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At least 37 records · Page 2Linked to original sources
PubMed1989

[Evaluation of suicide in legal accident insurance and private insurance].

The thesis, that suicides are chiefly understood to be terminal stage developments and indemnified through compliance with prerequisites of the insurance law norm, is critically explained with regard to the scientific-theoretical evolution. Recent interdisciplinary investigations (epidemiology, statistics, sociology, psychology, psychiatry) as well as the changing approach of a large section of the population towards suicidal behaviour (self-determination and the responsibility of the individual, human dignity, breaking away from handed down moral judgements) show that the estimation held with cogency in many quarters with respect to suicide as being a reliable symptom of a disease, cannot be maintained. This result is further supported by the record number of individuals, within the sphere of the private insurance, finding themselves in financial and political "marginal situations" (class and social problems, material safeguard for families and the like) and committing suicide after reasonably pondering their dilemma; a condition which in many aspects comes close to "balance suicide". From an insurance medical angle the relevant statutory provisions and the supreme court jurisdiction of the last years are put forward to the medical experts with the requirements derived hereunder.

Expert Testimony↗
PubMed1977

Private industry health insurance plans: type of administration and insurer in 1974.

This report examines the major forms of administration of private health insurance plans. Plans are classified according to whether they are employer-only or joint worker-employer-operated and according to whether they are negotiated or not. A further focus of examination that often reflects industry patterns is whether the plans cover workers of a single employer or involve multi-employer arrangements. These classifications of administration and the method of insuring benefits are examined in terms of proportions of workers with specified plan characteristics and health benefits.

Blue Cross Blue Shield Insurance Plans↗
PubMed1991

[Statutory accident insurance--obligatory social accident insurance in Switzerland].

According to the new Accident Insurance Law, in Switzerland it is mandatory for all employees to be insured against accidents and occupational diseases. The legal bases, organization and implementation of this mandatory social accident insurance are described. Discussed in particular are the specific Swiss features, such as the inclusion of non-occupational accidents (leisure-time accidents), and special medical aspects in the assessment of incapacity, injury and occupational diseases.

Accidents, Occupational↗
PubMed1989

[Change in the panorama of chronic diseases and their insurability by life insurance].

The health condition of man has changed considerably since life insurance companies have been established. The initial problem of the companies was the fact that many young persons died from tuberculosis. For many decades persons from families with tuberculosis cases or with underweight were not accepted for insurance on their lives. Nevertheless companies observed many deaths causes by this disease. Medical directors and actuaries studied these cases in detail (dates and numbers), even of the deceased. The resulting statistics formed the premium calculation basis for persons with an increased risk. Comparative studies allowed acceptance for more people. Within the last decades when sulfonamides, antibiotics and insulin were discovered and produced the mortality ratio decreased. Nowadays, even persons who suffered from tuberculosis do not present an increased risk anymore. The life expectancy has doubled during the last century. This is why degenerative diseases increased, especially the coronary heart diseases. While thirty years ago the mortality ratio stood at about 500%, improved medical and surgical therapy made prognosis easier and when risk factors can be eliminated the mortality ratio tends to be less than 200%. Since insulin is available, patients with type I-diabetes do not die anymore in coma, the remaining risk is the sclerosis of the vessels. Diabetes with adults increases with overweight, high blood pressure and hyperlipemia. The mortality ratio depends on these risk factors. Morbus Crohn, first described in 1932, seems to increase. Life insurance needs more long-term statistical data. For only some years we are confronted with the immunodeficiency "Aids".(ABSTRACT TRUNCATED AT 250 WORDS)

Cause of Death↗
PubMedDate not supplied

Insurance for the insurers. The use of genetic tests.

Genetic testing raises concerns that individuals will be denied health insurance (and thus, effectively, access to health care), or that employers will screen to eliminate potentially costly workers. Although we as a society do not yet concur on the degree to which private businesses have a responsibility to promote social justice, several different policy alternatives might allow us to weigh the interests of insurers, as businesses, against the interests of citizens in a responsible manner.

Eligibility Determination↗
PubMed1992

Risk variation and fallback insurers in universal coverage insurance plans.

This paper argues that optimal treatment of health expenditure risk variation over one's lifetime requires partial offsetting of experience-related premium fluctuations. It argues that government should provide protection against the risk of serious chronic illness by offering risk-related tax credits that offset some (though not all) of the changes in premiums due to such illnesses. The performance of a fallback insurer, present in most market-based health reform proposals, is shown to depend on whether or not it is permitted to risk rate. Forbidding any risk rating is likely to cause adverse selection problems, whereas permitting the fallback insurer to risk rate should help it to perform its proper role and avoid being subject to dumping of high risks.

Choice Behavior↗
PubMed1987

Actuarial status of the HI (hospital insurance) and SMI (supplementary medical insurance) Trust Funds.

This article is adapted from the 1987 Annual Reports of the Medicare Board of Trustees. It presents a summary of the current financial and actuarial status of the Hospital Insurance (HI) and Supplementary Medical Insurance (SMI) Trust Funds. The Board found that the present financing schedule for the HI program is sufficient to ensure the payment of benefits over the next 12-14 years if the intermediate (II-A and II-B) assumptions underlying the estimates are realized. Although steps have been undertaken to reduce the rate of growth in payments to hospitals, the Board urges Congress to take remedial measures to bring future HI program costs and financing into balance. The Board found the SMI program to be actuarially sound but recommends that Congress take action to curtail the rapid growth in that part of Medicare.

Financing, Organized↗
PubMed1992

[Estimation of the incidence of diabetes in the Federal Republic of Germany based on insurance data. A secondary data analysis of a representative random sample of locally insured persons in the city of Dortmund].

All records relating to medical prescriptions and services relating to diabetes for a representative sample (n = 6478) of inhabitants of Dortmund in 1988, who were members of the Local Health Insurance in Dortmund, were analysed. 264 patients (4.08%) were receiving antidiabetic drugs during that year, 198 (3.06%) oral ones, 42 (0.65%) insulin and 24 (0.37%) both. 12.41% of all those insured over the age of 60 were on antidiabetic drugs, more women than men (5.08 vs 2.94%; P less than 0.001). The most frequently used oral antidiabetics were sulphonylurea ones (95.1%), while the proportion of biguanides was only 4.4%. On the basis of established diagnosis, regular blood sugar and HbA1 tests, as well as optic fundi examination, a further 104 persons (1.60%) are assumed to have diabetes but not treated by drugs. This sample indicates an overall prevalence of diabetes of 5.68% among the population. Relating it to the age and sex pattern of the population of the Federal Republic of Germany this corresponds to a prevalence of diagnosed diabetes of 4.82%. Thus there are probably a little less than 4 million diabetic citizens of the Federal Republic of Germany.

Age Factors↗
PubMed1989

Life insurance and HIV testing: insurance theory, discrimination and solutions.

Part 1 describes briefly how the market for life insurance deals with HIV infection and how society has reacted to its policies. Part 2 examines the arguments for and against HIV testing: does it discriminate against individuals or is it just a logical extension of risk estimation procedures and underwriting techniques? In part 3 possible solutions are considered. Are solutions in the private sector, like banning HIV testing, warranted, should we look for a public solution that does not burden the private insurance industry, or is a mixed public-private solution desirable?

AIDS Serodiagnosis↗
PubMed1989

Physicians who have lost their malpractice insurance. Their demographic characteristics and the surplus-lines companies that insure them.

The present study analyzes demographic data on 920 physicians who lost their coverage and applied to a "surplus-lines" company that insures essentially all applicants. Our analysis reveals that (1) some specialties are heavily overrepresented in the surplus-lines pool, (2) physicians aged 45 to 54 years are also overrepresented, (3) board certification is seen as frequently in the surplus-lines group as in the US physician population, and (4) the percentage of foreign medical graduates in the surplus-lines pool is virtually the same as that in the US physician population. A model of the actuarial process by which claims data can lead to termination of standard coverage suggests that disproportionate representation of high-risk specialties is not simply a function of a high average claims rate. We also show that, in contrast to joint underwriting associations, surplus-lines companies impose high premiums, large deductibles, and restrictions on practice, all of which are likely to reduce the frequency of negligent behavior.

Actuarial Analysis↗
PubMed1989

[Military insurance. Military insurance regulations and the handling of diseases/injuries among draftees].

This article discusses civilian and military insurance regulations, including social support in case of illness or injury during compulsory military service. The procedure is exemplified by the treatment of conscripts who are diagnosed as having cancer testis while doing their compulsory service. It is essential that civilian medical practitioners are familiar with this procedure, so that they can advise any conscripts who consult them.

Adult↗
PubMed1987

Actuarial status of the OASI (old age survivors insurance) and DI (disability insurance) Trust Funds.

This article summarizes the current financial condition and actuarial status of the Old-Age, Survivors, and Disability Insurance (OASDI) program, as shown in the 1987 Annual Report of the Board of Trustees. The Trustees note that the assets of the OASI and DI Trust Funds, on a combined basis, will be sufficient to permit the timely payment of OASDI benefits for many years into the future, on the basis of all four sets of assumptions shown in the report. For the next 75 years, the estimates show that the OASDI program, overall, is in close actuarial balance, based on the two intermediate sets of assumptions. The DI program by itself, however, is not in close actuarial balance for the next 75 years. The actuarial deficit for the DI program could be remedied by a small reallocation of the contribution rate from OASI to DI, in such a way that the OASI program would remain in close actuarial balance and OASDI benefits would not be affected. Although the Trustees are not recommending such a reallocation, they note that the financial condition of the DI program will need to be carefully monitored.

Financing, Organized↗