nep-ias New Economics Papers
on Insurance Economics
Issue of 2019‒12‒09
fifteen papers chosen by
Soumitra K. Mallick
Indian Institute of Social Welfare and Business Management

  1. How Does Losing Health Insurance Affect Disability Claims? Evidence from the Affordable Care Act’s Dependent Care Mandate By Michael Levere; Heinrich Hock; Nancy Early
  2. Insurance Coverage and Access to Care for Workers with Disabilities, 2001–2017 By Anna Hill; Jody Schimmel Hyde
  3. La psychiatrie : un risque important en assurance santé ? By Romain Gauchon; Jean-Pascal Hermet
  4. Experiences with Government Sponsored Health Insurance Schemes in Indian States: A Fiscal Perspective. By Choudhury, Mita; Tripathi, Shruti; Dubey, Jay Dev
  5. How Do Low-Income Enrollees in the Affordable Care Act Marketplaces Respond to Cost-Sharing? By Lavetti, Kurt; DeLeire, Thomas; Ziebarth, Nicolas R.
  6. Examining the determinant factors affecting the sale of life insurance By Ranjbar, Mahnaz; Haratemeh, Mostafa Heidari
  7. The negative binomial-inverse Gaussian regression model with an application to insurance ratemaking By Tzougas, G.; Hoon, W. L.; Lim, J. M.
  8. Recent Changes and Reforms to the United Kingdom’s Income Support Program for People with Disabilities By Hande Inanc; David R. Mann
  9. Enticing Dually Eligible Beneficiaries to Enroll in Integrated Care Plans By Debra J. Lipson; Erin Weir Lakhmani
  10. Weather index insurance for protecting grain crop smallholders: Analyzing reliability of rainfall indexes as proxy for calibrating agricultural losses in the savannah middle-belt of Nigeria By Awolala, David O.; Mbaye, Aly A.; Fonta, William M.
  11. Reputation Effects in Repeated Audits, with Application to Insurance Fraud Deterrence By Reda Aboutajdine; Pierre Picard
  12. The Pathway to SSA Disability Program Entry Among Medicaid Enrollees 2007-2011: The Role of Serious Mental Illness, Multiple Impairments, and Recent Healthcare Utilization By Judith A. Cook; Jane K. Burke-Miller
  13. Risk assesment and control of IUU fishing for the marine insurance industry By , Oceana
  14. The effects of capital requirements on good and bad risk-taking By Pancost, N. Aaron; Robatto, Roberto
  15. Status and Reputation Nudging By Julia Rose; Michael Kirchler; Stefan Palan

  1. By: Michael Levere; Heinrich Hock; Nancy Early
    Abstract: We assess how SSI participation changes around age-26, the age at which young adults lose access to dependent care coverage. We find a significant uptick in SSI disability applications and awards as young adults age out of parental coverage.
    Keywords: SSI, health insurance, Affordable Care Act, disability policy
  2. By: Anna Hill; Jody Schimmel Hyde
    Abstract: Workers with disabilities have different options than their peers for obtaining health insurance, and face unique barriers in accessing care.
    Keywords: Workers, Disabilities, Affordable Care Act, Health insurance, Access to care
  3. By: Romain Gauchon (SAF - Laboratoire de Sciences Actuarielle et Financière - UCBL - Université Claude Bernard Lyon 1 - Université de Lyon); Jean-Pascal Hermet (ADDACTIS France)
    Abstract: The French Social Security has highlighted psychiatric diseases as a major risk. However, French private health insurance companies do not consider psychiatric care as an important topic. In this article is presented a study (based on four real health insurance databases) of the cost of a policyholder benefiting from a psychiatric follow-up care. It aims to provide a better understanding of this risk in an insurance context. It is shown that such a policyholder costs twice as much as an average policyholder, notably due to important expenses in hospitalization. Policyholders aged from 15 to 30 years, as well as the ones over 70 years old are the most concerned by this risk.
    Abstract: La psychiatrie a été identifiée par la Sécurité Sociale comme un enjeu majeur. Pourtant, celle-ci n'est pas identifiée comme un risque important par les organismes d'assurance santé complémentaire, si bien qu'aucune étude n'a été publiée en France sur sa prise en charge en dehors de l'Assurance Maladie. Cet article présente le résultat de travaux réalisés à partir de quatre bases de données regroupant les prestations versées par des complémentaires santé. L'objectif de cette analyse consiste à mieux comprendre ce risque et évaluer son coût pour les complémentaires santé. Cette étude permet de conclure qu'un assuré identifié comme étant suivi par un psychiatre présente un coût médical à la charge de l'assureur deux fois supérieur à celui d'un assuré moyen, notamment à cause de fortes dépenses en hospitalisation non psychiatrique. Les personnes ayant entre 15 et 30 ans et les séniors sont les plus concernés par ce risque.
    Date: 2019–11–01
  4. By: Choudhury, Mita (National Council of Applied Economic Research); Tripathi, Shruti (National Institute of Public Finance and Policy); Dubey, Jay Dev (National Institute of Public Finance and Policy)
    Abstract: The implications of expanding GSHI schemes in India has not been analyzed from a fiscal perspective. This paper analyzes the experiences of some of the early and largest GSHI schemes implemented in Indian States - in Andhra Pradesh, Tamil Nadu and Karnataka to understand the fiscal implications of initiating such schemes. We analyze three aspects: (a) the extent of fiscal burden on account of GSHI schemes and its consequences on other health expenditures, (b) the factors contributing to the extent of fiscal burden and (c) the effectiveness of spending on the schemes in terms of reducing out of pocket expenditure, extent of hospitalization coverage, and improved access to hospitalization services. Results suggest that expansion of GSHI schemes may skew expenditure away from primary and secondary care towards tertiary care, if fiscal space is limited. Although the schemes are largely dependent on private health providers for delivering services, a competitive public health system may help in containing costs and the corresponding fiscal burden. The evidence on effectiveness of public spending through such schemes has been mixed.
    Date: 2019–11
  5. By: Lavetti, Kurt (Ohio State University); DeLeire, Thomas (Georgetown University); Ziebarth, Nicolas R. (Cornell University)
    Abstract: The ACA requires insurers to provide cost-sharing reductions (CSRs) to low-income consumers on the marketplaces. We link 2013-2015 All-Payer Claims Data to 2004-2013 administrative hospital discharge data from Utah and exploit policy-driven differences in the value of CSRs that are solely determined by income. We find that enrollees with lower cost sharing have higher levels of health care spending, controlling for past health care use. We estimate the demand elasticity of total health care spending to be -0.10, but find larger elasticities for emergency room care, lifestyle drugs, and low-value care. We also find positive cross-price elasticities between outpatient and inpatient care.
    Keywords: demand elasticities, health insurance, moral hazard, ACA, marketplaces, AV-variants, low-value care, lifestyle drugs, value-based CSRs, Utah
    JEL: H24 H41 H43 H51 I11 I18 J32 J33 J68
    Date: 2019–10
  6. By: Ranjbar, Mahnaz; Haratemeh, Mostafa Heidari
    Abstract: Today, the insurance industry is one of the major economic institutions. Insurance, on the one hand, is a financial institution that plays an essential role in strengthening the economic fabric of the community, and on the other hand, by providing security and certainty, the scope for the expansion of productive activities. Meanwhile, life insurance is very important for all types of insurance. Because in life insurance, the length of the insurance is often more than one year, and even includes, in some cases, the life of the insurer. The objective of the current research is to study the impact of economic risks (depression, inflation, lowering the bank interest rates) on the sales of life insurances where the economic risks are initially measured through ARCH-GARCH family models and then the intensity of the impact of the economic risks are examined and determined on the sales of life insurances. In this regard, the type of research was correlation-causal and in terms of the nature and time it is considered to be practical and cross-sectional, respectively. In this research, time series data were used on the economic risks and the sales of the life insurances and they were used for the time period 1971 through 2015. The results showed that: A) Based on instantaneous response functions, by creating a positive shock equal to one standard deviation in the economic risks, the percentage of the sales of life insurances starts to decrease from the first year. As a result, increases in the economic fluctuations lead to decreases in the sales of life insurances. B) Variance analysis functions show that variables of inflation rates, gross domestic product, and interest rate fluctuations account for 0.56%, 1.33%, and 2.1% of the error variance for the sales of life insurances, respectively. C) Economic risks (depression, inflation, lowering the band interest rates) have significant impacts on the sales of life insurances.
    Date: 2018–07–02
  7. By: Tzougas, G.; Hoon, W. L.; Lim, J. M.
    Abstract: This paper presents the Negative Binomial-Inverse Gaussian regression model for approximating the number of claims as an alternative to mixed Poisson regression models that have been widely used in various disciplines including actuarial applications. The Negative Binomial-Inverse Gaussian regression model can be considered as a plausible model for highly dispersed claim count data and this is the first time that it is used in a statistical or actuarial context. The main achievement is that we propose a quite simple Expectation-Maximization type algorithm for maximum likelihood estimation of the model. Finally, a real data application using motor insurance data is examined and both the a priori and a posteriori, or Bonus-Malus, premium rates resulting from the Negative Binomial-Inverse Gaussian model are calculated via the net premium principle and compared to those determined by the Negative Binomial Type I and the Poisson-Inverse Gaussian regression models that have been traditionally used for a priori and a posteriori ratemaking.
    Keywords: Negative binomial-inverse Gaussian regression model; EM algorithm; Motor third party liability insurance; Ratemaking
    JEL: E6
    Date: 2019–07
  8. By: Hande Inanc; David R. Mann
    Abstract: In this study we review the operational aspects of Employment and Support Allowance (ESA)—the income support program for people with disabilities in the United Kingdom—and its potential policy lessons for the United States’ Social Security Disability Insurance (SSDI) program.
    Keywords: uk disability program, changes and reforms, disability insurance, disability, income support, reform, United Kingdom, United States
  9. By: Debra J. Lipson; Erin Weir Lakhmani
    Abstract: Mathematica researchers conducted a study to determine what factors were associated with state variation in participation rates in the Centers for Medicare and Medicaid Services’ Financial Alignment Initiative (FAI) that offered beneficiaries eligible for both Medicare and Medicaid enrollment in integrated Medicare–Medicaid plans (MMPs).
    Keywords: dual eligibles, integrated care plans, Financial Alignment Initiative, Medicare, Medicaid
  10. By: Awolala, David O.; Mbaye, Aly A.; Fonta, William M.
    Keywords: Environmental Economics and Policy, Crop Production/Industries
    Date: 2019–09
  11. By: Reda Aboutajdine (X-DEP-ECO - Département d'Économie de l'École Polytechnique - X - École polytechnique, CREST - Centre de Recherche en Économie et Statistique - ENSAI - Ecole Nationale de la Statistique et de l'Analyse de l'Information [Bruz] - X - École polytechnique - ENSAE ParisTech - École Nationale de la Statistique et de l'Administration Économique - CNRS - Centre National de la Recherche Scientifique); Pierre Picard (X-DEP-ECO - Département d'Économie de l'École Polytechnique - X - École polytechnique, CREST - Centre de Recherche en Économie et Statistique - ENSAI - Ecole Nationale de la Statistique et de l'Analyse de l'Information [Bruz] - X - École polytechnique - ENSAE ParisTech - École Nationale de la Statistique et de l'Administration Économique - CNRS - Centre National de la Recherche Scientifique)
    Abstract: In principal-agent problems, the repetition of interactions in a dynamic setting may alter the equilibrium outcomes. In insurance fraud, the frequency of auditor-auditee interactions is higher when there is collusion between policyholders and service providers (e.g., car repairers, health care providers...). The same service provider usually handles claims filed by many policyholders affiliated to the same insurer, and thus the insurer-service provider interactions are repeated with reputation effects. We analyze this issue in a repeated game where the insurer may potentially face a dishonest service provider who colludes with policyholders. The insurer has beliefs about the type (honest or dishonest) of the service provider and she may verify the truthfulness of the claim through costly audits. The reputation of the service provider corresponds to these beliefs and changes over time, and misbehaving deteriorates this reputation. In the end, it may lead to a breach of contract and thus represents a threat that may deter from defrauding. We show that, at early periods, the insurer audits agents who would not be monitored in a static setting because their reputation is good enough. Corresponding dishonest agents who slipped under the radar and have an initially good reputation do not defraud systematically at early periods, as opposed to the instantaneous game. In addition, auditing efforts for medium reputations are lower as dishonest agents want to preserve the possibility of defrauding later. Both aspects corresponds to a reputation-based deterrence mechanism, where the fear of deteriorating one's reputation acts as a discipline device for dishonest service providers.
    Keywords: Deterrence,Learning,Insurance fraud,Optimal auditing,Reputation
    Date: 2019–11–20
  12. By: Judith A. Cook; Jane K. Burke-Miller
    Abstract: We studied a random sample of Medicaid enrollment and claims data from 2007-2011 to identify low-income adults who moved between non-disabled and disabled eligibility, and between state benefits and SSA disability benefits (SSI/DI).
    Keywords: SSA, disability, Medicaid, serious mental illness, SSI
  13. By: , Oceana
    Abstract: Illegal, unreported and unregulated (IUU) fishing—also known as pirate fishing—is an unresolved and internationally pervasive problem, costing the global economy tens of billions of USD dollars annually. Those that participate in IUU fishing break or avoid fisheries management rules and succeed in operating outside the effective reach of government control. IUU fishing can deplete already overfished populations and can destroy vital marine habitats and ecosystems. This activity can also harm law-abiding fishers that suffer reduced fishing opportunities when the fish stocks they target are also targeted by IUU fishing vessels. Ending IUU fishing contributes to the global agenda to promote sustainable fishing and healthy oceans. This is underscored in UN Sustainable Development Goal 14 to “conserve and sustainably use the oceans, seas and marine resources” by committing countries to take action to eliminate IUU fishing by 2020.
    Date: 2018–09–16
  14. By: Pancost, N. Aaron; Robatto, Roberto
    Abstract: We study optimal capital requirement regulation in a dynamic quantitative model in which nonfinancial firms, as well as households, hold deposits. Firms hold deposits for precautionary reasons and to facilitate the acquisition of production inputs. Our theoretical analysis identifies a novel general equilibrium channel that operates through firms’ deposits and mitigates the cost of increasing capital requirements. We calibrate our model and find that the optimal capital requirement is 18.7% but only 13.6% in a comparable model in which only households hold deposits. Our novel channel accounts for most of the difference. JEL Classification: E21, G21, G32
    Keywords: capital requirements, deposit insurance, idiosyncratic risk, safe assets
    Date: 2019–12
  15. By: Julia Rose; Michael Kirchler; Stefan Palan
    Abstract: Status and reputation concerns are conjectured to be important especially in markets with information asymmetries between buyers and sellers, such as in credence goods markets. To investigate the effects of status and reputation on reciprocal behavior of sales personnel in a financial credence goods market, we run a natural field experiment. We send e-mail requests to insurance brokers asking for an appointment. We find that status nudging and, with a larger effect size, reputation nudging in the e-mails increase brokers' response rates compared to a neutral request. Both effects are robust across all responses, only counting affirmative responses, and in urban and rural areas.
    Keywords: Insurance brokers, natural field experiment, credence goods, status, reputation
    JEL: C93 G22 D12
    Date: 2019

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