پژوهشنامه بیمه
سال سی و چهارم شماره 2 (تابستان 1398)

One of the most important issues facing insurance companies is the determination of fair premium. Since no claims history leads to a reduction in the premium, in this study we assume that insureds have some sort of censored behavior at two points i and j. The frequency of two points i and j is significantly high in the observations. In this paper, we use an inflated Poisson distribution of two points i and j to estimate relative premium in Bonus-Malus system.  

In this paper we use i-j inflated Poisson model for modeling hunger for bonus. The method used is an approximation based on Bayesian methods for estimators of credibility under quadratic and LINEX loss functions.  

The numerical results show that if we model the phenomenon of customer hunger for bonus using two-point inflated Poisson models, the relative premium is significantly reduced which attracts customers. In addition, it is also shown that using the LINEX loss function is a suitable method to reduce the relative premium of customers.

In a rating system, an insurer's insurance records are used to calculate fair premiums. The problem addressed in this paper is modeling hunger for bonus based on non-reporting of small losses. The results of the present paper show that: (1) Relative premium is significantly reduced when modeling hunger for bonus by using inflated Poisson models; (2) relative premium estimator under LINEX loss function is less than this premium under quadratic loss function. Since Bonus-Malus system is based on number of claims, it cannot be a fair system, so it is recommended to use a system that incorporates both the number and severity of claims into the calculations.

Identifying and ranking Life Insurance Claim Management Process Vulnerability, causes, effects and solutions

Failure Mode and Effects Analysis (FMEA)

20 failures are identified and prioritized for the life insurance Claim Management process. Six items, including "customers’ lack of information at sale", "insurance vendors skills shortage and disregarding the product to fit customer needs", "Inaccurate risk assessment at the time of underwriting, especially in large group contracts", "customers failure to read contract’s terms and conditions", "lack of access to a reliable source for comprehensive information on Life Insurance contracts and their features" and "lack of appropriate risk assessment and underwriting" are the most effective failures according to FMEA Methodology. In fact, failures originated from sales network, failures related to information deficiency, management sector failures and failures originated from claim settlement employees are ranked as the first to fourth priority, respectively. Experts were asked about remedies for the identified failures. Accordingly, solutions were provided for each failure. Most Important solutions for prioritized failures include "providing sufficient training to vendors and motivating them for optimization of their performance based on the long term vision", "performing accurate risk management and requiring more than one risk assessor for assessing large group contracts at the time of underwriting", "Prioritizing perfect advisory in order to fully informing clients", "Providing periodic feedback from claim management to the sales network and underwriting sectors", "Establishing insureds’ health database ", "Compiling and reviewing Periodic Required Internal Standards”, “determining Quantitative and Qualitative Indicators for Employees’ Performance Assessment based on Standard Responsibilities and Required Training in an Effective and Transparent Manner" and "Facilitating Communication between Insurance Stakeholders by Upgrading Software Systems and Timely Updates", among the suggested solutions have been identified.

Findings show that a significant part of the problems of claim management are related to the inattention at the time of sale and underwriting. It seems there is no effective feedback from the claim management to the sales management. Therefore, not paying enough attention to modify customers' expectations when purchasing a product and misunderstanding problems have a significant role to play in customers’ satisfaction failure at the time of claim. Based on the received solutions provided by the experts, it seems that strengthening the interactions between the claim management and sales management as well as between the staff and line staff, along with formulating standards for task division and training and evaluating staff performance, and also promotion of tailor-made and failure-related training can play an important role in enhancing insurance companies' claim management.

The purpose of this study is to Identify and Rank Factors Affecting the Application of electronic insurance in the Insurance Industry by reviewing the related literature and expert opinions.

The method of this study is based on descriptive survey research. The population of the study consists of 10 experts, including university professors, managers and three insurance companies’ experts in Bousher city.

The results indicate that the underlying, infrastructural, cultural, and personality and attitude of customers are more important than the other dimensions. In addition, among the sub-indicators, publicity and awareness of the society about the usefulness and benefits of electronic insurance services, legal infrastructure, risk taking behavior, individual perception of risk and security are more important than the other sub-indicators.

In the absence of the above mentioned factors, such as personal data protection, prosecuting of cybercrimes, establishment and enforcement of digital signature credentials and legalization of digital signature, deployment of electronic insurance, insurance experts, user-friendly websites, insurance information social networks, deployment of electronic insurance would not be successful. Hence, the first step is to provide basic and simple electronic insurance contracts, such as personal insurance and personal accident insurance, at lower premiums which encourages people to demand such contracts.

The purpose of the present study is to investigate the effect of insurance services quality on the intention to buy Universal Life insurance and to investigate the mediating effect of customers’ previous buying experiences on the relationship between above mentioned factors.

This study, in terms of its purpose, is categorized as an applied research and based on methods and data collection is a descriptive-correlational survey research. Required data collected by passing questionnaires among   217 customers of an insurance company in Khorasan Razavi province using simple random sampling method. We take questionnaire from Kuster et al. (2016) study, which its validity and reliability was confirmed. For the purpose of the research, five hypotheses are developed that test the relationship between variables and are analyzed using PLS software of structural equations.

The findings indicate that the insurance services quality (before buying and during buying), as well as the customers’ past buying experiences have a significant effect on the intention to buy insurance services. The customers’ previous buying experience also plays a significant mediator role in the relationship between insurance service quality and customers’ intention to buy.

The results show that the insurance services quality can creates a positive experience for customers, which in return influences the customers’ purchasing intention. Therefore, according to the findings, managers and decision makers of the insurance industry should offer more appropriate insurance services and more diverse insurance policies that increase the customers’ purchasing incentive.

This study aims to examine and criticize the insured’s duty of disclosure, as his main duty, in the insurance contract which set in Iran insurance Act and also proposed in Insurance Bill. Finally, suggestions will be provided for amendment in Insurance Act and applying in Insurance Bill.

This research prepared in the descriptive-analytical method by using library sources.

Today, the insured's obligation to disclose has lost its original foundations and needs to be "modified" or annulled. In order to modify this obligation, the duty of fair presentation can be proposed. The second approach is insured’s obligation of disclosure, by providing sufficient information to draw insurer’s attention to important matters, so that the insurer may seek further information if necessary.

In Iranian insurance law, the insured's obligation to disclose, as set forth in Insurance Act 1937, is similar to the obligation to disclose in Marine Insurance Act 1906. This obligation today no longer enjoys the justification it had at the time the laws were enacted. It is therefore necessary to consider and address this issue in the "Commercial Insurance Bill", which was submitted to the parliament in order to replace Iran's Insurance Act, and to include a more appropriate duty, such as the obligation to introduce fair presentation is proposed.

This paper is intended to explain the status of the Iranian insurance law and its mutations in subrogation. Hence, we illustrate the problems facing insurance companies and the Physical Injuries Compensation Fund in the absence of that sound application of claim subrogation.

The present study is a comparative study compiled using the library method and referencing legal texts and related resources.

In the absence of full and prompt subrogation recovery of damages from negligent third party, subrogation cannot be fully functional.  In addition, in this circumstances, it is neither financially nor economically useful for insurance companies. Furthermore, despite recognizing the subrogation by legislator, it is not supported and guaranteed by a practical solution.

Subrogation should not be completely removed, but some reforms, such as modifying the succession method, administrative subrogation and non-judicial remedies can reduce the costs and transfere the desired functions to the institutions that are most appropriate for this purpose.