scholarly journals PERHITUNGAN PREMI DENGAN PENERAPAN DEDUCTIBLE PADA MODEL AKTUARIA UNTUK SICKNESS INSURANCE PERTANGGUNGAN SATU TAHUN

2019 ◽  
Vol 1 (1) ◽  
pp. 39-45
Author(s):  
Norisca Lewaherilla ◽  
G. Haumahu
Keyword(s):  
Health Insurance ◽  
Insurance Companies ◽  
Insurance Policy ◽  
Sickness Insurance ◽  
Insurance Benefits ◽  
Medical Expenses ◽  
Important Benefit ◽  
Insurance Product ◽  
Insurance Model ◽  
One Year

Health insurance is an insurance product that provides benefits if the insured is exposed to the risk of an accident or illness and causes loss of income, thus requiring costs. The most important benefit in this study from sickness insurance is the reimbursement of medical expenses. The design of determining premiums by applying deductibles (flat deductibles) is seen as one of the insurance policy policies that meet the principles of determining premiums. The actuarial aspects considered in the health insurance model in this study for the calculation of premiums relating to the type of insurance benefits with expense reimbursement for a period of one year coverage, with due regard to the type of work. The purpose of this study is to see the applied of deductible to the premiums that must be paid to insurance companies that provide benefits for claims submitted. The policy of applying deductibles certainly makes the amount of reimbursement change.

Het gezondheidsbeleid in België in handen van corporatieve organisaties

Res Publica ◽  
1995 ◽  
Vol 37 (1) ◽  
pp. 109-113
Author(s):  
Guy Peeters
Keyword(s):  
Health Insurance ◽  
Health Workers ◽  
Pressure Group ◽  
Insurance Policy ◽  
Sickness Insurance ◽  
Hospital Sector ◽  
Advantages And Disadvantages ◽  
The Social ◽  
Social Partners ◽  
The Government

Before the so-called 'bill Moureaux ', the health insurance policy in Belgium was contracted out by the government to the health workers and the health funds. Also in other sectors (hospitals), government contracted out. This subsidiarity has advantages and disadvantages.  Especially because of the unbearable budgetary excesses, this situation started to change since the beginning of the eighties, starting with the hospital sector. In the early nineties, the management of the sickness insurance also went through some radical changes. The budgetary envelope (budget objective) is now mainly established by those who finance the system, e.g. the government and the social partners (employers and workers), who must take their responsibilities. In this new perception, all partners must be made truly accountable.Government must pass on statistic material in order to be able to pursue a well-informed policy. It must also crank up some social debates, namely about the demographic ageing.Health funds and organisations of physicians need a further democratization. The health funds must accomplish at the same time several functions: pressure group, service and consumer defence.

scholarly journals CONSUMER BUYING BEHAVIOR OF COLLEGE AND UNIVERSITY TEACHERS REGARDING PROBLEMS AND SATISFACTION LEVEL IN CLAIM SETTLEMENT OF HEALTH INSURANCE PRODUCTS – AN ANALYTICAL STUDY OF RAJKOT CITY

2021 ◽  
pp. 13-15
Author(s):  
Vasani Suresh V. ◽  
Chitralekha H. Dhadhal
Keyword(s):  
Health Insurance ◽  
Analytical Study ◽  
Service Providers ◽  
Insurance Companies ◽  
Satisfaction Level ◽  
Insurance Policy ◽  
Buying Behavior ◽  
University Teachers ◽  
College And University ◽  
Buying Behaviour

This paper tries to analyze the Buying Behaviour of Health Insurance policy holders in terms of the problems they face in claiming health Insurance,their satisfaction level with regard to claim settlement and whether they differ in their Health Insurance Renewal Behaviour based on their income Levels .Data was collected by the Researchers from the 140 College and University Teachers of Rajkot city who have used health insurance products.The Findings of the study indicate that,86 (61.4%) out of the 140 Respondents surveyed, have Never made Claims from their Insurance Companies. As far as the Problems in claiming health Insurance are concerned, Most College and University Teachers Faced Problems in Communication with their Service Providers while Settling their Claims and they even Faced Difficulty in contacting their Service Provider companies during Claim Settlement. From the Policyholders who have made claims, Most are Satisfied with their insurance claim.Most consumerspreferredrenewingtheirpolicies on regularbasis.Andfinally health insurance policyholdersdonotdiffer intheirPolicyRenewalBehaviorbasedontheir IncomeLevels .

scholarly journals Faktor-Faktor yang Berhubungan dengan Keputusan Klaim Asuransi Kesehatan Kumpulan PT. SGMW Motor Indonesia pada Pialang Asuransi PT. Cipta Integra Duta

2021 ◽  
Vol 1 (01) ◽  
pp. 11-20
Author(s):  
Wawa Wardil Hasan
Keyword(s):  
Health Insurance ◽  
Secondary Data ◽  
Total Sample ◽  
Claim Data ◽  
Insurance Companies ◽  
P Value ◽  
Chi Square ◽  
Test Analysis ◽  
Insurance Benefits ◽  
Insurance Sector

Introduction: Commercial health insurance companies can cater to the diverse desires of individuals. However, as a consequence, the company will design various products according to public demand with certain terms and conditions in the policy. This study aims to determine the factors associated with the insurance claim decision of the group of PT. SGMW Motor Indonesia at Insurance Broker PT. Cipta Integra Duta 2020. Methods: This analysis uses independent submission variables that are claimed from completely rejected claims, accepted and claimed claims in their entirety and the dependent variable is insurance membership status, completeness of files, over-limit claims, health insurance benefits, non-original claim documents and resources. analysis of claims and insurance guarantee letters. This research data was obtained from secondary data in the form of claim data from PT SGMW Motor Indonesia for the period of coverage from January 1, 2020 to December 31, 2020 as an accumulation of the results of the analysis of claims from the insurer PT. International Services Pacific Cross with a total sample of 7,123. Statistical method using non-parametric comparative test analysis was performed on two variables using the Chi Square method. Results: The factors that were most related to the decision that were claimed in whole and claimed to be partially accepted were the health insurance benefits factor with a p value of 0.001 and human resource analysis claims with a p value of 0.000. Discussion: Therefore, it is necessary to improve the quality of human resources for claims analysts who work in the health insurance sector either by training, certification, seminars and periodic socialization, as well as socializing insurance benefits and advocating for insurance companies suspected of fraud in their claims analysis, so that public trust in insurance is needed, can grow.

scholarly journals An Overview Study of Health Insurance in India

2018 ◽  
Vol 2 (2) ◽  
Author(s):  
Vijayaraddi Vandali
Keyword(s):  
Health Insurance ◽  
Health Risks ◽  
Insurance Policy ◽  
Financial Loss ◽  
Consumer Awareness ◽  
Medical Expenses ◽  
Insurance Policies ◽  
Medical Emergencies ◽  
Healthcare Insurance ◽  
Hospital Stays

Health insurance is a mechanism by which a person protects himself from financial loss caused due to accident and/or disability. The chairman of Insurance Regulatory and Development Authority (IRDA) has mentioned that low consumer awareness and insufficient healthcare infrastructure are the major hindrances to widen the reach of healthcare insurance in India. Healthcare costs have witnessed a phenomenal rise in the current times. This has led the customers to insure not only themselves but their family members for any future medical expenses and other related requirements. The need to insure assumes is more importance for older generations who are either retired or will be retired in near future. Given high health cost, it is important for us to get covered for health risks. With this, a good insurance policy is needed to cover doctor's visit, laboratory tests, hospital stays and diagnostic tests. There are quite a few companies covering health risks with good insurance policies. Health insurance (popularly known as Mediclaim) offers protection in case of unexpected medical emergencies. In case of a sudden illness or accident, the health insurance policy takes care of the hospitalization, medical and other costs incurred. Thus, health insurance to be introduced to all consumers in India to protect them from financial loss caused by unfortunate incidents.

scholarly journals Awareness of health insurance policies among cardiac patients visiting a tertiary care cardiac hospital in South India

2021 ◽  
Vol 8 (5) ◽  
pp. 2455
Author(s):  
Archana S. Krishnan ◽  
Jawahar S. K. Pillai ◽  
Ramkrishna Mondal
Keyword(s):  
Health Insurance ◽  
Rural Areas ◽  
Access To Health Care ◽  
Communicable Disease ◽  
Tertiary Care ◽  
Cardiac Patients ◽  
Insurance Policy ◽  
Chi Square ◽  
Medical Expenses ◽  
Insurance Policies

Background: Healthcare expenditure is becoming a point of discussion in the recent past. Cardiac problems are the major non-communicable disease burden in the society. Health insurance play a major role to share individual health risks and there by provide better access to health care. In this study an attempt was made to find out the level of awareness of health insurance policies among cardiac patients in a tertiary care hospital.Methods: One hundred and twenty patients were surveyed using a pretested questionnaire comprising of thirty different questions related to health insurance. Simple statistical test and Chi square test was used to assess the association between the variables.Results: Only 41% were aware of health insurance among non-insured patients (n=100). It was found that only 16.7% (N=20) had chosen insurance policy and reason for having taken insurance was to cater to the huge medical expenses (14.2%). 45% patients were opted Insurance due to low premium and good reputation. Majority (42.5%) meet their medical expenses from salary. It was found that majority (55%) were satisfied with the insurance.Conclusions: It is found that less than one fifth of the patients opted for health insurance policy, which is very low. The level of awareness about insurance among the non-insured is also very poor. Study concluded that the awareness of health insurance is very poor especially in rural and semi-rural areas. Continuous awareness creation is needed to enhance the health insurance benefits and various features.

Medication Insurance Policy - a New Insurance Product in the Polish Health Care System

2015 ◽  
Vol 10 (4) ◽  
pp. 327-338
Author(s):  
Anna Piechota
Keyword(s):  
Health Care ◽  
Health Expenditure ◽  
New Product ◽  
Insurance Companies ◽  
Total Health Expenditure ◽  
Insurance Policy ◽  
Public Funds ◽  
Medication Costs ◽  
Insurance Product ◽  
Business Insurance

In the Polish healthcare system, medications (including compounded preparations) are wholly or partially paid for from public funds. Subsidising medications which are either central or incidental to treatment (e.g., when patients are unable to work because of an illness) means that medication costs make up a large percentage of total health expenditure and are a drain on the patients' purse. Medication insurance (or drug coverage) policies are a relatively new product and are featured in business insurance portfolios of only a handful of insurance companies offering coverage for medication costs. This article sets out to discuss and analyze available medication coverage policies. 

scholarly journals Factors affecting the value of the insurance policy An exploratory study on Saudi health insurance companies: العوامل المؤثرة في تحديد قيمة البوليصة التأمينية (دراسة استطلاعية على شركات التأمين الصحي السعودية)

2020 ◽  
Vol 4 (12) ◽  
Author(s):  
Ashwaq Safar Al-shahrani
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Relative Weight ◽  
Insurance Companies ◽  
Survey Method ◽  
Insurance Policy ◽  
Kingdom Of Saudi Arabia ◽  
Factors Affecting ◽  
Comprehensive Survey ◽  
Health Insurance Companies

The aim of the research was to identify the factors influencing the decisions of determining the value of the insurance policy. The research used the analytical descriptive method. The questionnaire was used as a tool for gathering information from the study members. The comprehensive survey method was applied by applying all insurance companies in the Kingdom of Saudi Arabia. The sample of the study was 200 employees, and the research reveals several results, the most important of which is that the insurance policy is different according to the type of contract which affects its value Relative weight 0.83. The size of danger determines the type, value and period of the insurance policy Relative weight 82.20. This affects the value of the insurance policy, with higher the health service provided to the insured. The study recommends the need to pay attention to health insurance and the need to raise the awareness among citizens about importance of health insurance. Also, insurance companies should minimize the limit of installment and it should include a large part of health services costs. In addition, they need to clarify more about the covering limit by the premium insurance policy, which may help to reduce the price of the insurance policy to suit all members of society in order to obtain the appropriate health services for them.

scholarly journals Satisfaction Level of Health Insured and Financial Profitability of Health Insurance Companies from Health Insurance Product

2019 ◽  
Vol 2 (4) ◽  
pp. 17-20
Author(s):  
Mahnoor Surahio ◽  
Preh Bhatti ◽  
Vinesh Kumar Kumar ◽  
Rashid Qureshi
Keyword(s):  
Health Insurance ◽  
Sample Size ◽  
Insurance Companies ◽  
Primary Data ◽  
Satisfaction Level ◽  
Significant Difference ◽  
Insurance Product ◽  
Health Insurance Companies ◽  
Financial Profitability

The research is focused on finding whether the insurance companies are providing health insurance to their clients are enough to meet their expectations or the employees are bound to pay the premium for availing the employer-based   health insurance. Another part of the study is focused on finding the financial profitability of health insurance companies particularly, from the health insurance product they are offering to their clients. The premium these companies charging are enough to generate the profitability of health insurance companies or there is not any significant impact on their profitability from this product. It is obvious that a sick employee would be less interested in his or her work and the ratio of absenteeism will increase. The main purpose is to evaluate if providing health insurance is a profitable activity for both sides. This research was conducted through primary data; the data has been collected with the help of adopted questionnaire and a sample size is of 70 respondents. It is found from the research that employees are moderately satisfied with employer-based insurance facility and there is not any significant difference between premium paid and utilized. So, insurance companies are earning less from health insurance product.

Improving Mental Health Insurance Benefits without Increasing Costs

2001 ◽  
Author(s):  
Merrile Sing ◽  
◽  
Steven Hill ◽  
Loren Puffer
Keyword(s):  
Mental Health ◽  
Health Insurance ◽  
Insurance Benefits

scholarly journals CioSy: A Collaborative Blockchain-Based Insurance System

Electronics ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 1343
Author(s):  
Faiza Loukil ◽  
Khouloud Boukadi ◽  
Rasheed Hussain ◽  
Mourad Abed
Keyword(s):  
Data Storage ◽  
Insurance Industry ◽  
Emerging Technology ◽  
Third Party ◽  
Insurance Companies ◽  
Smart Contracts ◽  
Insurance Policy ◽  
Insurance System ◽  
Advanced Technologies ◽  
Multiple Challenges

The insurance industry is heavily dependent on several processes executed among multiple entities, such as insurer, insured, and third-party services. The increasingly competitive environment is pushing insurance companies to use advanced technologies to address multiple challenges, namely lack of trust, lack of transparency, and economic instability. To this end, blockchain is used as an emerging technology that enables transparent and secure data storage and transmission. In this paper, we propose CioSy, a collaborative blockchain-based insurance system for monitoring and processing the insurance transactions. To the best of our knowledge, the existing approaches do not consider collaborative insurance to achieve an automated, transparent, and tamper-proof solution. CioSy aims at automating the insurance policy processing, claim handling, and payment using smart contracts. For validation purposes, an experimental prototype is developed on Ethereum blockchain. Our experimental results show that the proposed approach is both feasible and economical in terms of time and cost.

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