Party Liability Insurance Research Articles

Risk Retention and Management Implications of Medical Malpractice in the Italian Health Service

This work provides an economic exploration of the multifaceted world of medical malpractice risk. Third party liability insurance plays a central role in protecting healthcare providers and public care institutions from the financial consequences of medical malpractice claims, although in recent years, the industry landscape has been characterised by periods of distress for this type of protection, with rising litigations and reimbursement costs, resulting in a peculiarly complex market. For the Italian context, the study focuses on the financial repercussions for healthcare institutions of the growing trend towards risk retention practises, legally empowered by the introduction of Law No. 24/2017. The analysis employs Generalised Linear Models for the regressive approach to incorporate the structural and organisational characteristics of hospitals and uses quantitative simulations to explore different scenarios at a regional aggregate level. Due to the limited existing literature and data on the topic, this research aims to provide new methods for effectively understanding and managing this type of risk, thereby supporting decision-making processes in the healthcare sector.

TO THE CONCEPT OF INSURANCE INDEMNITY UNDER MOTOR TPL CONTRACTS

The present study is devoted to the issue of defining the concept of insurance compensation under contracts of compulsory motor third party liability insurance (hereinafter - CMTPL) in the system of related concepts of CMTPL using the formal-legal method of research. The article considers various approaches of insurance organisations to the concept of insurance indemnity in the context of legal relations in the field of CMTPL insurance, as well as examines the practical problems faced by both professional participants of the insurance services market - insurers, and persons who apply to them, whose property, in particular vehicles, has suffered as a result of damage caused to them by the perpetrators of road accidents. The paper analyses both regulatory legal acts in the field of CMTPL insurance and the practice of insurance organisations in carrying out their obligations under CMTPL insurance contracts in terms of insurance indemnities and related concepts: ‘insurance payments', “organisation of vehicle repair”, “insurance amounts”, etc. The paper concludes that it is necessary to establish legally the definition of the concept of insurance indemnity, to include in the content of this concept the organisation or payment for repairs within the insurance sum, and to justify the need to increase the terms of insurance indemnity in the form of repairs under CMTPL insurance contracts from thirty to forty-five days.

How far shall the protection of a traffic accident victim go under motor third party liability insurance?

This paper was inspired by a recent reference for a preliminary ruling lodged by the French Cour de Cassation (Mutuelle assurance des travailleurs mutualistes (Matmut) v TN and Others, Case C-236/23). The Cour de Cassation asked whether ‘Articles 3 and 13 ofDirective 2009/103 ofthe European Parliament and oftheCouncil of16 September 2009 must be interpreted as precluding the nullity of a contract for civil liability motor insurance from being declared enforceable against a passenger who is a victim where that person is also the policyholder and intentionally made a false statement atthe time of conclusion ofthe contract which gave rise to that nullity’. The Cour de Cassation observed that the CJEU had never ruled whether thenullity ofthe contract can be relied on against a victim who was a passenger in the vehicle where the victim is also the policyholder and the person who made the intentional false statement, which resulted in the insurance contract being null and void under national law. None ofthe judgments delivered by theCJEU relate to that specific situation. Even though the Court has been strengthening the rights of victims oftraffic accidents for many years, by applying arigorous interpretation oftheprovisions ofthemotor insurance directives precluding national rules that would allow for theavoidance ofapolicy response towards apassenger beyond the scope ofthe exclusions expressly allowed in the directives, some questions remain. In this case, we are dealing with an obvious insurance fraud committed by a person who subsequently suffered injuries in an accident caused by a driver ofthe vehicle for which a policy had been taken out by the injured person being atthe same time a policyholder. Should the EU law protect also those persons who are clearly attempting tomisuse an insurance contract? Shall we slur over the fact that by its nature an insurance contract has always been based onmutual trust (uberrimae fidei contract)? Should the rules governing motor third party liability insurance go as far as in no other insurance? Do fraudsters deserve protection? Keywords

Results of a Market Study of Vehicle Repairs Covered by Compulsory Motor Third Party Liability Insurance

Results of a Market Study of Vehicle Repairs Covered by Compulsory Motor Third Party Liability Insurance

Impact of differences between the Nuclear Law Act and the Vienna Convention on Civil Liability for Nuclear Damage on the Terms and Conditions of Nuclear Civil Liability Insurance

The focus of this article is that Polish legal provisions on civil liability for nuclear damage do not reflect the provisions of the Vienna Convention in all aspects. However, due to some limitations hereof, the considerations presented deal only with some selected issues that may affect the availability of nuclear third party liability insurance, and will be divided into two parts.The aim of the first part is to consider the major differences between the provisions of the Nuclear Law Act and the Vienna Convention, which include, among others, different deadlines for seeking compensation for nuclear personal injury and/or methods for satisfying such claims. Since both issues refer to personal injury, the notion of the latter is analysed, bearing in mind that certain discrepancies between the Polish Act and the Vienna Convention can also be noted.The second part discusses terms and conditions of third party nuclear liability insurance, entities specializing in offering such insurance, including nuclear pools and nuclear mutual insurance companies, as well as obstacles that may prevent third party nuclear liability insurance from being offered on the Polish market as compulsory insurance.This article covers only the rules relating to civil liability for nuclear personal injury resulting from the operation of a nuclear power plant, with those rules being considered primarily from the perspective of the insurance practice. The principles of civil liability for the transport of nuclear material from nuclear facilities, the operation of research reactors or of radioactive waste storage facilities have not been taken into account, as both insurers’ approach and terms and conditions of insurance covering said activities may vary slightly when compared with nuclear power plants.

Factors Affecting Choice of Comprehensive Motor Insurance in Nepal

Purpose: Compared to third party liability insurance, comprehensive motor insurance offers far more coverage. Nevertheless, despite the bigger benefit, owners of motor vehicles are not particularly motivated to purchase comprehensive auto insurance. The purpose of this study is to determine the primary determinants that influence the owners’ choice of auto insurance.
 Methodology: The study used a descriptive and quantitative research approach to look into how consumers’ choice of automobile insurance is influenced by social, psychological, economic, and vehicle factors. A systematic questionnaire was used to collect data, and it was disseminated both physically and digitally. A total of 247 samples were collected and determined to be useful for the study. Using the Statistical Package for Social Sciences (SPSS), version 26, twelve hypotheses were tested through the use of correlation, multiple regression, and crosstabs (chi-square) analysis in the study of the data.
 Findings and Conclusion: In addition, the study found that the choice of comprehensive motor insurance was significantly influenced by factors such as marital status, income, age and value of the vehicle, insurance knowledge, and claim history. It also found that psychological and economic factors had a significant impact on this decision. The study’s conclusions showed that people who could afford to pay a large premium, were financially secure, had higher insurance knowledge, and had a favorable claim settlement experience were the main factors influencing their decision to purchase comprehensive auto insurance.
 Implications: The research was conducted with few variables and there are a lot more variables that might be associated to the choice of motor insurance, as the R square value was only 32.4%. Further variables can be explored and the study can be carried out separately for four wheelers or two wheelers to be more specific. Based on the results, it is recommended that insurance companies focus on educating the public about the insurance coverages, risks, and advantages of having a comprehensive motor insurance, and simultaneously improve the claim service for the loss bearers.

DIGITIZATION AS A FACTOR OF MTPL DEVELOPMENT

This article reveals the concept, essence and significance of compulsory motor third party liability insurance (MTPL). The topic of digitalization is touched upon as a factor in the development of compulsory motor liability insurance and the use of more advanced information technologies in order to simplify the process of carrying out work in insurance activities. The article highlights and describes the characteristic features of compulsory motor liability insurance in Russia and in foreign countries. The idea of introducing digitalization as a factor in the development of compulsory motor third party liability insurance in Russia is substantiated. The article discusses the methods of digitalization in the development of compulsory motor liability insurance, the scheme of its functioning, and also develops new ways of introducing digitalization as a factor in the development of compulsory motor liability insurance. The article also analyzes the features of the development of compulsory motor liability insurance in Russia, the size of insurance premiums and payments by type of insurance. The article substantiates the main problems of the development of digitalization in the auto insurance market (including compulsory motor liability insurance), which were identified in the process of studying scientific articles, information sources and educational literature. Activities are being developed that are aimed at increasing the interest of vehicle owners in complying with traffic rules and accident-free driving through the amount of the insurance premium, which is paid when concluding an MTPL insurance contract.

Medical error and complication. Gloss to the Judgment of the Court of Appeal in Szczecin of 11 May 2017, I ACa 560/15

This gloss discusses the issues related to complications and medical error, notably the distinction between the error covered by third party liability versus undesirable results of treatment, commonly referred to as a complication or a medical failure. In medical practice, the latter gives rise to a number of practical and legal questions, at the same time being of considerable importance for insurance undertakings offering third party liability insurance. Taking into account the facts of the case and deliberations of the Court of Appeal in Szczecin in its judgment of 11 May 2017 (I ACa 560/15), the author of this gloss indicates that in the event of an error, irrespective of its nature (diagnostic error, therapeutic error, prognosis error, executive error), the doctor may be held liable for negative consequences that occur to the patient (health disorder, bodily injury or even death). However, if a doctor proves that in the case concerned a complication has occurred and that the complication is prognosed by the current medical expertise, the following mechanism applies: if the patient concerned has been advised of the possible occurrence of the complication and has given his or her informed consent to the treatment, the doctor bears no liability for negative results thereof. The cause of liability in the above case would not be a medical error, but the failure to obtain the patient’s informed consent that he or she is aware of possible complications of certain type. A distinction needs also to be made between the occurrence of a complication, the failure to provide a correct diagnosis and/or the failure to take remedial action in respect of the patient who exhibits negative effects of the treatment applied.

Analysis of the level of penetration and protection of car owners by the compulsory motor third party liability insurance system in the Russian Federation

Subject. The article considers the effectiveness of existing measures of government control over road traffic safety. Objectives. The focus is on assessing the level of protection of car owners by the compulsory civil liability insurance (OSAGO) for the period from 2014 to 2021. Methods. The study rests on methods of correlation and regression analysis. Results. The analysis of statistical data and law enforcement practice demonstrated that an increase in the number of administrative charges entails a decrease in the number of those who comply with the requirements of Federal Laws "On Road Safety" and "On Compulsory Insurance of Civil Liability of Vehicle Owners". The rise in inflation and the average size of insurance premiums and insurance payments have no impact on the number of contracts for compulsory motor third-party liability insurance (OSAGO) concluded in Russia. Conclusions. The existing measures of State regulation in the field of compulsory civil liability insurance are not effective enough. The established administrative sanctions for violation of requirements of compulsory civil liability insurance by car owners negatively affect the penetration of the institution of OSAGO and lead to a decrease in the overall protection of car owners and other road users by the mandatory liability insurance system.

Pemodelan Besar Klaim Asuransi untuk Jaminan Third Party Liability Menggunakan Distribusi Campuran Rayleigh-Rayleigh

This paper will discuss the modeling claim severity of ThirdParty Liability insurance using a mixed Rayleigh-Rayleigh distribution. The mixed Rayleigh-Rayleigh distribution is a distribution built on the basis of an infinitely mixed distribution. The mixed Rayleigh-Rayleigh distribution is a continuous distribution with one parameter, namely α. Parameters in the mixed Rayleigh-Rayleigh distribution can be estimated using the maximum likelihood estimator method through the Newton-Raphson iteration numerical method. The distribution fit test was carried out using the Kolmogorov-Smirnov fit test. The data used is data on Third Party Liability insurance claims with comprehensive coverage at PT. X for the 2019 policy for category 2 in all regions. Based on the results of applying the mixed Rayleigh-Rayleigh distribution on the data claim severity of Third Party Liability insurance with comprehensive coverage at PT. X in 2019 category 2 using the Kolmogorov-Smirnov test it can be concluded that the claims severity in regions 1 and 3 come from populations with a mixed Rayleigh-Rayleigh distribution, while the claim severity claims in region 2 come from populations that don't have a mixed Rayleigh-Rayleigh distribution.
 

Conditional tail moment and reinsurance premium estimation under random right censoring

We propose an estimator of the conditional tail moment (CTM) when the data are subject to random censorship. The variable of main interest and the censoring variable both follow a Pareto-type distribution. We establish the asymptotic properties of our estimator and discuss bias-reduction. Then, the CTM is used to estimate, in case of censorship, the premium principle for excess-of-loss reinsurance. The finite sample properties of the proposed estimators are investigated with a simulation study and we illustrate their practical applicability on a dataset of motor third party liability insurance.

Проблема мошенничества в сфере обязательного страхования автогражданской ответственности в России и регионах

Проблема мошенничества в сфере обязательного страхования автогражданской ответственности в России и регионах

The contribution of space objects insurance regulations to space traffic management

In this article, we argue that properly defined insurance regulations for the operation of space objects can become a building block of a sustainable space traffic management (STM) system. we look at Third Party Liability (TPL) insurance requirements asked by regulators at the time of licensing the operators of a space object and consider their impact on STM. The Liability Convention (1972) has States liable for damages dealt to third parties by operators they have licensed. A collision might result in potentially high financial costs, and States now take into consideration potential future financial liabilities when licensing spacecrafts. This has led to an increase in the number of States requiring the subscription, by operators of a space object, of a TPL insurance prior to authorizing the licensing of a space activity. We currently observe a variety of applicable regimes with regards to TPL insurance requirements: some states mandate it for all space objects, like the UAE, while others have requirements that can be waived in specific cases like the UK for smallsats. Others, like the USA don't mandate any TPL insurance for in-orbit activities and make them a voluntary-based subscription, while mandating it for launch and re-entry operations. TPL insurance typically varies based on risk exposure created by the licensed spacecrafts, the reliability of its operator, and risk mitigation measures put in place ex-ante and ex-post the spacecraft's launch. As such, underlying mechanics share common ground with STM metrics. Requiring the subscription of a TPL insurance has pros and cons. Requiring TPL insurance might reduce attractiveness by creating financial and administrative burdens on operators registering activities in a given country. On the other side, we believe such an obligation creates positive outcomes that directly contribute to a better STM regime. Firstly, it is expected that TPL insurance requirement regimes will induce operators in being more vigilant when conceiving systems and assuming operations of spacecrafts in order to provide guarantees that will reduce the TPL insurance paid to insurers. Secondly, imposing requirements forces regulators to improve their understanding of STM fundamentals and therefore contributes to bringing STM issues in the daily operations of licensing authorities. Thirdly, it will force markets to include a financial metric into STM by creating insurance products.

Przegląd orzecznictwa Sądu Najwyższego

Overview of the decisions of the Polish Supreme Court The Resolution of the Polish Supreme Court of October 6, 2022 (case file no. III CZP 119/22) is of particular importance for legal practice. The Court indicated that the compensation due from the insurance company under the contract of third party liability insurance of motor vehicle owners for damages arising from the use of these vehicles covers only necessary and economically justified repair costs. In the Resolution of October 6, 2022 (case file no. III CZP 112/22), the Polish Supreme Court stated that the ruling issued in closed session is a ruling that does not exist if the signature has been placed only under the entire document including the operative part and the main reasons for the ruling (Art. 357 § 5 Civil Procedure Code). Moreover, in the Resolution of June 2, 2022 (case file no. I CSK 219/22), the Polish Supreme Court decided that the submission by parents on behalf of a minor child of a declaration of inheritance rejection is an activity that exceeds the scope of the ordinary management of the child’s property, and making it without the prior consent of the guardianship court entails the nullity of this type of declaration. In addition, the Polish Supreme Court, in the Resolution of May 31, 2022 (case file no. II CSKP 34/22), stated that bringing an action by a parent on behalf of a child for the protection of personal rights against the other parent of that child is an act of representation of the child.

The market concentration and competitive environment of casco and motor third party liability insurance in Bulgaria

The market concentration and competitive environment of casco and motor third party liability insurance in Bulgaria

Zasady odpowiedzialności za szkodę wyrządzoną przez obiekt kosmiczny wyniesiony przez Rzeczpospolitą Polską w przestrzeń kosmiczną

According to the Convention on International Liability for Space Damage, drawn up in Moscow, London and Washington on 29 March 1972 in the event of damage being caused elsewhere than on the surface of the Earth to a space object by a space object of another launching State, the latter shall be liable only if the damage is due to its fault or the fault of persons for whom it is responsible. Therefore, every state is liable on the basis of the fault for damages which were caused by a space object dispatched from its territory. For this reason, the draft Act on space activities and the National Register of Space Objects of 10 July 2017 allows the State Treasury to raise a recourse claims for damages which were caused by a space object, from the owner of that space object, and if the operator is found to be guilty of causing damages, also from this operator to its full value. Moreover, this draft obliges the owners of space object to have compulsory third part liability insurance. Unfortunately, the last mentioned provision remains extremely laconic, and the compulsory third party liability insurance applicable to space objects will not be subject – per analogiam – to the provisions of the Act on Compulsory Insurance, the Insurance Guarantee Fund and the Polish Motor Insurers’ Bureau of 22 May 2003 as it is the case of motor vehicles.

Distortion of the cervical spine : Pathophysiology, diagnostics, treatment and assessment

Distortion or whiplash trauma of the cervical spine is an injury pattern associated with motor vehicle collisions and typically occurs after rear impact collisions, but is not limited to this type of collision and accident. The vast majority of these injuries are low-grade injuries according to the Quebec Task Force (QTF) classification, whereby no objective morphological correlates can be determined in clinical and radiological examinations. The prognosis is predominantly favorable and the condition is self-limiting; however, care must be taken with respect to complex courses with chronic pain and the manifestation of neuropsychiatric complaints. Due to the mechanism of the accident this injury pattern is particularly frequent in accidents associated with third party liability insurance claims. The discrepancy between subjective complaints and the presence of objective findings is a particular challenge for the assessment by the medical expert.

Multivariate Modelling of Motor Third Party Liability Insurance Claims

The aim of the study is to identity the main factors that affect claims amount paid by insurers in case of road accidents and to predict losses from valid third-party liability insurance (MTPLI) policies until their expiration. Such an assessment is essential to adequately cover MTPLI policies and ensure the sustainable development of insurance companies. The geography of the study covers the MTPLI market of Europe in the main areas, but a deeper analysis of the impact of various factors, interactions, and interrelationships in MTPLI product is focused on Latvian market data due to availability of high-quality primary data. The research is based on the analysis of primary Latvian MTPLI policies data of more than 128,000 road traffic accidents that have occurred during the time period from 2014 till 2020. Risk driver selection was performed based on the existing scientific studies and correlation analysis of the sample set. Both linear and nonlinear forms of relationships were used for modelling. A multivariate modeling was used to identify significant risk factors and to quantify their impact on loss of incidents. Statistical stability of the models was tested using chi-squared, t-tests and p-values. Validation of models calibrated where done using prediction errors measurements: mean square error (MSE), root mean squared error (RMSE), and mean absolute error (MAE) assessment both within sample and out of sample technics. The results indicated that the driver’s behavior (penalties and Bonus-Malus) as well as vehicle parameters (weight and age), had significant impacts on crash losses.

The development of Polish Supreme Court case law in the area of motor third party liability insurance – selected judgments in 2013–2021

The authors present selected cases of Polish Supreme Court decisions in the area of motor thirdparty liability insurance. The review can be divided into two sections: 1) the scope of pecuniary damage, especially the costs incurred by the injured party and 2) the contributory negligence of a victim of the event causing the damage.

Distribution of the Burden of Proof in the Claim Settlement Procedure in Voluntary Business Third Party Liability Insurance

The article is an attempt to analyse the legal standing of the policyholder, the insurer and the injured party in the context of an obligation to collect evidence at the stage of the claim settlement procedure as part of handling claims under voluntary third party liability insurance contracts concluded by entrepreneurs. It is important to establish the limits of the obligations of the insurer, the policyholder and the injured party in the claim settlement procedure, and in particular to consider the property interests of the insured entrepreneur in relation to the interests of the injured party. The article examines the insurer’s role in ascertaining facts of the case and conducting a legal assessment, as well as in obtaining material evidence necessary to handle claims of injured parties pursued against the insured entrepreneur and the third party liability insurer. In addition to discussing the application of Article 6 of the Polish Civil Code in the claim settlement procedure, the article addresses the objectives and functions of business third party liability insurance in the context of evidence collecting and weighing. Furthermore, the author considers the legal standing and scope of the insurer's activity in cases where the injured party has instituted court proceedings.