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This research sought to update understanding following improvements to treatment and deepen the understanding of the mortality risk associated with Type 1 or Type 2 diabetes, including relative risk in the presence of co-morbidities. Specifically, we developed a model to provide mortality predictions at a granular level for lives with and without diabetes. The model is tailored for use by the insurance industry to provide an updated source from which to appreciate the risk posed when underwriting people with diabetes. By providing an updated and deeper understanding of mortality risk, the research’s aim is to improve access to insurance for those individuals living with diabetes. The model combines industry standard underwriting risk factors, such as age, gender, deprivation index, body mass index (BMI), smoker status, blood pressure (BP) and cholesterol level, with various co-morbidities related to diabetes. A comprehensive analysis of mortality risk factors, between 2010 and 2019, for people with and without diabetes is undertaken on over 1.2 million records based on Clinical Practice Research Datalink (CPRD), Hospital Episode Statistics (HES) and Office for National Statistics (ONS) death registrations data. Cox proportional hazards models are used to estimate the probability of death, stratified by gender across three distinct populations: Type 1 diabetes, Type 2 diabetes and a general population sample. The model outputs produced are permutations of the following: gender; population split by general sample, Type 1 and Type 2 diabetes; and a time-dependent exponential model and a time-invariant homogeneous model. A Shiny model application allows interaction with the model outputs (https://0jv7e6-scott-reid.shinyapps.io/diabmdl/) and spreadsheets provide additional explanation. Useful insights were obtained through industry discussions on the variation of existing market practice against that implied by the results. Key rating factors were generally aligned with market practice, such as age, BMI, BP, cholesterol and years since a diabetes diagnosis. However, for a few significant mortality risks impacting co-morbidities, the results did not adhere to prior expectations. Exploratory work suggested that the order and sequencing of key co-morbidities for diabetes must be included in future model development.
US cattle producers face volatile prices due to cattle cycles, drought, and unexpected market shocks. USDA-RMA offers subsidized insurance programs like Livestock Risk Protection (LRP) to mitigate output risks, yet participation remains limited. Using a 21-year state-level panel and a two-part econometric model, this paper evaluates how risk management education workshops influence LRP utilization among feeder cattle producers. Results indicate that education workshops increase the likelihood of insurance participation, especially in non-pilot states, while subsidies dominate in pilot states. The marginal effect of education is smaller in higher subsidy environments, suggesting substitution between education and subsidy.
We develop a decision-support framework for cyber risk mitigation policies from the perspective of an organization with limited resources for security controls, upgrades, and cyber insurance. To balance the conflicting optimization objectives of the organization and the insurer, we propose a bi-level model that endogenously derives optimal strategies for both parties, accounting for key uncertainties underlying a cyber attack. We find that cyber insurance coverage increases with premium size, though this depends on the effectiveness of system upgrades. Notably, the latter has an ambiguous impact on the equilibrium budget allocation strategy and insurance contract design, such that a more effective upgrade need not attract a commensurately larger budget allocation. We further show that information asymmetry regarding the insurer’s risk aversion can lead the defender to a suboptimal budget allocation, resulting in higher realized losses relative to the symmetric-information benchmark.
Federated Learning is a novel method of training machine learning models, pioneered by Google, aimed for use on smartphones. In contrast to traditional machine learning, where data is centralised and brought to the model, Federated Learning involves the algorithm being brought to the data, ensuring privacy is preserved. This paper will demonstrate how insurance companies in a market could use this technique to build a claims frequency neural network prediction model collectively by combining and using all of their customer data, without actually sharing or compromising any sensitive information with each other. A simulated car insurance market with 10 players was created using the freMTPL2freq dataset. It was found that if all insurers were permitted to share their confidential data with each other, they could collectively build a model that achieved 5.57% of exposure weighted Poisson Deviance Explained (% PDE) on an unseen sample. However, if they are not permitted to share their customer data, none of them can achieve more than 3.82% exposure weighted PDE on the same unseen sample. With Federated Learning, they can retain all of their customer data privately and construct a model that achieves a similar level of accuracy to that achieved by centralising all the data for model training, reaching 5.34% exposure weighted PDE on the same unseen sample.
Insurance and its related products and instruments plays an important role in the management of risk and potential loss from terrorist attacks. This chapter will introduce the reader to the concept and structure of insurance and how the sector approaches catastrophic risks like terrorism. It will then explore the roles that insurance has, and that different actors play, in the process of insuring against loss caused by terrorism. In order to insure a risk, it must be possible to assess it and to model the potential loss to the insurer. So the process of how insurers assess and model the risk will be laid out. This sets the conditions for the challenges that such modelling faces and treatments of those challenges. The chapter concludes that the process of validation of models is critical to their success and is an excellent area for future research.
It is often thought that compulsory retirement funding gains support from paternalistic considerations. This paper examines this claim. I argue that compulsory retirement funding is more coherent when understood as an attempt at temporal smoothing than counterfactual insurance. An implication is that any paternalistic case for retirement funding faces problems that are more severe than they would be if compulsory retirement funding were insurance. I label these the problems of ‘inverted bias’ and of the ‘arbitrariness of income from labour’. The paper then makes some suggestions about how these points about paternalism bear on the problem of justice in retirement funding.
Stéphane Dees, Banque de France and Bordeaux School of Economics, University of Bordeaux, France,Selin Ozyurt-Miller, International Finance Corporation
Financial stability is essential for sustainable economic growth, and prudential policies have been reinforced since the Global Financial Crisis (GFC) to safeguard this stability. The Basel III framework introduced stringent capital, liquidity, and risk management requirements for banks, strengthening their resilience. In the face of growing climate-related risks, central banks and supervisory authorities must ensure that financial systems remain stable. Extreme weather events and abrupt transitions to a low-carbon economy can lead to significant financial losses, including asset stranding and increased defaults, threatening overall financial stability. Central banks and supervisory authorities must integrate climate risks into their financial supervision frameworks, adapting existing tools to manage these complex, systemic risks. Prudential responses must encompass both individual institutions and broader financial systems to mitigate the impact of climate change on financial stability. Ensuring a resilient financial system is crucial for maintaining economic stability in the transition to a low-carbon future.
The proponents of the ‘convenient solution’ discussed in Chapter 3 see the cost of climate action as one of government investment in new infrastructure. However, as there is not time for this to scale sufficiently, we must think differently about cost. Voluntarily restraining ourselves from emitting activities may save us money, but in most cases at present, purchasing equipment compatible with zero emissions costs more than the emitting alternative. Eventually, governments will legislate to ban emissions, by which time we will only compare the costs of different emissions-free alternatives. On the journey to that point, governments can aim to help us change by subsidising zero-emissions projects or taxing emitting activities. Carbon pricing has proved to be politically impossible, due to competition in trade and the high costs it would place on householders. Instead, we can all re-think the timescale of our purchasing decisions and recognise that paying for the higher costs of emissions-free options today is in reality an investment in the future, like a pension or savings account, aiming to avoid the far worse costs of a global war over food.
This study analyzed medium-to-long-term trends in long-term care insurance expenditures in Katsurao Village, which underwent complete evacuation following the Fukushima Daiichi Nuclear Power Plant accident, to elucidate the disaster’s impact on care needs. Long-term care insurance expenditure data of Katsurao Village from 2010 to 2023 were analyzed. Per capita long-term care expenditure was calculated by dividing the total long-term care insurance benefits by the population aged ≥65 years and compared to national averages. In 2016, when evacuation orders were largely lifted, per capita long-term care insurance expenditure reached JPY 562,970, approximately three times pre-disaster levels (JPY 197,461 in 2010). Although expenditures gradually decreased thereafter, they remained high at JPY 415,884 in 2023. Evacuation due to nuclear disaster leads to sustained increases in long-term care burden.
From agents and bearers of human rights, the volume turns to domains which some have seen as impervious to claimants of rights, but which have been refashioned thanks to their mobilization. Sara Silverstein explains how it was from the periphery – first small European states before World War II and later from the Global South after – that most work was done to elaborate entitlements to healthcare, whether at the local, national, or international level. Some of these impulses sprang from mechanisms of colonial rule, others from the biopolitical transformation of citizenship (including in the rise of mandatory insurance); and there is no doubt that the international standard-setting of the World Health Organization and other agencies played an important role.
This study examines sea loans in the Portuguese Empire (1600–1800). Structured as contingent contracts, this kind of credit served as a risk-sharing agreement for financing transoceanic trade routes. Using notarial protocols and court records, the study examines how maritime regulations, international political relations, and information problems influenced the pricing of loan agreements. The study demonstrates that the introduction of the convoy system, which distinguished Portugal–Brazilian connections, coincided with a downward trend in sea loan rates, which converged with those of safer short-term lending instruments. In contrast, periods of war and free navigation increased uncertainty, making maritime insurance and sea loans complementary instruments for risk management.
Provisions in consumer contracts that deprive consumers of recourse in the event of a product failure effectively cancel the insurance that the law would otherwise provide to consumers who are injured by sellers of consumer products. This redistributes wealth from the poorest consumers to richer consumers because richer consumers can afford to self-insure against the risk of product failure whereas poorer consumers cannot. It follows that consumer sovereigntist arguments that consumer indifference to consumer-unfriendly contract terms suggests that consumers prefer the lower prices that come with such terms are misleading here. The interests of rich and poor consumers diverge with respect to these contract terms and the fact that rich consumers may carry the day in the market does not imply the consumers as a group prefer these terms. Accordingly, the European approach to consumer law, which treats democratically elected governments regulating consumer contract terms as a more authentic reflection of popular will than the purchase decisions of consumers in markets, may be more appropriate when it comes to the regulation of consumer contracts.
This chapter discusses insurance as a central player in the purchasing of health goods and services. It points out the flaws and quirks in the insurance market that lead to an absence of perfect competition and the potential for skewed bargaining power between providers and insurers. Managed care is then outlined as an attempt by insurance companies to curtail health spending through utilization controls and narrow networks. Additional tools such as paying for wellness programs, bundling payments for episodes of care, and cost-effectiveness measures are also discussed as possibilities to improve the efficiency of payouts by insurers. The chapter concludes by reminding us that insurance companies make more money the less they pay out and that making it more difficult for beneficiaries to access care will allow them to accomplish that.
This chapter deals with the economics of prescription drugs and of insurance coverage for them. Sellers of drugs have temporary market power because of patents. Drugs are supplied under a cost structure with high fixed costs of research, discovery, and approval followed by low marginal cost of producing additional units; this structure does not permit competitive markets to exist during the period of patient protection. Health systems buy drugs for inpatients in the usual way, but outpatient and pharmacy sold drugs are priced above marginal cost with prices often distorted by insurance coverage. The result can be high prices (though not necessarily increasing ones). A potential solution to the inefficiencies in this market is an agreement between insurers and drug sellers to buy a predetermined volume with the marginal price of additional units low or zero – the so called “Netflix” model. The intent of above-cost pricing for drugs is to encourage the supply of innovative products, but evidence on whether the current patient system in the US achieves an ideal outcome is lacking.
This chapter begins by introducing the concept of corporate governance, and the regulatory role of directors’ duties. An appreciation of corporate governance methodologies gives context to the ‘hard law’ of directors’ duties. The chapter then considers who falls within the definition of director, the role of the director within the company, and how that role attracts legal and non-legal regulation. It also identifies who, beyond directors, can also be subject to directors’ duties. The chapter revisits the history of directors’ duties within Australian corporate law, building on the historical context provided by Chapter 1, and exploring the interrelationship between the duties applicable at common law, in equity, and according to statute. It concludes with the consequences of breach of the civil penalty provisions and options for exoneration and relief under the Corporations Act.
This chapter explores a form of anticolonial resistance that has gone relatively unnoticed by social theorists – insurrections aboard slaving ships. How might social theorists effectively represent, theorize, and contextualize these moments of anticolonial action? Drawing on the materials from the newly opened Lloyd’s archives, we discuss the importance of the insurance archive to histories of slavery and how these materials – despite their colonial ontologies – can offer novel understandings of anticolonial action. The materials permit scholars to uncover a complex set of financial logics that convey multiple different meanings about the category of the human and allow social theorists to ask different questions. Even the smallest details in the most highly localized spaces can provide insight into the nature of resistance and revolution.
This chapter introduces the major themes of the book. Insurance practices and related metaphors began expanding rapidly from a European base some 500 years ago. The simultaneous emergence of the modern state was hardly coincidental. Increasingly complex societies energized by market economies required protection from risks of various kinds. This required mobilizing and organizing private capital to achieve common goals. The deepening of markets and development of financial technologies now increases demands for protection beyond conventional borders. But where the fiscal power of the modern state underpinned national insurance and reinsurance systems, the absence of a global fiscal authority is exposed by rising cross-border, systemic, and global risks. That the background condition for necessary innovation in governance is uncertainty has also become undeniable.
This overview opens with the story of the great fire in Glarus, Switzerland, in 1861. Like those in other cities, the fire brought into clear view key elements of the insurance systems that modern societies needed to foster resilience. In its aftermath, the role of public authorities changed, reliance on new techniques for mobilizing private capital rose significantly, and the interaction of markets and states across established borders became deeper and more complex.
Exploring the economic ramifications of climate change, this chapter features insights from financial experts such as Sara Jane Ahmed, Managing Director and V20 Finance Advisor of the CVF-V20 Secretariat. It discusses the adverse effects on GDP growth, inflation, debt, and credit ratings, particularly in vulnerable economies. The chapter highlights the crucial role of financial markets, insurance, and climate finance in addressing these challenges. Innovative financing solutions such as Green Bonds and pre-arranged and trigger-based financing, including loss and damage finance, are explored as means to build economic resilience. The importance of sustainable economic policies and international cooperation is emphasised, with case studies from countries successfully integrating climate resilience into their economic planning. The chapter calls for increased investment in climate adaptation and mitigation to safeguard economic stability and promote sustainable development.
Climate activists are divided over whether to adopt strategies emphasizing stability and incremental change versus strategies promoting more extreme and immediate action. One way to promote policy stability is through private governance, that is, voluntary industry self-governance. Proponents argue this can stabilize expectations about the future, incentivize incremental reductions in emissions, and lock in policies and practices. This problem-solving approach serves to depoliticize debate but can lead to political backlash and repoliticization. I examine these dynamics through a case study of the financial sector, particularly the insurance industry. Collective attempts to ensure policy lock-in and stability include initiatives such as the United Nations Environment Programme Finance Initiative (UNEP-FI), the Glasgow Financial Alliance for Net Zero, and Net Zero Insurance Alliance. This is a case of failed depoliticization as demonstrated by the political backlash against these efforts.