Indemnity Payments Research Articles

Exploring the weather-yield nexus with artificial neural networks

CONTEXTWeather is a pivotal factor for crop production as it is highly volatile and can hardly be controlled by farm management practices. Since there is a tendency towards increased weather extremes in the future, understanding weather-related yield factors becomes increasingly important not only for yield prediction, but also for the design of insurance products. Although insurance products mitigate financial losses for farmers, they suffer from considerable basis risk, i.e., a discrepancy between losses and the indemnity payment. OBJECTIVEThe objective of this paper was to explore the potential of machine learning for estimating the relationship between crop yield and weather conditions at the farm level and to use it as a tool for reducing basis risk in index insurance applications. METHODSAn artificial neural network was set up and calibrated to a rich set of farm-level yield data in Germany, covering the period from 2003 to 2018. A nonlinear regression model, which uses rainfall, temperature, and soil moisture as explanatory variables for yield deviations, served as a benchmark. RESULTS AND CONCLUSIONSThe empirical application revealed that compared with traditional estimation approaches, the gain in forecasting precision by using machine learning techniques was substantial. Moreover, the use of regionalized models and disaggregated high-resolution weather data improved the performance of artificial neural networks. A considerable part of yield variability at the farm level, however, could not be captured by statistical methods which solely use “big weather data”. SIGNIFICANCEOur findings have important implications for the design of weather-index based insurance because they document that a rather high level of basis risk remains if insurance products are based on an estimation of the weather-yield relationship.

Stent encrustation or fragmentation? A case report of post stent removal encrustation in postpartum woman and literature review

BackgroundUreteral stents are commonly used in the field of urology to relieve ureteral obstruction. However, complications relating to ureteral stent use, such as encrustation continue to occur, especially with prolonged indwell time.Case presentationHere we present a 37-year-old postpartum woman with a foreign body in her bladder after removing a ureteral stent 1 month before. She insisted that the foreign body was the fragment of stent and asked for medical malpractice indemnity payments while the surgeon of her insisted that the stent was intact during the procedure. Finally, the foreign body was confirmed as an encrustation by cystoscopy and the patient received 10,000 yuan ($ 1500) as indemnity payments after encrustation removal.ConclusionIn the absence of guidelines, stent indwelling time vary with centers’ habits, stent materials and patient’s education. Early detection of stent encrustation and timely removal of the encrusted stent are still the best way to avoid stent retention. Violent stent removal is of danger and not recommended in any case.

Somebody's watching me! Impacts of the spot check list program in U.S. crop insurance

AbstractThe “Spot Check List” (SCL) is an important tool developed to help detect and deter fraud, waste, and abuse in the U.S. crop insurance program. This article examines whether the SCL program affects the extent of crop insurance losses and provides insights into the effectiveness of this program. Using proprietary, county‐level SCL data and panel data econometric procedures (which control for both observable and unobservable confounding factors), we find evidence that counties with more producers included in the SCL tend to have better actuarial performance (i.e., lower indemnity payment amounts) after these producers are informed about their listing on the SCL. In addition, the county‐level SCL effects tend to last for a couple more years beyond the initial year these SCL producers were informed of their listing. These results indicate that the SCL procedure has a notable impact on crop insurance losses and is a valuable tool for maintaining integrity of the program.

Medical malpractice in stress urinary incontinence management: A 30-year legal database review.

Background:The purpose of this study is to investigate the most common reasons for and judicial outcomes of malpractice claims related to stress urinary incontinence (SUI) management.Materials and methods:Using the Westlaw database, a search was performed using the terms “medical malpractice” or “negligence” in combination with “stress incontinence” or “stress urinary incontinence” between January 1, 1990 and January 1, 2020. Extracted information included trial date, demographic information, defendant profession, procedure performed, procedure complications, alleged malpractice, trial outcome, and monetary award. Data were analyzed using descriptive statistics.Results:The Westlaw search yielded 79 case results. Of the cases, 70.4% (n = 38/54) had a defense verdict, 22.2% (n = 12/54) had a plaintiff verdict, and 7.4% (n = 4/54) were settled. The most commonly implicated procedure was mid-urethral sling (63.2%, n = 36/57). Among the plaintiffs, 48.4% (n = 61/126) claimed negligence in preoperative care, 33.3% (n = 42/126) claimed negligence in surgical performance, and 18.3% (n = 23/126) claimed negligence in postoperative care. Lack of informed consent was the most common complaint related to negligence in preoperative care (42.6%, n = 26/61). The average indemnity payment was $1,253,644 for preoperative care negligence, $1,254,491 for surgical performance negligence, and $2,239,198 for postoperative care negligence. Of the defendants, 63.4% (n = 52) were gynecologists and 36.6% (n = 30) were urologists.Conclusions:Negligent preoperative care, with a particular emphasis on failure to obtain informed consent, and negligent surgical performance are the leading causes of malpractice claims during SUI management. Mid-urethral sling was the most commonly litigated procedure. This study highlights key factors to consider in minimizing malpractice risk during SUI management.

Association of Simulation Training With Rates of Medical Malpractice Claims Among Obstetrician-Gynecologists.

To compare malpractice claim rates before and after participation in simulation training, which focused on team training during a high-acuity clinical case. We performed a retrospective analysis comparing the claim rates before and after simulation training among 292 obstetrician-gynecologists, all of whom were insured by the same malpractice insurer, who attended one or more simulation training sessions from 2002 to 2019. The insurer provided malpractice claims data involving study physicians, along with durations of coverage, which we used to calculate claim rates, expressed as claims per 100 physician coverage years. We used three different time periods in our presimulation and postsimulation training claim rates comparisons: the entire study period, 2 years presimulation and postsimulation training, and 1 year presimulation and postsimulation training. Secondary outcomes included indemnity payment amounts, percent of claims paid, and injury severity. Compared with presimulation training, malpractice claim rates were significantly lower postsimulation training for the full study period (11.2 vs 5.7 claims per 100 physician coverage years; P<.001) and the 2 years presimulation and postsimulation training (9.2 vs 5.4 claims per 100 physician coverage years; P=.043). For the 1 year presimulation and postsimulation training comparison, the decrease in claim rates was nonsignificant (8.8 vs 5.3 claims per 100 physician coverage years; P=.162). Attending more than one simulation session was associated with a greater reduction in claim rates. Postsimulation claim rates for physicians who attended one, two, or three or more simulation sessions were 6.3, 2.1, and 1.3 claims per 100 physician coverage years, respectively (P<.001). Compared with presimulation training, there was no significant difference in the median or mean indemnity paid, percent of claims on which an indemnity payment was made, or median severity of injury after simulation training. We observed a significant reduction in malpractice claim rates after simulation training. Wider use of simulation training within obstetrics and gynecology should be considered.

Malpractice Cases in Breast Surgery: An Assessment of Litigation Involving Surgeons.

Improving patient safety and quality are priorities in health care. The study of malpractice cases provides an opportunity to identify areas for quality improvement. While the issues surrounding malpractice cases in breast cancer are often multifactorial, there are few studies providing insight into malpractice cases specifically related to common breast cancer surgical procedures. We sought to characterize the factors in liability cases involving breast cancer surgery. Closed cases from 2008 to 2019 involving a breast cancer diagnosis, a primary responsible service of general surgery, surgical oncology, or plastic surgery, and a breast cancer procedure were reviewed using data from the Controlled Risk Insurance Company (CRICO) Strategies Comparative Benchmarking System database, a national repository of professional liability data. A total of 174 malpractice cases were reviewed, of which 41 cases were closed with payment. Plastic surgeons were most commonly named (64%, 111/174), followed by general surgeons (30%, 53/174), and surgical oncologists (6%, 10/174). The most common allegation was error in surgical treatment (87%, 152/174), and infection, cosmetic injury, emotional trauma, foreign body, and nosocomial infections represented the top five injury descriptions. On average, indemnity payments were larger for high clinical severity cases. Technical skills, followed by clinical judgment, were the most commonly named contributing factors. The average payment per case was $130,422. Malpractice cases predominantly involve technical complications related to plastic surgery procedures. Better understanding of the malpractice environment involving surgical procedures performed for breast cancer may provide practical insight to guide initiatives aimed at improving patient outcomes.

Rates and Characteristics of Medical Malpractice Claims Against Hospitalists.

Hospitalists practice in high-stakes and litigious settings. However, little data exist about the malpractice claims risk faced by hospitalists. To characterize the rates and characteristics of malpractice claims against hospitalists. An analysis was performed of malpractice claims against hospitalists, as well as against select other specialties, using data from a malpractice claims database that includes approximately 31% of US malpractice claims. For malpractice claims against hospitalists (n = 1,216) and comparator specialties (n = 18,644): claims rates (using a data subset), percentage of claims paid, median indemnity payment amounts, allegation types, and injury severity. Hospitalists had an annual malpractice claims rate of 1.95 claims per 100 physician-years, similar to that of nonhospitalist general internal medicine physicians (1.92 claims per 100 physician-years), and significantly greater than that of internal medicine subspecialists (1.30 claims per 100 physician-years) (P < .001). Claims rates for hospitalists nonsignificantly increased during the study period (2009-2018), whereas claims rates for four of the five other specialties examined significantly decreased over this period. The median indemnity payment for hospitalist claims was $231,454 (interquartile range, $100,000-$503,015), significantly higher than the amounts for all the other specialties except neurosurgery. The greatest predictor of a hospitalist case closing with payment (compared with no payment) was an error in clinical judgment as a contributing factor, with an adjusted odds ratio of 5.01 (95% CI, 3.37-7.45). During the study period, hospitalist claims rates did not drop, whereas they fell for other specialties. Hospitalists' claims had relatively high injury severity and median indemnity payment amounts. The malpractice environment for hospitalists is becoming less favorable.

The merits of pooling claims: Mutual vs. stock insurers

This paper identifies combinations of premiums, equity capital contributions, default probabilities, and pool sizes, under which a risk-averse policyholder is indifferent between purchasing insurance coverage with a mutual or a shareholder insurance company. We analyze in a first step the combinations of premiums and equity contributions within a fixed pool size, such that a policyholder is indifferent to either of the two legal forms. In a second step, we include the restriction of a fixed default probability in both the mutual and shareholder insurance companies. In addition, we show that for a given default probability, a determined pool size and fair premiums (i.e., the premium equals the expected indemnity payments), a policyholder in the shareholder company experiences higher utility levels than a policyholder in a mutual insurance company. Hence, a risk-averse policyholder accepts an unfair premium in the shareholder company to obtain the same utility level provided by the mutual company.

Malpractice Litigation in Hand Surgery: A Comprehensive Nationwide Analysis.

The circumstances surrounding claims against hand surgeons have not been elucidated in the literature. The purpose of this study was to analyze trends in malpractice litigation regarding hand surgery through a nationwide legal database. The Westlaw legal research database was queried for verdicts and settlements between 1985 and 2017 for hand surgery-related malpractice cases. Cases were included if the hand surgeon was sued for malpractice. Procedure type and complications and/or adverse events that resulted in litigation were recorded. Patient characteristics, state, date of case, case outcomes, and indemnity payment were also noted. All dollar amounts were adjusted to 2017 values using the Consumer Price Index. In all, 171 cases (35 states) were included. The most frequently litigated surgeries were carpal tunnel releases followed by fracture treatment. Nerve injury was the predominant cause of litigation. The median nerve was predominantly injured, followed by the ulnar and radial nerves. In fracture surgery, malunion was the predominant cause, followed by weakness, nerve injury, and infection. In total, 72.5% of cases yielded verdicts in favor of the defense, 21.6% favored the plaintiff, and 5.9% were settled. Indemnity varied between $7800 and $8.99 million, averaging $570,397 for cases when the jury ruled in favor of the plaintiffs. Settled cases averaged $1,140,527. Malpractice litigation has substantial financial implications on surgeons and the health care system. Litigation arises most commonly from routine procedures (carpal tunnel release and fracture fixation) rather than complex surgical cases, potentially due to the high variability in operating surgeon subspecialization, with discrepant training.

A performance‐based payment: Signaling the quality of a credence good

We consider credence goods. A typical example of a credence good is an expert service. Experts often offer rebates contingent on their client's failure or bonus payments contingent on their client's success. This paper provides a different rationale for performance‐based payments than reducing moral hazard. We show that a performance‐based payment can be a signal of the seller's ability. Due to different success rates across expert abilities, a high‐ability expert can commit to offering larger indemnity payments contingent on a client's failure or smaller bonus payments contingent on a client's success. Thus, high quality is signaled by performance‐based pricing.

Litigation Patterns in Oncologic Nephrectomies: A 30-Year Review.

Introduction: The litigious environment encompassing the medical-legal domain is an increasing concern for surgical fields, with urology being no exception. The objective of our study was to systematically review, evaluate, and summarize the factors associated with oncologic nephrectomy litigation to determine possible factors contributing to verdicts or settlements. Materials and Methods: Publicly available verdict reports were retrieved using the Westlaw® legal database (Reuters). Cases were identified using the search term "nephrectomy" with dates ranging from January 1, 1990 to July 1, 2019. Each case was evaluated by two independent reviewers for defendant specialty, alleged breach in treatment, resulting complications, verdict outcomes, and indemnity payment. Complications were determined to be preoperative, perioperative, and postoperative. Data were analyzed using SPSS software to produce the descriptive statistics. Results: After accounting for duplicates and irrelevant cases, a total of 103 cases were analyzed with more than three-fourths being radical nephrectomies (78%). The most common claim was preoperative negligence (48%); however, negligence in perioperative care received the highest average monetary payment of $5,493,151. Forty-one percent of cases were perioperative with the majority being attributed to vascular injury (46%). The type of perioperative negligence claims and its average payment were found to be statistically significant (p = 0.042). Overall, 57% of cases denied the plaintiff's claims, whereas 28% were awarded. Conclusions: Our data show that although the highest number of cases were caused by preoperative negligence, perioperative negligence accounts for the highest settlement awards. This review provides insights into stages of management in the surgical management of renal cell cancer patients that may be subject to litigation.

Third party rights to reinsurance agreement under Brazilian law: a study on facultative civil liability insurance

Despite the impossibility to, under Brazilian law, as a rule, an insured or aggrieved third party seek payment of insurance indemnity directly from a reinsurer, it is recurrent the inclusion of reinsurers as defendants in lawsuits, especially in cases involving the purchase of facultative civil liability insurance. As a result of legislative, jurisprudential, bibliographical and documentary research, this study aims to shed light on the relationships and obligations established by reinsurance agreements and reject this unlawful practice at once. This is done through an initial dive into the insurance relationship and the facultative civil liability insurance and through the review of the particularities of reinsurance and the features that differ it from insurance, to, ultimately, reinforce the initial statement that served as a premise for this work.

Chinese History and the National Humiliation Narrative

This note describes how the Chinese Communist Party (CCP), founded in 1949, has attempted to create and maintain an official narrative of the country and regime that tilts toward the favorable and minimizes any negative. A key component of the historical narrative has been China's so-called Century of Humiliation, in which China suffered exploitation at the hands of various other nations. Mistreatment by foreigners resulted in China's being disadvantaged in unequal treaties, being impoverished by outrageous indemnity payments, and suffering territorial losses (e.g., Hong Kong and Macau) and violations of its sovereignty (e.g., foreign concessions). In announcing the founding of the PRC in 1949, CCP Chairman Mao Zedong said, Ours will no longer be a nation subject to insult and humiliation. We have stood up. Reference to the Century of Humiliation and China's refusal to be controlled any longer was meant to inspire and motivate national pride in the Chinese people. In recent years, the influence of the national humiliation narrative has become increasingly apparent in China's international actions. CCP has aggressively responded to perceived offenses by foreign entities, be they governments or companies, with public criticism and mobilization of Chinese netizens. This note was written to accompany The NBA, China, and Social Media: What Are the Rules of the Game? (UVA-E-0459), which outlines the Chinese reaction to 2019 social media posts sympathetic to protestors in Hong Kong. It gives background on the national humiliation narrative and its ongoing influence on China's relationship with its own people and with other nations. Excerpt UVA-E-0461 Jan. 25, 2021 Chinese History and the National Humiliation Narrative When considering the Chinese government's swift and unambiguous reaction to the October 2019 National Basketball Association (NBA) controversy, it is important to take into account the historical, social, and political drivers that have led to similar actions on the part of the Chinese government in the past. Over the past decade, the Chinese government has refined a strongly nationalistic historical narrative that emphasizes past injustices that have been inflicted by foreign powers on China. It has used this interpretation to justify severe responses to foreign actions that it perceives as blatant violations of its sovereignty or insults to the Chinese people. A Traditional Chinese View of History Chinese people take a great deal of ethnic pride in what the nation has accomplished over the span of its numerous dynasties that is, over its 5,000 years of history. Traditional histories include events prior to 3,000BCE, but it is important to realize that most of what is contained in such histories is accounts of mythical beings and legendary rulers. Chinese historical records gradually became more substantial during the first millennium BCE, comprising incomplete annals and associated commentaries; however, it is not until the second century BCE that Sima Qian compiled the first comprehensive history of China which is to a large extent based on the existing traditional histories. While the historical record might be incomplete, domestically there is a commonly accepted understanding of the events that constitute China's history; a view that is perpetuated in public education. . . .

Determinants of brain tumor malpractice litigation outcome and indemnity payments: a 29-year nationwide analysis.

Medical malpractice litigation is a significant challenge in neurosurgery, with more than 25% of a neurosurgeon's career on average spent with an open malpractice claim. While earlier research has elucidated characteristics of litigation related to brain tumor treatment, factors impacting outcome and indemnity payment amount are incompletely understood. The authors identified all medical malpractice cases related to brain tumors from 1988 to 2017 in VerdictSearch, a database of 200,000 cases from all 50 states. The outcome for each case was dichotomized from the perspective of the defendant physician as favorable (defendant victory) or unfavorable (plaintiff victory or settlement). Indemnity payments were recorded for cases that resulted in settlement or plaintiff victory. Univariate regression was used to assess the association between case characteristics and case outcome as well as indemnity payment amount. Subsequently, significant variables were used to generate multivariate models for each outcome. Statistical significance was maintained at p < 0.05. A total of 113 cases were analyzed, resulting most commonly in defendant (physician) victory (46.9%), followed by settlement and plaintiff victory (both 26.5%). The most common specialty of the primary defendant was neurosurgery (35.4%), and the most common allegation was improper diagnosis (59.3%). Indemnity payments totaled $191,621,392, with neurosurgical defendants accounting for $109,000,314 (56.9%). The average payments for cases with a plaintiff victory ($3,333,654) and for settlements ($3,051,832) did not significantly differ (p = 0.941). The highest rates of unfavorable outcomes were observed among radiologists (63.6%) and neurosurgeons (57.5%) (p = 0.042). On multivariate regression, severe disability was associated with a lower odds of favorable case outcome (OR 0.21, p = 0.023), while older plaintiff age (> 65 years) predicted higher odds of favorable outcome (OR 5.75, p = 0.047). For 60 cases resulting in indemnity payment, higher payments were associated on univariate analysis with neurosurgeon defendants (β-coefficient = 2.33, p = 0.017), whether the plaintiff underwent surgery (β-coefficient = 2.11, p = 0.012), and the plaintiff experiencing severe disability (β-coefficient = 4.30, p = 0.005). Following multivariate regression, only medical outcome was predictive of increased indemnity payments, including moderate disability (β-coefficient = 4.98, p = 0.007), severe disability (β-coefficient = 6.96, p = 0.001), and death (β-coefficient = 3.23, p = 0.027). Neurosurgeons were the most common defendants for brain tumor malpractice litigation, averaging more than $3 million per claim paid. Older plaintiff age was associated with case outcome in favor of the physician. Additionally, medical outcome was predictive of both case outcome and indemnity payment amount.

Malpractice Litigation in Glaucoma

To analyze and report the causes and outcomes of malpractice litigation for patients with a diagnosis of glaucoma. Retrospective case series. Malpractice litigation cases. The WestLaw database was reviewed for all malpractice litigation with ophthalmologist defendants in the United States between 1930 and 2014. All litigation involving glaucoma was included in this analysis and was compared with litigation in ophthalmology as a whole. The primary outcomes were the number of cases, jury award amounts, whether the case resolved in favor of the defendant, and the type of glaucomatous disease or procedure with the highest amount of litigation. Sixty-nine glaucoma malpractice cases were included. Overall, 62.3% of cases were resolved in favor of defendants. Twenty-nine cases were resolved via jury trial, 8 of which were associated with plaintiff verdicts with a mean adjusted jury award of $994 260. Ten cases resulted in settlements with mean adjusted indemnity of $1 210 414. Commonly litigated allegations included mismanagement of glaucoma (20.3%), failure to diagnose glaucoma (17.4%), failure to diagnose or mismanagement of angle-closure glaucoma (18.5%), adverse drug effects (14.5%), and trabeculectomy complications (8.7%). Overall, the median plaintiff award for all of glaucoma litigation was $977 476; the median award across all ophthalmic subspecialties was $568 302 (P= 0.25). For jury verdicts alone, the median award in glaucoma was $977 474, compared with $604 352 for all ophthalmology (P= 0.05). For settlements alone, the median indemnity payment in glaucoma was $955 988, compared with $827 051 for all ophthalmology (P= 0.24). Overall, the rate of plaintiff verdicts was similar in glaucoma and in ophthalmology as a whole; however, the magnitude of plaintiff awards was higher in glaucoma than in ophthalmology overall. Common scenarios leading to litigation included failure to diagnose or mismanagement of glaucomatous disease, as well as adverse drug effects and surgical complications. Many cases could have been avoided with careful examinations, thorough documentation in the patients' charts, and detailed conversations with patients.

Development of an irradiance-based weather derivative to hedge cloud risk for solar energy systems

For large energy consumers transitioning to high shares of solar energy, irradiance variability causes volatility in power generation and energy expenditures. Volatility in an end user’s cash flow is harmful to their financial health, especially in abnormally cloudy years. This paper explores the utility of an irradiance-based weather derivative in mitigating cloud weather risk and measures the effectiveness of the developed derivative by applying it to a case study of two Chilean copper mines. Weather derivatives are financial instruments tied to an underlying weather variable that act as an insurance for the contract holder, executing indemnity payments based on an index value. This research develops a contract with a combined index based on monthly sums of irradiance and cloudy day sequencing to mitigate a solar mine’s weather risk. The design and evaluation of contracts are based on LEELO, a linear optimization model outputting optimal sizes of solar photovoltaic, battery storage, and power-to-gas systems, as well as the operation of these systems for a given mine’s load, irradiance and technology costs. Results indicate contracts are effective in cloudier climates with increasing utility for mines installing solar energy systems until the year 2030. After 2030 batteries begin to become a more cost-effective risk-hedging mechanism as they become more affordable.

Characteristics of medical malpractice claims related to cancer in Florida.

202 Background: Florida is among the states that have highest number of cases and total medical malpractice payments. The aim of the study is to examine the characteristics of cancer-related malpractice cases in Florida. Methods: Cancer-related malpractice claims with payment occurred during Jan. 2005 to Dec. 2015 were identified from the Florida Office of Insurance Regulation (FLOIR) database. The characteristics of malpractice cases examined in the study includes cause of allegation, severity of injury, specialty of healthcare provider, length of delay in diagnosis, settlement stage, and indemnity paid. Results: A total of 811 claims were identified. The most common general cause was delay in diagnosis (49.8% of total claims), followed by failure to interpret test result (9.3%) and failure to perform procedure (9.2%). Among the claims of delay in diagnosis, 22.7% were breast cancer, followed by lung cancer (11.1%), and head and neck cancer (10.9%). About 30% claims reported death caused by malpractice. Radiologist (26.1%) was the most common specialty among all specialties, followed by general practice (12.2%) and internal medicine (11.6%). Radiologists were also more likely to have recurrent malpractice claims. The median payout was $250,000 (mean $277,493). The period from case report to settlement was 1.64 years on average. Conclusions: Delay in diagnosis was the most common cause of cancer-related malpractice suits. Our results aligned with previous reports that radiologists were more likely to be involved in the malpractice claims. This study highlights possible pathways to reduce malpractice litigation, as well as improving quality of care in cancer treatment.

Demand for Crop Insurance in Developing Countries: New Evidence from India.

Determining farmers’ real demand for crop insurance is difficult, especially in developing countries, where there is a lack of formal financial sector integration and a high reliance on informal risk mitigation options. We provide some new estimates of farmers’ willingness‐to‐pay for insurance in the context of a large‐scale subsidised programme in India. We conducted a discrete choice experiment with agricultural households across four states in India, enabling us to estimate preferences for specific insurance policy attributes such as coverage period, method of loss assessment, timing of indemnity payments and the cost of insurance. Our results suggest that farmers do value crop insurance under certain conditions and some are willing to pay a premium for such coverage in excess of the subsidised rates they are currently required to pay under this programme. In particular, farmers value the assurances that they will receive timely payouts when they incur losses, and may not have a strong preference for the method with which losses are assessed. On the other hand, farmers are quite sensitive to coverage periods. Our baseline assessment shows that when optimised to farmer requirements, there can be a sizeable demand for crop insurance by developing country farmers.

Satellite big data analytics for ethical decision making in farmer’s insurance claim settlement: minimization of type-I and type-II errors

Farmers submit claims to insurance providers when affected by sowing/planting risk, standing crop risk, post-harvest risk, and localized calamities risk. Decision making for settlement of claims submitted by farmers has been observed to comprise of type-I and type-II errors. The existence of these errors reduces confidence on agri-insurance providers and government in general as it fails to serve the needy farmers (type-I error) and sometimes serve the ineligible farmers (type-II error). The gaps in currently used underlying data, methods and timelines including anomalies in locational data used in crop sampling, inclusion of invalid data points in computation, estimation of crop yield, and determination of the total sown area create barriers in executing the indemnity payments for small and marginal farmers in India. In this paper, we present a satellite big data analytics based case study in a region in India and explain how the anomalies in the legacy processes were addressed to minimize type-I and type-II errors and thereby make ethical decisions while approving farmer claims. Our study demonstrates what big data analytics can offer to increase the ethicality of the decisions and the confidence at which the decision is made, especially when the beneficiaries of the decision are poor and powerless.

Factors and impact of physicians' diagnostic errors in malpractice claims in Japan.

Diagnostic errors are prevalent and associated with increased economic burden; however, little is known about their characteristics at the national level in Japan. This study aimed to investigate clinical outcomes and indemnity payment in cases of diagnostic errors using Japan's largest database of national claims. We analyzed characteristics of diagnostic error cases closed between 1961 and 2017, accessed through the national Japanese malpractice claims database. We compared diagnostic error-related claims (DERC) with non-diagnostic error-related claims (non-DERC) in terms of indemnity, clinical outcomes, and factors underlying physicians' diagnostic errors. All 1,802 malpractice claims were included in the analysis. The median patient age was 33 years (interquartile range = 10-54), and 54.2% were men. Deaths were the most common outcome of claims (939/1747; 53.8%). In total, 709 (39.3%, 95% CI: 37.0%-41.6%) DERC cases were observed. The adjusted total billing amount, acceptance rate, adjusted median claims payments, and proportion of deaths were significantly higher in DERC than non-DERC cases. Departments of internal medicine and surgery were 1.42 and 1.55 times more likely, respectively, to have DERC cases than others. Claims involving the emergency room (adjusted odds ratio [OR] = 5.88) and outpatient office (adjusted OR = 2.87) were more likely to be DERC than other cases. The initial diagnoses most likely to lead to diagnostic error were upper respiratory tract infection, non-bleeding digestive tract disease, and "no abnormality." Cases of diagnostic errors produced severe patient outcomes and were associated with high indemnity. These cases were frequently noted in general exam and emergency rooms as well as internal medicine and surgery departments and were initially considered to be common, mild diseases.