Insurance Providers Research Articles

Investigation into the matching problem between insurance demands and insurance supply in Shanxi Province, China

Abstract With the development of the social economy and the improvement of people’s living standards, the role of insurance in society has become increasingly important. The insurance industry’s growth is not in line with social demands. Insufficient insurance capacity or a mismatch between insurance products and demands in specific regions or industries can lead to increased social risks and unprotected interests. Taking Shanxi province as an example, it is a substantial industrial and energy base in China with abundant resources such as coal and power. Shanxi province is facing challenges of transformation and upgrading due to the transformation of economic structure and the increasing environmental awareness. The matching problem between social demands and insurance capacity becomes particularly important in this process. This paper aims to examine the issue of insurance demand and supply matching, using Shanxi province as a case study. The demand for insurance protection is increasing as social risks increase with rapid economic development and improvements in people’s living standards. However, there is a gap between insurance capacity and social demands, which limits the development of the insurance industry and the effective management of social risks. The characteristics of insurance demands and the current situation of insurance supply in Shanxi province are analyzed through a literature review and empirical research methods in this paper. It discusses the problems and shortcomings of the insurance industry in meeting social demands and proposes a series of policy recommendations to promote the matching of insurance demands and supply.

Study of traffic safety on the street and road network of Ternopil

The road safety issues in the city of Ternopil are studied in this article. The found actual deficiencies were structured according to the main indicators. Based on the analysis of the movement of traffic flows in the morning period, the most problematic sections of the SRN (street and road network) were identified. In general, the speed of traffic flows along the SRN in the evening peak period was found significantly lower than in the morning peak period. To analyze road traffic safety in the city of Ternopil, a cartographic method was applied. Based the obtained results, the road accidents in Ternopil mostly occur along main streets without clearly defined places of concentration. In this regard, a conditional indicator of the danger of transport corridors of Ternopil was derived, which allows analyzing the predominant location (clustering) of road accidents with victims in each district of the city. The current policy and practices of Ternopil in the field of road safety management need improvement. However, the volume of performed measures does not fully cover the need in traffic safety insurance and information provision of traffic participants. In general, it can be stated that proactive actions in the field of ensuring traffic safety are just starting in Ternopil (“starting city”). Thus, it differs favorably from the vast majority of other regional centers, in which the problem of traffic safety has not been even discussed so far. In addition, the plan for sustainable urban mobility is under consideration in the Ternopil City Territorial Community.

Type 2 diabetes severity in the workforce: An occupational sector analysis using German claims data.

Individuals of working age spend a significant amount of time at the workplace making it an important context for disease prevention and management. The temporal development and prevalence of T2D have been shown to differ in the working population based on gender, age group and occupational sector regardless of socioeconomic status. Given potential differences in risk factors associated with different work environments, this study aims to define vulnerable occupational groups by examining T2D severity and its trends in working men and women with T2D of two age groups and among nine occupational sectors. The study is based on claims data of the statutory health insurance provider AOKN. The study population consisted of all insured working individuals with T2D. T2D severity was measured using the adapted diabetes complications severity index-complication count (DCSI-CC). Mean DCSI-CC scores were calculated over four time periods between 2012 and 2019 for men and women of the age groups 18-45 and 46+ years and among nine occupational sectors. Trends of DCSI-CC were investigated using ordinal logistic regression analyses to examine the effect of time-period on the odds of having higher DCSI scores. Overall, there was a significant rise in T2D severity over time in working men and women of the older age group. Moreover, the study displayed occupational sector differences in T2D severity and its trends. Over all, working men of all sectors had higher DCSI-CC scores compared to working women. Individuals working in the sector "Transport, logistics, protection and security" and "Construction, architecture, measuring and building technology" had higher T2D severity, while those working in the "Health sector, social work, teaching & education" had relatively lower T2D severity. There was a gender-specific significant increase over time in T2D severity in the above-mentioned occupational sectors. The study displayed gender, age group and occupational sector differences in T2D severity and its trends. Working individuals could thus benefit from personalized prevention interventions that consider occupational contexts. As a next step, examining T2D trends and severity in specific occupations within the vulnerable occupational sectors is needed.

Determinants of Life Insurance Purchase Intention using Structured Equation Modelling with Focus on Saving Motive and Financial Literacy

Life insurance serves as an important financial instrument, which effectively safeguards the family against adverse financial consequences resulting from an untimely demise of the primary breadwinner. This research paper delves into the factors that impact the purchasing intentions of life insurance among married working professionals. Employing Structural Equation Modelling (SEM), the study analyses the impact of saving motives and financial literacy on life insurance purchasing intentions. The findings suggest that saving motives and financial literacy have a positive and significant effect on the purchase intention of life insurance. Furthermore, the paper demonstrates that incorporating continuous manifest variables enhances the model fit and provides more accurate estimates of the relationships between variables. This provides valuable insights for life insurance providers, enabling them to gain a better understanding of the factors influencing consumers’ purchase intentions.

Taxation and policyholder behavior: the case of guaranteed minimum accumulation benefits

AbstractThis paper considers variable annuity (VA) contracts embedded with guaranteed minimum accumulation benefit (GMAB) riders when policyholder’s proceeds are taxed upon early surrender or maturity. These contracts promise the return of the premium paid by the policyholder, or a higher rolled-up value, at the end of the investment period. A partial differential equation valuation framework which exploits the numerical method of lines is used to determine fair fees that render the policyholder and insurer breakeven. Two taxation regimes are considered: one where capital gains are allowed to offset losses and a second where gains do not offset losses. Most insurance providers highlight the tax-deferred features of VA contracts. We show that the regime under which the insured is taxed significantly impacts prices. If losses are allowed to offset gains then this enhances the market, increasing the policyholder’s willingness to participate in the market compared to the case when losses are not allowed to offset gains. With fair fees from the policyholder’s perspective, we show that the net profit is generally positive for insurance companies offering the contract as a naked option without any hedge. We also show how investment policy, as reflected in the Sharpe ratio, impacts and interacts with policyholder persistency.

Healthy enough to work up to age 67 and beyond? A longitudinal population-based study on time trends in working life expectancy free of cardiovascular diseases based on German health insurance data

BackgroundDue to the rising life expectancy in Western countries, the discussion about the increase in the retirement age is becoming more important. However, the prolongation of working lives cannot be...

Activity of Daily Living of Elderly People in Rural Setting of Nepal: Situation and Scenarios in Present Context

Ageing is the global issue that affects almost all countries of the globe but its pace and level varies largely. The activities of daily living of elderly people are affected by various factors which reduce the activeness of elderly for their fullest contribution for development of society and nation. The activities of daily living are decreases with increasing the age and requires due medical care, support and treatment. The objective of this paper is to examine the contributing factors for activity of daily living in rural setting of Nepal. The cross-sectional study was carried out in Sunkoshi Rural Municipality, Sindhuli district in 2022 in which 413 elderly people aged 60+years were interviewed applying structured questionnaire. Chi-square test was employed to assess the association between dependent and independent variables whereas logistic regression was used to examine the contributing independent variables to activity of daily living. Of the total respondents, the significant proportion of respondents needed help for urination (50.12%) followed by carrying things (38.74%), walking (26.63%) and standing up (18.16%) whereas the least expressed that they need help for feeding (5.81%). Elderly having higher age have significantly higher likelihood of need of help for activity of daily living [70-79 years of age (OR=4.40, CI: 2.77-6.98) and 80+ years of age (OR=15.02, CI: 6.18-36.50)] than elderly aged 60-69 years of age. The likelihood of need of help for supporting daily activity is observed higher in joint family (OR=2.79, CI: 1.75-4.42) Janajati (OR=2.48, CI: 0.79-3.64) and having no provision of insurance (OR=2.88, CI: 0.97-8.55). The likelihood of need of help for daily activities is found higher among elderly who stopped working completely (OR=4.38, CI:1.46-3.34). The likelihood of seeking help for daily activity is significantly higher among elderly who do not involve in vigorous and moderate intensity activity and need of such help is observed highest among elderly who does not have capacity of grazing animals, putting grass and collecting dung. Daily activity of elderly people is the major symbol of active and successful ageing so it is most essential to promote the activity of daily living by ensuring and enhancing the aforementioned aspects.

Determinants of Health Inequality in Sub-Saharan Africa: Further Evidence from Feasible Generalized Least Squares (FGLS) Approach

A nation’s progress is largely influenced by its state of health. This is so because a healthy people are not only able to work and support themselves, but are able to make a significant contribution to the socio-economic expansion and improvement to the community in which they reside. One of the major limitations to achieving the above fit is the increasing health disparity in the larger ecosystemn. And, despite the several initiatives and programmes developed to narrow the growing health gap across the various social strata among individuals around the world, it still persists. Motivated by the need to bridge this rising health gap, this study examines the determinants of health dispraities within the context of sub-Saharan Africa for the period 2004 to 2022, using the panel feasible/estimated generalised least squares. The results revealed that while public health spending per capita, income per capita, and health-oriented net official development assistance negatively and statistically impacted on health inequality, unemployment and income poverty positively and significantly impacted on health inequality in sub-Saharan Africa. Accordingly, the paper recommends, amongst others, the urgent need for policy makers in SSA region to pay greater attention to budgetry allocations to the health sector for the provision of health insurance and quality and affordable healthcare services. Such efforts should be complemented with the formulation of workable, active, measurable and employment-based policies across SSA region, aimed at creating stable and profitable jobs for the unemployed and under-employed masses.

Insurance Services and Protection of Economic Resources of Production in Rwanda in Sonarwa

The focus of this study was to assess the contribution of insurance services in the protection of economic resources of production, taking SONARWA Insurance Company as a case study. The study used a descriptive method whereby both qualitative and quantitative data were sought. The target population consisted of managers in public companies, private companies, semi-public companies, NGOs as well as individual clients who are experienced and paid a considerable premium and also employees of Sonarwa General who are managers and employees working in different departments. The total population came to 104 insured clients including 25 staff respondents from Sonarwa General in Kigali City. Slovin’s formula was used to calculate the sample size of 62 respondents of whom questionnaires were distributed to them to receive their views. The researcher designed a special interview schedule with insured clients using random sampling as well as top managers using purposive sampling. The data analysis was done using tables generated from SPSS. It was found that there was the effectiveness of insurance services in protecting economic resources as 21.0% of respondents said that quick compensation is one of the elements that make the insurance services of Sonarwa General very effective because the insured restart quickly their activities and continue its course of productivity. On the impact of insurance services from SONARWA on the sustainability of economic resources of the production of insured, 33.9% said that insurance services protect economic resources through the insurance of goods and properties, 17.7% for liability insurance, and 21.0% for financial operations and bid bonds. On the development of various insurance products and provision of opportunities to secure different types and categories of assets of the insured, 26 (41.9%) of respondents agreed that SONARWA-developed services and products protect the resources of the insured to about a tune of 61% to 80% risk protection against internal and external threats to be able to protect the economic resources of production of its clients. In addition, 24.2% of respondents were contented with the way Sonarwa identified major risks that may affect the economic resources of the insured so that it could establish appropriate ways to properly protect the economic resources of the insured against probable risks. Keywords: Insurance services, SONARWA, Insurance Companies, Economic resources, Insured.

Medical Costs Estimation Using Linear Regression Method

Medical costs are a significant issue in the health sector. High healthcare cost lead to the need to anticipate financial risks for individuals and insurance providers. Therefore, medical cost data analysis is necessary to estimate future medical expenses. This research implements data mining techniques using Simple and Multiple Linear Regression methods to estimate medical costs. The dataset used consists of insurance claim data obtained from Kaggle, which includes attributes such as age, gender, body mass index, number of children, smoking habits, region, and medical charges. The research findings that Multiple Linear Regression outperforms Simple Linear Regression in estimating the provided dataset, with R2 value of 80% and lower ?? MSE and MAE values than Simple Linear Regression. The application of linear regression in insurance claim data analysis can provide significant benefits for patients, hospitals, and insurance providers. Overall, this research highlights the effectiveness of data mining techniques, specifically linear regression, in estimating healthcare costs.

Medical Insurance Fraud Detection Using Machine Learning

Medical insurance fraud poses significant challenges to the healthcare industry, impacting financial resources and patient care. This research explores the application of machine learning methodologies to detect fraudulent activities within healthcare insurance claims. Medical insurance fraud detection is crucial to help insurance companies save money. Machine learning is a powerful tool that can be used to detect fraudulent activities in the healthcare industry. Fraud can be spread broadly and extremely costly to the therapeutic protection framework. Protection can be made unscrupulous and be a case designed to hide or alter such information meant for social insurance benefits. Cheats might be numerous and submitted by the protection guarantor or the safeguarded. The unscrupulous social insurance providers are the reason for extortion in the well-being segment. This research approach is to apply machine learning to find incidents of medical insurance fraud automatically. In conclusion, machine learning is a promising tool for detecting medical insurance fraud. It can help insurers detect fraudulent activities in real time, saving money on bogus claims.

CARE PLAN INVENTORY AND ASSESSMENT—A MEANS TO LEARN MORE ABOUT CMS

Abstract The Health and Aging Policy Fellowship (HAPF) provides an orientation on the federal government organization and an introduction to aging policy foundations and agencies. The goal of this orientation is to lead to a growth of a professional network as well as a policy placement opportunity. I will explain the process for choosing a HAPF placement with the Centers for Medicare and Medicaid Services (CMS) and Agency for Health Research and Quality (AHRQ). Using my HAPF experience as an example of how my interest in Age-Friendly Health System work at a large health system led to my placement and personal growth. I will discuss my reasoning in taking part in the Fellowship and the creation of CMS Care Plan Inventory and Assessment. Achieving goal-concordant care is the bedrock of Age-Friendly care. Creating care plans is a means for teams and insurance providers use to create goal concordant care. Measuring goal concordant care is a challenge, but development of care plans would be a potential start. CMS utilizes care planning in programs and in billing codes. My Health and Aging Policy Fellowship placement assessed how care planning is defined and what are the elements in CMS programs and billing codes and if these are aligned with care plan research from AHRQ. My experience, current interests and project development will be the example of how HAPF provided me with a better understanding of CMS programs and how billing code creation affects clinician behaviors and , in turn, patients.

Health inequality and health insurance coverage: The United States and China compared

We study inequality in the distribution of self-assessed health (SAH) in the United States and China, two large countries that have expanded their insurance provisions in recent decades, but that lack universal coverage and differ in other social determinants of health. Using comparable health survey data from China and the United States, we compare health inequality trends throughout the period covering the public health insurance coverage expansions in the two countries. We find that whether SAH inequality is greater in the US or in China depends on the concept of status and the inequality-sensitivity parameter used; however, the regional pattern of SAH inequality is clearly associated with health-insurance coverage expansions in the US but not significant in China.

Smart h‐Chain: A blockchain based healthcare framework with insurance fraud detection

AbstractIn today's smart applications, very frequently used data like electronic health records (EHR's) are highly sensitive and soft target to the unauthorized agencies. Data management, integrity, and security issues plague EHR systems. Insurance firms are prohibited by law and corporate privacy from sharing patient data, but because the data are not linked and synchronized among insurance providers, there has been a rise in healthcare fraud. A crucial component of an e‐health system is safe communication between patients, healthcare providers, and insurance companies. Building a system to securely manage and track insurance operations by combining data from all sources is required to combat health insurance fraud. Over time, blockchain grew in popularity, and the healthcare sector's interest in it led to the development of design concepts that addressed security issues. In this study, a blockchain‐based security architecture has been presented to protect the EHR and provide a secure method for patients, their caregivers, physicians, and insurance agents to access the clinical data of the patients. By using off‐chain storage and cryptographic key exchange through blockchain our approach also covers the scalability, integrity and access control issue that a healthcare system in general is facing.A crucial component of an e‐health system is safe communication between patients, healthcare providers, and insurance companies. A blockchain‐based security architecture has been presented to protect the EHR and provide a secure method for patients, caregivers, physicians, and insurance agents to access the clinical data of the patients.

Factors Influencing Technological Adoption in the Slovak Insurance Market

The global insurance sector has undergone significant transformation due to the widespread integration of digital technologies. E-insurance, which involves the provision of insurance and related financial services through digital platforms, represents a significant advancement in this context. Digital innovation has not only increased profits to insurance companies but also facilitated the development of effective business strategies, enhancing their market share. The objective of this analysis is to uncover the determinants influencing the adoption of innovative technological solutions in the Slovak insurance landscape between 2011 and 2021. Utilizing the Technology-Organization-Environment (TOE) framework, the study categorizes the factors affecting the incorporation of IT in e-insurance into three groups: technological, organizational, and environmental. The findings reveal that the environmental factor exerts the most substantial influence on technological adoption in insurance market. Moreover, the study highlights the ample opportunities for insurance companies in the Slovak market to enhance their position through digitalization. Particularly noteworthy is the positive impact of an insurance company's market share on the likelihood of e-insurance adoption.

Comparison Between Machine Learning Regression Modelling to Predict Individual Premium Price

<p>Machine Learning (ML) applications in healthcare aim to simplify people's lives by swiftly predicting and diagnosing diseases, outpacing the capabilities of most medical experts. A direct connection is established when technology, particularly digital health insurance, is employed to minimize the gap between insurance providers and policyholders. This has significantly transformed the way insurers create health insurance policies and has led to faster service delivery for consumers. Machine learning is utilized by insurance companies to offer clients precise, prompt, and efficient health insurance coverage. In this study, a regression method was trained and assessed to which one gets the bigger accuracy to forecast premium prices. The researchers accurately predicted the premium prices individuals incur based on various factors, such as age, diabetes, blood pressure issues, height, and weight. The experimental outcomes revealed the best method to predict is the KNN method in the data set that was used in the analysis, with an impressive accuracy of 87.73%. In comparison, the Random Forest is 87%, and the Boosting is 87.19% and the authors analyzed the model's performance using key metrics to assess its effectiveness. </p>

Financial impacts of climate change

ABSTRACTThis study uses panel data for the 50 states of the U.S. plus the District of Columbia from 1998 to 2018 to examine pricing effects of climate change on housing and insurance markets. We apply the mean group estimator and separate short-run from long-run impacts. The results indicate long-run relationships between the housing/insurance market and climate change, although no significant impacts of climate change on these markets appear in the long-run. In the short-run, we find significant negative impacts of fire occurrences on housing prices and mortgage rates, and significant positive impacts of flooding on insurance markets. Further analysis of states exposed to severe climate risks indicates no short- or long-run impacts of climate change. Thus, while realtors and insurance providers may price some climate-risks into mortgage and insurance in the short-run, they do not in the long-run.

Determinants of operational efficiency on the financial health of non-life insurance companies in South Africa

This study aimed to determine the effect of operational efficiency on financial health of non-life insurance companies in South Africa. Operational efficiency refers to an insurer’s ability to deliver its services while minimizing costs and maximizing profitability. A descriptive research design was used to achieve the objective of this study. The panel data from 2008–2019 used secondary data sourced from S&P Capital Q and Refinitiv Eikon, well-known databases with readily available data. The population of this study focuses on 32 non-life insurance companies with measurable markets of 57 domestic non-life insurance providers in South Africa. Data were analyzed using Fixed-effect regression, (Random-effect GLS regression, correlation, and the Hausman test. The result reveals that of all the variables, only premium growth correlates significantly (negative correlation) with financial health. This could be a result of a specific investment that resulted in a lower rate than that of a risk-free security. It is also important to note that a negative premium does not always indicate a problem. This can happen due to cancellations of reinsurance, reinsurer closures, paid off reinsurance ahead of time, under- pricing policies, inadequate reserves, high claim frequency, operational inefficiencies, investment losses, inadequate risk assessment, economic downturn, regulatory changes, catastrophic event, and any other events. It is essential for non-life insurance companies to carefully manage their underwriting practices, risk assessment, pricing strategies, and investment portfolios to avoid negative premium situations and maintain financial health.

Expectations of clients, insurers, and providers: a qualitative responsiveness assessment among private health insurance sector in Kampala-Uganda

BackgroundThere is less attention to assessing how health services meet the expectations of private health insurance (PHI) actors, clients, insurers, and providers in developing countries. Interdependently, the expectations of each actor are stipulated during contract negotiations (duties, obligations, and privileges) in a PHI arrangement. Complementary service roles performed by each actor significantly contribute to achieving their expectations. This study assessed the role of PHI in meeting the expectations of clients, insurers, and providers in Kampala. Lessons from this study may inform possible reviews and improvements in Uganda’s proposed National Health Insurance Scheme (NHIS) to ensure NHIS service responsiveness.MethodsThis study employed a qualitative case-study design. Eight (8) focus group discussions (FGDs) with insured clients and nine (9) key informant interviews (KIIs) with insurer and provider liaison officers between October 2020 and February 2021 were conducted. Participants were purposively selected from eligible institutions. Thematic analysis was employed, and findings were presented using themes with corresponding anonymized narratives and quotes.ResultsClient-Provider, Client-Insurer, and Provider-Insurer expectations were generally not met. Client-provider expectations: Although most facilities were clean with a conducive care environment, clients experienced low service care responsiveness characterized by long waiting times. Both clients and providers received inadequate feedback about services they received and delivered respectively, in addition to prompt care being received by a few clients. For client-insurer expectations, under unclear service packages, clients received low-quality medicines. Lastly, for provider-insurer expectations, delayed payments, selective periodic assessments, and inadequate orientation of clients on insurance plans were most reported. Weak coordination between the client-provider and insurer did not support delivery processes for responsive service.ConclusionHealth care service responsiveness was generally low. There is a need to commit resources to support the setting up of clearer service package orientation programs, and efficient monitoring and feedback platforms. Uganda’s proposed National Health Insurance Act may use these findings to: Inform its design initiatives focusing on operating under realistic expectations, investment in quality improvement systems and coordination, and efficient and accountable client care relationships.

Penerapan Undang-Undang Perlindungan Nelayan Terhadap Masyarakat Nelayan Di Provinsi Jawa Tengah

The protection of fishermen is based on Undang-Undang Nomor 7 Tahun 2016 with a research focus on the efforts made by the government to ensure the protection of fishing communities in Central Java. This research uses a qualitative-descriptive research type with data collection techniques using library research methods. Therefore, the type of data in this research is secondary data. The results of the research then contain the government's way of ensuring the protection of fishermen through the Fishermen's Insurance Premium Assistance program by the Ministry of Maritime Affairs and Fisheries. During the implementation of the program from 2016 to 2019, 111,547 small fishermen received insurance assistance from the government. The Central Java Provincial Government also provides a fishermen's insurance program through the Central Java Maritime and Fisheries Agency to provide wider opportunities for fishermen in Central Java to have insurance. In its implementation, the provision of fishermen's insurance has several obstacles, such as a limited budget and the fact that many fishermen are reluctant to register for insurance independently. Therefore, not all Central Java fishermen have this fishermen insurance. However, there have been fishermen who have felt the benefits of fishermen's insurance and began to realize that insurance is important to have. This study concludes that the implementation of the fishermen's insurance program can be said to be successful, but the implementation has not been optimal.