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Orientation: The South African Insurance Act 18 of 2017 became effective on 01 July 2018 as part of the new Twin Peaks regulatory system. The often stated reason for the new regulatory regime is the 2008 global financial crisis. Regulatory changes in the local environment took place during two distinct periods in history following the Sharpeville and Soweto uprisings in 1960 and 1976. International sanctions combined with an outflow of capital ultimately saw government amending the regulatory framework through new ownership requirements for all insurers in order to secure funds locally. Research purpose: The purpose of this research was to explain how the contextual dynamics impacted regulatory responses, and what was the subsequent effect on the short-term insurance industry. Motivation for the study: The motivation for the study was to explain and understand market dynamics following the regulatory tightening of the insurance industry within a historical framework. Research approach/design and method: This article provides an empirical analysis of how regulatory intervention transformed market characteristics and thus contributed to an understanding of the localisation of a financial industry, namely the short-term insurance industry. This was achieved through a description of the regulation, including the exploration of possible consequences at the time of two major events in history. Main findings: In both cases the findings were that the market size contracted, corrected and expanded within a few years. Practical/managerial implications: This article provides a practical analysis of local industry performance in an environment of legislative changes which may assist managers in a regulated industry. Contribution/value-add: The contribution is an industry analysis over an extended time frame which may add value in the adoption of similar domestication policies in the rest of Africa.

The article examines the investment potential of insurance companies as a factor in stabilizing the country’s financial system. The main focus is on analyzing the regulatory requirements in the European Union and the possibilities for their implementation in the insurance market of Ukraine. Insurance companies, especially those engaged in life insurance, are traditionally regarded as powerful institutional investors with substantial financial resources and the ability to undertake long-term investments in the real sector of the economy. It is has been determined that EU insurers invest in the real sector by purchasing corporate bonds, with their share in the structure of their investment portfolios accounting for approximately 25 percent (excluding investments in collective investment companies). In the investment portfolios of European insurance companies, government securities constitute the largest share, while the share of stocks is noticeably low. In Ukraine, both investments in stocks and investments in corporate bonds occupy negligible portions of insurers’ investments. It is underscored that regulatory requirements may act as one of the factors shaping an insurer’s investment strategy. In European Union countries, regulatory requirements for calculating solvency capital are defined in Directive 2009/138/EC (Solvency II) and Regulation (EU) No. 2015/35. The market risk module, as part of solvency capital, includes such risk sub-modules as interest rate risk, equity risk, spread risk, property risk, currency risk, and market concentration risk. The article notes that the European Commission has introduced a number of innovations related to the modification of certain solvency capital requirements in order to encourage insurers to invest into the real sector of the economy. In particular, they concerned the reduction of solvency capital requirement levels for investments such as investments in infrastructure projects; investments in unlisted equity; long-term equity investments. The article provides an assessment of the efficiency of such innovations. It is concluded that the experience of implementing such innovations may be relevant for implementation in Ukraine, considering that by 2027, some Ukrainian insurance companies will calculate their solvency capital according to rules harmonized with Solvency II.

The article substantiates the key importance of ensuring economic security in the insurance market in the context of addressing tasks for strengthening stability and ensuring its sustainable operation and activating development. By using a comprehensive approach to the mechanisms of ensuring economic security in the insurance market, the institutional, financial-economic, organizational-management, informational-analytical, and social-communication aspects are included. The substantive content, tools of influence, and relevant objects of regulation are revealed, allowing for a holistic understanding of the mechanisms for ensuring economic security in the insurance market. Emphasis is placed on providing regulatory and legal support for insurance operations, financial sustainability and transparency of the activities of insurance market participants, improving the quality of internal management of insurance companies, developing digital technologies, actuarial and analytical support, as well as strengthening trust in insurance from the public and businesses. It is noted that in terms of the institutional aspect, the mechanisms include insurance companies, insurance market intermediaries, regulatory bodies, and professional associations; in the financial-economic aspect – the assets of insurers, insurance reserves, insurance premiums, and payouts; in the organizational and managerial aspect – the governing bodies of insurance companies, internal control services, underwriting operations, audits, and the human resource potential of the industry; in the informational-analytical aspect – financial and statistical reporting, information flows, databases, analytics, and actuarial calculation systems; in the social-communication aspect – interaction with policyholders, the public, target consumer groups, and the media. It is determned that the effectiveness of mechanisms ensuring the economic security of the insurance market is confirmed by their ability to increase the resilience and transparency of market relations, strengthen the trust of market participants, and promote the stable development of the insurance industry.

The article applies a scientific-methodical approach to the taxation of insurers' incomes in order to achieve an optimal balance between the revenue base of the budget and the minimization of budget risks. Empirical measurement of relationships between the financial results of insurers and tax regulation of their activities using economic models and mathematical apparatus made it possible to develop the latest financial decision-making tools based on the Census II method. These tools contribute to the formation of the tax base (income after insurance activities) from the point of view of minimizing the impact of budgetary risks on the level of state budget revenues. The foundation of the developed scientific-methodological approach is the algorithm of actions for determining the actual deviation of the tax base from the calculated trend cycle. This allows us to minimize the risk of not receiving budget revenues and create multiple scenarios of resilience to the influence of external factors.The proposed approach makes it possible to produce alternative financial decisions regarding the choice of the taxation mechanism of domestic insurers in order to minimize budgetary risks. The practical significance of the obtained results is revealed in the developing theoretical and methodological provisions and outlined methodological approaches in practical activities, which justify the optimal choice of the tax base of insurance companies with the lowest level of variability, taking into account the influence of exogenous processes in a dynamic market background. This will form prerogatives to minimize the risk of not receiving budget revenues. It has been empirically proven that the specified scientific-methodical approach will contribute to the optimization of the insurance business taxation process, ensuring a balance between the interests of the state and all participants in this market.

Health insurers' role in healthcare systems based on managed competition comprises various tasks. Misconceptions about these tasks may result in low public trust, which may hamper health insurers in performing their tasks. This study examines the relationship between enrollees' perceptions of health insurers' tasks and their trust in them. A questionnaire in November 2021 asked respondents to indicate to what extent health insurers have to perform certain tasks, whether they actually perform them, and whether they think these tasks are important. Trust was measured using a validated multiple-item scale. The results from 837 respondents (56 per cent response rate) were analysed using multivariate regression models. A larger mismatch between enrollees' expectations about health insurers' tasks and their actual statutory tasks is related to less trust regarding the categories 'controlling healthcare costs' and 'mediation and quality of care'. Second, a larger mismatch between expectations and actually performed tasks is related to less trust for all categories. Importance of tasks only affects this relationship concerning 'informing about price and availability of care'. This study emphasises the importance of reducing enrollees' misconceptions as trust in health insurers is necessary to fulfil their role as purchaser of care.

The impact of insurer competition on welfare, negotiated provider prices, and premiums in the U.S. private health care industry is theoretically ambiguous. Reduced competition may increase the premiums charged by insurers and their payments made to hospitals. However, it may also strengthen insurers' bargaining leverage when negotiating with hospitals, thereby generating offsetting cost decreases. To understand and measure this trade-off, we estimate a model of employer-insurer and hospitalinsurer bargaining over premiums and reimbursements, household demand for insurance, and individual demand for hospitals using detailed California admissions, claims, and enrollment data. We simulate the removal of both large and small insurers from consumers' choice sets. Although consumer welfare decreases and premiums typically increase, we find that premiums can fall upon the removal of a small insurer if an employer imposes effective premium constraints through negotiations with the remaining insurers. We also document substantial heterogeneity in hospital price adjustments upon the removal of an insurer, with renegotiated price increases and decreases of as much as 10% across markets.

In health care systems based upon the principles of managed competition, health insurers are expected to act as prudent buyers of care. Consumers are expected to switch between insurers based upon the performance of insurers in this role. Yet, the Dutch experience shows that trust of consumers in health insurers is low and that switching consumers focus primarily on price. The question arises if consumers do in fact perceive and trust insurers as prudent buyers of care. We addressed this question by using a mixed-method approach. The results show that most people know that insurers buy health care and feel that the purchasing tasks suit their role. They even have reasonable, though fragile, trust in the purchasing competencies of the insurer. However, the results also revealed that consumers have insufficient information to cast a judgement about insurers as purchasers and incorrectly think that insurers are commercial organisations. Hence, improving the public information about insurers and their purchasing role seems to be crucial. Given the inherent complexity in the system, it remains to be seen if this objective can be reached in the (near) future. For that reason, policymakers should also consider additional measures to encourage that insurers will take integral purchasing responsibility.

Because of its importance to both policyholders and insurers, the duty to defend has been - and continues to be - extensively litigated.This book analyzes key aspects of the duty to defend in a practical fashion.It is a day-to-day resource for lawyers for both insurers and policyholders, as well as for courts.

This book shows how environmentalists have shaped the world's largest multilateral development lender, investment financier and political risk insurer to take up sustainable development. It challenges an emerging consensus over international organisational change to argue that international organisations (IOs) are influenced by their social structure and may change their practices to reflect previously antithetical norms such as sustainable development. The text locates sources of organisational change with environmentalists, thus demonstrating the ways in which non-state actors can effect change within large intergovernmental organisations through socialisation. It combines an account of international organisational change with detailed empirical evidence of change in one issue area across three institutions.

Background Policymakers have embraced substitution of hospital care to more affordable primary care as a means to contain rising healthcare costs and provide care closer to home. Health insurers play an important role in the extent to which substitution of care takes place. This study explores the perspective of Dutch health insurers on barriers and facilitators to facilitate a shift from hospitals to general practice in the current healthcare system. Methods Semi-structured group interviews were conducted with healthcare purchasers from various health insurers, involving fifteen participants from seven insurers representing 76.5% of the market. Thematic analysis was used to identify perceived facilitators and barriers for effective substitution of care. Results Long-term contracts that enable strategic planning and collaboration between general practices and hospitals, as well as strong organizational structures in general practice and long waiting times in hospitals are reported to facilitate substitution. Uncertainties around collaboration under the Competition Act, inadequate compensation through the risk equalization model, complex billing codes for innovative initiatives, a rigid national budgetary framework and strong bargaining power of hospitals as opposed to insurers and general practices are stated to hinder the shift towards general practice. Conclusions Key areas for improvement to facilitate substitution, as reported by healthcare purchasers, include clear guidelines on insurer collaboration, adjustments to the risk equalization model, strengthening the bargaining power of general practices, and promoting long-term contracts. This study provides insights into the perceived barriers and facilitators for care substitution from the payer’s perspective. Addressing these barriers is essential for facilitating the shift from hospital to general practice care. Also, potential discrepancies between perceptions and current regulations highlight areas where enhanced dialogue and collaboration between policy makers and health insurers could improve mutual understanding and regulatory compliance.