Insurance Pool Research Articles

Canadian Healthcare

The Canadian healthcare system is an industry that Canadians are rightfully proud of, and it ranks among the world’s leading healthcare systems (ranked 16th by Bloomberg). This sector is almost 100% state-funded, but every citizen is obliged to pay a medical care tax that is rather significant. As a result, every Canadian is entitled to equal healthcare, regardless of his or her financial position. State-guaranteed medical services are paid from the state foundations that accumulate insurance pools from the provincial tax revenues under the statutory health insurance program. All Canadian residents have a special plastic Health Card they are obliged to show in each medical institution they make recourse to. This card can also serve as an identity document. Pensioners are entitled to a Health 65Card with a wider range of services. Canadian healthcare is provided free of charge, with the exception of certain areas, such as dentistry, cosmetology, and ophthalmology. The majority (actually, more than a half) of medical practitioners are family doctors, and every Canadian has the right to choose a family doctor irrespective of his or her residential address.

LARGE-LOSS BEHAVIOR OF CONDITIONAL MEAN RISK SHARING

AbstractWe consider the conditional mean risk allocation for an insurance pool, as defined by Denuit and Dhaene (2012). Precisely, we study the asymptotic behavior of the respective relative contributions of the participants as the total loss of the pool tends to infinity. The numerical illustration in Denuit (2019) suggests that the application of the conditional mean risk sharing rule may produce a linear sharing in the tail of the total loss distribution. This paper studies the validity of this empirical finding in the class of compound Panjer–Katz sums consisting of compound Binomial, compound Poisson, and compound Negative Binomial sums with either Gamma or Pareto severities. It is demonstrated that such a behavior does not hold in general since one term may dominate the other ones conditional of large total loss.

Правові засади діяльності саморегулівних організацій в сфері агрострахування

The article is devoted to the study of the legal basis of the activities of self-regulatory organizations in the field of agrarian insurance in Ukraine. It is determined that stimulating the creation and functioning of self-regulatory organizations in agriculture aims at an optimal combination of market mechanisms and effective regulatory function of the state in the framework of business deregulation and corresponds to the Concept of the State Target Program for Agrarian Sector Development until 2022. The article presents the results of the analysis of the legal regulation of the Agrarian Insurance Pool – the only association of insurers that insure agricultural products with state support. The legal features of the Agrarian Insurance Pool are singled out, the basic principles, functions and features of its legal status are characterized. Based on the analysis of the legislation and practice of the Agrarian Insurance Pool, attention is focused on the problematic issues of legal regulation of the Agrarian Insurance Pool and suggested ways to improve the legislation of Ukraine in the study area. Keywords: self-regulatory organizations, agricultural producer, agriculture, agricultural products, Agrarian insurance Pool, agrarian risks, insurance with state support, insurance contract

Influence of farm size and insured type on crop insurance returns

AbstractIn this article, we empirically examine the impact of farm size and insured type on returns from crop insurance participation in four regions using unit‐level crop insurance contract data. Our quasi‐panel empirical model provides guidance on whether larger producers are riskier than smaller producers and whether cash producers are riskier than landlords. In our sample, we did not find evidence that large producers obtain higher returns from insurance participation than their smaller counterparts. In fact, we found evidence of the opposite that larger producers in Iowa and Nebraska receive less than their smaller counterparts. Our farm size results suggest that any legislation limiting crop insurance participation from large producers would negatively influence the insurance pool, driving up premiums and consequently administrative and operational subsidies and per‐acre premium subsidy dollars. We did find evidence that cash insured types get more back in insurance than landlords in both Montana and Oklahoma, suggesting the possibility of moral hazard in input usage. Our results also highlight spatial differences in crop insurance outcomes.

Mortality Risk Management Under the Factor Copula Framework—With Applications to Insurance Policy Pools

Mortality risk is one of the core risks that life insurers undertake. The uncertain future lifetime of each insured represents one risk factor, and the dependence structure among these risk factors determines the aggregate risk of an insurance policy pool. We propose using factor copulas to describe the dependence structure among the future lifetimes of numerous insureds. This differs from Chen, MacMinn, and Sun (2015) in that their focus is on pricing the securities linked to several mortality indexes. To mitigate the systematic mortality risk associated with an insurance pool, the insurer may purchase an asset exposed to similar systematic risk. We thus set up a two-factor copula framework and solve for the optimal investment amount in the asset. In numerical illustrations, we employ real-case data from a life insurer and a life settlement market maker involving hundreds of policies.

Legal features of insurance in the agricultural sector

The scientific article Sadruk Oksana Mykolayivna on the topic "Legal features of insurance in the agricultural sector" is devoted to the analysis of the features of insurance of agricultural products. The paper examines such concepts as "agricultural insurance", "risk in agricultural production", "index insurance of agricultural products" and others. The current state of development of agricultural insurance in Ukraine is analyzed, and such characteristic features of modern agricultural insurance as insufficient legal regulation of insurance relations in the agricultural sector are identified; low popularity of insurance among agricultural producers, which is caused by distrust of agricultural producers to insurance companies; insufficient state support for agricultural insurance in the country; insufficient supply from insurance companies and others. In addition, the authors studied the law "On the features of insurance of agricultural products with state support", namely the task of uniting insurers of the Agrarian Insurance Pool and noted the problems of its operation. Finally, the authors noted the need to develop index insurance of agricultural products, referring to the successful experience in such sectors of Ukraine's economy as energy, construction, restaurant business and others. The authors highlight the significant advantages of index insurance, such as low cost, transparency, simplicity of index insurance and the need to involve appraisers at the scene of the insured event. In the conclusions, the authors drew attention to the problems that arise today during the insurance of agricultural products and ways to overcome them. In addition, the article notes a significant step by the state to address the problems that arise during the insurance of agricultural products. Such a solution could be the Law of Ukraine, which provides for the introduction from 2021 of state support for insurance of agricultural products.

Ex-ante moral hazard: empirical evidence for private health insurance in Brazil

Abstract This paper explores the existence of ex-ante moral hazard in private health insurance in Brazil. Before the advent of illness, insured individuals have no incentives to seek preventive care if it is not previously contractible. The data set comprises longitudinal administrative records of health care utilization from a Brazilian employer-sponsored health insurance plan. The empirical strategy is based on an exogenous and anticipated shock in health insurance coverage not associated with health conditions. The results show an increase of up to 17% on medical visits and 22% on diagnostic tests due to the loss of health insurance. Medical visits start to increase five months before the individual leaves the health insurance pool, reaching its peak at two months prior to exit. For diagnostic tests, the increase was observed only in the last two months before the loss of health insurance coverage.

SIZE-BIASED TRANSFORM AND CONDITIONAL MEAN RISK SHARING, WITH APPLICATION TO P2P INSURANCE AND TONTINES

AbstractUsing risk-reducing properties of conditional expectations with respect to convex order, Denuit and Dhaene [Denuit, M. and Dhaene, J. (2012). Insurance: Mathematics and Economics 51, 265–270] proposed the conditional mean risk sharing rule to allocate the total risk among participants to an insurance pool. This paper relates the conditional mean risk sharing rule to the size-biased transform when pooled risks are independent. A representation formula is first derived for the conditional expectation of an individual risk given the aggregate loss. This formula is then exploited to obtain explicit expressions for the contributions to the pool when losses are modeled by compound Poisson sums, compound Negative Binomial sums, and compound Binomial sums, to which Panjer recursion applies. Simple formulas are obtained when claim severities are homogeneous. A couple of applications are considered: first, to a peer-to-peer insurance scheme where participants share the first layer of their respective risks while the higher layer is ceded to a (re)insurer; second, to survivor credits to be shared among surviving participants in tontine schemes.

The Political Economy of UHC Reform in Thailand: Lessons for Low- and Middle-Income Countries

Thailand achieved full population coverage of financial protection for health care in 2002 with successful implementation of the Universal Coverage Scheme (UCS). The three public health insurance schemes covered 98.5% of the population by 2015. Current evidence shows a high level of service coverage and financial risk protection and low level of unmet healthcare need, but the path toward UHC was not straightforward. Applying the Political Economy of UHC Reform Framework and the concept of path dependency, this study reviews how these factors influenced the evolution of the UHC reform in Thailand. We highlight how path dependency both set the groundwork for future insurance expansion and contributed to the persistence of a fragmented insurance pool even as the reform team was able to overcome certain path inefficient institutions and adopt more evidence-based payment schemes in the UCS. We then highlight two critical political economy challenges that can hamper reform, if not managed well, regarding the budgeting processes, which minimized the discretionary power previously exerted by Bureau of Budget, and the purchaser–provider split that created long-term tensions between the Ministry of Public Health and the National Health Security Office. Though resisted, these two changes were key to generating adequate resources to, and good governance of, the UCS. We conclude that although path dependence played a significant role in exerting pressure to resist change, the reform team’s capacity to generate and effectively utilize evidence to guide policy decision-making process enabled the reform to be placed on a “good path” that overcame opposition.

Model Risk, Mortality Heterogeneity and Implications for Solvency and Tail Risk

Mortality models used to assess longevity risk and retirement funding have been extended to stochastic models with trends and systematic risk. Systematic risk cannot be readily diversified in an insurance pool or pension fund. It is an important factor in assessing solvency and highlighting the tail risk in longevity insurance and pension products. Idiosyncratic risk can be diversified in typical pool sizes, although less effectively at the older ages. Mortality heterogeneity is not usually taken into account in stochastic mortality models. This is a mortality risk that reduces the effectiveness of idiosyncratic mortality risk pooling. Heterogeneity has been modelled with frailty models and more recently with Markov multiple state ageing models. This paper overviews recent developments in models for mortality heterogeneity and uses a model calibrated to both population mortality and health condition data to consider the impact of model risk and heterogeneity in assessing solvency and tail risk for longevity risk products.

State and trends of market development agricultural insurance of Ukraine

The state of the agrarian insurance market in Ukraine is analyzed. The data of insurance of crops in the period from 2005 to 2018 are given. Compares the indicators of 2018 underwriting year to the indicators of previous years: the number of concluded contracts, the size of the insured sown area, the sum of insurance contracts, insurance premiums, insurance payments and the number of types of insured crops. The trend of use of combined insurance protection is monitored: insurance against total death during the period of hibernation plus spring frosts. It was determined that the reason for a sharp increase in the conclusion of contracts for animal insurance in 2018 underwriting year is the conclusion of contracts with individuals. The essence and necessity of agrarian insurance for agricultural commodity producers are determined. The role of the state in the process of organization of agrarian insurance in Ukraine is determined. Participation of the state in support of agricultural risk insurance is dictated, on the one hand, by the uniqueness of agricultural risks, and, on the other hand, the need to make financial assistance to the state of agriculture targeted and targeted. It has been determined that due to lack of budget funds and for a number of other objective reasons, the government has refused to finance the previously introduced subsidized agricultural insurance program. Therefore, the state lost the opportunity to influence the market of agrarian insurance. The general level of development of insurance of agricultural risks at the present stage is investigated and the main reasons for the reluctance of agricultural enterprises to conclude insurance contracts for the safeguarding of their crops and future yields from possible risks are identified. Among these reasons are: high level of distrust of agricultural producers to insurers and low awareness of the general mechanism of agrarian insurance. Defined tasks that need to be done to increase the interaction between insurers and insurers in the agrarian insurance sector. The issues of cooperation of the Ministry of Agrarian Policy and Food with the IFC Project “Development of Financing of the Agrarian Sector in Europe and Central Asia”, which is aimed at establishing a constructive dialogue with the insurers, is disclosed. The given recommendations on introduction of an agrarian insurance pool in Ukraine.

Загальна характеристика правовідносин у сфері функціонування ринку зерна

In the article a legal relations in the field of grain market functioning is investigated. Particular attention is paid to the characteristics of the object (grains and products of its processing) and subjects of such legal relationships. Given the purpose of activities of business entities in this area, it is proposed to classify them into general (agricultural commodity producers) and special (grain warehouses, accredited exchanges, agrarian fund, agrarian insurance pool, guarantee fund of fulfillment of obligations for storage documents for grain). Key words: agrarian market, grain market, grain, grain market subjects, accredited stock exchange, Agrarian fund, Agricultural insurance pool, Guarantee Fund for fulfillment of obligations under grain storage documents.

“EARTHQUAKE WILL PASS, AND THE LIFE WILL GO ON”: A CRITICAL READING OF PUBLIC SPOTS OF DASK

Neoliberal governmentality encourages individuals to value their life as a proper(ty). The neoliberal valuation of life embraces ‘self-responsible’ and ‘competitive’ individuals. Drawing on the contingency of life, neoliberal governmentality intervenes in affects to govern individuals. For instance, individuals are made anxious by the insecurity, vulnerability and ambiguity about the unintended consequences of what may happen to them. In this study, we address how Turkish Catastrophe Insurance Pool/‘Natural Disaster Insurance Institution’ (Doğal Afet Sigortaları Kurumu—hereafter, DASK) intervenes in affects for neoliberal valuation of life as proper(ty). With an interpretive, a post-structuralist and a critical management approach, we examine and analyze the content of the public spots of DASK through the lens of neoliberal governmentality. Accordingly, these public spots portray the victims of Van earthquake as ‘compulsory guests’ and problematise being a compulsory guest. We remark that the compulsory guests do not feel at home at their relatives’ homes. Within the neoliberal precarization process to foster responsible subjects, DASK portrays the uneasiness—or properness—of compulsory guests through hopes, anxieties and fears so that individuals are encouraged to get their compulsory earthquake insurance to avoid being a compulsory guest.

人口高龄化对养老保险统筹账户支付能力的影响

人口高龄化对养老保险统筹账户支付能力的影响

Stretching scales? Risk and sociality in climate finance

The heterodox literature on financial risk has in recent years focused predominantly on how risk is distributed, and on the market instabilities and social inequalities that different risk distributions seed. Typically much less discussed is the constitution of financial risk, which is this article’s concern. Drawing empirical examples from two climate financial instruments, its particular interest is in the changing scale – social, spatial and temporal – of the “risk pools” associated with different financial products: the populations across which the products in question serve to aggregate underlying risk. The article explores how, against a historical backdrop of four decades of scale compression in the shape of risk individualization under neoliberalism, certain novel climate financial products seemingly indicate a contrary stretching of the risk pool. The article critically examines sovereign catastrophe insurance pools and green (climate) bonds, highlighting both the significance of the stretching that they effect but also the tensions and limits apparent in this emergent dynamic.

The Subpoena of Ethnographic Data

This essay outlines the author's experience of having his ethnographic data subpoenaed. It outlines the challenges of subpoena's to research, and suggests four solutions: (1) Apply for and utilize the National Institutes of Health certificate of confidentiality by asking health‐related questions over the course of one's research; (2) Establish a task force that articulates clear ethical guidelines for ethnographic research, with attention to the conditions wherein ethnographers can break confidentiality (and might also comply with subpoenas). These ethical guidelines should then be made clear to research subjects as a part of informed consent processes; (3) Demand that institutions (institutional review boards) that require confidentiality as a condition of research be required to defend that confidentiality through the office of the general counsel; (4) Socialize the cost of subpoenas, wherein scholars can be part of an insurance pool that will defend them in the event of a subpoena and thereby defend the general enterprise of ethnographic research.

Spatiotemporal interpolation through an extension of differential evolution algorithm for agricultural insurance claims

Assessment of actuarial risks in agricultural insurance is a specific area which evaluates risks in geographical framework. In order to manage weather related risks, the agricultural insurance portfolio is analyzed according to spatial and temporal characteristics of hazard regions. To reduce the basis risk associated with the location of meteorological stations, inverse distance weighting method with reduction approach is employed to interpolate meteorological values related to the location and the time of the reported agricultural claims. The results are evaluated for the data provided by Turkish Agricultural Insurance Pool, which is a unique agricultural claims data set covering more than 100 products for 5 different hazard types. Since height is a very significant factor that determines the values for the meteorological variables concerned in this study, altitude values are used to choose the best initial sample set. We extend stochastic differential evolution (DE) optimization algorithm to a multivariate setting for the spherical space to measure the closeness of estimated altitudes to actual altitudes. Moreover, we propose an optimal way of choosing the population size for the initialization step as another improvement in relation to DE algorithm.

Commercialization of obstetric and neonatal care in the Democratic Republic of the Congo: A study of the variability in user fees in Lubumbashi, 2014.

ObjectiveIn the Democratic Republic of the Congo, insufficient state financing of the health system produced weak progress toward targets of Millennium Development Goals 4 and 5. In Lubumbashi, almost all women pay out-of-pocket for obstetric and neonatal care. As no standard pricing system has been implemented, there is great variation in payments related to childbirth between health facilities and even within the same facility. This work investigates the determinants of this variation.MethodsWe conducted a cross-sectional study including women from admission through discharge at 92 maternity wards in Lubumbashi in March 2014. The women’s payments were collected and validated by triangulating interviews of new mothers and nurses with document review. We studied payments related to delivery from the perspective of women delivering. The total was the sum of the payments linked to seeking and accessing care and transport of the woman and companion. The determinants were assessed by multilevel regression.ResultsMedian payments for delivery varied by type: for an uncomplicated vaginal delivery, US$45 (range, US$17–260); for a complicated vaginal delivery US$60 (US$16–304); and for a Cesarean section, US$338 (US$163–782). Vaginal delivery was more expensive at health centers than in general referral hospitals or polyclinics. Cesarean sections done in corporate polyclinics and hospitals were more expensive than those done in the general referral hospitals. Referral of delivering women, use of more highly trained personnel, and a longer stay in the maternity unit contributed to higher expenses. A vaginal delivery in the private sector was more cost-effective than in the public sector.ConclusionTo guarantee universal coverage of high-quality care, we suggest that the government and funders in DRC support health insurance and risk pool initiatives, and introduce and institutionalize free mother and infant care.

The Liability Regime of Insurance Pools and Its Impact on Pricing

This work formally derives fairly priced premiums for the policyholder of an insurance pool and the risk-adequate equity contributions of the pool insurers’ equity holders in a contingent claims approach. The approach distinguishes between two liability regimes: joint liability and several liability. These regimes regulate the pool’s indemnification when one or more of the pool insurers cannot meet their full obligations because of insolvency. Joint liability is deduced to be the preferable regime for the policyholder in cost-savings terms if corporate income taxation is introduced as a market friction. This regime advantage vanishes if the pool insurers’ asset correlation is substantial or if their risk sharing becomes unbalanced. Additionally, we address risk-shifting problems and their regime-dependent effects on both stakeholder groups.

PMS35 - COSTS AND HEALTH SERVICE USE ASSOCIATED WITH FLUOROQUINOLONE-RELATED TENDON INJURIES

The aim of this study was to assess costs and health service use associated with tendon injuries resulting from fluoroquinolone antimicrobial use in Finland during 2002-2012. This retrospective observational study included data from the Finnish Pharmaceutical Insurance Pool’s pharmaceutical injury claims. In total 147 compensated claimants aged >18 years presenting tendon injuries after the use of fluoroquinolones were included in the study. Main outcomes of interest were the amount of outpatient visits to primary, secondary, tertiary and private healthcare, hospital days, rehabilitation and their costs. Indirect costs included in the analysis comprised time costs and compensation awarded to the claimants for pain and disability. According to preliminary results, outpatient visits to tertiary care (average 2,8 visits per claimant) were more frequent than to primary care (0,6). Hospital stays were the main cost drivers in this study with the average stay costing 2,947€ (range 0 – 12,615€). The average age of the claimants was 66,8 years (range 21-87) and 68,7% were males. 52% of the claimants had used oral corticosteroids in addition to fluoroquinolones, which is a known risk factor for tendon injuries. The estimated cost of a fluoroquinolone-related tendon injury ranged between 830 and 48,333 €. Although rare, fluoroquinolone-related tendon injuries can have significant economic implications in addition to causing long-term impairment. Further action is required to prevent and reduce fluoroquinolone-related tendon injuries, especially within risk groups.