Health Insurance: Basic Actuarial Models by Ermanno Pitacco

By Ermanno Pitacco

Health Insurance goals at filling a niche in actuarial literature, trying to resolve the widespread false impression with regard to either the aim and the contents of medical health insurance items (and ‘protection products’, extra in most cases) at the one hand, and the proper actuarial buildings at the other.

In order to hide the fundamental rules concerning medical health insurance ideas, the 1st few chapters during this booklet are quite often dedicated to the necessity for medical health insurance and an outline of coverage items during this zone (sickness assurance, twist of fate coverage, serious disease covers, source of revenue defense, long term care assurance, health-related merits as riders to lifestyles coverage policies). An creation to common actuarial and risk-management matters follows.

Basic actuarial types are offered for affliction coverage and source of revenue security (i.e. incapacity annuities). numerous numerical examples support the reader comprehend the most good points of pricing and booking within the medical health insurance sector. a brief advent to actuarial versions for long term care coverage items is usually supplied.

Advanced undergraduate and graduate scholars in actuarial sciences; graduate scholars in economics, enterprise and finance; and pros and technicians working in coverage and pension parts will locate this e-book of benefit.

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So, the claim administrator has to determine, according to all relevant conditions and facts, whether a disability is related to a previous claim and constitutes a recurrence or has to be considered as a new claim. 3 Accident Insurance Accident is usually meant as an “unintended, unforeseen, and/or violent event, which directly causes bodily injuries”. Accident insurance is also referred to as personal accident insurance. 1 Types of Benefits Various benefits can be provided by accident insurance policies.

3). Finally, we address some issues concerning the management of lifetime-related risks (Sect. 3). 1 The Individual Lifetime The lifetime of any given individual is, in mathematical terms, a random variable. Random fluctuations of the outcomes of individual lifetimes around the life expectancy (consistent with a given age-pattern of mortality) constitute the apparent consequence of this randomness. The randomness in the individual lifetime is usually called the individual longevity risk. From a wealth management perspective, a consequence of the individual longevity risk is the risk of outliving the resources in the post-retirement period, in particular if an appropriate life annuity/pension is not available to the retiree.

Stand-alone LTC cover, whose benefits consist in (partial) reimbursement of expenses related to LTC needs, in particular nursery, medical expenses, physiotherapy, etc. Usually, there are limitations on eligible expenses; further, deductibles as well as limit values are stated in the policy conditions. LTC benefits can also be provided by an LTC cover as a rider to sickness insurance. The resulting product is a lifelong sickness insurance. In order to cover LTC needs, eligible expenses are extended, so to include, for example, nursing home expenses.

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