Within the context of the insurable interest in cargo insurance contracts, in this publication the writer analyses the theoretical aspects of the insurable interest and the relevant laws. Dealing with the problems of determining the insurable interest in cargo insurance contracts the writer has examined the possible options of insurance of the cargo in transit, and while analysing the law governing transport and the sale of goods he examines a person‘s insurable interest in the (...) cargo insured and legal remedies to protect such an interest by concluding a cargo insurance contract. The writer believes that the legal regulation of the insurable interest in Lithuania, interpreting the insurable interest as a loss sustained by a policyholder, the insured or the beneficiary upon an event insured against, fails to guarantee the protection of proprietary and economic interests of persons engaged in the circulation of commodities. Laws governing cargo insurance contracts in Lithuania do not provide a flexible protection of interests of the participants in trade operations and impedes the development of trade and transit, therefore the legal regulation of cargo insurance, especially of the insurable interest should be improved. (shrink)

Business companies are at an unconventional and non-material risk that threatens their business reputation or brand potential in the market. (Cyber Risk), so insurance companies have introduced specialized insurance contracts designed to mitigate the impact of this devastating risk. The need for commercial companies to purchase cyber risk insurance policies has recently increased due to persistent and increasing threats to their operating systems containing the company's database and customers. It has become necessary for businesses to take note (...) of how the cyber risk policy can be covered. At the same time, it is difficult to identify common exceptions in cyber risk insurance contracts because it is relatively recent. In addition, there is a kind of confusion between the insurance contract of cyber risk and some contracts that you may suspect on the other hand. (shrink)

The economic costs to the insurers of complementary routine genetic testing would outweigh the benefits. However, should testing technology in future be refined so as to produce a cheap and reliable test, there is no reason why insurers might not take up predictive testing as part of the normal underwriting process. It is this possibility which justifies formulating a pre-emptive policy. At the very least, there are reasons for promoting and protecting the welfare of the proposer so as to redress (...) the bargaining positions between him or her as a consumer of a service and the insurer as a commercial concern. Further considerations relate to the social purpose of insurance as a social mechanism, and the need to find ways of avoiding undermining this in light of Human Genome Project. (shrink)

This volume is an exploration of the ethical issues raised by health insurance, which is particularly timely in the light of recent advances in medical research and political economy. Focusing on a wide range of areas, such as AIDS, genetic engineering, screening and underwriting, new disability legislation and the ethics of private and public health insurance, this comprehensive and sometimes controversial book provides an essential survey of the key issues in health insurance. Divided into two parts, the (...) first considers the ethics of underwriting, risk assessment and the acceptance and refusal of insurance risk by insurers. Discussing the unjust treatment of high-risk applicants, the authors identify sources of unfairness to both parties of the insurance contract, indicating how reasonable trade-offs can be made. The second part considers the argument for a mix of public and private insurance for acute and long-term care, offering recommendations for changes in the balance of social insurance, and discussing the shift toward long-term contracts in private health care and pension insurance. (shrink)

We describe the results of an experiment on decision making in an insurance context. The experiment was designed to test for the underlying rationality of insurance consumers, where rationality is understood in usual economic terms. In particular, using expected utility as the preference function, we test for positive marginal utility, risk aversion, and decreasing absolute risk aversion, all of which are normal postulates for any microeconomic decision context under uncertainty or risk. We find that there the discrepancy from (...) rational decision making increases with the sophistication of the rationality criteria, that irrationality concerning fair premium contracts is uncharacteristically high, and that the slope of absolute risk aversion seems to depend on the format of the insurance contract. (shrink)

Insurance fraud and abuse—international concerns—are inherent in the proposition of insurance and prevalent in insurer–insured interactions. While the subject of considerable industry and regulatory attention, this little-researched area of consumer behavior and consumer ethics represents persistent social policy questions and problems at multiple levels. This article addresses the issue by first defining insurance fraud and its origins in contract, as well as consumer- and insurer-management. The authors conclude by re-envisioning the problem as one of co-creation by (...) the consumer-insured and insurer personnel, proposing a framework for its study and resolution. (shrink)

This note examines the theory of optimal insurance purchasing in the presence of a nonpecuniary background risk. The occurrence of the qualitative uninsurable background loss can increase, decrease or can leave the marginal utility of wealth unchanged, whereas a financial background loss (as in Doherty and Schlesinger, 1883a) always increases it. Existing theorems on the optimal level of insurance and the optimal form of insurance contracts are shown to hold only under restrictive assumptions on the correlation level (...) between risks. The paper shows that sufficient conditions for the validity of the theorems depend not only on the correlation between the insurable and noninsurable losses, but also on the variation of the marginal utility of wealth with respect to the nonpecuniary variable. (shrink)

What level of government subsidy of higher education is justified, in what form, and for what reasons? We answer these questions by applying the hypothetical insurance approach, originally developed by Ronald Dworkin in his work on distributive justice. On this approach, when asking how to fund and deliver public services in a particular domain, we should seek to model what would be the outcome of a hypothetical insurance market: we stipulate that participants lack knowledge about their specific resources (...) and risks, and ask what insurance contracts they would take out to secure different types of benefit and protection in the domain in question. The great benefit of the hypothetical insurance approach is that it allows us to take apparently intractable questions about interpersonal distribution and transform them into questions about intrapersonal distributions: that is, questions about how an individual would choose to distribute risks and resources across the various lives that they might end up living, in light of their individual ambitions and preferences. Applying this approach to higher education, we argue that the UK model of higher education funding in which the costs of an individual's higher education are shared between general taxation and the individual herself, with the latter element to be paid retrospectively through an income-contingent state-backed loan, is vindicated as just. In particular, we argue that it is more just than alternatives such as a graduate tax, full funding through general taxation, and full privatisation. (shrink)

Termination in international contracts is considered a harsh sanction that harms international trade for each breach of contract or its provisions. The interest of international trade is fulfilled in maintaining and completing performance of contract, even if with a breach rectifiable by remedy. The termination destroys the contract and results in returning goods after their dispatch in addition to the accompanying new freight and insurance expenses and administrative and health procedures necessary for the entry and exit (...) of goods and to pay then refund the price. Moreover, the goods are exposed again to damage and perishing risks. Furthermore, the international sale contract is inherently associated with other international contracts such as goods transport contract, insurance contract and documentary credit through which the price is paid. If the sale contract is terminated, its effect will apply to all other associated contracts, if not performed, which produces many issues and hardships. (shrink)

Hazardous operational consequences of unethical behavior in high-risk projects can be traced back to inadequate relationships between businesses and the insurance industry. The communication of blame, as a consequence of major industrial accidents like the explosion of the Deepwater Horizon drilling rig in the Gulf of Mexico in April 2010, and the relevance of this communication of blame for subsequent insurance litigation, show that the awareness of the relationship between unethical behavior resulting in irresponsible procedural action and deficient (...) loss-prevention practices is a significant component of risk consciousness. The awareness of ethical origins of project risks could alter the methods of design and monitoring of insurance contracts for risky techno-organizational ventures. (shrink)

As the assumptions of perpetual economic and population growth no longer stand, the welfare systems built on such promises are in peril. Policymakers must reallocate the responsibility for providing care between generations. Democratic theories can help establish procedures for finding solutions, particularly in ageing democratic countries. By analysing existing representative and deliberative democratic theories, this paper explores how the interests of future generations could be included in such procedures. A hypothetical social health insurance scheme with the pay-as-you-go financial arrangement (...) is selected as an illustrative case. This paper argues that due to the intrinsic bias towards the current generation, both representative and deliberative democratic health policymaking are limited in making decisions that account for future generations. Instead, their interests could be at best represented by benevolent representatives. (shrink)

We use a controlled laboratory experiment to study firm’s protection against potential technological damages. The probability of a catastrophic event is known, and the firm’s costly investment in safety reduces it. The firm can also buy an insurance with full or partial refund against the consequences of the catastrophic event, which ultimately reduces the variance of the firm’s investment-in-safety lottery. The firm makes these two choices simultaneously, after observing the insurance contract proposed by an insurer who chooses (...) this contract within a set of premium–deductible combinations. We parametrize the insurer–firm game such that a risk-neutral insurer maximizes his expected profit by offering an actuarially fair contract with full insurance; a risk-neutral firm is indifferent between investing in safety and accepting a fair insurance contract. We aim at understanding whether investment in safety and insurance are substitutes or complements in the firm’s risk management of catastrophic events. In line with our predictions, the experimental results suggest that they are substitutes rather than complements: the firm’s investment in safety measures is affected by the insurer’s proposed contract, the latter usually involving only partial insurance. (shrink)

This article discusses the disability insurance industry in order to provide context regarding the potential impact of genetic testing on disability insurance. It describes disability income insurance, exploring both the protection it offers and its main contract provisions. It goes on to describe the private insurance market and the differences between group and individual insurance, and concludes with implications of genetic testing with respect to the private disability insurance market. The individual disability income (...) insurance market is theoretically of great interest as a matter of public policy since there is potential for unfair discrimination through genetic testing although this remains very unlikely as a matter of practice, however.It is more likely that a person will become disabled than die before age 65. The loss of income during a disability can be quite devastating. In contrast to the high risk and high impact of disability are the realities of the disability market. (shrink)

With the increasing mobility of the rural population in China and the growing number of residents moving to the cities for work or study, rural society is forming a pluralistic, interest-centered, “open” social networks relations that follows the modern rule of law contract. Based on Chinese General Social Survey data, the results of the empirical study finds that social insurance can significantly enhance the social interactions of rural residents in China, that is, formal social security system in rural (...) areas promotes informal social security mechanisms such as social interactions. The results of the grouping test show that rural residents in China’s different regions were affected by social insurance in different ways. Social insurance has a greater impact on the social interactions in the eastern region than in the middle and western regions. The propensity score matching method was used to reduce the sample selection bias, and the findings of the paper were found to be robust. (shrink)

For a many-to-many matching model with contracts, where all the agents have substitutable preferences, we provide an algorithm to compute the full set of stable allocations. This is based on the lattice structure of such set.

Using the behavioral agency model, we analyze how two compensation design characteristics, pay-performance sensitivity and duration of CEO compensation, affect corporate social performance. We find that the performance sensitivity of CEO pay is negatively associated with poor social performance but also negatively affects strong social performance. These results suggest that pay-performance sensitivity increases the relevance of potential negative consequences of poor social performance. However, the ‘insurance’ benefits of strong social performance may also become less relevant. With respect to the (...) duration of CEO compensation, we find that it reduces poor social performance. This finding confirms arguments that a long-term compensation time horizon increases the perceived threat that the negative effects of poor social performance will become visible. With our findings, we integrate behavioral agency theory with the traditional stakeholder views. (shrink)

: Decisions about funding health services are crucial to controlling costs in health care insurance plans, yet they encounter serious challenges from intellectual property protection—e.g., patents—of health care services. Using Myriad Genetics' commercial genetic susceptibility test for hereditary breast cancer (BRCA testing) in the context of the Canadian health insurance system as a case study, this paper applies concepts from social contract theory to help develop more just and rational approaches to health care decision making. Specifically, Daniels's (...) and Sabin's "accountability for reasonableness" is compared to broader notions of public consultation, demonstrating that expert assessments in specific decisions must be transparent and accountable and supplemented by public consultation. (shrink)

The impact of recent changes in public health insurance on community‐based health‐care in the USARecent changes in US government‐funded healthcare insurance are having profound impacts on all types of community‐based health‐care, reducing access to care by vulnerable populations. This article traces the impacts of recent policies on a range of community institutions in which nurses play a critical role, such as health centers, highlighting the effects on access to care and the survival of non‐profit services in less‐advantaged communities. (...) In general, the new policies shifted revenues into fixed payment per client contracts (capitation) paid to for‐profit managed care organizations and away from non‐profit community services. The full impact of this competitive, market‐oriented system of health services has just begun to be felt. The uncertainties and dissatisfactions assure continued activity to change current conditions, including efforts by groups that seek greater access to health services for all populations and security for committed providers and personnel, including nurses. (shrink)

The paper studies equilibrium contracts under adverse selection when there is repeated interaction between a principal and an agent over an infinite horizon, without commitment across periods. We show the second-best contract is offered in a perfect Bayesian equilibrium of the infinite horizon model. Unlike the equilibrium contracts in the finite-horizon, the equilibrium contracts in the infinite horizon are not subject to either the ratchet effect or take-the-money-and-run strategy, but rely on a carrot and stick strategy. We study two (...) important applications, one of which is about the optimal regulation of a publicly-held firm. This application has a mixture of both moral hazard and adverse selection. The other application is to the problem of optimal nonlinear pricing when the valuation of the buyers are drawn from a continuum. (shrink)

Electronic health records are likely to improve health care but in the U.S. they will also enable health insurers to be more selective in deciding to whom to deny coverage or whose premiums to increase. In a Rawlsian social contract (1971) the veil of ignorance does not conceal general scientific information from the hypothetical contracting parties. Nonetheless, this paper shows that social contract considerations rule out risk selection as morally impermissible. Since modern health care must in effect be (...) paid for by public or private insurance, and doing so is efficient, this is a basic part of health care justice. But for information ethics this argument does not extend beyond cases in which provision of information serves to deny a social primary good to members of society. (shrink)

Practice guidelines are an increasingly relevant feature of health insurance. One hundred and seventy-eight million people in the United States have some form of private health insurance coverage; coverage for 150 million of them is employment-related. Traditionally, this coverage was provided by employers purchasing a group contract under which an insurance carrier provided indemnity coverage for employees—that is, the insurance company paid all usual, customary, and reasonable charges incurred by an employee for medical care, subject (...) in some cases to an annual deductible and to a percentage of covered expenses, co-paid by the employee, for each service. In recent years, however, employers in greater numbers have switched to so-called self-insurance plans in which employees’ health care claims are paid directly by the employer. (shrink)

On March 23, 2010, President Obama signed into law the nation's first comprehensive health care reform bill, the Patient Protection and Affordable Care Act. Within weeks, twenty states filed lawsuits challenging the constitutionality of its most politically charged feature—an individual purchase mandate. By 2014, the bill requires most individuals to have health insurance. With certain exceptions (pertaining to income level and religious objections), individuals without qualifying coverage will pay an annual tax penalty. If anything, the tax penalty is too (...) low compared with the cost of insurance, so it may not provide sufficient incentive for healthy individuals to purchase insurance. But it remains controversial because it compels people to purchase coverage they choose not to have, raising the question whether Congress can lawfully and ethically require individuals to contract with, and transfer money to, a private party. (shrink)

In Vencor, Inc. v. National States Insurance Co., the U.S. Court of Appeals for the Ninth Circuit held that a Medigap insurance provider was only obligated to pay the rates that Medicare would have paid for the same care.Clarence Rollins purchased a Medigap insurance policy from National States Insurance Company to supplement his Medicare coverage. When Rollins became ill and required care beyond that which Medicare would cover, he received his medical treatment from Vencor Hospital-Phoenix. Upon (...) Rollins's death, NSIC paid Vencor $38,760. Vencor claimed that NSIC owed an additional $132,438 because NSIC was not entitled to the lower care rates established by Medicare. NSIC refused to pay Vencor's higher rates. As a result, Vencor sued NSIC for breach of contract.The U.S. District Court for the District of Arizona held, on a motion for summary judgment, that no breach occurred, and that NSIC was obligated to pay only the lower rates established by Mediare. The Ninth Circuit affirmed this decision. (shrink)

If the global economy seems unfair, how should we understand what a fair global economy would be? What ideas of fairness, if any, apply, and what significance do they have for policy and law? Working within the social contract tradition, this book argues that fairness is best seen as a kind of equity in practice.

Production in sweatshops entails an elevated risk of occupational injury and sickness due to accidents and exposure to dangerous working conditions. As most sweatshop locations lack basic social security systems, health problems have severe consequences for affected workers. Against this background, this article considers what obligations employers of sweatshop labor have to their workers, and how they should meet them. Based on core libertarian concepts, it shows that they are morally responsible for health problems caused by their management decisions, that (...) they should compensate affected workers, and that they must prevent potentially irreversible health problems. In line with Nozick’s contractarian method, the article further argues that these obligations should be implemented through a compulsory employment injury insurance system. Such a system would impose industry-wide health and safety standards, in contrast to the view that libertarianism excludes any labor regulation for the protection of workers, as an illegitimate interference in voluntary labor contracts. (shrink)

The research on technologies and methodologies for (accurate, real-time, spontaneous, three-dimensional…) facial expression recognition is ongoing and has been fostered in the past decades by advances in classification algorithms like deep learning, which makes them part of the Artificial Intelligence literature. Still, despite its upcoming application to contexts such as human–computer interaction, product and service design, and marketing, only a few literature studies have investigated the willingness of end users to share their facial data with the purpose of detecting emotions. (...) This study investigates the level of awareness and interest of 373 potential consumers towards this technology in the car insurance sector, particularly in the contract drafting phase, with a focus on differentiating the respondents between generation Y and Z. Results show that younger people, individuals with higher levels of education, and social network users feel more confident about this innovative technology and are more likely to share their expressive facial data. (shrink)

Resource finitude, cost containment, and a purchaser monopsony market have created public concern-about the moral and legal responsibility for quality assurance in health plans. Resource allocation and standards of care represent a clash of moral values in intensive care treatment. This essay advances a procedural model, based on legislation passed in Oregon, that could govern the incorporation of private sector health insurance plans in Oregon to assure democratic input from consumers, providers, and employers into a limited vision of individual (...) entitlement to consume futile or inappropriate care in intensive care units. The model, which I call the Oregonian ICU, presumes that rationing of care is implicit and not publicly disclosed under managed care. It focuses on maximizing the quality of limited benefits available in the basic managed care insurance tier. Limitations to futile and inappropriate care are developed on the basis of morally weighted prognostic scoring systems that inform the creation of negotiated private sector contracts. (shrink)

We study envy-free allocations in a many-to-many matching model with contracts in which agents on one side of the market (doctors) are endowed with substitutable choice functions and agents on the other side of the market (hospitals) are endowed with responsive preferences. Envy-freeness is a weakening of stability that allows blocking contracts involving a hospital with a vacant position and a doctor that does not envy any of the doctors that the hospital currently employs. We show that the set of (...) envy-free allocations has a lattice structure. Furthermore, we define a Tarski operator on this lattice and use it to model a vacancy chain dynamic process by which, starting from any envy-free allocation, a stable one is reached. (shrink)

Is information about a person's genome, whether derived from the analysis of DNA or otherwise, protected by the right to privacy? If it is, why and in what manner? It often appears that some people believe that the answer to this question is to be found in molecular genetics itself. They point to the rapid progress being made in basic and applied aspects of this field of biology; this progress has remarkably increased what is known about human genetics. Since knowledge (...) of a particular person's genetic makeup entails a potential intrusion into that person's most private realms and exposes him or her to dire results if revealed to others, they argue, the law needs to protect “genetic privacy.” There is nothing inherently wrong with this account, but it certainly presupposes that we know—and agree about—what it means to protect privacy and, indeed, what interests are implicated in the concept and why they matter. Rather than make this assumption, in this essay I first elaborate a concept of privacy before turning to the potential privacy implications that arise at the intersection of human genetics and the field of insurance. I argue that the core value here is self-determination broadly conceived—that control over one's genetic information may be important for achieving self-determination—but that at least in the context of contracts for life insurance, we should be reluctant to recognize “rights” that would permanently preclude the use of genetic data by insurers. (shrink)

The purpose of the present paper is to unveil whether the power distance/textual complexity duality attributed ordinarily to legal language applies to two different documents which are widely deployed, interpreted and applied in the global scope of commercial trade and communications, namely Lloyd’s Institute Cargo Clauses and the London International Court of Arbitration Rules. In choosing two texts which are the direct product of the law-making machinery of the Common law system, but which are used internationally, we ultimately undertake (...) to research whether opacity is really inherent to legal texts in English with an international scope of implementation. To scrutinise, illustrate and argue on the degree of difficulty and power distance in such legal instruments, the perspective of genre has been chosen as the most effective of instruments provided by current Applied Linguistics. Genre analysis permits to identify the genre or genres of a specialised professional community connected to the communicative group it comes from, the audience that receives it, the historical and cultural background and the extra-textual reality it aims to represent. The goal of our study, carried out through different levels: formal, discursive and, mainly, pragmatic, is to discern whether there exists any possible equation between power and textual complexity, and the consequences this entails for the understanding of the nature of these major international texts. (shrink)

The theoretical literature on vertical relationships usually assumes that beliefs about secret contracts take specific forms. In a recent paper, Eguia et al. (Games Econ Behav 109:465–483,2018) propose a new selection criterion that does not impose any restriction on beliefs. In this article, we extend their criterion by generalizing it to risk-averse retailers, and we show that risk aversion modifies the size of the belief subsets that support each equilibrium. We conduct an experiment which revisits that of Eguia et al. (...) (Games Econ Behav 109:465–483,2018). We design a new treatment effect on equilibrium selection depending on the retailers’ risk sensitivity. Experimental results confirm the treatment effect: the more sensitivity there is towards risk, the more the equilibrium played is consistent with passive beliefs. In addition, extending Eguia et al.’s (Games Econ Behav 109:465–483,2018) criterion to risk-averse retailers improves its predictive power on the equilibria played, especially for a population of retailers with moderate to extreme risk aversion. (shrink)

To solve the financing problem of the food producers, we consider a two-echelon contract food supply chain composed of a family farm with capital constraints and a food processing enterprise. With no capital constraints as the benchmark model, we analyze optimal decisions of the family farm and the food processing enterprise in the case of bank financing with bank participation only and bank financing with “government, bank, and insurance” coparticipation. Then, we discuss how the risk of yield uncertainty (...) influences the optimal decisions and profits of the family farm and the food processing enterprise under different financing situation. Meanwhile, the reason why the government subsidizes agriculture is explored, and the policy of minimum purchase price of the food is initiated when the market price is too low. Finally, the numerical examples and sensitivity analysis are presented. The results show that the bank financing with “government, bank, and insurance” coparticipation improves the welfare of supply chain members more obviously than the bank financing with bank participation only; when the rice price is too low, the policy of minimum purchase price of food is initiated, which increases the revenue and the growing enthusiasm of the family farm; the profits of the family farm and the food processing enterprise will decrease as the risk of yield uncertainty increases in the case of bank financing, and the risk of yield uncertainty will be reduced for the family farm when bank financing with “government, bank, and insurance” coparticipation. (shrink)

In market economy to protect consumers’ rights in an extremely important insure. This also applies to the insurance market generally understood as issues related to the conclusion and execution of insurance contracts. Insured is exposed to many dangers, is weaker in the insurance market, because insurance as professionals may impose their conditions Convenient for the transaction. This article aims to identify the market practices by means of the unfair terms used by insurance companies. The article (...) gives examples of unfair terms and points the consequences of their use. (shrink)

Uberrima Fides is a legal doctrine that governs insurance contracts and expects all parties to the insurance agreement to act in good faith by declaring all material facts relative to a policy. The doctrine originated in England in 1766 with the case Carter v Boehm ruled by Lord Mansfield. Ever since, it has become, with some differences in interpretation, a cornerstone of insurance relationships around the world. The role that trust plays within it, however, is not simple (...) and should not be taken for granted. While it is expected that an idea of trust represents an order of truth, trust in itself is the outcome of a complex negotiation of moral orders. Semiotically, trust operates here not as a Kantian category for the understanding but as a signifier of an order of truth that upholds the possibility for insurance relationships. Trust, as sign, operates as a condition of possibility for the performance of insurance. In this article, a Foucaultian approach is employed to problematise the idea of trust and its role in insurance relationships. The case of mis-selling of insurance policies in the United Kingdom since the 1980s, which has given rise to numerous legal rulings, is used as the empirical site for the problematisation. (shrink)

The recent proliferation of new data and technologies enables increasingly finer personalization of products and prices in every domain. In insurance, this revives and enlarges old debates around fairness that have never been completely settled. We will argue that the commonly accepted “actuarial fairness” as based on the “individual cost of risk” derives in fact from a conflation: while it indicates the average cost for a group of insureds from the perspective of an insurance company—and is therefore sound (...) from a business profitability viewpoint—it is arguable whether it represents the “fair price” for the individual insured. We first show in a historical perspective the intertwinement of conceptions of fairness with knowledge, in order to point to the alternative to actuarial fairness for insurance. We then describe the intrinsic difference between the insured and the insurer when underwriting an insurance contract. Finally, we build on this distinction to discuss the meaning of fairness in insurance prices. We thus hope to re-center the debate around insurance fairness on its underlying solidarity mechanisms rather than technical and actuarial considerations. (shrink)

In this paper, we discuss challenges associated with implementing a policy for Ancillary Care (AC) for related and unrelated (serious) adverse events during an Ebola vaccine trial conducted in a remote area of the Democratic Republic of the Congo. Conducting clinical trials in resourceconstrained settings can raise context-related challenges that have implications for study participants’ health and wellbeing. During the Ebola vaccine study, three participants were injured in road traffic accidents, but there were unexpected difficulties when trying to apply the (...) AC policy. First, because of the nature of the adverse events, the insurer refused to cover the costs. Second, the AC policy did not address treatments by traditional medicine, even though traditional medicines are frequently used and highly trusted in the study community. This highlighted a contrast between the researchers’ well-intentioned AC approach and the participants’ legitimate preferences. The way in which researchers should address their responsibility to provide AC is not straightforward; it requires contextualization. Our experience highlights the importance of involving community representatives and the local ethics committee to ensure development of an AC policy that is culturally and ethically appropriate. Additionally, the insurance contract should clearly stipulate which adverse events are linked to the trial participation, and thus eligible for coverage, to avoid controversies when claims are made. (shrink)

The formal theory of equality of opportunity emerged as a response – a friendly amendment – to Ronald Dworkin's (1981) characterization of resource egalitarianism, as defined by the allocation that would emerge from insurance contracts arrived at behind a thin veil of ignorance. This article compares several of the prominent versions of this response, put forth in the period 1993–2008. I argue that a generalization of Roemer's (1998) proposal is the most satisfactory approach. Inherent in that generalization is an (...) indeterminism, which reflects a philosophical problem: that we do not know what comprise the ethically correct rewards to effort. The indeterminism should be resolved, I propose, by an ancillary theory which limits the degree of inequality which is acceptable. (shrink)

In this paper I propose to examine the concept of discrimination from an ethical viewpoint. In a preliminary part, I will point out which aspects of the subject matter I will focus on and which I will leave aside (II). On the basis of the Aristotelian principle “treat like cases alike”, I will continue with a very formal definition, according to which discrimination can be understood as acting in a way that implies that like cases are not treated alike. This (...) leads to the difficult question of which cases are to be considered as “alike”, or which traits can serve as morally valid reasons for identifying cases as “unlike” (III). I will argue that this question cannot be answered independently from the specific circumstances and the normative premises referred to for describing these circumstances. My conclusion is that the concept of discrimination derives its “moral strength” solely from these normative premises. As a consequence, the use of the con- cept of discrimination can often be misleading since it falsely presupposes that there is agreement about the underlying normative premises (IV). Finally, I will illustrate the argumentation using “genetic discrimination” in connection with insurance contracts as an example (V). (shrink)

In the paper ‘Genetic information, insurance, and a pluralistic approach to justice’, Jonathan Pugh1 develops an argument from unresolved pluralism in our theories of justice, via the pluralism this occasions in relation to the specific question of the use of genetic test results in insurance underwriting, to the conclusion that the UK regulatory approach in relation to the use of GTRs in insurance is broadly correct.1 Pugh’s argument is wide-ranging and I cannot provide a complete critique of (...) it in this short comment, but I will gesture towards some strands of the argument that are potentially problematic. The first potential problem in the argument is that Pugh bases his argument on a very extensive range of accounts of justice, including pure maximising consequentialism, strict egalitarianism and libertarianism, among many others. If these are all accounts of justice, it is not strange that there is pluralism of conclusions in relation to a specific question of justice or discrimination, such as the use of GTRs in the underwriting of specific kinds of insurance contracts. Pugh’s range, for instance, includes accounts of justice that deny the direct importance of distributive concerns as well as accounts that see distributive concerns as crucial. These accounts disagree not only about the answer to Pugh’s question but also about …. (shrink)

This chapter reviews the relevant anthropology, starting with the apparent universality of the golden rule — do as you would be done by — in hunter-gatherer societies. It points out that all pure foraging societies have two properties: they do not tolerate bosses, and they share very fairly. A putative explanation of the first property is offered that appeals to the game theory discipline of mechanism design. The second property is explained as an evolutionary consequence of the implicit insurance (...) contracts that are common in animals as ahedge against hunger and starvation. If so, then we have an argument in support of the contention that Rawls' original position captures the deep structure of fairness norms wired into our brains. The analogy with Chomsky's deep structure of language is close. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Legal CommentaryGreg Vijayendran, PartnerThe issues arising for consideration in this case are:a). the nature of the investigator-subject relationship that gives rise to an ethical duty to disclose incidental findings;b). whether the research team in this case (including the principal investigator and co-investigator) has a duty to disclose the incidental finding observed to the research volunteer; andc). whether the research team has a further ethical duty to ensure that the (...) MRI scans are clinically evaluated to identify potential health problems.The starting point is to define “incidental findings” for clarity and precision. A good working definition of the same is “a finding concerning an individual research participant that has potential health or reproductive importance and that is discovered in the course of conducting research but is beyond the aims of the study”.1With regard to incidental findings, Miller, Mello and Joffe in an insightful article2 observe:… there is little ethical guidance available to steer such efforts, and practices appear to vary widely. Although several articles have catalogued the ethical dilemmas surrounding incidental findings, with the exception of seminal work by Henry Richardson and Leah Belsky on the more general topic of researchers’ obligations to provide ancillary clinical care to research subjects, systematic ethical analysis of the incidental findings problem is lacking.In this case scenario, there is no concurrent, overlapping physician-patient relationship (even if the research subjects were recruited from patients at the hospital’s memory clinic) that might provide an alternative [End Page 274] source of obligations relating to incidental findings. No representations have been made by the research team to the patient-volunteers. The patient-volunteers did not opt to be kept in the know as to incidental findings. Neither did they express a preference not to be informed of such findings. Had they done so, such a choice would presumably absolve the research team from keeping the patient-volunteers informed. From an autonomy perspective, there is no compelling reason why such a choice by a patient-volunteer should not be honoured.One view of the first issue outlined above is that the relationship between a research investigator and a research subject is founded in contract. On that premise, investigators have no default obligations, only what is expressed or implied in the terms of the “contracts” for recruiting volunteers. The relevant documents and data to be analysed would be the “contracts” executed by the parties and the informed consent form as well as interactions and iterations between investigators and patient-volunteers. Of particular significance would be representations made by the investigators that could form part of the terms of the contract. Apart from express terms, there would also be some rare implied terms — for example, an implied term of good faith although this has only been recognised in certain sui generis categories of contracts (for example, insurance contracts). Adopting this perspective strips away any fiduciary or professional aspects of the relationship and reduces the relationship to nothing more than a contractual one. Such a view relies on the legal relationship as a springboard for the ethical duties although this perspective would be reductive because very few implied duties are presumed. Unless incidental findings fall within the terms of the contract, investigators are under no obligation to respond to them. In the final analysis, the main objection to this contractual perspective is that it conflates legal duties with ethical duties when these two distinct types of obligations which investigators and a research team have to elucidate.An alternative approach involves a focus on professional relationships. Concepts of incidental findings and ancillary care presume some sort of professional relationship pursuant to which the findings are analysed as incidental or the care is determined as ancillary. “Professionals” refer to persons who are usually distinguished by their specialised knowledge and training as well as by their commitment to provide important services to patients, clients or consumers.3 Professional relationships are often, but not always, characterised by a service role, sometimes involving a fiduciary relationship.Although researchers cannot be viewed as having a service role vis-à-vis individual subjects, it is reasonable [End Page 275] to regard research as a professional activity. Researchers possess... (shrink)

The article analyses, in a comparative perspective, the phenomenon of the evolution of the protection of surviving spouse’s inheritance rights in France and Lithuania, the two legal systems historically having some points of interaction. The protection of the surviving spouse is one of the major preoccupations of married couples of today, the couple occupying a central role within the contemporary family. Comparative analysis reveals certain points of convergence between these two legal systems inasmuch the surviving spouse is considered by both (...) legislations as an heir ab intestat and whose protection over the years has been considerably strengthened. The surviving spouse is called to inherit alongside with the heirs of the first or second order and is entitled to the proportions in assets that have not ceased to increase. Lithuanian law seems to have been innovative at an earlier stage than French law, as it is only in the beginning of the 21st century that significant reforms were carried out in this area of law in France. Analysis has also revealed apparent differences in the scope of protection of the surviving spouse, both in regards to the protection provided by law (statutory protection), as well as protection organised by the will of the spouses (voluntary protection). In some respects the statutory protection is more extensive in France (for example, complementary statutory rights of the spouse in regards to the dwelling place or the quality of héritier réservataire) and the instruments of this protection seem to be more varied (for example, the possibility for the spouses to organise their matrimonial regime by inserting specific clauses into the nuptial contract, mechanisms outside the nuptial contracts, such as donations, wills or life insurance contracts). However, this protection might appear to be more extensive under Lithuanian law as far as the voluntary protection is concerned taking into account the introduction, by the new Lithuanian Civil Code of 2000, of the joint will of spouses under which the whole property of the deceased spouse shall be inherited by the surviving spouse (except the mandatory share of succession). The article raises some doubts as to the desirability or even feasibility of aligning the two models of protection given the fact that each of the two countries has its own history and traditions. Nevertheless, a proposition resurges from the analysis in regard to the possible improvement of the protection of the rights to the dwelling place of the surviving spouse under Lithuanian law. Some elements from the existing French model could be transposed given that the dwelling place is an essential family element providing some stability for the surviving spouse. (shrink)

The issue of mutual trust is an important element in each economic activity, especially in the global market economy. It also concerns insurance activity. Entering into contracts with clients, a life insurance company becomes a public trust institution. The long-term responsibility lies on the insurance company side. The act of 23 March 2003 on insurance activity sets forth that insurance institutions are obligated to systematically inform their insured clients about contract commitments. The paper shows (...) some examples of clients losing trust in insurance companies. It also defines public trust and the basic factors influencing public trust in life insurances. (shrink)

We study a regression tree algorithm tailored to casualty insurance pure premium estimation problems. Casualty insurance premium is mainly determined by the expected amount that the insurance companies have to pay for the contract. Therefore, casualy insurance companies have to estimate the expected insurance amount on the basis of insurance risk factors. This problem is formulated as a regression problem, i.e. estimation of conditional mean E[Y|x], where Y is insurance amounts and x (...) is risk factors. In this paper, we aim to implement the regression problem in regression tree framework. The difficulty of the problem lies in the fact that the distribution of insurance amount P is highly skewed and exhibits a long-tail toward positive direction. Conventional least-square-error regression tree algorithm is notoriously unstable under such long-tailed error distribution. On the other hand, several types of robust regression trees, such as least-absolute-error regression tree, are neither appropriate in this situation because they yields significant bias to conditional mean E[Y|x]. In this paper, we propose a two-stage tree fitting algorithm. In the first stage, the algorithm constructs a quantile tree, a kind of robust regression tree, which is stable but biased to conditional mean E[Y|x]. In the second stage, the algorithm corrects the bias using least-square error regression tree. We discuss the theoretical background of the algorithm and empirically investigate the performances. We applied the proposed algorithm to a car insurance data set of 318,564 records provided from a north-american insurance company and obtained significantly better results than conventional regression tree algorithm. (shrink)

The main indicators of assistance activity in the insurance market in Ukraine have been analyzed. Beneficial and negative trends of its development have been shown. The dynamics of the insurers' liquidation expenses structure and the payment of services expenses of the assistance establishments have been highlighted. Their structure has been shown due to the types of voluntary and compulsory insurance. The main problems hindering the effective development of the assistance services market have been characterized and the prospects of (...) its development have been offered. The aim of the research is to carry out comprehensive analysis of the current market of assistance services, to identify the main problems of their implementation and to point out the prospects of insurance market development. The dynamics of insurance bonuses and benefits including insurance compensation and services and the insurers' operating expenses concerning the payment of services of the assistance establishments has been analyzed on the basis of a sample survey of the main indicators of insurance market development due to the statistic data of National Committee of Financial Services. It has been revealed that majority of the insurance services provide settlement of insurance claims by offering assistance service. Alongside increasing of the share of insurance payment due to the contract providing the insurance service, allows the majority of insurance claims to be settled due to the payment of insurance compensation. Expenses on assistance services were the highest and the court expenses were the lowest in the structure of the insurer's liquidation expenses during 2011-2014. Expenses on services of the non-residential assistance establishments are low but they are increasing. It shows that emergency assistance to our citizens in the country and outside is being increased. Structure of assistance services in the voluntary and compulsory insurance market has been analyzed; main trends of assistance activity development according to the separate insurance services have been highlighted. In particular it was found out that the greatest amount of assistance services were provided due to the voluntary medical insurance, medical costs insurance, land transport insurance and compulsory insurance of civil liability of the owners of vehicles. On the basis of conducted analysis, we can draw a conclusion about the low level of assistance services market development. It is affected by negative trends of economic and political crisis, low solvency of insurers and the quality of insurance services, a lack of guaranties to provide emergency assistance in time, imperfect state regulation of assistance services provision, and a low level of institutional support. We offer to intensify the interaction between the insurers and assistance companies while providing insurance services including additional ones, insurance compensation, and settlement of insurance claims by ensuring emergency assistance in monetary and natural-material form. This will promote the increasing of quality of the insurance protection. (shrink)