Insurance Companies Research Articles

Revisiting Therapeutic Facet Joint Injections for Chronic Spinal Pain: A Case Series

Facet joint injections with steroids are a common therapeutic intervention for chronic pain management, particularly in patients with lumbar spondylosis and facet arthropathy. However, many insurance companies do not provide coverage for this helpful intervention. This case series presents four patients who experienced significant and sustained pain relief following therapeutic facet joint injections. The aim of this case series is to highlight the efficacy of facet joint injections with steroids in managing chronic spinal pain and to discuss the potential benefits of this treatment modality in patients who may not be interested in pursuing lumbar radiofrequency neurotomy.

Analisis Peran Undewriter Dalam Menyeleksi Risiko pada Produk Asuransi Kesehatan:

This study aims at the role of the underwriter in selecting the risk of health insurance products, knowing the obstacles encountered by the underwriter in selecting the risk and the solutions applied to overcome these obstacles, and knowing the underwriting process of group health insurance at AJB Bumiputera Medan. The type of research used is descriptive research, with a qualitative approach. The conclusions of this study briefly are: (1) Underwriters have an important role in insurance companies because underwriters determine whether the insurance coverage can be accommodated by the company or not. (2) Obstacles encountered by underwriters in selecting risks are the availability of incomplete participant data, previous experience data of the insured and prospective insured not providing the desired budget and benefits, while the solution is to contact the agent concerned to obtain additional information needed by the underwriter, apply analysis to groups of prospective insurance participants as new participants, and provide standard premium rates and benefits. (3) The underwriting process begins when marketing applies for SPPA until the issuance of the policy. Keywords: Underwriting, Underwriter, Group Health Insurance

Towards a Legal Regulation of Insurance Against Natural Disasters in Jordanian Legislation

Objectives: The current study aims at clarifying the legal solutions that can overcome the serious damage caused by natural disasters, within the framework of insurance contracts, and to clarify the mechanisms that enable insurance companies to cover natural disasters' risks. Theoretical Framework: In the first section, the concept of the insurance contract against natural disasters is explained, in the second section, the effects of the insurance contract against natural disasters are addressed while the third section, the confronting the effects of natural disasters' mechanisms are discussed. Methodology: This analytical comparative study addresses insurance against natural disasters in Jordanian legislation by reviewing and comparing the related legal texts in the compared legislations. Results: The study revealed a group of results, the most important among which include that introducing special system for insurance against natural disasters in Jordanian legislation requires that its content be based on the idea of social solidarity and also, the reinsurance process is also one of the means that can contribute to reducing the serious effects resulting from the occurrence of natural disasters. Recommendations: In light of the results revealed, the study concludes with a group of recommendations among which the necessity of formulating a special system for compulsory insurance of real estate properties built on the land of the Hashemite Kingdom of Jordan against the risks of natural disasters, in addition to the necessity of this system adopting a mechanism based on distributing the burden of compensating for damages resulting from the occurrence of these disasters on insurance companies on the one hand and reinsurance companies on the other hand, with the necessity of providing the necessary support from the state in this area.

Clustering based fuzzy classification with a noise cluster in detecting fraud in insurance

Fraud detection is one of the main issues in reducing the unsystematic risks in insurance business as its costs might reach to catastrophic amounts leading to higher loadings on reserves and premiums. Due to its cause of nature in diversity, fraud detection may require a wide range of factors and variables to be considered. To make logical relations between many factors and reveal their differences, estimate odds (or probabilities), and predict the fraud risk, scoring systems become an important aid. In this paper, we introduce a clustering-based fuzzy classification with a noise cluster (CBFCN) to identify the true state of a fraud. The approach proposed in this paper is based on fuzzy k-means clustering having a noise cluster (FKMN) and is a novel method for identifying outliers by achieving robust clustering. We integrate fuzzy theory to boost the prediction ability of machine learning (ML) approaches for a proper determination of the contributing features. The two critical features of the CBFCN method which are the membership values obtained from the FKMN clustering algorithm are implemented to capture the behavior of an existing structure better and detect the noise (extremes) in the dataset. Extensive analyses are made on two real datasets exposing different characteristics in their variables to demonstrate how CBFCN performs in detecting the fraud compared to the conventional approaches. Additionally, employing fuzzy approach to improve the ML performance is elaborated through the inclusion of noise clusters. The findings indicate that the suggested CBFCN models produce promising classification results in fraud detection in insurance claims occurrences.

Assessing the Pathophysiology, Morbidity, and Mortality of Obstructive Sleep Apnea.

The basic definitions of obstructive sleep apnea (OSA), its epidemiology, it's clinical features and complications, and the morbidity and mortality of OSA are discussed. Included in this treatise is a discussion of the various symptomatic and polysomnographic phenotypes of COPD that may enable better treatment and impact mortality in persons with OSA. The goal of this article is to serve as a reference for life and disability insurance company medical directors and underwriters when underwriting an applicant with probable or diagnosed sleep apnea. It is well-referenced (133 ref.) allowing for more in-depth investigation of any aspect of sleep apnea being queried.

Analisis Implementasi Strategi Pemasaran Asuransi Pendidikan Mitra Iqra Plus Dalam Kajian Asuransi Syariah

Atika Andriani1, Sri Ramadhani, Rahmat Daim Harahap2 1 FEBI UIN Sumatera Utara, Indonesia atikaandriani98@gmail.com1, Sriramadhani@gmail.com2, rdainharahap@uinsu.ac.id3 ABSTRACT Mitra Iqra Plus is one of the products owned by PT. Bumiputera Sharia Life Insurance, KPS Medan, which aims to help fund children's education. The purpose of this study was to determine the implementation of Mitra Iqra Plus' educational insurance marketing strategy in the study of sharia insurance at PT Asuransi Jiwa Syariah Bumiputera, KPS Medan, the application of sharia principles in the implementation of marketing life insurance products at PT Asuransi Jiwa Syariah Bumiputera, KPS Medan, and challenges in implementing sharia. marketing conducted by PT Asuransi Jiwa Syariah Bumiputera, KPS Medan. This type of research uses qualitative research. Data collection techniques in the form of interviews, observations, and documentation. The data analysis technique used is to reduce the data, present the data, then draw conclusions. The results show that PT Asuransi Jiwa Syariah Bumiputera, KPS Medan implements according to sharia marketing principles starting from Wisdom (Strategy), Needs (Needs), Halal (Tayyibat), Welfare (Falah), Mutual Consent. The inhibiting factors in implementing the Mitra Iqra Plus educational insurance marketing strategy are the lack of public knowledge about sharia insurance, lack of public trust in sharia insurance, lack of agents and customers who are difficult to collect for premium payments. The challenge is the lack of technology development, the weak market share of PT. AJS Bumiputera due to lack of support from the government and the community. Keywords: Implementation of Sharia Marketing Strategy, Mitra Iqra Plus, Sharia Insurance.

Product Oversight and Governance’s Actual Trends and Value for Money Provisions Within the IDD Framework

Abstract The article focuses on the renewed discipline of product oversight and governance in insurance law. Specifically, the contribution examines the significance of the value for money principle, which, through acts by the European Insurance and Occupational Pensions Authority (EIOPA), has had a considerable impact on the organization of insurance companies as well as on the policies ultimately distributed. Regarding the structure of the article, the first part addresses the contractual characterization provided by the Court of Justice of the European Union (CJEU) of so-called IBIPs (investment-based insurance products), for which the value for money principle is particularly impactful. The second part of the article focuses on the operation of product oversight and governance and the influence of the value for money principle on it. Finally, the last part of the analysis centers on the relationship between the CJEU’s precedents and their integration into the harmonizing policy conducted by European institutions, which inevitably also affects the field of financial and insurance law.

The Role of Machine Learning in Enhancing Corporate Financial Planning

Aim: To examine the role of machine learning in enhancing corporate financial planning. Problem Statement: In the past, corporate financial planning relied on statistical models and expert judgment which are often constrained by predefined assumptions and historical data. By so doing, they usually struggled to handle the non-linear and dynamic nature of financial markets causing limitations in their responsiveness and predictive power. Significance of Study: There is need to incorporate machine learning in corporate financial planning to provide a transformative technique via the introduction of advanced algorithms which are capable of analyzing diverse and vast datasets to uncover sophisticated relationships and patterns. Methodology: Recent relevant published articles in the area of machine learning in enhancing corporate financial planning were consulted. Relevant articles were sourced from the internet using the Google search engine. The abstract of the consulted published articles were thoroughly examined to study their relevance to the subject matter. Discussion: This review article examines the role of machine learning in enhancing corporate financial planning. It was found that machine learning techniques have crucial roles to play in the context of corporate financial planning via decision-making improvement, risk management, operational efficiency enhancement, fraud detection and enabling personalized experiences. Also, Machine Learning technologies have a wide variety of uses in corporate financial planning which enable banks and insurance companies in delivering tailored experiences that give their customers some preferences. Common identified machine learning approaches in corporate financial planning include predictive analytics, natural language processing, computer vision, reinforcement learning and anomaly detection approaches. Major areas of machine learning application include dynamic pricing and offers; regulatory compliance; personalized customer service; predictive analytics for customer retention; personalized product recommendations and so on. Furthermore, the implementation of Machine Learning (ML) in corporate financial planning and financial services industry provides many chances for enhancing customer experiences, improving efficiency and driving innovation. However, ML poses numerous challenges which should be addressed to attain the complete potential of these technologies. Conclusion: As technology continues to advance, financial institutions will need to route the challenges of bias mitigation, transparency and regulatory compliance while the ML full potential is equally leveraged. Also, machine learning has the potential to transform corporate financial planning via the provision of more adaptive, accurate and real-time insights.

Impact of COVID-19 on the Effectiveness of Financial Management of Insurance Companies in Mainland China

The COVID-19 pandemic starting in 2019 has brought significant disruption and turbulence to the global economy, specifically the financial sector. At the same time, the increased awareness of risk in businesses, governments, and individuals should alleviate this disruption to the insurance industry. However, the general trend of the Chinese insurance industry varies among companies, specifically into three types: companies with healthy financial conditions and positive subsidiary expansion, unhealthy financial conditions and negative subsidiary expansion, and unhealthy financial conditions and positive subsidiary expansion. By studying five listed prominent insurance companies in China using qualitative methods, researchers found a general relation between the financial metrics of an insurance company and the subsidiary expansion number, but this relationship isn’t inclusive. The cause of this variation is the difference in choosing a risky or prudent financial strategy and the adaptation to digital transformation.

Green insurance empowers high-quality development: A Literature Review

Green insurance plays a positive role not only in strengthening environmental risk management, aiding the development of green industries, and facilitating the application of new green technologies, but also in enhancing environmental and ecological protection. It can continuously raise public and societal awareness of green and environmental protection, guide the allocation of social resources, and support the green and low-carbon development of the economy and society. This paper reviews the literature on whether and how green insurance can empower high-quality development. The paper organizes domestic and international practices related to green insurance, summarizes the characteristics of three main international models and other typical developments of green insurance in China. It also focuses on the preliminary formation of the green insurance system in Huzhou City, Zhejiang Province, the combination of government and effective market, and the development status of multiple types of insurance. It summarizes the challenges faced, such as the imperfect professional service system and insufficient innovation, and finally proposes policy recommendations for the further development of green insurance, including the establishment and improvement of institutional systems and industry standards, and the effective enhancement of the marketization of insurance products.

The impact of agricultural insurance on farmers’ mental health: what we can learn from the literature

AbstractThis systematic review aimed to examine evidence in the extant literature on the nexus between agricultural insurance and the mental health of farmers. The key hypothesis was that increasing access to agricultural insurance will enhance the mental and emotional well-being of farmers globally and will consequently preserve the future of agriculture, particularly as climate change exacerbates weather risk. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. We searched several databases, including EBSCOHost Megafile, Scopus, Web of Science, PubMed (Medline) and Google Scholar, based on predetermined criteria in July 2024. We conducted a full-text review of twelve potential articles. None of the articles met the inclusion criteria and reported a clear understanding of the relationship between access to agricultural insurance and the mental health nexus. We concluded that there is no evidence to support the hypothesis that access to agricultural insurance has a positive impact on farmer’s mental health. Our hypothesis is premised on the fact that while agricultural insurance smoothens farmers’ income, this should lead to some forms of mental health advantage, but we do not have any evidence in extant literature. The lack of literature is perhaps due to the complexity of the agricultural insurance product design. We recommend studies that will provide reliably conclusive evidence on this critical issue because agriculture requires risk management tools to help farmers cope with multidimensional risks, including exacerbated weather events due to climate change.

Balancing Innovation and Profitability: Technological Diversification in Iran’s Insurance Industry

Abstract This study explores how technological diversification affects financial performance in Iran’s insurance industry. Using semi-structured interviews with six experts, including CEOs and faculty members, key indicators of technological diversification were identified, such as new underwriting software and digital advertising platforms. A 33-item questionnaire was developed based on these insights and distributed to top managers of Iranian insurance companies, with secondary financial data sourced from the Central Insurance of Iran. The study employes regression analysis and Partial Least Squares Structural Equation Modeling (PLS-SEM) to assess the impact of technological diversification on financial performance, controlling for firm size, debt ratio, and company age. Findings indicate a significant negative relationship between technological diversification and both Return on Equity (ROE) and Return on Assets (ROA), suggesting that the costs of adopting new technologies may outweigh their short-term financial benefits. Additionally, high debt ratios were found to adversely affect ROA, highlighting the financial risks of excessive borrowing.

Consumer Preferences for Health Services Offered by Health Insurance Companies in Germany

Abstract German health insurance companies increasingly strive to position themselves as health partners to their customers to improve customers’ health and contain costs. However, there is uncertainty about customers’ preferences for health services offered by health insurance companies. Therefore, this paper studies consumer preferences for health services that are or could be provided by health insurance companies in Germany. An online survey was conducted using two stated preference techniques to collect and analyze the data (namely, rating and ranking of health services considered by insurance companies). A sample of 880 German health insurance customers between 18 and 65 years old filled out the online questionnaire, of which 860 submitted complete responses. Ordinal logistic regression analysis was used for the rating and ranking. Preliminary examinations, care management, and health programs were the three health services most important to the respondents. The results suggest that people want their health insurance to support them with preventive health services that offer direct therapeutic value and not just informational, economic, access-related, or convenience-related benefits. These preferences for health services are homogeneous for most subgroups of the population, implying that health insurance companies could consider an overall strategy to address these preferences for all clients by focusing on the important health services. Key messages • People value health services provided by health insurers that offer direct therapeutic value over those that offer only informational, economic, access or convenience benefits. • As preferences are homogeneous across the population, insurers could consider an overall strategy by focusing on the important health services.

Cloud Computing in Insurance: Emerging Trends and Transformative Technologies

This article examines the transformative impact of emerging cloud computing trends on the insurance industry. As insurers increasingly adopt cloud-based solutions, several key technologies are poised to revolutionize operations, customer experiences, and business models. The integration of artificial intelligence and machine learning is enhancing underwriting accuracy, claims processing efficiency, and fraud detection capabilities. Edge computing is enabling real-time data analysis and decision-making, while serverless architectures are optimizing resource allocation and reducing costs. Blockchain technology is improving data security, transparency, and trust in transactions. Additionally, hybrid and multi-cloud strategies are providing insurers with greater flexibility and regulatory compliance. This comprehensive analysis explores these trends, their interconnections, and their potential to drive innovation in insurance. The article concludes by discussing the implications of these advancements for insurers, policyholders, and the broader financial services ecosystem, offering insights into future research directions and industry adaptations.

Public-Private Partnerships: A model for injury prevention and safety promotion – Benefitting communities and NGOs

Abstract Injuries are a leading cause of death up to 45years, and 12% of all hospital beds in Norway are dedicated to accident-related treatments. Addressing injuries poses a significant public health challenge, and preventing accidents is crucial for saving money and resources. The Norwegian Act of Public Health mandates that municipalities promote the population’s health and well-being, contribute to favourable environmental conditions, and prevent mental and somatic illnesses and injuries. This is echoed in various laws and regulations, providing a supportive framework for injury prevention and safety promotion. However, translating these laws and regulations into effective policies and preventive activities necessitates collaboration across sectors and levels. To meet these demands, a public-private partnership for safety has been established through five-year cooperation agreements between the Ministry of Health, Finance Norway (Association for financial and insurance industry in Norway), and the Norwegian Safety Forum (NSF). As a non-profit organization, NSF is a national advocate for safety, specializing in home and leisure injury prevention, road safety and Safe Community initiatives in Norway. Program Description The collaboration aims to reduce accidents and injuries. The agreement secures basic financing for NSF and serves as a platform for knowledge sharing and competence building across sectors. It facilitates seminars and meetings to promote learning among different professions, benefiting municipalities and the public. The collaboration leverages the Ministry’s resources, insurance companies’ data and knowledge, and NSF’s expertise to develop injury prevention programs through dialogue with communities and organizations. This model brings together private-public and NGO perspectives. It also provides enhanced possibilities for coordination on both national and community level, enhancing data and knowledge availability and strengthening capacity for safety promotion.

Asymmetric effects of life and non-life insurance on economic growth in Saudi Arabia: A nonlinear analysis

This paper explores the asymmetric effects of life and non-life insurance on economic growth in Saudi Arabia. Quarterly data on insurance penetration rates and GDP growth from 2009 to 2022, obtained from the Global Economy, Saudi Arabian Monetary Authority, and World Bank databases, are utilized. A nonlinear autoregressive distributed lag (NARDL) model is employed to examine the relationships between insurance and growth. The results reveal a significant and asymmetric relationship between life insurance penetration and GDP growth. Specifically, a 1% increase in life insurance penetration is associated with a 0.3% increase in GDP growth in the long run, while a 1% decrease shows no significant effect. For non-life insurance, both increases and decreases demonstrate significant but asymmetric impacts on growth. A 1% increase in non-life insurance penetration corresponds to a 0.2% increase in GDP growth, whereas a 1% decrease is linked to a 0.15% decrease in GDP growth. These findings support the ‘supply-leading’ hypothesis, suggesting that the insurance sector can play a leading role in promoting economic growth. The results provide new quantitative insights into the relationship between insurance and economic growth in Saudi Arabia, offering valuable implications for policymakers. It is suggested that the insurance industry can be leveraged to foster economic growth by promoting life insurance and managing the asymmetric impacts of non-life insurance.

Splenic injury associated with colonoscopy in hospitalized patients: incidence, risk factors, management and outcome

Objectives: The frequency of splenic injuries due to coloscopy is largely unknown. Therefore, the aim of this study was to give an estimate on the risk for hospitalized patients. Methods: Using an administrative data base of a health insurance company with more than 10 million insured subjects, patients undergoing in-patient colonoscopy associated with a splenic injury within 2 weeks were retrieved from the administrative records based upon OPS (comparable to ICPM) and ICD-10 codes. In each case identified (n=141), the individual course of the hospital stay was reconstructed and analyzed by 2 experienced physicians. Patients with overt other causes of splenic injuries (e. g. abominal surgery, trauma etc.) were not further evaluated. Results: Among 190,927 total colonoscopies over a 5-year period, 27 splenic lesions were most likely solely due to colonoscopy. This accounts for 14.1 splenic injuries per 100,000 colonoscopies or 1 lesion in 7,071 patients. Afflicted patient were older and more likely to be female than male (risk in females: 1 in 5,324 colonoscopies). Surgical interventions were carried out in 17 cases, predominantly splenectomy (n=15) whereas 10 events were managed conservately. Transfusions and requirement of intensive care unit treatment were strong predictors for the need of surgery. Most lesions (74%) were diagnosed within 48 hours after colonoscopy. Death occurred in 2 patients, but less likely directly due to the splenic injury. Conclusion: Adminstrative data analysis suggests that splenic injuries due to colonoscopy are more frequent than previously estimated. Endoscopists should be aware of this rare life-threatening adverse event.

Policy Solutions for Enhancing Drug Pricing Transparency and Reducing Health Care Costs in the United States

The excessive cost of prescription pharmaceuticals in the United States is an often-recognized issue for consumers, healthcare providers, and insurance companies alike. A major contributing factor to excess cost is the lack of transparency in drug pricing, which makes it difficult for stakeholders to understand the actual costs of medications. In this article, we look at two basic policy measures to ameliorate this issue. First, we explore providing consumers with clear information on medication costs at the point of prescription, specifically in outpatient doctors' offices. This policy seeks to empower patients and enhance informed decision-making by integrating drug cost information into electronic health records (EHRs), allowing physicians to discuss cost-effective alternatives with their patients. Second, we investigate potential federal regulations that would require pharmaceutical companies to publicly disclose reasons for price hikes, using specific benchmarks as guidelines. These regulations would mandate pharmaceutical companies to report heavy price increases and the factors contributing to these hikes, thereby holding manufacturers accountable and promoting price stability. By addressing these two policy measures, the article aims to enhance drug price transparency and reduce healthcare costs.

Digital divide in access and use of digital health technologies: what do we know from Germany?

Abstract Even though Germany is an industrialised country, health inequalities exist between individuals or population groups due to unequal access to scarce social resources such as money or knowledge. This case study illustrates the extent of the digital divide in access and use of digital health technologies. Data from the Liter@te study, in which 96 adults aged 18-64 years with low reading and writing skills living in Germany were asked about their digital health technology use and their digital health literacy, were compared with two parallel conducted population surveys in Germany (i.e., nationwide telephone survey on digitalisation and health with 1020 internet users aged 18 years and above, online survey on digitalisation in health care with 1839 adults aged 18-80 years insured at a statutory health insurance company). Adults with low reading and writing skills used digital devices in the health context such as computers (23% vs. 71%) or activity trackers (21% vs. 35%) less frequently than the general population, whereas no differences were reported in the use of smartphones (79% vs. 70%). In addition, 18% of adults with low reading and writing skills and 4% of the general population stated that they do not use digital health technologies. Other digital health technologies such as online appointment scheduling (25% vs. 81%) or health websites (32% vs. 45%) were also used less frequently by adults with low reading and writing skills compared to the general population. Participants in the Liter@te study who do not use digital health technologies reported more frequent access problems (e.g., no suitable device, technical problems, poor internet connection) than participants in the population survey. 35% of participants in the Liter@te study have a low digital health literacy (eHEALS score between 8-19/40 points), compared to only 8% in the population survey.

Risk sensitive control and an optimal reinsurance model of a network of insurance companies

Risk sensitive control and an optimal reinsurance model of a network of insurance companies