Search results for: social health insurance
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 16119

Search results for: social health insurance

16119 Evaluating the Possibility of Expanding National Health Insurance Funding From Zakat, Sudan

Authors: Fawzia Mohammed Idris

Abstract:

Zakat is an Islamic procedure for wealth distribution as a social protection mechanism for needy people. This study aimed to assess the possibility to expand the share of fund for national health insurance fund from zakat funds allocated for poor people by measuring the reduction of poverty that result from the investing on direct payment to the needy or by covering them in social health insurance. This study used stata regression as a statistical analysis tool and the finding clarified that there is no significant relationship between the poverty rate as the main indicator and, the number of poor people covered by national health insurance on one hand and the number of benefits poor people from the distribution of zakat fund. This study experienced many difficulties regarding the quality and the consistency of the data. The study suggested that a joint mission between national health insurance fund and zakat chamber to conduct study to assess the efficient use of zakat fund allocated to poor people.

Keywords: health finance, poverty, social health insurance, zakat

Procedia PDF Downloads 110
16118 Sustainability of Healthcare Insurance in India: A Review of Health Insurance Scheme Launched by States in India

Authors: Mohd Zuhair, Ram Babu Roy

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This paper presents an overview of the accessibility, design, and functioning of health insurance plans launched by state governments in India. In recent years, the governments of several states in India have come forward to provide health insurance coverage for the low-income group and rural population to reduce the out of pocket expenditure (OPE) on healthcare. Different health insurance schemes have different structures and offerings which differ in the different demographic factors. This study will portray a comparative analysis of the various health insurance schemes by analyzing different offerings and finance generation of the schemes. The comparative analysis will explain the lesson to be learned from these schemes and extend the existing knowledge of the health insurance in India. This would help in recognizing tension between various drivers and identifying issues pertaining to the sustainability of health insurance schemes in India.

Keywords: health insurance, out of pocket expenditure, universal healthcare, sustainability

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16117 Insights and Inferences Associated with Subscription of Health Insurance in the Informal Sector of India

Authors: Harinder Singh

Abstract:

The paper sheds light on the perceptions of the uninsured workers employed in the urban informal sector of India, towards the health insurance. In addition to this, it also explores the association of the identified perceptions with household decisions to enroll for health insurance schemes in India. Firstly the data taken from the primary survey of the uninsured workers employed in the urban informal sector was analyzed using exploratory factor analysis to evaluate the perceptions. Thereafter, logistic regression was employed to determine the association of the identified perceptions regarding the enrollment. Our study identifies twelve perceptions related to the health insurance enrollment of the uninsured workers employed in the urban informal sector of India. The study demonstrates that perceptions have the strongest association with the voluntary enrollment. These specifically relate to the lack of awareness about the need to buy health insurance; comprehensive coverage; income constraint; future contingencies and social obligations; lack of information; availability of subsidized government health care; linkage with government hospitals and preference for government schemes. Conclusions: Along with the food security, health security has become a crying need of the workers employed in the informal sector and the time has come to scale up the health insurance schemes for them in the country. Policy makers or marketers of health insurance policies should recognize the household perceptions as a potential barrier and try to develop a health insurance package as per the actual needs of the informal sector (low income) in India.

Keywords: association, enrollment, health insurance, informal sector, perceptions, uninsured

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16116 Understanding Health Behavior Using Social Network Analysis

Authors: Namrata Mishra

Abstract:

Health of a person plays a vital role in the collective health of his community and hence the well-being of the society as a whole. But, in today’s fast paced technology driven world, health issues are increasingly being associated with human behaviors – their lifestyle. Social networks have tremendous impact on the health behavior of individuals. Many researchers have used social network analysis to understand human behavior that implicates their social and economic environments. It would be interesting to use a similar analysis to understand human behaviors that have health implications. This paper focuses on concepts of those behavioural analyses that have health implications using social networks analysis and provides possible algorithmic approaches. The results of these approaches can be used by the governing authorities for rolling out health plans, benefits and take preventive measures, while the pharmaceutical companies can target specific markets, helping health insurance companies to better model their insurance plans.

Keywords: breadth first search, directed graph, health behaviors, social network analysis

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16115 Unintended Health Inequity: Using the Relationship Between the Social Determinants of Health and Employer-Sponsored Health Insurance as a Catalyst for Organizational Development and Change

Authors: Dinamarie Fonzone

Abstract:

Employer-sponsored health insurance (ESI) strategic decision-making processes rely on financial analysis to guide leadership in choosing plans that will produce optimal organizational spending outcomes. These financial decision-making methods have not abated ESI costs. Previously unrecognized external social determinants, the impact on ESI plan spending, and other organizational strategies are emerging and are important considerations for organizational decision-makers and change management practitioners. The purpose of thisstudy is to examine the relationship between the social determinants of health (SDoH), employer-sponsored health insurance (ESI) plans, andthe unintended consequence of health inequity. A quantitative research design using selectemployee records from an existing employer human capital management database will be analyzed. Statistical regressionmethods will be used to study the relationships between certainSDoH (employee income, neighborhood geographic living area, and health care access) and health plan utilization, cost, and chronic disease prevalence. The discussion will include an application of the social gradient of health theory to the study findings, organizational transformation through changes in ESI decision-making mental models, and the connection of ESI health inequity to organizational development and changediversity, equity, and inclusion strategies.

Keywords: employer-sponsored health insurance, social determinants of health, health inequity, mental models, organizational development, organizational change, social gradient of health theory

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16114 National Health Insurance: An Exploratory Study of Patient Satisfaction

Authors: Nihayatul Munaa, Nyoman A. Damayanti

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This study seeks to understand what factors might influence a patient’s perception of health care under national health insurance in early implementation. In Indonesia, National Health Insurance was first implemented in 2014 and planned to achieve universal health coverage by 2019. However, the little understanding of this new policy lead to increase of complaint in hospital as a health care provider. This is a observational descriptive study with cross sectional design method. Data was collected through in-depth interview with 96 patient from Jemursari Islamic Hospital of Surabaya (Rumah Sakit Islam Jemursari Surabaya) who participate in National Health Insurance. Subject was selected by simple random sampling. The findings demonstrated that from five categories, 82,3% patient was satisfied in reliability aspect and 85,4% in assurance aspect, while in tangible, responsiveness and empathy aspect > 90% patient was satisfied. Meanwhile, in Indonesia, the minimum service standard of healthcare of patient satisfaction is 90%.

Keywords: patient’s satisfaction, national health insurance, hospital, complaint

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16113 Consumption Insurance against the Chronic Illness: Evidence from Thailand

Authors: Yuthapoom Thanakijborisut

Abstract:

This paper studies consumption insurance against the chronic illness in Thailand. The study estimates the impact of household consumption in the chronic illness on consumption growth. Chronic illness is the health care costs of a person or a household’s decision in treatment for the long term; the causes and effects of the household’s ability for smooth consumption. The chronic illnesses are measured in health status when at least one member within the household faces the chronic illness. The data used is from the Household Social Economic Panel Survey conducted during 2007 and 2012. The survey collected data from approximately 6,000 households from every province, both inside and outside municipal areas in Thailand. The study estimates the change in household consumption by using an ordinary least squares (OLS) regression model. The result shows that the members within the household facing the chronic illness would reduce the consumption by around 4%. This case indicates that consumption insurance in Thailand is quite sufficient against chronic illness.

Keywords: consumption insurance, chronic illness, health care, Thailand

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16112 Social Protection Reforms in Indonesia: Towards a Life Cycle Based Social Protection System

Authors: Dyah Larasati, Karishma Alize Huda, Sri Kusumastuti Rahayu, Martin Daniel Siyaranamual

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Indonesia continues to reform its social protection system to provide the needed protection for its citizen. Indonesia Social Protection consisted of social assistance programs (non-contributory/tax-financed) specifically targeted for the poor and at-risk and social security/insurance program (contributory system). The social assistance programs have mostly been implemented since 1998. The national health insurance has been implemented since 2014 and the employment social insurance since 2015. One major reform implemented has been improving the targeting performance of its major social assistance portfolios including (1) Food Assistance for the poor families (Rastra and BPNT/noncash foods assistance); (2) Education Assistance for poor children; (3) Conditional Cash Transfer for poor families (PKH); and (4) Subsidized beneficiaries of National Health Insurance (JKN-PBI) for the poor and at-risk individuals. For the Social Insurance (through BPJS Employment program), several initiatives have been implemented to expand the program contributing members, although it mostly benefits the formal sector workers. However, major gaps still exist especially for the emerging middle-income groups who typically work at the informal sectors. They have yet to get the protection needed to sustain their social and economic growth. Since 2017, TNP2K (the National Team for Poverty Reduction) under the Vice President office has led the social protection discourse as the government understands the need to address vulnerabilities across the lifecycle and prioritize support to the most at-risk population particularly the elderly, young children and people with disabilities. Discussion and advocacy to recommend for more investment is continuing in order for the government to establish a comprehensive social protection system in the near future (2020-2024) that protects children through an inclusive child benefit program; build a system to benefit more working-age adults (including individuals with disabilities) and a three-tier elderly protection as they reach 65 years.

Keywords: poverty reduction, social assistance, social insurance, social protection

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16111 A Comparative Analysis of Clustering Approaches for Understanding Patterns in Health Insurance Uptake: Evidence from Sociodemographic Kenyan Data

Authors: Nelson Kimeli Kemboi Yego, Juma Kasozi, Joseph Nkruzinza, Francis Kipkogei

Abstract:

The study investigated the low uptake of health insurance in Kenya despite efforts to achieve universal health coverage through various health insurance schemes. Unsupervised machine learning techniques were employed to identify patterns in health insurance uptake based on sociodemographic factors among Kenyan households. The aim was to identify key demographic groups that are underinsured and to provide insights for the development of effective policies and outreach programs. Using the 2021 FinAccess Survey, the study clustered Kenyan households based on their health insurance uptake and sociodemographic features to reveal patterns in health insurance uptake across the country. The effectiveness of k-prototypes clustering, hierarchical clustering, and agglomerative hierarchical clustering in clustering based on sociodemographic factors was compared. The k-prototypes approach was found to be the most effective at uncovering distinct and well-separated clusters in the Kenyan sociodemographic data related to health insurance uptake based on silhouette, Calinski-Harabasz, Davies-Bouldin, and Rand indices. Hence, it was utilized in uncovering the patterns in uptake. The results of the analysis indicate that inclusivity in health insurance is greatly related to affordability. The findings suggest that targeted policy interventions and outreach programs are necessary to increase health insurance uptake in Kenya, with the ultimate goal of achieving universal health coverage. The study provides important insights for policymakers and stakeholders in the health insurance sector to address the low uptake of health insurance and to ensure that healthcare services are accessible and affordable to all Kenyans, regardless of their socio-demographic status. The study highlights the potential of unsupervised machine learning techniques to provide insights into complex health policy issues and improve decision-making in the health sector.

Keywords: health insurance, unsupervised learning, clustering algorithms, machine learning

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16110 Public Preferences and Willingness to Pay for Social Health Insurance in Iran: A Discrete Choice Experiment

Authors: Mohammad Ranjbar, Mohammad Bazyar, Blake Angell, Thomas Lung, Yibeltal Assefa

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Background: Current health insurance programs in Iran suffer from low enrolment and are not sufficient to attain the country to universal health coverage (UHC). We hypothesize that improving the enrollment rate and moving towards a more sustainable UHC can be achieved by improving the benefits package and providing new incentives. The objective of this study is to assess public preferences and willingness to pay (WTP) for social health insurance (SHI) in Iran. Methods: A discrete choice experiment (DCE) was conducted in 2021, using a self-administered questionnaire on 500 participants to estimate WTP and determine individual preferences for the SHI in Yazd, Iran. Respondents were presented with an eight-choice set and asked to select their preferred one. In each choice set, scenarios were described by eight attributes with varying levels. The conditional logit regression model was used to analyze the participants' preferences. Willingness to pay for each attribute was also calculated. Results: Most included attributes were significant predictors of the choice of a health insurance package. The maximum coverage of hospitalization costs in the private sector, ancillary services such as glasses, canes, etc., as well as coverage for hospitalization costs in the public sector and drug costs, were the most important determining factors for this choice. Coverage of preventive dental care did not significantly influence respondent choices. Estimating WTP showed that individuals are willing to pay more for higher financial protection, particularly against private sector costs; the WTP to increase the coverage of hospitalization costs in the private sector from 50% to 90% is estimated at 362,068 IR, Rials per month. Conclusion: This study identifies the key factors that the population value with regard to health insurance and the tradeoffs they are willing to make between them. Hospitalization, drugs, and ancillary services were the most important determining factors for their choice. The data suggest that additional resources coming into the Iranian health system might best be prioritized to cover hospitalization and drug costs and those associated with ancillary services.

Keywords: social health insurance, preferences, discrete choice experiment, willingness to pay

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16109 Insurance of Agricultural Activities as the Basis for Food Security

Authors: J. B. Akshataeva, G. T. Aigarinova, A. Amankulova, D. S. Kalkanova

Abstract:

This article examines some aspects of the insurance of agricultural activities, strategic documents on deepening investment opportunities. Insurance market development is before the society and the state. It also examines problems of agricultural insurance development in the market economy of Kazakhstan as the basis for food security.

Keywords: agriculture, food safety, insurance, privacy issues

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16108 The Effect of Catastrophic Losses on Insurance Cycle: Case of Croatia

Authors: Drago Jakovčević, Maja Mihelja Žaja

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This paper provides an analysis of the insurance cycle in the Republic of Croatia and whether they are affected by catastrophic losses on a global level. In general, it is considered that insurance cycles are particularly pronounced in periods of financial crisis, but are also affected by the growing number of catastrophic losses. They cause the change of insurance cycle and premium growth and intensification and narrowing of the coverage conditions, so these variables move in the same direction and these phenomena point to a new cycle. The main goal of this paper is to determine the existence of insurance cycle in the Republic of Croatia and investigate whether catastrophic losses have an influence on insurance cycles.

Keywords: catastrophic loss, insurance cycle, premium, Republic of Croatia

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16107 Pricing and Economic Benefits of Commercial Insurance Incorporated into Home-based Hospice Care

Authors: Lie-Fen Lin, Tzu-Hsuan Lin, Ching-Heng Lin

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Hospice care for terminally ill patients provides not only a better quality of life but also cost-saving benefits. However, the utilization of home-based hospice care (HBH care) remains low even for countries covered by National Health Insurance (NHI) programs in Taiwan. In the current commercial insurance policy, only hospital-based hospice benefits were covered. It may have an influence on the insureds chosen to receive end-of-life care in a hospitalized manner. Thus, how to propose a feasible method to advocate HBH care utilization rate of public health policies is an important issue. A total of 130,219 cancer decedents in the year 2011-2013 from the National Health Insurance Research Database (NHIRD) in Taiwan were included in this study. By adding a day volume pays benefits of HBH care as a commercial insurance rider, will provide alternative benefits for the insureds. A multiple-state Markov chain model was incorporated to estimate the transition intensities of patients in different states at the end of their lives (Non-hospice, HBH, hospital-based hospice), and the premiums were estimated. HBH care insurance benefits provide financial support and reduce the burden of care for patients. The rate-making of this product is very sensitive while the utilization rate is rising, especially for high ages. The proposed HBH care insurance is a feasible way to reduce the financial burden, enhance the care quality and family satisfaction of insureds. Meanwhile, insurance companies can participate in advocating a good medical policy to enhance the social image. In addition, the medical costs of NHI can reduce effectively.

Keywords: home-based hospice care, commercial insurance, Markov chain model, the day volume pays

Procedia PDF Downloads 181
16106 Evaluation of Demand of Fire Insurance in Iran and Embrace Digitalization to Improve It

Authors: Mahsa Ghorbani Jazin

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The insurance industry has a prominent place in the economy of every country in the world. Fire insurance policies are types of non-life insurance, which protect insureds against financial losses of fire and related risks. In this paper, factors that are affecting the demand for fire insurance in Iran have been examined. Due to this reason, information and data have been collected during the period 1989-2019. In this research, the final model was estimated. The obtained results represent that as the population and literacy rate increase, people are more willing to purchase fire insurance. On the other hand, the actual per capita income has a negative influence on the demand for this type of insurance. Also, the amount of compensation that is paid in losses can be assumed as an indirect advertisement for fire insurance and attracts people to buy this policy. Finally, the new technology in the insurance industry is examined as a new underestimated way for increasing demand, especially in Iran.

Keywords: fire insurance, demand, per capita income, literacy rate, population, compensation paid, Insurtech

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16105 Economic Evaluation of Cataract Eye Surgery by Health Attendant of Doctor and Nurse through the Social Insurance Board Cadr at General Hospital Anutapura Palu Central Sulawesi Indonesia

Authors: Sitti Rahmawati

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Payment system of cataract surgery implemented by professional attendant of doctor and nurse has been increasing, through health insurance program and this has become one of the factors that affects a lot of government in the budget establishment. This system has been implemented in purpose of quality and expenditure control, i.e., controlling health overpayment to obtain benefit (moral hazard) by the user of insurance or health service provider. The increasing health cost becomes the main issue that hampers the society to receive required health service in cash payment-system. One of the efforts that should be taken by the government in health payment is by securing health insurance through society's health insurance. The objective of the study is to learn the capability of a patient to pay cataract eye operation for the elders. Method of study sample population in this study was patients who obtain health insurance board card for the society that was started in the first of tri-semester (January-March) 2015 and claimed in Indonesian software-Case Based Group as a purposive sampling of 40 patients. Results of the study show that total unit cost analysis of surgery service unit was obtained $75 for unit cost without AFC and salary of nurse and doctor. The operation tariff that has been implemented today at Anutapura hospitals in eye department is tariff without AFC and the salary of the employee is $80. The operation tariff of the unit cost calculation with double distribution model at $65. Conclusion, the calculation result of actual unit cost that is much greater causes incentive distribution system provided to an ophthalmologist at $37 and nurse at $20 for one operation. The surgery service tariff is still low; consequently, the hospital receives low revenue and the quality of health insurance in eye operation department is relatively low. In purpose of increasing the service quality, it requires adequately high cost to equip medical equipment and increase the number of professional health attendant in serving patients in cataract eye operation at hospital.

Keywords: economic evaluation, cataract operation, health attendant, health insurance system

Procedia PDF Downloads 135
16104 Increasing National Health Insurance Scheme Enrolment in Ghana: Pro-Rata Insurance Premium Payment with Mobile Phone as the Answer

Authors: Joseph Marfo Boaheng, Daniel Ansong, Eugenia Amporfo

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Health Insurance is proposed to provide financial protection against catastrophic health care cost arising from disease. Ghana has had a National Health Insurance Scheme (NHIS) since 2003 with the current enrolment/retention rate of 36%. The main goal of the scheme is to provide equity in the health sector as well as ensuring affordable health care for the poor. However, the current payment system is not flexible to attract significant proportion of the poor informal sector onto the scheme. Looking at the extensive use of mobiles in the Ghana where about 29,220,602.00 registered mobile phone lines are actively in used as of June 2014, paying health insurance premium through mobile phone could be feasible to attract larger proportion of the informal sector onto the scheme. Methodology: The quantitative cross-sectional survey was used to solicit the required information from 877 respondents living in Kumasi, the second capital city of Ghana. The magnitude of the effect of Pro-rata system (flexible payment terms) on NHIS enrollment rate was estimated with binary logistic regression model. Results: The odds for an individual to enroll onto NHIS with mobile phone increases about 2 times more when payment of insurance premium is on pro-rata basis ie. flexible payment terms (p=0.008, CI=1.212-3.565). Conclusion: The study advocates the National Health Insurance Authority consider this alternative payment system that has the potential of attracting a greater proportion of the informal sector to be enrolled or retained onto the scheme.

Keywords: enrollment, health insurance, mobile phone, pro-rata

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16103 Historical Metaphors in Insurance: A Journey

Authors: Anjuman Antil, Anuj Kapoor, Neha Saini

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Purpose: The purpose of this paper is to study the evolution of insurance in India and the world. The paper also traced the historical basis of life insurance in the world and how it emerged as a major sector in India’s economy. The promotional strategies and distribution channel of top three companies in the Indian insurance sector are also discussed. Design/methodology/approach: The paper examined the secondary data which includes the reports issued by Insurance Regulatory Authority of India, websites of companies, books, and journals relevant to the study. Findings: The paper argued the role and importance of insurance in an emerging economy. The challenges and opportunities of the insurance sector are briefed out. The emerging areas in the insurance sector in terms of promotional strategies and distribution channel are also listed. Implications: The historical evolution can be studied by companies while formulating their strategies. It will help them analyse the insurance sector, how things have changed and how to change with the changing times. Originality/value: This paper gives comprehensive data regarding the background of the insurance sector. Along with historical perspective, marketing and distribution, current and future trends have been discussed.

Keywords: insurance, evolution, life insurance, marketing, distribution channels

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16102 Impact of U.S. Insurance Reimbursement Policy on Healthcare Business and Entrepreneurship

Authors: Iris Xiaohong Quan, Sharon Qi, Kelly Tianqin Shi

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This study focuses on the critical role of insurance policies in a world grappling with increasing mental health challenges, as they significantly influence the dynamics of healthcare businesses and entrepreneurial ventures. The paper utilizes the mental health sector as a case to examine the impact of insurance policies on healthcare service providers, entrepreneurs, and individuals seeking mental health support. This paper addressed the following research questions: To what extent do changes in insurance reimbursement policies affect the accessibility and affordability of mental health services for patients, and how does this impact the overall demand for such services? What are the barriers and opportunities that mental health entrepreneurs face and what strategies and adaptations do mental health businesses employ when navigating the evolving landscape of insurance reimbursement policies? How do changes in insurance reimbursement policies, specifically related to mental health services, influence the financial viability and sustainability of mental health clinics and private practices? Employing a self-designed survey aimed at autism spectrum disorder (ASD) treatment companies, alongside two in-depth case studies and an analysis of pertinent insurance policies and documents, this research aims to elucidate the multifaceted influence of insurance policies on the mental health industry. The findings from this study reveal how insurance policies shape the landscape of mental health businesses and their operations. A total of 821 autism treatment organizations or offices were contacted by telephone between November 1, 2019, and January 31, 2020. About half of the offices (53.33%) were established in the past five years, and 80% were established in the past 15 years. There is a significant increase in the establishment of ABA service centers in the recent two decades as a result of autism insurance reform, the increasing social awareness of ASD, and the redefinition of autism. In addition, almost half of the ABA service providers we surveyed had a patient size ranging from 20 to 50 in the year when the residence state passed the legislation for autism insurance coverage. On average, an ABA service provider works with 5.3 insurance companies. This research find that insurance is the main source of revenue for most ABA service providers. However, our survey reveals that clients’ out of pocket payment has been the second main revenue sources. Despite the changes of regulations and insurance policies in all states, clients still have to pay a fraction of, if not all, the ABA treatment service fees out of pocket. This research shows that some ABA service providers seek federal and government funds and grants to support their services and businesses. Our further analysis with the in-depth case studies and other secondary data also indicate the rise of entrepreneurial startups in the mental health industry. Overall, this research sheds light on both the challenges and opportunities presented by insurance policies in the mental health sector, offering insights into the new industry landscape.

Keywords: entrepreneurship, healthcare policy, insurance policy, mental health industry

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16101 Racial and Ethnic Health Disparities: An Investigation of the Relationship between Race, Ethnicity, Health Care Access, and Health Status

Authors: Dorcas Matowe

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Inequality in health care for racial and ethnic minorities continues to be a growing concern for many Americans. Some of the barriers hindering the elimination of health disparities include lack of insurance, socioeconomic status (SES), and racism. This study will specifically focus on the association between some of these factors- health care access, which includes insurance coverage and frequency of doctor visits, race, ethnicity, and health status. The purpose of this study will be to address the following questions: is having health insurance associated with increased doctor visits? Are racial and ethnic minorities with health insurance more or less likely to see a doctor? Is the association between having health insurance moderated by being an ethnic minority? Given the current implications of the 2010 Affordable Care Act, this study will highlight the need to prioritize health care access for minorities and confront institutional racism. Critical Race Theory (CRT) will demonstrate how racism has reinforced these health disparities. This quantitative study design will analyze secondary data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS) questionnaire, a telephone survey conducted annually in all 50 states and three US territories by state health departments in conjunction with the Center for Disease Control (CDC). Non-identifying health-related data is gathered annually from over 400,000 adults 18 years and above about their health status and use of preventative services. Through Structural Equation Modeling (SEM), the relationship between the predictor variables of health care access, race, and ethnicity, the criterion variable of health status, and the latent variables of emotional support and life satisfaction will be examined. It is hypothesized that there will be an interaction between certain racial and ethnic minorities who went to see a doctor, had insurance coverage, experienced racism, and the quality of their health status, emotional support, and life satisfaction.

Keywords: ethnic minorities, health disparities, health access, racism

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16100 Multivariate Dependent Frequency-Severity Modeling of Insurance Claims: A Vine Copula Approach

Authors: Islem Kedidi, Rihab Bedoui Bensalem, Faysal Manssouri

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In traditional models of insurance data, the number and size of claims are assumed to be independent. Relaxing the independence assumption, this article explores the Vine copula to model dependence structure between multivariate frequency and average severity of insurance claim. To illustrate this approach, we use the Wisconsin local government property insurance fund which offers several insurance protections for motor vehicles, property and contractor’s equipment claims. Results show that the C-vine copula can better characterize the multivariate dependence structure between frequency and severity. Furthermore, we find significant dependencies especially between frequency and average severity among different coverage types.

Keywords: dependency modeling, government insurance, insurance claims, vine copula

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16099 Impacts of Public Insurance on Health Access and Outcomes: Evidence from India

Authors: Titir Bhattacharya, Tanika Chakraborty, Prabal K. De

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Maternal and child health continue to be a significant policy focus in developing countries, including India. An emerging model in health care is the creation of public and private partnerships. Since the construction of physical infrastructure is costly, governments at various levels have tried to implement social health insurance schemes where a trust calculates insurance premiums and medical payments. Typically, qualifying families get full subsidization of the premium and get access to private hospitals, in addition to low cost public hospitals, for their tertiary care needs. We analyze one such pioneering social insurance scheme in the Indian state of Andhra Pradesh (AP). The Rajiv Aarogyasri program (RA) was introduced by the Government of AP on a pilot basis in 2007 and implemented in 2008. In this paper, we first examine the extent to which access to reproductive health care changed. For example, the RA scheme reimburses hospital deliveries leading us to expect an increase in institutional deliveries, particularly in private hospitals. Second, we expect an increase in institutional deliveries to also improve child health outcomes. Hence, we estimate if the program improved infant and child mortality. We use District Level Health Survey data to create annual birth cohorts from 2000-2015. Since AP was the only state in which such a state insurance program was implemented, the neighboring states constituted a plausible control group. Combined with the policy timing, and the year of birth, we employ a difference-indifference strategy to identify the effects of RA on the residents of AP. We perform several checks against threats to identification, including testing for pre-treatment trends between the treatment and control states. We find that the policy significantly lowered infant and child mortality in AP. We also find that deliveries in private hospitals increased, and government hospitals decreased, showing a substitution effect of the relative price change. Finally, as expected, out-of-pocket costs declined for the treatment group. However, we do not find any significant effects for usual preventive care such as vaccination, showing that benefits of insurance schemes targeted at the tertiary level may not trickle down to the primary care level.

Keywords: public health insurance, maternal and child health, public-private choice

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16098 Organizational Mortality of Insurance Organizations under the Conditions of Environmental Changes

Authors: Erdem Kirkbesoglu, A. Bugra Soylu, E. Deniz Kahraman

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The aim of this study is to examine the effects of some variables on organizational mortality of the Turkish insurance industry and calculate the carrying capacities of Turkish insurance industry according to cities and regions. In the study, organizational mortality was tested with the level of reaching the population's carrying capacity. The findings of this study show that the insurance sales potentials can be calculated according to the provinces and regions of Turkey. It has also been proven that the organizations that feed on the same source will have a carrying capacity in the evolutionary process.

Keywords: insurance, carrying capacity, organizational mortality, organization

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16097 A Comparative Study of Insurance Policies Worldwide in Public Private Partnerships

Authors: Guanqun Shi, Xueqing Zhang

Abstract:

The frequent occurrence of failures in PPP projects which caused great loss has raised attention from the government as well as the concessionaire. PPPs are complex arrangements for its long operation period and multiple players. Many types of risks in PPP projects may cause the project fail. The insurance is an important tool to transfer the risks. Through a comparison and analysis of international government PPP guidelines and contracts as well as the case studies worldwide, we have identified eight main insurance principles, discussed thirteen insurance types in different stages. An overall procedure would be established to improve the practices in PPP projects.

Keywords: public private partnerships, insurance, contract, risk

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16096 Impact of Brexit on the Structure of the European Insurance Market: A Solvency and Financial Condition Report Content Analysis of UK Insurance Companies

Authors: Antonia Müller, Svend Reuse

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The Brexit referendum in June 2016 led to different publications analysing potential consequences for European and British insurance companies under the European Passport. This study addresses a research gap, regarding the measures taken by insurance companies based in the United Kingdom and thus on structural changes to the European insurance market by an innovative structured Solvency and Financial Condition Report content analysis. In scope are all insurance companies based in the United Kingdom, that fall under the Solvency II supervisory regime. The results show that the majority of British Solvency II insurance companies in scope, conducting cross-border business to the European Union, have applied and reported measures to be able to continue operating this cross-border business after Brexit. In addition, the study shows that 34 new insurance companies based in the European Union were established as a result of Brexit, indicating structural changes to the European insurance market.

Keywords: brexit, europe, insurance market, solvency and financial condition repot, structural changes

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16095 An Approach to Practical Determination of Fair Premium Rates in Crop Hail Insurance Using Short-Term Insurance Data

Authors: Necati Içer

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Crop-hail insurance plays a vital role in managing risks and reducing the financial consequences of hail damage on crop production. Predicting insurance premium rates with short-term data is a major difficulty in numerous nations because of the unique characteristics of hailstorms. This study aims to suggest a feasible approach for establishing equitable premium rates in crop-hail insurance for nations with short-term insurance data. The primary goal of the rate-making process is to determine premium rates for high and zero loss costs of villages and enhance their credibility. To do this, a technique was created using the author's practical knowledge of crop-hail insurance. With this approach, the rate-making method was developed using a range of temporal and spatial factor combinations with both hypothetical and real data, including extreme cases. This article aims to show how to incorporate the temporal and spatial elements into determining fair premium rates using short-term insurance data. The article ends with a suggestion on the ultimate premium rates for insurance contracts.

Keywords: crop-hail insurance, premium rate, short-term insurance data, spatial and temporal parameters

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16094 By-Line Analysis of Determinants Insurance Premiums : Evidence from Tunisian Market

Authors: Nadia Sghaier

Abstract:

In this paper, we aim to identify the determinants of the life and non-life insurance premiums of different lines for the case of the Tunisian insurance market over a recent period from 1997 to 2019. The empirical analysis is conducted using the linear cointegration techniques in the panel data framework, which allow both long and short-run relationships. The obtained results show evidence of long-run relationship between premiums, losses, and financial variables (stock market indices and interest rate). Furthermore, we find that the short-run effect of explanatory variables differs across lines. This finding has important implications for insurance tarification and regulation.

Keywords: insurance premiums, lines, Tunisian insurance market, cointegration approach in panel data

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16093 An Assessment of the Extent and Impact of Motor Insurance Fraud Claims in Nigeria

Authors: Olatokunbo Shoyemi, Mario Brito, Ian Dawson

Abstract:

In recent times, the Nigerian motor insurers have experienced high volume of motor insurance claim pay-outs and insignificant contribution to the net premium income of the Nigerian insurance market, which has been a major concern for the shareholders/stakeholders. It has been argued that there are many factors that have brought about these concerns. However, anecdotal evidence (ongoing debates among industry practitioners) suggests prevalence of fraud due to poor practices in motor insurance business in Nigeria. This study is therefore aimed to carry out an assessment of fraud in motor insurance claims as perceived by experts in the Nigerian insurance market. This study adopted a descriptive research design, and the analysis was built on a survey among insurance experts in Nigeria using a designed questionnaire. A purposive and snowball sampling were used to select our sample (N = 120) - representing a selection of all professionally qualified insurance experts in Nigeria insurance industry. The study found that Nigerian insurance experts (i) largely agree that there is a problematic level of fraud in the Nigerian motor insurance industry; (ii) perceive soft fraud to be about 3 times more common than hard fraud in the Nigerian motor insurance industry, and (iii) strongly agree there are problematic impacts from fraud on the solvency of the Nigerian motor insurers. This paper has provided an empirical understanding of the existence, extent, and impact of fraud risks within the Nigerian insurance market based on expert knowledge and insights rather than, as has often been the case, a reliance on individual anecdotes.

Keywords: claims, net premium income, motor insurance, soft fraud, hard fraud

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16092 Agro-Insurance and Farming Development Opportunities in Georgia

Authors: Tamar Lazariashvili

Abstract:

Introduction: The agro-insurance has great importance for agricultural development in the country. In the article, the insurance market of the Georgian agricultural sector has been studied, the level of interest of farmers with insurance products and the trend of demand for those products are revealed; also, the importance of insurance is substantiated. Methodology: The following research methods are applied in the presented paper: statistical (selection, grouping, observation, trend) and qualitative research (in-depth interview with farmers). They claim that the main reason for aggravation is the low level of trust, less awareness about the conditions of the insurance contract. In order to eradicate distrust towards agro-insurance, it is recommended to increase awareness of insured farmers in terms of an insurance agreement. In the case of disputable issues between insurance companies and the customers (farmers), it is advisable to enact the Mediation Service, which will be able to protect the rights of insured farmers. Main Findings: Insurance companies prefer to deal with large farmers, the number of them is very small in Georgia as the credit market. The government interference in this sector is also a very cautious topic. However, the government can strengthen the awareness of farmers about the characteristics and advantages of the insurance system in order to increase the number of insured and reduce insurance premiums for farmers. Conclusion: Enactment of agro-insurance will increase the interest and confidence of financial institutions in the farming sector, financial resources will be accessible to the farmers that will facilitate the stable development of the sector in the country. The size of the agro-insurance market in the country should be increased, and the new territories should be covered. The State must have an obligation to ensure the risk of farmers and subsidize insurance companies. Based on the analysis of the insurance market, the conclusions on agro-insurance issues and the relevant recommendations are proposed.

Keywords: Agro-insurance, agricultural product, Agro-market, farming

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16091 Meeting the Parents on Facebook : A Case Study of the Swedish Social Insurance Agency’s Social Media Use

Authors: Cecilia Teljas

Abstract:

Many government agencies use social media to supplement their traditional communication channels. Government agencies are typically risk-averse, which makes social media practices problematic. However, this case study of the social media use of the Swedish social insurance agency shows considerable bi-directional communication between the agency and the public. On one hand, the agency’s aims, strategies, ways of working and experiences related to its social media communication practice are analyzed. On the other hand, the communication by both the agency and the public is studied on one of the agency’s Facebook pages. The results showed that it is possible for an agency to provide relevant and accurate information in real-time in social media if identifying and addressing different segments separately. Furthermore, as a result of context adaption this communication was rather informal and the practice can be considered to manifest positive democratic effects due to the increased availability and inclusion.

Keywords: e-government, social media, case study, discourse analysis

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16090 Risk Management of Natural Disasters on Insurance Stock Market

Authors: Tarah Bouaricha

Abstract:

The impact of worst natural disasters is analysed in terms of insured losses which happened between 2010 and 2014 on S&P insurance index. Event study analysis is used to test whether natural disasters impact insurance index stock market price. There is no negative impact on insurance stock market price around the disasters event. To analyse the reaction of insurance stock market, normal returns (NR), abnormal returns (AR), cumulative abnormal returns (CAR), cumulative average abnormal returns (CAAR) and a parametric test on AR and on CAR are used.

Keywords: study event, natural disasters, insurance, reinsurance, stock market

Procedia PDF Downloads 358