Insurers are effciently and accurately paying millions of claims that they should never pay at all. In fact, of all the key drivers of health care costs, losses from unnecessary payment is one of the few that insurers can immediately affect. In this white paper we define state-of-the-art prepayment analytic systems and explain how they differ from both claims edit and postpayment detection syst...

This paper examines the demand for on-board computers in trucking, distinguishing between their incentiveand resource-allocation-improving capabilities. I find that monitoring’s incentive benefits are high when perquisitetaking is attractive to drivers, driver effort is important, and verifying drivers’ actions to insurers is valuable. These results are consistent with agency theory and suggest...

The Affordable Care Act's medical loss ratio (MLR) regulation requires insurers to spend 80 percent or 85 percent of premiums on medical claims and quality improvements. In 2011, insurers falling below this minimum paid more than $1 billion in rebates. This brief examines how insurers spend their premium dollars--particularly their investment in quality improvement activities--focusing on diffe...

We develop a uni ed equilibrium model of competitive insurance markets that incorporates the demand and supply of insurance as well as insurers' asset and liability risks. Insurers' assets may be exposed to both idiosyncratic and systemic shocks. We obtain new insights into the relationship between insurance premia and insurers' internal capital that potentially reconcile the con icting predict...

A dynamic and open service market should be characterised by the frequent appearance of new and diverse services. But in the internet environment, where a significant proportion of the functionality of new services is supported by Customer Premises Equipment (CPE), deployment can be an issue. How can such a diverse range of new services be easily deployed particularly in a heterogeneous environ...

Purpose Insurance companies exist to manage the risk of others, which is why they are perceived be competitive in management (RM). Considering this, we investigate how different RM capabilities make insurers effective RM. These include understanding and (URRM), identification (RI), assessment analysis (RAA) monitoring (RMON) activities insurance companies. In addition, authors probe these can j...

This study examines the impact of ownership structure on reinsurance decisions in the Chinese property casualty insurance industry. The evidence shows that foreign insurers have higher reinsurance demand than domestic insurers. Specifically, foreign insurers are more likely to purchase volunteer reinsurance. More important, foreign insurers are associated with a higher percentage of facultative...

Advancements in mobile technology and the increasing capabilities of smart devices present promising opportunities to insurers struggling to meet evolving customer needs, gain market share and reduce costs through new efficiencies across the insurance value chain, especially in claims management. From self-service apps that allow customers to initiate a claim from the accident site, to smartpho...