Access to care for workers’ compensation patients in dense and sparse population centers

Background: Workers’ compensation was originated to provide a no-fault, timely access to appropriate medical care. Unfortunately, we have found that the system fails the injured worker in certain environments. By implementing procedural roadblocks in the form of initial claim denial and delay methods, the injured worker finds himself/herself in a battle of attrition. By delaying treatment and compensation benefits, the injured workers are “starved out” of their access to care and often walk away from their claim or accept a payout without treatment. Methods: We performed a randomized, consecutive case-series where 300 hypothetical patients called medical offices to attempt to arrange a physician consultation. We analyzed the ability of a patient to gain access (an appointment) to a primary care (N=100), orthopedic (N=100) and neurology (N=100) physician after stating that they were injured at work. We analyzed two cohorts, one as an injured worker that was given a claim number (N=150) and the other that was injured at work but not yet given a claim number (N=150). Conclusion: This study demonstrates how difficult it is to gain access to care as an injured worker. An injured worker in a low densely populated area without a claim number was unable to gain access to a primary care doctor in our cohort (100% denial rate). Even a patient with an accepted claim number in densely populated Cook County, IL had a 52% chance of being denied access to care with an orthopedic surgeon while a patient without a claim number had an 84% chance of being denied access to orthopedic care.

Optimal per-loss reinsurance and investment to minimize the probability of drawdown

<p style='text-indent:20px;'>In this paper, we study an optimal reinsurance-investment problem in a risk model with two dependent classes of insurance business, where the two claim number processes are correlated through a common shock component. We assume that the insurer can purchase per-loss reinsurance for each line of business and invest its surplus in a financial market consisting of a risk-free asset and a risky asset. Under the criterion of minimizing the probability of drawdown, the closed-form expressions for the optimal reinsurance-investment strategy and the corresponding value function are obtained. We show that the optimal reinsurance strategy is in the form of pure excess-of-loss reinsurance strategy under the expected value principle, and under the variance premium principle, the optimal reinsurance strategy is in the form of pure quota-share reinsurance. Furthermore, we extend our model to the case where the insurance company involves <inline-formula><tex-math id="M1">\begin{document}$ n $\end{document}</tex-math></inline-formula> <inline-formula><tex-math id="M2">\begin{document}$ (n\geq3) $\end{document}</tex-math></inline-formula> dependent classes of insurance business and the optimal results are derived explicitly as well.</p>

Asymptotically Normal Estimators of the Gerber-Shiu Function in Classical Insurance Risk Model

Nonparametric estimation of the Gerber-Shiu function is a popular topic in insurance risk theory. Zhang and Su (2018) proposed a novel method for estimating the Gerber-Shiu function in classical insurance risk model by Laguerre series expansion based on the claim number and claim sizes of sample. However, whether the estimators are asymptotically normal or not is unknown. In this paper, we give the details to verify the asymptotic normality of these estimators and present some simulation examples to support our result.

ANALISIS PENERAPAN SISTEM INFORMASI AKUNTANSI PEMBAYARAN KLAIM ASURANSI JIWA DALAM MENINGKATKAN PELAYANAN KEPADA NASABAH (STUDI KASUS PADA PT ASURANSI JIWASRAYA PERSERO AREA LHOKSEUMAWE)

This study was conducted to analyze the application of the Jiwasraya insurance claims payment accounting information system in improving service to customer life insurance claims. The data used in this study were primary data directly through the results of interviews with Jiwasraya Insurance Company employees, and customers. This is a descriptive qualitative study. The results of the study showed that the application of the life insurance claims payment accounting information system in improving service to customers at PT. Jiwasraya Insurance Persero Lhokseumawe area consisted of customers preparing all documents used in filing life insurance claims either died due to death or died due to accidents, following procedures for handling and administering death claims, waiting when checking procedures for recording life insurance claims i.e. by opening a claim payment in LBK in accordance with the account or estimated claim number in accordance with the applicable provisions, waiting for the results of life insurance claim reporting, and waiting for the results of the claim disbursement decision to be approved or rejected.

Optimal proportional reinsurance with common shock dependence to minimise the probability of drawdown

In this paper, we study the optimal proportional reinsurance problem in a risk model with two dependent classes of insurance business, where the two claim number processes are correlated through a common shock component, and the criterion is to minimise the probability of drawdown, namely, the probability that the value of the surplus process reaches some fixed proportion of its maximum value to date. By the method of maximising the ratio of drift of a diffusion divided to its volatility squared, and the technique of stochastic control theory and the corresponding Hamilton–Jacobi–Bellman equation, we investigate the optimisation problem in two different cases. Furthermore, we constrain the reinsurance proportion in the interval [0,1] for each case, and derive the explicit expressions of the optimal proportional reinsurance strategy and the minimum probability of drawdown. Finally, some numerical examples are presented to show the impact of model parameters on the optimal results.

KAJIAN HUKUM PENINGKATAN SERTIFIKAT HAK GUNA BANGUNAN MENJADI HAK MILIK DITINJAU DARI SURAT KEPUTUSAN GUBERNUR KEPALA DAERAH TINGKAT 1 KALIMANTAN TIMUR NOMOR 60 TAHUN 1990 TENTANG PENUNJUKAN DAN PENYERAHAN PENGUASAAN TANAH UNTUK MEMBANGUN PERUMAHAN PEGAWAI NEGERI DENGAN FASILITAS KPR-BTN DI LOA BAKUNG KECAMATAN SAMARINDA ULU KOTAMADYA SAMARINDA KEPADA PT. SEMANGGI SARANA REAL ESTATE (STUDI PADA PERUMAHAN KORPRI, LOA BAKUNG KOTA SAMARINDA)

The Decree of the Governor as a first lauder in Bprneo No. 60 of 1990 February 13, 1990, on appointment and Transfer Tenure Land to Build Housing Servants with amenities KPR-BTN in Loa Bakung District of north Samarinda makes residents Housing KORPRI can’t do improvement of its original certificate certified Broking become Proprietary cases occurred in 2013 involving housing residents KORPRI Loa Bakung Samarinda apply for status change represented by the board to the Governor of Borneo Cq. Head of the Bureau of Supplies Regional Secretary by Statement of Claim number 845.1 / 284 / IV / 2013 dated 18 April 2013 in order to increase private property it is still no clarity and actions to date Throughout the absence of a decision or clarity by the Governor of East Kalimantan Cq. Head of the Bureau of Supplies Provincial Secretary east kalimantan and the National Land Agency (BPN) Samarinda, the improvement of the status of land rights in housing KORPRI Loa Bakung Samarinda City of Broking become right coupled with no standardization of fees to increase land rights of both the agency will be difficult to materialize.

OPTIMAL MEAN–VARIANCE REINSURANCE WITH COMMON SHOCK DEPENDENCE

We consider the optimal proportional reinsurance problem for an insurer with two dependent classes of insurance business, where the two claim number processes are correlated through a common shock component. Using the technique of stochastic linear–quadratic control theory and the Hamilton–Jacobi–Bellman equation, we derive the explicit expressions for the optimal reinsurance strategies and value function, and present the verification theorem within the framework of the viscosity solution. Furthermore, we extend the results in the linear–quadratic setting to the mean–variance problem, and obtain an efficient strategy and frontier. Some numerical examples are given to show the impact of model parameters on the efficient frontier.