Aim of this study was to evaluate the long-term performance of teeth after direct restorations in general dental practices. Claims data from a national health insurance company was used to trace re-interventions after direct restorations on a day-count basis. All teeth with direct restorations placed from 2010 till 2024 entered the analysis. A Kaplan-Meier-Survival-Analysis evaluated the time without re-intervention. A new direct restoration affecting the respective tooth (1), a crown or partial crown on the same tooth (2) or the extraction of the respective tooth (3) counted as target events. Differences in survival rates between different restoration sizes were tested for significance using the Log-Rank-test. A number of 47.379.138 direct restorations placed within 8.668.014 patients were observed. At five years, 68 % of the related teeth showed no re-intervention while at ten years, more than 50 % were free of any re-interventions. About 40% of the respective teeth required no re-intervention after 15 years. At 10 years, two-surface restorations showed the highest survival rates when compared with one-surface, three-surface, and four-or-more-surface restorations. The differences were statistically significant (P<0.0001). A new filling on the respective tooth was by far the most prevalent re-intervention. Direct restorations showed an acceptable performance for up to 15 years. Teeth with very large restorations tend to have a significant shorter time without re-intervention.

Measures following abnormal non-invasive prenatal testing (NIPT) for trisomies 13, 18, and 21: A retrospective cohort study using billing data of the BARMER Health Insurance Company

Sex- and age-specific background incidence rates for various medical events in the German population aged≥50years using a nationwide monitoring system of claims data.

The traditional process of handling health insurance claims involves centralized systems and manual verification processes that are associated with high chances of delays, lack of transparency, and even fraud. Additionally, the lack of a secure and tamper-proof data sharing process between insurance companies, hospitals, and patients. This paper proposes a blockchain technology-based solution for the efficient management of health insurance claims, which is named HealthSureChainand is developed as a decentralized application on the permissioned Ethereum blockchain technology. Smart contract is used to automate the process of policy registration, premium payment, claims submission, eligibility checking, and claims approval. Medical records and patient data are stored in a secure manner through IPFS storage, while the hash of the data is stored on the blockchain for checking purposes. A predictive analytics component has been used to determine the future reserve fund requirements.

Abstract In recent years, numerous studies have indicated a strong connection between accidents and platformed delivery work. This article examines food delivery platforms in Singapore to explore how injuries are funneled into an economy of debility, where injury is directed toward profitable ends. Responding to this in Singapore, the Advisory Committee on Platform Workers forwarded plans to include platform workers under the Workers Injury Compensation Act (WICA), the country's workers’ compensation program, in 2022. The article assesses this move by analyzing three key areas: the sentimental videos used to justify this policy, dashcam footage of accidents on social media, and the accident insurance provided by platforms. Videos reflect on how injury is consistently presented as a personal issue that exacerbates a culture of debility by leading workers to downplay risks. This also shapes public sentiment, making it more likely that delivery workers are blamed for accidents. Platforms then monetize injury by implementing measures to reduce claims from accident policies, and by transforming workers into consumers of personalized insurance products. Together, these analyses provide a critical reading of the progressiveness of WICA, revealing its necessary interventions but also the compromises involved in recognizing debility.

This study evaluates the effectiveness of risk management policies within Zambia’s financial sector and their impact on institutional stability. Using a quantitative approach and purposive sampling, the research analyzed 20 financial institutions, including commercial banks, insurance companies, and microfinance firms, out of a total population of 85. Data gathered through semi-structured interviews and surveys were processed using SPSS 29, employing descriptive statistics alongside inferential methods such as correlation, factor analysis, and ANOVA. The findings reveal significant disparities in risk practices driven by institutional size and geography. Larger, urban-based institutions successfully implement sophisticated frameworks aligned with international Basel III standards; regression analysis confirmed this adherence significantly correlates with financial stability (beta = 0.48, p &lt; 0.01). Conversely, smaller rural institutions struggle with limited resources, outdated technology, and a lack of specialized staff. While 95% of the sector utilizes formalized risk documentation, a critical implementation gap exists, as only 60% perform regular reviews. Consequently, the study recommends targeted interventions, including standardized guidelines and enhanced training programs, to bolster the capacity of smaller institutions and ensure sector-wide resilience.

In modern countries with more complicated financial markets, financial literacy has grown into a crucial element of responsible financial decision-making. Customers are frequently introduced to a variety of financial instruments, such as digital investing platforms, retirement plans, mutual funds, insurance products, and equities markets. Despite the growing availability of such instruments, inadequate financial knowledge often limits the capacity of individuals to make wise investing choices. Academic professionals represent a unique group within the workforce due to their high educational qualifications and relatively stable income levels; however, financial competency is not always correlated with academic discipline expertise. This study investigates the association between academic experts employed by higher education institutions in Uttarakhand, India, and financial literacy and investment decision dynamics.Using primary data collected from structured questionnaires given to faculty members in specific districts, a quantitative research approach was chosen. The survey assesses respondents' perceptions of risk, investment behavior, financial literacy, and diversification of portfolios.Using statistical methods like "regression modeling," "correlation analysis," and "descriptive statistics," the effect of financial literacy on investment decision-making was examined. The findings shows that long-term risk tolerance, financial planning, and investment behavior are significantly impacted by financial literacy among academics. While people who have lower financial literacy levels typically rely on conventional saving choices like fixed deposits and savings accounts, those with higher financial literacy levels show increased interaction with diversified investment instruments like mutual funds, stocks, and retirement funds. In order to increase financial awareness and strengthen individual financial management, the study emphasizes the significance of focused financial literacy activities within academic institutions. By concentrating on a comparatively understudied demographic group within the Indian financial literacy landscape, the study adds to the body of literature.

This research intends to examine the impact of Claim Expense Ratio (CER) and Net Premium Growth (PGR) towards Liquidity Ratio (LIQ) of general insurance firms quoted at Indonesia Stock Exchange (IDX), incorporating Firm Size as a control variable. Using panel data from 5 general insurance companies with the largest market capitalization during 2017–2024 (40 observations), this study applies the Pooled Ordinary Least Squares (OLS) method. The F-test confirms the model is jointly significant (F = 3.461; p = 0.026), accompanied by an R² of 22.4%. Partially, only Firm Size proves to have a significant negative effect on the Liquidity Ratio (β = -0.054; p = 0.008), while CER (β = -0.068; p = 0.205) and PGR (β = -0.116; p = 0.332) are not statistically significant. The non-significance of CER and PGR is explained through the OJK regulatory framework that mandates the formation of technical reserves, rendering the effect of claims and premium growth on liquidity indirect. These findings contribute to the understanding that firm size characteristics are more dominant in determining liquidity levels than operational dynamics of claims and premiums in the Indonesian general insurance industry.

This research aims to assess solvency capital for life insurance companies beyond the 1-year horizon, with a focus on the Brazilian Capital Framework (BCF) and Solvency II (SII), through a stochastic model using Monte Carlo simulations. Most capital frameworks apply 1-year horizons, disregarding future capital needs arising from the evolution of longevity and mortality risk, particularly under different interest rate regimes. This study incorporates a stochastic multi-year approach to bridge this oversight. By addressing long-term solvency and exploiting stochastic mortality models, this study enhances the understanding of future capital requirements and the importance of robust long-term risk management in life insurance. The findings contribute to advancing regulatory frameworks and improving the financial sustainability of the life insurance sector, particularly in preparing for extreme scenarios such as pandemics or longevity improvements. The study employs deterministic and stochastic mortality models, utilizing Monte Carlo simulations to evaluate the requirements of capital need in a multi-year horizon. It calculates capital requirements for traditional life insurance products under various scenarios, offering a comparative analysis. This study reveals that current regulatory frameworks, such as SII and the BCF, should consider extending their 1-year horizon to incorporate future capital needs not fully captured by short-term perspectives. It evaluates the capital requirement under SII and BCF using a hypothetical portfolio of 10,000 male participants for traditional life insurance products (term-life, endowment, and whole-life). Findings indicate that while it is broadly understood that lower interest rates tend to increase capital requirements, our results provide a quantitative assessment of this effect under the BCF and SII. By applying multi-year stochastic simulations, we demonstrate how changes in the interest rate environment can shift the timing and magnitude of required capital, underscoring the relevance of long-term solvency projections in regulatory analysis.

The article provides an in-depth analysis of the digitalization process within the insurance market, highlighting its role in transforming the financial sector and advancing the digital economy. It defines digitalization as a crucial element in enhancing the operational efficiency of insurance companies and in establishing new business models. The study examines modern technologies being integrated into insurance practices, focusing on big data, artificial intelligence, machine learning, blockchain, and the Internet of Things (IoT), and how these technologies influence automation, underwriting, risk assessment, and insurance claim settlement. The development of digital technologies in insurance is largely based on the implementation of innovative solutions for collecting, analyzing, processing, transmitting and securely storing data. In this direction, modern tools are actively used, covering a wide range of capabilities. In particular, an important place is occupied by interactive platforms for online insurance, mobile applications for simplifying access to services, as well as specialized software designed to increase the efficiency of business processes. Particular attention is paid to the implementation of network solutions for automating operations and the use of artificial intelligence technologies, which allow analyzing large volumes of data and offering personalized approaches for each client. Significant emphasis is placed on how the digital environment alters interactions between insurers and clients, fostering the growth of online insurance, mobile apps, and digital platforms. The study explores how digitalization increases financial inclusion, makes insurance services more accessible, and enables the personalization of insurance products. It identifies key benefits of digital transformation in the insurance market, such as enhanced operational efficiency, lower administrative costs, faster data processing, and improved customer experiences. However, it also outlines major challenges and risks associated with digitalization, including cybersecurity threats, personal data protection concerns, technological dependencies, and the necessity for robust regulatory frameworks. The article argues for a comprehensive strategy for the digital transformation of insurance companies to maintain their competitiveness and ensure sustainable growth in the digital economy.

Africa's rapid urbanization and infrastructure expansion present both opportunities for economic development and challenges for environmental sustainability. This study examines the role of sustainable insurance as a catalyst for green building adoption and climate-resilient infrastructure in Africa. A PRISMA-guided systematic literature review of 42 studies published between 2016 and 2026 was conducted, integrating quantitative, qualitative, and conceptual evidence across five key themes: financial systems, insurance mechanisms, green building adoption, facilities management, and policy frameworks. The findings reveal that financial inclusion and innovation play a foundational role in enabling sustainable investment; however, insurance mechanisms remain underexplored despite their potential to influence investment behavior through risk pricing, premium differentiation, and capital allocation. Green building practices demonstrate clear environmental and operational benefits, yet adoption is constrained by financial, institutional, and knowledge barriers. Facilities management emerges as a critical component in operationalizing sustainability and generating performance data that informs insurance risk modeling. Based on these findings, the study proposes a triangular conceptual framework linking insurers, developers and investors, and facility managers through dynamic feedback mechanisms. The framework illustrates how sustainable insurance can align financial incentives with environmental performance, thereby accelerating the adoption of climate-resilient infrastructure. The study contributes to the literature by integrating fragmented research domains into a unified systems-based model and identifying key gaps, particularly the lack of empirical evidence on insurance-driven sustainability outcomes in Africa. The findings highlight the need for policy alignment, data system improvements, and innovation in insurance product design to support sustainable urban development. Future research should focus on empirically testing the proposed framework and examining insurance mechanisms across diverse African contexts.

This study aims to analyze the role of operational efficiency and revenue margins in improving the performance and sustainability of insurance companies through a literature review approach. The method used is a systematic literature review (SLR), which examines relevant scientific articles indexed in Google Scholar, particularly from selected journals. The selection process is carried out systematically based on inclusion and exclusion criteria, and analyzed using a thematic approach to identify patterns of relationships between variables.The research results show that operational efficiency has a positive relationship with company performance, although efficiency levels fluctuate and are not yet optimal. Revenue margins have also been shown to contribute significantly to company profitability, with most studies demonstrating a positive relationship between margins and performance. Furthermore, efficiency and revenue margins simultaneously play a role in determining company performance and sustainability, although the relationship is not always linear due to external factors such as market competition.The conclusion of this study confirms that the integration of efficiency and revenue margins is a crucial factor in improving performance and maintaining the sustainability of insurance companies. Therefore, companies need to manage both aspects in a balanced manner to achieve optimal and sustainable performance.

The phenomenon of insurance company defaults indicates the existence of legal uncertainty that directly impacts the weak protection afforded to policyholders as the aggrieved party in the contractual relationship. This situation reflects a gap between applicable legal norms and their implementation in practice, particularly regarding supervision, transparency, and dispute resolution mechanisms in the financial services sector. This study aims to analyze legal certainty for policyholders in cases of insurance company defaults through a normative legal approach. The methods used include legislative and conceptual approaches, utilizing primary, secondary, and tertiary legal sources analyzed qualitatively. The research results indicate that although the regulatory framework has established protections for policyholders, its effectiveness remains limited due to weak supervision, an imbalance in the positions of the parties involved, and the suboptimal roles of the policy guarantee institution and dispute resolution mechanisms. The discussion underscores the importance of strengthening a legal protection system that is both preventive and repressive to ensure legal certainty and enhance public confidence in the insurance industry.

High-value competition horses represent significant financial investments, making proper documentation and assessment of injuries particularly important in insurance claim cases. This review paper examines the pathological manifestations, forensic investigation methods and protective measures relevant to these situations. The review paper explores common pathological conditions affecting performance horses, diagnostic approaches for disease progression and forensic veterinary analysis techniques for characterising injury patterns. The distinction between accidental trauma and non-accidental injuries is examined through tissue damage patterns and the relationship between injuries and reported incidents. Emphasis is placed on systematic pathological examination methods, evidence collection and documentation processes used for insurance and legal contexts. Special attention is given to soring practices and their diagnostic indicators. Soring involves the intentional infliction of pain to a horse's legs or hooves in order to force the horse to perform an artificial, exaggerated gait. Understanding injury types and their postmortem characteristics helps veterinarians working with insurance companies and legal authorities provide accurate assessments. This supports animal welfare protection and objective evaluation in these cases.

Linking project data and data from routine clinical practice with healthcare-related data is essential for German healthcare research in order to answer complex questions validly and efficiently. Currently, fragmented data sources, heterogeneous legal requirements, and a lack of infrastructure prevent the optimal use and linking of these data. The Network University Medicine (NUM) is therefore developing a dedicated data infrastructure to link primary study data and routine clinical data with external healthcare-related data (e. g., data from statutory and private health insurance companies, data from cancer registries of the federal states, and data from registration offices). The position paper describes the various data worlds, including examples from epidemiological and clinical research that illustrate the added value and challenges of data linkage. In particular, it presents the new structures of the data acceptance and processing center (DAAeD) in the NUM, which is intended to enable quality-assured, data protection-compliant receipt and linkage of data. Standardized application and approval procedures as well as innovative privacy-preserving record linkage procedures are central to this. International experience, including from Scandinavia and the UK, demonstrates the benefits of such infrastructures for research and healthcare. In conclusion, we advocate rapid political and institutional implementation of the recommendations described in order to make health research in Germany competitive in international comparison and to ensure sustainable, patient-centered health care.

Background Influenza-like illness (ILI) affects women and men differently. These differences are due to a number of factors, with women often being more exposed and susceptible to ILI infections, while men are at higher risk of mortality. Little is known about how far back these differences reach in history. Objectives We investigated sex and gender differences in morbidity, mortality and work absenteeism in Switzerland with never-before-used historical 20th century data. Methods We analyzed several historical data series: Swiss-wide ILI/pneumonia mortality 1910–2022; ILI mortality/morbidity 1918–1929 in Basel-Stadt; and ILI-related insured sick days in 1918 from insurance companies. In addition, we analyzed sickness-related work absenteeism in a large company (Swiss Re) in Zurich 1918–1965 and in the national Swiss Postal Service 1902–1993. Results In all age groups, men had a higher ILI/pneumonia mortality risk than women, although these differences vary across time and age groups. In contrast, both morbidity in Basel-Stadt in the 1920s and the number of insured sick days in six selected insurance companies during the 1918 pandemic were higher for women than for men. Work absenteeism was also higher for women in both analyzed companies during the twentieth century. For the Swiss Postal Service, we find that during ILI epidemics and pandemics, work absenteeism was even higher among women than men. Conclusion We confirm that ILI/pneumonia mortality was higher in men than in women. We also find indications that women were more affected by ILI morbidity, including work absenteeism, which could be due to additional social gender effects.

The increasing trend of utilizing AI-based systems in financial information environments, including insurance underwriting, loan approval, and mortgage approval, demands the need for effective ethical governance. This paper proposes a Governance-Aware Ethical Architecture (GAEA) for financial information environments involving AI-based systems. The framework also incorporates an Ethical Constraint Engine for bias mitigation, a risk scoring system for assessing ethical violations in financial decisions, corrigibility functions for ensuring safe human intervention in AI decisions, and a multi-level audit system for supporting transparency and compliance. Continuous monitoring is also enabled through reinforcement learning from human feedback and formal constraints using linear temporal logic. The framework’s performance is also validated through experiments that demonstrate an ethical compliance rate of 87.3%, an alignment robustness value of 0.92 for Cohen’s κ, and an efficiency value of 94.1% for corrigibility.

This study examines how dividend announcements affect the stock prices of life insurance companies in Nepal. To do this, this study takes two main companies: Nepal Life Insurance Co. Ltd. (NLIC) and National Life Insurance Co. Ltd. (NLICL). These two are taken because their dividend amounts differ significantly. NLIC offered a high payout of 21.05%, while NLICL offered a lower payout of 12.50%. This study uses daily stock prices and the NEPSE index for the 10 days before and after news announcements in 2024 and 2025. The data shows that these announcements definitely move the market. On the day the news came out, NLIC’s stock jumped with a gain of 2.17% above the market, while NLICL had a smaller gain of 0.97%. A major finding is that high dividends keep investors interested for a long time. For the smaller dividend, people tended to sell their shares quickly to make a fast profit. Also, because prices started rising a few days before the official announcement, it seems the market is not perfectly efficient, and news might be leaking out early. This study is helpful for regular investors, policymakers, government agencies, insurance companies, etc., in Nepal who want to know the best time to buy or sell insurance stocks.

This article aims to analyze the default in the insurance agreement and to describe the legal considerations in the Supreme Court Decision Number 1137 K/Pdt/2020. Insurance as a contract cannot be separated from the negligence of one of the parties, namely the failure to fulfill its obligations. Such as insurance PT Astra Buana Medan Branch cannot carry out its obligations due to losses experienced by customers due to ownership of goods and default. The result of this case shows that the case was submitted to the Court based on Supreme Court Decision Number 1137 K / Pdt / 2020. This research itself uses Doctrinal legal research whose data is obtained by analyzing Supreme Court Decision Number 1137 K/Pdt/2020 and the Promissory Note Insurance Law. Based on examination and consideration, default is an act of breach of contract as referred to in Article 1238 of the Civil Code if the specified period has passed to fulfill an obligation, namely negligence. This happens, for example, in insurance contracts. Like PT, insurance companies often do not keep their promises. Astra Buana Medan Branch binds customers to purchase vehicle units using the unit purchase service, but PT. Because Astra Buana Medan branch did not keep its promise to submit insurance claims to its customers, the case was brought to court and indeed as confirmed in the Supreme Court Decision PT to fail to pay customer insurance claims.

No Abstract.