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The Forfeiture Of Coverage Defenses Rule: An Economic Analysis, Tom Baker, Ezra Friedman, Kyle D. Logue 2017 University of Pennsylvania Law School

The Forfeiture Of Coverage Defenses Rule: An Economic Analysis, Tom Baker, Ezra Friedman, Kyle D. Logue

Faculty Scholarship

In liability insurance, the duty to defend is broader than the duty to cover. Thus it is possible that an insurer that has a duty to defend a suit may not have the duty to cover the policyholder's liabilities in the suit. However, if the penalty for a breach of the duty to defend is limited to actual legal costs spent by the defendant, the insurer may have an incentive to refuse to defend, even when the duty to defend is clear. This occurs because the insurer will not internalize the consequences of an inadequate defense when it ultimately ...


Property And Pecuniary Risk Exposures: An Investigation Into Smes’ Shutdown And Mitigation Methods In Nigeria, Joshua Solomon Adeyele, Olubunmi Florence Osemene, Idowu Emmanuel Olubodun 2017 University of Jos, Jos-Nigeria

Property And Pecuniary Risk Exposures: An Investigation Into Smes’ Shutdown And Mitigation Methods In Nigeria, Joshua Solomon Adeyele, Olubunmi Florence Osemene, Idowu Emmanuel Olubodun

The Journal of Entrepreneurial Finance

Business Interruption (BI) insurance is not popular among the operators/owners of Small and Medium Enterprises (SMEs) in Nigeria. This study is an attempt to investigate causes of SMEs’ failure and to assist the owners on how to use BI to protect both the physical assets as well as future profits of their businesses. Hence, 389 SMEs were purposively selected from four major cities in Niger Delta Region (NDR) in Nigeria for this purpose. The statistical tools used for analysis were Phi and Cramer’s V. The extent of SMEs losses through means of sourcing for materials and strategy employed ...


A Discussion Of Social Protection And Private Insurance, Gary S. Fields 2017 Cornell University

A Discussion Of Social Protection And Private Insurance, Gary S. Fields

Gary S Fields

[Excerpt] This is a thoughtful and thought-provoking paper, informative and interesting. I learned a lot from reading this and have already passed it on to others. In my comments, I would like to do four things: highlight the major points and the rationale for them, raise a few quibbles, put forth some additional issues, and propose a possible resolution of a dilemma raised in the paper. But let us first try to be clear about what we are talking about. Professor Pestieau characterizes social insurance as being mandatory, universal, and redistributive. I would define it slightly differently: “Social insurance is ...


Using A Farmer's Beta For Improved Estimation Of Expected Yields, Miguel A. Carriquiry, Bruce Babcock, Chad E. Hart 2017 Iowa State University

Using A Farmer's Beta For Improved Estimation Of Expected Yields, Miguel A. Carriquiry, Bruce Babcock, Chad E. Hart

Chad Hart

Effects of sampling error in estimation of farmers' mean yields for crop insurance purposes and their implications for actuarial soundness are explored using farm- level corn yield data in Iowa. Results indicate that sampling error, combined with nonlinearities in the indemnity function, leads to empirically estimated insurance rates that exceed actuarially fair values. The difference depends on the coverage level, the number of observations used, and the participation strategy followed by farmers. A new estimator for mean yields based on the decomposition of farm yields into systemic and idiosyncratic components is proposed, which could lead to improved rate-making and reduce ...


A Changing Industry: An Analysis Of The Effects Of Direct-To-Consumer Advertising On The Insurance Industry, James Bonvicini 2017 University of Connecticut

A Changing Industry: An Analysis Of The Effects Of Direct-To-Consumer Advertising On The Insurance Industry, James Bonvicini

Honors Scholar Theses

Direct-to-consumer selling is a shift in the strategies of many companies. As technology continues to play a prominent role in business, companies need to adapt to accommodate, and take advantage of, new opportunities that become available. Many insurance companies are now focusing on improving their direct-to-consumer selling efforts and attracting consumers with new online selling platforms. This thesis looks at the changes inside and outside of the industry that led to this direct method of selling and the impact that this has on the intermediaries in the industry, with a focus on property and casualty businesses. Additionally, this thesis takes ...


A Mixed-Methods Study: Self-Efficacy And Barriers To Participation In Workplace Wellness Programs, Massiel Perez-Calhoon 2017 Brandman University

A Mixed-Methods Study: Self-Efficacy And Barriers To Participation In Workplace Wellness Programs, Massiel Perez-Calhoon

Dissertations

America needs a healthy workforce to sustain the country. The scourge of obesity continues to plague Americans despite government initiatives such as the Affordable Care Act and wellness programs in the workplace to combat this epidemic. However, despite initiatives to make America healthy, barriers continued to impede the nation’s health. Lack of awareness and sensitivity to what motivates individual participants versus group participants built formidable barriers to accessing all workplace employees equitably. The purpose of this study was twofold. First, the intent of this study was to explore the relationship between self-efficacy and the impact on participation and engagement ...


The Economic Realities Of Replacing The Affordable Care Act, Hanming Fang 2017 University of Pennsylvania

The Economic Realities Of Replacing The Affordable Care Act, Hanming Fang

Penn Wharton Public Policy Initiative

Using simulations based on a new economic model, this brief empirically examines the pivotal mechanisms of the Affordable Care Act, such as the individual mandate, employer mandate, and premium subsidies, to inform the debate over repealing and replacing the Affordable Care Act. The research suggests that the ACA, if left intact, in the long run significantly reduces the uninsured rate. The simulations also suggest that the employer mandate is not a crucial pillar for the success of the ACA. The analysis indicates it is the premium subsidy, rather than the employer mandate or the individual mandate, that is crucial for ...


Mutually Assured Protection Among Large U.S. Law Firms, Tom Baker, Rick Swedloff 2017 University of Pennsylvania Law School

Mutually Assured Protection Among Large U.S. Law Firms, Tom Baker, Rick Swedloff

Faculty Scholarship

Top law firms are notoriously competitive, fighting for prime clients and matters. But some of the most elite firms are also deeply cooperative, willingly sharing key details about their finances and strategy with their rivals. More surprisingly, they pay handsomely to do so. Nearly half of the AmLaw 100 and 200 belong to mutual insurance organizations that require member firms to provide capital; partner time; and important information about their governance, balance sheets, risk management, strategic plans, and malpractice liability. To answer why these firms do so when there are commercial insurers willing to provide coverage with fewer burdens, we ...


Risk Appetites And Empirical Survival Pattern Of Small And Medium Enterprises In Nigeria, Joshua S. Adeyele Dr., Osazee G. Omorokunwa Dr. 2017 University of Benin

Risk Appetites And Empirical Survival Pattern Of Small And Medium Enterprises In Nigeria, Joshua S. Adeyele Dr., Osazee G. Omorokunwa Dr.

The Journal of Entrepreneurial Finance

ABSTRACT

Small and medium enterprises (SMEs) are vital to economic growth and development of a nation. However, many of them fail in the first five years of incorporation due to their exposures to risk financing and strategies employed to meet customers’ need during business shutdown. Hence, this study is designed to verify how SMEs’ risk financing affect their continuity, and to model their survival patterns in context of risk financing and risk management approach employed by the operators. Two hundred and nine copies of valid questionnaire distributed to the respondents were filled and returned. Cramer’s V and multiple regressions ...


In Defense Of The Restatement Of Liability Insurance Law, Tom Baker, Kyle D. Logue 2017 University of Pennsylvania Law School

In Defense Of The Restatement Of Liability Insurance Law, Tom Baker, Kyle D. Logue

Faculty Scholarship

For most non-contractual legal claims for damages that are brought against individuals or firms, there is some form of liability insurance coverage. The Restatement of the Law Liability Insurance is the American Law Institute’s first effort to “restate” the common law governing such liability insurance policies, and we are the reporters. In a recent essay funded by the insurance industry, Yale Law Professor George Priest launched a strident critique of the Restatement project, arguing that the rules adopted in the Restatement:

(a) are radically contrary to existing case law,

(b) have a naïve “pro-policyholder” bias that ignores basic economic ...


The Affordable Care Act: A Study Of The Modern United States Health Insurance System, Paige A. Cameron 2016 University of Wyoming

The Affordable Care Act: A Study Of The Modern United States Health Insurance System, Paige A. Cameron

Honors Theses AY 16/17

In this paper I examine the outcome of the Affordable Care Act as it pertains to increases in insurance coverage. As part of this, I use prior projections provided before the law took effect by the nonpartisan Congressional Budget Office as a benchmark to determine whether the law met expected growth in insurance rates. The ACA was enacted to make many changes to the U.S. healthcare structure, including the adoption of insurance marketplaces and a cost-sharing system, the expansion of Medicaid, imposing both employer and individual mandates, and consumer protective rules. After examining data gathered by multiple nonpartisan studies ...


Medicare And The Aca: Shifting The Paradigm Of Fraud Detection, David P. Paul III, Sarah Clemente, Ronald McGrady, Rob Repass, Alberto Coustasse 2016 Marshall University

Medicare And The Aca: Shifting The Paradigm Of Fraud Detection, David P. Paul Iii, Sarah Clemente, Ronald Mcgrady, Rob Repass, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

Medicare fraud and abuse costs are estimated at 3%-10% of overall Medicare spending, which is expected to expand considerably until 2024 and as such the amount of fraud dollars would be expected to increase proportionally. The purpose of this research was to determine how recent reforms, especially the Patient Protection and Accountable Care Act, may affect Medicare fraud and abuse and to uncover the best strategies to combat Medicare fraud. The breadth of fraud and abuse within Medicare as well as recent reforms to fight fraud including legislative reforms, delivery system reforms, and other reforms including the formation of ...


Determinants Of Health Insurance Coverage For Farm Family Households: A Midwestern Study, Helen H. Jensen, William E. Saupe 2016 Iowa State University

Determinants Of Health Insurance Coverage For Farm Family Households: A Midwestern Study, Helen H. Jensen, William E. Saupe

Helen Jensen

Data from interviews with a random sample of farm households in eight counties in southwestern Wisconsin are used to describe the distribution of health insurance coverage among households and health related fringe benefits of off-farm employment. An analysis of health insurance coverage shows major factors associated with lack of health insurance to include lower total household income, larger household size, and being more conservative regarding risk in farming. Although not significant, the signs of coefficients estimated for formal education and lacking fringe benefits in operator off­ farm employment are consistent with expectations.


Insurance Against Extreme Events: Pairing Short-Term Incentives With Long-Term Strategies, Howard Kunreuther 2016 University of Pennsylvania

Insurance Against Extreme Events: Pairing Short-Term Incentives With Long-Term Strategies, Howard Kunreuther

Penn Wharton Public Policy Initiative

Consumers tend to purchase too little insurance or purchase it too late. Consequently, taxpayers wind up bearing substantial burdens for paying reconstruction costs from extreme events. The 2005 and 2012 hurricane seasons alone cost taxpayers nearly $150 billion. There is much that can be done to better facilitate the role that insurance can play in addressing losses from extreme events, both natural and man-made.


Medicare And The Aca: Shifting The Paradigm Of Fraud Detection, David P. Paul III, Sarah Clemente, Ronald McGrady, Rob Repass, Alberto Coustasse 2016 Marshall University

Medicare And The Aca: Shifting The Paradigm Of Fraud Detection, David P. Paul Iii, Sarah Clemente, Ronald Mcgrady, Rob Repass, Alberto Coustasse

Management Faculty Research

Medicare fraud and abuse costs are estimated at 3%-10% of overall Medicare spending, which is expected to expand considerably until 2024 and as such the amount of fraud dollars would be expected to increase proportionally. The purpose of this research was to determine how recent reforms, especially the Patient Protection and Accountable Care Act, may affect Medicare fraud and abuse and to uncover the best strategies to combat Medicare fraud. The breadth of fraud and abuse within Medicare as well as recent reforms to fight fraud including legislative reforms, delivery system reforms, and other reforms including the formation of ...


Health Insurance Co-Ops: Product Availability And Premiums In Rural Counties, Erika Ziller PhD, Zach Croll BA, Andrew Coburn PhD 2016 University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research Center

Health Insurance Co-Ops: Product Availability And Premiums In Rural Counties, Erika Ziller Phd, Zach Croll Ba, Andrew Coburn Phd

Access / Insurance

Created by the Affordable Care Act (ACA), Consumer Operated and Oriented Plans (CO-OPs) are private, non-profit health insurers that were designed to increase insurance plan choice and lower premiums in the Health Insurance Marketplaces. Early analyses of the ACA suggested that CO-OPs may be particularly beneficial for rural communities, where fewer individual and small group health insurance options have traditionally been available.

This Research and Policy Brief, authored by research staff at the Maine Rural Health Research Center, explores the early availability and role of CO-OPs in rural and urban counties. We describe the regional distribution and market prevalence of ...


Data On Vietnamese Patients' Financial Burdens And Risk Of Destitution, Quan-Hoang Vuong, Trong-Khang Nguyen 2016 Universite Libre de Bruxelles

Data On Vietnamese Patients' Financial Burdens And Risk Of Destitution, Quan-Hoang Vuong, Trong-Khang Nguyen

Quan-Hoang Vuong

The research process started in the first week of August 10, 2014 and ended early February 2015, obtaining qualified data for 330 patients from many hospitals in northern Vietnam. Its expansion was performed for an enlarged dataset through May 2015, containing 900 records. This article exemplifies the attempt to examine the likelihood of destitution among Vietnamese patients due to insufficient insurance coverage, cost of treatment and patient׳s status of residency during a curative hospital stay. The result suggests that the patients, who are poor and come from rural areas, face serious obstacles in accessing health care services. This data ...


Car Rental Industry Fraud, Dennise Veasley 2016 La Salle University

Car Rental Industry Fraud, Dennise Veasley

Economic Crime Forensics Capstones

Fraud occurs in all industries and businesses large and small. The car rental industry is not immune to fraud. Fraud is committed by the owners and employees against the customers for personal or corporate gain. The car rental industry is considered a large business based on revenue of a minimum of $38.5 million dollars annually. (Electronic Code of Federal Regulations from http://www.ecfr.gov/) The car rental industry in the United States in 2015 grossed over $27.11 billion as defined by the market data for the U.S. Car Rental Market published by Auto Rental News (http ...


Price Expectations And Risk Profiles Drive Commodity Program Choices, Alejandro Plastina, Chad Hart 2016 Iowa State University

Price Expectations And Risk Profiles Drive Commodity Program Choices, Alejandro Plastina, Chad Hart

Chad Hart

The optimal commodity program choice depends as much on the specific production system in each farm as on the producer’s expectations about future yields and prices. Furthermore, the risk profile of producers will weigh heavily in the decision. This article illustrates the role of price expectations and risk profiles in commodity program choice using the ISU Farm Bill Analyzer.


Price Expectations And Risk Profiles Drive Commodity Program Choices, Alejandro Plastina, Chad Hart 2016 Iowa State University

Price Expectations And Risk Profiles Drive Commodity Program Choices, Alejandro Plastina, Chad Hart

Chad Hart

The optimal commodity program choice depends as much on the specific production system in each farm as on the producer’s expectations about future yields and prices. Furthermore, the risk profile of producers will weigh heavily in the decision. This article illustrates the role of price expectations and risk profiles in commodity program choice using the ISU Farm Bill Analyzer.


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