R. Burkhauser, Lauren Hersch Nicholas, Maximilian D. Schmeiser
The rate of application for Social Security Disability Insurance (SSDI) benefits, as well as the number of beneficiaries has been increasing for the past several decades, threatening the solvency of the SSDI program. One possible remedy is to promote continued employment amongst those experiencing the onset of a work limiting disability through the provision of workplace accommodations. Using the Health and Retirement Study data linked to Social Security administrative records and a state fixed effects model, we find that the provision of workplace accommodation reduces the probability of application for SSDI following disability onset. We estimate that receipt of an accommodation reduces a worker’s probability of applying for SSDI by 30 percent over five years and 21 percent over 10 years. We then attempt to control for the potential endogeneity of accommodation receipt by exploiting exogenous variation in the implementation of state and federal anti-discrimination laws to estimate the impact of workplace accommodation on SSDI application in an instrumental variables (IV) model. While our coefficients continue to indicate that accommodation reduces SSDI application, we obtain implausibly large estimates of this effect. Overall our results imply that increasing accommodation is a plausible strategy for reducing SSDI applications and the number of beneficiaries.
{"title":"The Importance of State Anti-Discrimination Laws on Employer Accommodation and the Movement of Their Employees Onto Social Security Disability Insurance","authors":"R. Burkhauser, Lauren Hersch Nicholas, Maximilian D. Schmeiser","doi":"10.2139/ssrn.1961705","DOIUrl":"https://doi.org/10.2139/ssrn.1961705","url":null,"abstract":"The rate of application for Social Security Disability Insurance (SSDI) benefits, as well as the number of beneficiaries has been increasing for the past several decades, threatening the solvency of the SSDI program. One possible remedy is to promote continued employment amongst those experiencing the onset of a work limiting disability through the provision of workplace accommodations. Using the Health and Retirement Study data linked to Social Security administrative records and a state fixed effects model, we find that the provision of workplace accommodation reduces the probability of application for SSDI following disability onset. We estimate that receipt of an accommodation reduces a worker’s probability of applying for SSDI by 30 percent over five years and 21 percent over 10 years. We then attempt to control for the potential endogeneity of accommodation receipt by exploiting exogenous variation in the implementation of state and federal anti-discrimination laws to estimate the impact of workplace accommodation on SSDI application in an instrumental variables (IV) model. While our coefficients continue to indicate that accommodation reduces SSDI application, we obtain implausibly large estimates of this effect. Overall our results imply that increasing accommodation is a plausible strategy for reducing SSDI applications and the number of beneficiaries.","PeriodicalId":29865,"journal":{"name":"Connecticut Insurance Law Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74609342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Each year at least hundreds, and often thousands of Americans lose their homes to natural disasters striking populated areas, and tens of thousands lose their homes to single-instance fires, floods, or other catastrophes. A recurring storyline is that the majority of these homeowners are underinsured, meaning they have less insurance than it will cost to rebuild their homes. This Article analyzes whether that is indicative of correctible inefficiencies in the residential property insurance markets. The Article identifies two inefficiencies – (1) Inadequate information, which is impairing informed pricing decisions by purchasers; and (2) Dispute costs (such as litigation) in the instances of loss exceeding coverage. The Article proposes addressing these inefficiencies by adopting a mandatory disclosure, provided at time of purchase or renewal of insurance, based on the EnergyGuide program labeling appliances for energy consumption, and coupling the adoption of that disclosure with a litigation bar on adequacy of coverage.
{"title":"When Enough is Not Enough: Correcting Market Inefficiencies in the Purchase and Sale of Residential Property Insurance","authors":"K. Klein","doi":"10.2139/SSRN.1707687","DOIUrl":"https://doi.org/10.2139/SSRN.1707687","url":null,"abstract":"Each year at least hundreds, and often thousands of Americans lose their homes to natural disasters striking populated areas, and tens of thousands lose their homes to single-instance fires, floods, or other catastrophes. A recurring storyline is that the majority of these homeowners are underinsured, meaning they have less insurance than it will cost to rebuild their homes. This Article analyzes whether that is indicative of correctible inefficiencies in the residential property insurance markets. The Article identifies two inefficiencies – (1) Inadequate information, which is impairing informed pricing decisions by purchasers; and (2) Dispute costs (such as litigation) in the instances of loss exceeding coverage. The Article proposes addressing these inefficiencies by adopting a mandatory disclosure, provided at time of purchase or renewal of insurance, based on the EnergyGuide program labeling appliances for energy consumption, and coupling the adoption of that disclosure with a litigation bar on adequacy of coverage.","PeriodicalId":29865,"journal":{"name":"Connecticut Insurance Law Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90660964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This Article presents the recent U.S. “principles-based reserving” (PBR) reform of life insurance solvency regulation as a case study of how regulatory systems can “drift” from their putative objectives when the complexity of the regulated market outpaces the capabilities of traditional regulatory tools to effectuate those objectives. As the life insurance industry developed new products and investment strategies to confront interest rate volatility and the competitive effects of deregulation, regulators perceived the traditional, rigid formula-based methodologies of statutory accounting for reserves – which comprise by good measure insurers’ largest set of liabilities – as increasingly out of touch with market realities. Under the PBR reform, the statutory accounting system will allow firms to account for their reserves based on their own probabilistic estimates of the future economic value of those liabilities, taking into account past experience and predictive statistical models used in the firms’ internal risk management systems. The statutory reserving regime is a linchpin of life insurance solvency regulation, so regulators should only change it so drastically if they are certain the new approach will promote solvency. The Article considers the PBR reform in this context.The Article begins by explaining the purpose of solvency regulation in the insurance industry (of which statutory accounting is a central pillar) as a public administrative intervention into the insurance market to remedy corporate governance gaps due to insurers’ unique capital structures. It then distinguishes statutory accounting system from GAAP accounting by elaborating the former’s traditional conservatism and emphasis on long-term viability and solvency over short-term optimization metrics such as share price and earnings. The Article then draws on “new governance” and “reliability” theories to analyze the PBR reform as an attempt to restore meaning to the statutory accounting system in the face of the new market complexities and dynamism by tapping into regulated firms’ proprietary risk management systems. The Article considers, and finds unlikely, the possibility that firms will themselves adopt a conservative, reliability-focused outlook that privileges long-term solvency over short-term optimization metrics. Under such circumstances, the central task for regulators should be to create a system of “meta-risk management” that aims to encourage the institutionalization of social responsibility and reliability on the part of industry actors. The Article explains how the PBR reform is unlikely to embed conservative reliability-focused principles into insurers’ corporate governance structure, and recommends several modifications that might increase PBR’s effectiveness. Whether statutory accounting can in fact recoup its conservative underpinning is but a single manifestation of a larger problematic concerning the viability of public regulatory control in light of the i
{"title":"Combating the Teleological Drift of Life Insurance Solvency Regulation: The Case for a Meta-Risk Management Approach to Principles-Based Reserving","authors":"Robert F. Weber","doi":"10.15779/Z386W0Z","DOIUrl":"https://doi.org/10.15779/Z386W0Z","url":null,"abstract":"This Article presents the recent U.S. “principles-based reserving” (PBR) reform of life insurance solvency regulation as a case study of how regulatory systems can “drift” from their putative objectives when the complexity of the regulated market outpaces the capabilities of traditional regulatory tools to effectuate those objectives. As the life insurance industry developed new products and investment strategies to confront interest rate volatility and the competitive effects of deregulation, regulators perceived the traditional, rigid formula-based methodologies of statutory accounting for reserves – which comprise by good measure insurers’ largest set of liabilities – as increasingly out of touch with market realities. Under the PBR reform, the statutory accounting system will allow firms to account for their reserves based on their own probabilistic estimates of the future economic value of those liabilities, taking into account past experience and predictive statistical models used in the firms’ internal risk management systems. The statutory reserving regime is a linchpin of life insurance solvency regulation, so regulators should only change it so drastically if they are certain the new approach will promote solvency. The Article considers the PBR reform in this context.The Article begins by explaining the purpose of solvency regulation in the insurance industry (of which statutory accounting is a central pillar) as a public administrative intervention into the insurance market to remedy corporate governance gaps due to insurers’ unique capital structures. It then distinguishes statutory accounting system from GAAP accounting by elaborating the former’s traditional conservatism and emphasis on long-term viability and solvency over short-term optimization metrics such as share price and earnings. The Article then draws on “new governance” and “reliability” theories to analyze the PBR reform as an attempt to restore meaning to the statutory accounting system in the face of the new market complexities and dynamism by tapping into regulated firms’ proprietary risk management systems. The Article considers, and finds unlikely, the possibility that firms will themselves adopt a conservative, reliability-focused outlook that privileges long-term solvency over short-term optimization metrics. Under such circumstances, the central task for regulators should be to create a system of “meta-risk management” that aims to encourage the institutionalization of social responsibility and reliability on the part of industry actors. The Article explains how the PBR reform is unlikely to embed conservative reliability-focused principles into insurers’ corporate governance structure, and recommends several modifications that might increase PBR’s effectiveness. Whether statutory accounting can in fact recoup its conservative underpinning is but a single manifestation of a larger problematic concerning the viability of public regulatory control in light of the i","PeriodicalId":29865,"journal":{"name":"Connecticut Insurance Law Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89934907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We study a model in which retired single people optimally choose consumption, medical spending and saving while facing uncertainty about their health, lifespan and medical needs. This uncertainty is partially offset by insurance provided by the government and private institutions. We first show how well the model matches important features of the data and we analyze the degree of insurance provided by current programs. We then analyze the effects of some reforms, meant to capture changes in Medicaid and Medicare, on savings and medical expenditures.
{"title":"The Effects of Medicaid and Medicare Reforms on the Elderly’s Savings and Medical Expenditures","authors":"Mariacristina De Nardi, Eric French, J. Jones","doi":"10.2139/ssrn.1710723","DOIUrl":"https://doi.org/10.2139/ssrn.1710723","url":null,"abstract":"We study a model in which retired single people optimally choose consumption, medical spending and saving while facing uncertainty about their health, lifespan and medical needs. This uncertainty is partially offset by insurance provided by the government and private institutions. We first show how well the model matches important features of the data and we analyze the degree of insurance provided by current programs. We then analyze the effects of some reforms, meant to capture changes in Medicaid and Medicare, on savings and medical expenditures.","PeriodicalId":29865,"journal":{"name":"Connecticut Insurance Law Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73316540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The inherent tensions in the financial sector mean that episodes of extreme stress are inevitable, if unpredictable. This is so even if the regulatory and supervisory regimes are in many respects effective. The capacity of government to intervene may determine whether the distress is confined to the financial sector or breaks out into the real economy. Although adequate resolution authority to address a failing financial firm is a necessary objective of the current regulatory reform, a firm-by-firm approach will be unable to address a major systemic failure such as the Financial Crisis of 2007-08, which may require capital support of the financial sector to avoid severe economic harm. We therefore propose the creation of a Systemic Emergency Insurance Fund ("the Fund") ("SEIF"), scaled appropriately to the size of the US economy, $1 trillion. The facility should be funded (and partially pre-funded) by risk-adjusted assessments on all large financial firms, including hedge funds, that benefit from systemic stability. The Department of the Treasury ("Treasury") would administer the Fund, use of which would be triggered by a “triple key” concurrence among Treasury, the Federal Deposit Insurance Corporation ("FDIC"), and the Federal Reserve ("Fed"). Unlike a taxpayer “bailout,” such a fund would mutualize systemic risk among financial firms through a facility overseen by the regulators. The funding mechanism will give financial firms new incentives to warn regulators of growing systemic risk. Such standby emergency authority avoids the need for high stakes legislative action mid-crisis, which can be destabilizing even if successful and catastrophic if not. Such an approach is superior to the financial sector nationalization strategy that is found in the newly enacted Dodd-Frank financial regulatory reform.
{"title":"Confronting Financial Crisis: Dodd-Frank's Dangers and the Case for a Systemic Emergency Insurance Fund","authors":"Jeffrey N. Gordon, Christopher Muller","doi":"10.2139/SSRN.1636456","DOIUrl":"https://doi.org/10.2139/SSRN.1636456","url":null,"abstract":"The inherent tensions in the financial sector mean that episodes of extreme stress are inevitable, if unpredictable. This is so even if the regulatory and supervisory regimes are in many respects effective. The capacity of government to intervene may determine whether the distress is confined to the financial sector or breaks out into the real economy. Although adequate resolution authority to address a failing financial firm is a necessary objective of the current regulatory reform, a firm-by-firm approach will be unable to address a major systemic failure such as the Financial Crisis of 2007-08, which may require capital support of the financial sector to avoid severe economic harm. We therefore propose the creation of a Systemic Emergency Insurance Fund (\"the Fund\") (\"SEIF\"), scaled appropriately to the size of the US economy, $1 trillion. The facility should be funded (and partially pre-funded) by risk-adjusted assessments on all large financial firms, including hedge funds, that benefit from systemic stability. The Department of the Treasury (\"Treasury\") would administer the Fund, use of which would be triggered by a “triple key” concurrence among Treasury, the Federal Deposit Insurance Corporation (\"FDIC\"), and the Federal Reserve (\"Fed\"). Unlike a taxpayer “bailout,” such a fund would mutualize systemic risk among financial firms through a facility overseen by the regulators. The funding mechanism will give financial firms new incentives to warn regulators of growing systemic risk. Such standby emergency authority avoids the need for high stakes legislative action mid-crisis, which can be destabilizing even if successful and catastrophic if not. Such an approach is superior to the financial sector nationalization strategy that is found in the newly enacted Dodd-Frank financial regulatory reform.","PeriodicalId":29865,"journal":{"name":"Connecticut Insurance Law Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84769643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The U.S. legal system has multiple and complex regulatory regimes for insurance which combine statutes, administrative regulations and common law rules. Regulation of insurance is predominantly done by the fifty states, and this increases the system’s complexity. The regulatory regimes generally divide the industry, the subject of regulation, from the consumers, which are to be protected, without regard for the status or sophistication of the insurance consumer. This article focuses on the role of insurance law and regulation within the legal system, and in particular the divide between business or commercial insurance and that provided for consumers, more commonly known as personal lines. The article is divided into six major sections: 1) economic aspects of insurance, 2) academic perceptions of the field, 3) procedural aspects, 4) legislation, 5) the distinction between consumer and commercial risks and 6) substantive aspects of consumer protection in insurance law.
{"title":"Insurance Law Between Business Law and Consumer Law","authors":"J. Thomas","doi":"10.2139/SSRN.1666234","DOIUrl":"https://doi.org/10.2139/SSRN.1666234","url":null,"abstract":"The U.S. legal system has multiple and complex regulatory regimes for insurance which combine statutes, administrative regulations and common law rules. Regulation of insurance is predominantly done by the fifty states, and this increases the system’s complexity. The regulatory regimes generally divide the industry, the subject of regulation, from the consumers, which are to be protected, without regard for the status or sophistication of the insurance consumer. This article focuses on the role of insurance law and regulation within the legal system, and in particular the divide between business or commercial insurance and that provided for consumers, more commonly known as personal lines. The article is divided into six major sections: 1) economic aspects of insurance, 2) academic perceptions of the field, 3) procedural aspects, 4) legislation, 5) the distinction between consumer and commercial risks and 6) substantive aspects of consumer protection in insurance law.","PeriodicalId":29865,"journal":{"name":"Connecticut Insurance Law Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84072747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-08-03DOI: 10.36646/mjlr.44.3.transplant
B. Liang, E. Minelli
Organ transplant candidates are often denied life saving organs on account of their medical marijuana drug use. Individuals who smoke medicinal marijuana are typically classified as substance abusers, and ultimately deemed ineligible for transplantation, despite their receipt of the drug under a physician's supervision and prescription. However, patients who smoke cigarettes or engage in excessive alcohol consumption are routinely considered for placement on the national organ transplant waiting list. Transplant facilities have the freedom to regulate patient selection criteria with minimal oversight. As a result, the current organ allocation system in the United States is rife with inconsistencies and results in disparities in allocation decisions. This Article reviews the history and underlying rationale of organ allocation in the United States and the National Organ Transplant Act. It then examines ill-founded policies regarding transplant candidates who present issues of substance "abuse" compared with substance "use," and the resulting disparities in waiting-list criteria. In response, a model rule for a national set of patient selection guidelines is provided. Definitions of terms, distinctions regarding proper patient classification, and protocols for a second chance policy to be used in the event of a relapse among wait-listed patients are addressed. Finally, stipulations that require designated abstention periods as well as random drug screenings in relation to subsequent relisting are also included. This policy distinguishes between candidates who present issues of substance use versus substance abuse. The use of such a model allocation policy will promote equity and scientific bases in the organ allocation process.
{"title":"Transplant Candidates and Substance Use: Adopting Rational Health Policy for Resource Allocation","authors":"B. Liang, E. Minelli","doi":"10.36646/mjlr.44.3.transplant","DOIUrl":"https://doi.org/10.36646/mjlr.44.3.transplant","url":null,"abstract":"Organ transplant candidates are often denied life saving organs on account of their medical marijuana drug use. Individuals who smoke medicinal marijuana are typically classified as substance abusers, and ultimately deemed ineligible for transplantation, despite their receipt of the drug under a physician's supervision and prescription. However, patients who smoke cigarettes or engage in excessive alcohol consumption are routinely considered for placement on the national organ transplant waiting list. Transplant facilities have the freedom to regulate patient selection criteria with minimal oversight. As a result, the current organ allocation system in the United States is rife with inconsistencies and results in disparities in allocation decisions. This Article reviews the history and underlying rationale of organ allocation in the United States and the National Organ Transplant Act. It then examines ill-founded policies regarding transplant candidates who present issues of substance \"abuse\" compared with substance \"use,\" and the resulting disparities in waiting-list criteria. In response, a model rule for a national set of patient selection guidelines is provided. Definitions of terms, distinctions regarding proper patient classification, and protocols for a second chance policy to be used in the event of a relapse among wait-listed patients are addressed. Finally, stipulations that require designated abstention periods as well as random drug screenings in relation to subsequent relisting are also included. This policy distinguishes between candidates who present issues of substance use versus substance abuse. The use of such a model allocation policy will promote equity and scientific bases in the organ allocation process.","PeriodicalId":29865,"journal":{"name":"Connecticut Insurance Law Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77252731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The French pension system has for long been characterised by its very low reliance on funded pensions, which have almost become a taboo subject since the Second World War. While other countries have often complemented statutory pensions with funded occupational pension schemes, in France, the social partners have put in place an encompassing network of supplementary pension arrangements financed on a pay-as-you-go (PAYG) basis. The generosity of these schemes and their defence by trade unions and part of the business community has considerably limited the room for expansion of funded pension schemes. However, the role played by these supplementary PAYG schemes has significantly changed over the last two decades. First, the gradual harmonization of rules within the different schemes and their compliance with EU social security regulations are leading to their quasi “first-pillarization”. Second, similar to statutory pensions, these schemes have also undergone gradual retrenchment and will offer reduced replacement rates. As a result, the development of pension savings has been implicitly promoted, although more on a voluntary basis than on a compulsory one. Despite a unification in the regulatory framework governing funded – occupational and personal – pension plans, access to these schemes remains mostly limited to high-skilled workers.
{"title":"Complementing or Replacing Old Age Insurance? The Growing Importance of Funded Pensions in the French Pension System","authors":"","doi":"10.2139/SSRN.1634840","DOIUrl":"https://doi.org/10.2139/SSRN.1634840","url":null,"abstract":"The French pension system has for long been characterised by its very low reliance on funded pensions, which have almost become a taboo subject since the Second World War. While other countries have often complemented statutory pensions with funded occupational pension schemes, in France, the social partners have put in place an encompassing network of supplementary pension arrangements financed on a pay-as-you-go (PAYG) basis. The generosity of these schemes and their defence by trade unions and part of the business community has considerably limited the room for expansion of funded pension schemes. However, the role played by these supplementary PAYG schemes has significantly changed over the\u0000last two decades. First, the gradual harmonization of rules within the different schemes and their compliance with EU social security regulations are leading to their quasi “first-pillarization”. Second, similar to statutory pensions, these schemes have also undergone gradual retrenchment and will offer reduced replacement rates. As a result, the development of pension savings has been implicitly promoted, although more on a voluntary basis than on a compulsory one. Despite a unification in the regulatory framework governing funded – occupational and personal – pension plans, access to these schemes remains mostly limited to high-skilled workers.","PeriodicalId":29865,"journal":{"name":"Connecticut Insurance Law Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80602629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-07-26DOI: 10.1111/j.1740-1461.2010.01207.x
D. Hyman, Bernard Black, C. Silver
All insurance has coverage limits, and insurers usually control whether a case is settled or tried. If the insurer rejects a within-limits settlement offer, the insured bears the risk of an above-limits verdict. In response, virtually every state has imposed a “duty to settle” on insurers, which creates incentives for plaintiffs to make at-limits offers and for insurers to accept those offers when expected damages exceed limits. We study the association between the duty to settle, settlement at limits, claim duration, and defense costs using detailed data from Texas for 1988-2005 on closed, commercially insured personal injury claims. We focus principally on medical malpractice suits against physicians, but find consistent evidence for other types of cases. We find strong evidence that the duty to settle affects settlement dynamics. Essentially all physician-defendant cases that settle at-limits are preceded by an at-limits demand. Roughly 20% of physician-defendant cases settle at 90-100% of policy limits (“broad at-limits”) and 13% settle exactly at limits (“exact at-limits”). Broad- and exact-at-limits cases close about five months faster than similar “below-limits” cases -- a roughly 20% shorter time from suit to settlement, controlling for payout and type of harm. Broad- and exact-at-limits cases also have substantially lower defense costs, controlling for case duration and complexity. More broadly, as the payout/limits ratio approaches 1 from below, duration declines (controlling for payout) and defense costs decline (controlling for payout and duration). Payouts above-limits are uncommon; when they occur, insurers are the primary payers. Policy limits alone cannot explain these results; most likely reflect a combination of policy limits and the duty to settle.
{"title":"Settlement at Policy Limits and the Duty to Settle: Evidence from Texas","authors":"D. Hyman, Bernard Black, C. Silver","doi":"10.1111/j.1740-1461.2010.01207.x","DOIUrl":"https://doi.org/10.1111/j.1740-1461.2010.01207.x","url":null,"abstract":"All insurance has coverage limits, and insurers usually control whether a case is settled or tried. If the insurer rejects a within-limits settlement offer, the insured bears the risk of an above-limits verdict. In response, virtually every state has imposed a “duty to settle” on insurers, which creates incentives for plaintiffs to make at-limits offers and for insurers to accept those offers when expected damages exceed limits. We study the association between the duty to settle, settlement at limits, claim duration, and defense costs using detailed data from Texas for 1988-2005 on closed, commercially insured personal injury claims. We focus principally on medical malpractice suits against physicians, but find consistent evidence for other types of cases. We find strong evidence that the duty to settle affects settlement dynamics. Essentially all physician-defendant cases that settle at-limits are preceded by an at-limits demand. Roughly 20% of physician-defendant cases settle at 90-100% of policy limits (“broad at-limits”) and 13% settle exactly at limits (“exact at-limits”). Broad- and exact-at-limits cases close about five months faster than similar “below-limits” cases -- a roughly 20% shorter time from suit to settlement, controlling for payout and type of harm. Broad- and exact-at-limits cases also have substantially lower defense costs, controlling for case duration and complexity. More broadly, as the payout/limits ratio approaches 1 from below, duration declines (controlling for payout) and defense costs decline (controlling for payout and duration). Payouts above-limits are uncommon; when they occur, insurers are the primary payers. Policy limits alone cannot explain these results; most likely reflect a combination of policy limits and the duty to settle.","PeriodicalId":29865,"journal":{"name":"Connecticut Insurance Law Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87863406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In countries like the US and the Netherlands health insurance is provided by private firms. These private firms can offer both individual and group contracts. The strategic and welfare implications of such group contracts are not well understood. Using a Dutch data set of about 700 group health insurance contracts over the period 2007-2008, we estimate a model to determine which factors explain the price of group contracts. We find that groups that are located close to an insurers’ home turf pay a higher premium than other groups. This finding is not consistent with the bargaining argument in the literature as it implies that concentrated groups close to an insurer’s home turf should get (if any) a larger discount than other groups. A simple Hotelling model, however, does explain our empirical results.
{"title":"Health Insurance Competition: The Effect of Group Contracts","authors":"J. Boone, R. Douven, Carline Droge, I. Mosca","doi":"10.2139/ssrn.1618764","DOIUrl":"https://doi.org/10.2139/ssrn.1618764","url":null,"abstract":"In countries like the US and the Netherlands health insurance is provided by private firms. These private firms can offer both individual and group contracts. The strategic and welfare implications of such group contracts are not well understood. Using a Dutch data set of about 700 group health insurance contracts over the period 2007-2008, we estimate a model to determine which factors explain the price of group contracts. We find that groups that are located close to an insurers’ home turf pay a higher premium than other groups. This finding is not consistent with the bargaining argument in the literature as it implies that concentrated groups close to an insurer’s home turf should get (if any) a larger discount than other groups. A simple Hotelling model, however, does explain our empirical results.","PeriodicalId":29865,"journal":{"name":"Connecticut Insurance Law Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87460505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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