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This study aims to identify the propensity for clients (legal and natural persons) to adopt peer-to-peer (P2P) short-term insurance policies as opposed to traditional and/or centralized short-term.

In this paper data was collected through a survey of 102 sampled short-term insurance clients using convenience sampling. The TAM2 questionnaire was adapted to evaluate the intention to adopt a P2P insurance policy.

The findings of this study shed light on the factors influencing the adoption and (dis)continuation of short-term insurance products, both traditional and digital, among South African consumers. The results demonstrate that perceived usefulness, ease of use, trust, risk perception and subjective norm play crucial roles in individuals' intention to use or (dis)continue the use of these insurance products.

The study's findings provide actionable insights for practitioners in the short-term insurance sector, with a focus on marketers and e-commerce professionals. These insights emphasize the need to prioritize user-friendly design and trust-building measures in the development of P2P insurance systems. Additionally, practitioners should consider harnessing the power of social influence and carefully balancing innovative features with familiarity in their marketing efforts. These strategies are poised to enhance the adoption and competitive positioning of P2P insurance solutions amidst the evolving landscape of digital transformation.

This study makes a substantial contribution by employing the technology acceptance model (TAM) in a novel and unconventional manner. It not only explicates the intricate dynamics governing the adoption and discontinuation of short-term insurance products, encompassing both conventional and digital alternatives, within the South African consumer milieu but also extends its purview to infer the reasons behind the limited widespread adoption of the digital counterpart, despite its superior value proposition compared to the traditional offering. The findings elucidate the critical determinants shaping individuals' decisions in this dynamic market segment. This research enhances the global discourse on insurance adoption with a unique South African perspective and furnishes insurers and marketers with empirically grounded insights to optimize their strategies and cultivate substantive connections with their target demographic.

This study aims to deepen the understanding of insurers’ role within the return-to-work (RTW) process by uncovering and categorizing the multiple roles assumed by the insurer based on the claimant’s perceptions and identifying the underlying mechanisms that explain the relationship between perceived insurer roles and occupational rehabilitation outcomes.

The author used a qualitative approach with theory-guided content analysis to examine 24 semi-structured interviews with occupational rehabilitation claimants who had undergone occupational rehabilitation within the earnings-related pension insurance system in Finland.

The author uncovered three perceived insurer roles in relation to other stakeholders in the rehabilitation network: financier, coordinator and leader. These roles have different perceived responsibilities and influences on rehabilitation outcomes. Additionally, the author found four perceived insurer roles in relation to the claimants, which varied according to their democracy and activity levels: ally, facilitator, enforcer or enemy. Based on this study, the author recommends that insurers adopt democratic and participatory actor roles (ally and facilitator) to promote the RTW process in occupational rehabilitation.

This inaugural study applied role theory to insurers within the RTW process, developing a new framework of insurer profiles. This study reveals the dynamic nature of insurers and enhances the understanding of the connections between perceived insurer roles and rehabilitation outcomes.

Insurance companies exist to manage the risk of others, which is why they are perceived to be competitive in risk management (RM). Considering this, we investigate how different RM capabilities make insurers effective in RM. These capabilities include understanding risk and risk management (URRM), risk identification (RI), risk assessment and analysis (RAA) and risk monitoring (RMON) activities in insurance companies. In addition, the authors probe how these capabilities can jointly yield a competitive advantage for the insurance industry under the resource-based view (RBV) and dynamic capabilities perspective (DCP).

The authors present a latent variable RM model for the insurance industry and employ structural equation modeling (SEM) to test the hypotheses. Furthermore, the authors also conduct confirmatory factor analysis (CFA) and convergent and discriminant validity analysis for model fit and invariance testing, respectively.

The results show that insurers who investigated RM-related capabilities directly influence their risk management practices (RMPs). Moreover, improving these capabilities will make insurers more effective in managing the risks of others. Thus, RM as a business process will yield a competitive advantage for the insurance sector. The findings are supported by the theoretical insights presented by the RBV and DCP. Furthermore, the model also adheres to the convergent and discriminant validity cut-off values.

To the best of the authors’ knowledge, this is the first study examining insurers' RM practices as a source of a competitive advantage.

保險公司存在的目的是為其它公司或個人管理其風險；因此，保險公司在風險管理方面、被認為具有競爭能力。故此、我們擬研究不同的風險管理能力是如何能使保險公司有效地管理風險的呢？這些風險管理能力包括對風險及風險管理之了解、風險辨識、風險評估和分析，以及在保險公司內的風險監控活動。再者，我們探究這些風險管理能力如何根據資源基礎觀點及動態能力理論共同為保險業創造競爭優勢。

我們為保險業展示一個潛在變項風險管理模型，並使用結構方程模型，來測試我們的假設；而且，我們為模型適配度而進行了驗證性因素分析，又為不變性檢定而進行了驗證輻合及驗證區別效度分析。

研究結果顯示、若保險公司審査與風險管理相關之能力，這會直接影響其對風險管理之措施；而且，若保險公司能改善其風險管理之能力，這會使它們更有效地管理其它公司或個人的風險。因此，作為業務過程的一環、風險管理會為保險業創造競爭優勢。我們的研究結果，得到資源基礎理論及動態能力理論提供之理論見解所支持；而且，我們的模型從附驗證輻合及驗證區別效度的截止值。

據我們所知，本研究為首個研究、去探討保險公司的風險管理措施如何為它們創造競爭優勢。

This paper investigates why bancassurance coexists with alternative insurance distribution channels in the long run, considering the bank channel is known to involve lower costs than traditional distribution systems. It tests the product-quality hypothesis that maintains that the higher costs of some distribution systems represent expenses associated with producing higher product quality, greater service intensity and/or skills to solve principal-agent conflicts.

An analysis is conducted on firms operating in the life segment of the Spanish insurance industry over an eight-year sample period. First, the author estimates cost efficiency and profit inefficiency using data envelopment analysis. Cost efficiency enables one to evaluate if the use of the banking channel increases cost efficiency. Profit inefficiency is addressed to identify the existence/absence of product-quality differences. The performance implications of using bancassurance are analyzed by applying Heckman's two-stage random-effects regression model.

The results support the product-quality arguments. The use of banking channel was found to increase cost efficiency. However, the distribution channel/s utilized did not affect profit inefficiency.

A regulatory environment that supports the development of bancassurance enables this and alternative distribution channels to be sorted into market niches, where each system enjoys comparative advantages in order to minimize insurer costs and maximize insurer revenues. There is no single optimal insurance distribution system.

This is the first study to investigate why bancassurance coexists with alternative insurance distribution channels.

This paper aims to contribute to the understanding of the mechanisms that evolve during reputational scandals and lead to changes in industry regulation. It explores the processes by which a demand for external industry regulation evolves, also addressing the consequences of firms’ competitive behaviors which lead to substantial misbehavior and the destruction of reputational capital. The authors are interested in whether and how regulatory activities – in the case analyzed here, changes in insurance regulation regarding sales commissions for insurance brokers – are used as a costly, external behavioral control mechanism (third-loop learning) to terminate a reputational scandal that cannot be stopped by internal controls at a firm level (first-loop and second-loop learning) anymore.

The paper explores a real-life case in the German insurance industry that peaked in 2012 and has been well documented by broad media coverage, complemented by interviews with leading industry representatives. Using causal process tracing as a methodology, the authors study the factors in the case that led to an industry scandal. The authors further analyze why the insurance firms involved were not able to limit the scandal’s impact by internally controlling their behaviors, but had to call for external regulation, thus imposing costly restrictions on sales and contract processes. To identify the mechanisms underlying this result, theories from the fields of economics (game theory) and sociology (vicious cycle of bureaucracies), as well as organizational learning theory, are used.

The authors find that individual rationality does not suffice to prevent insurance firms from scandalous business practices, e.g. via implementing appropriate internal behavioral control measures within their organizations. If, as a result, misbehavior leads to reputational scandals, and the destruction of reputational capital spills over to the whole industry, a vicious cycle is set in motion which can be terminated by regulation as an externally enforced control mechanism.

This study is limited to the analysis of a single case study, combining published materials, e.g. broad media coverage, with interviews from representatives of the insurance industry. Nevertheless, the underlying mechanisms that have been identified can be used in other case studies as well.

The paper shows that if firms want to avoid increasing regulation, they must implement strong reputational risk management (RRM) to counteract short-term profit pressure and to avoid restrictive regulation imposed on the industry as a whole. Furthermore, it sheds light on the relevance of spillover effects for RRM, as not only employee behavior within an organization might lead to the destruction of reputational capital but also that from other firms, e.g. from elsewhere within an industry.

The paper contributes by emphasizing a direct causal link between corporate scandals, loss of reputation and regulatory change within the insurance industry. Furthermore, the paper contributes by combining economic theories with organizational theories to understand real-life phenomena.

Despite the sophisticated regulatory regime established in Solvency II, analysts should be able to consider other less complex indicators of the soundness of insurers. The Z-score measure, which has traditionally been used as a proxy of individual risk in the banking sector, may be a useful tool when applied in the insurance sector. However, different methods for calculating this indicator have been proposed in the literature. This paper compares six different Z-score approaches to examine which one best fits insurance companies. The authors use a final dataset of 183 firms (1,382 observations) operating in the Spanish insurance sector during the period 2010–2017.

In the first stage, the authors opt for a root mean squared error (RMSE) criterion to evaluate which of the various mean and SD estimates that are used to compute the Z-score best fits the data. In the second stage, the authors estimate and compare the explanatory power of the six Z-score measures that are considered by using an ordinary least squares (OLS) regression model. Finally, the authors report the results of the baseline equation using the system-GMM estimator developed by Arellano and Bover (1995) and Blundell and Bond (1998) for dynamic panel data models.

The authors find that the best formula for calculating the Z-score of insurance firms is the one that combines the current value of the return on assets (ROA) and capitalization with the SD of the returns calculated over the full sample period.

The main limitation of the research is that it addresses only the Spanish insurance sector, and consequently, the implications of the findings must be framed in this institutional context. However, the authors think that the results could be extrapolated to other countries. Future research should consider including different countries and analyzing the usefulness of aggregated insurer-level Z-scores for macroprudential monitoring.

The Z-score may be a useful early warning indicator for microprudential supervision. In addition to being an indicator of the soundness of insurers simpler than those established in the current regulation, the information provided by this accounting-based measure may help analysts and investors obtain a better understanding of insurance firms' risk factors.

To the best of the authors’ knowledge, this study is the first to examine and compare different approaches to calculating Z-scores in the insurance sector. The few available results on the predictive power of the Z-score are mixed and focus on the banking sector.

雖然在償付能力標準II 內已建立了精密的監管制度，但分析人員應可以考慮以不太複雑的指標，來分析保險公司的穩健程度。Z-分數的估量在銀行業一向作為是個體風險的代理而使用，而Z-分數如應用於保險業，或許會成為有用的工具。唯在文獻裏，學者和研究人員提出了不同的方法來計算這個指標。本文比較六個不同的Z-分數估量方法，以研究出最適合保險公司的方法。我們使用一個最終數據集，包括在2010年至2017年期間在西班牙保險業界營運的183間公司（1382 個觀察）。

在首個階段，我們選擇使用一個方均根誤差(RMSE) 標準來衡量用來計算Z-分數的各個平均值和標準差估量中哪個最適合使用於有關的數據。在第二個階段， 我們以普通最小平方 (OLS) 迴歸模型，去估計並比較被考慮的六個Z-分數估量的解釋力。最後，我們以Arellano與Bover (1995), 以及Blundell與Bond (1998) 為動態追蹤資料模型而發展出來的系統-廣義動差估計推定量，來發表我們基線方程式的結果。

我們發現，計算保險公司Z-分數的最佳公式是把資產收益率及資本總額的現值，和在整個樣本期間計算出來的囘報的標準差結合起來的公式。

我們研究主要的局限為：研究只涉及西班牙的保險業；因此，研究結果的含意，必須在這個體制的背景框架下來闡釋。唯我們相信研究結果或許可外推至其它國家。未來的研究，應考慮納入不同國家作為研究對象，並分析保險公司層面的集成Z-分數的功用，以求達到宏觀審慎監控的目的。

Z-分數或許就微觀審慎監管而言是一個有用的早期警告器。這些以會計為基礎的估量而提供的資訊，除了較現時規例内已建立顯示保險公司穩健程度的各個指標更簡單外，還會幫助分析人員和投資者更了解保險公司的風險因素。

據我們所知，本研究為首個研究，去探討並比較保險業內的Z-分數的計算方法。以前關於Z-分數預測能力的，為數不多並可供取閱的研究結果均不統一；而且，這些研究都聚焦探討銀行業。

To investigate the effects of payor–provider integration on the operational performance of health service provision. The research explores whether integration governs agency problems and tilts the incentives of diverse actors toward more systematic outcomes.

A two stage multimethod case study of occupational health services. A qualitative stage aimed to understand the reasons, mechanisms, and outcomes of payor–provider integration. A quantitative stage evaluated the performance of the integrated hospital against fee-for-service partner hospitals with a sample of 2,726 patients.

Payor–provider integration mitigates agency problems on multiple levels of the service system by complementing formal governance mechanisms with informal mechanisms. Compared to partner hospitals, the integrated hospital yielded 9% lower the total costs of occupational injuries achieved primarily by emphasizing conservative care and faster recovery.

Focuses on occupational health services in Finland. Provides initial evidence of the effects of payor–provider integration on the operational performance.

Vertical integration may provide systematic outcomes but requires mindful implementation of multiple mechanisms. Rigorous change management initiative is advised.

For patients, the research shows payor–provider integration of health services can be implemented in a manner that it reduces care costs while not compromising care quality and customer satisfaction.

This study provides a rare longitudinal analysis of payor–provider integration in health-care operations management. The study adds to the knowledge of operational performance improvement of health services.

From 1979 to 2023, the takaful structure has been adopted in many jurisdictions, making the documenting of its early days of establishment relatively difficult and somewhat unreliable. This is unlike conventional insurance, where the history and legislation are well documented and archived in various research (Hellwege, 2016; Marano and Siri, 2017). The purpose of this paper is to provide a chronology for the establishment and development of takaful via the takaful establishment in each jurisdiction, documenting its first takaful operator and first takaful regulation.

This paper has used a qualitative method in the form of reviewing literature and available data such as journals, books and official resources. The data is thoroughly analysed in order to build the chronology for takaful. It adopted an exploratory research design, which is deemed suitable in situations where few works of literature have examined the subject (Neuman, 2014). The paper explores the establishment and non-establishment of takaful in 57 countries. The paper categorises the countries into seven regions starting with the GCC, Levant, Asia, Central Asia, Africa, Europe and Others.

The takaful chronology presented in this paper shows that takaful operations exist in 47 jurisdictions, starting from Sudan and the UAE in 1979, with the most recent adopters being Morocco and Iran in December 2021. It is found that 22 jurisdictions do not have takaful regulations, and the Takaful Act 1984, issued in Malaysia, is considered the first takaful regulation that sets the basis for other regulations that follow.

The paper contributes to the literature by providing a comprehensive chronology of takaful, especially as the few existing timelines have been found to be incomplete and consist of contradictory information.

A range of strategies to improve pharmaceutical care has been implemented by population health management (PHM) initiatives. However, which strategies generate the desired outcomes is largely unknown. The purpose of this paper is to identify guiding principles underlying collaborative strategies to improve pharmaceutical care and the contextual factors and mechanisms through which these principles operate.

The evaluation was informed by a realist methodology examining the links between PHM strategies, their outcomes and the contexts and mechanisms by which these strategies operate. Guiding principles were identified by grouping context-specific strategies with specific outcomes.

In total, ten guiding principles were identified: create agreement and commitment based on a long-term vision; foster cooperation and representation at the board level; use layered governance structures; create awareness at all levels; enable interpersonal links at all levels; create learning environments; organize shared responsibility; adjust financial strategies to market contexts; organize mutual gains; and align regional agreements with national policies and regulations. Contextual factors such as shared savings influenced the effectiveness of the guiding principles. Mechanisms by which these guiding principles operate were, for instance, fostering trust and creating a shared sense of the problem.

The guiding principles highlight how collaboration can be stimulated to improve pharmaceutical care while taking into account local constraints and possibilities. The interdependency of these principles necessitates effectuating them together in order to realize the best possible improvements and outcomes.

This is the first study using a realist approach to understand the guiding principles underlying collaboration to improve pharmaceutical care.

The authors consider the mutual benefits of the ceding company and reinsurance company in the design of reinsurance contracts. Two objective functions to maximize social expected utilities are established, which are to maximize the sum of the expected utilities of both the ceding company and reinsurance company, and to maximize their products. The first objective function, additive, emphasizes the total gains of both parties, while the second, multiplicative, accounts for the degree of substitution of gains of one party through the loss of the other party. The optimal price and retention of reinsurance are found by a grid search method, and numerical analysis is conducted. The results indicate that the optimal solutions for two objective functions are quite different. However, optimal solutions are sensitive to the change of the means and volatilities of the claim loss for both objective functions. The results are potentially valuable to insurance regulators and government entities acting as reinsurers of last resort.

In this paper, the authors apply relatively simple, but in the view significant, methods and models to discuss the optimization of excess loss reinsurance strategy. The authors only consider the influence of loss distribution on optimal retention and reinsurance price but neglect the investment factor. The authors also consider the benefits of both ceding company and reinsurance company to determine optimal premium and retention of reinsurance jointly based on maximizing social utility: the sum (or the product) of expected utilities of reinsurance company and ceding company. The authors solve for optimal solutions numerically, applying simulation.

This paper establishes two optimization models of excess-of-loss reinsurance contract against catastrophic losses to determine optimal premium and retention. One model considers the sum of the expected utilities of a ceding company and a reinsurance company's expected utility; another considers the product of them. With an example, the authors find the optimal solutions of premium and retention of excess loss reinsurance. Finally, the authors carry out the sensitivity analysis. The results show that increasing the means and the volatilities of claim loss will increase the optimal retention and premium. For objective function I, increasing the coefficients of risk aversion of or reducing the coefficients of risk aversion of will make the optimal retention reduced but the optimal premium increased, and vice versa. However, for objective function 2, the change of coefficient of risk aversion has no effect on optimal solutions.

Utility of the two partners: The ceding company and the reinsurance company, may have different weights and different significance. The authors have not studied their relative significance. The simulation approach in numerical methods limits us to the probability distributions and stochastic processes the authors use, based on, generally speaking, lognormal models of rates of return. This may need to be generalized to other returns, including possible models of shocks through jump processes.

In the recent two decades, reinsurance companies have played a great role in hedging mega-catastrophic losses. For example, reinsurance companies (and special loss sharing arrangements) paid as much as two-thirds of the insured losses for the September 11, 2001 tragedy. Furthermore, large catastrophic events have increased the role of governments and regulators as reinsurers of last resort. The authors hope that the authors provide guidance for possible balancing of the needs of two counterparties to reinsurance contracts.

Nearly all governments around the world are engaged in regulation of insurance and reinsurance, and some are reinsurers themselves. The authors provide guidance for them in these activities.

The authors believe this paper to be a completely new and original contribution in the area, by providing models for balancing the utility to the ceding insurance company and the reinsurance company.

我們探討分出公司和再保險公司在再保險合約的設計上、如何能達至互利互惠。研究確立了兩個目標函數，分別為把分出公司和再保險公司兩者之預期效用的總和最大化，以及把它們的產品最佳化。第一個目標函數是加法的，強調兩個參與方的總增益;而第二個目標函數則是乘法的，這個目標函數，闡釋參與方因另一方虧損而有所收益之取代度。再保險的最佳價格和自留額是利用網格搜索法找出的，數值分析也予以進行。研究結果顯示，兩個目標函數的最佳解決方案甚為不同。唯最佳解決方案會對就這兩個目標函數而言的追討損失的波動、以及其平均值之改變產生敏感反應。研究結果將會見其價值於作為在萬不得已的時候的再保險人的保險業規管機構和政府實體。

在這學術論文裡，我們採用了相對簡單、但我們認為是重要的方法和模型，來探討超額賠款再保險策略的優化課題。我們只考慮虧損分佈對最佳自留額和再保險價格的影響，而不去檢視投資因素。我們亦考慮對分出公司和再保險公司兩者的利益，來釐定最佳保費和再保險的自留額，而這兩者則共同建基於把社會效益最大化之上：再保險公司和分出公司的預期效益的總和 (或其積數) 。 我們採用類比模仿方法、來解決尋求在數字上最佳解決方案的問題。

本研究建立了就應對嚴重虧損而設的兩個超額賠款再保險合約的優化模型，來釐定最佳的保費和自留額。其中一個模型考慮了分出公司和再保險公司兩者各自的預期效益的總和。另外的一個模型則考慮了兩者的預期效益的積數。透過例子，我們找到了保費和超額虧損再保險自留額的最佳解決方案。最後，我們進行了敏感度分析。研究結果顯示、若增加追討損失的平均值和波動，則最佳自留額和保費也會隨之而增加。就第一個目標函數而言，若增加風險規避係數、或減少這個係數，則最佳自留額會隨之而減少，但最佳保費卻會隨之而增加，反之亦然。唯就第二個目標函數而言，風險規避係數的改變，對最佳解決方案是沒有影響的。

• – 有關的兩個夥伴之效用性：分出公司和再保險公司或有不同的份量和重要性。我們沒有探討兩者的相對重要性。

• – 我們以數值方法為核心的類比模仿研究法、使我們局限於機率分配和一般而言建基於投資報酬率對數常態模型之隨機過程的使用。我們或許需要調節研究法。以能概括其它回報收益，包括透過跳躍過程而可能達至之沖擊模型。

– 有關的兩個夥伴之效用性：分出公司和再保險公司或有不同的份量和重要性。我們沒有探討兩者的相對重要性。

– 我們以數值方法為核心的類比模仿研究法、使我們局限於機率分配和一般而言建基於投資報酬率對數常態模型之隨機過程的使用。我們或許需要調節研究法。以能概括其它回報收益，包括透過跳躍過程而可能達至之沖擊模型。

在過去20年裡，再保險公司在控制極嚴重災難性的損失上曾扮演重要的角色。例如、再保險公司 (以及特殊的損失分擔安排) 為了2001年9月11日的災難事件而支付多至保險損失的三分之二的費用。而且，重大的災難性事件使政府及作為最後出路再保險人的調控者得扮演更重要的角色。我們希望研究結果能為再保險合約兩對手提供指導，以平衡雙方的需要。

全球差不多每個政府都參與保險和再保險的管理工作，有部份更加本身就是再保險人。研究結果為他們的管理工作提供了指導。

我們相信本學術論文、提供了平衡分出保險公司和再保險公司效用性的模型，就此而言，本論文在相關的領域上作出了全新和獨創性的貢獻。