to numeracy. In addition, individuals with greater decision‐making abilities make better LTCI choices, amplifying selection by education and numeracy. This points at a trade‐off between decision simplicity and selection in insurance markets and suggests other steps are needed to enhance the performance of private LTCI markets. [ABSTRACT FROM AUTHOR]

We propose a multiperiod insurance model under a bonus–malus system with two rate classes and consider an insured who has purchased full insurance for her losses. To explore the potential advantage of underreporting her insurable losses, the insured follows a barrier strategy and only reports lossses above the barrier to the insurer. We obtain a unique equilibrium declaration strategy in closed form for a risk‐neutral insured who maximizes her expected wealth, and in semiclosed form for a risk‐averse insured who maximizes her expected exponential utility of wealth, both over an exogenous random horizon. We find that the equilibrium barriers for the two classes are equal and strictly greater than zero, offering a theoretical explanation for the underreporting of insurable losses, a form of ex post moral hazard. Finally, we consider the case of three rate classes and show, through numerical examples, that the equilibrium barriers are not equal. [ABSTRACT FROM AUTHOR]

Peru has a fragmented health insurance system in which most insureds can only access the providers in their insurer's network. The two largest sub-systems covered about 53% and 30% of the population at the start of the pandemic; however, some individuals have dual insurance and can thereby access both sets of providers. We use data on 24.7 million individuals who belonged to one or both sub-systems to investigate the effect of dual insurance on COVID-19 mortality. We estimate recursive bivariate probit models using the difference in the distance to the nearest hospital in the two insurance sub-systems as Instrumental Variable. The effect of dual insurance was to reduce COVID-19 mortality risk by 0.23% compared with the sample mean risk of 0.54%. This implies that the 133,128 COVID-19 deaths in the sample would have been reduced by 56,418 (95%CI: 34,894, 78,069) if all individuals in the sample had dual insurance. [ABSTRACT FROM AUTHOR]

In previous decades, seminal theories were advanced addressing the problems of asymmetric information. These scholarly works confirmed a significant positive correlation between insurance coverage and risk in insurance markets. We showed that when regression models were used to analyze the asymmetric information problem, the sample selection bias and chosen regression methods could produce distinct results. Moreover, samples at different quantiles may lead to considerably different levels of information asymmetry. The present research suggests that quantile regression models be employed to better reveal the situation of the insurance market and reduce estimation errors. [ABSTRACT FROM AUTHOR]

This paper employs a statistical mechanical model as a framework to investigate how socioeconomic factors of individuals such as gender and place of residence influence their decision when deciding between comprehensive and third-party motor insurance policies in Ghana. Data from a general insurance firm was used for this investigation taking five years' worth of transactions into account. The methods of partial least squares and the ordinary least squares are, respectively, used to estimate the parameters of the interacting and the non-interacting models in the Multipopulation Currie-Weiss model in a discrete choice framework. The findings showed that both location and gender have discernible influences on how people choose their motor insurance. We encourage insurance companies to intensify their campaign on the importance of motor insurance to all vehicle/car owners, especially those in rural areas in order to reduce the risk and associated losses in vehicular accidents on Ghanaian roads. [ABSTRACT FROM AUTHOR]

Climate change is fundamentally destabilizing the private insurance industry, with many high-profile insurance companies exiting states in the face of catastrophic, climate-induced risk. This rapid "insurance retreat" represents a major market signal in response to climate-exacerbated risks. Private businesses are making actuarial decisions, assessing that some locations are just too vulnerable to insure. At the same time, this insurance retreat also poses a policy challenge for states as they react to the mounting insurance gaps left by exiting private insurers. This Article analyzes insurance retreat, its attendant policy challenges, and the lessons that can be drawn from state responses. It first describes the causes and effects of private insurance retreat. Then, the Article examines different potential policy responses to insurance retreat, including interventions modeled after the federal National Federal Insurance Program (NFIP) as well as state insurance programs in California, Florida, and Louisiana. Finally, the Article offers a comparative analysis of these different policy response options. It observes that existing policies differ substantially along two important dimensions: 1) extent of government intervention, and 2) prioritization of physical risk concerns versus financial transition concerns. It also explores how the different state programs show surprisingly diverse policy approaches and how--contrary to assumptions--many do not actually subsidize insurance affordability. Through these observations, the Article uncovers unexpected examples of state insurance policies complementing, rather than contravening, pricing signals sent by private insurance retreat. [ABSTRACT FROM AUTHOR]

With the passage of IRDA Act 1999, Insurance Industry was opened to private companies and as of now we have 70+ Insurance Companies in India including Life, General and Reinsurance Branches. In order to encourage technological innovation IRDAI has constituted Sandbox committee which allows insuretech companies to innovate products and adopt Use and Tile instead of File and Use. Artificial Intelligence and Data Analytics started impacting businesses across spectrum positively. Insurance Industry is no exception. Role of Artificial Intelligence has only quadrupled in recent years. What started as a Sandbox moment approved by regulator has taken a giant leap with the advent of AI, Block chain and Analytics? This paper is to highlight key developments in Insurance Industry adopting Artificial Intelligence, Block chain and Analytics. [ABSTRACT FROM AUTHOR]

The main objective was to examine the various enforcement action (penalties) which were imposed by IRDAI on Life and General insurance industry for violation of various insurance rules and regulations. The research was a fact-finding descriptive research based on historical penalty orders published by IRDAI. After analysing the 67 orders published on IRDAI website, it was found that penalty amounting to Rs 1190 lakhs was imposed on general insurers and Rs 206 lakhs was imposed on life insurers. Total penalty amount combined for life and general insurers was 1396 lakhs. Out of which 607 lakhs (43.48%) was related to uncommon category violation and 789 lakhs (56.52%) was related to common category violation between life and general insurers. Total frequency of violation for general and life insurance industry combined was 127 times, with common category violation was 101 times (79.52%) and uncommon category violation was 26 times (20.48%). [ABSTRACT FROM AUTHOR]

The article describes the contribution of insurance in financial and social inclusion in society. The article presents a picture of past initiatives of the Indian insurance sector to promote financial and social inclusion in India, the future plans and the challenges ahead in achieving this aim. It also highlights the role of digital technology in helping the insurance sector achieve financial and social inclusion. [ABSTRACT FROM AUTHOR]

Developed economies like USA, UK etc. have utilised insurance as a supplementary tool for creating a protected society by strengthening the existing social security net through affordable health insurance programmes, pension and annuity insurance plans, liability insurance etc. In comparison, insurance in India is still seen as an investment tool, rather than as a risk mitigation mechanism. Though Government has taken measures to replicate the model followed in West through social security schemes like Pradhan Mantri Jeevan Jyoti Bima Yojana (PMJJBY), Pradhan Mantri Suraksha Bima Yojana (PMSBY), Pradhan Mantri Jan Arogaya Yojana (PMJAY) etc., but still a large section of the society perceives insurance as a means to get tax benefits, instead of a buffer to protect against financial losses in case of an unfortunate event. Protection Gap which is a measure of the uninsured losses of a country, is significantly higher for India when compared to other developed or developing nations. The mortality protection gap in life insurance, which dominates the Indian insurance industry, is at staggering 87% as per a survey done by National Insurance Academy. Despite health insurance being the top contributor under non-life segment in India, the health protection gap stands at 73%. The estimated pension protection gap is even higher at 93%. Thus, it becomes imperative for the Indian insurance industry to bridge these gaps through high decibel awareness campaigns, so that citizens can leverage insurance as a tool for financial protection (and not as substitute for return-oriented investments) and reap its real benefits. [ABSTRACT FROM AUTHOR]

This study examines into the profound effects of financial inclusion on India's insurance sector, which is a vital component of societal financial services access. It emphasizes the catalytic role of financial inclusion in expanding the industry's reach and creativity, which has a substantial impact on insurance penetration rates, product development, and technology integration. Thus, policymakers believe that financial inclusion will remain incomplete unless insurance inclusion programs are also pushed to increase penetration. The synthesis offered seeks to provide a thorough understanding of financial inclusion's role in transforming the Indian insurance business. By combining findings gathered from various research and papers, the study provides a comprehensive picture of the links between financial inclusion policies and insurance sector achievements in India. The current study covers the importance of microinsurance in promoting financial inclusion in India's rural and urban populations as well as the transformative impact of digital solutions, and the results of government and corporate attempts to integrate marginalized communities into the insurance environment The study is based on secondary data, and this paper examines insurance inclusion as a tool for financial inclusion in India. [ABSTRACT FROM AUTHOR]

Copyright of Sakarya University Journal of Law Faculty (SHD) is the property of Sakarya University Journal of Law Faculty (SHD) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study investigates the board's role in shaping insurers' risk-taking using data of 49 Indian insurance firms from 2014 to 2021. We captured the insurer's risk using four proxy measures: underwriting, investment, insolvency and total risks. To address potential endogeneity concerns in the relationship with board attributes, we employ a two-step Generalized Method of Moments (GMM) approach. Robustness checks are conducted using the panel quantile estimation approach. The empirical analysis reveals that life insurers face greater underwriting risk than non-life insurers. A larger board with duality appears to mitigate insurers' risk, particularly in the case of life insurers. The presence of independent directors on insurer boards, along with an optimal frequency of board meetings, effectively mitigates risk among Indian insurers. The study concludes that dual regulations erode regulatory discipline among public insurers, leading to an inadequate governance structure. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Natural Hazards & Environment (JNHE) / Doğal Afetler ve Çevre Dergisi (DACD) is the property of Artvin Coruh University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: This study aims to develop a comprehensive framework for discussing sustainability within the insurance industry, extending the traditional Environmental, Social, and Governance (ESG) dimensions to include economic and technological considerations. This inclusion is vital, recognizing that financial stability and the adoption of innovative technologies are fundamental to meeting other sustainability targets. Design/methodology/approach: We base our findings on an extensive literature review, case studies, and interactive workshops with key stakeholders in the insurance industry. Our analytical framework employs Porter's (1985) insurance-specific value chain, complemented by Berliner's (1982) insurability criteria, to distinguish between insurable and non-insurable risks. Findings: Our results show that the insurance industry is sustainable because it actively incorporates and contributes to sustainability goals across environmental, social, economic, and technological dimensions. This is illustrated through the identification of 50 distinct contributions across the insurance value chain, showcasing the sector's unique position to significantly influence the sustainability discourse. Practical implications: Addressing the pressing challenges of sustainability and insurability necessitates a strategic, collective response from the global insurance and risk management community. This paper proposes several policy recommendations, including enhancing risk assessment methodologies, diversifying insurance product offerings, encouraging cross-sectoral collaboration, and prioritizing investments in resilience and preventive measures. Originality/value: By broadening the sustainability discussion to encompass economic and technological facets, this paper enriches the dialogue surrounding the insurance industry's role in sustainability. It aims to inform decision-makers across the industry, political spheres, and broader society about the necessity of sustainability, fostering pertinent political discussions and highlighting avenues for future research. [ABSTRACT FROM AUTHOR]

Insurance for human life is very important, and it requires a sense of comfort and safety. So that many companies have established their business in the field of insurance, behind insurance companies that provide security protection. Not all companies run smoothly in other words the company is inseparable from the threat of bankruptcy. This research focuses on legal certainty for customers when an insurance company with claim obligations is declared bankrupt. The research problem addresses the challenges faced by customers in such situations and the legal protection available to them. The purpose of this research is to find out the responsibility of insurance companies that are declared bankrupt in fulfilling customer claims and to find out the legal certainty for customers in cases when insurance companies that have claims obligations are declared bankrupt. The methodology used is normative juridical, by analyzing the law based on literature study, articles in the Civil Code, Law Number 21 of 2011 concerning OJK, Law Number 37 of 2004 concerning Bankruptcy and postponement of debt payment obligations, and Insurance Law. The results discuss the importance of legal protection provided by the Financial Services Authority and the Deposit Insurance Corporation for insurance customers in bankruptcy cases. The findings underscore the need for compliance with certain legal provisions to ensure customer protection, especially in cases involving insolvent insurance companies. The implications of this study emphasize the importance of legal certainty and the role of regulatory bodies in protecting customer rights in the insurance sector. [ABSTRACT FROM AUTHOR]

This research delves into the fusion of spatial clustering and predictive modeling within auto insurance data analytics. The primary focus of this research is on addressing challenges stemming from the dynamic nature of spatial patterns in multiple accident year claim data, by using spatially constrained clustering. The spatially constrained clustering is implemented under hierarchical clustering with a soft contiguity constraint. It is highly desirable for insurance companies and insurance regulators to be able to make meaningful comparisons of loss patterns obtained from multiple reporting years that summarize multiple accident year loss metrics. By integrating spatial clustering techniques, the study not only improves the credibility of predictive models but also introduces a strategic dimension reduction method that concurrently enhances the interpretability of predictive models used. The evolving nature of spatial patterns over time poses a significant barrier to a better understanding of complex insurance systems as these patterns transform due to various factors. While spatial clustering effectively identifies regions with similar loss data characteristics, maintaining up-to-date clusters is an ongoing challenge. This research underscores the importance of studying spatial patterns of auto insurance claim data across major insurance coverage types, including Accident Benefits (AB), Collision (CL), and Third-Party Liability (TPL). The research offers regulators valuable insights into distinct risk profiles associated with different coverage categories and territories. By leveraging spatial loss data from pre-pandemic and pandemic periods, this study also aims to uncover the impact of the COVID-19 pandemic on auto insurance claims of major coverage types. From this perspective, we observe a statistically significant increase in insurance premiums for CL coverage after the pandemic. The proposed unified spatial clustering method incorporates a relabeling strategy to standardize comparisons across different accident years, contributing to a more robust understanding of the pandemic effects on auto insurance claims. This innovative approach has the potential to significantly influence data visualization and pattern recognition, thereby improving the reliability and interpretability of clustering methods. [ABSTRACT FROM AUTHOR]

Despite improvements in the insurance sector's performance, there are still misconceptions among the public, fueled by negative media coverage. These misconceptions exist across all areas of insurance, including life insurance and travel insurance. Insurance companies are working to communicate the positive role insurance plays and address these misconceptions through public education campaigns and improved communication with customers. However, mainstream media outlets need to do more to spread news of positive insurance outcomes and debunk myths. The insurance industry has made significant advancements, such as faster claims response times and improved customer experience, but these achievements are often overshadowed by negative coverage. [Extracted from the article]

The purpose of this empirical study is to examine the relationship between key risk management components such as catastrophic indicators, underwriting practices, liquidity levels, and the retention index, and their impact on the financial performance of Algerian insurance companies. The research was conducted over a four-year period, from 2017 to 2021, using quarterly data from Algeria's insurance company. The analysis was divided into two models. The first model concentrated on the effects of disasters and underwriting techniques on economic performance, while the second model examined the effects of retention and liquidity on economic profitability. The autoregressive distributed lag model (ARDL) was used for both models. The study showed that catastrophic risk and underwriting risk have a negative impact on short-term economic profitability, while liquidity risk and retention risk have a positive impact. Additionally, there are balanced long-term relationships between these risks and economic profitability. The study provides valuable insights into how certain risks affect an insurance company's profitability. Using these findings, the Algerian Insurance Company can improve its risk management strategies, increasing profits and financial security in the long term. These findings may be useful not only for this specific company but also for other insurance companies dealing with similar risks. This study stands out for its specific focus on the Algerian insurance sector, thorough analysis of various risk factors, the use of the ARDL model, reliance on financial data, and its practical implications for the industry. These distinct features contribute to advancing academic understanding and offering valuable insights for insurance professionals and policymakers.

The study intends to determine how leadership techniques adjusted to the trends impact employee job satisfaction, considering the mediating influence of perceived organizational politics in light of the expanding influence of digital technology and virtual work settings. The study included a solid sample of 300 workers from different parts of Jordan. The employees filled out the questionnaire anonymously. 5-point rating Likert scales were used to capture a range of viewpoints. Using the Partial Least Squares software, this study applies Structural Equation Modelling analysis to examine the relationships between job satisfaction, perceived organizational politics, and leadership styles in Jordanian insurance companies. The study focuses on all employees of insurance companies in Jordan, including people working at various administrative levels. The most common length of job tenure was between one and five years (38.67%). Initial results show a strong beneficial relationship between transformational leadership philosophies and contentment at work (β = 0. 378, t = 6.266, LL = 0.483, UL = 0.718, p < 0.001). Similarly, transformational leadership had the highest standardized effect on perceived organizational politics with a coefficient of 0.443. Furthermore, the complex processes by which leadership philosophies tangentially affect job satisfaction levels are revealed by the role of mediation of perceived organizational politics.

Abstract.Given that insurance companies often operate across multiple lines of insurance business, where claim frequencies on different lines are often correlated, it often becomes advantageous to employ multivariate count modeling where dependence between lines of business can be included in the modeling. Due to the operation of bonus-malus systems where there is a reward to the insurance policyholder for not claiming, claims data in automobile insurance often exhibits an excess of common zeros, a characteristic known as multivariate zero-inflation. In this article, we propose two approaches to address this feature. The first approach involves utilizing a multivariate zero-inflated model, where we artificially enhance the probability of common zeros based on standard multivariate count distributions. The second approach applies a multivariate zero-modified model, which separately handles the common zeros and the number of claims incurred in each line given that at least one claim occurs. We present several models under these frameworks, along with detailed inference procedures. In the applications section, we conduct a comprehensive comparative analysis of these models using data from an automobile insurance portfolio. [ABSTRACT FROM AUTHOR]

Contemporary capitalist societies use different institutions to manage economic risks. While different public welfare state and financial institutions (banks, capital markets) have been studied across coordinated and liberal market economies, the different worlds of private insurance institutions have been understudied. Building on new insurance data sets (1880–2017), we find that countries with a Maritime (USA, GBR, CAN) in contrast to the more backward Alpine (AUT, DEU, CHE) insurance tradition developed bigger life and nonlife insurance earlier, with less state-associated and reinsurance enterprises, but riskier investments steered toward financial markets. We argue that the larger and more "Maritime" the insurance sector, the more it made welfare states liberal and securities markets large. Insurance is thus a hidden factor for countries' varieties of capitalism and worlds of welfare. The recent convergence on the Maritime model, however, implies that the riskier and risk-individualizing type of private insurance has added to privatization and securitization trends everywhere. [ABSTRACT FROM AUTHOR]

The insurance industry has used parametric solutions to transfer catastrophe risks since the 1990s. Instead of relying on a lengthy process to assess a claim, these products pay the insured a pre-agreed amount if the physical characteristics of the event fulfill pre-defined conditions. Cat-in-a-box or cat-in-a-circle triggers, commonly used tools for tropical cyclone risk transfer, provide a payout to the insured if the track of a hurricane crosses the perimeter of a geographic area defined by a polygon or a circle with a certain intensity. Cat-in-a-grid solutions are novel and more sophisticated. They rely on a set of multiple cat-in-a-box triggers arranged on an orthogonal grid. The consideration of multiple geographic domains instead of a single box or circle is helpful to reduce basis risk, i.e., the difference between the parametric loss estimate and the target loss. In the case study for Miami presented here, for instance, a cat-in-a-grid solution showed 18.5% less basis risk than a typical cat-in-a-box alternative. To organize the different types of triggers within a common framework, we classify the existing alternatives based on whether they use a single geographic domain (like a box or a circle) or multiple domains (like a grid). We discuss their advantages and disadvantages and describe the process required to calibrate any one solution with the help of a catastrophe-risk model. We focus, in particular, on the analysis and construction of cat-in-a-grid triggers, the alternative that we believe offers the greatest potential for global standardization and adoption. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to systemically review the literature on Anterior Saphenous Vein (ASV) reflux treatment and insurance impediments to treatment coverage. Methods: A literature search was performed using a PRISMA framework. In addition, a cross-sectional analysis of insurance policies for ASV treatment was evaluated. Results: Published evidence and treatment considerations in the literature for ASV treatment are discussed. In 155 of 226 (68.6%) insurance policies reviewed coverage of ASV ablation was allowed while 62/226 (27.4%) did not specify coverage and 9/226 (4.0%) specified ASV treatment was not covered. Of the 155 that provide ASV coverage, 98 (62.2%) provide coverage with criteria such as requiring prior treatment of the great saphenous vein. Conclusions: Vein treatment experts should continue to advocate to insurance carriers to update their varicose vein treatment policies to reflect the substantial clinical evidence so that patients with ASV reflux can be appropriately treated. [ABSTRACT FROM AUTHOR]

As in other countries, regulated savings in France are intricately woven into dense regulatory frameworks driven by explicit governmental objectives. The anticipated marketization of the French economy should have eradicated them; however, a substantial portion of regulated savings has managed to evade this process. Is this phenomenon attributable to the tenacious grip of the French state-led tradition? Not entirely, as another subset of these savings has indeed undergone marketization. The landscape of French regulated savings is notably distinguished by a growing dichotomy: on one side, non-marketized products offered by banks, and on the other, increasingly marketized products provided by insurers. Drawing upon process tracing, we contend that these ostensibly conflicting developments emanate from the distinct and precise institutional dependencies between state and private actors in which these products are enmeshed. The prevailing status quo within the banking sector is owed to banks' engagement in a mutually advantageous, long-term exchange of favors with state actors. Faced with the trade-off between offering less lucrative products and risking the endangerment of this relationship, banks have opted for the former. In contrast, an assertive strategy has gained traction in the insurance industry. Yet, strategies for the marketization of regulated savings aligned with state priorities have been implemented, even when insurers expressed opposition. [ABSTRACT FROM AUTHOR]

We perform a textual analysis of insurers' climate risk disclosures and construct a climate change risk management quality index. Our index captures to what extent insurers identify, manage, and adjust their business model to climate change risk. We find that natural disasters in an insurer's home state lead to an increase in climate change risk management quality. The effect of natural disasters in an insurer's geographic markets on climate change risk management seems to be less pronounced. Overall, these results are consistent with salience theories of choice. [ABSTRACT FROM AUTHOR]

Centralized insurance can be found in both the private and public sectors. This paper provides a microeconomic study of the risk‐sharing mechanisms in these markets, where multiple policyholders interact with a centralized monopolistic insurer. With minimal assumptions on the risk preferences of the market participants, we characterize Pareto optimality in terms of the agents' risk positions and their assessment of the likelihoods associated with their loss tail events. We relate Pareto efficiency in this market to a naturally associated cooperative game. Based on our theoretical results, we then consider a model of flood insurance coverage via an illustrative example. The lessons drawn from our theoretical results and this example lead to important policy implications for the existing National Flood Insurance Program in the United States. [ABSTRACT FROM AUTHOR]

Copyright of Polish Statistician / Wiadomości Statystyczne is the property of State Treasury - Statistics Poland and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Proportionality, pivotal to EU regulations and Solvency II, tailors rules to insurers' size and complexity. Inconsistent application by supervisory authorities (NSAs) necessitates clarity to prevent undue costs. This study examines the issue via a review of the literature and industry discussions, emphasizing Solvency II's introduction of proportionality and the varied interpretations it evokes. Transparent communication is crucial, and regulatory evolution must align with market dynamics, with the European Insurance and Occupational Pensions Authority (EIOPA) fostering convergence. Assessing proportionality mandates a comprehensive evaluation of an insurer's nature, scale, and complexity. Regulatory distinctions between first-party and third-party risks could enhance market efficiency. Ultimately, a holistic, market-oriented approach is essential for proportionate regulation in the insurance sector, requiring concerted efforts to elucidate frameworks, foster transparency, and align regulatory evolution with market dynamics. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to explore the gap between the need for gender-affirming voice and communication services (GAVCS) and insurance coverage within one state. Method: An electronic, cross-sectional survey of transgender/gender-diverse (TGD) adults assessed the incidence of insurance and cost barriers to GAVCS. Then, policies from 22 major insurers were reviewed using a web-based search and telephone inquiries. Finally, a tool was developed for clinicians to share available coverage for GAVCS by insurer. Results: Over half (53%) of 115 respondents reported vocal incongruence, but only 19.1% had pursued GAVCS. Of those who had not, 57% reported cost and/or insurance coverage were barriers (most of whom were commercially insured). Less than half of major Ohio insurance plans mentioned GAVCS coverage, and of those who did, less than half would consider covering it on a caseby- case basis. Creation of a tool that explained coverage across insurance companies was helpful, but challenging and labor-intensive. Conclusions: TGD individuals often experience a mismatch between their gender identity and societal perceptions of their voice, which can worsen dysphoria and compromise safety. GAVCS align voice with gender identity but are inconsistently covered by health insurance and can be costly, particularly for individuals who face socioeconomic marginalization. Inconsistent transparency in communicating coverage criteria further exacerbates access to GAVCS. Poor insurance coverage of GAVCS is an important barrier to accessing this evidence-based care, and more transparency and consistency in coverage is critical. [ABSTRACT FROM AUTHOR]

Inappropriate antimicrobial use is a global problem, especially because the use of antimicrobials in excess of appropriate doses is associated with increased antimicrobial resistance. Duplicate prescriptions are an issue contributing to inappropriate antimicrobial use. This study aimed to analyse antibiotic prescriptions during a specific month to examine the frequency of outpatients receiving duplicate antibiotic prescriptions and the associated determinants. Utilizing the Japan Medical Data Centre health insurance claim database, we retrospectively identified 527,110 insured individuals with at least one medicine prescription in October 2014. Data regarding age, gender, antibiotic drug usage, and health insurance status were extracted. Duplicate prescriptions entailed a patient receiving two or more prescriptions of systemic antibiotics from multiple facilities within one month. The risk factors for duplicate antibiotic prescriptions were evaluated using logistic regression analysis. Of the total sample, 131,709 individuals (25.0%) received antibiotics, and 24,529 of these individuals (18.6%) had duplicate prescriptions. Third-generation cephalosporins accounted for the largest proportion of prescriptions (37.4%). Duplicate prescriptions were significantly associated with sex, age, medical facilities, and health insurance status. These findings could help to identify patients at risk of duplicate antibiotic prescriptions, highlighting the need to promote proper antimicrobial use in both patients and medical professionals. [ABSTRACT FROM AUTHOR]

This study presents a conceptual framework that identifies how service companies can create customer value through an omnichannel service delivery. Extant knowledge is synthesized to develop an integrated framework that identifies the building blocks, modifiers, enablers and drivers of customer perceived value built by an omnichannel service delivery. Insights are drawn from the omnichannel literature and combined with qualitative data from senior managers responsible for the development of the omnichannel strategy for major players in the French insurance industry. The study arrives at the following conclusions. First, the building blocks of customer perceived value provided by an omnichannel service delivery—customer effort, service quality, integration quality and trust—are identified. Second, the relevance of the building blocks is found to vary based on the levels of product and activity complexity. Third, customer information management and IT infrastructures are identified as key enablers of an omnichannel service delivery. Finally, support and further clarification are provided for the drivers of the implementation of a successful omnichannel strategy: company, customer, channel relationships and environmental factors. This study responds to calls for strategic studies to integrate multiple variables and takes a holistic and managerial perspective on omnichannel strategies in a service context. [ABSTRACT FROM AUTHOR]

While term life insurance has historically been sold to income-earning men to secure the financial futures of their families, in India there is a growing number of life insurance products targeting women, particularly unwaged housewives. In marketing these financial products to Indian women, I show how life insurance companies incorporate the feminist critique of devalued domestic labor. Drawing on analysis of insurance policies, marketing and promotional materials, as well as personal advice articles, it goes on to show how there is, something uncanny or unsettling about the way life insurance not only commodifies and financializes domestic labor, but also focuses on the reproductive bodies of women through health riders. The article situates contemporary discourses of life insurance for women within a longer history of women's property and of mobilizing capital through rather than for women in India. [ABSTRACT FROM AUTHOR]

Background: When today's efforts to achieve universal health coverage are mainly directed towards low-income settings, it is perhaps easy to forget that countries considered to have universal, comprehensive and high-performing health systems have also undergone this journey. In this article, the aim is to provide a century-long perspective to illustrate Sweden's long and ongoing journey towards universal health coverage and equal access to healthcare. Methods: The focus is on macro-level policy. A document analysis is divided into three broad eras (1919–1955; 1955–1989; 1989–) and synthesises seven points in time when policies relevant to overarching goals and regulation of universal health coverage and equal access were proposed and/or implemented. The development is analysed and concluded in relation to two egalitarian goals in the context of health: equality of access and equal treatment for equal need. Results: Over the past century, macro-level policy evolved from the concept of creating access for the neediest and those reliant on wages for their survival to a mandatory insurance with equal right to healthcare for all. However, universal health coverage was not achieved until 1955, and individuals had to rely on their personal financial resources to cover the cost at the time of care utilization until the 1970s. It was not until 1983 that legislation explicitly stated that access to healthcare should be equal for the entire population (horizontal equity), while a vertical equity-principle was not added until 1997. Subsequently, ideas of free choice and privatization have gained significance. For instance, they aim to increase service access, addressing the Swedish health system's Achilles' heel in this regard. However, the principle of equal access for all is now being challenged by the emergence of private health insurance, which offers quicker access to services. Conclusions: brief summary and potential implications It can be concluded that there is no perpetual Swedish healthcare model and various dimensions of access have been the focus of policy discussion. The discussion on access barriers has shifted from financial to personal and organizational ones. Today, Sweden still ranks high in terms of affordability and equity in international comparisons: although not as well as a decade ago. Whether this marks the beginning of a new trend intertwined with a decline in Sweden's welfare 'exceptionalism', or is a temporary decline remains to be assessed in the future. [ABSTRACT FROM AUTHOR]

Objectives: Healthcare screening identifies factors that impact patient health and well-being. Hunger as a Vital Sign (HVS) is widely applied as a screening tool to assess food security. However, there are no common practice screening questions to identify patients who are nutrition insecure or acquire free food from community-based organizations. This study used self-reported survey data from a non-Medicaid insured adult population approximately one year after the start of the COVID-19 pandemic (2021). The survey examined the extent to which the HVS measure might have under-estimated population-level food insecurity and/or nutrition insecurity, as well as under-identified food and nutrition insecurity among patients being screened for social risks in the healthcare setting. Methods: Data from a 2021 English-only mailed/online survey were analyzed for 2791 Kaiser Permanente Northern California (KPNC) non-Medicaid insured members ages 35-85 years. Sociodemographics, financial strain, food insecurity, acquiring free food from community-based organizations, and nutrition insecurity were assessed. Data from respondents' electronic health records were abstracted to identify adults with diet-related chronic health conditions. Data were weighted to the age × sex × racial/ethnic composition of the 2019 KPNC adult membership. Differences between groups were evaluated for statistical significance using adjusted prevalence ratios (aPRs) derived from modified log Poisson regression models. Results: Overall, 8.5% of participants reported moderate or high food insecurity, 7.7% had acquired free food from community-based organizations, and 13% had nutrition insecurity. Black and Latino adults were significantly more likely than White adults to have food insecurity (17.4% and 13.1% vs 5.6%, aPRs = 2.97 and 2.19), acquired free food from community-based organizations (15.1% and 15.3% vs 4.1%, aPRs = 3.74 and 3.93), nutrition insecurity (22.1% and 23.9% vs 7.9%, aPRs = 2.65 and 2.64), and food and nutrition insecurity (32.4% and 32.5% vs 12.3%, aPRs = 2.54 and 2.44). Almost 20% of adults who had been diagnosed with diabetes, prediabetes, ischemic CAD, or heart failure were food insecure and 14% were nutrition insecure. Conclusions: Expanding food-related healthcare screening to identify and assess food insecurity, nutrition insecurity, and use of community-based emergency food resources together is essential for supporting referrals that will help patients achieve optimal health. [ABSTRACT FROM AUTHOR]

Introduction: Despite national goals to eliminate Hepatitis C (HCV) and the advancement of curative, well-tolerated direct-acting antiviral (DAAs) regimens, rates of HCV treatment have declined nationally since 2015. Current HCV guidelines encourage treatment of HCV by primary care providers (PCPs). Payors have reduced restrictions to access DAAs nationally and in California however it remains unclear if the removal of these restrictions has impacted the proportion of PCPs prescribing DAAs at a health system level. Our objective was to examine the proportion of DAAs prescribed by PCPs and specialists and to describe the population receiving treatment in a single health system from 2015 to 2022. Methods: We examined the proportion of DAAs prescribed by PCPs and specialists and the population receiving treatment through a retrospective analysis of claims data in the University of California, Los Angeles (UCLA) Health System from 2015 to 2022. We described number of prescriptions for HCV medication prescribed by PCPs and specialists by year, medication type, and physician specialty. We also described numbers of prescriptions by patient demographics and comorbidities. Results: A total of 1515 adult patients received a prescription for HCV medication through the UCLA Health System between 2015 and 2022. The proportion of patients receiving prescriptions for PCPs peaked at 19% in 2016, yet decreased to 5.7% in 2022, an average of 13% across all years. Median age of patients receiving treatment was 60 years old, and 56% of patients receiving HCV treatment had commercial insurance as their primary payer. Conclusions: HCV treatment declined from 2015 to 2022 among specialists and PCPs in our health system. Older patients comprised the majority of patients receiving treatment, suggesting a need for novel approaches to reach patients under 40, an age group with significant increases in HCV transmission. [ABSTRACT FROM AUTHOR]

Claims with high severity and low probability constitute a high risk for the insurance market. One tool to deal with this kind of event is the Extreme Value Theory (EVT). The main goal of this article is to apply the EVT to Actuarial Science using a different estimator for parameters, allowing the calculation of pure reinsurance premiums and the choice for the retention limit for insurance companies. The execution was split into two parts: (i) comparing the estimators through simulations, and; (ii) using data from 5 SUSEP lines of business with different natures, intending to estimate some extreme value statistics. In simulation studies, the Pickands estimator was very promising, but the limited amount of data resulted in a great variance when applied to real cases. Lastly, we concluded that the EVT is a powerful tool for insurance, capturing the behavior of extreme clams amount better than traditional models. [ABSTRACT FROM AUTHOR]

The implementation effect of Inherent Defects Insurance (IDI), which is currently being vigorously promoted in China, requires urgent improvement. A game model of the insurance company, contractor, and risk management institution in the performance stage is constructed from the perspective of the insurance company, and a simulation is carried out using system dynamics to address project quality problems caused by rent-seeking behaviors. The values of cooperation loss, reputation loss, and supervision cost were altered to explore the evolution process of each agent's behavior and the influence of each factor on the change of the agent's strategy. The findings indicate that the active supervision of insurance companies is positively influenced by the rent-seeking strategies of contractors and the intentional rent-seeking strategies of risk management institutions. In the context of long-term cooperation, it can be observed that there will be no rent-seeking behavior, and that the supervision cost is the main factor affecting the insurance company's strategy. The verification results are based on scientific evidence and provide a theoretical foundation for the implementation and application of IDI in the market. [ABSTRACT FROM AUTHOR]

The global insurance industry has been significantly impacted by recent innovations and trends in information and communication technology (ICT). The technology has speeded up modifications in business behaviors. Through the technology acceptance model (TAM), this study looks into potential influences on the adoption of mobile insurance. It also explores potential influences on Himachal Pradesh policyholders' intent to use mobile insurance technology. A total of 185 responses from users of mobile insurance technology were collected through a structured questionnaire. Structural equation model (SEM) technique was employed for statistical analysis. According to the findings, usage of mobile insurance technology increases as long as customers see it as a helpful tool. The results showed that the main components for promoting mobile insurance technology in Himachal Pradesh were privacy policy, perceived usefulness, perceived ease of use, and attitude. The performance matrix also showed that "Attitude" was the most important component. Hence, insurance companies should concentrate on encouraging prospective clients to have favorable attitudes towards mobile insurance technology. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to determine the impact of digital nomadism on the relationship between tourism and traditional insurance models, the opportunities and challenges that digital nomadism brings to the insurance industry and future predictions. Design/methodology/approach: A review approach was used, utilizing industry reports, statistics, market research and previous studies. Findings: Digital nomadism will directly bring about the development of personalized insurance products and services. The journey that began with digital health insurance will propel the industry to entirely new horizons. Originality/value: The study offers a new perspective in this field by addressing the relationship between digital nomadism and the insurance industry. [ABSTRACT FROM AUTHOR]

This article explores the concept of captive insurance companies, which are insurance companies owned by a corporate affiliate or subsidiary that provide coverage for risks not adequately covered by commercial insurance. It discusses the benefits of captives, such as filling coverage gaps and accessing the reinsurance market. The article also touches on federal and state regulations for captives and highlights the top states for captive formation in the US. It emphasizes the importance of risk diversification and working with experienced captive managers to ensure compliance with IRS regulations. [Extracted from the article]