The article is devoted to the generalization of methodological approaches to the optimization of the insurance company portfolio of services and the development of an algorithm for optimizing the ...insurance company's services portfolio. Insurance market of Ukraine is in a state of transformation, which is associated with changes in the institutional conditions of insurance, changes in the priorities of policyholders, macroeconomic instability, the spread of the COVID-19 pandemic. Institutional changes in the insurance market of Ukraine and macroeconomic instability have led to the "cleansing" of the insurance market and the exit of insurance companies that do not ensure transparency, solvency and efficiency. In the three quarters of 2021, 41 insurance companies left the Ukrainian insurance market, ie one in five insurance companies ceased operations. The relevance of optimizing the insurance company's portfolio of services is proved, which is due to the need for insurance companies to review their own portfolios to ensure financial stability, solvency and efficiency in a competitive insurance market of Ukraine. It is proposed to consider the optimization of the insurance company's portfolio of services as a set of interconnected and consecutive stages that are consistent and logical, as well as adaptive to modern realities of the insurance market of Ukraine, aimed at achieving profitability and maximizing the value of the insurance company. The first five stages of optimizing the insurance company's portfolio should be considered the most important, as it provides for determining the methodological principles of optimizing the insurance portfolio. Substantiation of the type of insurance company's portfolio and justification of the list of criteria for optimizing the insurance company's portfolio are interrelated stages that determine the individual basic parameters of the optimized portfolio for the insurance company depending on the chosen type of portfolio. Calculations for the optimization of the insurance company's portfolio of services involve the implementation of economic and mathematical modeling of the structure of the insurance services portfolio and the definition of its targets. Following a certain period of time, the insurance company must assess the effectiveness of achieving the optimal portfolio of services of the insurance company and the impact on key performance indicators of the insurance company, including net financial result and value of the insurance company, the presence of deviations of actual and optimal indicators. Keywords: insurance, insurance company, insurance company portfolio, optimization, Markovic model, insurance market of Ukraine.
Purpose
This study examines whether Brazilian health insurance companies (HICs) engage in earnings management through discretionary accruals or operational decisions by refraining from reporting a ...low indicator of sustainability in the market (IDSM).
Design/methodology/approach
The study used the Jones and Modified Jones models to identify earnings management through discretionary accruals and used the model described by Roychowdhury to estimate the abnormal behaviors of operational decisions. Data covering 2012 to 2018 were collected from the ANS website.
Findings
The results show that HICs engaged in earnings management to avoid reporting a low IDSM. The findings should help health insurance clients make decisions regarding the purchase or change of health insurance. The findings should also encourage regulators to improve their evaluation of the economic and financial risks around HICs.
Originality/value
The National Agency of Supplementary Health (ANS) established a qualification program for HICs, monitoring them based on a set of indicators. Managers may have an incentive to use earnings management to obtain indices that meet the requirements of the ANS qualification program in order to avoid showing signs of abnormality.
研究目的
本研究旨在探討巴西的醫療保險公司，透過避免報導低的市場可持續性指標，是以裁決性應計，抑或是以操作決策來進行盈餘管理。
研究的原創性
國立輔助醫療辦事處 (註：此為直譯)(The National Agency of Supplementary Health)為醫療保險公司建立了一個資格檢定機制，基於一套指標來監管這些公司。公司主管或會有鼓勵性的誘因去使用盈餘管理來取得符合國立輔助醫療辦事處資格檢定機制所要求的指標，從而避免顯示異常的跡象。
研究設計/方法/理念
本研究使用Jones 模型及Modified Jones模型，透過裁決性應計來辨認盈餘管理，研究亦使用羅伊喬杜里 (Roychowdhury) 描述的模型， 來估計操作決策的異常行為。數據取自國立輔助醫療辦事處的網址，並涵蓋2012年至2018年期間。
研究結果
研究結果顯示，醫療保險公司進行盈餘管理，以求避免報導低的市場可持續性指標。研究結果應可幫助醫療保險客戶在購買或更改醫療保險時作適當的決定。研究結果亦可鼓勵監管者改善他們對醫療保險公司的經濟及財務風險所作的評估。
This paper introduces a contingent claim model, offering a financial perspective on the global climate policy challenge. The model prioritizes the use of carbon tariffs to prevent carbon leakage and ...cap-and-trade initiatives to incentivize carbon emission reductions. In this model, manufacturers in an exporting country's supply chain collaborate with a life insurance company to acquire carbon allowances through the cap-and-trade mechanism. The importing country enforces carbon tariffs to protect its import-substitution industries and to prevent carbon leakage, assessed by the effective carbon tariff rate. Our findings show that increasing carbon tariffs on final products and intermediate goods reduces equity for both the life insurance company and the importer but strengthens carbon tariff protection. Conversely, a stricter regulatory cap within the exporting country's cap-and-trade system bolsters equity for the life insurance company and the importer but weakens carbon tariff effectiveness in the importing country. This dilemma underscores the urgent need for global collaboration in managing carbon emissions. Our research highlights the complex challenges of global climate policies. It is suggested to foster efficient and sustainable international cooperation in shaping climate policies to address these challenges.
•We use a contingent claim model to study international climate policy dilemmas.•Raising carbon tariffs reduces equity for both the insurance company and the importer.•Raising tariffs on Intermediate and final products enhances carbon tariff protection.•Higher regulatory cap weakens carbon tariff effectiveness in the importing country.•We advocate for international coordination to tackle climate policy challenges.
The article identifies the problems and prospects for improving the management of the development of insurance companies in Ukraine. The need to make strategically effective decisions that maximize ...the adaptation of insurance companies to the external environment, the formation of tactical tasks on their basis, is detected. It is noted that, like any economic activity, insurance requires the introduction of a quality management system. Hence, the overall efficiency of insurance company management consists of the levels of efficiency of managing individual subsystems: financial resources, marketing, sales, etc. In the existing structural and process model of an insurance company, the boundaries between structural levels are not clearly defined. Some elements of structures equally belong to different structural groups, in which case often one structure overlaps or intersects with another. It is found that government regulation of insurance companies should be based on principles that will ensure its efficiency, adequacy and transparency, promote the development and profitability of insurance providers and protect consumers of insurance services. It is concluded that one of the important conditions for effective management of the development of insurance companies in Ukraine is the use of modern management technologies and government support in the form of regulation of their activities, based on certain principles that ensure its efficiency, adequacy and transparency, will contribute to the development and profitability of insurance workers and protect consumers of insurance services. A methodical approach to determining the efficiency of managing the development of insurance companies is proposed, which is based on the use of the following coefficients: uncertainty of management activities; concentration of functions; accumulation of dysfunctions by the organizational structure; rationalization of the use of elements; concentration of elements; complexity of the organizational structure of management, which allows to establish the differences between the existing and the desired state of the basic indicators of the efficiency of the development management system of an economic entity.
The purpose of the article is to study the peculiarities of taxation and doing business by insurance companies under martial law and to determine an algorithm of actions if an insured event occurred ...during the wartime. Our country is at war now, the current task for business consists in supporting the economy of our State, and this can only be done by preserving the business that operates in Ukraine and pays taxes. Insurance companies must accumulate their strength and do everything to be useful to society for the preservation of Ukraine. The rules of doing business have changed, this is also because of the changes in tax legislation in the wartime. The state for the duration of martial law has simplified tax rules and conditions for doing business. The government has introduced significant changes to reduce the tax burden on insurance companies and on citizens of the country. The amount of taxes paid to the State and local budgets depends on the financing of the defense capability of our country and the performance of other functions assigned to the State. Taxes must be paid on time and in full. The current system of taxation of insurance companies has some problems that require their further study and search for solutions. This will give impetus to new opportunities for the development of the insurance business in our country, since precisely the insurance market is an important component of a market economy that protects people’s well-being and makes a profit by investing temporarily free money in promising projects.
This Paper Discusses Due To The Legal Failure To Pay By The Insurance On The Insurance Policy Of The Insured. The agreement between the two parties insured (insurance company) and the insured (policy ...holder) at the time of making an insurance policy is important, because insurance or coverage is a form of agreement. In recent years, Indonesia has been shocked by the number of insurance cases, which has made policyholders from any insurance company to be wary or worried about their money that has entered the insurance company. These policy holders (insured) seek justice and legal certainty by taking various legal methods. This normative research uses the method of legislation and a conceptual approach. This paper aims to analyze the legal consequences of the insurer failing to pay on the rights of the insured and the legal protection for the insured affected by the default. The results of this study indicate that legal remedies that can be taken by the Insured to minimize losses are one of them by paying attention to the time limit for granting claims and benefits that have been agreed in the Insurance Policy which is generally 30 (thirty) days after the agreement. The Financial Services Authority has the authority to ask the Insurer to stop activities if it has the potential to harm the community. It is also authorized to facilitate the settlement of consumer complaints that have been harmed by actors in financial service institutions (Insurers).
Insurance companies are in a special position because of their ability to assess and mitigate the risks faced by their customers. They are susceptible to a series of uncertainties, given their role ...in protecting individuals, professionals, and businesses. By providing comprehensive coverage and assistance in the event of unforeseen events such as natural disasters, accidents, or loss of life, insurance companies play a vital role in providing financial assistance and mitigating the adverse effects of such events. Insurance companies play a vital role in the economy by providing financial assistance and mitigating the negative effects of unforeseen events. Financial performance indicators, such as financial ratio analysis to measure the health of the insurance company, are essential tools for assessing the financial stability and growth potential of insurance companies. This study found that SAA, the leader of the Algerian insurance market, had good financial performance from 2019 to 2021. Evaluating the financial performance of an insurance company was the objective of this research, with a particular focus on the case of SAAs from 2019 to 2021 by performing an analysis using the ratio method. The case of this study focused on the preparation of financial statements and the presentation of financial performance indicators of SAA, which is the leader of the Algerian insurance market. The results reveal that SAA demonstrated good financial performance over the three-year study period.SAA’s financial analysis indicates that the company’s financial structure is solid. This research contributes to the field of financial analysis, highlighting the advantages of using financial ratios to assess the financial performance of insurance companies.
Patient perception and the organizational and safety culture of health professionals are an indirect indicator of the quality of care. Both patient and health professional perceptions were evaluated, ...and their degree of coincidence was measured in the context of a mutual insurance company (MC Mutual). This study was based on the secondary analysis of routine data available in databases of patients' perceptions and professionals' evaluations of the quality of care provided by MC Mutual during the period 2017-2019, prior to the COVID-19 pandemic. Eight dimensions were considered: the results of care, coordination of professionals, trust-based care, clinical and administrative information, facilities and technical means, confidence in diagnosis, and confidence in treatment. The patients and professionals agreed on the dimension of confidence in treatment (good), and the dimensions of coordination and confidence in diagnosis (poor). They diverged on confidence in treatment, which was rated worse by patients than by professionals, and on results, information and infrastructure, which were rated worse by professionals only. This implies that care managers have to reinforce the training and supervision activities of the positive coincident aspects (therapy) for their maintenance, as well as the negative coincident ones (coordination and diagnostic) for the improvement of both perceptions. Reviewing patient and professional surveys is very useful for the supervision of health quality in the context of an occupational mutual insurance company.
Insurance X is one of the life insurance company in Indonesia, as technology advances the company's business processes are using information technology (IT) and information systems (IS) to make them ...more effective and efficient. The use of IT and IS in the company have been developed since they started the business, until now they still developing their IT and IS to help their business but they have some problems related to the usage of IT and IS. This indicates that their IT governance is still need some improvement. In this paper, the authors will do some analysis to the company's IT problems and try to solve it based on COBIT 5 framework which is a standart for IT governance. The result of this study shows that the maturity of the company's IT governance is on level 2 (managed) and the target maturity is level 3 (established). This study also gives some improvement recommendations for the IT governance to reach that maturity target. Keywords: Life Insurance Company, IT Governance, COBIT 5 Framework
A health insurance contract is a private contract between individual entities (usually an insurance company and an individual). A health insurance company is needed to manage risks, and it accounts ...for them by placing insured individuals in the risk pool. In this way, individuals do not suffer the full economic consequences of their purchasing behaviour and are able to shift the uncertain but potentially costly burden to all policyholders. However, healthcare is a public concern, as it is a constitutional right in Qatar, but no government, no matter how wealthy, can alone finance healthcare. Health insurance is a financing mechanism for healthcare, and therefore, Qatar's government established the National Health Insurance Company (NHIC). The story of the NHIC did not end well, as the company was dissolved. What happened, and what shall be done? To improve Qatar's health insurance scheme, the state must make a rational economic choice and shift the scheme to the private health insurance market with government intervention through regulations.
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