Insurance Providers Research Articles

Factors Associated with Presentation of Severe Adolescent Idiopathic Scoliosis

Background: Adolescent idiopathic scoliosis (AIS) is a common referral to pediatric orthopaedic surgeons. Timely treatment with appropriate bracing decreases the risk of curve progression and need for surgical intervention. Despite pediatrician screening, patients still present to orthopaedic surgeons with curve magnitudes too large for nonoperative bracing to prevent progression to surgical curve magnitude. The aim of this study was to identify the sociodemographic differences between patients who are initially diagnosed with mild versus moderate/severe AIS.Methods: This retrospective cross-sectional study included patients aged 10 to 18 years diagnosed with AIS between 2011-2021 at a major metropolitan tertiary care center. Scoliosis severity was classified based on initial radiographs. Sociodemographic factors were recorded including patient addresses, which were cross-referenced with the diversitydatakids.org Child Opportunity Index (COI) database, which analyzes the quality of resources in a geographic area.Results: Gender, health insurance provider, race/ethnicity, and COI were all found to have a statistically significant relationship with Cobb angle (CA) and age at initial presentation. The odds of presenting with severe (versus mild and moderate) scoliosis were 2.3 times higher for patients who identified as Black/African American compared to those who identified as White. Additionally, the odds of initially presenting with severe scoliosis were almost 40% higher in females compared to males. Furthermore, each stepwise increase in COI was associated with a 17%-19% decrease in odds of presenting with severe scoliosis, depending on standardization.Conclusions: There are sociodemographic disparities in the identification and initiation of treatment for AIS. Specifically, the odds of presenting with severe scoliosis are increased in patients who identify as Black/African American or female and/or come from areas with lower access to resources (as defined by COI). Appropriate and timely referral to a pediatric orthopaedic surgeon for AIS treatment thus requires 1) educating primary care providers, pediatricians, and scoliosis screeners on how to appropriately identify scoliosis and the risks associated with late identification/referral and 2) public health initiatives, such as universal school screenings or outreach mobile clinics, to address access to care for patients at risk for late scoliosis identification.Level of Evidence: Level III (Retrospective cohort study) Key Concepts•At the time of diagnosis, a patient's curve magnitude (calculated via Cobb angle) and future growth potential have significant implications in both curve progression and treatment planning.•Avoiding spinal fusion by early curve identification and appropriate nonoperative (i.e., brace) treatment reduces patient risk and healthcare spending.•There are sociodemographic disparities in the identification and initiation of treatment for adolescent idiopathic scoliosis.•The odds of presenting with severe scoliosis are increased in patients who identify as Black/African American or female and/or come from areas with a lower access to resources (as defined by the Child Opportunity Index).

Selective Dorsal Rhizotomy: Patient Demographics and Postoperative Physical Therapy

BackgroundSelective dorsal rhizotomy (SDR) is a surgical procedure that permanently alters lower extremity spasticity, common in children with spastic cerebral palsy (CP). Intensive postoperative physical therapy (PT) is recommended following SDR. The first purpose of this study is to describe and compare patient demographics between children who received SDR and the population of children with CP at one institution. The second purpose of this study is to compare the completed dose of postoperative PT with the clinically recommended dose for a subset of ambulatory children who underwent SDR. MethodsThis retrospective, observational study included 60 children with spastic CP following SDR. A subset (n = 12 ambulatory children) was included to describe the dose of postoperative PT. Information gathered from electronic medical records included age at the time of SDR, sex, Gross Motor Function Classification System level, anatomic distribution, race, county-level habitancy, health insurance provider, timed current procedural terminology codes, and location for postoperative PT encounters within a single institution. ResultsBlack or African American children (P = 0.002), children living in large central metro areas (P = 0.033), and children with public insurance (P ≤ 0.001) were significantly less likely to receive SDR. Children undergoing SDR do not achieve the recommended dose of PT after hospital discharge. ConclusionSDR is not equally accessed by patient populations, and postoperative PT frequency is below current recommendations throughout the rehabilitation process. Future studies need to investigate why these disparities exist and what prevents children from meeting the clinically recommended dose of postoperative PT after SDR.

HPV infection and breast cancer risk: insights from a nationwide population study in Taiwan.

The prevalence of cancer, specifically breast cancer, has raised globally. The etiology of breast cancer has been attributed to age, genetic mutations, reproductive history, hormone therapy, lifestyle factors, and viral infections. The human papillomavirus (HPV) has been one of the most widespread sexually transmitted infection in the United States. The role of HPV in breast oncogenesis was hypothesized before, yet the association remained unclear. In this study, we employed a nationwide population study using centralized patient data managed by the Ministry of Health and Welfare in Taiwan and the Taiwan Cancer Registry database. The breast cancer incidence rates of the 467,454 HPV patients were compared to twice as many non-HPV patients with matching sex and age. Cumulative breast cancer incidence rates were presented by a Kaplan-Meier curve, and the relative risk of breast cancer for HPV and non-HPV patients were calculated using Cox-regression model. Our results indicated a crude hazard ratio (HR) and an adjusted hazard ratio (aHR) of 2.336 and 2.271, respectively, when comparing the risk of breast cancer in the HPV and non-HPV group. The risk of breast cancer was comparable or higher than those of head and neck cancer (aHR=1.595) and cervical cancer (aHR=2.225), which both were found to have causal relationships with HPV. The Kaplan-Meier curve further illustrated a higher cumulative risk across 84 months for HPV patients (p<.0001). Besides HPV, age (p<.0001), insurance providers (p<.001), and comorbidities such as abnormal liver function (aHR=1.191, p=.0069) and hyperlipidemia (aHR=1.218, p=.0002) were found to be correlated with higher risks of breast cancer. A correlation between HPV and breast cancer can be inferred using national health databases. More molecular studies are required to understand the mechanism of the virus-induced oncogenesis of the breast.

Microdiscectomy Insurance Medical Necessity Criteria Are Inconsistent and Unnecessarily Restrictive.

Microdiscectomy for patients with chronic lumbar radiculopathy refractory to conservative therapy has significantly better outcomes than continued nonoperative management. The North American Spine Society (NASS) outlined specific criteria to establish medical necessity for elective lumbar microdiscectomy. We hypothesized that insurance providers have substantial variability among one another and from the NASS guidelines. A cross-sectional analysis of US national and local insurance companies was conducted to assess policies on coverage recommendations for lumbar microdiscectomy. Insurers were selected based on their enrollment data and market share of direct written premiums. The top 4 national insurance providers and the top 3 state-specific providers in New Jersey, New York, and Pennsylvania were selected. Insurance coverage guidelines were accessed through a web-based search, provider account, or telephone call to the specific provider. If no policy was provided, it was documented as such. Preapproval criteria were entered as categorical variables and consolidated into 4 main categories: symptom criteria, examination criteria, imaging criteria, and conservative treatment. The 13 selected insurers composed roughly 31% of the market share in the United States and approximately 82%, 62%, and 76% of the market share for New Jersey, New York, and Pennsylvania, respectively. Insurance descriptions of symptom criteria, imaging criteria, and the definition of conservative treatment had substantial differences as compared with those defined by NASS. Although a guideline to establish medical necessity was developed by NASS, many insurance companies have created their own guidelines, which have resulted in inconsistent management based on geographic location and selected provider. Providers must be cognizant of the differing preapproval criteria needed for each in-network insurance company in order to provide effective and efficient care for patients with lumbar radiculopathy.

What protects me also makes me behave: The role of directors' and officers' liability insurance on empire-building managers in China

In this paper, we examine the monitoring effect of Directors' and Officers' liability insurance (D&O insurance) on firms' acquisitions in China. We find that firms with managers covered by D&O insurance are less likely to undertake acquisitions and if they do, their acquisitions are associated with smaller bid premium of the acquired targets, higher stock returns upon acquisition announcements, and better operating performance post-acquisition. The deterrence of D&O insurance on acquisition is more pronounced when the insurance providers are more active and when managerial moral hazard is more likely to exist. Further findings suggest that D&O insurance diminishes the effect of CEO's overconfidence and risk-seeking behaviors on their acquisition decisions. Overall, our study suggests that D&O insurance can play an effective monitoring role that deters empire-building acquisitions.

Can Hip and Knee Arthroplasty Surgeons Help Address the Osteoporosis Epidemic?

Osteoporosis is a known, modifiable risk factor for lower extremity periprosthetic fractures. Unfortunately, a high percentage of patients at risk of osteoporosis who undergo THA or TKA do not receive routine screening and treatment for osteoporosis, but there is insufficient information determining the proportion of patients undergoing THA and TKA who should be screened and their implant-related complications. (1) What proportion of patients in a large database who underwent THA or TKA met the criteria for osteoporosis screening? (2) What proportion of these patients received a dual-energy x-ray absorptiometry (DEXA) study before arthroplasty? (3) What was the 5-year cumulative incidence of fragility fracture or periprosthetic fracture after arthroplasty of those at high risk compared with those at low risk of osteoporosis? Between January 2010 and October 2021, 710,097 and 1,353,218 patients who underwent THA and TKA, respectively, were captured in the Mariner dataset of the PearlDiver database. We used this dataset because it longitudinally tracks patients across a variety of insurance providers throughout the United States to provide generalizable data. Patients at least 50 years old with at least 2 years of follow-up were included, and patients with a diagnosis of malignancy and fracture-indicated total joint arthroplasty were excluded. Based on this initial criterion, 60% (425,005) of THAs and 66% (897,664) of TKAs were eligible. A further 11% (44,739) of THAs and 11% (102,463) of TKAs were excluded because of a prior diagnosis of or treatment for osteoporosis, leaving 54% (380,266) of THAs and 59% (795,201) of TKAs for analysis. Patients at high risk of osteoporosis were filtered using demographic and comorbidity information provided by the database and defined by national guidelines. The proportion of patients at high risk of osteoporosis who underwent osteoporosis screening via DEXA scan within 3 years was observed, and the 5-year cumulative incidence of periprosthetic fractures and fragility fracture was compared between the high-risk and low-risk cohorts. In total, 53% (201,450) and 55% (439,982) of patients who underwent THA and TKA, respectively, were considered at high risk of osteoporosis. Of these patients, 12% (24,898 of 201,450) and 13% (57,022 of 439,982) of patients who underwent THA and TKA, respectively, received a preoperative DEXA scan. Within 5 years, patients at high risk of osteoporosis undergoing THA and TKA had a higher cumulative incidence of fragility fractures (THA: HR 2.1 [95% CI 1.9 to 2.2]; TKA: HR 1.8 [95% CI 1.7 to 1.9]) and periprosthetic fractures (THA: HR 1.7 [95% CI 1.5 to 1.8]; TKA: HR 1.6 [95% CI 1.4 to 1.7]) than those at low risk (p < 0.001 for all). We attribute the higher rates of fragility and periprosthetic fractures in those at high risk compared with those at low risk to an occult diagnosis of osteoporosis. Hip and knee arthroplasty surgeons can help reduce the incidence and burden of these osteoporosis-related complications by initiating screening and subsequently referring patients to bone health specialists for treatment. Future studies might investigate the proportion of osteoporosis in patients at high risk of having the condition, develop and evaluate practical bone health screening and treatment algorithms for hip and knee arthroplasty surgeons, and observe the cost-effectiveness of implementing these algorithms. Level III, therapeutic study.

Mining Opinions on a Prominent Health Insurance Provider from Social Media Microblog: Affective Model and Contextual Analysis Approach

Social media plays a significant role in enhancing communication among organizations, communities, and individuals. Besides being a mode of communication, the data generated from these interactions can also be leveraged to assess the performance of an institution or organization. People may evaluate public companies based on the opinions of their users. However, user-supplied information is brief and written in natural language. In addition to being brief, the process of sending messages or engaging in other social media interactions contains a great deal of context information. This multiplicity of context can be utilized to conduct a more in-depth analysis of user opinion. This study presents a new approach to opinion mining for social media microblogging data by applying an affective model and contextual analyses. The affective model is applied for sentiment analysis to measure the degree of each adjective from user opinion by evaluating adjectives according to their varying levels of pleasure and arousal. The contextual analysis in this paper is modeled based on topic, user, adjective, and personal characteristics. The contextual analysis has four main features: (1) Temporal keyword sentiment context, (2) Temporal user sentiment context, (3) User impression context, and (4) Temporal user character context. Our affective model outperformed 75.6% the accuracy and 74.98% of F1-score, rather than SVM. In the experiment, the contextual analysis performed graph visualization of output results for each query feature for future development. Feature one to four successfully processes the query to produce a visualization graph.

Postoperative Chest X-rays After Open Reduction Internal Fixation of Clavicle Fractures May Not Be Cost-effective or Necessary.

To assess the utility of chest x-rays following open reduction internal fixation of clavicle fractures. Particularly in terms of detection of acute postoperative pneumothorax and cost- effectiveness of obtaining routine chest x-rays post-operatively. A retrospective cohort study. Level I trauma centerPatients 236 patients who underwent ORIF from 2013 to 2020 between the ages of 12 and 93. Chest x-ray performed post-operatively. Presence of acute postoperative pneumothorax. Of the 236 patients who underwent surgery 189 (80%) of patients received a CXR post-operatively 7 (3%) of patients experienced respiratory symptoms. All patients who had respiratory symptoms received a post-operative CXR. Those who did not receive a CXR post-operatively did not experience any respiratory complications. Two patients in the cohort had a postoperative pneumothorax, which were both present pre-operatively and unchanged in size post-operatively. Both of these patients were managed with general anesthesia and endotracheal intubation for surgery. The most common finding on CXR post-operatively was atelectasis. The cost of a portable CXR can be upwards of $594 when including technology, personnel fees, and radiological interpretation. Post-operative chest x-rays after clavicle open reduction and internal fixation did not detect any acute postoperative pneumothorax in asymptomatic patients. It is not cost-effective to routinely get chest x-rays in patients following open reduction internal fixation of clavicle fractures. In our study, of the 189 chest x-rays performed, only seven patients experienced postoperative respiratory symptoms. Our healthcare system as a total could have saved upwards of $108,108 in total for these patients as they may have been considered non-reimbursable by an insurance provider.

Adverse Selection in Low-Income Health Insurance Markets: Evidence from an RCT in Pakistan

We present robust evidence on adverse selection in hospitalization insurance for low-income individuals that received first-time access to insurance. A large randomized control trial from Pakistan allows us to separate adverse selection from moral hazard, estimate how selection changes at different points of the demand curve, and test simple measures to limit adverse selection. The results reveal substantial selection in individual policies, leading to welfare losses and the threat of a market breakdown. Bundling insurance policies at the household level or higher almost eliminates adverse selection, thus mitigating its welfare consequences and facilitating sustainable insurance supply. (JEL D82, G22, I13, I18, O15, O16)

Assessing the Assessing the Efficiency of Takaful and Insurance Companies in Emerging Markets

This research was conducted to compare and contrast the effectiveness of Takaful and Conventional insurance providers in developing markets like Pakistan. This was achieved by collecting and analyzing information from the databases of four Takaful and four traditional insurance providers covering 2012-2018. The technical, cost and allocative efficiencies were determined using data envelopment analysis. Total assets and employee count were inputs, while investment income, net premium revenue, and other income were measured as outcomes. Labour and asset costs were included in determining profitability. As of 2012, Pakistan's Takaful insurance sector was considered extremely technically efficient. Conventional insurance companies were more technically efficient than Takaful insurance companies throughout the review period, with an average technical efficiency score of 0.890 compared to 0.730 for Takaful insurance companies. Pak-Qatar General Takaful was found to be the most technically efficient (0.855), Pak-Qatar Family Takaful most allocative (0.703) and cost-efficient (0.597) among all Takaful insurance firms in Pakistan. On average the technical efficiency score is 0.810, allocative efficiency 0.490 and cost efficiency 0.407. Tobit regression estimates found that investment income, size of the firm and number of employees significantly affects the efficiency scores of insurance companies. Based on the above discussion the researcher concludes that conventional and Takaful insurance companies require to improve their technical, allocative and cost efficiencies.

Factors Affecting Farmers’ Willingness to Pay for Agricultural Insurance: A Literature Survey (2004-2023)

Agriculture is a critical component of many economies, and the livelihood of farmers is often highly dependent on their ability to manage crop and livestock production risks. This study provides a comprehensive synthesis of the existing literature, shedding light on the intricate dynamics shaping farmers' decisions to invest in agricultural insurance. Based on the literature survey made for 54 relevant research studies (conducted between 2004 and 2023), this study presents an extensive review of research on factors affecting farmers' willingness to pay for livestock insurance. The study aggregates and analyzes findings from many sources, offering valuable insights for policymakers, insurance providers, and researchers. The study's findings inform the design of targeted interventions and awareness campaigns to enhance the financial protection of farmers, ensuring their stability in the face of economic and climatic uncertainties. In this way, the findings are significant in the context of global agricultural resilience and food security.

ADOPTION OF DIGITAL STRATEGY IN HEALTH INSURANCE SECTORWITH SPECIAL REFERENCE TO BHOPAL CITY

Digitalization brought a huge revolution in India. There have been many changes with the introduction of cashless transactions for a cashless economy. There is rapid growth of the digital health insurance market in India. Digital sales of health insurance products have helped customers to get updated and in-depth information about the products and increase the quick online sales, policy issuance and quick claim settlement. A structured questionnaire was designed and data was collected from agents and service providers. The data was analysed and interpreted by applying inferential statistics. The study will help companies to identify the strategies adopted by insurance providers to make digital health insurance popular.

Disparities in screening mammography utilization among Hispanic women in rural Texas from 2002 to 2018.

To examine the trends of racial/ethnic and urban-rural disparities in screening mammography use with a focus on Hispanic women in rural Texas, as well as to further investigate barriers to mammography screening practices. A serial cross-sectional study was conducted on screening mammography including eligible female respondents (≥ 40years) from the Texas Behavioral Risk Factor Surveillance System survey from 2002 to 2018. Weighted descriptive analyses showed persistent racial/ethnic and urban-rural disparities in mammography screening rates among eligible women (≥ 40years) in Texas. Overall, the mammography screening rates for women in rural areas were significantly lower than women in urban areas with a mean rate of 64.09% versus 70.89% (p < 0.001). Rural Hispanic women had the lowest mean mammography screening rate (55.98%) among all eligible women which is 16.27% below the mean mammography screening rate of non-Hispanic white women in urban areas. Weighted logistic regression model revealed that women with no health insurance or primary care providers were 52% (95% Confidence Interval [CI] 0.36-0.63, p < 0.001) or 54% (95% CI 0.35-0.6, p < 0.001) less likely having an up-to-date mammography screening compared with women with health insurance or primary care providers, respectively. Our study demonstrated significant and persistent racial and urban-rural disparities in screening mammography utilization among Hispanic women compared with non-Hispanic white women from 2002 to 2018. Healthcare access is a major contributor to these disparities. It highlights the need for wide-scale interventions from public health and policymakers targeting under screened racial minorities and rural regions population to promote screening mammography services among disadvantaged population.

Factors influencing adherence to clinical practice guidelines in patients with suspected chronic coronary syndrome: a qualitative interview study in the ambulatory care sector in Germany

BackgroundChronic coronary syndrome (CCS) is a potentially progressive clinical presentation of coronary artery disease (CAD). Clinical practice guidelines (CPGs) are available for prevention, diagnosis, and treatment. Embedded in the “ENLIGHT-KHK” healthcare project, a qualitative study was conducted to identify factors that influence guideline adherence from the perspective of general practitioners (GPs) and cardiologists (CA) in the ambulatory care sector in Germany.MethodsGPs and CAs were surveyed via telephone using an interview guide. The respondents were first asked about their individual approach to caring for patients with suspected CCS. Subsequently, the accordance of their approach with guideline recommendations was addressed. Finally, potential measures for assisting with guideline adherence were discussed. The semi-structured interviews were transcribed verbatim and analysed using a qualitative content analysis in accordance with Kuckartz and Rädiker. Factors influencing adherence to CPGs were categorised by assessing whether they (i) inhibited or facilitated guideline adherence, (ii) played a role in patients at risk of CCS or with suspected or known CCS, (iii) were mentioned in implicit or explicit thematic reference to CPGs, and (iv) were declared a practical problem.ResultsBased on interviews with ten GPs and five CAs, 35 potential influencing factors were identified. These emerged at four levels: patients, healthcare providers, CPGs, and the healthcare system. The most commonly cited barrier to guideline adherence among the respondents was structural aspects at the system level, including reachability of providers and services, waiting times, reimbursement through statutory health insurance (SHI) providers, and contract offers. There was a strong emphasis on interdependencies between factors acting at different levels. For instance, poor reachability of providers and services at the system level may result in inexpedience of guideline recommendations at the CPG level. Likewise, poor reachability of providers and services at the system level may be aggravated or alleviated by factors such as diagnostic preferences at the patient level or collaborations at the provider level.ConclusionsTo assist with adherence to CPGs regarding CCS, promoting measures may be needed that account for interdependencies between barriers and facilitators at various healthcare levels. Respective measures should consider medically justified deviations from guideline recommendations in individual cases.Trial registrationGerman Clinical Trials Register: DRKS00015638; Universal Trial Number (UTN): U1111-1227-8055.

Drivers of potential policyholders’ uptake of insurance in Kenya using Random Forest

The low adoption of insurance by potential policyholders in developing countries like Kenya is a cause for concern for insurers, regulators, and other marketing stakeholders. To effectively design targeted marketing strategies to boost insurance adoption, it is crucial to determine the factors that affect insurance uptake among potential policyholders. In this study, the 2021 FinAccess Survey, which interviewed sampled individuals above 16 years in Kenya and machine learning techniques, including Random Forest, XGBoost, and Logistic Regression, were utilized to uncover the factors driving insurance uptake and the reasons for the low adoption of insurance among potential policyholders. Random Forest was the most robust model of the three classifiers based on Kappa score, recall score, F1 score, precision, and area under the operating characteristic curve (approaching 1). The paper explores eight reasons why people currently do not have insurance policies. The results indicated that affordability was the primary driver of uptake with 68.67% of having expressed a desire to possess insurance but are unable to afford it. The highest level of education being the next most significant factor. Cultural and religious beliefs and mistrust of insurance providers were found to have a minimal impact on uptake. These findings imply that offering affordable insurance products and conducting awareness campaigns are critical to increase insurance adoption.

Perspectives of Part-Time Augmentative and Alternative Communication Use in Adults and Implications for Pediatric Service Delivery

Purpose: Speaking autistic adults who use augmentative and alternative communication (AAC) part-time increasingly share their experiences of insufficient, unreliable, or inconsistent speech. Their experiences detail how forced communication through verbal speech alone causes harm and how AAC systems allow them to communicate freely. The purpose of this clinical focus article is to (a) define intermittent, unreliable, and inconsistent speech as experienced by autistic adults; (b) discuss implications for service delivery of AAC to autistic children; and (c) present an example of a pediatric part-time AAC assessment through a case study. Method: This clinical focus article presents a case study of an AAC assessment completed at a university clinic for a speaking child who experiences intermittent speech. Data from the case study were collected through chart review, a semistructured interview with the parent, and short surveys sent to the family. The case study presents the background and history of the client, planning for the assessment procedures, and details of the assessment procedures and data collected, and summarizes the results of the assessment. Results: The results of the assessment led to the successful funding of an AAC system through a third-party insurance provider. A summary of the follow-up session with the family after the device was received is provided. Conclusions: Characteristics of the mother's advocacy for her child's communication and its implications for the case study are discussed. Future directions of this research include the development of communication choice–affirming assessment and intervention protocols created in collaboration with autistic adults to support children who experience insufficient, intermittent, or unreliable speech.

Agricultural insurance as a climate risk adaptation strategy in developing countries: a case of Nigeria

ABSTRACT Despite the potential benefits of agricultural insurance in helping farmers adapt to climate risks, its uptake among smallholder farmers remains limited. This study analyses the drivers of awareness and adoption of agricultural insurance in Nigeria to better understand the adoption process. 1,080 farming households were surveyed across six agro-ecological zones in Nigeria, covering areas with different socio-economic characteristics of farmers and levels of climate risk. Data were collected through face-to-face interviews between October 2020 and February 2021. The results show that more than half of the farmers were unaware of agricultural insurance. Logit regression results show that education, herd size, access to a bank, weather information, and flood experience positively influence awareness and adoption of agricultural insurance. In addition to low awareness, the main barriers to adoption are lack of knowledge about the effectiveness of insurance, difficulty in affording insurance, and farmers’ low level of trust in insurance providers. Late payment of claims and inadequate compensation were the main challenges faced by adopters of agricultural insurance. Raising awareness and helping farmers to assess the effectiveness of agricultural insurance, as well as developing a supportive institutional environment, would help to build a well-functioning insurance market. Key policy insights To increase the uptake of agricultural insurance, it is first necessary to raise awareness among farmers. Government agencies should consider monitoring and sanctioning insurance agencies and companies that fail to comply with contractual agreements to promote and ensure prompt payment of due compensation; to increase transparency of insurance providers’ performance; and to increase confidence in insurance providers. We recommend using different premium payment methods, adjusting land policies, improving access to weather information, and increasing access to bank credit for smallholder farmers to increase farmers’ motivation to use insurance.

Analysis of Process Re-engineering on Organizational Performance of NHIF in Northern Region, Kenya

Companies across the world are turning to strategic innovation as a reaction to the growing volatility and complexity of the business environment they are facing. The primary goal of this research is to determine the impact of process reengineering on the organizational performance of the National Health Insurance Fund (NHIF) in chosen counties in Kenya's northern region. Knowledge-based theory served as the theoretical foundations for this investigation. For the purpose of collecting data, a descriptive survey research design was used, which included the utilization of both primary and secondary data sources. Primary data was collected via the use of structured questionnaires. The study's target group was made up of 64 NHIF workers who work in the chosen county offices, according to the researchers. It was necessary to conduct a census in order to determine the sample size of all 64 workers, and a random sampling method was utilized in order to ensure that each participant has an equal chance to participate in the research. The gathered data was examined with the help of SPSS in order to identify the connection between the research factors. Descriptive and inferential statistics were used in analyzing the data and a multiple regression model was applied to establish the relationship amongst the studied factors. The study established a moderate positive relationship between process re-engineering and organizational performance (p=0.001). Consequently, in terms of recommendation, the government may consider implementing policies that enable the NHIF to develop and innovate it products concurrently protecting the interests of the members. The government should also provide marketing regulations and policies to ensure that the NHIF products are fully marketed to reach the entire population since it is the primary health insurance provider in Kenya.

Lupus and the Bottom Line: Why we Need to Talk About the Economic Impact

Lupus and the Bottom Line: Why we Need to Talk About the Economic Impact

Analysis of Motor Vehicle Insurance Coverage Under Indonesian Insurance Law

Motorized vehicles are one of the forms of transportation that are needed by Indonesian people to carry out their daily activities. The development of motorized vehicles in circulation will also make traffic conditions more congested. Motor vehicle insurance is insurance for losses in which there is no specific regulation in the Commercial Code (KUHD). All general general insurance provisions in the Criminal Code apply to motor vehicle insurance. The research method used is descriptive qualitative research with an empirical juridical approach. Insurance law is an object of civil law, if it is concluded that unless specified in the Commercial Law Code (KUHD) as a special provision as an agreement. An insurance agreement is an agreement in which one party (guarantor) agrees to bear the risk of an event where the event cannot be determined. On this basis the other party (the insured) is threatened and has an agreed interest in the occurrence of the insured event. The insurer will pay the insured in the form of money or other benefits that have financial value. Insurance in the Criminal Code shows that there is a scope arrangement that focuses on fire insurance, while there are various other types of insurance that also require regulation. From what has been discussed above, it can be concluded that the insurance business as an institution that collects funds belonging to the public runs its business adhering to sound business principles and is responsible for the arrangements ordered by the government and also accountability is carried out by issuing insurance policies that have been agreed upon jointly by the insured and the insurer as well as the premium payment by the insured to the insurer so that there is a transfer of risks arising between the rights and obligations between the two.