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  Subjects -> STATISTICS (Total: 130 journals)
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Geneva Papers on Risk and Insurance - Issues and Practice
Journal Prestige (SJR): 0.392
Citation Impact (citeScore): 1
Number of Followers: 13  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1018-5895 - ISSN (Online) 1468-0440
Published by Springer-Verlag Homepage  [2467 journals]
  • Does the legalisation of cannabis for medicinal use impact private health
           insurer prescription drug expenditures'

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      Abstract: Abstract We evaluate whether health insurer aggregate prescription drug expenditures change after the legalisation of medicinal cannabis using U.S. health insurer financial filings reported to state insurance regulators and compiled by the National Association of Insurance Commissioners for private health insurers from 2010 to 2018. We analyse this question for health insurers in the individual market, which includes plans sold on the Affordable Care Act exchanges, the small group market, which consists of fully insured plans sold to employers with fewer than 50 employees, and the large group market, which consists of fully insured plans sold to employers with more than 50 employees. For all three markets, the treatment effects are not significant. Thus, we find no impact of medical cannabis legalisation on health insurer prescription drug expenditures, despite the potential disruption to the health insurance market. Had legalisation increased prescription drug expenditures, the increases in cost would have been borne by enrollees, which is troubling since healthcare costs are rising faster than inflation.
      PubDate: 2023-01-17
       
  • Correction to: Does private health insurance prevent the onset of critical
           illness and disability in a universal public insurance system'

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      PubDate: 2023-01-01
       
  • On insurance and health risks

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      PubDate: 2023-01-01
       
  • Can risk rating increase the ability of voluntary deductibles to reduce
           moral hazard'

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      Abstract: Abstract Several regulated health insurance markets include the option for consumers to choose a voluntary deductible. An important motive for this option is to reduce moral hazard. In return for a voluntary deductible, consumers receive a premium rebate, which is typically community rated. Under community rating, voluntary deductibles are particularly attractive for low-risk consumers. Since these people use relatively little medical care, the total moral hazard reduction might be relatively small compared to the total healthcare spending. This paper examines the potential moral hazard reduction under risk-rated premiums. We use Chile as a case study due to institutional features that make it a valid benchmark for other countries. Our simulations show that in the presence of self-selection and under a uniform percentage moral hazard reduction across risk types, the absolute moral hazard reduction from a voluntary deductible is indeed expected to be larger in a system with risk-rated premiums than in a system with community-rated premiums. Nevertheless, sensitivity checks show that this conclusion might no longer hold as the percentage moral hazard reduction is lower for high-risk individuals compared to low-risk individuals.
      PubDate: 2023-01-01
       
  • Does private health insurance prevent the onset of critical illness and
           disability in a universal public insurance system'

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      Abstract: Abstract There are numerous studies investigating the effect of health insurance on healthcare utilisation, but there is little empirical evidence examining the effect of private health insurance on objective health outcomes in a universal public health system. Tracking each individual’s health status using panel data, we explore whether there is a difference in the probability of contracting a critical illness or becoming disabled between the privately insured and uninsured. The empirical analysis showed that the incidence of severe disease and disability was 0.76–0.52 times and 0.63–0.31 times lower, respectively, for those with private health insurance. Many theoretical and empirical studies have argued that excessive healthcare utilisation caused by owning health insurance incurs social costs. However, if health insurance lowers the likelihood of serious illness and disability, in the long run, it may lower healthcare utilisation and have a positive effect on human capital and social welfare.
      PubDate: 2023-01-01
       
  • On the financial superiority of Medicaid specialist insurers: a novel
           transactions cost/supply chain approach

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      Abstract: Abstract From 2002 to 2016, U.S. health insurers specialising in Medicaid financially outperformed health insurers specialising in other populations (i.e. groups, individuals, Medicare and federal employees). For this robust finding we developed a novel methodology incorporating transactions cost economics theory with supply chain performance models. The novel approach regards the insured populations as products supplied to health insurers (‘buyers’) in a supply chain. The populations are the ‘indigent’, ‘elderly’, ‘employed’ etc. Each has different care utilisation frequencies of encounters, admissions to hospitals and days in hospital, as well as severities of expenses, contractual arrangements and transaction costs advantages. The population attributes act on return on capital (ROC) through their differential interactions with insurer (buyer) attributes. The results suggest that Medicaid specialist insurers, with their extensive involvement with indigents, have the easiest pathways toward ROC optimisation by tweaking benefits, premiums and administrative expenses, which proxy transaction cost advantages.
      PubDate: 2023-01-01
       
  • On children’s motives to influence parents’ long-term care insurance
           purchase: evidence from Switzerland

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      Abstract: Abstract Long-term care (LTC) is not only a concern for elderly individuals but also for their adult children, as the latter often provide financial support and informal care to their elderly dependents. Adult children may therefore have strong incentives to have their parents purchase LTC insurance. Using data from a 2019 Swiss survey, this article first identifies a set of variables, including self-reported interest about LTC insurance, whether elderly parents live with their children and if the latter have provided informal help with personal care, which help predict the interest of adult children in having their parents covered against LTC risk. Second, it investigates the main characteristics of children’s motives for influencing their parents to purchase LTC insurance, which are classified as either altruistic, i.e. related to parental well-being, or self-interested, i.e. related to the child’s well-being. The results offer valuable insights for both policymakers and insurers when designing public LTC policies and LTC insurance products.
      PubDate: 2023-01-01
       
  • Family ties and commercial health insurance consumption in China

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      Abstract: Abstract Studying the factors that influence commercial health insurance consumption is essential in insurance economics. Family ties are important factors that affect consumer behaviour, especially in Eastern countries such as China. We construct an index to measure family ties and examine their effect on commercial health insurance consumption. We also use an instrumental variable approach to address endogeneity and apply a complementary log–log regression to deal with rare-event bias. We find that family ties have significantly positive impacts on individuals’ and families’ commercial health insurance consumption. The effect of family ties on commercial health insurance consumption is greater in individuals/families with higher income levels, those in eastern provinces, and those who are older.
      PubDate: 2023-01-01
       
  • Moral hazard in Australian private health insurance: the case of dental
           care services and extras cover

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      Abstract: Abstract We assess ex post moral hazard in Australian private health insurance (PHI) relating to dental care services (so-called extras cover) using the longitudinal Household, Income and Labour Dynamics in Australia (HILDA) Survey. Cross-sectional probit regressions specify dental care use as a function of dental care demand and endogenous PHI policy holding, including self-assessed health condition, health risk factors and socio-economic controls including age, income, education, family structure and welfare status. We find that ex post moral hazard results in the additional use of dental care services by PHI holders. Further, dynamic analysis indicates that PHI, no matter how sporadic, is always associated with significantly more likely use of dental care services, increasing when continuously held, suggesting strong persistence in moral hazard.
      PubDate: 2023-01-01
       
  • Cognitive abilities and long-term care insurance: evidence from European
           data

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      Abstract: Abstract Long-term care (LTC) is one of the largest financial risks faced by the elderly. Yet, it remains largely uninsured. This paper explores the relationship between cognitive abilities and private voluntary or supplementary long-term care insurance (LTCI) ownership as another possible factor contributing to the small size of the market. We used data from a European panel survey, which collects detailed information on both private insurance coverage and three indicators of cognitive abilities: numeracy, verbal fluency and memory skills. We find that memory, but not numeracy or verbal fluency, has a positive and statistically significant effect on the probability of owning private LTCI above and beyond other characteristics such as general education, family, risk factors, income and wealth. Fixed effects estimates show that a one-standard deviation increase in the recall measure score is associated with a 0.5 percentage point increase in the probability of holding insurance for the baseline sample and a 1 percentage point increase among the younger cohort. The findings suggest that cognitive limitations in LTCI decision-making are likely to be linked to information processing skills and can be an important factor affecting the expansion of the market that need to be taken into consideration in policy design.
      PubDate: 2023-01-01
       
  • Managed care or carefully managed' Management of underwriting
           profitability by health insurers

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      Abstract: Abstract Managed care provides health insurers a unique opportunity for discretion over certain aspects of financial reporting. Specifically, managed care mechanisms provide health insurers with a stronger ability to engage in loss control. To test whether and how health insurers exploit their ability to manage losses, we examine whether insurers with greater opportunity to manage care report significantly better underwriting performance in the fourth quarter relative to other health insurers. Using quarterly statutory filings from 2003 to 2016, we find evidence that a health insurer’s share of enrollment in health maintenance organisation (HMO) plans, characterised by their use of ‘gatekeeper’ physicians, is significantly and negatively related to their reported fourth quarter medical loss ratio (MLR). Additionally, while we find that fourth quarter MLRs are higher for all health insurers following the implementation of the Patient Protection and Affordable Care Act (ACA), the ACA does not appear to have intensified the loss control efforts of those insurers with more enrollment in HMO plans.
      PubDate: 2023-01-01
       
  • Modelling and predicting enterprise-level cyber risks in the context of
           sparse data availability

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      Abstract: Abstract Despite growing attention to cyber risks in research and practice, quantitative cyber risk assessments remain limited, mainly due to a lack of reliable data. This analysis leverages sparse historical data to quantify the financial impact of cyber incidents at the enterprise level. For this purpose, an operational risk database—which has not been previously used in cyber research—was examined to model and predict the likelihood, severity and time dependence of a company’s cyber risk exposure. The proposed model can predict a negative time correlation, indicating that individual cyber exposure is increasing if no cyber loss has been reported in previous years, and vice versa. The results suggest that the probability of a cyber incident correlates with the subindustry, with the insurance sector being particularly exposed. The predicted financial losses from a cyber incident are less extreme than cited in recent investigations. The study confirms that cyber risks are heavy-tailed, jeopardising business operations and profitability.
      PubDate: 2022-12-10
       
  • Insurance and enterprise: cyber insurance for ransomware

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      Abstract: Abstract Selling insurance gives insurers an incentive to manage insured risks. The “insurance-as-governance” literature demonstrates that insurers often make insurance conditional on ex ante risk reduction or mitigation. But insurance governs in support of enterprise, not security for its own sake. Tight underwriting inhibits enterprise—not only for insured businesses but also for the business of insurance. This paper highlights ex post loss reduction as a form of insurance-based governance. Drawing on interviews with industry insiders, we explore how insurers addressed the evolving problems of moral hazard, uncertainty and correlated losses since the 1990s. We find that cyber insurance developed sophisticated remedies to contain liabilities and quickly restore affected IT systems, but largely left security decisions to the insured. This facilitated enterprise in the short run but undermined security in the longer term: funding and expediting ransom payments encourages further attacks. As businesses improved their resilience, cybercriminals adapted and ransoms escalated, calling insurability into question. Yet there remains little appetite for imposing restrictive conditionality in this highly competitive market. Instead, insurers have turned to governments to contain criminal threats and cushion catastrophic losses.
      PubDate: 2022-12-04
       
  • How default effects and decision timing affect annuity uptake and health
           consciousness

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      Abstract: Abstract Annuities provide a lifelong income stream and can therefore help individuals to mitigate the risk of outliving their savings, a highly topical issue in the context of increasing life expectancies. Given that real-world annuitization rates remain relatively low, we investigate the influence of behavioral biases on people’s choice between a lifelong annuity and a lump sum payout. In so doing, we focus on the impact of default effects due to a preselected annuity option (default option) and the impact of the decision’s timing (decisions on annuitization taken by younger individuals refer to a distant future, those taken by older individuals to a near future) on annuity uptake and health consciousness. We used a scientific survey panel to conduct an online experiment with a diversified sample of 339 participants (55.2% female, average age = 42.5 years). Our results show that the timing of the decision moderates the default effect on annuity uptake, in that the effect of a preselected (default) annuity option is stronger for distant-future decisions (i.e., choice of annuity instead of lump sum at retirement made by younger participants purchasing a deferred annuity) than for near-future decisions made by older individuals who are closer to retirement. We further find that the default effect moderates health consciousness after choosing an annuity. Health consciousness is stronger in the no-default condition than in the annuity default condition.
      PubDate: 2022-11-19
       
  • Institutional determinants of insurance penetration in Africa

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      Abstract: Abstract This paper investigates the institutional determinants of insurance demand in Africa. We used a panel of 42 countries over the period 1996–2017. A system GMM approach was used for the estimations. Consistent with previous results, we find that institutional quality has positive and significant effects on insurance penetration in Africa. Specifically, regulatory quality, rule of law, control of corruption, political stability and absence of violence, and government effectiveness are the five institutional quality indicators that have positive and significant effects on the demand for total insurance and life insurance. However, only regulatory quality, control of corruption and government effectiveness are positively associated with non-life insurance demand. This indicates that governments should improve the business environment and strengthen the political environment to boost insurance development in Africa.
      PubDate: 2022-10-16
      DOI: 10.1057/s41288-022-00278-2
       
  • Evaluating traditional, dynamic and network business models: an
           efficiency-based study of Chinese insurance companies

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      Abstract: Abstract Data envelopment analysis (DEA) is extensively adopted to evaluate the relative efficiencies of a group of insurance companies from a multidimensional perspective. Selecting an appropriate DEA framework for insurance businesses, however, remains ambiguous. We use the slack-based measure (SBM) models in DEA to evaluate insurance efficiencies from four perspectives, namely, SBM, network SBM (NSBM), dynamic SBM (DSBM), and dynamic network SBM (DNSBM) frameworks. We present the applicability of DEA to 32 unique companies operating in the Chinese insurance industry over the sample period 2014–2018. Through analyses, we highlight key DEA results and related constraints in reaching the most appropriate performance benchmarks for evaluating insurance companies’ efficiencies. We find that building a network structure for insurance efficiency evaluation is necessary because of the superiority of NSBM and DNSBM results over those of the conventional SBM and DSBM models. After including dynamic effects, we find consistent results in the divisional and overall efficiencies. Overall, this study provides insight for insurance companies to implement more efficient and effective ways to evaluate their performances in terms of profitability and investment in a challenging business environment.
      PubDate: 2022-10-01
      DOI: 10.1057/s41288-021-00246-2
       
  • The relationship between net promoter score and insurers’ profitability:
           an empirical analysis at the customer level

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      Abstract: Abstract This paper examines the relationship between customer satisfaction and profitability at the level of the individual customer. In many industries, investigations detect a positive, decreasing relationship between customer satisfaction and firm profitability. The insurance industry has rarely been the object of such investigations. Pooser and Browne (2018) started this discussion by examining U.S. insurers at the firm level. We provide reasons why the positive satisfaction–profitability relationship might be reversed, particularly in the case of the insurance industry. We conduct an array of OLS regressions with customer-level data. Our results reveal a strong positive relationship between customer satisfaction and profitability. The effect is considerably large and also robust when investigating the effect of several customer characteristics on this relationship. We recommend that the increase in profitability is induced by a strong positive correlation between customer satisfaction and premium income, while satisfaction is not associated with the combined ratio.
      PubDate: 2022-10-01
      DOI: 10.1057/s41288-021-00237-3
       
  • Implications of bundled offerings for business development and competitive
           strategy in digital insurance

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      Abstract: Abstract The ubiquitous availability of interconnected digital devices does not only change the kinds of risks that can be insured and the way insurance companies work, it also facilitates the formation of bundled offerings across different industrial sectors, including insurance as well as other products and services. We identify two distinct patterns in which such bundles change value creation in the insurance industry, which we describe as sales bundles and value bundles. In the former, the objects of insurance become more specific and risks can be estimated more precisely, but insurance becomes an add-on to other offerings at the point of sale. In the latter, insurance is merged with other products and services in comprehensive value bundles in which the exact distribution of responsibilities remains flexible. Although huge effort is required to establish these value bundles and maintain their systemic infrastructures, they create many new opportunities for business development in the insurance industry.
      PubDate: 2022-10-01
      DOI: 10.1057/s41288-021-00244-4
       
  • Business environment, political risk, governance, Shariah compliance and
           efficiency in insurance companies in the MENA region

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      Abstract: Abstract Widespread political and economic changes over the past several decades have influenced MENA insurance firms’ business environment fundamentally. This study investigates the influence of business environment, political risk, governance and Shariah compliance on efficiency in the insurance market from 2007 to 2017 using unbalanced panel data from 125 listed insurance firms across MENA countries. The study emphasises that a less favourable business environment exerts pressure on insurance firms and also identified an improvement in efficiency over the sample period, which may be attributed to the role played by challenging business conditions in increasing efficiency. Further, the results showed that variability in general economic conditions and influence of governance indicators explain efficiency, while solvency has a multifaceted effect on efficiency. Finally, the study found that Islamic insurance’s relative failure to enhance efficiency may be attributable to its failure to establish a distinct identity or draw a clear line between its mode of operation and that of conventional insurance, as well as the issue of customer confidence. Overall, the study emphasises the importance of controlling business environmental conditions in cross-country efficiency studies.
      PubDate: 2022-10-01
      DOI: 10.1057/s41288-021-00232-8
       
  • The impact of tax-subsidized health insurance on health and out-of-pocket
           burden in China

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      Abstract: Abstract To achieve a tiered healthcare system in China, the government has beefed up efforts to encourage people to embrace private health insurance. One of the steps is to introduce tax-subsidized health insurance (TSHI) in 2015. This paper assesses whether TSHI is successful in improving health and easing financial burden. Using unique data from the Domestic TSHI Consumers Evaluation Survey in 2019 and Propensity Score Matching method, we find that TSHI has been effective in improving participants’ health status, but not in lowering out-of-pocket (OOP) burden. Besides, TSHI can increase the utilization of both inpatient and outpatient care, which provides a possible explanation for beneficial health effect. From an internal perspective, TSHI has the potential to reduce disparities in health and access to healthcare services. Our results provide implications on modifying the benefit design of TSHI to better complement basic medical insurance system and on reforming the current tax incentive policy to reach out a large number of low-income people.
      PubDate: 2022-08-30
      DOI: 10.1057/s41288-022-00276-4
       
 
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