Do insurance defrauders want to be punished?

We analyze a Principal-Agent model of an insurer who faces an adverse selection problem. He is unable to observe if his client has a high risk or a low risk of having an accident. At the underwriting of the contract, the insurer requests the client to declare his risk. After that, the former can costly audit the truthfulness of this announcement. If the audit confirms a false declaration, the insurer is legally allowed to punish the defrauder. We characterize the efRcient contracts when this punishment is bounded from above by a legal restriction. Then, we do some comparative statics on the efRcient contracts and on the agent's utility. The most important result of this paper concerns the legal limit to a defrauder's punishment. We prove that there exists a uni que value of this legal limit that maximizes the expected utility of a high risk type. Facing this particular value of the legal limit to a defrauder's punishment, the insurer will effectively audit a low risk reporto We also show that this particular value increases with the probability of facing a high risk policyholder. Therefore, when this probability is sufRciently high, the nullity of the contract is not enough. From the point of view of a potential defrauder, the law should allow harder sanctions. This is an striking result because the nullity of the contract is a common sanction for this kind of fraud in the USA and in some European countries.

Project portfolio management: an analysis from the insurance industry IT area

This paper aims to bring more information related to the critical question "how IT areas of insurance companies are defining and delivering their strategic initiatives Portfolios?" and make conclusions based on the collected data. To reach these interpretations, it is composed of a theoretical investigation on the theme, a strategy delineation for the research methodology and a conclusion presentation based on the findings. In this last part, this study concluded that explored organization does not applied a sufficient number of best practices answering the critical question as "the company is not mature on this subject".

Situação financeira e satisfação do consumidor das operadoras de saúde suplementar no Brasil

Este artigo elabora um diagnóstico sobre a situação financeira das operadoras de saúde suplementar no Brasil de acordo com a modalidade de gestão (seguro saúde, medicina de grupo, cooperativa médica, filantrópica e autogestão). Como indicador principal de saúde financeira, utiliza-se uma versão adaptada do zscore de Altman. Paralelamente, o estudo examina empiricamente os determinantes de satisfação do consumidor do sub-sistema suplementar de saúde, focando a análise no impacto da situação financeira da operadora e nas modalidades de gestão existentes sobre o nível de reclamações registradas junto à Agência Nacional de Saúde Suplementar. Para tanto, utiliza-se uma amostra de 270 operadoras de saúde suplementar para o período 2003-2005, e são utilizadas regressões de dados em painel, com variáveis de controle de mercado, operacionais e de gestão. Os resultados indicam que (1) as operadoras de saúde se beneficiam de economias de escala, (2) as empresas que operam no modelo de autogestão têm melhor situação financeira que as demais, e (3) as despesas com marketing não impactam a satisfação dos consumidores dos planos de saúde no Brasil. Finalmente, encontra-se também evidência fraca de que boa situação financeira implica melhor satisfação do consumidor.

Optimal unemployment insurance for couples

This work analyzes the optimal design of an unemployment insurance program for couples, whose joint search problem in the labor market differ significantly from the problem faced by single agents. We use a version of the sequential search model of the labor market adapted to married agents to compare optimal constant policies for single and married agents, as well as characterize the optimal constant policy when the agency faces single and married agents simultaneously. Our main result is that an agency that gives equal weights to single and married agents will want to give equal utility promises to both types of agents and spend more on the single agent.

Financial guarantees in Brazilian life insurance and pension plans

Recently regulated Brazilian life and pension products offer a benefit structure composed of minimum guaranteed annual rate, in°ation adjustment according to a price index and participation on an investment fund performance. We present a valuation model for these products. We establish a fair condition relationship between minimum guarantees and participation rates, and explore its behavior over a space of maturities, interest rates, and also fund and price index volatilities and correlation. Besides consistency to reference models, we found that the effect of the fund volatility is conditioned to the price index volatility level and the correlation between them.

Public policy for pensions, health and sickness insurance

Includes bibliography

Public policy for pensions, health and sickness insurance: potential lessons from Sweden for Latin America

Includes bibliography

Insurance underwriter or financial development fund: what role for reserve pooling in Latin America?

Includes bibliography

Prevention and insurance of conflict and terrorism: issues and evidence for Latin America

Includes bibliography

Medical care equity for older persons in Chile: the role of the insurance sector

Includes bibliography

Social vulnerability, insurance and risk diversification in Latin America and the Caribbean

Includes bibliography

The role of insurance in social protection

Includes bibliography

Health-care financing and equity: public insurance in Chile

Includes bibliography

The financial protection impact of the public health system and private insurance in Brazil

Includes bibliography