Optimal Claim Settlement Strategies under Constraint of Cap on Claim Loss

In this paper, we examine the question of how to devise an optimal insurance claim settlement scheme under the constraint of a cap on the amount of the claim payment. We establish objective functions to maximize the net benefit due to exaggerated claims while at the same time maximizing the total expected wealth of the insured. Then, we establish a dual objective function to minimize the total expected loss, including the perspective of the insurer. Finally, we illustrate applications of our work and provide numerical analysis of it along with an example.

MEAN–VARIANCE INSURANCE DESIGN WITH COUNTERPARTY RISK AND INCENTIVE COMPATIBILITY

This paper studies the optimal insurance design from the perspective of an insured when there is possibility for the insurer to default on its promised indemnity. Default of the insurer leads to limited liability, and the promised indemnity is only partially recovered in case of a default. To alleviate the potential ex post moral hazard, an incentive compatibility condition is added to restrict the permissible indemnity function. Assuming that the premium is determined as a function of the expected coverage and under the mean–variance preference of the insured, we derive the explicit structure of the optimal indemnity function through the marginal indemnity function formulation of the problem. It is shown that the optimal indemnity function depends on the first and second order expectations of the random recovery rate conditioned on the realized insurable loss. The methodology and results in this article complement the literature regarding the optimal insurance subject to the default risk and provide new insights on problems of similar types.

Optimal Insurance Indemnity and Reinsurance Strategy for Health Insurance

“Health insurance + health management” package has recently become one of the most important nonlife insurance products, and its pricing technique has drawn attention from both academia and industry. This paper investigates the optimal indemnity design and per-loss reinsurance strategy for the health insurance package, where the reinsurance contract is assumed to combine the quota-share type and the excess-of-loss type. By applying the Lagrange multiplier method and optimal control technique, we develop the solutions to the corresponding optimization problems and obtain the optimal deductible. Then, we proceed to solve the optimal quota-share proportion and the optimal stop-loss retention based on the optimal insurance indemnity. In addition to theoretical results, numerical examples are also given to illustrate the effects of various key parameters on the optimal indemnity design and combinational reinsurance strategy.

Fair Insurance Premium Rate in Connected SEIR Model under Epidemic Outbreak

In this paper, we aim to determine an optimal insurance premium rate for health-care in deterministic and stochastic SEIR models. The studied models consider two standard SEIR centres characterised by migration fluxes and vaccination of population. The premium is calculated using the basic equivalence principle. Even in this simple set-up, there are non-intuitive results that illustrate how the premium depends on migration rates, the severity of a disease and the initial distribution of healthy and infected individuals through the centres. We investigate how the vaccination program affects the insurance costs by comparing the savings in benefits with the expenses for vaccination. We compare the results of deterministic and stochastic models.