Incentive Effects of Community Rating in Insurance Markets: Evidence from Massachusetts Automobile Insurance

Rate regulations in insurance markets often impose cross-subsidies in insurance premiums from low-risk consumers to high-risk consumers. This paper develops the hypothesis that premium cross-subsidies affect risk taking by insurance consumers, and tests this hypothesis by examining the marginal impact of premium subsidies and overcharges on future insurance costs. The empirical analysis uses 1990–2003 rating cell-level data from the Massachusetts automobile insurance market, in which regulation produced large cross-subsidies across cells. Consistent with the hypothesized effects, premium subsidies are found to be significantly related to higher future insurance costs, and the opposite effects are found for premium overcharges.     

The Impact of No-Fault Legislation on Automobile Insurance

Abstract

Since its inception, the effectiveness of no-fault legislation has been highly debated. Although some research suggests that no-fault laws are effective in reducing costs, other evidence suggests that the current no-fault systems may not meet the original objectives. This study provides a detailed assessment of the relation of no-fault laws and automobile insurance losses for the period 1994 to 2007. By examining total automobile insurance losses along with liability and personal injury protection losses, we are able to determine if and how specific provisions of the laws are related to claims costs. We find a negative relation between the presence of a no-fault law and total losses, which suggests that no-fault systems are associated with lower losses than the traditional tort system. In addition, an examination of no-fault-only states suggests that specific provisions of no-fault laws, such as thresholds and limitations on benefits, have some effect on losses. With the sunset of Colorado’s no-fault legislation in 2003, the recent passage of Personal Injury Protection Reform in Florida, and proposed federal choice legislation, the overall impact of no-fault as well as the specific components of the laws are of heightened importance to consumers, insurers, and lawmakers.     

Claims Auditing in Automobile Insurance: Fraud Detection and Deterrence Objectives

Research on insurer management of opportunism in claiming has developed in two parallel literatures. One is a theoretical literature on insurance contracting that yields predictions about the nature of optimal auditing strategies for the deterrence of fraud. The other is a literature based upon statistical analysis of claims that yields empirical strategies for the detection of fraudulent claims. This article links the two literatures by providing an empirical assessment of insurers’ auditing practices in relation to theoretical predictions. The analysis makes use of a data set on the disposition of more than 1,000 randomly selected automobile personal injury protection claims settled in the state of Massachusetts. The findings of the article are consistent with the use of rational auditing strategies by insurers and with the use of audits for both deterrence and detection.     

Testing for Asymmetric Information in the Automobile Insurance Market Under Rate Regulation

This article examines whether adverse selection or moral hazard could be induced by rate regulation, which prohibits insurance companies from considering some attributes of drivers in setting premiums. Using an individual data set from a heavily regulated automobile insurance market, we arrived at several conclusions, as follows. First, no evidence of adverse selection or moral hazard is found in general: conditional on all the variables observed by insurer, the null hypothesis of independence between risk and coverage is not rejected at reasonable levels of statistical significance. Second, this result is robust in the sense that it holds under several empirical procedures and different definitions of risk and coverage. Third, we find that unobserved variables do not induce adverse selection: the null hypothesis that consumers in risky regions are more likely to purchase insurance is tested against the alternative and rejected. Our study supports the view that the adverse selection phenomenon exists only to a very limited extent in this market.     

Measuring Selection Incentives in Managed Care: Evidence From the Massachusetts State Employee Insurance Program

Capitation gives insurers incentive to manipulate their offerings to attract the healthy and deter the sick. We calculate the incentives for such service-specific quality distortions using managed care medical and pharmacy spending data for fiscal years 2001 and 2002 from the Massachusetts State Employee Insurance Program. Services most vulnerable to stinting are cardiac care, diabetes care, and mental health and substance abuse services. Empirically, the financial temptation to distort service quality increases nonlinearly with supply-side cost sharing. Our empirical results highlight how selection incentives work at cross-purposes with efforts to reward excellent chronic disease management. Initiatives coupling pay-for-performance with risk adjustment and mixed payment hold promise for aligning incentives with quality improvement.     

Expiration Dates in Automobile Insurance Contracts: The Curious Case of Last Policy Month Claims in Taiwan

This paper investigates a widespread trend in the Taiwanese automobile insurance market in which the loss claims of vehicle damage insurance contracts have a high propensity to occur just before the end of the policy year (as opposed to calendar year). We show that certain uncommon characteristics of claim data are consistently observed in the last policy month. We indirectly show that there is a severe time-varying excess claim problem in this market. The major sources of excess claims can be explained by the bonus-malus system problem and the auto-dealer incentive issue.     

Detection of Automobile Insurance Fraud With Discrete Choice Models and Misclassified Claims

The insurance industry is concerned with the detection of fraudulent behavior. The number of automobile claims involving some kind of suspicious circumstance is high and has become a subject of major interest for companies. This article demonstrates the performance of binary choice models for fraud detection and implements models for misclassification in the response variable. A database from the Spanish insurance market that contains honest and fraudulent claims is used. The estimation of the probability of omission provides an estimate of the percentage of fraudulent claims that are not detected by the logistic regression model.     

补充医疗保险对居民消费的影响——来自城乡居民大病保险的证据

促进消费对我国稳定经济增长和构建新发展格局至关重要。本文基于中国家庭追踪调查数据(CFPS),利用地级市层面实施城乡居民大病保险的时间差异,运用双重差分法估计了大病医疗保险对居民消费的影响。结果表明,大病保险使家庭人均消费显著增长了约6%。使用了事件分析法、置换检验、改变回归样本和控制变量等一系列检验后,结论仍保持一致,且这一效果在期初住院率高、储蓄率高以及收入较高的家庭中更明显。进一步地,本文检验了大病保险对居民消费的三种可能影响渠道,发现降低家庭对未来医疗支出风险的预期是大病保险促进家庭非医疗消费进而影响家庭总消费的主要渠道,印证了我国居民对高额医疗支出的担忧是影响消费意愿的重要因素。本文研究对于完善多层次医疗保障体系和促进居民消费具有启示意义。     

医药分开改革的政策效果——基于医疗保险报销数据的经验分析

2015年开始,按照国务院对公立医院改革的政策要求,公立医院改革试点城市全部取消药品加成,实施医药分开改革。本文基于某省会城市医疗保险报销数据,采用双重差分模型,估计了医药分开改革对医疗费用支出水平和支出结构的影响,为评估医药分开改革的政策效果提供了及时的和严谨的经验证据。实证分析显示,从支出水平看,医药分开改革使患者住院费用总支出显著增加了4.9%,但是由于病人自付比例同时出现了显著下降,自付金额没有显著地上涨;从支出结构看,医药分开改革使患者药费支出显著下降了9.5%,但是护理费和治疗费支出显著增加了69.7%和53.4%。医药分开改革还导致患者在短时期内的就诊次数出现了显著增加。总结而言,公立医院医药分开改革改善了公立医院收入结构,但是没有起到降低医疗费用支出的效果,也没有显著降低病人医疗成本负担。     

The Cost of Duplicative Regulation: Evidence From Risk Retention Groups

A vast majority of insurers are regulated by each state in which they conduct business; however, a small subset of specialized firms, risk retention groups (RRGs), are largely exempt from most aspects of duplicative regulation no matter how many states they operate. This article analyzes the differences between RRGs and standard insurers specializing in commercial liability insurance to determine the cost of duplicative regulation. The costs associated with multi‐state regulation are significantly higher than those for single‐entity regulation. These high regulatory compliance costs reduce the technical efficiency of firms, deter firms from operating in additional states, and increase the price of insurance.     

The Impact of Exchange Rate on Firm Performance: Evidence from Korean Firms

This article analyzes the role of exchange rate in explaining firm investment between 2006 and 2014, considering both export and import channels as possible factors along with other firm-level characteristics based on the Census on Establishments. Using the detailed information on exports and imports from the data, we are able to capture the cost and revenue channel more precisely compared to the previous existing literature. The empirical analysis shows that the export channel appears to be insignificant as opposed to conventional wisdom. However, the import channel is significant and shows that currency appreciation may not necessarily decrease a firm’s investment level.     

The Determinants of Private Debt Holdings: Evidence From the Life Insurance Industry

Life insurers hold the majority of private debt. Lenders in the private debt market must have the ability to evaluate the credit quality of borrowers and to perform ongoing risk monitoring. The purpose of this study is to examine the determinants of private debt holdings in the life insurance industry. The results suggest that larger insurers, insurers with higher financial quality, mutual insurers, publicly traded insurers, insurers facing stringent regulation, and insurers with greater cash holdings are more prevalent lenders in the private debt market.     

Evidence of Asymmetric Information in the Automobile Insurance Market: Dichotomous Versus Multinomial Measurement of Insurance Coverage

In the empirical analysis of information asymmetry in automobile insurance markets, prior research used a dichotomous measurement approach that induces excessive bundling in coverage measurements and sample selection biases. To improve on the conditional correlation method for testing information asymmetry, we propose a multinomial measurement approach that constructs coverage categories at ordered multinomial levels. With this approach, we find robust evidence of information asymmetry in both coverage area and coverage amount choices, which we could not find with the dichotomous measurement approach. It thus demonstrates the sensitivity of the empirical findings to the method used to measure insurance coverage.     

The Impact of Federal Interest Rate Regulations on the Small Saver: Further Evidence

This paper provides further evidence on the distributional impact of interest rate ceilings on the small saver. Cross-section data from the 1977 Consumer Credit Survey was used to estimate the implicit losses imposed on different income classes by government regulations. Our findings generally support earlier studies which found the implicit burden to be regressive among income classes. However, the degree of regressivity showed a marked decrease since 1970. These results may be explained by portfolio adjustments of households and financial innovations in response to deposit rate ceilings and accelerating inflation during the 1970s.     

Compensation and Board Structure: Evidence From the Insurance Industry

Monitoring by outside board members and incentive compensation provisions in executive pay packages are alternative mechanisms for controlling incentive problems between owners and managers. The control hypothesis suggests that if incentive conflicts vary materially, those firms with more outside directors also should implement a higher degree of pay‐for‐performance sensitivity. Our evidence is consistent with this control hypothesis. We document a relation between board structure and the extent to which executive compensation is tied to performance in mutuals: compensation changes are significantly more sensitive to changes in return on assets when the fraction of outsiders on the board is high.     

基于非寿险分析的营业税改增值税对保险业的影响研究

保险业并未纳入2012年“营改增”范围,但是我国现行保险业营业税制度滞后于我国保险业的发展,因此随着“营改增”试点的进展,保险业进行增值税改革将是大势所趋.本文拟通过借鉴新西兰的反计还原法,设置我国非寿险业增值税制度,运用数据模拟分析“营改增”对非寿险业的影响.     

First-Party Versus Third-Party Compensation for Automobile Accidents: Evidence From Canada

Insurance regimes for compensating losses arising from automobile accidents vary by jurisdiction, ranging from a pure tort system to a pure no-fault system, with both systems having well-documented benefits and costs. The majority of published research focuses on the benefits and costs associated with the compensation for bodily injury. This article extends the existing literature by examining the differences between first-party and third-party recovery for both physical damage and bodily injury losses in Canada. Our comparison of auto insurance costs per insured vehicle suggests that government-run, pure no-fault provinces have lower average costs than provinces with private tort and modified no-fault. Lower costs arise from the elimination of tort costs associated with noneconomic damages, lower claims settlement costs due to first-party compensation, and scales of economy arising from monopoly power. The second goal of the article is to examine the impact of first- versus third-party compensation on the settlement of property damage claims. We analyze the claim files of a large insurer that operates within both a traditional tort (third-party) environment and a first-party recovery environment for property damage. We find that in a first-party recovery regime claims are settled sooner, settlement costs are lower, and not-at-fault drivers are compensated at a higher rate than in the traditional tort environment.