the purchase of insurance may cause the insureds to increase the costs of insurance companies, compared to their estimation of costs. if after the demand of insurance services, the loss ratio of insurance companies increases because of consumer behavior, moral hazard will be evident. in this paper, after introducing the literature, the presence of moral hazard in iran insurance company is teste...

The book Preteklost in prihodnost ('The past and the future') is sixteenth volume GIS v Sloveniji (GIS Slovenia) series commemorates its 30th anniversary. goal of to present wide variety research findings on geographical information systems Slovenia recent years. Powerful geoinformatic tools precise data facilitate processes phenomena, their modelling. presents project outputs results areas suc...

BACKGROUND Inappropriate antibiotic use significantly contributes to antibiotic-resistance, resulting in reduced antibiotic efficacy and increasing physical burden and cost of disease. The goal of this study was to explore antibiotic usage patterns in South Korea using 2007-2014 health insurance claims data. METHODS We used the Health Insurance Review & Assessment Service data, which represen...

Collecting insurance fraud samples is costly and if performed manually is very time consuming. This issue suggests usage of unsupervised models. One of the accurate methods in this regards is Spectral Ranking of Anomalies (SRA) that is shown to work better than other methods for auto insurance fraud detection specifically. However, this approach is not scalable to large samples and is not appro...

Usage Factor – 2013/2014 The Springer Journal Usage Factor 2013/14 was calculated as suggested by the COUNTER Code of Practice for Usage Factors. It is the median value of the number of downloads in 2013/14 for all articles published online in that particular journal during the same time period. The Usage Factor calculation is based on COUNTER-compliant usage data on the SpringerLink platform.(...

Finding an appropriate insurance product on the Web can be a difficult and time-consuming process. The majority of insurers continue to build sites that are structured on a corporate orientation rather than customer needs. Customers are left on their own to figure out how to analyse and compare different proposals. In this paper we analyse the application of machine learning techniques in model...

BACKGROUND A robust medical claims review system is crucial for addressing fraud and abuse and ensuring financial viability of health insurance organisations. This paper assesses claims adjustment rate of the paper- and electronic-based claims reviews of the National Health Insurance Scheme (NHIS) in Ghana. METHODS The study was a cross-sectional comparative assessment of paper- and electroni...

BACKGROUND Out-of-pocket payments make up about 80% of medical care spending at hospitals in Laos, thereby putting poor households at risk of catastrophic health expenditure. Social security schemes in the form of community-based health insurance and health equity funds have been introduced in some parts of the country. Drug and Therapeutics Committees (DTCs) have been established to ensure rat...