Insurance Problems Research Articles

Continuous Glucose Monitoring Attrition in Youth With Type 1 Diabetes.

The purpose of the study was to identify the most common reasons for and timing of continuous glucose monitoring (CGM) attrition in youth with type 1 diabetes (T1DM). This single center retrospective chart review included youth with T1DM <22 years seen between November 1, 2021, and October 31, 2022. Data were gathered from CGM cloud-based software and the electronic medical record. Among 2663 youth, 88.3% (n = 2351) actively used CGM, and 5.9% (n = 311) had CGM attrition. Those who discontinued CGM were older (17.0 vs 14.9 years, P = .0001), had a longer T1DM duration (7.4 vs 5.1 years), higher A1C (9% vs 7.4%), and were non-Hispanic Black (NHB; 34.0% vs 11.5%). The odds of CGM attrition were 5.0 and 2.8 times higher in NHB and Latine youth, respectively, compared to non-Hispanic White youth. Median time to CGM discontinuation was 4 months, 21 days after initiation; 57% of youth who discontinued did so in the first 6 months of use. The most common reasons for CGM attrition were problems with device adhesion (18.4%), dislike device on the body (10.8%), insurance problems (9.5%), pain with device use (8.3%), and system mistrust due to inaccurate readings (8.2%). NHB and Latine youth were more likely to discontinue CGM due to insurance problems (3.2% vs 15.1% vs 16.7%). To support equitable, uninterrupted CGM use, education at CGM initiation should address practical approaches to improve adhesion and wearability and provide a clear pathway to obtaining supplies. Interventions to support sustained CGM use should occur within the first 6 months of initiation.

Two stackelberg games in life insurance: Mean-variance criterion

Abstract We study two continuous-time Stackelberg games between a life insurance buyer and seller over a random time horizon. The buyer invests in a risky asset and purchases life insurance, and she maximizes a mean-variance criterion applied to her wealth at death. The seller chooses the insurance premium rate to maximize its expected wealth at the buyer’s random time of death. We consider two life insurance games: one with term life insurance and the other with whole life insurance—the latter with pre-commitment of the constant investment strategy. In the term life insurance game, the buyer chooses her life insurance death benefit and investment strategy continuously from a time-consistent perspective. We find the buyer’s equilibrium control strategy explicitly, along with her value function, for the term life insurance game by solving the extended Hamilton–Jacobi–Bellman equations. By contrast, in the whole life insurance game, the buyer pre-commits to a constant life insurance death benefit and a constant amount to invest in the risky asset. To solve the whole life insurance problem, we first obtain the buyer’s objective function and then we maximize that objective function over constant controls. Under both models, the seller maximizes its expected wealth at the buyer’s time of death, and we use the resulting optimal life insurance premia to find the Stackelberg equilibria of the two life insurance games. We also analyze the effects of the parameters on the Stackelberg equilibria, and we present some numerical examples to illustrate our results.

The Impact of the WTO Agricultural Agreement on Developing Countries

Abstract: Agricultural insurance, as an agricultural risk management tool to disperse agricultural risks, compensate farmers' losses and safeguard agricultural production, has become an indispensable part of the agricultural security system in various countries. However, due to the high cost of agricultural insurance, many countries provide financial subsidies for agricultural insurance. This paper introduces the help of agricultural insurance subsidies to countries in World Trade Organization (WTO), summarizes the main features and inadequacies of relevant WTO rules, and analyzes the existing problems of agricultural insurance subsidies from four aspects based on the practice of American agricultural insurance subsidies. The main conclusions of this paper include: first, the rules of agricultural insurance subsidy are limited and the classification is not clear, which seriously harms the agricultural development of developing countries; second, income insurance and natural disaster insurance in premium subsidies are regarded as "green box" tools, which need to meet certain conditions, otherwise there is still the possibility of being regarded as "amber box" tools; third, the current WTO rules on agricultural insurance subsidies are more conducive to the development of developed countries, but the agricultural insurance subsidies in developing countries lag behind and are difficult to implement, and the rules on agricultural insurance subsidies urgently need to be improved. Fourth, the double standards of developed countries and developing countries have caused differences in the classification of agricultural insurance subsidies. Finally, the thesis puts forward some suggestions on the compliance development of China's agricultural insurance subsidies under the framework of WTO rules.

Der Reformvorschlag einer preisindexierten Dynamisierung der Rente

Abstract This article deals with the financing problems of statutory pension insurance in Germany, which are primarily the result of demographic changes in the population. It discusses the reform proposal of a price-indexed dynamisation of pensions and highlights the economic considerations and political ideas underlying the current linking of pensions to wage trends. The advantages and disadvantages of an alternative link to price trends are discussed. Furthermore, the reform proposal of a differentiated pension adjustment is critically examined. Differentiated adjustments are usually intended to protect only particularly vulnerable pensioners from high inflation.

Abstract A101: Barriers to cancer care access in Puerto Rico: Exploring clinical and sociodemographic disparities

Abstract INTRODUCTION: In 2020, Puerto Rico (PR) reported 14,168 new cancer cases and 5,354 cancer-related deaths. Timely access to diagnosis and treatment are crucial for enhancing survival and quality of life among cancer patients. Our study aimed to identify barriers to accessing cancer treatment and explore their association with patients selected clinical and sociodemographic characteristics. METHODS: In this ongoing cross-sectional study, cancer patients aged 21+ years, who received active treatment within the past year and resided in PR, completed an online survey. Accessing cancer treatment was defined as self-reported difficulties to initiate or continue cancer treatment. Data were analyzed using descriptive statistics. Contingency tables were generated to assess the relationship of access to cancer treatment and selected characteristics using the Chi-Square test. RESULTS: As of May 16, 2024, a total of 318 participants were eligible and completed the online survey. Most of the participants were women (71.1%), unemployed (68.6%), lived in urban/suburban areas (69.6%), and have multimorbidity (72.3%). The mean age was 58.8±12.6 years. Approximately 30.5% of the participants experienced at least one barrier to accessing cancer treatment, with the most common barriers including health insurance problems (43.3%), lack of communication with healthcare providers (20.6%), and financial problems (24.7%). Barriers to accessing cancer treatment were more likely to occur among women (34.5% vs.20.6%; p=0.02), and those with multimorbidity (33.9% vs.21.6%; p=0.03) than among their counterparts. Furthermore, barriers to accessing cancer treatment were observed mainly among those with lower cancer stages (localized:28.4%, regional:42.9%, distant:22.6%; p&amp;lt;0.05). CONCLUSION: In PR, cancer patients facing challenges in accessing treatment are primarily affected by health insurance problems, lack of communication, and financial issues, which underscores the need for comprehensive support. Further studies should evaluate the experiences of cancer patients when seeking treatment and develop targeted cancer care plans to address these specific concerns effectively. IRB: This project was approved by the Institutional Review Board of the University of Puerto Rico Comprehensive Cancer Center (IRB # 2023-11-123). Citation Format: Lorena González-Sepúlveda, Sofía Contreras-Fernández, Karina Torres-Mojica, Rocío Del Mar Avilés-Mercado, Juan Paulo González-Mayoral, Nancy Cardona-Cordero, Marievelisse Soto-Salgado. Barriers to cancer care access in Puerto Rico: Exploring clinical and sociodemographic disparities [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A101.

Stochastic optimal control problem of consumption and pension insurance with uncertain lifetime and its application to real-life data

We consider a continuous-time model of optimal consumption and pension insurance for a consumer with an uncertain lifetime. In the model, the consumer earns a stochastic wage income during her working life and optimally allocates her income between personal consumption, pension insurance, and securities with a deterministic dynamic return. Due to the weak development of the stock market in developing countries, employees' income comes mainly from wages and interest on savings from banks, that are discussed in this paper. The consumer's utility and bequest functions are constant absolute risk aversion (CARA). By characterizing the optimality condition of the consumer's problem using the Hamilton-Jacobi-Bellman equation, we find the optimal consumption and pension insurance as a function of wealth in closed form. We consider an application of the model while estimating its key elements using real-life data on age-specific population size, labor income, and interest rates. We show that as the absolute risk aversion for consumption increases, consumption and wealth move in the opposite direction. We also present a novel finding that wealth and consumption can be negatively related across consumers with different levels of consumption risk aversion.

The Current Situation and Problems of Pet Liability Insurance in China

The Current Situation and Problems of Pet Liability Insurance in China

Payment Systems, Insurance, and Agency Problems in Healthcare: A Medically Framed Real-Effort Experiment

Payment Systems, Insurance, and Agency Problems in Healthcare: A Medically Framed Real-Effort Experiment

Linearisation techniques and the dual algorithm for a class of mixed singular/continuous control problems in reinsurance. Part II: Numerical aspects

Linearisation techniques and the dual algorithm for a class of mixed singular/continuous control problems in reinsurance. Part II: Numerical aspects

Medical professional liability insuarance

The aim of the study is to form an integrated approach to understanding the context and legal necessity of medical professional liability insurance.&#x0D; The methodological basis of the study is a set of scientific techniques and methods of scientific knowledge, including dialectical, historical-legal, logical-legal, system-structural, method of forecasting and comparative jurisprudence. Dialectical method has provided opportunities to analyze scientific positions regarding the content and development of medical professional liability insurance. Historical-legal method helps to study the genesis of the development of insurance in specific historical and legal situations, the development of theoretical scientific thought and legislation. The method of comparative law is used to study the legislative and regulatory acts of Ukraine and other countries in the world as well as to clarify the advantages and disadvantages of the mechanism of legal regulation the insurance of medical professional liability in various countries in the world. Systemic and structural methods have helped to clarify the content of the contracts connected with this kind of insurance. Formal-logical method has allowed analyzing the provisions of the legislation of Ukraine in the sphere of this type of insurance.&#x0D; Results. This study contains a comprehensive scientific analysis of modern problems of medical professional liability insurance. The elements of the medical professional liability insurance contract are defined, namely: subject matter, insured, beneficiary, insurance risk, insurance event, conditionals of insurance compensation payment. It is stipulated that medical professional liability insurance contract shall have separate grounds for refusal to pay insurance compensation, inherent only to this type of insurance. It is shown that this type of insurance helps to manage the risks in medical practice activities. The concept of this type of insurance has been researched. The conditions to terminate the medical professional liability insurance have been identified.&#x0D; Conclusions. Having considered the issues of medical professional liability insurance and examined the conditions of the medical professional liability insurance contract, it has been made a conclusion that it is necessary to introduce this type of insurance as mandatory for healthcare institutions and private practitioners. It has been proposed to introduce compulsory medical professional liability insurance by approving necessary alterations the valid legislation.

Worst-case risk measures of stop-loss and limited loss random variables under distribution uncertainty with applications to robust reinsurance

Worst-case risk measures of stop-loss and limited loss random variables under distribution uncertainty with applications to robust reinsurance

A multiagent collaborative development strategy for environmental pollution liability insurance based on an evolutionary game

AbstractTo improve the problem of environmental pollution liability insurance, this paper constructs an evolutionary game model based on the government, insurance companies, and polluting enterprises. The findings indicate that in an imperfect market, penalty and subsidy mechanisms boost insurance rates. Reinsurance facilitates insurer underwriting, prompting gradual government withdrawal. Effective pricing mechanisms by insurance companies enhance environmental liability insurance operations amid evolving market mechanisms, offering theoretical guidance for addressing challenges in implementing such insurance.

A dynamic game approach for optimal consumption, investment and life insurance problem

AbstractIn this paper, we consider a multi-agent portfolio optimization model with life insurance for two players with random lifetime under a dynamic game approach. Each player is a price-taker and invests in the market to maximize her own utility for consumption and bequest. The market is complete and consists of n different assets, of which $$n-1$$ n - 1 are risky with prices driven by Geometric Brownian motion, while one is risk-free. We analyze both the non-cooperative and cooperative scenarios, and by considering the family of CRRA utility functions, we determine the closed-form expressions of the optimal consumption, investment, and life insurance for both players. A sensitivity analysis is provided both to illustrate the impact of the biometric and risk aversion parameters on the optimal controls and to compare the non-cooperative strategies with the cooperative ones. As a result, we suggest that cooperation favors the consumption optimality, while non-cooperation promotes the coverage of the risk of death.

RETRACTED: Ways to use interdisciplinary connections by showing the solution of one insurance problem in teaching

See the retraction notice E3S Web of Conferences 538, 00001 (2024), https://doi.org/10.1051/e3sconf/202453800001

The Problem of Independent Director Liability Insurance and its Solution from the Perspective of Game Theory

The Problem of Independent Director Liability Insurance and its Solution from the Perspective of Game Theory

Research on the Current Situation, Problem and Suggestion of Liability Insurance in Our Country—Taking Pet Insurance as an Example

Research on the Current Situation, Problem and Suggestion of Liability Insurance in Our Country—Taking Pet Insurance as an Example

Optimal Investment–Consumption–Insurance Problem of a Family with Stochastic Income under the Exponential O-U Model

A household consumption and optimal portfolio problem pertinent to life insurance (LI) in a continuous time setting is examined. The family receives a random income before the parents’ retirement date. The price of the risky asset is driven by the exponential Ornstein–Uhlenbeck (O-U) process, which can better reflect the state of the financial market. If the parents pass away prior to their retirement time, the children do not have any work income and LI can be purchased to hedge the loss of wealth due to the parents’ accidental death. Meanwhile, utility functions (UFs) of the parents and children are individually taken into account in relation to the uncertain lifetime. The purpose of the family is to appropriately maximize the weighted average of the corresponding utilities of the parents and children. The optimal strategies of the problem are achieved using a dynamic programming approach to solve the associated Hamilton–Jacobi–Bellman (HJB) equation by employing the convex dual theory and Legendre transform (LT). Finally, we aim to examine how variations in the weight of the parents’ UF and the coefficient of risk aversion affect the optimal policies.

Optimal Insurance: Dual Utility, Random Losses, and Adverse Selection

We study a generalization of the classical monopoly insurance problem under adverse selection (see Stiglitz 1977) where we allow for a random distribution of losses, possibly correlated with the agent’s risk parameter that is private information. Our model explains patterns of observed customer behavior and predicts insurance contracts most often observed in practice: these consist of menus of several deductible-premium pairs or menus of insurance with coverage limits–premium pairs. A main departure from the classical insurance literature is obtained here by endowing the agents with risk-averse preferences that can be represented by a dual utility functional (Yaari 1987). (JEL D81, D82, D86, D91, G22)

The low odds of poor women with small business loans emerging from poverty: Critical social policy implications for Pakistan

AbstractThe government of Pakistan has been relying on the microfinance industry to reduce poverty among poor women in Pakistan. Using a theoretical framework that argues for limiting the abilities and capacity of existing microfinance services, we empirically investigate the odds of poor women remaining in poverty despite microfinance loan provision. We collected data from four provinces in Pakistan and analyzed it using multivariate logistic regression. Three‐fourths of the 442 women respondents live below poverty lines and are unable to emerge from poverty due to factors such as: housing instability, food insecurity, lack of savings, insufficient loan size and high installment rates, lack of gender solidarity through group borrowing, and threats of domestic violence. Lack of health insurance and critical health problems such as infectious diseases, having suffered an injury, chronic ailments, and mental health challenges are also preventing poverty emergence. We conclude by recommending key social policy development agendas that need to be introduced by the state, in partnership with the microfinance sector, to support women borrowers and help them emerge from poverty.

Patient-centered, value-based management of incidental findings in radiology

As abyproduct of the increased use of high-resolution radiological imaging, the prevalence of incidental findings (IFs) has been increasing for years. The discovery of an incidental finding can allow early treatment of apotentially health-threatening disease and thus decisively change the course of the disease. However, many incidental findings are of low risk with little or no health impact, and yet their discovery often leads to acascade of additional investigations. It is undisputed that incidental findings can have adirect impact on the life of the person and that not only psychosocial aspects such as worries and anxiety due to false-positive findings play arole, but that insurance, legal or professional problems can also occur under certain circumstances, which is why the correct handling of incidental findings and the accompanying ethical challenges that apply to them regularly give rise to discussions. General principles to consider when managing incidental findings are responsibility for the well-being of the patient/study participant and of society. In order to avoid overdiagnosis and overtreatment and to achieve high patient benefit, radiologists and clinicians must know how to properly deal with IFs. In recent years, various national and international societies have published important guidelines ("white papers") on how to deal with the management of IFs. It is important that radiologists are fully aware of and follow these guidelines and are also available to referring physicians for further discussions and advice. The most important fact is that the well-being of the patient must always be at the center of all decisions.