Biztosítási és pénzügyi kockázat együttes hatása a biztosítók szolvencia-számításánál (Common effect of insurance and financial risk in the solvency calculation of insurers)

A Szolvencia II néven említett új irányelv elfogadása az Európai Unióban új helyzetet teremt a biztosítók tőkeszükséglet-számításánál. A tanulmány a biztosítók működését modellezve azt elemzi, hogyan hatnak a biztosítók állományának egyes jellemzői a tőkeszükséglet értékére egy olyan elméleti modellben, amelyben a tőkeszükséglet-értékek a Szolvencia II szabályok alapján számolhatók. A modellben biztosítási illetve pénzügyi kockázati "modul" figyelembevételére kerül sor külön-külön számolással, illetve a két kockázatfajta közös modellben való együttes figyelembevételével (a Szolvencia II eredményekkel való összehasonlításhoz). Az elméleti eredmények alapján megállapítható, hogy a tőkeszükségletre vonatkozóan számolható értékek eltérhetnek e két esetben. Az eredmények alapján lehetőség van az eltérések hátterében álló tényezők tanulmányozására is. ____ The new Solvency II directive results in a new environment for calculating the solvency capital requirement of insurance companies in the European Union. By modelling insurance companies the study analyses the impact of certain characteristics of insurance population on the solvency capital based on Solvency II rules. The model includes insurance and financial risk module by calculating solvency capital for the given risk types separately and together, respectively. Based on the theoretical results the difference between these two approaches can be observed. Based on the results the analysis of factors in°uencing the differences is also possible.

Solvency risk minimizing guaranteed returns in life insurance

Return guarantee constitutes a key ingredient of classical life insurance premium calculation. In the current low interest rate environment insurers face increasingly strong financial incentives to reduce guaranteed returns embedded in life insurance contracts. However, return guarantee lowering efforts are restrained by associated demand effects, since a higher guaranteed return makes the net price of the insurance cover lower. This tradeoff between possibly higher future insurance obligations and the possibility of a larger demand for life insurance products can theoretically also be considered when determining optimal guaranteed returns. In this paper, optimality of return guarantee levels is analyzed from a solvency point of view. Availability and some other properties of optimal solutions for guaranteed returns are explored and compared in a simple model for two measures of solvency risk (company-level and contract-level VaR). The paper concludes that a solvency risk minimizing optimal guaranteed return may theoretically exist, although its practical availability can be impeded by economic and regulatory constraints.

Assessing the effectiveness of two-year banking and insurance technology programs of junior colleges in Taiwan, R.O.C.: An application of the Context Input Process Product (CIPP) evaluation model

The purpose of this descriptive study was to evaluate the banking and insurance technology curriculum at ten junior colleges in Taiwan. The study focused on curriculum, curriculum materials, instruction, support services, student achievement and job performance. Data was collected from a diverse sample of faculty, students, alumni, and employers. ^ Questionnaires on the evaluation of curriculum at technical junior colleges were developed for use in this specific case. Data were collected from the sample described above and analyzed utilizing ANOVA, T-Tests and crosstabulations. Findings are presented which indicate that there is room for improvement in terms of meeting individual students' needs. ^ Using Stufflebeam's CIPP model for curriculum evaluation it was determined that the curriculum was adequate in terms of the knowledge and skills imparted to students. However, students were dissatisfied with the rigidity of the curriculum and the lack of opportunity to satisfy the individual needs of students. Employers were satisfied with both the academic preparation of students and their on the job performance. ^ In sum, the curriculum of the two-year banking and insurance technology programs of junior college in Taiwan was shown to have served adequately preparing a work force to enter businesses. It is now time to look toward the future and adapt the curriculum and instruction for the future needs of the ever evolving high-tech society. ^

Eliciting Preferences for Social Health Insurance in Ethiopia : A Discrete Choice Experiment

Peer reviewed

Health insurance competition in Germany – the role of advertising

In the 1990s, competition among public health insurance funds (‘sickness funds’) was introduced in Germany. As one means of competition, free choice of initial health funds and subsequent switching between them was made available to all insured. Since then, the number of funds has decreased substantially, and funds have had to engage in competitive strategies to remain in the market. In this paper, we want to analyse the funds' advertising activities in the face of the changed competitive environment. This has not been possible to date due to a lack of data. We use two new datasets to get a first insight into the potential effects of competition on funds' advertising strategies; one of the volume and cost of advertisements and one of their contents. Our results suggest that competition has been associated with an increase in the amount of advertising. As to the adverts themselves, we find that there was a decrease in the share of advertisements of a ‘general’ content in favour of advertisements of a more ‘fund-specific’ content. The data therefore indicate that once the market was open to switching of funds by the insured, funds' advertising efforts changed to differentiating their own perceived strengths from those of competitor funds. These observations allow us to draw some tentative conclusions about the relevance of (attempts of) risk selection by health funds via advertisements and about the general success of the pro-competitive legislation.

Factors associated with hospitalization after suicide spectrum behaviors: results from a multicentre study in Spain

Objectives: to identify factors associated with admission after suicide spectrum behaviors. Methods: Patient's characteristics, the nature of their suicidal behavior, admission rates between centres, and factors associated with admission have been examined in suicide spectrum presentations to emergency departments in three Spanish cities. Results: Intent of the suicidal behavior had the greatest impact on hospitalization. Older age, living alone, self-harm method not involving drug overdose, previous history of suicide spectrum behaviors and psychiatric diagnosis of schizophrenia, mood or personality disorder were independently associated with being admitted. There was a three-fold between-centre difference in the rate of hospitalization. Conclusions: widespread differences in the rate of hospitalization were primarily accounted for by characteristics of the individual patients and their suicidal behavior.

Health Literacy and Medicare Recipient's Knowledge of Health Insurance Options

Health literacy is a major problem for the aging population (Parker, Ratzan, & Lurie, 2003). The significance of this study was to access the relationship between health literacy and knowledge of Medicare to determine ways in which seniors can effectively navigate their healthcare insurance.

Immigration and the demand for life insurance: evidence from Canada, 1911

This article analyses the determinants of the demand for life insurance using sample data from the 1911 Census of Canada. We find that immigrants' demand for life insurance was on average around 13 percentage points lower than that of native-born Canadians, with the effect varying by province of settlement. We interpret these findings as evidence suggesting a greater appetite for risk among self-selecting immigrants relative to native-born Canadians. We also uncover evidence of a slow assimilation of immigrants in terms of life insurance holdings, slower indeed than the process of assimilation in terms of earnings.

Audit report on the Northeast Iowa Schools Insurance Trust for the year ended June 30, 2015

Audit report on the Northeast Iowa Schools Insurance Trust for the year ended June 30, 2015

146th Annual Report of the Insurance Division, August 2016

Annual report on the insurance industry. Statistical tables reflect in detail the financial condition of all insurance companies licensed to do business in Iowa, based on their sworn annual statements covering the twelve-month period beginning January 1, 2015, and ending December 31, 2015, filed with the Division.

145th Annual Report of the Insurance Division, August 2015

Annual report on the insurance industry. Preliminary material outlines Insurance Division activities generally. The statistical tables reflect in detail the financial condition of all insurance companies licensed to do business in Iowa, based on their sworn annual statements covering the twelve-month period beginning January 1, 2014, and ending December 31, 2014, filed with the Division.

Should I stay or should I go – Factors associated with hospitalization risk among older persons in Sweden

An increasingly older population will most likely lead to greater demands on the health care system, as older age is associated with an increased risk of having acute and chronic conditions. The number of diseases or disabilities is not the only marker of the amount of health care utilized, as persons may seek hospitalization without a disease and/or illness that requires hospital healthcare. Hospitalization may pose a severe risk to older persons, as exposure to the hospital environment may lead to increased risks of iatrogenic disorders, confusion, falls and nosocomial infections, i.e., disorders that may involve unnecessary suffering and lead to serious consequences. Aims: The overall aim of this thesis was to describe and explore individual trajectories of cognitive development in relation to hospitalization and risk factors for hospitalization among older persons living in different accommodations in Sweden and to explore older persons' reasons for being transferred to a hospital. Methods: The study designs were longitudinal, prospective and descriptive, and both quantitative and qualitative methods were used. Specifically, latent growth curve modelling was used to assess the association of cognitive development with hospitalization. The Cox proportional hazards regression model was used to analyse factors associated with hospitalization risk overtime. In addition, an explorative descriptive design was used to explore how home health care patients experienced and perceived their decision to seek hospital care. Results: The most common reasons for hospitalization were cardiovascular diseases, which caused more than one-quarter of first hospitalizations among the persons living in ordinary housing and nursing home residents (NHRs). The persons who had been hospitalized had a lower mean level of cognitive performance in general cognition, verbal, spatial/fluid, memory and processing speed abilities compared to those who had not been hospitalized. Significantly steeper declines in general cognition, spatial/fluid and processing speed abilities were observed among the persons who had been hospitalized. Cox proportional hazards regression analysis showed that the number of diseases, number of drugs used, having experienced a fall and being assessed as malnourished according to the Mini Nutritional Assessment scale were related to an increased hospitalization risk among the NHRs. Among the older persons living in ordinary housing, the risk factors for hospitalization were related to marital status, i.e., unmarried persons and widows/widowers had a decreased hospitalization risk. In addition, among social factors, receipt of support from relatives was related to an increased hospitalization risk, while receipt of support from friends was related to a decreased risk. The number of illnesses was not associated with the hospitalization risk for older persons in any age group or for those of either sex, when controlling for other variables. The older persons who received home health care described different reasons for their decisions to seek hospital care. The underlying theme of the home health care patients’ perceptions of their transfer to a hospital involved trust in hospitals. This trust was shared by the home health care patients, their relatives and the home health care staff, according to the patients. Conclusions: This thesis revealed that middle-aged and older persons who had been hospitalized exhibited a steeper decline in cognition. Specifically, spatial/fluid, processing speed, and general cognitive abilities were affected. The steeper decline in cognition among those who had been hospitalized remained even after controlling for comorbidities. The most common causes of hospitalization among the older persons living in ordinary housing and in nursing homes were cardiovascular diseases, tumours and falls. Not only health-related factors, such as the number of diseases, number of drugs used, and being assessed as malnourished, but also social factors and marital status were related to the hospitalization risk among the older persons living in ordinary housing and in nursing homes. Some risk factors associated with hospitalization differed not only between the men and women but also among the different age groups. The information provided in this thesis could be applied in care settings by professionals who interact with older persons before they decide to seek hospital care. To meet the needs of an older population, health care systems need to offer the proper health care at the most appropriate level, and they need to increase integration and coordination among health care delivered by different care services.

Do you want some cash-back?: assessing the demand for a no-claim rebate life-insurance product

Diseña e implementa un experimento de campo en el Perú rural, con el fin de examinar la sensibilidad de la demanda de los productos de microseguros de vida con la introducción de las devoluciones, que son reembolsos parciales de la prima del seguro cuando no se produce alguna eventualidad en el asegurado. Se encontró que las devoluciones crean mayores niveles de confianza entre el asegurador y el asegurado, lo que promete aumentar la demanda de seguros. Los resultados sugieren que las devoluciones pueden ser productos de innovación atractivos en los países en desarrollo.

Essays on the Effects of Social Insurance for Disability

This dissertation examines how social insurance, family support and work capacity enhance individuals' economic well-being following significant health and income shocks. I first examine the extent to which the liquidity-enhancing effects of Worker's Compensation (WC) benefits outweigh the moral hazard costs. Analyzing administrative data from Oregon, I estimate a hazard model exploiting variation in the timing and size of a retroactive lump-sum WC payment to decompose the elasticity of claim duration with respect to benefits into the elasticity with respect to an increase in cash on hand, and a decrease in the opportunity cost of missing work. I find that the liquidity effect accounts for 60 to 65 percent of the increase in claim duration among lower-wage workers, but less than half of the increase for higher earners. Using the framework from Chetty (2008), I conclude that the insurance value of WC exceeds the distortionary cost, and increasing the benefit level could increase social welfare. Next, I investigate how government-provided disability insurance (DI) interacts with private transfers to disabled individuals from their grown children. Using the Health and Retirement Study, I estimate a fixed effects, difference in differences regression to compare transfers between DI recipients and two control groups: rejected applicants and a reweighted sample of disabled non-applicants. I find that DI reduces the probability of receiving a transfer by no more than 3 percentage points, or 10 percent. Additional analysis reveals that DI could increase the probability of receiving a transfer in cases where children had limited prior information about the disability, suggesting that DI could send a welfare-improving information signal. Finally, Zachary Morris and I examine how a functional assessment could complement medical evaluations in determining eligibility for disability benefits and in targeting return to work interventions. We analyze claimants' self-reported functional capacity in a survey of current DI beneficiaries to estimate the share of disability claimants able to do work-related activity. We estimate that 13 percent of current DI beneficiaries are capable of work-related activity. Furthermore, other characteristics of these higher-functioning beneficiaries are positively correlated with employment, making them an appropriate target for return to work interventions.

Impact of radiofrequency ablation for patients with varicose veins on the budget of the German statutory health insurance system

Objectives: In contrast to other countries, surgery still represents the common invasive treatment for varicose veins in Germany. However, radiofrequency ablation, e.g. ClosureFast, becomes more and more popular in other countries due to potential better results and reduced side effects. This treatment option may cause less follow-up costs and is a more convenient procedure for patients, which could justify an introduction in the statutory benefits catalogue. Therefore, we aim at calculating the budget impact of a general reimbursement of ClosureFast in Germany. Methods: To assess the budget impact of including ClosureFast in the German statutory benefits catalogue, we developed a multi-cohort Markov model and compared the costs of a “World with ClosureFast” with a “World without ClosureFast” over a time horizon of five years. To address the uncertainty of input parameters, we conducted three different types of sensitivity analysis (one-way, scenario, probabilistic). Results: In the Base Case scenario, the introduction of the ClosureFast system for the treatment of varicose veins saves costs of about 19.1 Mio. € over a time horizon of five years in Germany. However, the results scatter in the sensitivity analyses due to limited evidence of some key input parameters. Conclusions: Results of the budget impact analysis indicate that a general reimbursement of ClosureFast has the potential to be cost-saving in the German Statutory Health Insurance.