Die Überwachung des versicherungsaufsichtsrechtlichen Risikomanagement durch den Aufsichtsrat

§ 64a VAG intensifies control of insurance undertakings through their supervisory board concerning risk management. These extended duties and the new risk management specific qualification standards will result in higher liability risks for the members of the supervisory board. However, the new law does not ensure that the supervisory board is supplied with the information necessary to comply with these requirements. Particularly information of the supervisory board of insurance undertakings in a group is seriously insufficient. On the other hand the Federal Financial Supervisory Authority in its MaRisk VA Circular concedes rights to information to the supervisory board which conflict with the basic conception of corporate law, e.g. permanent direct contacts between the supervisory board and staff of the risk management function. Insurance undertakings can react to the new challenges by professionalizing the supervisory board, establishing audit committees, internal limitation of the admissible maximum number of supervisory board’s seats and/or by purchasing D &; O insurance.     

Prämienanpassungen im Risikoklassenmodell der Privaten Krankenversicherung

In Zähle (Blätter DGVFM 31:39–64, 2010), a risk class model for the portability of the reserves for increasing age in Germany’s private health insurance system was introduced. In the present article, this model is extended in such a way that also successive premium adjustments are taken into account. In our model, the current risk class of an insurant does not play any role for a premium adjustment. In fact, only the risk class, to which the insurant belonged at the beginning of the contract, matters for a premium adjustment. From a mathematical point of view, our model provides a neat solution for the problem of the portability of the reserves for increasing age. In particular, the presented model is a real extension of the conventional model of Germany’s private health insurance system insofar as the conventional model can be recovered by restricting to a single risk class. So the well-tried premium calculation principle will basically remain.     

Status-Quo des Prozessmanagements deutscher Erstversicherungsunternehmen im Kontext der MaRisk (VA)

Since their legal force at the beginning of year 2009 within the scope of minimum requirements for risk management of German insurance companies (MaRisk (VA)), German insurers are discussing the following issues: The implementation of a risk strategy consistent with business strategy and the development of controlling instruments to manage risks resulting from this strategy. There is often undervalued the circumstance that due to MaRisk (VA) there is given an increased need for action concerning the organizational framework, especially process organisation. Each process material to a specific risk has to be identified, documented and permanently monitored. This survey shows that process management has a too small importance within the German insurance industry. These preconditions do not suffice to be compliant with the organizational framework of MaRisk (VA).     

Ursachen geschlechtsspezifischer Kostenunterschiede in der Privaten Krankenversicherung: Eine empirische Untersuchung unter besonderer Berücksichtigung der Anforderungen des AGG

The new “Allgemeine Gleichbehandlungsgesetz” (General Equal Treatment Act) also influences the premium calculation of the German Private Health Insurance to antagonize gender discrimination in premiums. The higher premiums in the Private Health Insurance women pay are caused by higher expectation of life, by the risk of fertility, and by higher individual health-care costs for health services. We study how strong the gender influence in health-care costs of men and women are and if they are influenced by the factors mentioned above. We analyse if there is any gender discrimination in premium calculation in the Private Health Insurance. The results show that after eliminating the factors only a small reduction of premiums is found. We still find a cost difference between women and men. This difference can be explained by the different usage of health services but this depends less on the gender rather on individual psychosocial factors.     

Die Arbeitsteilung zwischen privater und sozialer Krankenversicherung aus ökonomischer Sicht

This contribution emphasizes adverse selection as the economists’ favored explanation of the preponderance of social insurance (SV) over private insurance (PV) since adverse selection creates an efficiency advantage of SV. However, the article also cites the limited ability of SV to effectively deal with moral hazard effects as an efficiency downside of SV. Moreover, three challenges are emerging that could well favor PV (and in particular, private health insurance PKV) rather than SV (and in particular, social health insurance GKV) – subject to the crucial condition that the PKV industry invest in product innovation.     

Die Arglistanfechtung des Versicherungsvertrags bei fehlender textförmiger Nachfrage nach Gefahrumständen

The article treats the issue of disputing an insurance contract for reasons of malice in the event of an insurance company failing to comply with the requirements pertaining to the risk-issue-conversation provided by the VVG. According to §19 Abs. 1 VVG, the policy holder is merely required to answer questions about risk issues that are presented to him in writing and timewise before the policy holder has submitted his offer respectively in the time frame between submission of the offer by the policy holder and the acceptance by the insurance company. It is contentious whether an insurance company that has violated §19 Abs. 1 VVG may nevertheless dispute the insurance contract for reasons of malice in case of misrepresentation or omission of information on part of the policy holder. The article argues for an application of §241 Abs. 2 BGB in conjunction with §123 Abs. 1 BGB in addition to §19 Abs. 1 VVG—and thus in favor of an insurance company’s possibility to dispute the insurance contract. The protection of the policy holder’s rights is not an issue in the problem of applying the correct provision. They must rather be considered when determining the requirements of the contract dispute.     

Die EU-Sektoruntersuchung zu den Unternehmensversicherungen: Meistbegünstigungsklauseln in Rückversicherungsverträgen unter Berücksichtigung des Kartellrechts

In the EU-Sector-Inquiry on business insurance the European Commission drew attention to Best Terms and Conditions Clauses (BTC-Clauses) in Reinsurance contracts and found alleged violations against Art. 81 EGV. However, the Commission did not provide a legal classification in detail. The use of BTC-Clauses is mostly favoring cedants, a fact made obvious by the market participants’ reactions to the Commission’s final report. Nevertheless, the implementation of Solvency II standards may decline the use of BTC-Clauses (regarding the harmonization of premiums) because the cedent has to deposit different amounts of equity for his claims depending on the reinsurance company’s rating.     

Die niederländische Gesundheitsreform 2006 – Vorbild für eine weitere Reform des Krankenversicherungswesens in Deutschland?

The health sector of many European countries has been subject of a profound process of change for years. Since the federal elections of 2009 a discussion on the direction of the German health insurance system has emerged. In this context, German neighboring countries like Switzerland or the Netherlands are considered due to their changes in health policy for decades. This work deals with the effects of the recent Dutch health care reform. Due to the combination of the two elements “Bürgerversicherung” and “Kopfpauschale”, it serves as a possible model for further reform in the German health system since its introduction in 2006. Special attention was paid to the consolidation of statutory and private insurance in a general citizens insurance in the Netherlands “three-pillar model”. Because of the medium-term time horizon, financial impacts on state and private households and changes in competition between insured individuals, insurers and providers could be analysed. Especially, positive effects in terms of increasing competition and reducing the two-tier health care became apparent.     

Naturgefahrenmodellierung in internen Risikomodellen – Unverzichtbares Rüstzeug für Strategieentscheidungen des Managements der Zukunft

Management requires internal models, which will usually span a period of several years (such as five), for analysing the financial situation of the insurance company and supporting strategic value- and risk-based company management. Catastrophe risks play an important role in risk management as a substantial share of the company’s entire risk capital is committed to natural catastrophes. So the article aims to compare two approaches in modelling storm loss in the context of applicability in strategic management. Concretely modelling deductibles in storm insurance is shown using the mathematical statistical approach. A case study will analyse various strategies and their effects on the insurance company’s single and multi-year risk-return position using example data where risk is dominated by catastrophes in order to give a concrete idea for the use of multi-period internal models in the context of management.     

Gibt es den umverteilungsfreien Sicherheitszuschlag im Versicherungsentgelt?

Research on insurance premium loadings so far mainly focussed on pricing problems or on the optimal risk reserve process. In contrast, this article investigates, which redistribution effects between the insured and the insurer could arise from the payment and use of loadings, and whether there are situations which do not involve redistribution. On the basis of different models of increasing complexity various cases are analysed. It is shown that in addition to the cases with redistribution by loadings there are special constellations without such redistribution.     

Die Nutzung des Internet durch österreichische Versicherungsunternehmen

This paper compares the internet activities of Austrian insurers within a survey of all members of the Austrian Insurance Association. The analysis is structured according to potential interests of new customers, existing customers, the external sales force, financial intermediaries, investors, the general public, job searchers, and suppliers of inputs. Austrian insurers use the internet primarily for a general presentation of their company and products as well as for linking interested customers to their conventional sales force. Few insurers integrate their relation to suppliers, job searchers, investors, or their external sales force into their homepage. A full business transaction including binding quotes and full contracting through the internet is only provided by few insurers for selected products. Consequently, few cross border internet activities can be found.     

Die Asset Management Gesellschaft im Versicherungswesen — Gestaltungsmöglichkeiten, Problemfelder

The first part of the paper deals with the basic legal and organizational conditions, which are important in the case of insurance matters when founding an Asset Management. Its main emphasis deals with criteria which must be met when assuming the taking over of functions in the sense of § 5 subparagraph 3 no. 4 VAG. The author holds the opinion that insurance companies which hand over the above mentioned functions to an Asset Management company, exercise certain rights to advise this company. The second part is concerned with practical problems which arise in terms of organizational matters whenever a handing over of functions takes place from a legal point of view as mentioned in the first part of the paper. Finally, the opinion is taken that due to the remaining responsibility of the financial executive officers in insurance companies, Asset Management companies dealing with the assets of insurance companies have limited power.     

Die Umsetzung der europäischen Compliance-Vorgaben im österreichischen und deutschen VAG 2016

As member states of the European Union both Austria and Germany adopted the provisions of the Solvency II Directive in their national supervisory law. So this European Directive leads to a more convergent, consistent level of regulation and supervision a comparing view on the implementation of the Directive in both countries, Austria and Germany, really seems interesting. This paper compares the Austrian and German Supervisory Law in special respect to the current compliance-regulation in this countries.     

Die stochastische Modellierung von Großschäden für den Einsatz in internen Risikomodellen der Schadenversicherung

Along with individual corporate management and regulatory matters for instance within EU regime Solvency II, Internal Risk Models are very important for major general insurance companies. Of crucial importance in building these internal models, is the stochastic modelling of large claims and in particular, the selection and parameterization of suitable probability distributions for the amount and number of claims based on empirical data. To this end, in practice, a visually-based methodology is more appropriate and workable than strict mathematical approaches. Based on a practical case study, this paper provides some insight into a visually-based methodology for internal risk models.