Insurance Domain Research Articles

A Comparative Assessment of Indicators for Public Sector General Insurance Companies : An Indian Perspective

Academic research in the insurance sector is limited to the life insurance segment with non-life insurance being an under focus area. This paper addressed the void in literature by studying the general insurance sector by comparing the performance from an Indian perspective. The research was based on studying all the major companies operating in the general insurance sector in India focusing on the critical dimensions of premiums collected by the insurance companies, claims paid to the insured, and commissions paid to sales agents. As the Indian market is led by public sector companies, all the four major general insurance companies were researched, and a comparative assessment was made across two different geographic markets. The objective of the paper was not only to establish the linkages for firm performance across geographic markets, but also to identify a set of themes for future research to strengthen the body of literature on general insurance industry in India. The paper would have far reaching influence for general insurance practitioners too by providing the nuances of performance on relevant dimensions in the general insurance domain.

Partitioning Sorted Sets: Overcoming Choice Overload While Maintaining Decision Quality

We investigate the joint use of partitioning and sorting as a choice architecture to overcome consumer choice overload in large product sets. Partitioning first presents a small initial set of alternatives with the option to click through to see the remaining alternatives. Sorting presents alternatives in order of attractiveness based on a user model that is helpful to the decision-maker. We propose that Sets with Partitioning and Sorting (SPSs) improve consumers’ choice outcomes by increasing their focus on the most attractive alternatives and their use of more compensatory decisions. Results from two controlled survey-based experiments and a field study in the domain of health insurance support this positive impact of SPSs when sorting quality is high. However, there is also a potential harmful effect of partitioning when sorting quality is low. We discuss implications of our findings and propose a practical approach to select partitioning size depending on sorting quality.

Non-Traditional Data Mining Applications in Taiwan National Health Insurance (NHI) Databases

This study examines time-sensitive applications of data mining methods to facilitate claims review processing and provide policy information for insurance decision-making vis-à-vis the Taiwan National Health Insurance (NHI) databases. In order to obtain the best payment management, a hybrid mining (HM) approach, which has been grounded on the extant knowledge of data mining projects and health insurance domain knowledge, is proposed. Through the integration of data warehousing, online analytic processing, data mining techniques and traditional data analysis in the healthcare field, an easy-to-use decision support platform, which will assist in directing the health insurance decision-making process, is built. Drawing from lessons learned within a case study setting, results showed that not only is HM approach a reliable, powerful, and user-friendly platform for diversified payment decision support, but that it also has great relevance for the practice and acceptance of evidence-based medicine. Essentially, HM approach can provide a critical boost to health insurance decision support; hence, future researchers should develop and improve the approach combined with their own application systems.

Policy measures and cyber insurance: a framework

ABSTRACTThe role of the insurance industry in driving improvements in cyber security has been identified as mutually beneficial for both insurers and policy-makers. To date, there has been no consideration of the roles governments and the insurance industry should pursue in support of this public–private partnership. This paper rectifies this omission and presents a framework to help underpin such a partnership, giving particular consideration to possible government interventions that might affect the cyber insurance market. We have undertaken a qualitative analysis of reports published by policy-making institutions and organisations working in the cyber insurance domain; we have also conducted interviews with cyber insurance professionals. Together, these constitute a stakeholder analysis upon which we build our framework. In addition, we present a research roadmap to demonstrate how the ideas described might be taken forward.

ProcessProfiler3D: A visualisation framework for log-based process performance comparison

An organisation can significantly improve its performance by observing how their business operations are currently being carried out. A great way to derive evidence-based process improvement insights is to compare the behaviour and performance of processes for different process cohorts by utilising the information recorded in event logs. A process cohort is a coherent group of process instances that has one or more shared characteristics. Such process performance comparisons can highlight positive or negative variations that can be evident in a particular cohort, thus enabling a tailored approach to process improvement. Although existing process mining techniques can be used to calculate various statistics from event logs for performance analysis, most techniques calculate and display the statistics for each cohort separately. Furthermore, the numerical statistics and simple visualisations may not be intuitive enough to allow users to compare the performance of various cohorts efficiently and effectively. We developed a novel visualisation framework for log-based process performance comparison to address these issues. It enables analysts to quickly identify the performance differences between cohorts. The framework supports the selection of cohorts and a three-dimensional visualisation to compare the cohorts using a variety of performance metrics. The approach has been implemented as a set of plug-ins within the open source process mining framework ProM and has been evaluated using two real-life datasets from the insurance domain to assess the usefulness of such a tool. This paper also derives a set of design principles from our approach which provide guidance for the development of new approaches to process cohort performance comparison.

Implementation of the redesigned Community Health Fund in the Dodoma region of Tanzania: A qualitative study of views from rural communities.

The need to understand how an intervention is received by the beneficiary community is well recognised and particularly neglected in the micro-health insurance (MHI) domain. This study explored the views and reactions of the beneficiary community of the redesigned Community Health Fund (CHF) implemented in the Dodoma region of Tanzania. We collected data from focus group discussions with 24 groups of villagers (CHF members and nonmembers) and in-depth interviews with 12 key informants (enrolment officers and health care workers). The transcribed material was analysed thematically. We found that participants highly appreciate the scheme, but to be resolved are the challenges posed by the implementation strategies adopted. The responses of the community were nested within a complex pathway relating to their interaction with the implementation strategies and their ongoing reflections regarding the benefits of the scheme. Community reactions ranged from accepting to rejecting the scheme, demanding the right to receive benefit packages once enrolled, and dropping out of the scheme when it failed to meet their expectations. Reported drivers of the responses included intensity of CHF communication activities, management of enrolment procedures, delivery of benefit packages, critical features of the scheme, and contextual factors (health system and socio-political context). This study highlights that scheme design and implementation strategies that address people's needs, voices, and values can improve uptake of MHI interventions. The study adds to the knowledge base on implementing MHI initiatives and could promote interests in assessing the response to interventions within the MHI domain and beyond.

Application of k-NN and Naïve Bayes Algorithm in Banking and Insurance Domain

Application of k-NN and Naïve Bayes Algorithm in Banking and Insurance Domain

Performance Evaluation of the Intermediary Channels of Life Insurance Industry in India

The present study aims to canvass the performance of intermediary channels in Indian Life Insurance Industry viz. individual agents, corporate agents, bancassurance, brokers and direct selling. The conduct of performance has been deliberated in context of business premium collected and number of policies issued by various channels through Two-Way ANOVA. The data has been figured out over the period of seven years, i.e. from 2006- 07 to 2012-13. The findings demonstrate that in the context of premium as well as policy, there is difference in mean scores for various categories of channels, but no difference has been found with respect to time period. Besides the study also measures the augmentation in their performance, through compound annual growth rate (CAGR) by using the log linear regression model which reveals that individual agent is the foremost performing channel in terms of generating business. But sustaining efficacy of every channel has become one of the confronting issues for insurance domain.

THE ROLE OF PREGNANCY IN MICRO HEALTH INSURANCE: EVIDENCE OF ADVERSE SELECTION FROM PAKISTAN

ABSTRACTWith increasing interest from commercial players in developing insurance markets to meet the needs of low‐income people, efforts to find sustainable products have expanded rapidly yet remain elusive. This is particularly true in the domain of health insurance, where the general challenges of offering voluntary private health insurance are often exacerbated by poor underlying health services and a lack of public health programs. In an effort to identify new opportunities to expand health insurance protection to underserved markets, we analyze a rich data set from a micro health insurance program in Pakistan. Observing that pregnancy‐related care accounts for 40 percent of all claims and 36 percent of the total claims amount, we focus much of our attention on understanding the role of pregnancy in micro health insurance. We find evidence of extensive adverse selection related to pregnancy claims, both with regard to original coverage purchase and with regard to renewal. In many countries, pregnancy health care is provided by or paid for by the government. We encourage consideration of this possibility, leaving the remaining health care needs for market‐based health insurance.

Commitments and interaction norms in organisations

In an organisational setting such as an online marketplace, an entity called the `organisation' or `institution' defines interaction protocols, monitors agent interaction, and intervenes to enforce the interaction protocols. The organisation might be a software system that thus regulates the marketplace, for example. In this article we abstract over application-specific protocols and consider commitment lifecycles as generic interaction protocols. We model interaction protocols by explicitly-represented norms, such that we can operationalise the enforcement of protocols by means of norm enforcement, and we can analyse the protocols by a logical analysis of the norms. We adopt insights and methods from commitment-based approaches to agent interaction as well as from norm-based approaches to agent behaviour governance. First, we show how to use explicitly-represented norms to model commitment dynamics (lifecycles). Second, we introduce an operational semantics to operationalise norm enforcement. Third, we show how to logically analyse interaction protocols by means of commitment dynamics and norm enforcement. The model, semantics, and analysis are illustrated by a running example from a vehicle insurance domain.

Editorial: The economics of risk

Vol. 12 of The Mathematics Enthusiast addresses the notion of risk from a variety of viewpoints, mathematical or otherwise. This editorial examines risk, starting from a historical perspective to frame current educational policies that have been influenced by ensuing economic principles. Risk has historically been associated with numerous cultures in the context of dice games or gambling (Sriraman & Lee, 2014) .Risk was first empiricized in the financial sector during the advent of western colonialism in late 15th century when ships made voyages to the East and investors needed assurance about the risk associated in relation to the payout from a successful voyage. One sees the birth of maritime insurance during this period to address the needs of the mercantile sector which invested in risky shipping ventures. Another area in which risk was empiricized and calculated was in the domain of life insurance. It is well known among historians of statistics, that Edmond Halley in the 17th century constructed a life table to demonstrate how premiums can be calculated as a function of age. Even though the death of an individual was unpredictable, data on patterns of longevity for groups became a basis of study whereby risk could be more accurately assessed for the purpose of calculating premiums or pensions (Halley, 1693).The economic dimension of risk in the 21st century is ubiquitous with existence in the developed world and forms the basis of neo-liberal economies and their associated markets. This ranges from auto-insurance premiums to investments made by governments for research, development and education. Educational reform in the U.S has been tied to risk as seen in the 1983 report from the National Commission on Excellence in Education under the auspices of the Reagan administration. The report entitled "A Nation at Risk" is often cited in the literature when addressing the failure of public schools and the need for reform in public education. It became somewhat of a pre-cursor for the private sector to intervene in public education since tax dollars spent on schools needed to be accounted for in terms of deliverable and measurable outcomes. Subsequent legislation in the form of "No Child Left Behind" (NCLB) enacted in 2001 held public schools accountable on the basis of student performance. The goal of this legislation was not only to reform public education but also to systematically close public schools that placed "students at risk" through probationary measures on the basis of student performance outcomes on standardized tests. By holding public schools and teachers responsible for inadequately addressing student needs, the onus of reform could be shifted to charter and private schools. One can argue that the increased role of the federal government in public education in the U.S has resulted in the marketization of public education by allowing the private sector to fill in the gap left by public schools. Funding initiatives such as the "Race to the Top" which were part of the American Recovery and Reinvestment Act of2009 furthered market economy goals of "competition" to put into place a reward system for states and schools that adhered to educational policies for schools anchored in performance based assessments and other measurable deliverables.A consequence of this has been a further increase in charter schools in states like Illinois and a demise of the public school system. …

An Empirical Research Regarding the Link between Tax Insurance, Level of Living Standards and Development of the Insurance Branch

The goal of the paper is to realize an empirical research regarding the link between tax insurance, level of living standards and development of insurance branch. Current financial and economic crisis accentuates high unemployment, fulminate bankruptcy of many firms and impossibility of quantification of negative economic and social consequences. That's why, fiscal specialists believe that taxation of insurance represents an important issue both for insurers and the European or/and national supervisory body of insurance market, and also for individuals or/and legal entities. EU attempts to harmonize first the national legislations regarding the taxation and then those relating to insurance, aiming to ensure the specific solvency of insurance companies. Estimating that, the significance of fiscal considerations in the decision to subscribe insurances contracts, different European countries, including Romania, have tried and managed through its fiscal laws to apply different ways for fiscal deductibility of insurance expenses. The taxation of insurance should be regarded and analyzed both from the perspective of gross premiums subscribed and received by insurance companies and services from the insurer. Insurers ‘benefits may take various forms (daily allowances, sums insured in case of life or death, rents, amounts provided for single-premium policy, those with capitalization) depending on the policy and concluded the nature of risk covered. Taxation of these benefits are achieved with the principles and logic of tax (a tax or insurance premiums or benefits), but depends on the binding and/or voluntary policy. Legislation regarding taxation is changing frequently. Besides this, we assist now at several changes, both in legislation regarding the accounting and insurance domain. To avoid failure of these entities, the European Commission, through its agencies, helped to create the legal framework to ensure the solvency of insurance companies. The implementation of IAS/IFRS in our country, for insurance companies, helped supervisors and local decision makers to use XRL in order to disclosure the accounting information's in financial statements understandable for the investor. Between taxation – legislation – accounting – solvency exist a real connection, which positive evolution will help the standard of live. In order to do so I performed an analysis on a sample of 32 countries and a horizon of 6 years (2005, 2007, 2008, 2009, 2010 and 2011). During our work, we tested 4 linear regression models (life gross written premiums, non-life gross written premiums, number of insurance companies and number of employees in the insurance sector). The results will confirm the existing link between development level of countries and insurance, but exclude the relationship between taxation and insurance. The conclusions of the paper will help the practitioners and The Financial Supervisory Authority in their decisions. We must point out that this study is a continuation of our work started in 2009.

Adverse Selection in Emerging Health Insurance Markets: Evidence from Microinsurance in Pakistan

With increasing interest from commercial players in developing insurance markets to meet the needs of low-income people, efforts to find sustainable products have expanded rapidly yet remain elusive. This is particularly true in the domain of health insurance, where the general challenges of offering voluntary private health insurance are often exacerbated by poor underlying health services and a lack of public health programs. In an effort to identify new opportunities, we analyze a rich data set from Pakistan to understand the influence of pregnancy on adverse selection and overall profitability of a micro health insurance product that is similar in design to others micro insurance products. Our results indicate that pregnancy-related benefits account for a significant source of claim counts and loss payments. We also find evidence of extensive adverse selection related to pregnancy claims, indicating significant take up by those who know they are pregnant prior to enrollment. Furthermore, households with only pregnancy claims tend to renew at lower rates than do households with other acute or chronic claims. We estimate that excluding coverage for pregnancy from market-based products, supplemented by government provision of maternity care may offer an avenue towards sustainability.

Case study of software product line construction in e-insuBanking and customisation mechanism

Cyber customer support domain is increasingly spread in life insurance industry so that the necessity of product line is requested. Because many channel systems in insurance domain are required for specific customer segmentation. Each channel system should be based on main business information system but each has little differences in user interface and service features. For improving the productivity in this domain, software product line engineering can be adopted. In this paper, we suggested software product line architecture and customising mechanism in e-insuBanking domain. With suggested architecture and customisation environment, it is possible to configure the new software product from the product line.

A fuzzy approach to value-based service contract selection

Service contract matchmaking tools support customers in accurate service selection. Basically, these tools rank services according to the degree of match between explicit customer preferences and contractual terms offered by service providers. However, the usage of such tools assumes that a customer is aware of the contractual terms and that he/she is able to specify preferences on them. Actually, customers often specify preferences only on a limited set of well-known terms. This paper describes an approach to service contract selection that adopts the value in use concept to quantify the trade-off between benefits and sacrifices related to contractual terms on which the customer has omitted to specify preferences. Fuzzy logic is used to evaluate benefits and sacrifices, and the relevance that customers attribute to specific contractual terms is considered to quantify the value in use. Experimental activities in the car insurance domain demonstrate the feasibility and effectiveness of the approach.

AN ONTOLOGY FOR COORDINATION

Independent agents that interact within open, distributed, and decentralized environments need to collaboratively regulate their activities in order to facilitate the harmonious and successful achievement of possibly conflicting tasks. Coordination is the process of managing these interactions by identifying and possibly resolving the interdependencies occurring between such activities. A successful coordination mechanism facilitates mutually beneficial interdependencies (e.g., by ensuring activities are not duplicated) while avoiding adverse outcomes (e.g., by preventing two processes simultaneously accessing the same non-shareable resource, potentially causing deadlock). However, for such a mechanism to work effectively within open systems, agents need to communicate and reason about activities, resources, and their properties; i.e., to commit to a shared ontology of coordination that defines the semantics underlying the different coordination regimes. This article describes an ontological approach to coordination in which agents dynamically manage the interdependencies that arise during their interactions. A proof-of-concept implementation in the insurance domain is described and empirically evaluated.

The concept, types and basic properties of insurance against ecological damages

Insurance against ecological damages is a domain of insurance, within which damages caused by environmental contamination are covered by means of different insurance contract types and modalities. The paper analyses the fundamental characteristics of different types and modalities of insurance against ecological damages: liability insurance of damages caused by environmental contamination, first party insurance and direct insurance against ecological damages. By comparing the above insurance types the author points out their advantages and drawbacks within the field of providing insurance coverage against ecological damages.

Size and Return Periods of Extreme Disasters

Size and Return Periods of Extreme Disasters Extreme disasters occur rarely and altogether occasionally, and therefore, the determination of maximum possible size or maximum expected size of natural and other disasters is important for the safety management and for the insurance domain, and considerable attention is paid to it. Systematic methodology development has been supported by professional papers since 70s of the last century or so. At present, the extreme value methods based on the great numbers of law, fuzzy sets etc. are used. The example shows the high differences in the extreme values existing in the application of old concepts and new methods. By use of the extreme value methods, it is also possible to calculate the return period of extreme disasters. The example showing return periods for different disaster sizes is given.

A Study Of Customer Satisfaction With Life Insurance In Chandigarh Tricity

Over the last few years, developments in the insurance sector have resulted in a paradigm shift in the way the business is conducted. Customer servicing today has become the focal point of insurance companies. However, there is absolutely no exaggeration in mentioning that the amount of customer grievances in the insurance domain has gone up steeply. Redressal of customers’ grievances is just a reactive way of insurers providing the minimum expected customer service. The need of the hour is a more proactive approach aimed at seeking what additional elements would delight the customer more and more. This study explores factors, which are important determinants of customer satisfaction in case of life insurance customers, to see how much effect the factors have on overall customer satisfaction; and identifies the common grievances of customers with regard to their life insurance policies. The study was restricted in the tricity of Chandigarh, Mohali and Panchkula. The factors identified for overall customer satisfaction are customised and timely service, Brand USP Considerate employees Price Immunity and results indicate that satisfaction with product offerings is the primary driver of overall customer satisfaction in case of insurance policies, even if the after sale service is not up to the satisfaction level. Customers were satisfied with their insurance policies but they were not satisfied with the quality of agents.

Poster 2: Genetic Discrimination of Individuals at Risk of Huntington's Disease: Further Analysis of the RESPOND-HD Data From Australia (Site 144)

We secured a grant from the Legal Services Board of Victoria to fund a follow-on project from RESPOND-HD to analyze and explore the Australian experience of genetic discrimination (GD), using HD as a case model. The objectives are 1) improving knowledge of laws related to GD, 2) improved legal services, and 3) development of easily accessible resources (brochure, website) informing consumers of their rights. Results Of 60 participants (65% female; 35% male; 60% HD gene positive; 40% gene negative), aged between 20 and 69 years, 32% reported experiencing GD, with mean number of incidences 3.17 (±3.35). Participants experienced discrimination in employment, social, and insurance domains. For example, 17% of respondents had been refused insurance coverage, 20% offered coverage only at a higher premium, 55% told because of family history they could get only limited coverage, and 36% told that due to test results they could get only limited coverage. Responses to Discrimination 1 Action—getting involved in activities 2 Inaction—do nothing, react with positivity, feel surprised by discrimination 3 Involvement—information provision, research involvement 4 Advice—regarding event or potential for event 5 Advocacy—to reduce stereotyping, providing education Awareness of Legislation Victoria's anti-discrimination laws are contained in the Equal Opportunity Act 1995, Disability Discrimination Act 1992, and Human Rights and Equal Opportunity Commission Act 1986. Regarding GD, 17% of participants knew where to make a complaint; 27% knew of laws preventing employers from unfairly using genetic information; 15% knew of laws preventing health insurance companies from accessing or requiring genetic information about an insured person; and 10% knew of laws preventing these companies from using genetic information to deny insurance. We aim to increase these percentages. We are funded to hold focus groups to discuss results and clarify issues with several cohorts (gene-negative participants, gene-positive participants, family members, case workers, health professionals, and researchers), and also for a public launch of the above-mentioned resources.