Settlement Of Insurance Claims Research Articles

ROLES OF LIFE INSURANCE CLAIM SETTLEMENT ON INSURANCE PENETRATION IN NIGERIA

The impact of life insurance claim settlement on the insurance penetration rate in Nigeria was investigated in this study. The study examined the relationship between the insurance penetration rate and the trend of life insurance claims in Nigeria from 2000 to 2023, as well as the impact of paid life insurance claims on the insurance penetration rate in Nigeria over the same period. The study's data, which was gathered between 2000 and 2023, was examined using charts and the Autoregressive Distributed Lag (ARDL) model co-integration technique. The findings showed that, although the insurance penetration rate fluctuated, both the amount of life insurance claims paid and the insurance penetration rate in Nigeria showed an upward trend from 2000 to 2023. Additionally, the study confirmed that life insurance claims significantly influenced Nigeria’s insurance penetration rate, though negatively over the long term. Hence, this study conclude that life insurance claim settlement plays significant role on insurance penetration in Nigeria. By identifying the factors that influence public trust in life insurance and highlighting the link between claim efficiency and policy uptake, this study makes unique contributions to the body of research on insurance penetration. These findings are particularly valuable for policymakers, as they illustrate the importance of balancing consumer needs with the operational sustainability of life insurance firms. Therefore, this study recommended among others that financial authorities should design a framework of life insurance claim that put into consideration the interest of the people and life insurance business in terms of time and amount, in ways that promote penetration rate in the insurance companies.

Enhancing model performance in detecting lodging areas in wheat fields using UAV RGB Imagery: Considering spatial and temporal variations

Fast and accurate assessment of wheat lodging holds significant importance for disaster prevention and agricultural insurance claim settlement. However, lodging detection is often influenced by the spatial and temporal heterogeneity of fields, leading to inconsistent lodging features in images captured at different times and locations. This inconsistency poses challenges for evaluating model performance and obtaining consistent results. In this study, we proposed a comprehensive lodging area detection model performance evaluation method for multi-year and multi-phenological periods. Three evaluation indicators—accuracy, potential, and stability—were introduced to assess model performance from different perspectives. Additionally, a weighted method is employed to combine the results of multiple experiments. To evaluate the performance of lodging area segmentation in wheat fields, we selected three feature adaptive models (CBAM-unet, SE-unet, and Swin-transformer) along with the Unet model.The experimental results are as follows: (1) Swin-transformer achieved the highest weighted average accuracy (Acccp) of 83.53% among the four models evaluated. (2) Swin-transformer exhibited the highest upper limit of segmentation accuracy, reaching 97.98%. However, its average accuracy in the prediction experiment was 85% of the upper limit, suggesting potential for optimization. (3) CBAM-unet demonstrated the lowest overall weighted segmentation accuracy variance (35.92) compared to the other three models, indicating higher stability. Based on the experimental results it can be seen that our proposed method and model can address the challenge of evaluating lodging area detection models under spatial and temporal heterogeneity.

Integrated secure distance bounding and hardware-based security: A case study for the insurance claim verification of farmers during COVID-19.

Given the rapidly evolving developments in Fintech, Insurtech, Open Banking, and Mobile Money business models in recent years, the capability for ensuring strong authentication remains the most pressing need for the protection of security and privacy of data in this sector as in many other areas. The security-integrity of insurance and financial transactions and workflows is vitally dependent on access control mechanisms to deliver strong multi-factor authentication (MFA) with operationally acceptable latency and throughput to support real-time response, particularly as demanded by the increasing online and mobile financial service models. The Critical-Chains Project was motivated by the above objectives as underpinned by the overarching commitment to accountability engineering as required by the operational logic. This must be crucially supported by real-time hardware-enabled services comprising authentication (including Distance Bounding and Prover's Proximal Location Presence Verification), hardware security and cryptography (AUTH-as-a-Service, Hardware-Security-as-a-Service, Cryptography-as-a-Service) as delivered through the Critical-Chains main framework. This paper reports on the development and evaluation of the innovative Hardware-enabled authentication and security capabilities of the Critical-Chains framework which is successfully validated in the context of financial services, specifically the insurance claim settlement application domain, and can also be deployed in any other domains where trusted authentication and specific location-time bound prover's presence verification is required.

Тенденції розвитку та перспективи активізації збуту суб’єктів страхового ринку України

Research shows that during 2018–2021, positive changes were observed in the market of insurance products in Ukraine, although the number of insurance companies has constantly decreased in recent years. The conducted analysis enabled a trend toward the growth of net insurance premiums and net insurance payments in Ukraine. However, in the pandemic, the operating conditions of domestic insurers have changed significantly, as a result of which they have improved existing insurance programs, introduced new insurance products to the market, and organized online sales of their products — the importance of the latter increases in the conditions of martial law. Taking into account that the use of mobile devices is multiplying in Ukraine, developing and using a suitable mobile application is an urgent direction for activating activities in the field of sales for insurance companies. It is most commonly used for property insurance products with a high frequency of minor claims. It was determined that today mobile applications are used for the sale of insurance products by such companies as “UNIQA Insurance Group” PJSC, “Ingo Ukraine” PJSC, “Knyazha Vienna Insurance Group” PJSC, “Greenwood Life Insurance” LLC, “Ukrainian joint-stock insurance company “Aska”” PJSC and PrJSC “Insurance company “ARX””. The article analyzes their primary functions. Existing applications of insurance companies on the Ukrainian market help their clients to obtain operational information about current insurance contracts, calculate the cost of a new insurance contract, make an online payment of the insurance premium, make an appointment with a doctor, and upload personal documents for insurance payment. The recommended main functions of the insurer’s mobile application are information search, purchase of an insurance product, maintenance of insurance policies and their renewal, insurance claim settlement, and maintenance of damages.

Use of social health insurance for hospital care by internal migrants in China-Evidence from the 2018 China migrants dynamic survey.

China's welfare system including social health insurance has been closely linked to its unique household registration system, despite high population mobility over the past few decades. This study aimed to determine the pattern of health insurance usage from internal migrants in mainland China for hospital care. Data were extracted from the 2018 China Migrants Dynamic Survey. The respondents who enrolled in a social health insurance program and reported illness or injury over the past year were eligible for this study (n = 15,302). Two groups of outcome indicators were calculated assessing the use (incidence and settlement location) of insurance funds for hospital care and the burden of hospital expenditure (total hospital expenditure, out-of-pocket payments, and share of insurance reimbursement), respectively. Logit regression and Heckman's sample selection models were established to determine the predictors of insurance fund usage and the burden of hospital expenditure, respectively. Most respondents enrolled in a social health insurance program outside of their residential location (70.72%). About 28.90% were admitted to a hospital over the past year. Of those hospitalized, 72.98% were admitted to a hospital at their migration destination, and 69.96% obtained reimbursement from health insurance, covering on average 47% of total hospital expenditure. Those who had a local insurance fund aligned with residency (AOR = 2.642, 95% CI = 2.108-3.310, p < 0.001) and enrolled in employment-based insurance (AOR = 1.761, 95% CI = 1.348-2.301, p < 0.001) were more likely to use insurance funds for hospital care, and paid less out-of-pocket (β = -0.183 for local funds, p = 0.017; β = -0.171 for employment-based insurance, p = 0.005) than others. A higher share of insurance reimbursement as a proportion of hospital expenditure was found in the employment-based insurance enrollees (β = 0.147, p < 0.001). Insurance claim settlement at the residential location was associated with lower total hospital expenditure (β = -0.126, p = 0.012) and out-of-pocket payments (β = -0.262, p < 0.001), and higher share of insurance reimbursement (β = 0.066, p < 0.001) for hospital expenditure. Low levels of health insurance benefits for hospital care are evident for internal migrants in mainland China, which are associated with the funding arrangements linked to household registration and inequality across different funds.

Research and design of medical data sharing and insurance automatic claim system based on blockchain technology

In recent years, blockchain technology has been applied to various business scenarios with its characteristics of decentralization, openness, self-consistency and information immutable. In the medical insurance industry, disputes often occur between insurance institutions and policyholders due to inaccurate personal information and different confirmation of contract terms. With the digitalization of medical information and the rapid development of science and technology, insurance claim settlement schemes based on blockchain and homomorphic encryption can enable the hospital, the insurance institution and policyholders to establish a trusted mechanism, which can ensure the authenticity and security of the policyholder's personal information and the validity of the contract. The scheme combines Paillier homomorphic encryption and blockchain smart contract while designing access control list to control patients' data. In the scenario of insurance claim settlement, it can not only protect the privacy of patients' medical data, but also ensure the correct settlement result of insurance claim.

Detection of COVID-19 Using Deep Learning Techniques and Cost Effectiveness Evaluation: A Survey.

Graphical-design-based symptomatic techniques in pandemics perform a quintessential purpose in screening hit causes that comparatively render better outcomes amongst the principal radioscopy mechanisms in recognizing and diagnosing COVID-19 cases. The deep learning paradigm has been applied vastly to investigate radiographic images such as Chest X-Rays (CXR) and CT scan images. These radiographic images are rich in information such as patterns and clusters like structures, which are evident in conformance and detection of COVID-19 like pandemics. This paper aims to comprehensively study and analyze detection methodology based on Deep learning techniques for COVID-19 diagnosis. Deep learning technology is a good, practical, and affordable modality that can be deemed a reliable technique for adequately diagnosing the COVID-19 virus. Furthermore, the research determines the potential to enhance image character through artificial intelligence and distinguishes the most inexpensive and most trustworthy imaging method to anticipate dreadful viruses. This paper further discusses the cost-effectiveness of the surveyed methods for detecting COVID-19, in contrast with the other methods. Several finance-related aspects of COVID-19 detection effectiveness of different methods used for COVID-19 detection have been discussed. Overall, this study presents an overview of COVID-19 detection using deep learning methods and their cost-effectiveness and financial implications from the perspective of insurance claim settlement.

Analysis of the Role of Agents in Helping Settlement of Insurance Claims at PT. Prudential Life Assurance Binjai Branch

An Insurance agent is a person chosen by an insurance company who plays a role in finding customers, talk about policy terms, and help policyholders. The purpose of this study is to determine the role of agents insurance in PT. Prudential Life Assurance Cabang Binjai. The method used in this study is a qualitative method with data collection techniques, interview, observation on PT. Prudential Life Assurance Cabang Binjai. The results of this study indicate that agents help participants in resolving claims by explaining the procedure for claims, help complete the documents needed when you want to submit a claim, and waiting for the results of verification and validation until the claim comes out.

Analysis and Mechanism of Settlement of Insurance Claims of PT Prudential Syariah Prestasi Binjai

From the data, Indonesia is a country that is generically controlled by a Muslim population. And Prudential Insurance is an opportunity to meet the needs of Muslims using premiums according to sharia. Therefore, prudential companies provide various insurance premiums such as life insurance and asset management. The Prudential Syariah Prestasi Binjai Insurance company not only offers the products that have been described but also helps provide protection for the insured along with investing in a very long period of time and has a high risk. The purpose of this study is to increase knowledge on the procedure for the claim settlement mechanism at PT Prudential Syariah Prestasi Binjai. This study uses qualitative data collection techniques using literature studies and interviews based on several company sources at PT Prudential Syariah Prestasi Binjai. And the output based on this research tells that the benefits of PT Prudential Syariah put 99 (ninety nine) years of protection combined using investment. Meanwhile, the prudential insurance claim mechanism will go through a process that has been determined in the policy and the claim section has been prepared, where the insured is required to fill out all the specified claim forms.

The Disproportionate Rights and Duties of the Insurer and the Insured in Fiji

Much judicial and academic ink has been spilled over pre – and post-contractual rights and duties of insurer and insured, and it continues to flow, even now. Due to a lack of specialized knowledge and skills, policyholders are always in a weak bargaining position when proposing insurance (Qing Luo, ‘The Legal Protection of the Insured: a comparative study of Chinese, UK, and Australian Insurance Law’, Doctoral Thesis, City University of Hong Kong, CityU Scholars, 14 July 2006, 1, (accessed 25 August 2021, 2:20 pm FST) https://scholars.cityu.edu.hk/en/theses/the-legal-protec tion-of-the-insured(8b392fcd-0a72-4591-81ce-9fced f2a7feb).html). The insured is further disadvantaged because the insurer will only be prepared to enter into a contract of insurance upon its terms; and not tailor-make policies to suit the needs of the insured. Hence, the insured has no choice but to accept what is being offered. The insured is further embraced by the fact that insurance regulations generally protect the insurance industry and the insurer and impose heavy responsibilities on the policyholder. This article is a critical examination of the rights and duties of insurers and insured, vis-à-vis good faith, contracts of insurance, and settlement of insurance claims. The biggest challenge facing the insurance industry is the lack of consumer protection. The regulators of the industry should ensure that insurance regulations perpetrate fairness. Consumer, Inequality, Insurance, Regulation, Scheme

Ex gratia as an alternative for settlement of insurance claims outside the court

Ex gratia as an alternative for settlement of insurance claims outside the court

Optimal Claim Settlement Strategies under Constraint of Cap on Claim Loss

In this paper, we examine the question of how to devise an optimal insurance claim settlement scheme under the constraint of a cap on the amount of the claim payment. We establish objective functions to maximize the net benefit due to exaggerated claims while at the same time maximizing the total expected wealth of the insured. Then, we establish a dual objective function to minimize the total expected loss, including the perspective of the insurer. Finally, we illustrate applications of our work and provide numerical analysis of it along with an example.

Sistem Prosedur Pialang Asuransi Syariah Berbasis Digital di Indonesia

Identifying the risk of the insured party is the main task of the insurance broker who acts as the insured's representative who has the right to become an intermediary between the insured party and the insurance company. The purpose of this study is to analyze the governance of sharia insurance brokers in identifying the risks that exist to the insured. Qualitative method is a method used to provide a comprehensive picture. The results of this study state that sharia insurance brokers have implemented good corporate governance and have carried out their duties and obligations as representatives implementing the values of governance, risk management and Sharia Compliance. Sharia Insurance Broker professionalism will be felt by the insured if the insurance claim settlement can be done in accordance with the agreement.

Інноватизація страхового бізнесу в умовах розвитку цифрової економіки

The article defines the current trends of innovatizing the insurance business in the digital economy. The stages of development of modern insurance technologies (InsurTech), which are innovative products in the insurance sector of financial infrastructure, are provided. The instruments of digitalization of business processes for sale of insurance products, settlement of insurance claims, bookkeeping and tax accounting, risk underwriting, document flow are presented. The dynamics of global investments in technological innovations of insurance companies on a global scale have been specified. The volume of global investments and concluded agreements in InsurTech sector by insurance sectors is analyzed and it is proved that 2020 is a period of awareness of the importance and role of digital technologies implementation in the insurance industry, recognition of the value of the digitalization vector of insurance business and global investments in InsurTech development with the highest recorded values. It is identified that the leader in attracting investments in the processes of innovatizing is the property insurance industry (P&amp;C), which has compiled 53% of the total financing and 63% of the concluded agreements. The individual health insurance industry (L&amp;H) ranks second in terms of indicators, maintaining overall investment attractiveness, high amounts of financing and the introduction of insurance technologies. The economic, technological, organizational management, and legal factors that stimulate or inhibit the innovative activity of insurance companies in Ukraine are systematized. Based on the generalization of problems and weaknesses that are relevant and impede the desired pace of innovatizing the insurance business in the digital economy, a SWOT analysis matrix of the feasibility of InsurTech implementation is proposed. It is determined that the introduction of innovations and the development of insurance on the basis of digitalization are currently a catalyst for the strategic development of the insurance business, improving the quality of insurance products and successful activities in an increasingly customer-oriented financial sector.

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.

Growth and Performance of General Insurance Companies in India – Premium Rate and Claim Settlement Perspective

Life is full of risks and uncertainties. In fact risk is everywhere. Even when you ride a bike to the nearest shop in the street, there is a risk. One must protect himself or herself from this risk. The solution is insurance. Broadly it is two types i.e. life insurance and non-life insurance (general insurance). In this paper we discuss about only general insurance. General insurance helps in securing ourselves and things we value like homes, cars, bikes or any other property from any kind of mishap whether it is big or small. General insurance protect insured property from fire accidents, floods, earthquakes, storms, thefts, travel accidents/mishaps or any other kind of calamity, even from the cost incurred against us from legal action depending upon the type of policy selected by the insurer. From the post liberalization scenario, general insurance in India is growing rapidly. The reasons behind its spectacular growth are allowing private companies to enter into Indian market, low insurance premium, TPAs (Third Party Administrators), Fast and immediate settlement of insurance claims, Innovative general insurance policies, discounts in insurance products, increasing awareness among people, more distribution channels etc. The other side of the coin is, public sector insurance companies are facing cut throat completion from private insurance companies as they offer wide variety of policies at a low premium. Due to this few general insurance companies are closed and few are forced to come out with same polices and services. Ultimately the performance of public sector general insurance companies also enhanced with the competitive moves by private players. On the other hand, customers are also exposed to new trends in the insurance market. Insurance Regulatory and Development Authority (IRDA) is the apex body in India to monitor the activities of insurance companies. It has laid down standard terms and conditions to general insurance companies and also given scope for personal accidental life insurance policies. IRDA has taken all the measures to improve the performance of general insurance companies as it is one of the fast growing areas in Indian economy.

The Dynamics of General Insurance Sector in India Growth and Performance Perspective

Life is full of risks and uncertainties. In fact risk is everywhere. Even when you ride a bike to the nearest shop in the street, there is a risk. One must protect himself or herself from this risk. The solution is insurance. Broadly it is two types i.e. life insurance and non-life insurance (general insurance). In this paper we discuss about only general insurance. General insurance helps in securing ourselves and things we value like homes, cars, bikes or any other property from any kind of mishap whether it is big or small. General insurance protect insured property from fire accidents, floods, earthquakes, storms, thefts, travel accidents/mishaps or any other kind of calamity, even from the cost incurred against us from legal action depending upon the type of policy selected by the insurer. From the post liberalization scenario, general insurance in India is growing rapidly. The reasons behind its spectacular growth are allowing private companies to enter into Indian market, low insurance premium, TPAs (Third Party Administrators), Fast and immediate settlement of insurance claims, Innovative general insurance policies, discounts in insurance products, increasing awareness among people, more distribution channels etc. The other side of the coin is, public sector insurance companies are facing cut throat completion from private insurance companies as they offer wide variety of policies at a low premium. Due to this few general insurance companies are closed and few are forced to come out with same polices and services. Ultimately the performance of public sector general insurance companies also enhanced with the competitive moves by private players. On the other hand, customers are also exposed to new trends in the insurance market. Insurance Regulatory and Development Authority (IRDA) is the apex body in India to monitor the activities of insurance companies. It has laid down standard terms and conditions to general insurance companies and also given scope for personal accidental life insurance policies. IRDA has taken all the measures to improve the performance of general insurance companies as it is one of the fast growing areas in Indian economy. General insurance companies under public sector are facing lot of challenges from private players and to with stand in the completion, even they have improved a lot in their quality of service in multiple facets like decreasing the premium, quick settlement in claims etc. In a nut shell, general insurance business is contributing significantly to Gross Domestic Product (GDP).

Operational Efficiency of Selected General Insurance Companies in India

Life is full of risks and uncertainties. In fact risk is everywhere. Even when you ride a bike to the nearest shop in the street, there is a risk. One must protect himself or herself from this risk. The solution is insurance. Broadly it is two types i.e. life insurance and non-life insurance (general insurance). In this paper we discuss about only general insurance. General insurance helps in securing ourselves and things we value like homes, cars, bikes or any other property from any kind of mishap whether it is big or small. General insurance protect insured property from fire accidents, floods, earthquakes, storms, thefts, travel accidents/mishaps or any other kind of calamity, even from the cost incurred against us from legal action depending upon the type of policy selected by the insurer. From the post liberalization scenario, general insurance in India is growing rapidly. The reasons behind its spectacular growth are allowing private companies to enter into Indian market, low insurance premium, TPAs (Third Party Administrators), Fast and immediate settlement of insurance claims, Innovative general insurance policies, discounts in insurance products, increasing awareness among people, more distribution channels etc. The other side of the coin is, public sector insurance companies are facing cut throat completion from private insurance companies as they offer wide variety of policies at a low premium. Due to this few general insurance companies are closed and few are forced to come out with same polices and services. Ultimately the performance of public sector general insurance companies also enhanced with the competitive moves by private players. On the other hand, customers are also exposed to new trends in the insurance market. Insurance Regulatory and Development Authority (IRDA) is the apex body in India to monitor the activities of insurance companies. It has laid down standard terms and conditions to general insurance companies and also given scope for personal accidental life insurance policies. IRDA has taken all the measures to improve the performance of general insurance companies as it is one of the fast growing areas in Indian economy.

Likelihood Construction of Hawkes Process in Insurance Claim Settlement Process

The construction of the likelihood equation in the point process models plays a very important role, especially to obtain a good estimator of the parameters of a model. This paper aims to construction of the likelihood of Hawkes process in solving the problem of the claim filing process in the nonlife insurance company. In the construction process, the excitation function with exponential decay is used. The result shows that the total likelihood function of the process depend on probability no claim at time t, the number of policyholder at time t, and the excitation function.

Influence of Material Composition of Structures on the Accuracy of Flood Loss Evaluation

This paper focuses on the evaluation of flood losses in buildings using genetic algorithms. Specifically, the paper aims to evaluate the influence of material structure and, consequently, different prices on the accuracy of evaluation, taking into account the size of rooms, i.e. the length and width, shape, width-to-length ratio, and flooding depth. The calculation considered three variants of the floor covering solution: laminated composite covering, PVC covering and carpet covering. The results show that the genetic algorithm methodology under development can be used for various materials and compositions, given adequate inclusion of an itemised budget in the data set. The achieved accuracy of evaluation with deviations of <-1 %; 1.72 %> meets the needs of e.g. settlement of insurance claims.