Essays on Insurer

Interview with a pharmacist

Interview:

Apparently, over the counter medications are those that can be sold to the client without necessarily having any prescription by the provider. The Food and Drug Administration has been at the forefront in monitoring the adherence to issues of over the counter medications so that pharmacists do not sell other medications not classified as OTC. Similarly, the FDA has over time made changes and reviews on the regulations and rules that guide OTC medication sales (West, Wilk, Rae, Muszynski, Stipec, Alter & Regier, 2015). One of the emerging issues that have affected the pharmacists is the introduction of a ...

Introduction

Natural law theory and positivism are two approaches to thinking that differ in the basic legal principles and rules on the treatment of law. Principles and rules influence English jurisprudence and the administration of justice through the attitudes, perspectives, approaches, decisions and pronouncements of judges and jurists. Natural law theory and positivism dominate respective areas of English jurisprudence and adjudication process, but these approaches may also simultaneously exert influence to raise issues and cause developments in other areas.

Influence of Natural Law Theory

Natural law is “the order of the dynamic tendencies that are proper to man as a rational being”. The rule of ...

Abstract

In healthcare financial management, health insurance contributes in determining the healthcare services. The fee schedule provides a list of charges reimbursed for service providers and suppliers. Center for Medicare services, CMS, uses the fee schedule to determine the facilities and non-facility in healthcare provisions. Physicians, ambulance and medical equipment services among others help in the determination of the fee schedule by Medicare Physician Fee Structure (MPFS). The study focuses on CPT code 99214-office visit as the reference in the service delivery by the center of Medicare services. The Medicare and Medicaid rates are essential in determination the fee schedule. ...

[U.S Healthcare Systems HSC 301 02 - Online]

Healthcare Reflection Paper

The documentary shows countries throughout the world that have extensive medical coverage for all citizens at lower prices than what a typical U.S citizen would pay. The documentary shows that the U.S could fix their healthcare system if it could take the technology and services offered by some countries while reforming the insurance industry. The U.S has a user pay, market dominated system in which citizens are concerned about their privacy so adopting some of the best features of health care system from around the world may be difficult. Most governments ...

Abstract

The healthcare systems comprise of many services that can lead to the successful delivery of treatment to the patients. Patients can receive their treatment and then the member or the hospital can contact the third party payer to reimburse them. There are numerous reimbursement methods and clients chose one that they. The methods include; the Value-Based Purchasing Medical Reimbursement, pay for performance, fee-for- service and episode-of-care payment. Each method has both its advantages and disadvantages to either the patient or the hospital. An acute care hospital which provides quality treatment to the patients within a short period utilizes the ...

There are many types of insurance that are available nowadays. Most of the, however, are reduced to following ones: life, health, auto (vehicle), deposit, property, etc. insurances. (Kunreuther,1996, pp. 35-62 ) The choice you make about insuring something is doubtlessly an exceedingly important choice of your life – what does it depend on? First off, it depends on the financial situation you find yourself in, possessions you have and risks that you might face. In the present assignment we are to analyze the financial situation of Sally Chan, a Senior Creative Director, living in Malaysia and on the basis of ...

Introduction

Throughout this discussion, we will analyze the history of life insurance companies, any major events which impacted the life insurance industry, including the Great Recession of 2007 which lasted for two years, rules or regulations proposed by Congress that govern the present operation of life insurance companies, including any changes of insurance laws, the current Presidential candidates plan on implementing for the life insurance industry and future expectations of the operational life insurance environment.

History

The life insurance industry began in the ancient city of Rome around 100 B.C. The Roman militant leader named Caius Marius, had created a certain ...

Abstract

This paper explores various published articles that address employee insurance programs available for employees in an organization, particularly in the United States. The article discusses different aspects life insurance and disability so that when they are evaluated collectively, they create a rational analysis of the subject of the research. Hasman et al. (2004) explain the current employee insurance situation in the country. Martoccio (2010) and Fronstin (2007) provide a detailed discussion of employee benefits. The discussion available in these two sources tends to create several categories of both life insurance and disability insurance, describing how offering such plans may ...

Health insurance is insurance that provides a payment in the form of benefits if a person receives an injury or becomes sick. It includes money for any losses that a person might have from an accident, medical expense, disability, or accidental death. There are two main forms of insurance providers that include the government and an insurance company. The insurer will estimate the overall risk of the expenses related to health care among the individual or group. This is the best way for the insurer to create a finance structure like the premium that the person would pay each ...

Abstract

Health Insurance is a form of insurance where an individual is insured against the risk of paying medical expenses in case they are in need of various types of medical care. Health insurance may not appear beneficial especially when a person stays for many years without becoming sick or requiring any medical care attention. However, it is clear that health insurance is necessary for every individual as it comes with numerous benefits. These benefits include protection from running into a financial ruin, access to preventive and primary care services, access to follow-up care services, eligibility to options for offsetting ...

Insurance

The term risk management refers to a plan based business that is targeted towards identifying, assessing and prioritizing of the risk of different kinds, that may interfere or that may affect an individual or organization in an unwanted way. Therefore, once the individual or the organization identifies the risk to which they are exposed, they follow a suitable risk management plan to minimize the impact of such unwanted events from their life.

Importance of Risk Management

Important to note, be it an individual or an entity, everyone is more or less exposed to some sort of risk owing to dynamic nature of our ...

Financial Institution Supervision: Insurance Companies

Introduction Insurance, in the simplest terms, means a transference of risk from the insured to the insurer. Around the world, individuals, families and businesses take advantage of the provisions of insurance so as to protect the possibilities of catastrophic losses that could occur due to loss of life or failure of a business. Over a period of time, the insurance industry has matured to throw up a multitude of products, and has grown into a multibillion-dollar industry. The management of risk is the key to the operations of the insurance industry. While insurance agencies have necessary internal checks and ...

The Patient Protection and Affordable Care Act (PPACA) became a federal statute in March of 2010 (H. R. 3590, 2010). The PPACA required that group health plans and health insurance issuers cover all applicants for health insurance without regard to pre-existing conditions or sex of the applicant. Dependent insurance is required to cover uninsured children up to the age of 26. The PPACA further required that group health plans and health insurance issuers provide a stipulated minimum standard benefit at the same rates for everyone. Subsidies were available for eligible individuals, small business, and families. Government subsidies were made ...

Reflection Paper

The concept of insurance may have started a long time ago through informal risk sharing practices. Modern insurance is a more recent development that began in the 16th Century. However, the impact and the essence of insurance only became of interest to the financial market over 100 years ago and it has grown to be an immense international business. The insurance theory is applied in a number of ways including the Affordable Health Care Act, compensation of workers, liability, and property. The insurance theory also has a wide array of functions in claims administration, underwriting, marketing and in companies ...

Insurable interest

Jeff had an insurable interest in the building at the time of the loss. Jeff owns the building and stores its inventory as well as operating a restaurant in the building. When fire destroyed the building, Jeff suffers a financial loss including the loss of revenue from the restaurant business. Therefore, he has an insurable interest in the building. Richard does not have an insurable interest in the building at the time of the loss. A person can only have an insurable interest in a property if the loss or damage to the property results in a financial loss ...

Critically Discuss Whether Life Insurance Should Be Perceived as a Luxury or Need In The Context of the Evolving Dependency Dynamic of the Modern Family.

Abstract

The purpose of this paper is to examine the primary purpose of life insurance as a financial product and to analyze what are the advantages and disadvantages of having life insurance. Some recent statistics were used to create a framework of why and how many people purchase this product and what are the determinants which influence their decisions. When discussing whether life insurance is a necessity or a luxury, the price is the important ...

Abstract

In this research paper our major focus is on employee cover and the benefits that accrue to the insurance cover. Further the data examines different health care issues and worker’s satisfaction with the treatment they get in health facilities today in building their future trust of the nation’s healthcare system. Medical care programs designed for these workers are also another factor to be discussed and its importance to the client to confirm their loyalty if they are fully functional and help their workers when need arises. If taxes on employees were to be increased some of the ...

Question 1: Ensuring compliant coding and billing

Adhering to accurate coding and billing processes is one of the most important elements in ensuring RCM coding and billing compliance. A critical process that can be used to ensure RCM practices comply with coding and billing regulatory guidance and industry standards is regular monitoring and auditing of medical claims before submission for payments such as the ICD-10 standards (CureMD, 2016; Kochhar, n.d.). Frequent request follow-up and verification activities improve and strengthen the overall coding and billing processes of a firm by helping ensure that all the necessary right safeguards are in place to avoid errors (MetricStream Inc., 2016). ...

Management Perspectives

The following Case Study will deal with QBE Insurance, revealing and discussing its organizational structure, strategies, role and legitimacy of management and also about the role of ethics and ethical practices. QBE Insurance is one of the biggest insurance companies in the world with headquarter in Sydney. It works in all main insurance markets with general number of employers 14 500 people in 37 countries of the world. The company is listed in top 20’s largest insurance and reinsurance companies of the world. The major strategy of the company is that how they define it, to bring really ...

Indeed creditors of a corporate cannot claim the assets of a company’s shareholders should the company become insolvent. This is contrasted to the situation regarding a sole proprietorship in which the creditors are allowed by the law to put claim on the property of the sole proprietor in case the assets of the business are not sufficient to cater of all of the creditor’s claims. Indeed, it is fair for the shareholders of a company to have a limited liability and for the owner of a sole proprietorship to have an unlimited liability. A shareholder with unlimited liability is one whose personal property ...

Consumer Driven Health Plans (CDHPs) are medical insurance plans which allow a person to pay for certain medical services directly, rather than pay premiums to the insurer, who in turn caters for the expenses. Basically they save the consumer from paying high premiums in a comprehensive health insurance cover (Eagle et.al., 2009). The consumer is given the option of selecting which service to pay for based on their needs (Balser Group, 2013). High Deductable Health Plans on the other hand attract low premiums but the consumer has to bare more out of pocket expenses than in conventional health insurance policies (McKenzie ...

Insurance company

As of February 14, 2014, U.S. insurance company AIG intended to cut 3% employees worldwide, according to Financial Times. On Thursday, the company announced that the severance pay for 1500 is $ 265 million, thus, AIG continues to reorganize its business. As of April 10, 2014, AIG had some problems with underwriting profits, nevertheless, despite several problems in the past the company shows some improvements. Smart investors are focusing on the business and the actions of management: by making unpopular moves today, AIG is taking a long-term bet that a simplified, streamlined company down the road will be much more profitable ...

1. What is the role of congress in policy making process? A policy is defined as a course of action that is established by the legislature, executive or the judiciary to influence the behaviors and decisions of the citizens in a federal state. Policy making process is not a monopolized affair and, therefore, involves decisive interactions among all arms of the government and the public participation. The congress and the President participate mutually in the legislative roles to a greater extent. However, their roles are made distinct at some point. The Congress is mandated in Law making, representation of the citizens as ...

Introduction

Automobile liability insurance is generally a mandatory practice in most of the countries of the world including the United States. There are four major categories of car insurance, which include tort liability, choice no-fault, add-on, and no-fault insurance. The major differences in these car insurance types include availability of restrictions on the right to sue and if the policy holder’s insurer pays first party benefits, notwithstanding which driver was at fault for the occurrence of a motor vehicle accident. According to the Insurance Information Institute, the no fault insurance is usually intended to lower the cost of automobile insurance ...

The actual charge associated with profitable health advancement implementation can be disappointing. Middle managers employ a likely important however badly recognized position inside health advancement implementation. Health care, in the US undoubtedly, is suffering along with wanting assist. Indeed, hospital treatment has produced unbelievable innovations in the past. The actual well-known problems range between professional medical glitches, which in turn through a few company accounts are the ninth primary cause of dying in the states, for the soaring charge associated with health. Just how much used right now presents in relation to one-sixth of the U.S. gross domestic merchandise; it continues ...

Introduction

Ideally, the survey was conducted in California, Unites States for the two months: November and December 2013. The total number of respondents was 24 people: 12 males and 12 females were selected. This was from all age brackets; that is 16 - over 65, in the following order: 3 males and 2 females in age bracket 16 - 25, 2 males and 3 females in age bracket 26 - 35, 3 males and 2 females in age bracket 36 - 55, 2 males and 3 females in age bracket 56 – 65, and 2 males and 2 females in ages ...

INSURANCE FRAUD

EXECUTIVE SUMMARY Insurance fraud is the term used for explaining the misrepresentation that the individuals or a group of people make so that they can avail more benefits from the insurance companies to which they are actually not entitled too. The transparency in the representation is important for securing the rights and overburdening the company from the claims which have actually not taken place. The insurance companies take different measures for protecting the rights and ensuring that they are protected from the insurance fraud. For this the rules and regulations are implemented using which they sometimes protect themselves from ...

The concept of disaster bonds: Overview of catastrophe bonds

Capital markets experience a number of risks that cause investors huge sums of cash. Catastrophe bonds (cat bonds) are a form of principal-at-risk debt securities issued by insurance companies to investors that allow direct transfer of low-frequency, high-sensitivity risk to capital markets. Traditionally, debt securities only allowed insurance companies to repay full principal amount upon maturity of the bond. The introduction of catastrophe bonds solved this situation. Upon the occurrence of one or more catastrophe event, the outstanding principal of the insured reduces. Examples of catastrophe events covered by this bond include natural disasters (earthquakes, hurricane), deaths caused by an outbreak ...

THE HEALTH CARE MARKET

Qn 1 Access to health care services varies from state to state. In the U.S, healthcare services have tremendously evolved from a predominantly volunteer or charitable system where patients paid little or no money at all to business entities (Ameringer, 2008). The healthcare industry is now one of the largest industry employing over 13 million workers with a projection to increase by 5 million by 2015. According to Ameringer, its very unfortunate that the health system problems lie with delivery system that drives low quality and inefficient care in a country filled with latest technological advancements and skilled health care professionals. ...

- The market of new patented drugs does not have price takers as is present in perfect competition. The companies that make the braded drugs are price makers. The consumers have to buy the specific drugs from them because there are no other manufacturers of the same. The market is characterized by barriers to entry. This is because the manufacturers have to develop, brand their products, apply for patents and meet many other regulations. The patent drugs market does not operate on perfect information. Information failure and time lags during communication are characteristic features. - The consumer’s ...

- Evaluation of a drug label including patient reported outcomes (Limit 2 pages)The evaluation of the PRO will include the following information:a) Company, generic, brand name and therapeutic class of the product

Brand name: HUMIRA

Generic name: adalimumab Therapeutic class of the product: Antirheumatic b) AHFS or other Drug Classification

AHFS: 92.00

c) FDA Approved Indication

Humira got FDA approval in the year 2002

e) Identity the type of studies that were conducted by the pharmaceutical company to support the PRO claims. e.1. Trial design, randomization and blinding procedures Ans: Mostly randomised clinical trials were designed to learn about the effects of Humira. Blinding was not performed to all ...

ABSTRACT

This paper gives a comprehensive focus on risk management as an important tool for project management. Every project has its risk and, therefore, there is no way they can be avoided but mitigation measures can be incorporated when these risks are identified early enough. This paper gives a justification why risk management is a critical success factor for a project. It gives a discussion of the process involved in risk management, including risk planning and management, risk identification, qualitative risk analysis, quantitative risk analysis, and risk response planning. In addition, it provides more information to the project managers on good practice to ensure effective ...

Following the American Psychological Association’s Guidelines

Educational Institution CAR TRACKING DEVICES AND THE EFFECT ON car insurance PREMIUMS Introduction Insurance is an agreement where the insurer (company) agrees to pay to the policyholder (individual or company) a certain amount to compensate for loss in the event of the occurrence of an uncertain event (Feldman and Brown, 2005). Insurance coverage transfers the risk of loss from an event occurring in exchange for the payment of a fixed amount of money called the insurance premium. Risk recognition is a factor in determining the amount of premiums that would be paid by the policyholder. Premium computation takes into ...

Q. 6 The official is exercising discretionary power. As a representative of an agency, the official has the discretion to decide which cases would progress to the prosecution stage and which ones will not. However, in exercise of this power, the official must be guided by certain rules and precedents and for him to recommend that the brother-in-law’s case do proceed to trial then the case must meet the required threshold. The fact that in the ordinary sense the case would not have proceeded to trial means that the official is biased towards the brother-in-law for the reason ...

As a fundamental of contemporary society, law is crucial in enabling society coexist and interact in an orderly manner. The case in study suggests a typical case scenario where an official happens to be related to a potential case defendant, abate on current bitter terms. This may be a reason for the official’s procedure to prosecute the brother-in-law, bringing about the issue of discretion. It is present when an agency has two or more alternatives, to a given case, with regard to case proceedings and prosecution. In this case under study, it may hold true or not that the official’s brother-in-law is ...

Introduction

Risk and risk factors are some of the threatening entities of a functioning firm or company. The risk-management process involves the systematic application of management policies and practices as well as procedures, with the intention of establishing a context of communication and consultation with relevant stakeholders. The treatment, monitoring, and reviewing of risks also comprises of identification, analysis, and evaluation. A risk is the possibility of a loss or other adverse event that has the potential to interfere with an organization’s or individual’s ability to fulfill its or his/her objectives. Risk identification ensures that an organization or the individual identifies ...

The business sector is increasingly competitive: competition between the consumer and the service provider. In order to make profits, companies engage in numerous strategic planning and information sourcing. On the other hand, consumers compete with service providers in information sourcing in order to make favorable decisions. The insurance sector portrays its competitive nature through their methods of information asymmetry. My essay is to point out the key economical issues related to asymmetry of information in the insurance sector. All of the key issues related to the insurance trade, including the assessments of compensations for damages. Like in ...

Every country in the world is involved in the process of globalization. As a result, technologies became very important in everyone’s life. No one can image his/her day without mobile phones, the Internet, social networks or other devices. For sure, this made a great impact on the way people communicate with each other today. No doubt, technologies led to the decline in face-to-face communication, especially, in business, as now many deals can be negotiated on the Internet. The same situation was in the Dutch large insurer, Achmea NV, which is going to cut 4,000 jobs in the nearest ...

Introduction

Risk and risk factors are the cornerstones of a functioning firm or company. The risk-management process involves the systematic application of management policies and practices as well as procedures, with the intention of establishing a context of communication and consultation with relevant stakeholders. The treatment, monitoring, and reviewing of risks also comprises identification, analysis, and evaluation. Consider a scenario where a top company employs a new CEO and one of her first decisions is to ensure that safety is a major priority. Twoof the new rules being established state that all employees are required to use safety gear while in the manufacturing department of the ...

Introduction

There has been an increase in the demand for security. Nowadays, a sense of security may be considered as the next basic goal after the basic items which include food, shelter and clothing. Majority of the people requires economic and health security. A person with economic security will be able to satisfy the basic needs in the present and future. Economic risk refers to the probability of losing economic security. Historically, economic risk was managed through making informational agreements between the parties concerned. The insurer would compensate the injured party. The pooling concept was later formalized in the insurance industry. ...

Introduction

Trade was one of the most important economic activities of the ancient civilization. Initially trade was mainly conducted on land .As the scope of the activity expanded with time, another mode of transportation; water transport started to become gradually important and started to attract the attention of commercial enterprises. As this mode of transport became more important, there arose a need for the formulation of insurance scheme to protect the water vessels, the passengers, and cargo for the various risks that they faced in this transport mode. Marine insurance is therefore one of the oldest forms of insurance that has ...

Houston Insurance Holdings is a leading specialty insurer based in Texas, USA. However, its scope of operation extends beyond the United States of America and has offices in the United Kingdom, Spain and Ireland. The insurance company underwrites 100 classes of specialty insurance products in 180 countries around the world. The company has five underwriting segments namely: Professional liability, U.S Property Casualty, Accident and Health and U.S Surety and Credit International. The firm engages in the diverse business portfolio in order to ensure consistent underwriting results irrespective of the market cycles. This has contributed to an impressive performance of ...

Business Law Case Analysis

FACTS Green initiated a construction plan of thirty four homes in lee on March of 2004. The homes were to be known as Thurston Woods. In order to construct chimneys for the homes, Green signed a contract with Birch Masonry; experts in chimney constructions. Middlesex Mutual insured all construction works done by Birch Masonry thus assuming liability in case of any liabilities as stipulated in the contract signed between Birch Masonry and their clients. Therefore, in order to do business with Green, Birch ordered their insurer to add Green to the policy as an additional named insured. Mutual complied with ...

Insurance refers to contract entered between two parties where one party obligates to compensate the other for a particular loss or damage. The agreement put forward usually has considerations which are in the form of regular payments. Parties involved in the contract process include insurer and insured. Insurer, usually a company, is a party that provides insurance cover to another party and provides protection for any loss that may occur in the future. Alternatively, the insured is the party that seeks protection from the insurer. Therefore, the insured agrees to pay a certain amount of money for protection against risks. This amount paid ...

It is prudent to begin by saying that Conoco Philips is an oil group that is organised around four areas of activities. The areas include refining and distribution (taking about 76.2% of net sales. Secondly, hydrocarbon exploration and production (taking about 20.2%), thirdly, processing and distribution of a gas (3.5%) and others taking 0.1%. this corporation is considered the world’s largest independent exploration and production company that is based on reserves and the production of natural gas and the liquid. His headquarters are based in Texas, Houston and it has operations in more than thirty countries. Bond issue ...

Introduction

Health insurance is a form of insurance cover that caters for surgical and medical expenses that are incurred by the insured. Health insurance can either pay the care provider directly or reimburse the insured for expenses incurred from injury or illness. Some employers use it as a non-monetary benefit package to attract highly qualified employees. There are various types of health insurance plans. Nevertheless, all plans are expected to offer a minimum level of coverage. Some plans are comprehensive implying that they provide a variety of services. The coverage offered could be dental coverage, maternity coverage and prescription drug coverage. The various types ...

The AT&T organization is one of the leading data communication firm in the entire world providing the people in the American North location with the appropriate means of communication. For several years, the AT&T firm is recognized as the leading telecommunication service provider to the expected human population. Commencing at a low-level status in the 1980s the telecommunication organization has improved in various ways and projects through the 1990s to the current innovations (Gnanasivam 97). The AT&T organization is considered as one of the leading communication firm in the world today. This is because of the diversification of the readily ...

Health Management: The Canadian Perspective

There is one issue in Canada that tends to prevail more than any other Canadian public policy debate which is the issue of health care and health care delivery. This paper seeks to explain the various features of the Canadian health care system, the range of problems that have to be addressed in the system and the most prominent proposed ways of dealing with the problems in the industry. The Canadian health care industry was the second largest employer in the country exactly three years ago. The industry, having employed two million people, is paramount to the economic development ...

Law of Demand and supply

Introduction In economics, the law of demand and supply is one of the essential theories governing an economy. The theory of demand and supply determines price, accessibility, and the demand for a given service or product. Demand definition is the willingness of consumers to purchase a certain good or service in the market. The cost of the service or good reflects the consumer’s buying decision. The demand for an item is high when its price is lower than other supplementary goods. The curve of demand theory slopes downward due to the inverse relationship.

Alternatively, supply is the willingness of a ...

Introduction

In any market condition, information plays a critical role in structuring the demand and supply forces. All other things being constant, perfect and complete information to both buyers and sellers ensures that price determination takes place at a point that provides maximum benefit to the society as a whole. In such cases, the buyers or the sellers cannot influence the price. This scenario ensures equitable distribution of benefits to everyone in the society. However, perfect information is a characteristic of an ideal perfect market alone. It is not experienced in real life scenarios. Information asymmetry is a common phenomenon in the real life imperfect ...

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Life Insurance Introduction Insurance is a means to manage the risk of financial losses incurred due to unforeseen events and contingencies. Unforeseen events can be in the form of accident, illness, fire outbreak or loss of life. These incidents are not only emotionally stressfully, but also financially draining. Insurance is critical for protection of the latter. Primarily, there are three components of an insurance agreement, the insurer, the insured and the policy holder. In case of a life insurance policy, the insured and the policy holder are usually the same person. For a home insurance policy, home is insured and ...

Introduction

Being prepared for any possibility and take preventive measures is the need of the hour to avoid any untoward situation in life. But, prevention is always better than cure for the treatment of any situational ailment. Such kind of happening could be meeting with minor or major accident or incident. As any untoward happening is an external phenomena which is beyond the control of anyone. Also, it is known what will happen next and to whom. In this context, taking safety precautions and adopting safety measures is the only way to take on the challenges of any unfortunate ...

Part A

It is important to note that electric fire is fatal and its outbreak must be followed by emergency evacuation process. For a big building accommodating a lot of people, the evacuation procedures should be well planned so that greater number of people are saved from being engulfed by the fire. Planning entails coming up with procedures that would enable greater number of people exposed to the risk to be saved. It is the role of the principal contractor to ensure that the workplace is safe. This means that the principal contractor has to plan for the provision of amenities. The contactor ...