Communications for Statistical Applications and Methods
/
v.24
no.3
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pp.211-226
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2017
The chain-ladder method, for which run-off data is employed is popularly used in the rate-adjustment and loss-reserving practices of non-life-insurance and health-insurance companies. The method is applicable when the underlying assumption of a consistent development pattern is in regards to a cumulative loss payment after the occurrence of an insurance event. In this study, a modified chain-ladder algorithm is proposed for when the assumption is considered to be only partially appropriate for the given run-off data. The concept of a structural-change point in the run-off data and its reflection in the estimation of unpaid loss amounts are discussed with numerical illustrations. Experience data from private health insurance coverage in Korea were analyzed based on the suggested method. The performance in estimation of loss reserve was also compared with traditional approaches. We present evidence in this paper that shows that a reflection of a structural-change point in the chain-ladder method can improve the risk management of the relevant insurance products. The suggested method is expected to be utilized easily in actuarial practice as the algorithm is straightforward.
In many non-life insurance applications past data are given in a form known as the run-off triangle. Smoothing such data using parametric crisp regression models has long served as the basis of estimating future claim amounts and the reserves set aside to protect the insurer from future losses. In this article a fuzzy counterpart of the Hoerl curve, a well-known claim reserving regression model, is proposed to analyze the past claim data and to determine the reserves. The fuzzy Hoerl curve is more flexible and general than the one considered in the previous fuzzy literature in that it includes a categorical variable with multiple explanatory variables, which requires the development of the fuzzy analysis of covariance, or fuzzy ANCOVA. Using an actual insurance run-off claim data we show that the suggested fuzzy Hoerl curve based on the fuzzy ANCOVA gives reasonable claim reserves without stringent assumptions needed for the traditional regression approach in claim reserving.
Hoyol Jhang;So Jin Park;Ah-Ram Sul;Hye Young Jang;Seong Ho Park
Korean Journal of Radiology
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v.25
no.5
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pp.414-425
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2024
Objective: This study aims to explore the opinions on the insurance coverage of artificial intelligence (AI), as categorized based on the distinct value elements offered by AI, with a specific focus on patient-centered outcomes (PCOs). PCOs are distinguished from traditional clinical outcomes and focus on patient-reported experiences and values such as quality of life, functionality, well-being, physical or emotional status, and convenience. Materials and Methods: We classified the value elements provided by AI into four dimensions: clinical outcomes, economic aspects, organizational aspects, and non-clinical PCOs. The survey comprised three sections: 1) experiences with PCOs in evaluating AI, 2) opinions on the coverage of AI by the National Health Insurance of the Republic of Korea when AI demonstrated benefits across the four value elements, and 3) respondent characteristics. The opinions regarding AI insurance coverage were assessed dichotomously and semi-quantitatively: non-approval (0) vs. approval (on a 1-10 weight scale, with 10 indicating the strongest approval). The survey was conducted from July 4 to 26, 2023, using a web-based method. Responses to PCOs and other value elements were compared. Results: Among 200 respondents, 44 (22%) were patients/patient representatives, 64 (32%) were industry/developers, 60 (30%) were medical practitioners/doctors, and 32 (16%) were government health personnel. The level of experience with PCOs regarding AI was low, with only 7% (14/200) having direct experience and 10% (20/200) having any experience (either direct or indirect). The approval rate for insurance coverage for PCOs was 74% (148/200), significantly lower than the corresponding rates for other value elements (82.5%-93.5%; P ≤ 0.034). The approval strength was significantly lower for PCOs, with a mean weight ± standard deviation of 5.1 ± 3.5, compared to other value elements (P ≤ 0.036). Conclusion: There is currently limited demand for insurance coverage for AI that demonstrates benefits in terms of non-clinical PCOs.
This study, performed to analyze the factors associated with health and cancer screening using preventive programs form health insurance among the women of a community, through a survey of about 923 women in Euijungbu-city. The subjects of the study were selected by a proportional cluster sampling method. The self-reported questionnaire was intended to fine factors associated with health screening and cancer screening. The results of this study were as follows: 1. In the case of health screening using health insurance, 14.1% of the subjects turned out to have been screened once or more in their respective life-time. Reasons given for non-participation in the screening were : 'lacking screening information', a belief that' it's not useful' and a belief that they' weren't sick'. 2. The factors associated with health screening behavior were age, educational level, number of doctor visits, BMI and health promotion behavior(p<0.01, p<0.05). Also, the factors associated with health screening behavior were cue to action and health status, and the predictors on health screening behavior were age and health promotion behavior(p<0.01, p<0.05). 3. In the case of cancer screening through the health insurance, 7.4% of the subjects turned out to have been screened once or more respectively in their life-times. Reasons given for non-participation in the screening were : 'lacking screening information', a belief they 'weren't sick' and that it's not useful'. 4. The factors associated with cancer screening behavior were age, educational level, income, alcholol intake, exercise, number of doctor visits and BMI(p<0.01, p<0.05). Aditional factors associated with cancer screening behavior were cue to action, health belief score and health status. Predictors for cancer screening behavior were: age, health belief score, screening attitude and health status(p<0.01, p<0.05). As indicated by the above results, a lack of information was an important factor for a lack of participation in screening. Age and cue to action were also important factors in promoting the cancer screening rate. Therefore, a dissemination of information about cancer screening contributes to the promotion of a screening rate, and cooperation between health insurance and local health cancer facilitates to be public the community-based cancer screening program.
In Korea, the standard for calculating the profit of a general insurance, which constitutes the loading in the premium, is not specified, and most of the non-life insurance companies reflect 2~5% of the premium as profit margin. Although the transparency of pricing is required due to the nature of insurance products, there are insufficient standards and empirical studies on the determination of insurance price factors in the domestic insurance industry. In this study, we propose a method of calculating the expected profit margin of general insurance. A way for calculating the expected profit margin of the general insurance is to reflect the shareholder demand on the capital that the insurance company should secure against the risk of loss due to the profit/loss volatility, as a ratio to the insurance premium. Shareholders should be compensated for the risks associated with their insurance operations, and the opportunity cost of these shareholders is to be reflected in premiums. In this study, we calculate the amount of capital that the company should accumulate to prepare insurance risk for each product, and insurance risk is defined as the volatility of insurance operating profit/loss. And insurance risk is calculated using stochastic simulation based on Dynamic Financial Analysis (DFA) methodology. Finally, we calculate the expected profit margins for 25 products and analyzed the difference between those and the profit ratio of domestic general insurance.
International Journal of Advanced Culture Technology
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v.10
no.2
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pp.79-85
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2022
Article 10 of the Constitution All citizens have dignity and values as humans and have the right to pursue happiness. There is a need for support measures such as a means to realize the respect of dignity and values as humans, and how to efficiently maintain policies on welfare for the elderly classified as the socially disadvantaged. It was considered necessary to develop an elderly-friendly city for economic, physical, and social life. Dasan Jeong Yak-yong's respect for adults was to practice the ideology of Confucianism, so this was the most important thing in the past Joseon Dynasty. In particular, it was considered important to think of adults first in practicing filial piety.This study focuses on the long-term care insurance system for the elderly, one of the welfare policy measures for the elderly. The significance of implementing the long-term care insurance system for the elderly is to benefit not only the elderly, but also all generations, including the middle-aged and children who were in charge of long-term care. To this end, the government should properly manage the factors of the social insurance financial crisis caused by the low birth rate and aging population.In addition, concerns about health insurance are high, so it is necessary to secure an appropriate level of government budget for health insurance financial management and minimize unnecessary non-benefit. In addition, it is necessary to induce appropriate medical use through connection with construction medical insurance.
Our article investigates the risk implication of ownership structure in life insurance companies. We set up a model to identify the priority structure of policyholder's and shareholder's cashflow claims, and to derive its implications. Current literature on this issue has focused on the agency paradigm or the risk-sharing efficiency. Fama and Jensen(1983a, 1983b) and Mayers and Smith(1981, 1986, 1988, 1990, 1994) argue that the survival of both the corporate and the mutual form of organization is due in part to the relative efficiencies in controlling agency problems. With regard to insurance business, agency problems arise because of the three functions inherent in the organizations:manager, risk-bearer(owner), and policyholder. Stock insurers are characterized by the potentially complete separation of all three functions while mutual insurers merger the policyholder with the ownership function. Doherty and Dionne(1993) and Doherty(1991) concentrate their analysis on differences in the efficiency of risk sharing between participating and non-participating policies. They argue that when the undiversifiable risk has higher portion in business risk, combining policy and equity claims into a single package is a more efficient risk-sharing contract than a simple prepaid risk-transfer. Among various methods for assembling the policy/equity package, Doherty and Dionne(1993) and Doherty(1991) suggest that policy/equity package offered by the mutual is the most efficient risk-sharing arrangement. There has been a controversy on the property of participating policies sold by life insurance corporations in Korea. Some scholars argue that participating policyholders of Korean life insurance companies have shared the cashflow risk with shareholders. They emphasize that insurance firms have used dividend reserves to supplement for equity deficits. Thus, they argue that the economic entities of Korean life insurance companies are mutual companies though their legal entities are corporations. Our article explicitly sets up each stakeholder's cashflow claim in stock and mutual insurers, and thus identify risk differences in shareholder and policyholder. Using our model, we could derive direct implications on the controversy. Our model shows that life insurance companies would sell participating policies since policyholders would have the incentive to share the risk inherent in their primary claims with equityholders. And there exists a fundamental difference in shareholder's risk and equityholder's.
Kim, Jungeun;Lee, Jonghyuk;Jeong, Ji Hoon;Kang, Minku;Bang, Joon Seok
Korean Journal of Clinical Pharmacy
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v.24
no.4
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pp.255-264
/
2014
Objective: The aims of this study are to investigate the total volume of prescribed medicines against Alzheimer's disease (AD) and the trends of usage by analyzing the claims-data from the Korea National Health Insurance Service. Method: The demographic and claims-data were included the major AD treating medicines such as donepezil, galantamine, rivastigmine and memantine, and analyzed during the period of 2010~2012. The assessing criteria were gender, age, habitation, types of medical institution, code of ingredients, outcomes of treatment, volume and amount of claims, and the numbers of patients with dementias. After trimming the data, it were analyzed by the market size, demographic traits, characteristics of medical service, characteristics of each anti-AD medicine, etc. Results: Among the chosen 4 medicines, donepezil had the top prescription volumes. Most prevalent prescribing preparations of donepezil were conventional types. However, among the non-conventional types, oro-dispersible formulation is the fast increasing one in both volume and growth rate. This specialized preparations to improve both toleration and adherence, tend to being prescribed generally at the tertiary medical institutions. While the younger patients with mild-to-moderate AD mostly treated by expensive medicines in resident at the tertiary hospitals, the rest older patients with severe AD have been treated non-expensive one at long-term care facilities. Conclusion: AD is a chronic illness therefore, long-term use of therapeutic medications are highly important. If an anti-AD treatment was applied steadily in the earlier stages, it would be achieved not only improving the quality of life of patient but also reducing the expenses in the medical and nursing cares. As the socioeconomical impacts of AD is expanding, healthcare professionals need to aware the importance of pharmacotherapy and to improve sociopolitical fundamentals.
The car insurance market in Korea has already entered (or is in the process of entry) a mature market that is characterized by increased competition by market participants. Participants are expected to compete more intensively in order to survive. Together with a slowdown in market growth the goal of non-life insurers' marketing strategies is to enhance existing customer loyalty because it is easier to raise their loyalty via customer satisfaction than to attract new customers in a stagnant market. In this article, we investigate what factors affect customer loyalty, and suggest some specific ways to establish and implement marketing strategies. We use a generalized additive partial linear model in order to find some significant factors.
Credibility theory is one of important theories in actuarial science to produce proper insurance premium. In this paper, new partial credibilities are proposed and introduced with widely accepted credibility theories such as rule of relative exposure volume, square root rule, B$\ddot{u}$hlmann credibility and B$\ddot{u}$hlmann-Straub credibility. Also, with credibilities estimated by current and newly suggested, the performance of the accuracy for estimating the risk is compared through real data analysis and we show that the newly suggested methods are improving the performance by reducing the error.
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