پژوهشنامه بیمه
سال سی و دوم شماره 4 (زمستان 1396)

Selling unnecessary health care services to patients brings a lot of pressure to insurance companies. This study wants to investigate the effect of increasing competition among doctors which is regarded as increased induced demand, on health expenditures. This is a practical, descriptive - analytic research which is held using panel data in an eight-year period (from 2006 to 2013). After using suitable econometrics tests, we use a Driscoll - kraay test for final estimation of the model. According to the results, by increasing the physician density, health expenditures will increase at a cubic equation and in this case, the induced demand hypothesis based on the effect of the increase in physician density on health expenditure in Iran will not be rejected. According to the findings, with one percent increase in the physician density, health expenditures will increase by 0.38 percent. By taking into account the significant relationship between physician density and health care costs, as well as changing the concavity of the obtained function, it seems like decision-makers of this area, such as health insurers( as the buyers of services) must pay more attention to control these challenges in policies.

This paper presents a dynamic model to determine the effective factors which are responsible for making changes to the number of insured persons in health insurance companies and to study different policies for improving the system behavior toward its desired goals. For this purpose, all components of an insurance company including investment units, payment of medical expenses units, units which are related to the advertisement policies of the company and all other components that together will result in a complete collection of the company have been studied. According to the feedback relationships between these variables and the complexity of the issues, we use system dynamics approach for modeling and analyzing the effect of different policies. Given the goal of achieving the detailed results, Iranian Social Security Insurance is used as a case study. By taking into consideration this organization data from 2001 to 2011 in the proposed model, the results show that some parameters such as changes in investment policies and advertisement are effective factors, as far as the attraction of insurance company for people is concerned.

Life insurances in Iran, despite following a growing trend, still constitute an insignificant part of insurance industry compared to that of the global average, or the industry vision's targeted countries. The purpose of this article is to find the roots of this problem and to determine the related dynamic mechanisms. Previous studies and interviews with experts are used as the framework to establish and simulate a system dynamics model for the problem. Analysis of the simulation results show that not only is it possible to maintain the current growing trend in the industry for the next 10 years, but also the most important factors which will have effects on the future of life insurance industry are: scale of sales network and agents, measures which affect their sales productivity, and careful management of financial resources to fulfill the generated commitments, to name but a few. According to the analyses, the future of life insurance is in the hands of its policy and decision makers rather than being controlled by exogenous variables.

In order to set precise, as well as fair standards and regulations, it is necessary to recognize agency relationships, and insurance industry stakeholders’ rights, in conjunction with their interests. In this respect, authorities in charge of the compilation of international and national accounting standards are trying to provide appropriate standards, combined with their requirements for financial reports by precisely recognizing and sketching the relationships among insurance industry stakeholders. Iran's Standard Committee has introduced "Accounting Standard No. 28" in the year 2006 for general insurance activities. The present paper studies the adequacy of accounting standard requirements by assessing the influence of the calculation methods of financial factors on two indicators of "benefit" and "solvency" which stand for the stakeholders’ interests and profits, respectively. According to the results, "Accounting Standard No. 28" is not adequate enough to unite the rights of the stakeholders (insurer & insured), as far as general insurance activities are concerned.

Arbitration is one of the prominent dispute resolutions in business and industry. The important role of the arbitration, not only reduces lawsuits in courts but also accelerates the compensation and satisfaction. In addition, it could reduce other possible harms in the insurance industry. However, the insurance industry does not use this approach and even in its latest policy change, as follows: compulsory insurance law of damages incurred by third parties as a result of vehicles’ accidents (9 May 2016) in which there was a good opportunity for the better appearance of arbitration, there is no evidence of benefiting from this potential chance. Although the authorities stipulated in articles 29 and 39 may comply with the arbitration, looking more accurately will lead to resulting otherwise; because damage assessment agent (mentioned in article 39) does not match the appraisal expert and the council (mentioned in article 29) does not match the independent legal entity. Therefore, they are not subject to arbitration rules. This paper analyses these articles, in addition to the concepts which are related to arbitration.

Insurance development is regarded as one of the states’ solutions, in particular, democratic and public-oriented states, to attain a sustained healthy community so that all individual’s life dimensions in the community would be sheltered by insurance generalization and development. The purpose of the present research is to identify and prioritize barriers to health insurance system implementation based on a three-branch model in three structural, contextual, and behavioral dimensions. The present research methodology is an exploratory-based qualitative-quantitative approach. Research qualitative statistical population includes 30 experts of social security insurance of Zahedan, by interviewing with whom research data was collected. Then, using theme analysis method, interview contents were analyzed, in which three barriers’ sub-dimensions were identified; and then, factors were ranked using analytical hierarchy process (AHP) through Expert choice software. AHP results show that the test inconsistency rate is 0.03, which is less than 0.1 and leads to the reliability of research instrument. In addition, analytical hierarchy process results also demonstrate that the contextual dimensions with the weight of 0.582 are assigned the maximum prioritization followed by structural and behavioral aspects with weights of 0.279 and 0.139, respectively. For quantitative study, 250 questionnaires were randomly distributed among social security insurance staff in Zahedan. Research sample mean test results reveal that from responders’ perspectives all dimensions of behavioral, contextual, and structural barriers influence the health insurance system implementation.