Original Research Paper
Risk assessment in insurance
N. Hozarmoghadam; M. Ghanbarzadeh; M. Bazyar; M. Abbasi
Abstract
BACKGROUND AND OBJECTIVES: Despite the great importance of supplementary health insurance, one of the obstacles to its expansion is that the willingness to pay for it is not known. The disregard for insurance calculations in the law and the supportive views of policy makers in this area have meant that ...
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BACKGROUND AND OBJECTIVES: Despite the great importance of supplementary health insurance, one of the obstacles to its expansion is that the willingness to pay for it is not known. The disregard for insurance calculations in the law and the supportive views of policy makers in this area have meant that premiums have been set by the insurer and for this reason may not match the costs incurred. With this in mind, the main objective of this article is to identify the factors that influence consumers' willingness to pay for supplementary health insurance and to estimate their willingness to pay.METHODS: To achieve these objectives, the library study, expert panel, and discrete choice experiment methods were used along with the common analysis technique.FINDINGS: Based on the results of the qualitative part, eight features were extracted for the health insurance package at four levels. The results of the quantitative part also showed that people in Tehran derive the most benefit from insurance coverage for inpatient services. This benefit is greater for inpatient services in the private sector than in the public sector. In addition, coverage of outpatient services carries more weight in people's preferences than other characteristics. Also, the desirability and willingness to pay for coverage of dental services was significant and for coverage of long-term care, paraclinical services and rehabilitation was rated as moderate. Medical devices have the least benefit to people and the presence of this feature in the supplementary health insurance package has the least impact on people's willingness to pay. The insurance premium also has a negative influence on the choice of supplementary insurance. The results also show that the demographic (topical) and socioeconomic characteristics of the insured can influence people's preferences.CONCLUSION: People are most willing to pay for "dental services", "home care" and "numerous medical centers under contract", which should be considered by insurers when drafting policies.
Case Study
Future research in the insurance industry
َA. Khosravi; N. Mohammadi sarab
Abstract
BACKGROUND AND OBJECTIVES: Product diversification is a common strategy used by economic enterprises to reduce risk, increase brand strength, maintain market dominance, optimize resource utilization, and increase income and profitability. Although diversification is not a new concept, there is a need ...
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BACKGROUND AND OBJECTIVES: Product diversification is a common strategy used by economic enterprises to reduce risk, increase brand strength, maintain market dominance, optimize resource utilization, and increase income and profitability. Although diversification is not a new concept, there is a need for studies that quantitatively analyze the diversification process in more detail. This study aims to categorize products for insurance companies into three groups: competitive or active products, products with competitive potential or active potential, and products without competitive potential or inactive potential. In addition, the study aims to determine the order of potentially active products using greedy, maximum, high grade, low grade and combined strategies to improve the diversification of insurance activities within companies.METHODS: The present study uses an analytical-descriptive approach in terms of method and a practical approach in terms of purpose. First, the study calculates the revealed relative advantage using five-year average data (2017-2021) of insurance premiums of 29 analyzed companies in 16 areas of insurance activities. It then assesses the diversity of insurance companies by creating a company-product matrix. This matrix is used to calculate the proximity index and visualize the network of insurance products within the country. The product space of the 29 insurance companies is mapped and the position of each company is determined based on the number of different products, diversifiable products and non-diversifiable products. The study then calculates the probability of diversification for products that do not have a relative advantage. Finally, the study uses network science to determine the prioritization of products for diversification and competitiveness based on different strategies.FINDINGS: The study found that each of the 29 companies studied had different levels of competitive potential in offering insurance activities. A product space encompassing all insurance companies was visualized, and a roadmap for diversifying the scope of insurance activities of these companies based on different strategies was established by applying network science.CONCLUSION: Privatization of the Iranian insurance industry started in 2002 and had a significant impact on the structure of the industry and the behavior of the companies. Product diversification is proving to be a key strategy for insurance companies seeking to increase their competitiveness and profitability. In this study, the number of different products offered by the 29 insurance companies was calculated. It was found that Alborz Insurance Company has the greatest product diversity with 10 products, while the Middle East, Kish, Asmari and Qeshm insurance companies have the least diversity with only one product each. In the study, the insurance products were categorized into active, potentially active and inactive products based on the relative advantage or inactivity of the companies. The product space of the 29 insurance companies was mapped to identify active, potentially active and inactive products. Using path network science and a roadmap, the study identified diversification strategies for insurance companies based on four main approaches: Maximum strategy, greedy strategy, high degree strategy, low degree strategy and a combined strategy (using Berda and Copeland''s methods). The maximum strategy prioritized the products with the strongest links to active products at each stage. For example, New Trade Insurance Company selected life insurance as the top priority for diversification, followed by other types of insurance and driver and liability accident insurance. The greedy strategy selected the products with the highest probability of activation in order of shortest activation time in each phase. The high-grade strategy focused on selecting products with the most connections to other products in the network for diversification, while the low-grade strategy opted for products with the fewest network connections for activation in each stage. The high-level and maximum strategies prioritized activities that would increase competitiveness and allow more products to compete in the product network in the future. Conversely, the greedy and low-degree strategies could lead to lower competitiveness in future activities. The study suggests that the path and roadmap for product diversification may vary across insurance companies, so they may pursue short-term strategies (greedy and low degree), long-term strategies (high degree and maximum), or a combination of both.If one opts for a greedy strategy with a low degree, it is less likely to be competitive in the product network in the future.
Promotional-Science Article
New Insurance Technologies
L. Izadi; Sh. Elahi; A. Hasanzadeh; S. Shafiee
Abstract
BACKGROUND AND OBJECTIVES: Without an effective monitoring system, organizations cannot successfully accomplish their missions and properly allocate their resources. Millions of health insurance transactions are conducted every month. These transactions should be examined from both a "real" and "scientific" ...
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BACKGROUND AND OBJECTIVES: Without an effective monitoring system, organizations cannot successfully accomplish their missions and properly allocate their resources. Millions of health insurance transactions are conducted every month. These transactions should be examined from both a "real" and "scientific" perspective. Investigating this volume of transactions, detecting errors and misconduct, and preventing misconduct requires intelligent monitoring. A model that enables intelligent monitoring for health insurance holistically and taking into account the main beneficiaries has not yet been presented. This research focuses on developing a model for smart monitoring in basic health insurance.METHODS: A detailed action design research (ADR) methodology consisting of two diagnostic and four design cycles within the Iranian Health Insurance Organization was applied in this research. This model proposes four separate ADR cycles for the diagnosis, design, implementation, and evolution of the artifact development solution, and in each cycle it goes through the activities of problem formulation, artifact creation, evaluation, reflection, and learning. The required control patterns for the organization's interaction in a business network were identified using agency theory. The concepts and problems of supervision in health insurance were categorized in the first cycle of diagnosis and conceptualization of the problem using systematic mapping. In the second cycle, 24 interviews were conducted using the snowball method to identify the current situation of the organization as well as the issues and problems. Finally, a system model that provides smart monitoring in health insurance was presented based on the components of smart monitoring.FINDINGS: The proposed model for smart surveillance in health insurance includes five levels. First, the data resource layer includes internal and external organizational systems that provide the data resources required for surveillance. Second, the data storage layer includes the data warehouse where data is extracted, transformed and loaded from various sources. Thirdly, the data presentation, analysis and knowledge capture layer provides monitoring reports, analysis tools and data mining techniques for knowledge extraction. Text mining methods extract knowledge from the texts available in the company's knowledge portal. The fourth layer, the knowledge storage layer, involves loading the extracted knowledge into the knowledge repository. Finally, the knowledge utilization and presentation layer provides a system for searching, displaying and using knowledge that is linked to the knowledge portal and the company's transaction systems.CONCLUSION: This research provides a framework of process and outcome criteria for basic health insurance, control, and monitoring based on the organization theory and the monitoring process. By adding the knowledge warehouse and data warehouse, the current research model enables the coverage of all types of knowledge and includes various monitoring criteria. The advantage of the presented model is that by combining the concepts of data warehouse, knowledge extraction, knowledge warehouse and knowledge portal, it creates a framework for better decision making in all organizations. For health insurance companies in particular, the model presented provides a framework of outcome criteria and a process based on health insurance beneficiaries that can form the basis for the work of the monitoring department.
Original Research Paper
Risk management in the insurance industry
R. Zare zade; R. Ghousi; E. Mohammadi; H. ghanbari
Abstract
BACKGROUND AND OBJECTIVES: The capital market is one of the most influential institutions in the country when it comes to the economic improvement of society, and the optimal investment in this market has always been the main concern of investors and researchers in this field. Nowadays, a lot of research ...
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BACKGROUND AND OBJECTIVES: The capital market is one of the most influential institutions in the country when it comes to the economic improvement of society, and the optimal investment in this market has always been the main concern of investors and researchers in this field. Nowadays, a lot of research has been done to form an investment portfolio and various models have been introduced to optimize the investment portfolio. This study aims to investigate the performance of different investment portfolio optimization models under different scenarios in the insurance industry and pension funds as one of the main pillars of the capital market.METHODS: This study investigates the performance of different investment portfolio optimization models using variance, semivariance, standard deviation, semistandard deviation, conditional value at risk and conditional drawdown at risk under different scenarios. The optimized investment portfolio using the beta return-based mean-variance model and the CAPM model is also presented as an alternative consideration for investors with higher accuracy and as a basis for decision making. The data used for this research were collected from April to March 1401 on a daily basis from Tehran Stock Exchange.FINDINGS: Monthly stock returns indicate that the respective stocks were not stable and did not show a steady trend during the analyzed period. By forming an investment portfolio consisting of shares of insurance companies and pension funds, the return and risk of each investment model were determined, providing investors with comprehensive information. Depending on their risk appetite or risk aversion, investors can choose different investment strategies to maximize the benefits of their investment.CONCLUSION: This research shows that the portfolio formed with the Conditional Drawdown at Risk measure has a return of 22%, the highest return among the analyzed models in the insurance industry in the Tehran Stock Exchange market.
Original Research Paper
Insurance Social Studies
B. Mirzaei; A. Mohammadi; M. Nawabakhsh
Abstract
Objective: The present research was conducted with the aim of exploring and explaining organizational factors affecting third-party liability insurance violations in the Iranian insurance industry.Methods: The current study is based on a descriptive-exploratory mixed methodology. The statistical population ...
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Objective: The present research was conducted with the aim of exploring and explaining organizational factors affecting third-party liability insurance violations in the Iranian insurance industry.Methods: The current study is based on a descriptive-exploratory mixed methodology. The statistical population of the qualitative part of the study includes experts from the fields of insurance management and economic sociology and development. The survey was conducted using a purposive and snowball sampling method of 26 experts until saturation. The statistical population of the quantitative part of the study included employees of Tehran insurance companies. A total of 354 people were selected as a statistical sample using a cluster sampling method. The instrument for data collection was semi-structured interviews with experts in the qualitative part and questionnaires in the quantitative part. The validity of the questionnaire was confirmed by form and content methods and its reliability by the Cronbach's alpha method. The data from the qualitative part of the study was analyzed using the thematic analysis method and the data from the quantitative part using confirmatory factor analysis with the Amos21 software.Results: Based on the results of the qualitative part, a total of 52 basic themes, 18 organizing themes and 5 inclusive themes (organizational justice, organizational commitment, informal organization, organizational culture and legality) were identified. According to the results of the quantitative part, organizational justice and organizational commitment have a negative and inverse effect with -0.84 and -0.56, respectively, and the variable of informal organization has a positive and direct effect with 0.54 on the violations of employees of insurance companies operating in the field of third-party liability insurance. The variable of organizational justice had an effect on the violations of insurance company employees through the influence on organizational commitment and informal organization.Conclusion: Based on the research findings, it is suggested that the organizational factors presented in this study should be considered in the strategic plans of the insurance industry in addressing insurance violations and should be emphasized by insurance companies. In the area of organizational justice, it is suggested that in order to restore organizational justice, the mentioned values should be considered among the employees of the insurance companies and the implementation of justice in the organizational processes. In terms of organizational commitment, it is suggested that the dimensions of organizational commitment considered in this research should be considered as a basis for improving the organizational commitment of employees. In relation to informal organization, it is also suggested that if there is a positive attitude towards informal organizations, their existence should be used in line with the objectives and strategies of insurance companies.
Original Research Paper
Loss adjuster in insurance
S. Shams; M. Esnaashari; M. Piadeh Kohsar
Abstract
BACKGROUND AND OBJECTIVES: The estimate of reserved claims is based on the prediction of the final amount of claims that have not yet been settled and which the insurer has undertaken to pay. The micro-level approach estimates the amount of each unsettled claim separately. In this context, the time taken ...
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BACKGROUND AND OBJECTIVES: The estimate of reserved claims is based on the prediction of the final amount of claims that have not yet been settled and which the insurer has undertaken to pay. The micro-level approach estimates the amount of each unsettled claim separately. In this context, the time taken to settle a claim is an important variable, as large claims usually take longer to settle and may not be paid in the relevant financial period. Non-payment of claims may be due to a lack of timely reporting, a high volume of cases or legal complications. Therefore, there may also be censored data. In this article, we use the copula function approach to model the dependency structure of the settlement duration and claim amount variables.METHODS: In this study, the amount of each unpaid claim is estimated separately using a micro-level approach. For this purpose, the duration of the settlement of each claim is considered as a variable that depends on the amount of the claim. Based on the modeling of the dependency structure between the claim amount and the settlement duration using the copula function and using the general characteristics of the claims as predictor variables, each unpaid claim is estimated. The marginal distributions of the claim amount and the settlement period based on covariates explain the stochastic behavior of each of them and are modeled separately. In the copula function approach, the dependence structure of the variables can be considered separately from their marginal distributions. By choosing or constructing an acceptable and appropriate copula function with the dependence structure of the claim amount and the duration of its settlement, and taking into account the particular characteristics and conditions of inflation, the amount of an unpaid claim can be estimated more accurately. In this study, the accuracy of the estimation and the validity of the proposed model are evaluated using simulations.FINDINGS: The proposed method is implemented for the data collection of one of the insurance companies regarding the cases of the employer's professional liability claims in 8 years, from March 2013 to March 2021, which includes unpaid claims. In order to evaluate the error in estimating the claim amount with this method in this data set, 1000 samples are taken from the data whose claim amount is known and settled and each time a number similar to the actual number is censored, the known values are censored and their amount is estimated. Then the estimation error is calculated using the criteria mentioned in the article. And finally, it can be seen that the results have a good accuracy rate.CONCLUSION: In the article, it can be seen that the selected copula function has acceptable results for the estimation of reserved claims.
