Hasil untuk "Insurance"

Graham D. Burchell, Colin Gordon, Peter Miller

F. F. Reichheld, W. Sasser

J. Pratt

R. Townsend

This paper focuses on avoidable moral hazard and offers one explanation for limited insurance markets, for closely held firms, and for seemingly simple as opposed to contingent forms of debt. Agents have random endowments of a consumption good which are such that there are gains to trading contingent claims. But any realization of an endowment is known only by its owner unless a verification cost is borne. Contracts in such a setting are said to be consistent if agents submit to verification and honor claims in accordance with prior agreements. The Pareto optimal consistent contracts which emerge are shown to have familiar characteristics.

Asim K. Dey

Extreme weather events are becoming more common, with severe storms, floods, and prolonged precipitation affecting communities worldwide. These shifts in climate patterns pose a direct threat to the insurance industry, which faces growing exposure to weather-related damages. As claims linked to extreme weather rise, insurance companies need reliable tools to assess future risks. This is not only essential for setting premiums and maintaining solvency but also for supporting broader disaster preparedness and resilience efforts. In this study, we propose a two-step method to examine the impact of precipitation on home insurance claims. Our approach combines the predictive power of deep neural networks with the flexibility of copula-based multivariate analysis, enabling a more detailed understanding of how precipitation patterns relate to claim dynamics. We demonstrate this methodology through a case study of the Canadian Prairies, using data from 2002 to 2011.

Liang Hong

The extant insurance literature demonstrates a paucity of finite-sample valid prediction intervals of future insurance claims in the regression setting. To address this challenge, this article proposes a new strategy that converts a predictive method in the unsupervised iid (independent identically distributed) setting to a predictive method in the regression setting. In particular, it enables an actuary to obtain infinitely many finite-sample valid prediction intervals in the regression setting.

Yongtai Cho, Eun-Young Choi, Jung Yeol Han et al.

Abstract Background Antiemetics are commonly prescribed for nausea and vomiting during pregnancy (NVP), affecting up to 80% of pregnant women. However, data on their long-term neurodevelopmental effects are limited. We therefore aimed to assess the risk of neurodevelopmental disorders and delays in children exposed to antiemetics commonly prescribed during pregnancy. Methods This nationwide cohort study, designed to emulate a pragmatic trial, used South Korea’s National Health Insurance Service mother–child linked database, 2009–2023. The primary exposure of interest was metoclopramide, while pyridoxine, doxylamine, dimenhydrinate, domperidone, and ondansetron were included in secondary analyses. Non-exposed pregnancies within the cohort served as comparators. The outcomes included seven neurodevelopmental disorders—autism spectrum disorder, cerebral palsy, communication disorder, intellectual disorder, movement disorder, attention deficit hyperactivity disorder (ADHD), and epilepsy—as well as neurodevelopmental delays assessed using the validated Korean Developmental Screening Test. Overlap weights based on potential confounders were applied to a Cox proportional hazard model to estimate hazard ratios (HR) with 95% confidence intervals (CI). Results Among 630,904 children included, 281,476 (44.6%) were exposed to metoclopramide during pregnancy, while 131,837 (20.9%), 1383 (0.2%), 12,013 (1.9%), 14,531 (2.3%), and 5673 (0.9%) were respectively exposed to pyridoxine, doxylamine, dimenhydrinate, domperidone, and ondansetron. There was no substantial association between antiemetic exposure during pregnancy and neurodevelopmental disorders and delays. Findings were consistent across various subgroup and sensitivity analyses, except for a slightly elevated risk of attention-deficit hyperactivity disorder (HR 1.12, 95% CI 1.06–1.18) in children exposed to metoclopramide during the second half of pregnancy and neurodevelopmental delays in those exposed to metoclopramide for ≥ 7 days. Conclusions This large-scale study found no association between antiemetic exposure during pregnancy and the risk of neurodevelopmental disorders or delays in children, providing reassurance for the use of antiemetics in pregnancy to treat nausea and vomiting. However, the slightly elevated risks observed in certain subgroups warrant further investigation. Meanwhile, these findings may assist in guiding decisions when considering antiemetic treatment during pregnancy.

Soo Min Ahn, Seonok Kim, Ye-Jee Kim et al.

<h4>Introduction</h4>Patients with rheumatoid arthritis (RA) face a significantly higher risk of major adverse cardiovascular events, including stroke, due to the pivotal role of inflammation in atherosclerosis and thrombosis. Various anti-rheumatic agents may influence stroke risk either by increasing or decreasing it, and this effect remains unclear. This study aimed to investigate the association between different anti-rheumatic agents and the risk of incident stroke in patients with RA using a nationwide claims database.<h4>Methods</h4>In this nested case-control study, the Korean Health Insurance Review and Assessment data of 35,133 patients newly diagnosed with seropositive RA from January 2011 to December 2020 were used. Incident ischemic stroke cases were identified and matched with randomly selected controls at a 1:4 ratio. The usage of anti-rheumatic agents was measured from the date of RA diagnosis to the index date and stratified in terms of exposure time and duration. The risk of stroke associated with each anti-rheumatic agent was estimated using conditional logistic regression and adjusted for comorbidities and concomitant drug use.<h4>Results</h4>Of the 35,133 patients, 1,386 (3.9%) cases were newly diagnosed with new-onset stroke. Thus, 1,384 stroke cases and 5,499 controls with newly diagnosed RA were included in the analysis. Current exposure to sulfasalazine (aOR: 0.79, 95% CI: 0.65-0.97) and hydroxychloroquine (aOR: 0.83, 95% CI: 0.72-0.96) was associated with a decreased risk of stroke, while current exposure to glucocorticoids (aOR: 1.71, 95% CI: 1.46-2.00) and tocilizumab (aOR: 3.47, 95% CI: 1.70-7.08) was related to an increased risk of stroke.<h4>Conclusion</h4>In this nationwide cohort study of patients with RA, treatment with sulfasalazine and hydroxychloroquine was associated with a decreased risk of stroke, while glucocorticoids and tocilizumab were linked to an increased risk of stroke. The association of tocilizumab with stroke should be cautiously interpreted due to the statistical limitations.

Asmik Nalmpatian, Christian Heumann

This study presents a framework for high-resolution mortality simulations tailored to insured and general populations. Due to the scarcity of detailed demographic-specific mortality data, we leverage Iterative Proportional Fitting (IPF) and Monte Carlo simulations to generate refined mortality tables that incorporate age, gender, smoker status, and regional distributions. This methodology enhances public health planning and actuarial analysis by providing enriched datasets for improved life expectancy projections and insurance product development.

Liyuan Cui, Wenyuan Li

This paper investigates optimal investment and insurance strategies under a mean-variance criterion with path-dependent effects. We use a rough volatility model and a Hawkes process with a power kernel to capture the path dependence of the market. By adding auxiliary state variables, we degenerate a non-Markovian problem to a Markovian problem. Next, an explicit solution is derived for a path-dependent extended Hamilton-Jacobi-Bellman (HJB) equation. Then, we derive the explicit solutions of the problem by extending the Functional Ito formula for fractional Brownian motion to the general path-dependent processes, which includes the Hawkes process. In addition, we use earthquake data from Sichuan Province, China, to estimate parameters for the Hawkes process. Our numerical results show that the individual becomes more risk-averse in trading when stock volatility is rough, while more risk-seeking when considering catastrophic shocks. Moreover, an individual's demand for catastrophe insurance increases with path-dependent effects. Our findings indicate that ignoring the path-dependent effect would lead to a significant underinsurance phenomenon and highlight the importance of the path-dependent effect in the catastrophe insurance pricing.

Gabriela Wojak, Ernest Górka, Michał Ćwiąkała et al.

This paper examines how Polish consumers are adapting to online insurance purchasing channels and what factors influence their preferences. Drawing on a structured survey of 100 respondents with varied demographic profiles, the study explores purchasing frequency, channel usage, price sensitivity, trust, and decision-making behaviors. Results indicate a clear shift toward digital tools, with many consumers valuing the speed, convenience, and transparency of online platforms, particularly for simple insurance products. However, barriers remain, including concerns about data security, lack of personal guidance, and difficulty understanding policy terms. A hybrid model is emerging, where online tools are used for research and comparison, while traditional agents are consulted for complex decisions. Respondents emphasized the importance of trust and personal contact, showing that emotional and psychological factors still play a role in digital adoption. Price was the dominant decision factor, but many consumers also prioritized service quality and reliability. The study concludes that insurers should invest in user-friendly digital experiences while maintaining human support options. Strategic omnichannel integration is recommended to meet diverse customer needs and reduce digital exclusion. Limitations of the study include a modest sample size and focus on the Polish market. Future research should investigate the role of AI in digital distribution, segment preferences by insurance type, and analyze trends across different regions or age groups. This paper adds empirical value to the understanding of insurance distribution and consumer behavior in digitally transforming financial markets.

Sebastian Calcetero Vanegas, Andrei L. Badescu, X. Sheldon Lin

Claim reserving in insurance has been studied through two primary frameworks: the macro-level approach, which estimates reserves at an aggregate level (e.g., Chain-Ladder), and the micro-level approach, which estimates reserves at the individual claim level Antonio and Plat (2014). These frameworks are based on fundamentally different theoretical foundations, creating a degree of incompatibility that limits the adoption of more flexible models. This paper introduces a unified statistical framework for claim reserving, grounded in population sampling theory. We show that macro- and micro-level models represent extreme yet natural cases of an augmented inverse probability weighting (AIPW) estimator. This formulation allows for a seamless integration of principles from both aggregate and individual models, enabling more accurate and flexible estimations. Moreover, this paper also addresses critical issues of sampling bias arising from partially observed claims data-an often overlooked challenge in insurance. By adapting advanced statistical methods from the sampling literature, such as double-robust estimators, weighted estimating equations, and synthetic data generation, we improve predictive accuracy and expand the tools available for actuaries. The framework is illustrated using Canadian auto insurance data, highlighting the practical benefits of the sampling-based methods.

Delia Coculescu, Maximilian Janisch, Thomas Lehéricy

Pharmaceutical markets for life-saving therapies combine monopoly power with insurance coverage. We build a tractable sequential game in which a patent-holder chooses the drug price, a profit-maximising insurer sets its premium, and a population of heterogeneous agents decide whether to insure and, conditional on diagnosis, whether to purchase treatment. Two sufficient statistics - subjective illness probability and reservation price - capture heterogeneity and nest risk-aversion and liquidity-constraint motives within a unified framework. We prove existence of subgame-perfect Nash equilibria and show that entry of an insurer strictly raises producer profits but may raise or lower both drug prices and treatment uptake, depending on the joint distribution of the population statistics. Numerical experiments calibrated to flexible parametric families illustrate non-monotone comparative statics and quantify conditions under which insurance reduces access. Our results provide benchmarks for evaluating price negotiations, price caps, and subsidy schemes in high-cost drug markets.

Yhlas Sovbetov

This paper examines influences of brand dynamics on insurance premium productions in Turkey using a dynamic GMM panel estimation technique sampling 31 insurance firms over 2005-2015. The results reveals that brands trust appears as a chief driving force behind premium production where its unit increase augments premium outputs by 5.32 million Turkish Liras (TL). Moreover, the brand value of firms also appears a statistically significant determinant of premium sales, but its size impact remains limited comparing to brand trust, i.e. a million TL increase in brand value generates only 0.02 million TL increase in sales. On the other hand, the study also documents a strong momentum driven from past years premium production with trade-off magnitude of 1 to 0.85. This might imply a higher loyalty-stickiness of customers in Turkey, as well as a self-feeding "bandwagon effect".

Ignacio Alarcón, Susana Mondschein, Alvaro Urzua et al.

Conflict of interest: No Introduction and Objectives: Alcohol-associated cirrhosis (AAC) is the leading cause of death from cirrhosis in the world. In recent years, an increase in alcohol consumption and AAC has been observed, especially in women, young people, low socioeconomic levels, and certain ethnic groups. Objective: To perform a descriptive study of patients hospitalized for AAC and non-alcohol-associated cirrhosis (NAAC) in Chile between 2001 and 2020, stratified by socioeconomic and demographic variables of the patients. Patients / Materials and Methods: Of 72,096 hospital discharges, 44,971 patients hospitalized for AAC and non-alcohol-associated cirrhosis (NAAC) in Chile between 2001 and 2020, were identified. A descriptive statistical study was carried out on the behavior of the AAC and NAAC at the national and regional levels by sex, age, and health insurance provider. Additionally, a study of patient survival rates was carried out using Kaplan-Meier. Results and Discussion: The results are detailed in Table 1: presents the number of cases per 100,000 inhabitants in the corresponding group under study. Conclusions: When calculating the number of discharges per 100,000 inhabitants in Chile over the years, the AAC has remained relatively constant, while the NAAC has shown a reduction of more than 50%, going from 12.8 to 6.2 hospital discharges. Furthermore, of the total discharges due to cirrhosis, nearly two-thirds correspond to AAC.Regarding the differences between health insurance, a contrast is observed between the AAC and NAAC. AAC is more prevalent in patients with public health insurance, both for men and women. Although NAAC is higher in patients with private health insurance for both sexes, it does not present significant differences between forecast and sex compared to AAC.Finally, an age trend is observed in discharges due to cirrhosis, both in AAC and NAAC, especially in the age groups of 50-59 and 60-69. Furthermore, it is precisely in these age groups that AAC tends to be more prevalent than NAAC.

Aida M. S. Salem, Takwa Mohamed AbdEltwwab, Hanan Hosni Moawad et al.

<b>Background/Objectives</b>: Hemophilia A is an X-linked recessive illness produced by a deficiency of coagulation factor VIII. This study aimed to evaluate serum vitamin D in hemophilic pediatric patients and its correlation with joint health and quality of life. <b>Methods</b>: This case-control study was performed on ninety children under the age of 18 years old and separated into two groups: study group of 45 children with hemophilia A and control group of 45 healthy children at an outpatient pediatric hematology clinic at the Beni-Suef University hospitals. <b>Results</b>: Serum vitamin D levels were significantly lower in hemophilia A patients than in controls (<i>p</i> < 0.001). The level of serum vitamin D was deficient in 38 (84.4%), insufficient in 4 (8.8%) and sufficient in 3 (6.6%) in the study group while deficient in 8 (17.7%), insufficient in 16 (35.5%) and sufficient in 21 (46.6%) in the control group. Total hemophilia joint health score (HJHS) had a significant negative correlation with serum total calcium (R = −0.31, <i>p</i> = 0.038) and serum vitamin D level (R = −0.974, <i>p</i> < 0.001) while also positively correlated with alkaline phosphatase (R = 0.834, <i>p</i> < 0.001). A quality-of-life index that is specific to total hemophilia (Haemo-Qol/Haem-A-QoL) had a significant positive correlation with total hemophilia joint health score (HJHS) (R = 0.934, <i>p</i> < 0.001) and negatively correlated with serum vitamin D level (R = −0.924, <i>p</i>-value lower than 0.001), alkaline phosphatase (R = 0.842, <i>p</i> < 0.001), and severity of hemophilia (R = 0.67, <i>p</i> < 0.001). <b>Conclusions</b>: patients with hemophilia A had lower vitamin D levels than healthy controls. The severity of vitamin D deficiency is related positively to (HJHS) hemophilia and quality of life hemophilia cases according to Haemo-QoL.

Tobias Wand, Oliver Kamps, Benjamin Skjold

Cooperation between individuals is emergent in all parts of society, yet mechanistic reasons for this emergence is ill understood in the literature. A specific example of this is insurance. Recent work has, though, shown that assuming the risk individuals face is proportional to their wealth and optimising the time average growth rate rather than the ensemble average results in a non-zero-sum game, where both parties benefit from cooperation through insurance contracts. In a recent paper, Peters and Skjold present a simple agent-based model and show how, over time, agents that enter into such cooperatives outperform agents that do not. Here, we extend this work by restricting the possible connections between agents via a lattice network. Under these restrictions, we still find that all agents profit from cooperating through insurance. We, though, further find that clusters of poor and rich agents emerge endogenously on the two-dimensional map and that wealth inequalities persist for a long duration, consistent with the phenomenon known as the poverty trap. By tuning the parameters which control the risk levels, we simulate both highly advantageous and extremely risky gambles and show that despite the qualitative shift in the type of risk, the findings are consistent.

Marcus C. Christiansen, Christian Furrer

Thiele's differential equation explains the change in prospective reserve and plays a fundamental role in safe-side calculations and other types of actuarial model comparisons. This paper presents a `model lean' version of Thiele's equation with the novel feature that it supports any canonical insurance model, irrespective of the model's intertemporal dependence structure. The basis for this is a canonical and path-wise model construction that simultaneously handles discrete and absolutely continuous modeling regimes. Comparison theorems for differing canonical insurance models follow directly from the resulting stochastic backward equations. The elegance with which these comparison theorems handle non-equivalence of probability measures is one of their major advantages over previous results.

Jonathan Hoseana, Felivia Kusnadi, Gracia Stephanie et al.

We present a design and financial analysis of a health insurance based on an SIH-type epidemic model. Specifically, we first construct the model in a continuous form, study its dynamical properties, and formulate the financial quantities involved in our insurance. Subsequently, we discretise the model using the forward Euler method, study the dynamical properties of the resulting discrete model, and formulate discrete analogues of the above financial quantities. We conduct a numerical simulation using two sets of parameter values, each representing a disease-free and an endemic scenario, which reveals that in the latter scenario, the insurance's gross premium is higher, the insurer's minimum loss-preventing start-up capital is lower, and the insurer's total profit is higher, compared to the corresponding values in the former scenario. Finally, through a sensitivity analysis, we show that in both scenarios, the disease's basic reproduction number, the gross premium, the minimum start-up capital, and the total profit depend most sensitively on the population's natural death coefficient, the disease's incidence coefficient, the hospitalisation benefit, and the premium surcharge percentage allocated to profit, respectively.

Łukasz Orłowski

This article determines a position of resolutions adopted by the Polish Financial Supervision Authority. Within the system of sources of law these resolutions are referred to as “recommendations”, and sometimes as “guidelines”. The author aims to answer a question whether the Authority can base its executive decisions on legal norms which the Authority had articulated itself. Through an application of a formal-dogmatic and an empirical-legal approach the researcher attempts to determine whether resolutions adopted by the Polish Financial Supervision Authority can be included in a catalogue of normative forms of administrative activity, whether they can be placed within the dichotomic classification of sources of law. Are such “recommendations” legally binding for the entities in the financial market? Finally, the analysis will focus on whether the Authority has expressis verbis competence to issue “guidelines” that are subsequently directed to the insurance sector in an imperative form, with expectation of implementation thereof. Or does this supervisory Authority appropriate competence of other authorities by application of legal interpretation of the law? At the end of this dogmatic research the Author attempts to answer the question: “What is the purpose of «recommendations»”?