Long-term follow-up of whiplash injuries reported to insurance companies: a cohort study on patient-reported outcomes and impact of financial compensation.

PubMed

Rydman, Eric; Ponzer, Sari; Brisson, Rosa; Ottosson, Carin; Pettersson-Järnbert, Hans

2018-06-01

The long-term outcome of Whiplash-associated disorder (WADs) has been reported to be poor in populations from medical settings. However, no trials have investigated the long-term prognosis of patients from medico-legal environment. For this group, the "compensation hypothesis" suggests financial compensation being associated with worsened outcome. The aims of this study were to describe long-term (2-4 years) non-recovery rates in participants with WAD recruited from insurance companies and to investigate the association between self-reported non-recovery and financial compensation. 144 participants, reporting neck pain after a motor vehicle accident, were recruited from two major insurance companies in Sweden. Self-reported recovery was measured at 6 months and 2-4 years. Those who received financial compensation from an insurance company were compared with those who received no compensation. The overall non-recovery rate after 2-4 years was 55.9% (66/118). In the non-compensated group, the non-recovery rate was 51.0% (25/49) and in the compensated group 73% (27/37) (p = 0.039). Adjusted OR was 4.33 (1.37-13.66). High level of pain at baseline was a strong predictor of non-recovery [OR 46 (4.7-446.0)]. However, no association was found between pain level at baseline and financial compensation. The non-recovery rate among patients making insurance claims is high, especially among those receiving financial compensation even if causal relationship cannot be determined based on this study. However, lack of association between baseline level of pain and compensation supports the compensation hypothesis.

48 CFR 52.228-4 - Workers' Compensation and War-Hazard Insurance Overseas.

Code of Federal Regulations, 2010 CFR

2010-10-01

... War-Hazard Insurance Overseas. 52.228-4 Section 52.228-4 Federal Acquisition Regulations System... Text of Provisions and Clauses 52.228-4 Workers' Compensation and War-Hazard Insurance Overseas. As prescribed in 28.309(b), insert the following clause: Workers' Compensation and War-Hazard Insurance Overseas...

[Pesticide poisonings compensated by the INAIL in 1995-98].

PubMed

Germani, D; Forzato, G; Ossicini, A; Settimi, L

2001-01-01

The present paper describes agricultural pesticide-related accidents compensated by the Italian national institute for insurance of occupational accidents (INAIL) from January 1995 to December 1998. During the period under study, 643 accidents claims were examined by INAIL and 549 received compensation. The Italian regions with the highest number of compensation during the period under study were Puglia (no. 102), Sicily (no. 66), Emilia-Romagna (no. 61), and Veneto (no. 55). The national annual rate of pesticide-related accidents, estimated by dividing the number of cases receiving compensation by the number of insured agricultural workers was 12 per 100,000 per year. The regions with the highest rates were Puglia and Marche (27 per 100,000 per year), Liguria (22 per 100,000 per year), and Sicily (18 per 100,000 per year). Most of the cases (70%) occurred among male workers. The agents most frequently reported to have caused the accidents were fungicides (32.2%). For a relevant number of cases (34.2%) the exposure was not specified.

48 CFR 652.228-71 - Worker's Compensation Insurance (Defense Base Act)-Services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Insurance (Defense Base Act)-Services. 652.228-71 Section 652.228-71 Federal Acquisition Regulations System... Clauses 652.228-71 Worker's Compensation Insurance (Defense Base Act)—Services. As prescribed in 628.309-70(b), insert the following clause: Workers' Compensation Insurance (Defense Base Act)—Services (JUN...

48 CFR 652.228-71 - Worker's Compensation Insurance (Defense Base Act)-Services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Insurance (Defense Base Act)-Services. 652.228-71 Section 652.228-71 Federal Acquisition Regulations System... Clauses 652.228-71 Worker's Compensation Insurance (Defense Base Act)—Services. As prescribed in 628.309-70(b), insert the following clause: Workers' Compensation Insurance (Defense Base Act)—Services (JUN...

48 CFR 652.228-71 - Worker's Compensation Insurance (Defense Base Act)-Services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Insurance (Defense Base Act)-Services. 652.228-71 Section 652.228-71 Federal Acquisition Regulations System... Clauses 652.228-71 Worker's Compensation Insurance (Defense Base Act)—Services. As prescribed in 628.309-70(b), insert the following clause: Workers' Compensation Insurance (Defense Base Act)—Services (JUN...

48 CFR 652.228-71 - Worker's Compensation Insurance (Defense Base Act)-Services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Insurance (Defense Base Act)-Services. 652.228-71 Section 652.228-71 Federal Acquisition Regulations System... Clauses 652.228-71 Worker's Compensation Insurance (Defense Base Act)—Services. As prescribed in 628.309-70(b), insert the following clause: Workers' Compensation Insurance (Defense Base Act)—Services (JUN...

48 CFR 652.228-71 - Worker's Compensation Insurance (Defense Base Act)-Services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Insurance (Defense Base Act)-Services. 652.228-71 Section 652.228-71 Federal Acquisition Regulations System... Clauses 652.228-71 Worker's Compensation Insurance (Defense Base Act)—Services. As prescribed in 628.309-70(b), insert the following clause: Workers' Compensation Insurance (Defense Base Act)—Services (JUN...

48 CFR 728.309 - Contract clause for worker's compensation insurance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... INTERNATIONAL DEVELOPMENT GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 728.309 Contract clause... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Contract clause for worker... resulting in contracts which require worker's compensation insurance, USAID has contracted with an insurance...

48 CFR 728.309 - Contract clause for worker's compensation insurance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... INTERNATIONAL DEVELOPMENT GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 728.309 Contract clause... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Contract clause for worker... resulting in contracts which require worker's compensation insurance, USAID has contracted with an insurance...

48 CFR 628.305 - Overseas workers' compensation and war-hazard insurance.

Code of Federal Regulations, 2010 CFR

2010-10-01

...' compensation and war-hazard insurance. 628.305 Section 628.305 Federal Acquisition Regulations System...' compensation and war-hazard insurance. (b)(1) Acquisitions for services, including construction but excluding... employees and their beneficiaries for war-hazard injury, death, capture, or detention as prescribed by the...

48 CFR 1328.305 - Overseas workers' compensation and war-hazard insurance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Overseas workers' compensation and war-hazard insurance. 1328.305 Section 1328.305 Federal Acquisition Regulations System... workers' compensation and war-hazard insurance. The designee authorized to recommend a waiver to the...

The New Zealand accident compensation scheme.

PubMed

Barter, R W

1977-05-01

Reference is made to legislation concerned with the introduction of the New Zealand Accident Compensation Scheme in 1974. The author's experience of the Scheme is based on an exchange visit in 1975. The basic principles are community responsibility and universal entitlement to compensation. Earnings-related benefits are paid to the injured person, and flat-rate payments to non-earners. The Scheme is administered by a three-man Commission with wide responsibilities for accident prevention, rehabilitation services, administration of funds, records, public relations, and an independent Appeals Authority. There have been far reaching consequences on medical practice. The Commission construe the phrase 'Personal Injury by Accident' as damage to the human system which is not designed by the person injured: the implications of such a definition are briefly discussed. The administrative costs of any similar Scheme in the United Kingdom would be enormous and it is doubtful whether the benefits would justify the cost.

48 CFR 28.305 - Overseas workers' compensation and war-hazard insurance.

Code of Federal Regulations, 2010 CFR

2010-10-01

...' compensation and war-hazard insurance. 28.305 Section 28.305 Federal Acquisition Regulations System FEDERAL...' compensation and war-hazard insurance. (a) Public-work contract, as used in this subpart, means any contract... operations under service contracts and projects in connection with the national defense or with war...

48 CFR 2928.305 - Overseas workers' compensation and war hazard insurance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Overseas workers' compensation and war hazard insurance. 2928.305 Section 2928.305 Federal Acquisition Regulations System...' compensation and war hazard insurance. The authority of the Agency Head to recommend to the Secretary of Labor...

The amount of consolation compensation in road traffic accidents.

PubMed

Jou, Rong-Chang

2014-06-01

This study aimed to investigate the amount of consolation compensation that road accident perpetrators were willing to pay victims. It used 2010 statistics for general road accidents from Taiwan's National Police Agency (NPA) for further sampling and to mail questionnaires. In investigating consolation compensation, the framework of the contingent valuation method was used, and the data were collected through the design of different scenarios. In this study, five injury levels were designed to further analyse the consolation compensation price the perpetrators were willing to pay: minor injury, moderate injury, serious injury, disability, and death. The results revealed the price that many perpetrators were willing to pay was zero; however, we overcame this issue by using the Spike model. The estimated results showed that road accident perpetrators were willing to pay more consolation compensation with increased injury severity. Copyright © 2014 Elsevier Ltd. All rights reserved.

14 CFR 294.40 - Aircraft accident liability insurance requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS CANADIAN CHARTER AIR TAXI OPERATORS Insurance Requirements § 294.40 Aircraft accident liability insurance requirements. No Canadian charter air taxi operator shall...

14 CFR 294.40 - Aircraft accident liability insurance requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS CANADIAN CHARTER AIR TAXI OPERATORS Insurance Requirements § 294.40 Aircraft accident liability insurance requirements. No Canadian charter air taxi operator shall...

Asbestos-related occupational cancers compensated under the Industrial Accident Compensation Insurance in Korea.

PubMed

Ahn, Yeon-Soon; Kang, Seong-Kyu

2009-04-01

Compensation for asbestos-related cancers occurring in occupationally-exposed workers is a global issue; this is also an issue in Korea. To provide basic information regarding compensation for workers exposed to asbestos, 60 cases of asbestos-related occupational lung cancer and mesothelioma that were compensated during 15 yr; from 1993 (the year the first case was compensated) to 2007 by the Korea Labor Welfare Corporation (KLWC) are described. The characteristics of the cases were analyzed using the KLWC electronic data and the epidemiologic investigation data conducted by the Occupational Safety and Health Research Institute (OSHRI) of the Korea Occupational Safety and Health Agency (KOSHA). The KLWC approved compensation for 41 cases of lung cancer and 19 cases of mesothelioma. Males accounted for 91.7% (55 cases) of the approved cases. The most common age group was 50-59 yr (45.0%). The mean duration of asbestos exposure for lung cancer and mesothelioma cases was 19.2 and 16.0 yr, respectively. The mean latency period for lung cancer and mesothelioma cases was 22.1 and 22.6 yr, respectively. The major industries associated with mesothelioma cases were shipbuilding and maintenance (4 cases) and manufacture of asbestos textiles (3 cases). The major industries associated with lung cancer cases were shipbuilding and maintenance (7 cases), construction (6 cases), and manufacture of basic metals (4 cases). The statistics pertaining to asbestos-related occupational cancers in Korea differ from other developed countries in that more cases of mesothelioma were compensated than lung cancer cases. Also, the mean latency period for disease onset was shorter than reported by existing epidemiologic studies; this discrepancy may be related to the short history of occupational asbestos use in Korea. Considering the current Korean use of asbestos, the number of compensated cases in Korea is expected to increase in the future but not as much as developed countries.

48 CFR 752.228-3 - Worker's compensation insurance (Defense Base Act).

Code of Federal Regulations, 2010 CFR

2010-10-01

... insurance (Defense Base Act). 752.228-3 Section 752.228-3 Federal Acquisition Regulations System AGENCY FOR... Clauses 752.228-3 Worker's compensation insurance (Defense Base Act). As prescribed in 728.309, the... contracting officer. (a) The Contractor agrees to procure Defense Base Act (DBA) insurance pursuant to the...

48 CFR 752.228-3 - Worker's compensation insurance (Defense Base Act).

Code of Federal Regulations, 2011 CFR

2011-10-01

... insurance (Defense Base Act). 752.228-3 Section 752.228-3 Federal Acquisition Regulations System AGENCY FOR... Clauses 752.228-3 Worker's compensation insurance (Defense Base Act). As prescribed in 728.309, the... contracting officer. (a) The Contractor agrees to procure Defense Base Act (DBA) insurance pursuant to the...

48 CFR 752.228-3 - Worker's compensation insurance (Defense Base Act).

Code of Federal Regulations, 2014 CFR

2014-10-01

... insurance (Defense Base Act). 752.228-3 Section 752.228-3 Federal Acquisition Regulations System AGENCY FOR... Clauses 752.228-3 Worker's compensation insurance (Defense Base Act). As prescribed in 728.309, the... contracting officer. (a) The Contractor agrees to procure Defense Base Act (DBA) insurance pursuant to the...

48 CFR 752.228-3 - Worker's compensation insurance (Defense Base Act).

Code of Federal Regulations, 2012 CFR

2012-10-01

... insurance (Defense Base Act). 752.228-3 Section 752.228-3 Federal Acquisition Regulations System AGENCY FOR... Clauses 752.228-3 Worker's compensation insurance (Defense Base Act). As prescribed in 728.309, the... contracting officer. (a) The Contractor agrees to procure Defense Base Act (DBA) insurance pursuant to the...

48 CFR 752.228-3 - Worker's compensation insurance (Defense Base Act).

Code of Federal Regulations, 2013 CFR

2013-10-01

... insurance (Defense Base Act). 752.228-3 Section 752.228-3 Federal Acquisition Regulations System AGENCY FOR... Clauses 752.228-3 Worker's compensation insurance (Defense Base Act). As prescribed in 728.309, the... contracting officer. (a) The Contractor agrees to procure Defense Base Act (DBA) insurance pursuant to the...

The willingness to pay of parties to traffic accidents for loss of productivity and consolation compensation.

PubMed

Jou, Rong-Chang; Chen, Tzu-Ying

2015-12-01

In this study, willingness to pay (WTP) for loss of productivity and consolation compensation by parties to traffic accidents is investigated using the Tobit model. In addition, WTP is compared to compensation determined by Taiwanese courts. The modelling results showed that variables such as education, average individual monthly income, traffic accident history, past experience of severe traffic accident injuries, the number of working days lost due to a traffic accident, past experience of accepting compensation for traffic accident-caused productivity loss and past experience of accepting consolation compensation caused by traffic accidents have a positive impact on WTP. In addition, average WTP for these two accident costs were obtained. We found that parties to traffic accidents were willing to pay more than 90% of the compensation determined by the court in the scenario of minor and moderate injuries. Parties were willing to pay approximately 80% of the compensation determined by the court for severe injuries, disability and fatality. Therefore, related agencies can use our study findings as the basis for determining the compensation that parties should pay for productivity losses caused by traffic accidents of different types. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Reform of occupational insurance medical treatment from the perspective of an accident insurance consultant].

PubMed

Kalbe, P

2016-11-01

The reform of occupational insurance medical treatment in 2011 also resulted in many changes for occupational insurance consultants in private practice. The transformation of the physicians participating in treatment status (H-Arzt) to accident insurance consultant status (D-Arzt) has resulted in a significant increase in numbers in outpatient fields, which in some cases leads to increased competition. The tentative flexibilization of the conditions for participation of a D‑Arzt is welcomed but must be broadened to safeguard the future. The relaxation of obligatory attendance of a D‑Arzt is contemporary and is welcomed. The regularly checked obligation for further education initially led to irritation but has now been extensively coordinated with the mandatory further education for contract physicians. As from 1 January 2016 many smaller alterations and specifications in the implementation regulations have been undertaken. The scale of charges for physicians in invoicing with accident insurance companies as with other scales of charges is urgently in need of reform with respect to the performance rating and in particular to the classification.

Conflicts between Public Car Insurance and Public Medical Insurance in Japan: International Comparison Survey

PubMed Central

SAKAGUCHI, Kazuki; MORI, Koichiro

2014-01-01

This paper clarifies essential issues regarding conflicts between public car insurance and public medical insurance in Japan, presenting the findings of an international survey to detect similar problems in other countries and discussing possible options for the resolution of these problems. Three essential issues are important to note: (i) Different prices between the two systems of public insurance provide stakeholders with the irrelevant incentive to apply public medical insurance in the case of car accidents; (ii) Public medical insurance sometimes covers medical expenses due to car accidents, although it should not cover them in principle; and (iii) The costs are imposed on tax payers unconsciously when people use public medical insurance for car accidents. Five findings were obtained from the international survey: (1) Most countries have compulsory car insurance; (2) Private insurance companies manage the financial affairs of compulsory car insurance in most developed countries; (3) Fault for casualties is not considered in the compensation of medical expenses in most countries; (4) Japan is unique in that people can choose between the two systems of public insurance; and (5) Prices for the same medical services differ between the two systems of public insurance in only a few countries. In consideration of the above findings, we provide five options for the resolution of this issue from the viewpoint of victim relief. PMID:25624784

Conflicts between Public Car Insurance and Public Medical Insurance in Japan: International Comparison Survey.

PubMed

Sakaguchi, Kazuki; Mori, Koichiro

2014-04-01

This paper clarifies essential issues regarding conflicts between public car insurance and public medical insurance in Japan, presenting the findings of an international survey to detect similar problems in other countries and discussing possible options for the resolution of these problems. Three essential issues are important to note: (i) Different prices between the two systems of public insurance provide stakeholders with the irrelevant incentive to apply public medical insurance in the case of car accidents; (ii) Public medical insurance sometimes covers medical expenses due to car accidents, although it should not cover them in principle; and (iii) The costs are imposed on tax payers unconsciously when people use public medical insurance for car accidents. Five findings were obtained from the international survey: (1) Most countries have compulsory car insurance; (2) Private insurance companies manage the financial affairs of compulsory car insurance in most developed countries; (3) Fault for casualties is not considered in the compensation of medical expenses in most countries; (4) Japan is unique in that people can choose between the two systems of public insurance; and (5) Prices for the same medical services differ between the two systems of public insurance in only a few countries. In consideration of the above findings, we provide five options for the resolution of this issue from the viewpoint of victim relief.

41 CFR 301-10.452 - May I be reimbursed for personal accident insurance?

Code of Federal Regulations, 2010 CFR

2010-07-01

... personal accident insurance? 301-10.452 Section 301-10.452 Public Contracts and Property Management Federal...-TRANSPORTATION EXPENSES Special Conveyances Rental Automobiles § 301-10.452 May I be reimbursed for personal accident insurance? No. That is a personal expense and is not reimbursable. ...

41 CFR 301-10.452 - May I be reimbursed for personal accident insurance?

Code of Federal Regulations, 2011 CFR

2011-07-01

... personal accident insurance? 301-10.452 Section 301-10.452 Public Contracts and Property Management Federal...-TRANSPORTATION EXPENSES Special Conveyances Rental Automobiles § 301-10.452 May I be reimbursed for personal accident insurance? No. That is a personal expense and is not reimbursable. ...

41 CFR 301-10.452 - May I be reimbursed for personal accident insurance?

Code of Federal Regulations, 2013 CFR

2013-07-01

... personal accident insurance? 301-10.452 Section 301-10.452 Public Contracts and Property Management Federal...-TRANSPORTATION EXPENSES Special Conveyances Rental Automobiles § 301-10.452 May I be reimbursed for personal accident insurance? No. That is a personal expense and is not reimbursable. ...

41 CFR 301-10.452 - May I be reimbursed for personal accident insurance?

Code of Federal Regulations, 2014 CFR

2014-07-01

... personal accident insurance? 301-10.452 Section 301-10.452 Public Contracts and Property Management Federal...-TRANSPORTATION EXPENSES Special Conveyances Rental Automobiles § 301-10.452 May I be reimbursed for personal accident insurance? No. That is a personal expense and is not reimbursable. ...

41 CFR 301-10.452 - May I be reimbursed for personal accident insurance?

Code of Federal Regulations, 2012 CFR

2012-07-01

... personal accident insurance? 301-10.452 Section 301-10.452 Public Contracts and Property Management Federal...-TRANSPORTATION EXPENSES Special Conveyances Rental Automobiles § 301-10.452 May I be reimbursed for personal accident insurance? No. That is a personal expense and is not reimbursable. ...

Prior History of Back Pain in Patients with Compensable and Non-Compensable Injuries.

ERIC Educational Resources Information Center

Pellecchia, Geraldine L.

1993-01-01

Data were collected retrospectively from insurance information forms and histories of 111 patients (ages 14-84) referred to physical therapy for evaluation of back and/or neck pain. Analysis indicated that patients with compensable (work-related or motor vehicle accident) injuries infrequently acknowledged prior episodes of back or neck pain. (JDD)

Evolution of global contribution in multi-level threshold public goods games with insurance compensation

NASA Astrophysics Data System (ADS)

Du, Jinming; Tang, Lixin

2018-01-01

Understanding voluntary contribution in threshold public goods games has important practical implications. To improve contributions and provision frequency, free-rider problem and assurance problem should be solved. Insurance could play a significant, but largely unrecognized, role in facilitating a contribution to provision of public goods through providing insurance compensation against the losses. In this paper, we study how insurance compensation mechanism affects individuals’ decision-making under risk environments. We propose a multi-level threshold public goods game model where two kinds of public goods games (local and global) are considered. Particularly, the global public goods game involves a threshold, which is related to the safety of all the players. We theoretically probe the evolution of contributions of different levels and free-riders, and focus on the influence of the insurance on the global contribution. We explore, in both the cases, the scenarios that only global contributors could buy insurance and all the players could. It is found that with greater insurance compensation, especially under high collective risks, players are more likely to contribute globally when only global contributors are insured. On the other hand, global contribution could be promoted if a premium discount is given to global contributors when everyone buys insurance.

Workers' compensation: a historical review and description of a legal and social insurance system.

PubMed

Kiselica, Daria; Sibson, Bruce; Green-McKenzie, Judith

2004-05-01

The workers' compensation system is a no-fault legal and social insurance system established to address compensation issues that involve work-related injuries and illnesses. The system was developed in response to dissatisfaction with common law litigation on the parts of injured workers and employers. The history of the development of workers' compensation is reviewed, and a general description of the system is offered, including discussion of state law and insurance structures, benefits and costs, administrative boards/commissions, and the federal systems for workers' compensation and related programs. The recent history of the workers' compensation system is provided, the recommendations of the National Commission on State Workmen's Compensation Laws in 1972 are reviewed, and the problems and state-initiated changes in worker's compensation that occurred during the 1990s are discussed.

38 CFR 8.4 - Deduction of insurance premiums from compensation, retirement pay, or pension.

Code of Federal Regulations, 2010 CFR

2010-07-01

...' Relief DEPARTMENT OF VETERANS AFFAIRS NATIONAL SERVICE LIFE INSURANCE Premiums § 8.4 Deduction of insurance premiums from compensation, retirement pay, or pension. The insured under a National Service life insurance policy which is not lapsed may authorize the monthly deduction of premiums from disability...

38 CFR 8.4 - Deduction of insurance premiums from compensation, retirement pay, or pension.

Code of Federal Regulations, 2011 CFR

2011-07-01

...' Relief DEPARTMENT OF VETERANS AFFAIRS NATIONAL SERVICE LIFE INSURANCE Premiums § 8.4 Deduction of insurance premiums from compensation, retirement pay, or pension. The insured under a National Service life insurance policy which is not lapsed may authorize the monthly deduction of premiums from disability...

Loss control and its place in the insurance industry.

PubMed

Kelly, A B

1986-08-01

The historical development of the insurance industry's role in efforts to prevent industrial accidents and occupational disease will be discussed. The various approaches that have evolved include fire insurance, casuality insurance, and compensation for occupational diseases. The basic approach used in insurance programs involved with occupational disease is to identify the toxic material to which employees are exposed, recommend engineering controls to reduce the exposure, and suggest a medical surveillance program. The insurance industry's efforts in industrial hygiene are also described.

Industrial accident compensation insurance benefits on cerebrovascular and heart disease in Korea.

PubMed Central

Kim, Hyeong Su; Choi, Jae Wook; Chang, Soung Hoon; Lee, Kun Sei

2003-01-01

The purpose of this study is to present the importance of work-related cerebrovascular and heart disease from the viewpoint of expenses. Using the insurance benefit paid for the 4,300 cases, this study estimated the burden of insurance benefits spent on work-related cerebrovascular and heart disease. The number of cases with work-related cerebrovascular and heart disease per 100,000 insured workers were 3.36 in 1995; they were increased to 13.16 in 2000. By the days of occurrence, the estimated number of cases were 1,336 in 2001 (95% CI: 1,211-1,460 cases) and 1,769 in 2005 (CI: 1,610-1,931 cases). The estimated average insurance benefits paid per person with work-related cerebrovascular and heart disease was 75-19 million won for medical care benefit and 56 million won for other benefits except medical care. By considering the increase in insurance payment and average pay, the predicted insurance benefits for work-related cerebrovascular and heart disease was 107.9 billion won for the 2001 cohort and 192.4 billion won for the 2005 cohort. From an economic perspective, the results will be used as important evidence for the prevention and management of work-related cerebrovascular and heart disease. PMID:12923322

Occupational exposure monitoring data collection, storage, and use among state-based and private workers' compensation insurers.

PubMed

Shockey, Taylor M; Babik, Kelsey R; Wurzelbacher, Steven J; Moore, Libby L; Bisesi, Michael S

2018-06-01

Despite substantial financial and personnel resources being devoted to occupational exposure monitoring (OEM) by employers, workers' compensation insurers, and other organizations, the United States (U.S.) lacks comprehensive occupational exposure databases to use for research and surveillance activities. OEM data are necessary for determining the levels of workers' exposures; compliance with regulations; developing control measures; establishing worker exposure profiles; and improving preventive and responsive exposure surveillance and policy efforts. Workers' compensation insurers as a group may have particular potential for understanding exposures in various industries, especially among small employers. This is the first study to determine how selected state-based and private workers' compensation insurers collect, store, and use OEM data related specifically to air and noise sampling.  Of 50 insurers contacted to participate in this study, 28 completed an online survey. All of the responding private and the majority of state-based insurers offered industrial hygiene (IH) services to policyholders and employed 1 to 3 certified industrial hygienists on average. Many, but not all, insurers used standardized forms for data collection, but the data were not commonly stored in centralized databases. Data were most often used to provide recommendations for improvement to policyholders. Although not representative of all insurers, the survey was completed by insurers that cover a substantial number of employers and workers. The 20 participating state-based insurers on average provided 48% of the workers' compensation insurance benefits in their respective states or provinces. These results provide insight into potential next steps for improving the access to and usability of existing data as well as ways researchers can help organizations improve data collection strategies. This effort represents an opportunity for collaboration among insurers, researchers, and

Latent class analysis of accident risks in usage-based insurance: Evidence from Beijing.

PubMed

Jin, Wen; Deng, Yinglu; Jiang, Hai; Xie, Qianyan; Shen, Wei; Han, Weijian

2018-06-01

Car insurance is quickly becoming a big data industry, with usage-based insurance (UBI) poised to potentially change the business of insurance. Telematics data, which are transmitted from wireless devices in car, are widely used in UBI to obtain individual-level travel and driving characteristics. While most existing studies have introduced telematics data into car insurance pricing, the telematics-related characteristics are directly obtained from the raw data. In this study, we propose to quantify drivers' familiarity with their driving routes and develop models to quantify drivers' accident risks using the telematics data. In addition, we build a latent class model to study the heterogeneity in travel and driving styles based on the telematics data, which has not been investigated in literature. Our main results include: (1) the improvement to the model fit is statistically significant by adding telematics-related characteristics; (2) drivers' familiarity with their driving trips is critical to identify high risk drivers, and the relationship between drivers' familiarity and accident risks is non-linear; (3) the drivers can be classified into two classes, where the first class is the low risk class with 0.54% of its drivers reporting accidents, and the second class is the high risk class with 20.66% of its drivers reporting accidents; and (4) for the low risk class, drivers with high probability of reporting accidents can be identified by travel-behavior-related characteristics, while for the high risk class, they can be identified by driving-behavior-related characteristics. The driver's familiarity will affect the probability of reporting accidents for both classes. Copyright © 2018 Elsevier Ltd. All rights reserved.

14 CFR 291.22 - Aircraft accident liability insurance requirement.

Code of Federal Regulations, 2010 CFR

2010-01-01

... (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS CARGO OPERATIONS IN INTERSTATE AIR TRANSPORTATION General Rules for All-Cargo Air Transportation § 291.22 Aircraft accident liability insurance requirement. No air carrier shall operate all-cargo aircraft or provide all-cargo air transportation unless such carrier has...

[Insurance system. Prevention from viewpoint of the insurer].

PubMed

Brechtbühl, P

1978-12-01

The purpose of an insurance must not be restricted to the payment of claims to those insured persons who suffered a loss, for loss prevention is much preferable to claim settlement. A whole range of different institutions and measures has been established by the Swiss insurers, in which many insurance branches participate. The loss preventing activities can be listed as follows:--Activities of the fire insurers to prevent and fight fires. This is the prevailing duty of the Consulting Agency for Fire Prevention (BfB) as well as the Fire Prevention Service for Industry and Trade (BVD).--Activities of the accident insurers to prevent accidents. The fight against accidents, mostly traffic accidents, in sports and at home is the foremost task of the Swiss Council for the Prevention of Accidents (BfU), an institution created by the Conference of Accident Insurance Managers (UDK) and the Swiss National Accident Insurance Fund (SUVA).--The Health Service in life insurance, after all the periodical medical examinations and consultations granted by many insurers to their insured persons, as well as the pamphlets aiming at health education published by several Companies and finally institutions and measures to promote fitness, e.g. VITA-Parcours.

48 CFR 628.305 - Overseas workers' compensation and war-hazard insurance.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., shall include the contractual obligation for coverage under the Defense Base Act (42 U.S.C. Sections... local workers' compensation laws. (2) Individuals who are self-employed (i.e., they have not incorporated) do not meet the definition of an employee. No Defense Base Act insurance is required when...

48 CFR 628.305 - Overseas workers' compensation and war-hazard insurance.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., shall include the contractual obligation for coverage under the Defense Base Act (42 U.S.C. Sections... local workers' compensation laws. (2) Individuals who are self-employed (i.e., they have not incorporated) do not meet the definition of an employee. No Defense Base Act insurance is required when...

48 CFR 628.305 - Overseas workers' compensation and war-hazard insurance.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., shall include the contractual obligation for coverage under the Defense Base Act (42 U.S.C. Sections... local workers' compensation laws. (2) Individuals who are self-employed (i.e., they have not incorporated) do not meet the definition of an employee. No Defense Base Act insurance is required when...

48 CFR 628.305 - Overseas workers' compensation and war-hazard insurance.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., shall include the contractual obligation for coverage under the Defense Base Act (42 U.S.C. Sections... local workers' compensation laws. (2) Individuals who are self-employed (i.e., they have not incorporated) do not meet the definition of an employee. No Defense Base Act insurance is required when...

Hospital characteristics related to the hospital length of stay among inpatients receiving invasive cervical discectomy due to road traffic accidents under automobile insurance in South Korea.

PubMed

Shin, Kyoung Won; Lee, Hyo Jung; Nam, Chung Mo; Moon, Ki Tae; Park, Eun-Cheol

2017-08-16

In South Korea, people injured in road traffic accidents receive compensation for medical costs through their automobile insurance. However, the automobile insurance system appears to manage health care inefficiently. This study aimed to investigate the factors associated with the hospital length of stay (LOS), which was used as an indicator of healthcare utilization, for inpatients covered by automobile insurance and undergoing invasive cervical discectomy. Insurance claims data from 158 hospitals were used. The study included 850 inpatients who were involved in automobile accidents in 2014 and 2015 and who underwent invasive cervical discectomy. Poisson regression analysis was performed to examine the associations between the LOS and hospital-level characteristics. The mean LOS for inpatients covered by automobile insurance was 25.75 days. A higher proportion of inpatients with automobile insurance were associated with a longer LOS (rate ratio [RR]: 1.027 per 1% increase, 95% confidence interval [CI]: 1.012-1.042). A higher hospital volume of invasive cervical discectomy (RR: 0.970 per 10 case increase, 95% CI: 0.945-0.997), bed turnover rate (RR: 0.988 per 1 increase, 95% CI: 0.979-0.997), and number of neurosurgeons or orthopedic specialists (RR: 0.930 per 1/100 beds increase, 95% CI: 0.876-0.987) were associated with a shorter LOS. Our findings suggest that inpatients covered by automobile insurance were associated with a longer LOS when treated at small-sized, low-provider, and low-volume hospitals with high proportions of such patients. Based on these findings, policymakers and healthcare professionals ought to consider improved strategies for efficient management of automobile insurance for inpatients in small-sized hospitals.

Compensation for occupational injuries and diseases in special populations: farmers and soldiers.

PubMed

Kwon, Young-Jun; Lee, Soo-Jin

2014-06-01

Some types of workers such as farmers and soldiers are at a higher risk of work-related injury and illness than workers from other occupations. Despite this fact, they are not covered under the Industrial Safety Health (ISH) Act or the Industrial Accident Compensation Insurance (IACI) Act. The Safety Aid System for Farmers (SASF) is a voluntary insurance scheme, and it is the only public compensation plan for self-employed farmers. Fifty percent of SASF premiums are subsidized by the Korean government. Soldiers are compensated by the Veterans' Pension (VP) Act. The approval standard of and procedure for the VP Act are provided in the Decree of VP Act, and the Council for VP Benefits determines work-relatedness in the claimed cases. Meanwhile, SASF applies the insurance clause automatically without any expert advice or additional procedures. Furthermore, compared with IACI, these programs pay fewer benefits to workers. Thus, a stronger institutional strategy is needed to maintain a safe work environment, to protect workers' health in unavoidably hazardous environments, and to compensate for work-related injuries and diseases.

The association between attributions of responsibility for motor vehicle accidents and patient satisfaction: a study within a no-fault injury compensation system.

PubMed

Thompson, Jason; Berk, Michael; O'Donnell, Meaghan; Stafford, Lesley; Nordfjaern, Trond

2015-05-01

This study set out to test the relationship between attributions of responsibility for motor vehicle accidents and satisfaction with personal injury compensation systems. The study analysed survey data from 1394 people injured in a motor vehicle accident who were compensated under a no-fault personal injury compensation system. Patients' ratings of satisfaction with the compensation system across five domains (resolves your issues, keeps you up-to-date, treats you as an individual, cares about you, and overall satisfaction) were analysed alongside patient attributions of responsibility for their accident (not responsible, partly responsible, totally responsible). Postaccident physical and mental health status, age, gender, and duration of compensation claim were controlled for in the analysis. A multivariate analysis of covariance indicated attributions of responsibility for accidents were significantly associated with levels of patient satisfaction across all five domains under study (F (10, 2084) = 3.7, p<0.001, η(2)  =0.02). Despite access to virtually indistinguishable services, patients who attributed responsibility for their accidents to others were significantly less satisfied with the injury compensation system than those who attributed responsibility to themselves. Satisfaction with no-fault motor vehicle injury compensation services are associated with patients' attributions of responsibility for their accident. Compensation systems and other rehabilitation services monitoring patient satisfaction should adjust for attributions of responsibility when assessing levels of patient satisfaction between time periods, services, or injured populations. Differences in levels of patient satisfaction observed between compensation or rehabilitation populations may reflect differences in attributions of responsibility for accidents rather than objective service quality. © The Author(s) 2014.

[Compensation of unforeseeable medical complications following cosmetic surgery finally made possible by ONIAM].

PubMed

Theissen, A; Pujol, N; Lascar, T; Flavin, P; Fuz, F; Niccolai, P

2015-02-01

In the absence of any proven medical fault by a plastic surgeon, the patient could not obtain compensation through national solidarity (as stipulated by the Law of March 4th 2002). Indeed ONIAM (France's National Office for Medical Accidents' Compensation) has always rejected any claims on the grounds that cosmetic surgery differs from medical care. Through its judgment of February 5th 2014, France's final Court of Appeals settled the question and considered cosmetic surgery as medical care; in case of serious injuries following unforeseeable medical complications, the patient may be compensated by ONIAM, as with any other medical act. This jurisprudence will certainly result in medical liability insurers be no longer those only responsible for compensation of injuries following cosmetic surgery. Plastic surgeons' insurance premiums should logically become cheaper. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Cost analysis of brachial plexus injuries: variability of compensation by insurance companies before and after surgery.

PubMed

Felici, N; Zaami, S; Ciancolini, G; Marinelli, E; Tagliente, D; Cannatà, C

2014-04-01

Traumatic paralysis of the brachial plexus is an extremely disabling pathology. The type of trauma most frequently suffered by this group of patients is due to motorcycle injuries. It therefore affects a population of young patients. In the majority of cases, these patients receive compensation for permanent damage from insurance companies. Surgery of the brachial plexus enables various forms of functional recovery, depending on the number of roots of the brachial plexus involved in the injury. The aim of this study is to compare the functional deficit and the extent of the related compensation before and after surgical intervention, and to evaluate the saving in economic terms (understood as the cost of compensation paid by insurance companies) obtainable through surgical intervention. The authors analysed the functional recovery obtained through surgery in 134 patients divided into 4 groups on the basis of the number of injured roots. The levels of compensation payable to the patient before surgical intervention, and 3 years after, were then compared. The results showed that the saving obtainable through surgical treatment of brachial plexus injuries may exceed 65% of the economic value of the compensation that would have been attributable to the same patients if they had not undergone surgical treatment. © Georg Thieme Verlag KG Stuttgart · New York.

Helmet use and risk compensation in motorcycle accidents.

PubMed

Ouellet, James V

2011-02-01

The "risk compensation" hypothesis suggests that individuals offset perceived gains in safety by increasing their risk-taking behavior to maintain a stable or "homeostatic" level of risk. If this is true for motorcyclists, then helmet use, which reduces the risk of brain injury and death, may lead helmet users to take more risks when they ride. Thus, increased risk-taking by helmet users should show up as overrepresentation in crashes, and accident reconstruction should reveal risky behaviors in the seconds just before the crash. This article examines data from two separate studies involving the on-scene, in-depth investigation and reconstruction of motorcycle crashes: 900 in Los Angeles (1976-1977) and another 1082 in Thailand (1999-2000). Each crash was investigated on scene within minutes of its occurrence by teams of specially trained researchers and later reconstructed in order to identify precrash and crash events, verify helmet use/nonuse, etc. "Exposure" data on helmet use and other readily visible factors were also collected for the population-at-risk by observing riders who passed by each accident scene some time after a crash that had been investigated by the team. In this article, helmeted and unhelmeted accident-involved riders are compared to each other as well as to the population-at-risk. In Thailand, helmeted riders did not differ significantly from unhelmeted riders in alcohol use, precrash speed, being the primary or sole cause of the crash, or unsafe speed or lane positioning for the traffic conditions; they were no more likely to be in a single-vehicle accident, to crash by running off the road, or to lose control. In Los Angeles, drinking riders were half as likely to wear a helmet as nondrinkers. However, when drinkers and nondrinkers were segregated, helmeted riders were no more likely to cause their crash, run stop signs or red lights, commit other traffic code violations, or run off the road. They did not differ in speed or single

[The German Statutory Accident Insurance: A successful example of a value-based healthcare structure].

PubMed

Wich, Michael; Auhuber, Thomas; Scholtysik, Dirk; Ekkernkamp, Axel

2018-02-01

In the mid-1920s Porter and others developed a reform approach for existing health care systems, aiming at a patient-focused, value-based orientation. Improving patient outcomes by attaining, preserving and restoring good health is inherently less costly than dealing with poor health. The authors of the present article will outline that the German statutory accident insurance system, which was already introduced in1884 and is of an evolving nature, reflects key elements of Porter's efficient value-based health care system. The German accident insurance system with its statutory mandate limited to the prevention and rehabilitation of work-related damage to one's health can also serve as a model for other larger health care insurance systems. Prevention and rehabilitation is pursued using all appropriate means to achieve the set goals of protecting and restoring individual health. In line with these objectives, the statutory health insurance controls the process in terms of the required care quality. The components of a complex health care system, usually managed by a variety of different institutions, are consolidated. Thus it can be ensured that in both prevention and rehabilitation all services that are necessary to keep focussing the value "individual health" rather than indemnities are applied. Copyright © 2018. Published by Elsevier GmbH.

The growth in applications for Social Security Disability Insurance: a spillover effect from workers' compensation.

PubMed

Guo, Xuguang; Burton, John F

2012-01-01

We investigate the determinants of application for Social Security Disability Insurance (DI) benefits in approximately 45 jurisdictions between 1981 and 1999. We reproduce findings of previous studies of the determinants of DI application then test the additional influence of changes to workers' compensation program benefits and rules on DI application rates. Our findings indicate that the programs are interrelated: When workers' compensation benefits declined and eligibility rules tightened in the 1990s, the DI application rate increased.

Physician-patient relationship and medical accident victim compensation: some insights into the French regulatory system.

PubMed

Ancelot, Lydie; Oros, Cornel

2015-06-01

Given the growing amount of medical litigation heard by courts, the 2002 Kouchner law in France has created the Office National d'Indemnisation des Accidents Médicaux (ONIAM), whose main aim is to encourage out-of-court settlements when a conflict between a physician and the victim of a medical accident occurs. More than 10 years after the implementation of this law, the statistics analysing its effectiveness are contradictory, which raises the question of the potential negative effects of the ONIAM on the compensation system. In order to address this question, the article analyses the impact of the ONIAM on the nature of settlement negotiations between the physician and the victim. Using a dynamic game within incomplete information, we develop a comparative analysis of two types of compensation systems in case of medical accidents: socialised financing granted by the ONIAM and private financing provided by the physician. We show that the ONIAM could encourage out-of-court settlements provided that the hypothesis of judicial error is relevant. On the contrary, in the case of a low probability of judicial errors, the ONIAM could be effective only for severe medical accidents.

The differential effect of compensation structures on the likelihood that firms accept new patients by insurance type.

PubMed

Bullock, Justin B; Bradford, W David

2016-03-01

Adequate access to primary care is not universally achieved in many countries, including the United States, particularly for vulnerable populations. In this paper we use multiple years of the U.S.-based Community Tracking Survey to examine whether a variety of physician compensation structures chosen by practices influence the likelihood that the practice takes new patients from a variety of different types of insurance. Specifically, we examine the roles of customer satisfaction and quality measures on the one hand, and individual physician productivity measures on the other hand, in determining whether or not firms are more likely to accept patients who have private insurance, Medicare, or Medicaid. In the United States these different types of insurance mechanisms cover populations with different levels of vulnerability. Medicare (elderly and disabled individuals) and Medicaid (low income households) enrollees commonly have lower ability to pay any cost sharing associated with care, are more likely to have multiple comorbidities (and so be more costly to treat), and may be more sensitive to poor access. Further, these two insurers also generally reimburse less generously than private payors. Thus, if lower reimbursements interact with compensation mechanisms to discourage physician practices from accepting new patients, highly vulnerable populations may be at even greater risk than generally appreciated. We control for the potential endogeneity of incentive choice using a multi-level propensity score method. We find that the compensation incentives chosen by practices are statistically and economically significant predictors for the types of new patients that practices accept. These findings have important implications for both policy makers and private health care systems.

[Rehabilitation in the German statutory accident insurance. Guide to the new outpatient and inpatient structures].

PubMed

Simmel, S; Bühren, V

2015-02-01

The German statutory accident insurance (DGUV) has the statutory mandate to eliminate or to prevent an aggravation of the consequences of accidents by all appropriate means and is based on the principle of rehabilitation before pension. For this, special methods have been developed in recent decades, such as employer's mutual insurance inpatient further treatment (BGSW, Berufsgenossenschaftliche Stationäre Weiterbehandlung) and extended outpatient physiotherapy (EAP, Erweiterte Ambulante Physiotherapie). In 2012 the workplace-related musculoskeletal rehabilitation (ABMR, Arbeitsplatz-bezogene muskuloskelettale Rehabilitation) was added to these complex treatments. For complex injuries and delayed healing these methods approach their limits. The accident clinics of the Association of Clinics in Statutory Accident Insurance (KUV, Klinikverbund der gesetzlichen Unfallversicherung) provide a number of specialized rehabilitation measures in order to ensure an optimal seamless rehabilitation of the severely injured. In addition to complex inpatient rehabilitation (KSR, Komplexe Stationäre Rehabilitation) integrated special rehabilitation procedures, such as neurorehabilitation for severely traumatic brain injured patients and rehabilitation after spinal cord injury and other special rehabilitation methods, such as occupation-oriented rehabilitation (TOR, Tätigkeitsorientierte Rehabilitation) and pain rehabilitation, ensure that the German Society for Trauma Surgery (DGU) phase model of trauma rehabilitation is implemented. This provides an early start in the context of acute treatment as so-called early rehabilitation. After a specialized post-acute rehabilitation, additional therapeutic options are often required. An appropriate treatment of severely injured patients is important, for example through rehabilitation managers, which must not end with discharge from the rehabilitation hospital. The aim of all efforts is the reintegration into the working and social

What can the drivers' own description from combined sources provide in an analysis of driver distraction and low vigilance in accident situations?

PubMed

Tivesten, Emma; Wiberg, Henrik

2013-03-01

Accident data play an important role in vehicle safety development. Accident data sources are generally limited in terms of how much information is provided on driver states and behaviour prior to an accident. However, the precise limitations vary between databases, due to differences in analysis focus and data collection procedures between organisations. If information about a specific accident can be retrieved from more than one data source it should be possible to combine the available information sets to facilitate data from one source to compensate for limitations in the other(s). To investigate the viability of such compensation, this study identified a set of accidents recorded in two different data sources. The first data source investigated was an accident mail survey and the second data source insurance claims documents consisting predominantly of insurance claims completed by the involved road users. An analysis of survey variables was compared to a case analysis including word data derived from the same survey and filed insurance claims documents. For each accident, the added value of having access to more than one source of information was assessed. To limit the scope of this study, three particular topics were investigated: available information on low vigilance (e.g., being drowsy, ill); secondary task distraction (e.g., talking with passengers, mobile phone use); and distraction related to the driving task (e.g., looking for approaching vehicles). Results suggest that for low vigilance and secondary task distraction, a combination of the mail survey and insurance claims documents provide more reliable and detailed pre-crash information than survey variables alone. However, driving related distraction appears to be more difficult to capture. In order to gain a better understanding of the above issues and how frequently they occur in accidents, the data sources and analysis methods suggested here may be combined with other investigation methods such

Epidemiologic characteristics of compensated occupational lung cancers among Korean workers.

PubMed

Ahn, Yeon-Soon; Jeong, Kyoung Sook

2014-11-01

An understanding of the characteristics of occupational lung cancer is important to establish policies that prevent carcinogen exposure and to compensate workers exposed to lung carcinogens. This study analyzed the characteristics of occupational lung cancers in workers who were compensated under the Industrial Accident Compensation Insurance Law between 1994 and 2011. A total of 179 occupational lung cancers were compensated. The main carcinogenic exposure was asbestos, followed by crystalline silica and hexavalent chromium. The mean exposure duration and latency were 19.8 and 23.2 yr. The most common industry was manufacturing, followed by construction and transportation. The most common occupation was maintenance and repair, followed by foundry work, welding, painting, and spinning or weaving. Although asbestos was predominant carcinogen, the proportion of these cases was relatively low compared to other developed countries. Proper surveillance system is needed to monitor occupational lung cancer and improve prevention measures.

42 CFR 411.39 - Automobile and liability insurance (including self-insurance), no-fault insurance, and workers...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Automobile and liability insurance (including self-insurance), no-fault insurance, and workers' compensation: Final conditional payment amounts via Web portal... Coverage That Limits Medicare Payment: General Provisions § 411.39 Automobile and liability insurance...

42 CFR 411.39 - Automobile and liability insurance (including self-insurance), no-fault insurance, and workers...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Automobile and liability insurance (including self-insurance), no-fault insurance, and workers' compensation: Final conditional payment amounts via Web portal... Coverage That Limits Medicare Payment: General Provisions § 411.39 Automobile and liability insurance...

Procedural justice and quality of life in compensation processes.

PubMed

Elbers, Nieke A; Akkermans, Arno J; Cuijpers, Pim; Bruinvels, David J

2013-11-01

There is considerable evidence that being involved in compensation processes has a negative impact on claimants' health. Previous studies suggested that this negative effect is caused by a stressful compensation process: claimants suffered from a lack of communication, a lack of information, and feelings of distrust. However, these rather qualitative findings have not been quantitatively investigated yet. This observational study aimed to fill this gap of knowledge, investigating the claimants' perceived fairness of the compensation process, the provided information, and the interaction with lawyers and insurance companies, in relation to the claimants' quality of life. Participants were individuals injured in traffic accidents, older than 18 years, who were involved in a compensation process in the Netherlands. They were recruited by three claims settlement offices. Outcome measures were procedural, interactional, and informational justice, and quality of life. Participants (n=176) perceived the interaction with lawyers to be fairer than the interaction with insurance companies (p<.001). The length of hospital stay was positively associated with procedural justice (β=.31, p<.001). Having trunk/back injury was negatively related to procedural justice (β=-.25, p=.001). Whiplash injury and length of time involved in the claim process were not associated with any of the justice scales. Finally, procedural justice was found to be positively correlated with quality of life (rs=.22, p=.004). The finding that the interaction with insurance companies was considered less fair than the interaction with lawyers may imply that insurers could improve their interaction with claimants, e.g. by communicating more directly. The result that claimants with mild injuries and with trunk/back injuries considered the compensation process to be less fair than those with respectively severe injuries and injuries to other body parts suggests that especially the former two require an

[Drugs and occupational accident].

PubMed

Bratzke, H; Albers, C

1996-02-01

In a case of a fatal occupational accident (construction worker, fall from roof, urine test positive for cocaine and THC, e.g. cannabis) the question arised to what extent those drug-related occupational accidents occur. In the literature only few cases, mainly dealing with cannabis influence, have been reported, however, a higher number is suspected. Cocaine and other stimulating drugs (amphetamine) are more often used to increase physical fitness. By direct or indirect interference with vigilance these compounds may provoke accidents. Due to the lack of a legal basis proving of the influence of drugs at the working place is still very limited, although highly sensitive chemical-toxicological assay procedures are available to detect even the chronic abuse (in hair). In the general conditions of accident insurances a compensation is excluded when alcohol is involved, but drugs are not mentioned. It is indeed difficult to establish a concentration limit for drugs like that existing for alcohol (1.1%). In each case the assay of the drug involved and exact knowledge of its specific effects is in an essential prerequisite to prove the causal relationship.

Securitization product design for China's environmental pollution liability insurance.

PubMed

Pu, Chengyi; Addai, Bismark; Pan, Xiaojun; Bo, Pangtuo

2017-02-01

The environmental catastrophic accidents in China over the last three decades have triggered implementation of myriad policies by the government to help abate environmental pollution in the country. Consequently, research into environmental pollution liability insurance and how that can stimulate economic growth and the development of financial market in China is worthwhile. This study attempts to design a financial derivative for China's environmental pollution liability insurance to offer strong financial support for significant compensation towards potential catastrophic environmental loss exposures, especially losses from the chemical industry. Assuming the risk-free interest rate is 4%, the market portfolio expected return is 12%; the financial asset beta coefficient is 0.5, by using the capital asset pricing model (CAPM) and cash flow analysis; the principal risk bond yields 9.4%, single-period and two-period prices are 103.85 and 111.58, respectively; the principal partial-risk bond yields 10.09%, single-period and two-period prices are 103.85 and 111.58, respectively; and the principal risk-free bond yields 8.94%, single-period and two-period prices are 107.99 and 115.83, respectively. This loss exposure transfer framework transfers the catastrophic risks of environmental pollution from the traditional insurance and reinsurance markets to the capital market. This strengthens the underwriting capacity of environmental pollution liability insurance companies, mitigates the compensation risks of insurers and reinsurers, and provides a new channel to transfer the risks of environmental pollution.

Commitment-Insurance: Compensating for the Autonomy Costs of Interdependence in Close Relationships

PubMed Central

Murray, Sandra L.; Holmes, John G.; Aloni, Maya; Pinkus, Rebecca T.; Derrick, Jaye L.; Leder, Sadie

2014-01-01

A model of the commitment-insurance system is proposed to examine how low and high self-esteem people cope with the costs interdependence imposes on autonomous goal pursuits. In this system, autonomy costs automatically activate compensatory cognitive processes that attach greater value to the partner. Greater partner-valuing compels greater responsiveness to the partner’s needs. Two experiments and a daily diary study of newlyweds supported the model. Autonomy costs automatically activate more positive implicit evaluations of the partner. On explicit measures of positive illusions, high self-esteem people continue to compensate for costs. However, cost-primed low self-esteem people correct and override their positive implicit sentiments when they have the opportunity to do so. Such corrections put the marriages of low self-esteem people at risk: Failing to compensate for costs predicted declines in satisfaction over a one year period. PMID:19634974

[15 years insurance statistics of incidents and accident types of combat sports injuries of the Rhineland-Pfalz Federal Sports Club].

PubMed

Raschka, C; Parzeller, M; Banzer, W

1999-03-01

The primary intention of this study is the grouping of sports accidents, being described by the athletes in their own words in a classification system of specific accident classes with regard to specific motions and topography. The investigation is based on the data of the sports insurance Gerling-Konzern during a 15-year period in Rhineland Palatinate (1981-1995). The study is based on the insurance documents and clinical protocols if available. 137 accident protocols were related to this 15-year period including weight lifting (n = 1) and martial arts (n = 136). Listed in hierarchical order we received the following results: judo (n = 47), karate (n = 44), wrestling (n = 22), taekwondo (n = 9), boxing (n = 7), ju-jutsu (n = 5), fencing (n = 1) and aikido (n = 1). In accordance to accident types there were no sex related differences. As special preventive measures we suggest the use of protective mouthguards and solid glasses, proprioceptive training and physiological taping for knee, ankle and elbow joints.

Insurance in clinical research

PubMed Central

Ghooi, Ravindra B.; Divekar, Deepa

2014-01-01

Aims and Objectives: Sponsors need to pay for management of all serious adverse events suffered by subjects in a clinical trial and to compensate for injuries or deaths related to the trial. This study examines if insurance policies of trials, cover all contingencies that require reimbursement or compensation. Materials and Methods: Insurance policies of trials submitted to Sahyadri Hospitals between January 2013 and December 2013 were studied, with respect to the policy period, the limit of liability, deductibles, and preconditions if any. Results: All the policies studied had some deficiencies, in one respect or the other and none had a provision to pay full compensation if required. Some insurers have put in preconditions that could jeopardize the payment of compensation to subjects. Conclusions: Insurances are complicated documents, and need to be critically examined by the ethics committee before approval of the study documents. PMID:25276622

[Study on optimal model of hypothetical work injury insurance scheme].

PubMed

Ye, Chi-yu; Dong, Heng-jin; Wu, Yuan; Duan, Sheng-nan; Liu, Xiao-fang; You, Hua; Hu, Hui-mei; Wang, Lin-hao; Zhang, Xing; Wang, Jing

2013-12-01

To explore an optimal model of hypothetical work injury insurance scheme, which is in line with the wishes of workers, based on the problems in the implementation of work injury insurance in China and to provide useful information for relevant policy makers. Multistage cluster sampling was used to select subjects: first, 9 small, medium, and large enterprises were selected from three cities (counties) in Zhejiang Province, China according to the economic development, transportation, and cooperation; then, 31 workshops were randomly selected from the 9 enterprises. Face-to-face interviews were conducted by trained interviewers using a pre-designed questionnaire among all workers in the 31 workshops. After optimization of hypothetical work injury insurance scheme, the willingness to participate in the scheme increased from 73.87%to 80.96%; the average willingness to pay for the scheme increased from 2.21% (51.77 yuan) to 2.38% of monthly wage (54.93 Yuan); the median willingness to pay for the scheme increased from 1% to 1.2% of monthly wage, but decreased from 35 yuan to 30 yuan. The optimal model of hypothetical work injury insurance scheme covers all national and provincial statutory occupational diseases and work accidents, as well as consultations about occupational diseases. The scheme is supposed to be implemented worldwide by the National Social Security Department, without regional differences. The premium is borne by the state, enterprises, and individuals, and an independent insurance fund is kept in the lifetime personal account for each of insured individuals. The premium is not refunded in any event. Compensation for occupational diseases or work accidents is unrelated to the enterprises of the insured workers but related to the length of insurance. The insurance becomes effective one year after enrollment, while it is put into effect immediately after the occupational disease or accident occurs. The optimal model of hypothetical work injury insurance

Self-mutilations in private-accident-insurance cases.

PubMed

Dotzauer, G; Iffland, R

1976-04-21

Self-inflicted injuries can be classified in groups. One group deals with the simulation of illness, another with the occurrence itself and the application of chemical, thermic or mechanical methods. One sector concerns self-mutilation, which, from a psychiatrist's point of view, is interesting. At this time we are more concerned with the problems of proving it. In wartime and even during military service in peace-time soldiers inflict mutilating injuries on themselves. They are motivated by the notion that they will gain benefit from their action. Economic gain plays a role in the case of people who have taken out private accident insurance: self mutilation to simulate the result of an accident. Our investigation into self-mutilation started with an analysis under the following aspects of 123 cases: age, sex, occupation, place of residence, place and time of deed, method employed (weapon used), localisation, single or multiple wound, direction of injury, position of fingers, nature of edges of wound. Whether or not an injury was suffered voluntarily or involuntarily can only be determined with the help of auxiliary facts. It must be clarified whether or not the information given by the injured person ties in with facts concerning the place where the injury was sustained, its position and its direction. The medico-legal expert should not interpret medical findings without relating them to the facts of the case. Indeed, he should start by examining the claimant's account of the accident. To some extent it almost requires the work of a general staff to compare the findings of a careful medical investigation with the injuries themselves. If the injury was inflicted by a certain tool information must be available regarding, for example, the "accident with the saw" together with an assessment of the wounds sustained (utilization of clinical material). Sometimes tests on corpses need to be carried out because these can provide information on mechanical and physical

[Diagnosis and insurance compensation of occupational diseases in construction industry].

PubMed

Bresciani, M; Riva, M M; Giorgi, M; Ghezzi, L; Sidoti, C; Mosconi, G

2007-01-01

The aim of this study is to evaluate the outcome of 302 occupational diseases in building workers detected by UOOML Ospedali Riuniti of Bergamo and notified to INAIL from 2000 to 2005. The 41.3% of cases were accepted as work-related. Among remaining cases (58.7%), INAIL rejected 40.9% for lack or absence of documentation. 59.1% for no adhesion to legal medicine criteria. By analysis of occupational diseases detected in the last 5 years, we found an increase of muscle-skeletal disorders, for which, now, diagnostic procedure and insurance evaluation are difficult. This work shows a wide gap between reported occupational diseases of buildings workers and compensation given by INAIL. These results underlines the need of comparison among involved institutions in order to standardize statistical and diagnostic instruments.

Insurance: A School District's Constant Concern

ERIC Educational Resources Information Center

Tanzman, Jack

1973-01-01

Examines answers to the questions most frequently asked about insurance by school boards and administrators. Discusses the kinds of insurance available and their uses, the outside use of schools, bus contracts, accident athletic insurance, special fire insurance, car insurance, and insurance for school board members. (AUTHOR/DN)

Empirical Bayesian Geographical Mapping of Occupational Accidents among Iranian Workers.

PubMed

Vahabi, Nasim; Kazemnejad, Anoshirvan; Datta, Somnath

2017-05-01

Work-related accidents are believed to be a serious preventable cause of mortality and disability worldwide. This study aimed to provide Bayesian geographical maps of occupational injury rates among workers insured by the Iranian Social Security Organization. The participants included all insured workers in the Iranian Social Security Organization database in 2012. One of the applications of the Bayesian approach called the Poisson-Gamma model was applied to estimate the relative risk of occupational accidents. Data analysis and mapping were performed using R 3.0.3, Open-Bugs 3.2.3 rev 1012 and ArcMap9.3. The majority of all 21,484 investigated occupational injury victims were male (98.3%) including 16,443 (76.5%) single workers aged 20 - 29 years. The accidents were more frequent in basic metal, electric, and non-electric machining jobs. About 0.4% (96) of work-related accidents led to death, 2.2% (457) led to disability (partial and total), 4.6% (980) led to fixed compensation, and 92.8% (19,951) of the injured victims recovered completely. The geographical maps of estimated relative risk of occupational accidents were also provided. The results showed that the highest estimations pertained to provinces which were mostly located along mountain chains, some of which are categorized as deprived provinces in Iran. The study revealed the need for further investigation of the role of economic and climatic factors in high risk areas. The application of geographical mapping together with statistical approaches can provide more accurate tools for policy makers to make better decisions in order to prevent and reduce the risks and adverse outcomes of work-related accidents.

Development of methods for using workers' compensation data for surveillance and prevention of occupational injuries among State-insured private employers in Ohio.

PubMed

Wurzelbacher, Steven J; Al-Tarawneh, Ibraheem S; Meyers, Alysha R; Bushnell, P Timothy; Lampl, Michael P; Robins, David C; Tseng, Chih-Yu; Wei, Chia; Bertke, Stephen J; Raudabaugh, Jill A; Haviland, Thomas M; Schnorr, Teresa M

2016-12-01

Workers' compensation (WC) claims data may be useful for identifying high-risk industries and developing prevention strategies. WC claims data from private-industry employers insured by the Ohio state-based workers' compensation carrier from 2001 to 2011 were linked with the state's unemployment insurance (UI) data on the employer's industry and number of employees. National Labor Productivity and Costs survey data were used to adjust UI data and estimate full-time equivalents (FTE). Rates of WC claims per 100 FTE were computed and Poisson regression was used to evaluate differences in rates. Most industries showed substantial claim count and rate reductions from 2001 to 2008, followed by a leveling or slight increase in claim count and rate from 2009 to 2011. Despite reductions, there were industry groups that had consistently higher rates. WC claims data linked to employment data could be used to prioritize industries for injury research and prevention activities among State-insured private employers. Am. J. Ind. Med. 59:1087-1104, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

The effectiveness of insurer-supported safety and health engineering controls in reducing workers' compensation claims and costs.

PubMed

Wurzelbacher, Steven J; Bertke, Stephen J; Lampl, Michael P; Bushnell, P Timothy; Meyers, Alysha R; Robins, David C; Al-Tarawneh, Ibraheem S

2014-12-01

This study evaluated the effectiveness of a program in which a workers' compensation (WC) insurer provided matching funds to insured employers to implement safety/health engineering controls. Pre- and post-intervention WC metrics were compiled for the employees designated as affected by the interventions within 468 employers for interventions occurring from 2003 to 2009. Poisson, two-part, and linear regression models with repeated measures were used to evaluate differences in pre- and post-data, controlling for time trends independent of the interventions. For affected employees, total WC claim frequency rates (both medical-only and lost-time claims) decreased 66%, lost-time WC claim frequency rates decreased 78%, WC paid cost per employee decreased 81%, and WC geometric mean paid claim cost decreased 30% post-intervention. Reductions varied by employer size, specific industry, and intervention type. The insurer-supported safety/health engineering control program was effective in reducing WC claims and costs for affected employees. © 2014 Wiley Periodicals, Inc.

The Effectiveness of Insurer-Supported Safety and Health Engineering Controls in Reducing Workers’ Compensation Claims and Costs

PubMed Central

Wurzelbacher, Steven J.; Bertke, Stephen J.; Lampl, Michael P.; Bushnell, P. Timothy; Meyers, Alysha R.; Robins, David C.; Al-Tarawneh, Ibraheem S.

2015-01-01

Background This study evaluated the effectiveness of a program in which a workers’ compensation (WC) insurer provided matching funds to insured employers to implement safety/health engineering controls. Methods Pre- and post-intervention WC metrics were compiled for the employees designated as affected by the interventions within 468 employers for interventions occurring from 2003 to 2009. Poisson, two-part, and linear regression models with repeated measures were used to evaluate differences in pre- and post-data, controlling for time trends independent of the interventions. Results For affected employees, total WC claim frequency rates (both medical-only and lost-time claims) decreased 66%, lost-time WC claim frequency rates decreased 78%, WC paid cost per employee decreased 81%, and WC geometric mean paid claim cost decreased 30% post-intervention. Reductions varied by employer size, specific industry, and intervention type. Conclusions The insurer-supported safety/health engineering control program was effective in reducing WC claims and costs for affected employees. PMID:25223846

[The birth of the Italian workers' compensation authority and its contribution to improving health conditions of workers and general population].

PubMed

Bonifaci, G; Sferra, C; Riva, M A

2010-01-01

In 1898 the compulsory work accident insurance was introduced in the Italian legislation: both public and private organizations could provide insurance to the workers. In 1933 the Cassa Nazionale Infortuni (founded in 1884) was unified to other small public funds in a single body, the Italian Workers' Compensation Authority (INAIL). During the post-war recovery INAIL founded hospitals and wards fully dedicated to work traumas (Orthopaedic Traumatic Centres or Burns Centres) and opened rehabilitation and prosthetic centres for injured workers. In this view, INAIL and Italian National Olympic Committee supported the first official Paralympic Games, held in Rome in 1960. Nowadays many hospitals originally owned by INAIL belong to the Italian National Health System and provide healthcare also to general population. However INAIL continues its mission in workers' protection and confirms its main role in the field of accident prevention and rehabilitation of injured workers, also thanks to recent legislative modifications.

Compensation for occupational diseases by chemical agents in Korea.

PubMed

Kwon, Soon-Chan; Roh, Soo-Yong; Lee, Ji-Hoon; Kim, Eun-A

2014-06-01

Investigation into the frequency of compensation for occupational diseases (ODs) caused by hazardous chemicals revealed an important opportunity for the improvement and further development of occupational health and safety systems in Korea. In response to concerns after outbreaks of disease due to chemical exposure, specific criteria for recognition of ODs were established and included in the Enforcement Decree of the Labor Standard Act (LSA) and the Industrial Accident Compensation Insurance Act (IACIA) on June 28, 2013. However, the original versions of the LSA and IACIA contain several limitations. First, the criteria was listed inconsistently according to the symptoms or signs of acute poisoning. Second, all newly recognized hazardous chemicals and chemicals recognized as hazardous by the International Labor Organization (ILO) were not included in the LSA and IACIA. Although recent amendments have addressed these shortcomings, future amendments should strive to include all chemicals listed by the ILO and continuously add newly discovered hazardous chemicals as they are introduced into the workplace.

[Essential aspects of ophthalmological expert assessment in private accident insurance].

PubMed

Tost, F

2014-06-01

Commissions for an expert assessment place basically high demands on commissioned eye specialists because this activity differs from the normal routine field of work. In addition to assessing objective symptoms and subjective symptomatics in a special analytical manner, eye specialists are expected to have knowledge of basic legal terminology, such as proximate cause, evidence and evidential value. Only under these prerequisites can an ophthalmologist fulfill the function of an expert with a high level of quality and adequately adjust the special medical ophthalmological expertise to the requirements of the predominantly legally based clients commissioning the report and oriented to the appropriate valid legal norms. Particularly common difficulties associated with making an ophthalmological expert report for private accident insurance, e.g. determination of the reduction in functional quality, consideration of partial causality and assessment of diplopia are discussed.

The scope and specific criteria of compensation for occupational diseases in Korea.

PubMed

Song, Jaechul; Kim, Inah; Choi, Byung-Soon

2014-06-01

The range of diseases covered by workers' compensation is constantly expanding. However, new regulations are required for the recognition of occupational diseases (ODs) because OD types evolve with changes in industrial structures and working conditions. OD criteria are usually based on medical relevance, but they vary depending on the social security system and laws of each country. In addition, the proposed range and extent of work-relatedness vary depending on the socio-economic conditions of each country. The Labor Standards Act (LSA) and the Industrial Accident Compensation Insurance Act (IACIA) of Korea employ lists based on their requirements without listing causes and diseases separately. Despite a considerable reshuffle in 2003, the basic framework has been maintained for 50 yr, and many cases do not fit into the international disease classification system. Since July 1, 2013, Korea has expanded the range of occupational accidents to include occupational cancers and has implemented revised LSA and IACIA enforcement decrees. There have been improvements to OD recognition standards with the inclusion of additional or modified criteria, a revised and improved classification scheme for risk factors and ODs, and so on.

DOLWD Division of Workers' Compensation

Science.gov Websites

' Compensation Act (Act). The Act provides for the payment by employers or their insurance carriers of medical -related medical and disability benefits. Workers' Compensation also requires the payment of benefits to Workforce Development, Workers' Compensation Division, Medical Services Review Committee will meet June 15

22 CFR 62.14 - Insurance.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Insurance. 62.14 Section 62.14 Foreign... § 62.14 Insurance. (a) Sponsors shall require each exchange visitor to have insurance in effect which... amount of $10,000; and (4) A deductible not to exceed $500 per accident or illness. (b) An insurance...

"Wrapping Up" Your Construction Insurance.

ERIC Educational Resources Information Center

Ferraro, Mark

1998-01-01

School facility managers are beginning to use a special insurance-management technique called wrap-up. The project owner purchases a bulk construction insurance policy consisting of general liability, excess liability, workers' compensation, and builders' risk insurance. Wrap-ups ensure competitive pricing, safety incentives, lower claims costs,…

31 CFR 50.51 - Adjustments to the Federal share of compensation.

Code of Federal Regulations, 2012 CFR

2012-07-01

... compensation. 50.51 Section 50.51 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM... insurer's aggregate amount of insured losses for acts of terrorism in that Program Year. Amounts recovered... terrorism, or similar events. Compensation provided by Federal programs for insured losses excludes benefit...

31 CFR 50.51 - Adjustments to the Federal share of compensation.

Code of Federal Regulations, 2014 CFR

2014-07-01

... compensation. 50.51 Section 50.51 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM... insurer's aggregate amount of insured losses for acts of terrorism in that Program Year. Amounts recovered... terrorism, or similar events. Compensation provided by Federal programs for insured losses excludes benefit...

31 CFR 50.51 - Adjustments to the Federal share of compensation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... compensation. 50.51 Section 50.51 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM... insurer's aggregate amount of insured losses for acts of terrorism in that Program Year. Amounts recovered... terrorism, or similar events. Compensation provided by Federal programs for insured losses excludes benefit...

The battle over workers' compensation.

PubMed

Ellenberger, J N

2000-01-01

Faced with lower profits and rapidly increasing premium costs in the 1980s, insurers and employer organizations cleverly parlayed the public perception of worker fraud and abuse in the workers' compensation system (that they helped to create) into massive legislative changes. Over the last decade, state legislators and governors, Republican and Democrat alike, have jumped on this bandwagon, one that workers and their allies have dubbed the workers' compensation "deform" movement. Alleging a "game plan" and a calculated campaign on the part of insurers and employers, the author looks at the major components of changes that were made, examines the elements of workers' compensation over which employers and insurers have gained control, and discusses Newt Gingrich's efforts to capitalize on employer and insurer fervor over the system. This campaign whistled through the country until it goaded the labor movement, injured workers, the trial bar, and others in Ohio in 1997 to organize themselves to stand up to employers by defeating the deform law through a ballot initiative. The article details that battle and suggests that similar voices can be achieved through a return to grassroots organizing and mobilization.

75 FR 30106 - Terrorism Risk Insurance Program; Recordkeeping Requirements for Insurers Compensated Under the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-28

... DEPARTMENT OF THE TREASURY Terrorism Risk Insurance Program; Recordkeeping Requirements for... Budget. The Terrorism Risk Insurance Program Office within the Department of the Treasury is soliciting... original and two copies) to: Terrorism Risk Insurance Program, Public Comment Record, Suite 2100...

31 CFR 50.50 - Federal share of compensation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Section 50.50 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM RISK INSURANCE... Federal share of compensation will be paid by Treasury unless the aggregate industry insured losses... insurer's proportionate share of insured losses from a State residual market insurance entity or State...

[No-fault medical accidents: review of two years' activity of the regional commission for the compensation of medical accidents of the Provence-Alpes-Côtes d'Azur region (PACA)].

PubMed

Piercecchi-Marti, M-D; Sastre, B; Zuck, S; François, A; Genety, C; Bartoli, C; Leonetti, G

2008-01-01

Compensation for victims of medical accidents identified as no-fault medical accidents (NFMA) will be financed by national solidarity: this is a major and innovative feature of the Law of March 4, 2002 relative to Patients' Rights. In this review, we analyse the decisions of the regional commission on compensation of medical accidents in the Provence-Alpes-Côtes d'Azur (PACA) region of France in 2004 and 2005, and we attempt to identify the prevalence of certain surgical procedures liable to result in NFMA and to define the concept of "unintended consequences" in the context of state of health of the patient and the predictable course of the malady. We hope to improve the medical information given to the patient and thereby the overall quality of management. NFMA was acknowledged in 57 claims, about 10% of all those received by the commission during this period. Nearly half of the claims were within the competence of the commission because of the existence of serious sequelae (Permanent Partial Disability) in 47%. No typical profile of age or gender emerged in the patients with NFMA. The majority of cases occurred after surgical procedures, in particular gastrointestinal surgery and orthopaedic surgery; 91% were planned procedures. We did not identify increased risk related to any given type of surgery, particular disease condition, or precise anatomic region. Complications were those usually observed such as neurological complications in vascular surgery or perforations in gastrointestinal surgery. The interpretation of NFMA has undergone an evolution during this two-year period. In 2004, previous poor health status precluded acknowledgment of a medical accident, the argument being that there was a predisposition to the complication which occurred. In 2005, compensation was based on a reduced Partial Permanent Disability score compared to the patient's previous health status. This became a means of measuring the impact of the medical complication on an already

Insurability and mitigation of flood losses in private households in Germany.

PubMed

Thieken, Annegret H; Petrow, Theresia; Kreibich, Heidi; Merz, Bruno

2006-04-01

In Germany, flood insurance is provided by private insurers as a supplement to building or contents insurance. This article presents the results of a survey of insurance companies with regard to eligibility conditions for flood insurance changes after August 2002, when a severe flood caused 1.8 billion euro of insured losses in the Elbe and the Danube catchment areas, and the general role of insurance in flood risk management in Germany. Besides insurance coverage, governmental funding and public donations played an important role in loss compensation after the August 2002 flood. Therefore, this article also analyzes flood loss compensation, risk awareness, and mitigation in insured and uninsured private households. Insured households received loss compensation earlier. They also showed slightly better risk awareness and mitigation strategies. Appropriate incentives should be combined with flood insurance in order to strengthen future private flood loss mitigation. However, there is some evidence that the surveyed insurance companies do little to encourage precautionary measures. To overcome this problem, flood hazards and mitigation strategies should be better communicated to both insurance companies and property owners.

Compensation of research-related injuries in the European Union.

PubMed

Avilds, Miguelangel Ramiro

2014-12-01

The planned reform of the Clinical Trials Directive has re-opened the debate over how to implement and interpret research-related injuries regulation. In the European Union (EU), clinical trials are currently regulated by Directive 2001/20/EC, which establishes the provision of mandatory insurance before clinical trials commence but is silent on the system of liability. The proposed new Regulation will impact biomedical research assurance in all EU Member States because it points to insurance costs as being one of the causes of the fall in the number of clinical trials carried out in the EU. Despite the adoption of a risk-balance approach, the proposed new Regulation does not include a no-fault compensation system to protect subjects participating in clinical trials. An adequate protection of the rights and wellbeing of trial subjects would require not only mandatory insurance for clinical trials but also a no-fault compensation system. The new regulation should include a general clause requiring mandatory insurance and establishing liability insurance based on no-fault compensation; an exception clause, enabling the performance of clinical trials without insurance in the case of low-risk interventions or non-commercial clinical trials; and an exclusion clause, excluding compensation when there is no causal connection between injuries and clinical trial.

Clarification of Workmen's Compensation Insurance.

ERIC Educational Resources Information Center

Shapley, Allen E.

This document attempts to answer questions resulting from the 1972 Michigan Supreme Court Ruling relative to agricultural employees under the Workmen's Compensation Act (WCA). The sections of this paper outline a history of the WCA; employers covered; definition of "regularly employ"; clarification of "thirteen weeks";…

48 CFR 1352.271-90 - Insurance requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... and automobile insurance to insure the risks described in paragraph (c) of clause 1352.271-79. This insurance shall be for $1,000,000.00 on account of any one accident or occurrence with respect to each...

48 CFR 1352.271-90 - Insurance requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... and automobile insurance to insure the risks described in paragraph (c) of clause 1352.271-79. This insurance shall be for $1,000,000.00 on account of any one accident or occurrence with respect to each...

48 CFR 1352.271-90 - Insurance requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... and automobile insurance to insure the risks described in paragraph (c) of clause 1352.271-79. This insurance shall be for $1,000,000.00 on account of any one accident or occurrence with respect to each...

48 CFR 1352.271-90 - Insurance requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... and automobile insurance to insure the risks described in paragraph (c) of clause 1352.271-79. This insurance shall be for $1,000,000.00 on account of any one accident or occurrence with respect to each...

48 CFR 1352.271-90 - Insurance requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... and automobile insurance to insure the risks described in paragraph (c) of clause 1352.271-79. This insurance shall be for $1,000,000.00 on account of any one accident or occurrence with respect to each...

20 CFR 726.6 - The Office of Workers' Compensation Programs.

Code of Federal Regulations, 2013 CFR

2013-04-01

... FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED BLACK LUNG BENEFITS; REQUIREMENTS FOR COAL... number of functions with respect to the regulation of both the self-insurance and commercial insurance... Coal Mine Workers' Compensation, Office of Workers' Compensation Programs, U.S. Department of Labor...

Evaluating the influential priority of the factors on insurance loss of public transit

PubMed Central

Su, Yongmin; Chen, Xinqiang

2018-01-01

Understanding correlation between influential factors and insurance losses is beneficial for insurers to accurately price and modify the bonus-malus system. Although there have been a certain number of achievements in insurance losses and claims modeling, limited efforts focus on exploring the relative role of accidents characteristics in insurance losses. The primary objective of this study is to evaluate the influential priority of transit accidents attributes, such as the time, location and type of accidents. Based on the dataset from Washington State Transit Insurance Pool (WSTIP) in USA, we implement several key algorithms to achieve the objectives. First, K-means algorithm contributes to cluster the insurance loss data into 6 intervals; second, Grey Relational Analysis (GCA) model is applied to calculate grey relational grades of the influential factors in each interval; in addition, we implement Naive Bayes model to compute the posterior probability of factors values falling in each interval. The results show that the time, location and type of accidents significantly influence the insurance loss in the first five intervals, but their grey relational grades show no significantly difference. In the last interval which represents the highest insurance loss, the grey relational grade of the time is significant higher than that of the location and type of accidents. For each value of the time and location, the insurance loss most likely falls in the first and second intervals which refers to the lower loss. However, for accidents between buses and non-motorized road users, the probability of insurance loss falling in the interval 6 tends to be highest. PMID:29298337

Evaluating the influential priority of the factors on insurance loss of public transit.

PubMed

Zhang, Wenhui; Su, Yongmin; Ke, Ruimin; Chen, Xinqiang

2018-01-01

Understanding correlation between influential factors and insurance losses is beneficial for insurers to accurately price and modify the bonus-malus system. Although there have been a certain number of achievements in insurance losses and claims modeling, limited efforts focus on exploring the relative role of accidents characteristics in insurance losses. The primary objective of this study is to evaluate the influential priority of transit accidents attributes, such as the time, location and type of accidents. Based on the dataset from Washington State Transit Insurance Pool (WSTIP) in USA, we implement several key algorithms to achieve the objectives. First, K-means algorithm contributes to cluster the insurance loss data into 6 intervals; second, Grey Relational Analysis (GCA) model is applied to calculate grey relational grades of the influential factors in each interval; in addition, we implement Naive Bayes model to compute the posterior probability of factors values falling in each interval. The results show that the time, location and type of accidents significantly influence the insurance loss in the first five intervals, but their grey relational grades show no significantly difference. In the last interval which represents the highest insurance loss, the grey relational grade of the time is significant higher than that of the location and type of accidents. For each value of the time and location, the insurance loss most likely falls in the first and second intervals which refers to the lower loss. However, for accidents between buses and non-motorized road users, the probability of insurance loss falling in the interval 6 tends to be highest.

[Accidents in travellers - the hidden epidemic].

PubMed

Walz, Alexander; Hatz, Christoph

2013-06-01

The risk of malaria and other communicable diseases is well addressed in pre-travel advice. Accidents are usually less discussed. Thus, we aimed at assessing accident figures for the Swiss population, based on data of the register from 2004 to 2008 of the largest Swiss accident insurance organization (SUVA). More than 139'000 accidents over 5 years showed that 65 % of the accidents overseas are injuries, and 24 % are caused by poisoning or harm by cold, heat or air pressure. Most accidents happened during leisure activities or sports. More than one third of the non-lethal and more than 50 % of the fatal accidents happened in Asia. More than three-quarters of non-lethal accidents take place in people between 25 and 54 years. One out of 74 insured persons has an accident abroad per year. Despite of many analysis short-comings of the data set with regard to overseas travel, the figures document the underestimated burden of disease caused by accidents abroad and should affect the given pre-health advice.

28 CFR 301.318 - Civilian compensation laws distinguished.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Civilian compensation laws distinguished... Civilian compensation laws distinguished. The Inmate Accident Compensation system is not obligated to... under civilian workmen's compensation laws in that hospitalization is usually completed prior to the...

The German Statutory Health Insurance Program.

ERIC Educational Resources Information Center

Stassen, Manfred

1993-01-01

Describes the German health insurance system which is mandatory for nearly all German citizens. Explains that, along with pension, accident, and unemployment insurance, health insurance is one of four pillars of the German national social security system. Asserts that controlling costs while maintaining high health care standards is a national…

Physical, social and emotional function after work accidents: a medicolegal perspective.

PubMed

Holtedahl, Robin; Veiersted, Kaj Bo

2007-01-01

The aim of this study was to analyse social and functional consequences of work accidents in a group of workers' compensation claimants who had been referred from the National Insurance Administration for a medicolegal assessment. The injured workers were evaluated on average 3 years after their accidents. Their medical records were analysed, and each injury was scored according to the Abbreviated Injury Scale (AIS). Participants completed the Short Form Questionnaire (SF-36). Factors relating to outcome on SF-36 were analysed using univariate and multivariate methods. 191 claimants returned the SF-36 (62%), 83% of the respondents had an AIS score of less than two, 33% reported working full time. Compared to population-based norms, the respondents reported significantly reduced health on all eight scales of SF-36. Better health and function was mainly associated with a higher level of education and more serious injuries. The extent of social support in the workplace after the accident was only partly related to outcome. The importance of psychosocial factors when making injury assessments in a medicolegal setting is highlighted.

The Swedish system for compensation of patient injuries.

PubMed

Johansson, Henry

2010-05-01

Since 1975 Sweden has had a patient insurance system to compensate patients for health-related injuries. The system was initially based on a voluntary patient insurance solution, but in 1997 it was replaced by the Patient Insurance Act. The current Act covers both physical and mental injuries. Although about 9,000-10,000 cases are processed in Sweden annually, compensation is paid in barely half of these cases. In the Swedish patient injury claim processing system, the Patient Claims Panel is the authority that plays an important role in ensuring fair and consistent application of the Act.

28 CFR 301.106 - Repetitious accidents.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Repetitious accidents. 301.106 Section 301.106 Judicial Administration FEDERAL PRISON INDUSTRIES, INC., DEPARTMENT OF JUSTICE INMATE ACCIDENT COMPENSATION General § 301.106 Repetitious accidents. If an inmate worker is involved in successive accidents...

28 CFR 301.106 - Repetitious accidents.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Repetitious accidents. 301.106 Section 301.106 Judicial Administration FEDERAL PRISON INDUSTRIES, INC., DEPARTMENT OF JUSTICE INMATE ACCIDENT COMPENSATION General § 301.106 Repetitious accidents. If an inmate worker is involved in successive accidents...

12 CFR 303.205 - Applications for bonuses and increased compensation for senior executive officers.

Code of Federal Regulations, 2010 CFR

2010-01-01

... compensation for senior executive officers. 303.205 Section 303.205 Banks and Banking FEDERAL DEPOSIT INSURANCE... for bonuses and increased compensation for senior executive officers. (a) Scope. Any insured state..., shall submit an application to pay a bonus or increase compensation for any senior executive officer. (b...

Paving the road to negligence: the compensation for research-related injuries in Spain.

PubMed

Ramiro Avilés, Miguel A

2015-01-01

The planned reform of the regulation of clinical trials in Spain has reopened the debate over how to regulate research-related injuries. Act 29/2006 and Royal Decree 223/2004 regulate the insurance of research-related injuries, and they include a general clause requiring mandatory insurance and imposing a no-fault compensation system; they also contain an exception clause enabling clinical trials to be carried out without insurance under some conditions, and an exclusion clause excluding compensation when there is no causal connection between injuries and a clinical trial. National legislation is under review, affecting the requirement of mandatory insurance and paving the road to a liability system based on negligence, which will affect the level of protection of the persons enrolled in clinical trials because it would not ensure compensation. Regulatory texts on individuals' participation as research subjects should include not only mandatory insurance, but also a no-fault compensation system for cases when voluntary research subjects are injured, irrespective of negligence.

Auto Accidents: Reducing Frequency, Increasing Recovery.

ERIC Educational Resources Information Center

Comeaux, Linda Atkins

1988-01-01

Careful hiring, monitoring, training, discipline, and safety policies will reduce school automobile and bus accidents. Guidelines are offered for accident reporting, claim handling, and dealing with insurance adjusters. (MLF)

The administrative process for recognition and compensation for occupational diseases in Korea.

PubMed

Kwon, Soon-Chan; Kim, Hyoung-Ryoul; Kwon, Young-Jun

2014-06-01

In the Workers' Compensation Insurance (WCI) system in Korea, occupational diseases (ODs) are approved through deliberation meetings of the Committee on Occupational Disease Judgment (CODJ) after disease investigations when workers or medical institutions requested the Korea Workers' Compensation and Welfare Service (COMWEL) for medical care benefits. Insufficient data presented by employers or workers or lack of objective evidence may increase the possibility of disapproval. The expertise of accident investigation staff members should be reinforced and employers' and related institutions' obligations to cooperate and submit data should be specified under the law. The deliberation meetings of the CODJ are held separately for musculoskeletal, cerebro-cardiovascular, and medical diseases, and the judgments of ODs are made by the chairperson of COMWEL and six committee members by majority vote by issue. To reinforce the expertise of the members of the CODJ, periodic education and a system to accredit the committee members after appropriate education should be introduced. To fairly and quickly compensate for diseases that occur in workers, the criteria for the recognition of occupational diseases should be continuously amended and the systems for disease investigations and judgments should be continuously improved.

[Myocardial infarction as cause of an accident. The role of multislice CT in polytrauma management, differential diagnosis and insurance aspects].

PubMed

Kleber, C; Oswald, B; Bail, H J; Haas, N P; Kandziora, F

2008-12-01

We present for the first time the use of contrast-enhanced multislice computed tomography in trauma care to detect acute myocardial infarction and verify it as the cause of a traffic accident. In addition to the case report, cardiac contusion, coronary dissection, and facets of insurance law are discussed. The determination of acute myocardial infarction, cardiac contusion, and coronary dissection can be challenging, but answers can be found in the medical history and accident details. The trauma surgeon in the emergency department must always be interested in clarifying the cause of trauma and keeping a secondary diagnosis in mind to strive for the goal of optimal and complete polytrauma care.

No-Fault Malpractice Insurance

PubMed Central

Bush, J. W.; Chen, M. M.; Bush, A. S.

1975-01-01

No-fault medical malpractice insurance has been proposed as an alternative to the present tort liability approach. Statistical examination of the concept of proximate cause reveals not only that the question of acceptable care, and therefore of fault, is unavoidable in identifying patients deserving compensation, but also that specifying fault in an individual case is scientifically untenable. A simple formula for a Coefficient of Causality clarifies the question of proximate cause in existing trial practices and suggests that many of the threats associated with malpractice suits arise from the structure of the tort-insurance system rather than from professional responsibility for medical injury. The concepts could provide the basis for a revised claims and compensation procedure. PMID:1146300

78 FR 35326 - Division of Longshore and Harbor Workers' Compensation; Proposed Extension of Existing Collection...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-12

...' Compensation Act (LHWCA) requires covered employers to secure the payment of compensation under the Act and its... Insurance, or by becoming authorized self-insured employers (33 U.S.C. 932 et seq). Each authorized.... Similarly, each authorized self-insurer (or employer seeking authorization) is required to fully secure its...

Effects of employer-sponsored health insurance costs on Social Security taxable wages.

PubMed

Burtless, Gary; Milusheva, Sveta

2013-01-01

The increasing cost of employer contributions for employee health insurance reduces the share of compensation subject to the Social Security payroll tax. Rising insurance contributions can also have a more subtle effect on the Social Security tax base because they influence the distribution of money wages above and below the taxable maximum amount. This article uses the Medical Expenditure Panel Survey to analyze trends in employer health insurance contributions and the distribution of those costs up and down the wage distribution. Our analysis shows that employer health insurance contributions increased faster than overall compensation during 1996-2008, but such contributions grew only slightly faster among workers earning less than the taxable maximum than they did among those earning more. Because employer health insurance contributions represent a much higher percentage of compensation below the taxable maximum, health insurance cost trends exerted a disproportionate downward pressure on money wages below the taxable maximum.

Underutilization of worker's compensation insurance among professional orchestral musicians.

PubMed

Chimenti, Ruth L; Van Dillen, Linda R; Prather, Heidi; Hunt, Devyani; Chimenti, Peter C; Khoo-Summers, Lynnette

2013-03-01

Orchestral musicians commonly have playing-related symptoms (PRS) but few use worker's compensation (WC) insurance for assessment and treatment. The purpose of this study was to examine the frequency of, and factors related to, filing a WC claim among musicians. An online questionnaire was completed by 261 members of the International Conference of Symphony and Opera Musicians (ICSOM). The responses were analyzed to describe the frequency and type of injuries, perceived cause of PRS, and severity of injury in musicians who did and did not file a WC claim. Of the musicians, 93% reported PRS in the 12 months prior to the study. Only 9 musicians filed WC claims during their careers, and all claims were for upper extremity injuries. The most frequent reason for not filing a WC claim was insufficient severity. Yet among musicians describing their PRS as not severe enough for a WC claim, 47% had symptoms for >15 minutes after playing and 16% had symptoms that interfered with daily activities. These data suggest there is frequent under-reporting of injuries to WC among professional orchestral musicians. Although most musicians reported PRS that persisted after playing, the most common reason for not filing a WC claim was insufficient severity of symptoms perceived by the musicians. Future research should focus on clearly defining severity for PRS-related injuries and determining when treatment for overuse syndromes should be paid for through the WC system.

The association between subjective socioeconomic status and health inequity in victims of occupational accidents in Korea

PubMed Central

Seok, Hongdeok; Yoon, Jin-Ha; Roh, Jaehoon; Kim, Jihyun; Kim, Yeong-Kwang; Lee, Wanhyung; Rhie, Jeongbae; Won, Jong-Uk

2016-01-01

Objectives: We aimed to investigate the health inequity of victims of occupational accidents through the association between socioeconomic status and unmet healthcare need. Methods: Data from the first and second Panel Study of Workers' Compensation Insurance were used, which included 1,803 participants. The odds ratio and 95% confidence intervals for the unmet healthcare needs of participants with a lower socioeconomic status and other socioeconomic statuses were investigated using multivariate regression analysis. Results: Among all participants, 103 had unmet healthcare needs, whereas 1,700 did not. After adjusting for sex, age, smoking, alcohol, chronic disease, recuperation duration, accident type, disability, and economic participation, the odds ratio of unmet healthcare needs in participants with a lower socioeconomic status was 2.04 (95% confidence interval 1.32-3.15) compared to participants with other socioeconomic statuses. Conclusions: The victims of occupational accidents who have a lower socioeconomic status are more likely to have unmet healthcare needs in comparison to those with other socioeconomic statuses. PMID:27885246

The association between subjective socioeconomic status and health inequity in victims of occupational accidents in Korea.

PubMed

Seok, Hongdeok; Yoon, Jin-Ha; Roh, Jaehoon; Kim, Jihyun; Kim, Yeong-Kwang; Lee, Wanhyung; Rhie, Jeongbae; Won, Jong-Uk

2017-01-24

We aimed to investigate the health inequity of victims of occupational accidents through the association between socioeconomic status and unmet healthcare need. Data from the first and second Panel Study of Workers' Compensation Insurance were used, which included 1,803 participants. The odds ratio and 95% confidence intervals for the unmet healthcare needs of participants with a lower socioeconomic status and other socioeconomic statuses were investigated using multivariate regression analysis. Among all participants, 103 had unmet healthcare needs, whereas 1,700 did not. After adjusting for sex, age, smoking, alcohol, chronic disease, recuperation duration, accident type, disability, and economic participation, the odds ratio of unmet healthcare needs in participants with a lower socioeconomic status was 2.04 (95% confidence interval 1.32-3.15) compared to participants with other socioeconomic statuses. The victims of occupational accidents who have a lower socioeconomic status are more likely to have unmet healthcare needs in comparison to those with other socioeconomic statuses.

The Role of the Orthopaedic Surgeon in Workers' Compensation Cases.

PubMed

Daniels, Alan H; Kuris, Eren O; Palumbo, Mark A

2017-03-01

Workers' compensation is an employer-funded insurance program that provides financial and medical benefits for employees injured at work. Because many occupational injuries are musculoskeletal in nature, the orthopaedic surgeon plays an important role in the workers' compensation system. Along with establishing the correct diagnosis and implementing an appropriate treatment plan, the clinician must understand the fundamental components of the workers' compensation system to manage an injured employee. Ultimately, effective claim management requires collaboration among the employer, the employee, the legal representatives, the insurance company, and the orthopaedic surgeon.

Workers' experiences with compensated sick leave due to musculoskeletal disorder: a qualitative study.

PubMed

Choi, Min; Kim, Hyoung-Ryoul; Lee, Jinwoo; Lee, Hye-Eun; Byun, Junsu; Won, Jong Uk

2014-01-01

The most common occupational disease that is compensated by Industrial Accident Compensation Insurance (IACI) in Korea is musculoskeletal disease (MSD). Although complaints about the workers' compensation system have been raised by injured workers with MSD, studies that examine workers' experiences with the Korean system are rare. This paper is a qualitative study designed to examine injured workers' experiences with the workers' compensation system in Korea. The aim of this study is to explore the drawbacks of the workers' compensation system and to suggest ways to improve this system. All workers from an automobile parts factory in Anseong, GyeongGi province who were compensated for MSD by IACI from January 2003 to August 2013 were invited to participate. Among these 153 workers, 142 workers completed the study. Semi-structured open-ended interviews and questionnaires were administered by occupational physicians. The responses of 131 workers were analyzed after excluding 11 workers, 7 of whom provided incomplete answers and 4 of whom were compensated by accidental injury. Based on their age, disease, department of employment, and compensation time, 16 of these 131 workers were invited to participate in an individual in-depth interview. In-depth interviews were conducted by one of 3 occupational physicians until the interview contents were saturated. Injured workers with MSD reported that the workers' compensation system was intimidating. These workers suffered more emotional distress than physical illness due to the workers' compensation system. Injured workers reported that they were treated inadequately and remained isolated for most of the recuperation period. The compensation period was terminated without ample guidance or a plan for an appropriate rehabilitation process. Interventions to alleviate the negative experiences of injured workers, including quality control of the medical care institutions and provisions for mental and psychological care for

Improve medical malpractice law by letting health care insurers take charge.

PubMed

Reinker, Kenneth S; Rosenberg, David

2011-01-01

This essay discusses unlimited insurance subrogation (UIS) as a means of improving the deterrence and compensation results of medical malpractice law. Under UIS, health care insureds could assign their entire potential medical malpractice claims to their first-party commercial and government insurers. UIS should improve deterrence by establishing first-party insurers as plaintiffs to confront liability insurers on the defense side, leading to more effective prosecution of meritorious claims and reducing meritless and unnecessary litigation. UIS should improve compensation outcomes by converting litigation cost- and risk- laden "tort insurance" into cheaper and enhanced first-party insurance. UIS also promises dynamic benefits through further reforms by contract between the first-party and liability insurers that would take charge of system. No UIS-related costs are apparent that would outweigh these benefits. © 2011 American Society of Law, Medicine & Ethics, Inc.

12 CFR 2.5 - Bank compensation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Bank compensation. 2.5 Section 2.5 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY SALES OF CREDIT LIFE INSURANCE § 2.5 Bank compensation. (a) Nothing contained in this part prohibits a bank employee, officer, director, or principal...

12 CFR 2.5 - Bank compensation.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 1 2011-01-01 2011-01-01 false Bank compensation. 2.5 Section 2.5 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY SALES OF CREDIT LIFE INSURANCE § 2.5 Bank compensation. (a) Nothing contained in this part prohibits a bank employee, officer, director, or principal...

45 CFR 146.145 - Special rules relating to group health plans.

Code of Federal Regulations, 2014 CFR

2014-10-01

... benefits are excepted in all circumstances— (i) Coverage only for accident (including accidental death and... insurance and automobile liability insurance; (iv) Coverage issued as a supplement to liability insurance; (v) Workers' compensation or similar coverage; (vi) Automobile medical payment insurance; (vii...

29 CFR 2590.732 - Special rules relating to group health plans.

Code of Federal Regulations, 2014 CFR

2014-07-01

... benefits are excepted in all circumstances— (i) Coverage only for accident (including accidental death and... insurance and automobile liability insurance; (iv) Coverage issued as a supplement to liability insurance; (v) Workers' compensation or similar coverage; (vi) Automobile medical payment insurance; (vii...

20 CFR 703.313 - Revocation of authorization to self-insure.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Revocation of authorization to self-insure... LONGSHOREMEN'S AND HARBOR WORKERS' COMPENSATION ACT AND RELATED STATUTES INSURANCE REGULATIONS Authorization of Self-Insurers § 703.313 Revocation of authorization to self-insure. The Office may for good cause shown...

33 CFR 135.207 - Insurance as evidence.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Insurance as evidence. 135.207 Section 135.207 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OFFSHORE OIL POLLUTION COMPENSATION FUND...

33 CFR 135.207 - Insurance as evidence.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Insurance as evidence. 135.207 Section 135.207 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OFFSHORE OIL POLLUTION COMPENSATION FUND...

33 CFR 135.207 - Insurance as evidence.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Insurance as evidence. 135.207 Section 135.207 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OFFSHORE OIL POLLUTION COMPENSATION FUND...

33 CFR 135.207 - Insurance as evidence.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Insurance as evidence. 135.207 Section 135.207 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OFFSHORE OIL POLLUTION COMPENSATION FUND...

33 CFR 135.207 - Insurance as evidence.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Insurance as evidence. 135.207 Section 135.207 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OFFSHORE OIL POLLUTION COMPENSATION FUND...

26 CFR 54.9831-1 - Special rules relating to group health plans.

Code of Federal Regulations, 2013 CFR

2013-04-01

... excepted in all circumstances— (i) Coverage only for accident (including accidental death and dismemberment... automobile liability insurance; (iv) Coverage issued as a supplement to liability insurance; (v) Workers' compensation or similar coverage; (vi) Automobile medical payment insurance; (vii) Credit-only insurance (for...

26 CFR 54.9831-1 - Special rules relating to group health plans.

Code of Federal Regulations, 2011 CFR

2011-04-01

... excepted in all circumstances— (i) Coverage only for accident (including accidental death and dismemberment... automobile liability insurance; (iv) Coverage issued as a supplement to liability insurance; (v) Workers' compensation or similar coverage; (vi) Automobile medical payment insurance; (vii) Credit-only insurance (for...

26 CFR 54.9831-1 - Special rules relating to group health plans.

Code of Federal Regulations, 2014 CFR

2014-04-01

... excepted in all circumstances— (i) Coverage only for accident (including accidental death and dismemberment... automobile liability insurance; (iv) Coverage issued as a supplement to liability insurance; (v) Workers' compensation or similar coverage; (vi) Automobile medical payment insurance; (vii) Credit-only insurance (for...

26 CFR 54.9831-1 - Special rules relating to group health plans.

Code of Federal Regulations, 2012 CFR

2012-04-01

... excepted in all circumstances— (i) Coverage only for accident (including accidental death and dismemberment... automobile liability insurance; (iv) Coverage issued as a supplement to liability insurance; (v) Workers' compensation or similar coverage; (vi) Automobile medical payment insurance; (vii) Credit-only insurance (for...

78 FR 956 - National Vaccine Injury Compensation Program: Revised Amount of the Average Cost of a Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-07

... Vaccine Injury Compensation Program: Revised Amount of the Average Cost of a Health Insurance Policy The... average cost of a health insurance policy as it relates to the National Vaccine Injury Compensation... revised amounts of an average cost of a health insurance policy, as determined by the Secretary, are to be...

75 FR 2551 - National Vaccine Injury Compensation Program: Revised Amount of the Average Cost of a Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-15

... Vaccine Injury Compensation Program: Revised Amount of the Average Cost of a Health Insurance Policy The... average cost of a health insurance policy as it relates to the National Vaccine Injury Compensation... revised amounts of an average cost of a health insurance policy, as determined by the Secretary, are to be...

77 FR 801 - National Vaccine Injury Compensation Program: Revised Amount of the Average Cost of a Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-06

... Vaccine Injury Compensation Program: Revised Amount of the Average Cost of a Health Insurance Policy The... average cost of a health insurance policy as it relates to the National Vaccine Injury Compensation... revised amounts of an average cost of a health insurance policy, as determined by the Secretary, are to be...

76 FR 5180 - National Vaccine Injury Compensation Program: Revised Amount of the Average Cost of a Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-28

... Vaccine Injury Compensation Program: Revised Amount of the Average Cost of a Health Insurance Policy The... average cost of a health insurance policy as it relates to the National Vaccine Injury Compensation... revised amounts of an average cost of a health insurance policy, as determined by the Secretary, are to be...

[Expert assessment of hearing loss within the scope of the social compensation law and the law regarding severely handicapped patients].

PubMed

Plath, P

1992-10-01

Special problems are described concerning expert opinions on hearing disability and hearing loss with regard to the German Social Rights for Compensation and the laws for handicapped persons. In some aspects there are similarities to the rights of accident insurance, but disability programs question only the degree of handicap present and not the source of the hearing loss. The expert opinion on the subject's ability to work in his or any other profession must only determine the patient's ability to hear and the tasks needed to fulfill the profession. Special attention is given to the problems arising from tinnitus.

How does the purchasing staff of an accident insurance organization seek information about treatment effectiveness?

PubMed Central

Dwairy, Mai N.; Kendall, Nicholas

2002-01-01

Objectives: The objective is to study how the staff who purchase health care services for a large national government accident-compensation system seek information on treatment effectiveness, how they assess the quality of that information, whether they question the information sources they choose, and how familiar they are with the key concepts of evidence-based health care (EBHC). Method: Staff (22 out of 34) of the health purchasing division of the New Zealand Accident Compensation Corporation (NZ ACC) were interviewed using eight preformatted questions to which they could provide open and multiple answers. Responses were subsequently codified into typologies for quantitative analysis. Results: Most respondents report that they assess the effectiveness of a treatment by accessing published information (nonhuman sources), by consulting others (human sources), or by both means. They assess the quality of information mostly by consulting others, and the second-highest proportion of responses state that they do not know how to evaluate the quality of information. No clear preference emerges with respect to the types of information needed to determine the effectiveness of treatments. The majority of the staff believes they can access information needed to determine treatment effectiveness through the Internet or information databases such as MEDLINE. Although most said they understand the key concepts of EBHC, only five out of twenty-two were able to accurately describe them. Conclusions: The findings suggest that there is a low level of awareness among the staff of the NZ ACC regarding the use of evidence and understanding of the key concepts of EBHC. Many surveyed staff members lack the skills or training to directly question information about effectiveness of a treatment. They have little idea of the information required to determine the effectiveness of a treatment, and the majority appears to lack the skills to evaluate the health care literature. PMID:11999181

Risk, Ambiguity, and Insurance.

DTIC Science & Technology

1984-10-01

ambiguous, insurance firms are reluctant to market coverage. The oae of nulear power provides a graphic example. Neither risk managers of nuclear... kowledgeable about their chances of an accident than are insurance companies who have detailed records (of. Svenson, 1981). Note specifically that for low...nuclear power plants (SlovL et al., 1983). ore generally, people may consider events that can only occur once in a lifetime, such as death or a serious

[Potential under-registration of occupational accidents in the Mexican Institute of Social Security].

PubMed

Salinas-Tovar, José Santiago; López-Rojas, Pablo; Soto-Navarro, María Oralia; Caudillo-Araujo, David Efraín; Sánchez-Román, Francisco Raúl; Borja-Aburto, Victor Hugo

2004-01-01

To assess the potential under-registration of work-related accidents in the Mexican Institute of Social Security. A countrywide cross-sectional study was carried out with information collected from 27 district offices of the Mexican Institute of Social Security (MISS), on workers seen at MISS emergency rooms during November 2001 because of a probable accident at work. We compared these reports to official records of work-related accidents to estimate the proportion of incomplete reports. Data analysis consisted of descriptive statistics for each variable; the annual estimation of incomplete reporting proportions was made by multiplying by twelve months; 95% confidence intervals were estimated using Poisson's exact method for a proportion. Data from 27 out of 37 MISS district offices revealed that 7211 cases were not recognized as work accidents, accounting for an underestimation of 26.3%, ranging between 0 and 68% among the different district offices. The accidents that were most frequently left unregistered were mild and blunt injuries. Under-registration can affect worker compensation plans and the financial balance of the institution's occupational risk insurance. Research is needed to investigate and eliminate the causes of under-registration. Employers, the industry, and health institutions should be involved in this effort. The English version of this paper is available at: http://www.insp.mx/salud/index.html.

48 CFR 1852.228-75 - Minimum insurance coverage.

Code of Federal Regulations, 2010 CFR

2010-10-01

... performance of this contract: (a) Worker's compensation and employer's liability insurance as required by applicable Federal and state workers' compensation and occupational disease statutes. If occupational... $100,000, except in States with exclusive or monopolistic funds that do not permit workers...

Do compensation processes impair mental health? A meta-analysis.

PubMed

Elbers, Nieke A; Hulst, Liesbeth; Cuijpers, Pim; Akkermans, Arno J; Bruinvels, David J

2013-05-01

Victims who are involved in a compensation processes generally have more health complaints compared to victims who are not involved in a compensation process. Previous research regarding the effect of compensation processes has concentrated on the effect on physical health. This meta-analysis focuses on the effect of compensation processes on mental health. Prospective cohort studies addressing compensation and mental health after traffic accidents, occupational accidents or medical errors were identified using PubMed, EMBASE, PsycInfo, CINAHL, and the Cochrane Library. Relevant studies published between January 1966 and 10 June 2011 were selected for inclusion. Ten studies were included. The first finding was that the compensation group already had higher mental health complaints at baseline compared to the non-compensation group (standardised mean difference (SMD)=-0.38; 95% confidence interval (CI) -0.66 to -0.10; p=.01). The second finding was that mental health between baseline and post measurement improved less in the compensation group compared to the non-compensation group (SMD=-0.35; 95% CI -0.70 to -0.01; p=.05). However, the quality of evidence was limited, mainly because of low quality study design and heterogeneity. Being involved in a compensation process is associated with higher mental health complaints but three-quarters of the difference appeared to be already present at baseline. The findings of this study should be interpreted with caution because of the limited quality of evidence. The difference at baseline may be explained by a selection bias or more anger and blame about the accident in the compensation group. The difference between baseline and follow-up may be explained by secondary gain and secondary victimisation. Future research should involve assessment of exposure to compensation processes, should analyse and correct for baseline differences, and could examine the effect of time, compensation scheme design, and claim settlement on

The use of VA Disability Compensation and Social Security Disability Insurance among working-aged veterans.

PubMed

Wilmoth, Janet M; London, Andrew S; Heflin, Colleen M

2015-07-01

Although there is substantial disability among veterans, relatively little is known about working-aged veterans' uptake of Department of Veterans Affairs (VA) Disability Compensation and Social Security Disability Insurance (DI). This study identifies levels of veteran participation in VA disability and/or DI benefit programs, examines transitions into and out of VA and DI programs among veterans, and estimates the size and composition of the veteran population receiving VA and/or DI benefits over time. Data from the 1992, 1993, 1996, 2001, 2004, and 2008 Survey of Income and Program Participation (SIPP) are used to describe VA and DI program participation among veterans under the age of 65. The majority of working-aged veterans do not receive VA or DI benefits and joint participation is low, but use of these programs has increased over time. A higher percentage of veterans receive VA compensation, which ranges from 4.9% in 1992 to 13.2% in 2008, than DI compensation, which ranges from 2.9% in 1992 to 6.7% in 2008. The rate of joint participation ranges from less than 1% in 1992 to 3.6% in 2008. Veterans experience few transitions between VA and DI programs during the 36-48 months they are observed. The number of veterans receiving benefits from VA and/or DI nearly doubled between 1992 and 2008. There have been substantial shifts in the composition of veterans using these programs, as cohorts who served prior to 1964 are replaced by those who served after 1964. The findings suggest potential gaps in veterans' access to disability programs that might be addressed through improved coordination of VA and DI benefits. Copyright © 2015 Elsevier Inc. All rights reserved.

Aviation and insurance

NASA Technical Reports Server (NTRS)

Mayo, R H

1922-01-01

This article considers some of the causes which hinder the development of aircraft insurance. Different risks are discussed as well as the causes of aircraft accidents. Pilot error, poor airdromes, weather conditions, poorly adapted airplanes, and engine failures are all examined and some conclusions are made.

Insurance, risk, and magical thinking.

PubMed

Tykocinski, Orit E

2008-10-01

The possession of an insurance policy may not only affect the severity of a potential loss but also its perceived probability. Intuitively, people may feel that if they are insured nothing bad is likely to happen, but if they do not have insurance they are at greater peril. In Experiment 1, respondents who were reminded of their medical insurance felt they were less likely to suffer health problems in the future compared to people who were not reminded of their medical insurance. In Experiment 2a, participants who were unable to purchase travel insurance judged the probability of travel-related calamities higher compared to those who were insured. These results were replicated in Experiment 3a in a simulation of car accident insurance. The findings are explained in terms of intuitive magical thinking, specifically, the negative affective consequences of "tempting fate" and the sense of safety afforded by the notion of "being covered."

45 CFR 146.145 - Special rules relating to group health plans.

Code of Federal Regulations, 2011 CFR

2011-10-01

... circumstances. The following benefits are excepted in all circumstances— (i) Coverage only for accident..., including general liability insurance and automobile liability insurance; (iv) Coverage issued as a supplement to liability insurance; (v) Workers' compensation or similar coverage; (vi) Automobile medical...

45 CFR 146.145 - Special rules relating to group health plans.

Code of Federal Regulations, 2012 CFR

2012-10-01

... circumstances. The following benefits are excepted in all circumstances— (i) Coverage only for accident..., including general liability insurance and automobile liability insurance; (iv) Coverage issued as a supplement to liability insurance; (v) Workers' compensation or similar coverage; (vi) Automobile medical...

45 CFR 146.145 - Special rules relating to group health plans.

Code of Federal Regulations, 2013 CFR

2013-10-01

... circumstances. The following benefits are excepted in all circumstances— (i) Coverage only for accident..., including general liability insurance and automobile liability insurance; (iv) Coverage issued as a supplement to liability insurance; (v) Workers' compensation or similar coverage; (vi) Automobile medical...

Applying crash data to injury claims - an investigation of determinant factors in severe motor vehicle accidents.

PubMed

Shannon, Darren; Murphy, Finbarr; Mullins, Martin; Eggert, Julian

2018-04-01

An extensive number of research studies have attempted to capture the factors that influence the severity of vehicle impacts. The high number of risks facing all traffic participants has led to a gradual increase in sophisticated data collection schemes linking crash characteristics to subsequent severity measures. This study serves as a departure from previous research by relating injuries suffered in road traffic accidents to expected trauma compensation payouts and deriving a quantitative cost function. Data from the National Highway Traffic Safety Administration's (NHTSA) Crash Injury Research (CIREN) database for the years 2005-2014 is combined with the Book of Quantum, an Irish governmental document that offers guidelines on the appropriate compensation to be awarded for injuries sustained in accidents. A multiple linear regression is carried out to identify the crash factors that significantly influence expected compensation costs and compared to ordered and multinomial logit models. The model offers encouraging results given the inherent variation expected in vehicular incidents and the subjectivity influencing compensation payout judgments, attaining an adjusted-R 2 fit of 20.6% when uninfluential factors are removed. It is found that relative speed at time of impact and dark conditions increase the expected costs, while rear-end incidents, incident sustained in van-based trucks and incidents sustained while turning result in lower expected compensations. The number of airbags available in the vehicle is also a significant factor. The scalar-outcome approach used in this research offers an alternative methodology to the discrete-outcome models that dominate traffic safety analyses. The results also raise queries on the future development of claims reserving (capital allocations earmarked for future expected claims payments) as advanced driver assistant systems (ADASs) seek to eradicate the most frequent types of crash factors upon which insurance

20 CFR 703.312 - Period of authorization as self-insurer.

Code of Federal Regulations, 2010 CFR

2010-04-01

... regulations in this part, and OWCP. (b) A self-insurer who has secured its liability by depositing an... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Period of authorization as self-insurer. 703... LONGSHOREMEN'S AND HARBOR WORKERS' COMPENSATION ACT AND RELATED STATUTES INSURANCE REGULATIONS Authorization of...

26 CFR 1.79-1 - Group-term life insurance-general rules.

Code of Federal Regulations, 2011 CFR

2011-04-01

... precludes individual selection. (b) May group-term life insurance be combined with other benefits? No part... that does not provide general death benefits, such as travel insurance or accident and health insurance... 26 Internal Revenue 2 2011-04-01 2011-04-01 false Group-term life insurance-general rules. 1.79-1...

A Policy Intervention Study to Identify High-Risk Groups to Prevent Industrial Accidents in Republic of Korea.

PubMed

Yi, Kwan Hyung; Lee, Seung Soo

2016-09-01

The objective of this study is to identify high-risk groups for industrial accidents by setting up 2003 as the base year and conducting an in-depth analysis of the trends of major industrial accident indexes the index of industrial accident rate, the index of occupational injury rate, the index of occupational illness and disease rate per 10,000 people, and the index of occupational injury fatality rate per 10,000 people for the past 10 years. This study selected industrial accident victims, who died or received more than 4 days of medical care benefits, due to occupational accidents and diseases occurring at workplaces, subject to the Industrial Accident Compensation Insurance Act, as the study population. According to the trends of four major indexes by workplace characteristics, the whole industry has shown a decreasing tendency in all four major indexes since the base year (2003); as of 2012, the index of industrial accident rate was 67, while the index of occupational injury fatality rate per 10,000 people was 59. The manufacturing industry, age over 50 years and workplaces with more than 50 employees showed a high severity level of occupational accidents. Male workers showed a higher severity level of occupational accidents than female workers. The employment period of < 3 years and newly hired workers with a relatively shorter working period are likely to have more occupational accidents than others. Overall, an industrial accident prevention policy must be established by concentrating all available resources and capacities of these high-risk groups.

20 CFR 703.204 - Decision on insurance carrier's application; minimum amount of deposit.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Decision on insurance carrier's application..., DEPARTMENT OF LABOR LONGSHOREMEN'S AND HARBOR WORKERS' COMPENSATION ACT AND RELATED STATUTES INSURANCE REGULATIONS Insurance Carrier Security Deposit Requirements § 703.204 Decision on insurance carrier's...

34 CFR 106.39 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false Health and insurance benefits and services. 106.39... Prohibited § 106.39 Health and insurance benefits and services. In providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient shall not...

10 CFR 1042.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Health and insurance benefits and services. 1042.440... in Education Programs or Activities Prohibited § 1042.440 Health and insurance benefits and services. Subject to § 1042.235(d), in providing a medical, hospital, accident, or life insurance benefit, service...

20 CFR 703.311 - Required reports; examination of self-insurer accounts.

Code of Federal Regulations, 2010 CFR

2010-04-01

... section of the regulations in this part. The self-insurer must permit the Office or its duly authorized... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Required reports; examination of self-insurer... LABOR LONGSHOREMEN'S AND HARBOR WORKERS' COMPENSATION ACT AND RELATED STATUTES INSURANCE REGULATIONS...

49 CFR 25.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Health and insurance benefits and services. 25.440... Basis of Sex in Education Programs or Activities Prohibited § 25.440 Health and insurance benefits and services. Subject to § 25.235(d), in providing a medical, hospital, accident, or life insurance benefit...

45 CFR 2555.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Health and insurance benefits and services. 2555... Activities Prohibited § 2555.440 Health and insurance benefits and services. Subject to § 2555.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its...

24 CFR 3.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Health and insurance benefits and... Activities Prohibited § 3.440 Health and insurance benefits and services. Subject to § 3.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its...

32 CFR 196.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false Health and insurance benefits and services. 196... Activities Prohibited § 196.440 Health and insurance benefits and services. Subject to § 196.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its...

13 CFR 113.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Health and insurance benefits and....440 Health and insurance benefits and services. Subject to § 113.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient...

36 CFR 1211.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Health and insurance benefits... Activities Prohibited § 1211.440 Health and insurance benefits and services. Subject to § 1211.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its...

38 CFR 23.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Health and insurance... Prohibited § 23.440 Health and insurance benefits and services. Subject to § 23.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a...

[The effectiveness of compensation system for mesotheliomas due to occupational exposure to asbestos and determinants for requests and awards: an evaluation based on record-linkage between the Veneto Mesothelioma Register and the claims and compensations recorded by the National Insurance Institute (INAIL)].

PubMed

Merler, Enzo; Bressan, Vittoria; Bilato, Anna Maria; Marinaccio, Alessandro

2011-01-01

To determine the rate of requests for compensation and of compensations awarded for mesothelioma cases due to occupational exposure to asbestos; to identify factors that may influence the outcome; to provide an appreciation of the amount of compensation. Record-linkage study at individual level between the new cases of mesothelioma occurred among the residents of the Veneto Region (Northern Italy) between 1999- 2007 and the file of the Insurance Institute, with individual data on all claims and compensations. Adjusted logistic regression models were used to estimated the association between submitting claims and obtaining an award and socio-demographic and other characteristics. 349 on 499 mesotheliomas considered to be due to occupational exposure to asbestos submitted a claim (70% of those of occupational origin) and 72%of claims were accepted. The welfare system covers only 35%of mesothelioma occurred. The probability of submitting and obtaining a claim was associated with gender, cancer site, age at diagnosis, vital status, and residence or local office in charge of the evaluation. A strong discrimination against women is observed. If exposure to asbestos at work was due to a direct manipulation of asbestos, claims were more easily accepted.As a consequence,mesothelioma occurred among construction workers, the occupational activity at the origin of the largest number of occurring mesotheliomas, are more frequently rejected.When submitted by a relative, the lag between a request for compensation and the decision is on average of about two years. This is the first study in Italy using a record-linkage method and was made possible thanks to a population based mesothelioma Register and the availability of memorized information of the Insurance Institute.The welfare system shown clear limitations and there is the need for more appropriate strategies.

18 CFR 1317.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Health and insurance... § 1317.440 Health and insurance benefits and services. Subject to § 1317.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient...

48 CFR 970.2803-1 - Workers' Compensation Insurance.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Management, within the Headquarters procurement organization, other officials, and the Heads of Contracting... Office of Resource Management, within the Headquarters procurement organization, is responsible for... SUPPLEMENTARY REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Bonds and Insurance 970.2803-1 Workers...

48 CFR 970.2803-1 - Workers' Compensation Insurance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Management, within the Headquarters procurement organization, other officials, and the Heads of Contracting... Office of Resource Management, within the Headquarters procurement organization, is responsible for... SUPPLEMENTARY REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Bonds and Insurance 970.2803-1 Workers...

48 CFR 970.2803-1 - Workers' Compensation Insurance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Management, within the Headquarters procurement organization, other officials, and the Heads of Contracting... Office of Resource Management, within the Headquarters procurement organization, is responsible for... SUPPLEMENTARY REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Bonds and Insurance 970.2803-1 Workers...

48 CFR 970.2803-1 - Workers' Compensation Insurance.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Management, within the Headquarters procurement organization, other officials, and the Heads of Contracting... Office of Resource Management, within the Headquarters procurement organization, is responsible for... SUPPLEMENTARY REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Bonds and Insurance 970.2803-1 Workers...

48 CFR 970.2803-1 - Workers' Compensation Insurance.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Management, within the Headquarters procurement organization, other officials, and the Heads of Contracting... Office of Resource Management, within the Headquarters procurement organization, is responsible for... SUPPLEMENTARY REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Bonds and Insurance 970.2803-1 Workers...

The European influence on workers' compensation reform in the United States

PubMed Central

2011-01-01

Workers' compensation law in the United States is derived from European models of social insurance introduced in Germany and in England. These two concepts of workers' compensation are found today in the federal and state workers' compensation programs in the United States. All reform proposals in the United States are influenced by the European experience with workers' compensation. In 2006, a reform proposal termed the Public Health Model was made that would abolish the workers' compensation system, and in its place adopt a national disability insurance system for all injuries and illnesses. In the public health model, health and safety professionals would work primarily in public health agencies. The public health model eliminates the physician from any role other than that of privately consulting with the patient and offering advice solely to the patient. The Public Health Model is strongly influenced by the European success with physician consultation with industry and labor. PMID:22151643

26 CFR 1.106-1 - Contributions by employer to accident and health plans.

Code of Federal Regulations, 2010 CFR

2010-04-01

... referred to in section 105(e)) which provides accident or health benefits directly or through insurance to....106-1 Contributions by employer to accident and health plans. The gross income of an employee does not... insurance or otherwise) to the employee for personal injuries or sickness incurred by him, his spouse, or...

77 FR 59986 - Announcement Regarding a Change in Eligibility for Unemployment Insurance (UI) Claimants in New...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-01

... Eligibility for Unemployment Insurance (UI) Claimants in New York in the Emergency Unemployment Compensation... Unemployment Insurance (UI) claimants in New York in the Emergency Unemployment Compensation 2008 (EUC08... month average, seasonally adjusted total unemployment rate be at least 110 percent of one of the rates...

76 FR 58566 - Proposed Information Collection (Report of Accidental Injury in Support of Claim for Compensation...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-21

... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0104] Proposed Information Collection (Report of Accidental Injury in Support of Claim for Compensation or Pension/Statement of Witness to Accident... for Compensation or Pension/Statement of Witness to Accident, VA Form 21- 4176. OMB Control Number...

20 CFR 302.7 - Establishing base year service and compensation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Establishing base year service and compensation. 302.7 Section 302.7 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT QUALIFIED EMPLOYEE § 302.7 Establishing base year service and compensation. (a...

20 CFR 302.7 - Establishing base year service and compensation.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true Establishing base year service and compensation. 302.7 Section 302.7 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT QUALIFIED EMPLOYEE § 302.7 Establishing base year service and compensation. (a...

20 CFR 302.7 - Establishing base year service and compensation.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false Establishing base year service and compensation. 302.7 Section 302.7 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT QUALIFIED EMPLOYEE § 302.7 Establishing base year service and compensation. (a...

20 CFR 302.7 - Establishing base year service and compensation.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Establishing base year service and compensation. 302.7 Section 302.7 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT QUALIFIED EMPLOYEE § 302.7 Establishing base year service and compensation. (a...

20 CFR 302.7 - Establishing base year service and compensation.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Establishing base year service and compensation. 302.7 Section 302.7 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT QUALIFIED EMPLOYEE § 302.7 Establishing base year service and compensation. (a...

46 CFR 326.4 - Reports of accidents and occurrences.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 8 2011-10-01 2011-10-01 false Reports of accidents and occurrences. 326.4 Section 326... MARINE PROTECTION AND INDEMNITY INSURANCE UNDER AGREEMENTS WITH AGENTS § 326.4 Reports of accidents and occurrences. The Agent shall report every accident or occurrence of a P&I nature promptly to both the Director...

46 CFR 326.4 - Reports of accidents and occurrences.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 8 2010-10-01 2010-10-01 false Reports of accidents and occurrences. 326.4 Section 326... MARINE PROTECTION AND INDEMNITY INSURANCE UNDER AGREEMENTS WITH AGENTS § 326.4 Reports of accidents and occurrences. The Agent shall report every accident or occurrence of a P&I nature promptly to both the Director...

5 CFR 870.703 - Election of Basic insurance.

Code of Federal Regulations, 2010 CFR

2010-01-01

....603. If the individual doesn't convert to an individual policy, insurance stops at the end of the... force reduces by 2 percent of the BIA each month until the maximum reduction is reached. This reduction... compensation. The amount of Basic insurance in force reduces by 1 percent of the BIA each month until the...

29 CFR 500.121 - Coverage and level of insurance required.

Code of Federal Regulations, 2010 CFR

2010-07-01

... REGULATIONS MIGRANT AND SEASONAL AGRICULTURAL WORKER PROTECTION Motor Vehicle Safety and Insurance for Transportation of Migrant and Seasonal Agricultural Workers, Housing Safety and Health for Migrant Workers... workers' compensation coverage is provided. (c) The insurance to be obtained under paragraph (a) of this...

76 FR 73021 - Agency Information Collection (Report of Accidental Injury in Support of Claim for Compensation...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-28

... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0104] Agency Information Collection (Report of Accidental Injury in Support of Claim for Compensation or Pension/Statement of Witness to Accident... of Claim for Compensation or Pension/Statement of Witness to Accident, VA Form 21- 4176. OMB Control...

Insurance against climate change and flood risk: Insurability and decision processes of insurers

NASA Astrophysics Data System (ADS)

Hung, Hung-Chih; Hung, Jia-Yi

2016-04-01

1. Background Major portions of the Asia-Pacific region is facing escalating exposure and vulnerability to climate change and flood-related extremes. This highlights an arduous challenge for public agencies to improve existing risk management strategies. Conventionally, governmental funding was majorly responsible and accountable for disaster loss compensation in the developing countries in Asia, such as Taiwan. This is often criticized as an ineffective and inefficient measure of dealing with flood risk. Flood insurance is one option within the toolkit of risk-sharing arrangement and adaptation strategy to flood risk. However, there are numerous potential barriers for insurance companies to cover flood damage, which would cause the flood risk is regarded as uninsurable. This study thus aims to examine attitudes within the insurers about the viability of flood insurance, the decision-making processes of pricing flood insurance and their determinants, as well as to examine potential solutions to encourage flood insurance. 2. Methods and data Using expected-utility theory, an insurance agent-based decision-making model was developed to examine the insurers' attitudes towards the insurability of flood risk, and to scrutinize the factors that influence their decisions on flood insurance premium-setting. This model particularly focuses on how insurers price insurance when they face either uncertainty or ambiguity about the probability and loss of a particular flood event occurring. This study considers the factors that are expected to affect insures' decisions on underwriting and pricing insurance are their risk perception, attitudes towards flood insurance, governmental measures (e.g., land-use planning, building codes, risk communication), expected probabilities and losses of devastating flooding events, as well as insurance companies' attributes. To elicit insurers' utilities about premium-setting for insurance coverage, the 'certainty equivalent,' 'probability

Ten years' experience using an integrated workers' compensation management system to control workers' compensation costs.

PubMed

Bernacki, Edward J; Tsai, Shan P

2003-05-01

This work presents 10 years of experience using an Integrated Workers' Compensation Claims Management System that allows safety professionals, adjusters, and selected medical and nursing providers to collaborate in a process of preventing accidents and expeditiously assessing, treating, and returning individuals to productive work. The hallmarks of the program involve patient advocacy and customer service, steerage of injured employees to a small network of physicians, close follow-up, and the continuous dialogue between parties regarding claims management. The integrated claims management system was instituted in fiscal year 1992 servicing a population of approximately 21,000 individuals. The system was periodically refined and by the 2002 fiscal year, 39,000 individuals were managed under this paradigm. The frequency of lost-time and medical claims rate decreased 73% (from 22 per 1000 employees to 6) and 61% (from 155 per 1000 employees to 61), respectively, between fiscal year 1992 and fiscal year 2002. The number of temporary/total days paid per 100 insureds decreased from 163 in fiscal year 1992 to 37 in fiscal year 2002, or 77%. Total workers' compensation expenses including all medical, indemnity and administrative, decreased from $0.81 per $100 of payroll in fiscal year 1992 to $0.37 per $100 of payroll in fiscal year 2002, a 54% decrease. More specifically, medical costs per $100 of payroll decreased 44% (from $0.27 to $0.15), temporary/total, 61% (from $0.18 to $0.07), permanent/partial, 63% (from $0.19 to $0.07) and administrative costs, 48% ($0.16 to $0.09). These data suggests that workers' compensation costs can be reduced over a multi-year period by using a small network of clinically skilled health care providers who address an individual workers' psychological, as well as physical needs and where communication between all parties (e.g., medical care providers, supervisors, and injured employees) is constantly maintained. Furthermore, these results

33 CFR 136.111 - Insurance.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Insurance. 136.111 Section 136.111 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES...

33 CFR 136.111 - Insurance.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Insurance. 136.111 Section 136.111 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES...

33 CFR 136.111 - Insurance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Insurance. 136.111 Section 136.111 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES...

33 CFR 136.111 - Insurance.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Insurance. 136.111 Section 136.111 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES...

33 CFR 136.111 - Insurance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Insurance. 136.111 Section 136.111 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES...

31 CFR 50.54 - Payment of Federal share of compensation.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance: Treasury 1 2014-07-01 2014-07-01 false Payment of Federal share of compensation. 50.54 Section 50.54 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM RISK INSURANCE PROGRAM Claims Procedures § 50.54 Payment of Federal share of compensation. (a) Timing...

31 CFR 50.54 - Payment of Federal share of compensation.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance: Treasury 1 2012-07-01 2012-07-01 false Payment of Federal share of compensation. 50.54 Section 50.54 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM RISK INSURANCE PROGRAM Claims Procedures § 50.54 Payment of Federal share of compensation. (a) Timing...

31 CFR 50.54 - Payment of Federal share of compensation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 false Payment of Federal share of compensation. 50.54 Section 50.54 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM RISK INSURANCE PROGRAM Claims Procedures § 50.54 Payment of Federal share of compensation. (a) Timing...

75 FR 18887 - Division of Longshore and Harbor Workers' Compensation; Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-13

... covered employers to secure the payment of compensation under the Act and its extensions by purchasing... becoming authorized self-insured employers (33 U.S.C. 932 et seq). Each authorized insurance carrier (or... authorized self-insurer (or employer seeking authorization) is required to fully secure its Longshore Act...

Associations with duration of compensation following whiplash sustained in a motor vehicle crash.

PubMed

Casey, Petrina P; Feyer, Anne Marie; Cameron, Ian D

2015-09-01

Continued exposure to compensation systems has been reported as deleterious to the health of participants. Understanding the associations with time to claim closure could allow for targeted interventions aimed at minimising the time participants are exposed to the compensation system. To identify the associations of extended time receiving compensation benefits with the aim of developing a prognostic model that predicts time to claim closure. Prospective cohort study in people with whiplash associated disorder. Time to claim closure, in a privately underwritten fault based third party traffic crash insurance scheme in New South Wales, Australia. Cox proportional hazard regression modelling. Of the 246 participants, 25% remained in the compensation system longer than 24 months with 15% remaining longer than three years. Higher initial disability (Functional Rating Index≥25 at baseline) (HRR: 95% CI, 1.916: 1.324-2.774, p<0.001); and lower initial mental health as measured by SF-36 Mental Component Score (HRR: 95% CI, 0.973: 0.960-0.987, p<0.001) were significantly and independently associated with an increased time-to-claim closure. Shorter time to claim closure was associated with having no legal involvement (HRR: 95% CI, 1.911: 1.169-3.123, p=0.009); and, not having a prior claim for compensation (HRR: 95% CI, 1.523: 1.062-2.198, p=0.022). Health and insurance related factors are independently associated with time to claim closure. Both factors need to be considered by insurers in their assessment of complexity of claims. Interventions aimed at minimising the impact of these factors could reduce claimants' exposure to the compensation system. In turn insurers can potentially reduce claims duration and cost, while improving the health outcomes of claimants. Copyright © 2015 Elsevier Ltd. All rights reserved.

Possibility of reducing costs of mining operations - economic aspects of workplace accidents

NASA Astrophysics Data System (ADS)

Duda, Adam

2017-11-01

The article presents methods of calculating costs of workplace accidents incurred by an employer, and the influence of the number and severity of accidents on changes in the amount of accident insurance contribution paid by an employer within the framework of the social security system.

45 CFR 618.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 3 2011-10-01 2011-10-01 false Health and insurance benefits and services. 618.440 Section 618.440 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE..., hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient...

45 CFR 618.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 3 2013-10-01 2013-10-01 false Health and insurance benefits and services. 618.440 Section 618.440 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE..., hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient...

45 CFR 618.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 3 2012-10-01 2012-10-01 false Health and insurance benefits and services. 618.440 Section 618.440 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE..., hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient...

45 CFR 618.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Health and insurance benefits and services. 618.440 Section 618.440 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE..., hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient...

Health and life insurance as an alternative to malpractice tort law.

PubMed

Sumner, Walton

2010-06-02

Tort law has legitimate social purposes of deterrence, punishment and compensation, but medical tort law does none of these well. Tort law could be counterproductive in medicine, encouraging costly defensive practices that harm some patients, restricting access to care in some settings and discouraging innovation. Patients might be better served by purchasing combined health and life insurance policies and waiving their right to pursue malpractice claims. The combined policy should encourage the insurer to profit by inexpensively delaying policyholders' deaths. A health and life insurer would attempt to minimize mortal risks to policyholders from any cause, including medical mistakes and could therefore pursue systematic quality improvement efforts. If policyholders trust the insurer to seek, develop and reward genuinely effective care; identify, deter and remediate poor care; and compensate survivors through the no-fault process of paying life insurance benefits, then tort law is largely redundant and the right to sue may be waived. If expensive defensive medicine can be avoided, that savings alone could pay for fairly large life insurance policies. Insurers are maligned largely because of their logical response to incentives that are misaligned with the interests of patients and physicians in the United States. Patient, provider and insurer incentives could be realigned by combining health and life insurance, allowing the insurer to use its considerable information access and analytic power to improve patient care. This arrangement would address the social goals of malpractice torts, so that policyholders could rationally waive their right to sue.

[Costs of hand emergencies].

PubMed

Raimbeau, G

2003-10-01

In France at the present time, there is no comprehensive registry of hand injuries. Three types of occurrences; motor vehicle accidents, work accidents, and accidents incident to activities of daily living, are covered by different types of insurance. It is the individual insurance companies, payers of the indemnification, who maintain registries of these accidents. Statistics on work accidents are very detailed and consistent, but they are oriented toward risk management. The aggregate cost of traumatic injuries to the hand is not known. Only large financial institutions are equipped to determine appropriate preventive measures and to establish premium rates based on loss experience. In 2001, hand injuries accounted for 27% of work accidents causing loss of work of at least 1 day. About 29.8% of these work accidents caused permanent partial impairment. About 17.7% of total days lost and 18.2% of the total costs of permanent impairment were due to hand injuries. In the system of compensation for work accidents, there is a major difference in the cost according to the severity of the impairment. If the permanent impairment is equal to or less than 9%, a lump sum payment is made, but if the permanent impairment is over 9%, the worker receives regular payments for the rest of his life. In 2000, the average cost of a work injury with partial permanent impairment of over 9% was [symbol: see text] 85,405, while the average cost of a lump sum settlement was only [symbol: see text] 1479, a ratio of 57 to 1. The compensation costs represent 80% of the cost of work accidents, while the cost of treatment, including all providers and institutions, makes up only 20% of the cost. Compensation for sequelae of accidents in the course of daily life is new for the insurance companies, although these accidents are frequent and often cause significant repercussions in the professional lives of victims because of the loss of hand function. Provision of optimal treatment for these

Establishment of Korean Nuclear Ombudsman System Importing Compensation and Insurance Concept for Residents

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hyun Seok Ko; Yong Min Kim; Young Wook Lee

2006-07-01

. So it is not established a firm phase as right relief body to be believed by public with lack of independence, authority and specialty. Therefore the establishment of organization that can be the role as special ombudsman organization about sensitive and special matter like nuclear matter is necessary. Definite establishment element of ombudsman system is to introduce of congress type ombudsman element, to be permanent standing system ombudsman, to limit jurisdiction extent and have strong authority, to be able to access easily, to be composed of legal and nuclear specialist. One of important requirements of resident is compensation. So, based on the resident compensation theory about aversion equipment, ombudsman system should be established introducing the insurance theory through risk management as functional background for appropriate compensation. (authors)« less

34 CFR 106.39 - Health and insurance benefits and services.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 34 Education 1 2012-07-01 2012-07-01 false Health and insurance benefits and services. 106.39 Section 106.39 Education Regulations of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS... Prohibited § 106.39 Health and insurance benefits and services. In providing a medical, hospital, accident...

A methodological proposal to evaluate the cost of duration moral hazard in workplace accident insurance.

PubMed

Martín-Román, Ángel; Moral, Alfonso

2017-12-01

The cost of duration moral hazard in workplace accident insurance has been amply explored by North-American scholars. Given the current context of financial constraints in public accounts, and particularly in the Social Security system, we feel that the issue merits inquiry in the case of Spain. The present research posits a methodological proposal using the econometric technique of stochastic frontiers, which allows us to break down the duration of work-related leave into what we term "economic days" and "medical days". Our calculations indicate that during the 9-year period spanning 2005-2013, the cost of sick leave amongst full-time salaried workers amounted to 6920 million Euros (in constant 2011 Euros). Of this total, and bearing in mind that "economic days" are those attributable to duration moral hazard, over 3000 million Euros might be linked to workplace absenteeism. It is on this figure where economic policy measures might prove more effective.

31 CFR 50.51 - Adjustments to the Federal share of compensation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Adjustments to the Federal share of compensation. 50.51 Section 50.51 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM... and the insurer's recoveries for insured losses from other sources shall not be greater than the...

INDUSTRIAL DERMATOLOGIC PROBLEMS—Interrelationships Between Physician, Patient, Employer and Insurance Carrier

PubMed Central

Hall, A. Fletcher

1954-01-01

Dermatologists, employers, insurance carriers and patients often flounder in misunderstanding when dealing with industrial dermatosis. A large part of such misunderstanding stems from too limited a knowledge of compensation insurance law by physicians, employee-patients and many employers. Physicians dealing with industrial cases should not only familiarize themselves with compensation law and insurance practices, but take it upon themselves to interpret such considerations to their employee-patients and, where necessary, to their patients' employers. Present-day employer-employee relationships are frequently on a most impersonal basis, and great mutual benefit will accrue to all parties when the position and objectives of each are understood by the others and the provisions and limitations of the law are known to all. The dermatologist handling industrial cases must take the responsibility of bringing this about. PMID:13116027

Underreporting of maritime accidents to vessel accident databases.

PubMed

Hassel, Martin; Asbjørnslett, Bjørn Egil; Hole, Lars Petter

2011-11-01

Underreporting of maritime accidents is a problem not only for authorities trying to improve maritime safety through legislation, but also to risk management companies and other entities using maritime casualty statistics in risk and accident analysis. This study collected and compared casualty data from 01.01.2005 to 31.12.2009, from IHS Fairplay and the maritime authorities from a set of nations. The data was compared to find common records, and estimation of the true number of occurred accidents was performed using conditional probability given positive dependency between data sources, several variations of the capture-recapture method, calculation of best case scenario assuming perfect reporting, and scaling up a subset of casualty information from a marine insurance statistics database. The estimated upper limit reporting performance for the selected flag states ranged from 14% to 74%, while the corresponding estimated coverage of IHS Fairplay ranges from 4% to 62%. On average the study results document that the number of unreported accidents makes up roughly 50% of all occurred accidents. Even in a best case scenario, only a few flag states come close to perfect reporting (94%). The considerable scope of underreporting uncovered in the study, indicates that users of statistical vessel accident data should assume a certain degree of underreporting, and adjust their analyses accordingly. Whether to use correction factors, a safety margin, or rely on expert judgment, should be decided on a case by case basis. Copyright © 2011 Elsevier Ltd. All rights reserved.

Health and life insurance as an alternative to malpractice tort law

PubMed Central

2010-01-01

Background Tort law has legitimate social purposes of deterrence, punishment and compensation, but medical tort law does none of these well. Tort law could be counterproductive in medicine, encouraging costly defensive practices that harm some patients, restricting access to care in some settings and discouraging innovation. Discussion Patients might be better served by purchasing combined health and life insurance policies and waiving their right to pursue malpractice claims. The combined policy should encourage the insurer to profit by inexpensively delaying policyholders' deaths. A health and life insurer would attempt to minimize mortal risks to policyholders from any cause, including medical mistakes and could therefore pursue systematic quality improvement efforts. If policyholders trust the insurer to seek, develop and reward genuinely effective care; identify, deter and remediate poor care; and compensate survivors through the no-fault process of paying life insurance benefits, then tort law is largely redundant and the right to sue may be waived. If expensive defensive medicine can be avoided, that savings alone could pay for fairly large life insurance policies. Summary Insurers are maligned largely because of their logical response to incentives that are misaligned with the interests of patients and physicians in the United States. Patient, provider and insurer incentives could be realigned by combining health and life insurance, allowing the insurer to use its considerable information access and analytic power to improve patient care. This arrangement would address the social goals of malpractice torts, so that policyholders could rationally waive their right to sue. PMID:20525190

77 FR 57595 - Comment Request for Information Collection for Unemployment Compensation for Ex-Servicemembers...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-18

... Collection for Unemployment Compensation for Ex-Servicemembers (UCX), Extension Without Revisions AGENCY... Unemployment Insurance, Employment and Training Administration, U.S. Department of Labor, 200 Constitution... the paying state's unemployment insurance law which apply to unemployed claimants who worked in the...

Iatrogenic nerve injury in a national no-fault compensation scheme: an observational cohort study.

PubMed

Moore, A E; Zhang, J; Stringer, M D

2012-04-01

Iatrogenic nerve injury causes distress and disability, and often leads to litigation. The scale and profile of these injuries has only be estimated from published case reports/series and analyses of medicolegal claims.   To determine the current spectrum of iatrogenic nerve injury in New Zealand by analysing treatment injury claims accepted by a national no-fault compensation scheme. The Accident Compensation Corporation (ACC) provides national no-fault personal accident insurance cover, which extends to patients who have sustained a treatment injury from a registered healthcare professional. Nerve injury claims identified from 5227 treatment injury claims accepted by the ACC in 2009 were analysed. From 327 claims, 292 (89.3%) documenting 313 iatrogenic nerve injuries contained sufficient information for analysis. Of these, 211 (67.4%) occurred in 11 surgical specialties, particularly orthopaedics and general surgery; the remainder involved phlebotomy services, anaesthesia and various medical specialties. The commonest causes of injury were malpositioning (n = 40), venepuncture (n = 26), intravenous cannulation (n = 21) and hip arthroplasty (n = 21). Most commonly injured were the median nerve and nerve roots (n = 32 each), brachial plexus (n = 26), and the ulnar nerve (n = 25). At least 34 (11.6%) patients were referred for surgical management of their nerve injury. Iatrogenic nerve injuries are not rare and occur in almost all branches of medicine, with malpositioning under general anaesthesia and venepuncture as leading causes. Some of these injuries are probably unavoidable, but greater awareness of which nerves are at risk and in what context should facilitate the development and/or wider implementation of preventive strategies. © 2012 Blackwell Publishing Ltd.

Insurance is Everybody's Business. Series on Public Issues No. 15.

ERIC Educational Resources Information Center

Caddy, Douglas; Dethloff, Henry C.

In this booklet, one of a series intended to apply economic principles to major social and political issues of the day, the workings of the American insurance industry, a central part of the American economy, are described. Insurance provides a means to transfer or spread risk, thus helping to assure economic survival despite chance, accident, or…

31 CFR 50.33 - Entities that do not share profits and losses with private sector insurers.

Code of Federal Regulations, 2010 CFR

2010-07-01

... and losses with private sector insurers. 50.33 Section 50.33 Money and Finance: Treasury Office of the...' Compensation Funds § 50.33 Entities that do not share profits and losses with private sector insurers. (a... share profits and losses with a private sector insurer is deemed to be a separate insurer under the...

26 CFR 1.105-5 - Accident and health plans.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 2 2011-04-01 2011-04-01 false Accident and health plans. 1.105-5 Section 1.105... health plans. (a) In general. Sections 104(a)(3) and 105 (b), (c), and (d) exclude from gross income certain amounts received through accident or health insurance. Section 105(e) provides that for purposes...

26 CFR 1.105-5 - Accident and health plans.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 2 2013-04-01 2013-04-01 false Accident and health plans. 1.105-5 Section 1.105... health plans. (a) In general. Sections 104(a)(3) and 105 (b), (c), and (d) exclude from gross income certain amounts received through accident or health insurance. Section 105(e) provides that for purposes...

26 CFR 1.105-5 - Accident and health plans.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 2 2010-04-01 2010-04-01 false Accident and health plans. 1.105-5 Section 1.105... health plans. (a) In general. Sections 104(a)(3) and 105 (b), (c), and (d) exclude from gross income certain amounts received through accident or health insurance. Section 105(e) provides that for purposes...

26 CFR 1.105-5 - Accident and health plans.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 2 2012-04-01 2012-04-01 false Accident and health plans. 1.105-5 Section 1.105... health plans. (a) In general. Sections 104(a)(3) and 105 (b), (c), and (d) exclude from gross income certain amounts received through accident or health insurance. Section 105(e) provides that for purposes...

World Trade Organization, ILO conventions, and workers' compensation.

PubMed

LaDou, Joseph

2005-01-01

The World Trade Organization, the World Bank, and the International Monetary Fund can assist in the implementation of ILO Conventions relating to occupational safety and health in developing countries. Most countries that seek to trade globally receive permission to do so from the WTO. If the WTO required member countries to accept the core ILO Conventions relating to occupational safety and health and workers' compensation, it could accomplish something that has eluded international organizations for decades. International workers' compensation standards are seldom discussed, but may at this time be feasible. Acceptance of a minimum workers' compensation insurance system could be a requirement imposed on applicant nations by WTO member states.

42 CFR 100.2 - Average cost of a health insurance policy.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Average cost of a health insurance policy. 100.2 Section 100.2 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES VACCINE INJURY COMPENSATION § 100.2 Average cost of a health insurance policy. For purposes of determining...

41 CFR 101-4.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Health and insurance... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 101-4.440 Health and insurance benefits and services. Subject to § 101-4.235(d), in providing a medical, hospital, accident, or...

20 CFR 702.161 - Liens against assets of insurance carriers and employers.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Liens against assets of insurance carriers... AND PROCEDURE General Provisions Liens on Compensation § 702.161 Liens against assets of insurance..., be subrogated to all the rights of the person receiving such payments. The Secretary may institute...

Estimating workers' marginal valuation of employer health benefits: would insured workers prefer more health insurance or higher wages?

PubMed

Royalty, Anne Beeson

2008-01-01

In recent years the cost of health insurance has been increasing much faster than wages. In the face of these rising costs, many employers will have to make difficult decisions about whether to cut back health benefits or to compensate workers with lower wages or lower wage growth. In this paper, we ask the question, "Which do workers value more -- one additional dollar's worth of health benefits or one more dollar in their pockets?" Using a new approach to obtaining estimates of insured workers' marginal valuation of health benefits this paper estimates how much, on average, employees value the marginal dollar paid by employers for their workers' health insurance. We find that insured workers value the marginal health premium dollar at significantly less than the marginal wage dollar. However, workers value insurance generosity very highly. The marginal dollar spent on health insurance that adds an additional dollar's worth of observable dimensions of plan generosity, such as lower deductibles or coverage of additional services, is valued at significantly more than one dollar.

A Police and Insurance Joint Management System Based on High Precision BDS/GPS Positioning

PubMed Central

Zuo, Wenwei; Guo, Chi; Liu, Jingnan; Peng, Xuan; Yang, Min

2018-01-01

Car ownership in China reached 194 million vehicles at the end of 2016. The traffic congestion index (TCI) exceeds 2.0 during rush hour in some cities. Inefficient processing for minor traffic accidents is considered to be one of the leading causes for road traffic jams. Meanwhile, the process after an accident is quite troublesome. The main reason is that it is almost always impossible to get the complete chain of evidence when the accident happens. Accordingly, a police and insurance joint management system is developed which is based on high precision BeiDou Navigation Satellite System (BDS)/Global Positioning System (GPS) positioning to process traffic accidents. First of all, an intelligent vehicle rearview mirror terminal is developed. The terminal applies a commonly used consumer electronic device with single frequency navigation. Based on the high precision BDS/GPS positioning algorithm, its accuracy can reach sub-meter level in the urban areas. More specifically, a kernel driver is built to realize the high precision positioning algorithm in an Android HAL layer. Thus the third-party application developers can call the general location Application Programming Interface (API) of the original standard Global Navigation Satellite System (GNSS) to get high precision positioning results. Therefore, the terminal can provide lane level positioning service for car users. Next, a remote traffic accident processing platform is built to provide big data analysis and management. According to the big data analysis of information collected by BDS high precision intelligent sense service, vehicle behaviors can be obtained. The platform can also automatically match and screen the data that uploads after an accident to achieve accurate reproduction of the scene. Thus, it helps traffic police and insurance personnel to complete remote responsibility identification and survey for the accident. Thirdly, a rapid processing flow is established in this article to meet the

A Police and Insurance Joint Management System Based on High Precision BDS/GPS Positioning.

PubMed

Zuo, Wenwei; Guo, Chi; Liu, Jingnan; Peng, Xuan; Yang, Min

2018-01-10

Car ownership in China reached 194 million vehicles at the end of 2016. The traffic congestion index (TCI) exceeds 2.0 during rush hour in some cities. Inefficient processing for minor traffic accidents is considered to be one of the leading causes for road traffic jams. Meanwhile, the process after an accident is quite troublesome. The main reason is that it is almost always impossible to get the complete chain of evidence when the accident happens. Accordingly, a police and insurance joint management system is developed which is based on high precision BeiDou Navigation Satellite System (BDS)/Global Positioning System (GPS) positioning to process traffic accidents. First of all, an intelligent vehicle rearview mirror terminal is developed. The terminal applies a commonly used consumer electronic device with single frequency navigation. Based on the high precision BDS/GPS positioning algorithm, its accuracy can reach sub-meter level in the urban areas. More specifically, a kernel driver is built to realize the high precision positioning algorithm in an Android HAL layer. Thus the third-party application developers can call the general location Application Programming Interface (API) of the original standard Global Navigation Satellite System (GNSS) to get high precision positioning results. Therefore, the terminal can provide lane level positioning service for car users. Next, a remote traffic accident processing platform is built to provide big data analysis and management. According to the big data analysis of information collected by BDS high precision intelligent sense service, vehicle behaviors can be obtained. The platform can also automatically match and screen the data that uploads after an accident to achieve accurate reproduction of the scene. Thus, it helps traffic police and insurance personnel to complete remote responsibility identification and survey for the accident. Thirdly, a rapid processing flow is established in this article to meet the

77 FR 54927 - Comment Request for Information Collection for Unemployment Insurance (UI) Benefit Accuracy...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-06

... Collection for Unemployment Insurance (UI) Benefit Accuracy Measurement (BAM), Extension Without Revisions... Andrew Spisak, Office of Unemployment Insurance, Room S-4524, Employment and Training Administration, U.S... payments in three programs: State UI, Unemployment Compensation for Federal Employees (UCFE), and...

The Diploma in Rehabilitation Studies--The Birth of a New Form of Industry-Driven Learning.

ERIC Educational Resources Information Center

Leberman, Sarah I.

The Accident Rehabilitation and Compensation Insurance Corporation (ARCIC) provides no-fault rehabilitation and compensation to all New Zealanders. In order to meet the training needs created by ARCIC's recent shift to a case management approach, the Victoria University of Wellington instituted a program to train case managers. The 27-week program…

[Sports accidents: 1963-1973 statistics].

PubMed

Fasler, S

1976-01-01

Every year, the Swiss Accident Insurance Administration is paying a considerable amount of money for sports accidents. From 1963 to 1973 the number of these accidents has increased more markedly than other types of accidents. Different tendencies can be observed in the different types of sports: skiing accidents have, after a long period of retrogression until 1973, shown a noticeable augmentation again. Football accidents and accidents in other types of sports have on the other hand increased year by year. Mountaineering and aquatic sports often result in fatal accidents. The numerous preventive measures in skiing accidents have obviously been successful. Not only the fractures have decreased, but also the average number of days where sickness benefit was paid. Next to the traffic accidents, the skiing accidents are the most expensive ones. The nature of the healing cost in sports accidents has changed during the period from 1967 to 1972, depending on the different types of sports. In particular, hospital costs have changed considerably. The number of medical consultations per accident has decreased. Payment of sickness benefit has followed the development of the salaries on the one hand and the modifications of the number of lost days on the other. Finally, the costs of the annuities show more or less the same tendency as the ones for sickness benefit. A very gross estimation on the economical losses through sports accidents in Switzerland makes us believe that the direct and indirect costs actually amount to more than one thousand millions of Swiss Francs per year.

Work unit compensation.

PubMed

Sodano, M J

1991-01-01

The author describes an innovative "work unit compensation" system that acts as an adjunct to existing personnel payment structures. The process, developed as a win-win alternative for both employees and their institution, includes a reward system for the entire department and insures a team atmosphere. The Community Medical Center in Toms River, New Jersey developed the plan which sets the four basic goals: to be fair, economical, lasting and transferable (FELT). The plan has proven to be a useful tool in retention and recruitment of qualified personnel.

48 CFR 3052.217-95 - Liability and insurance (USCG).

Code of Federal Regulations, 2010 CFR

2010-10-01

... inclusion of any premium expense or charge for any reserve made on account of self-insurance for coverage... of and shall not affect the pricing structure of the contract, and are additional to the compensation...

Occupational Disease and Workers’ Compensation: Coverage, Costs, and Consequences

PubMed Central

Leigh, J Paul; Robbins, John A

2004-01-01

Most of the costs of occupational disease are not covered by workers’ compensation. First, the authors estimated the deaths and costs for all occupational disease in 1999, using epidemiological studies. Among the greatest contributors were job-related cancer, chronic respiratory disease, and circulatory disease. Second, the authors estimated the number of workers’ compensation cases, costs, and deaths for 1999, using data from up to 16 states representing all regions of the country. Unlike the epidemiological studies that emphasized fatal diseases, the workers’ compensation estimates emphasized nonfatal diseases and conditions like tendonitis and hernia. Comparisons of the epidemiological and workers’ compensation estimates suggest that in 1999, workers’ compensation missed roughly 46,000 to 93,000 deaths and $8 billion to $23 billion in medical costs. These deaths and costs represented substantial cost shifting from workers’ compensation systems to individual workers, their families, private medical insurance, and taxpayers (through Medicare and Medicaid). Designing policies to reduce the cost shifting and its associated inefficiency will be challenging. PMID:15595947

Markets for individual health insurance: can we make them work with incentives to purchase insurance?

PubMed

Swartz, K

2001-01-01

Simple income-based incentives to purchase health insurance (tax credits or deductions, or subsidies) are unlikely to succeed in significantly reducing the number of uninsured because income is not a good predictor of the extent to which individuals use medical service. Proposals to provide incentives to low-income people so they will purchase individual health insurance need to address the inherent tension between the interests of low-risk and high-risk people who rely on individual coverage. If carriers are forced to cover all applicants and to community rate premiums, low-risk people will drop coverage or not apply for it because premiums will exceed their expected need for insurance. Concern for people who currently have access to individual coverage calls for careful examination of options to permit incentive programs to succeed with the individual insurance markets. In particular, attention should focus on using alternatives to simple income-based subsidies to spread the burden of high-risk people's costs broadly, rather than impose the costs on low-risk people who purchase individual coverage. This paper describes three such alternatives. One uses risk adjustments and two rely on reinsurance so that carriers are compensated for the higher costs of covering high-risk people who use incentives to buy insurance. One alternative also permits risk selection by insurance carriers.

Work-related accidents and occupational diseases in veterinarians and their staff.

PubMed

Nienhaus, Albert; Skudlik, Christoph; Seidler, Andreas

2005-04-01

We assessed the occupational hazards in veterinary practice by analysing accident insurance data in order to stimulate strategies to prevent occupational accidents and diseases in veterinarians and their staff. Approximately 10,000 veterinary practices comprising about 27,500 veterinarians and their staff are covered by the Institution of Statutory Accident Insurance of the Health and Welfare Service (BGW). Each year about 2,000 accident and occupational disease claims are filed by these veterinarians and their staff. The claims for the 5-year period from 1998 to 2002 are analysed in this paper. For 2002, the incidence rate for accidents in the workplace was 105.4 per 1,000 full-time workers, a rate 2.9-times higher than for general practitioners of human medicine. When only severe accidents resulting in a loss of work time of more than 3 days were analysed, the relative risk increased to 9.2. Approximately 66% of the reported accidents are due to scratches, bites, or kicks from animals. Claims of occupational disease are filed 2.7-times more often by veterinarians and their staff than by general practitioners and their staff. The occupational diseases filed most often concern the skin (39%), followed by allergic respiratory diseases (30.5%), and infectious diseases (19.1%). Prevention strategies for veterinarians should focus on accidents caused by animals. The prevention of occupational diseases should focus on skin diseases, respiratory disease, and infections.

Professional indemnity insurance and the practice of medicine during bullfights in France.

PubMed

Franchitto, Nicolas; Gavarri, Laurent; Telmon, Norbert; Rougé, Daniel

2008-12-01

Bullfighting can provoke strong reactions, for fans and laymen alike. Risks to the health of participants are inseparable from the spectacle. Organisers call on a medical team whose main task is to treat the bullfighter's injuries. Despite the special features of this medical practice doctors are not exempt from the possibility of the question of their liability being raised in the event of medical malpractice and large financial damages for the bullfighter if he is harmed. The doctor's public liability and professional indemnity insurance contract is therefore all the more important, in fact, this insurance covers damages for harm caused by the policy holder from the moment he is declared liable. In the statute of 4th March 2002, the French legislature brought in compulsory insurance for health professionals with the aim of achieving the best possible compensation for harm. While public liability and professional indemnity insurance is compulsory for doctors, the purpose of making this insurance compulsory is to cover compensation for harm suffered by the victim. In the case of bullfights, faced with insufficient legal regulation and the fact that more often than not the medicine practised in this field is on a voluntary basis, it might be interesting to offer some thoughts on the special features of the insurance contract that ought to be adapted to these extreme working conditions.

Risky Business: A Primer on School Insurance

ERIC Educational Resources Information Center

Denker, Deb; Martocci, Elda

2009-01-01

In some ways, education institutions are like any other business when it comes to insurance coverage. Property could be damaged, accidents may be blamed on negligence, and employees may be injured during the course of the workday. Traveling sports teams, field trips, and transportation responsibilities increase the possibility that something will…

Occupational accidents aboard merchant ships

PubMed Central

Hansen, H; Nielsen, D; Frydenberg, M

2002-01-01

Objectives: To investigate the frequency, circumstances, and causes of occupational accidents aboard merchant ships in international trade, and to identify risk factors for the occurrence of occupational accidents as well as dangerous working situations where possible preventive measures may be initiated. Methods: The study is a historical follow up on occupational accidents among crew aboard Danish merchant ships in the period 1993–7. Data were extracted from the Danish Maritime Authority and insurance data. Exact data on time at risk were available. Results: A total of 1993 accidents were identified during a total of 31 140 years at sea. Among these, 209 accidents resulted in permanent disability of 5% or more, and 27 were fatal. The mean risk of having an occupational accident was 6.4/100 years at sea and the risk of an accident causing a permanent disability of 5% or more was 0.67/100 years aboard. Relative risks for notified accidents and accidents causing permanent disability of 5% or more were calculated in a multivariate analysis including ship type, occupation, age, time on board, change of ship since last employment period, and nationality. Foreigners had a considerably lower recorded rate of accidents than Danish citizens. Age was a major risk factor for accidents causing permanent disability. Change of ship and the first period aboard a particular ship were identified as risk factors. Walking from one place to another aboard the ship caused serious accidents. The most serious accidents happened on deck. Conclusions: It was possible to clearly identify work situations and specific risk factors for accidents aboard merchant ships. Most accidents happened while performing daily routine duties. Preventive measures should focus on workplace instructions for all important functions aboard and also on the prevention of accidents caused by walking around aboard the ship. PMID:11850550

Compensating Wounded Warriors: An Analysis of Injury, Labor Market Earnings, and Disability Compensation Among Veterans of the Iraq and Afghanistan Wars

DTIC Science & Technology

2012-01-01

DoD), the Department of Veterans Affairs (VA), and the Social Security Administration (SSA) have compensated for lost earnings. This monograph... Social Security Disability Insurance...September 11, 2001, and December 2006. These longitudinal, largely administrative data were obtained from DoD, the VA, and SSA and were linked by Social

78 FR 59374 - Announcement Regarding a Change in Eligibility for Unemployment Insurance (UI) Claimants in...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-26

... Eligibility for Unemployment Insurance (UI) Claimants in Alaska, Mississippi, and Wisconsin in the Emergency Unemployment Compensation 2008 (EUC08) Program AGENCY: Employment and Training Administration, Labor. ACTION... week insured unemployment rate in Alaska was 3.9 percent, falling below the 4.0 percent trigger rate...

78 FR 68865 - Announcement Regarding a Change in Eligibility for Unemployment Insurance (UI) Claimants in...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-15

... Eligibility for Unemployment Insurance (UI) Claimants in Alaska, Mississippi, and Wisconsin in the Emergency Unemployment Compensation 2008 (EUC08) Program AGENCY: Employment and Training Administration, Labor. ACTION... week insured unemployment rate in Alaska was 3.9 percent, falling below the 4.0 percent trigger rate...

[100 years with certificates: Danish Society of Insurance Medicine 1902-2002].

PubMed

Permin, Henrik

2002-01-01

Danish Society of Insurance Medicine was formed in 1902 as an association between the Danish Society of Accident Insurance and the Danish Society of Life Insurance Medicine, both founded a year before. The purpose of the society is to apply and to further the scientific basis of insurance medicine. The meetings also play a role as a forum for discussions. The members of the society are all working part-time in an insurance company in Denmark (in contrast to many other countries where it is a full-time job). The members are mainly specialists in medicine and surgery. During the first half life of the society nearly all members were high-qualified doctors, i.e. professors and consultants at a university hospital in Copenhagen usually with a doctoral degree. These prominent doctors had a significant influence on insurance medicine in Denmark. The managing directors of the Insurance Companies were invited to the meetings. Many scientific works and textbooks were written on the subject. The society arranges two meetings yearly - one concerning with life insurance and one with accident-insurance medicine. Previously, the question put to the medical adviser was always "Which impairments can still be insured?", but today the question is the opposite "Which impairments are not insurable?" The members have increased to currently 112, still only men, but today the members are younger, comprise fewer professors and fewer with a doctoral degree. During the last 6 years, all interested members in the insurance companies have been invited to the meetings, providing a broader input for the discussions. The topic of the meeting is of current interest: new laws or a new treatment of a disease (medication, surgery) which has been introduced. One to three speakers open the meeting, followed by a discussion. The meetings are always concluded with a light meal and a glass of wine, in earlier days also with cigars and Danish schnaps. 190 meetings have been held during the last 100 years

Work-related accidents among the Iranian population: a time series analysis, 2000-2011.

PubMed

Karimlou, Masoud; Salehi, Masoud; Imani, Mehdi; Hosseini, Agha-Fatemeh; Dehnad, Afsaneh; Vahabi, Nasim; Bakhtiyari, Mahmood

2015-01-01

Work-related accidents result in human suffering and economic losses and are considered as a major health problem worldwide, especially in the economically developing world. To introduce seasonal autoregressive moving average (ARIMA) models for time series analysis of work-related accident data for workers insured by the Iranian Social Security Organization (ISSO) between 2000 and 2011. In this retrospective study, all insured people experiencing at least one work-related accident during a 10-year period were included in the analyses. We used Box-Jenkins modeling to develop a time series model of the total number of accidents. There was an average of 1476 accidents per month (1476·05±458·77, mean±SD). The final ARIMA (p,d,q) (P,D,Q)s model for fitting to data was: ARIMA(1,1,1)×(0,1,1)12 consisting of the first ordering of the autoregressive, moving average and seasonal moving average parameters with 20·942 mean absolute percentage error (MAPE). The final model showed that time series analysis of ARIMA models was useful for forecasting the number of work-related accidents in Iran. In addition, the forecasted number of work-related accidents for 2011 explained the stability of occurrence of these accidents in recent years, indicating a need for preventive occupational health and safety policies such as safety inspection.

Doctors and retribution: the hospitalisation of compensation claims in the Highlands of Papua New Guinea.

PubMed

van Amstel, Hans; van der Geest, Sjaak

2004-11-01

The cultures in the Papua New Guinea Highlands are characterised by a tradition of retribution. Compensation is part of an elaborate system of exchanging gifts, goods and services. Compensation is paid to those who have suffered some kind of loss for which others are held responsible. Such incidents include death or injury caused by fighting, a road accident or domestic violence, theft, rape, gossip, and property damage. Fear of revenge is an important motive for paying compensation. The hospital has become an increasingly important institution for retribution. It provides medical reports to support compensation claims of physical damage in cases involving violence or an accident. Case material, collected by one of the authors who conducted fieldwork in a hospital in the Southern Highlands, shows that the hospital has established itself as an authoritative actor in the local compensation culture. Doctors spend about one afternoon per week writing medical reports for compensation claims. These reports have become an attractive extra source of income for the hospital. The article describes and analyses a number of cases to illustrate the hospital's role in the production and legitimisation of retribution.

Road accidents caused by sleepy drivers: Update of a Norwegian survey.

PubMed

Phillips, Ross Owen; Sagberg, Fridulv

2013-01-01

The current study tests, updates and expands a model of factors associated with sleepy driving, originally based on a 1997 survey of accident-involved Norwegian drivers (Sagberg, F., 1999. Road accidents caused by drivers falling asleep. Accident Analysis & Prevention 31, 639-649). The aim is to establish a robust model to inform measures to tackle sleepy driving. The original questions on (i) tiredness-related accidents and (ii) incidents of sleep behind the wheel in the last 12 months were again posed in 2003 and 2008, in independent surveys of Norwegian drivers involved in accidents reported to a large insurance company. According to those drivers at-fault for the accident, tiredness or sleepiness behind the wheel contributed to between 1.9 and 3.9 per cent of all types of accident reported to the insurance company across these years. Accident-involved drivers not at fault for the accident reported a reduction in the incidence of sleep behind the wheel for the preceding year, decreasing from 8.3 per cent in 1997 to 2.9 per cent in 2008. The reasons for this are not clear. According to logistic regression analysis of survey responses, the following factors were robustly associated with road accidents involving sleepy driving: driving off the road; good road conditions; longer distance driven since the start of the trip; and fewer years with a driving licence. The following factors are consistently associated with reports of sleep behind the wheel, whether or not it leads to an accident: being male; driving further per year; being younger; and having sleep-related health problems. Taken together these findings suggest that young, inexperienced male drivers who drive long distances may be a suitable target for road safety campaigns aimed at tackling sleepy driving. Copyright © 2012 Elsevier Ltd. All rights reserved.

Occupational disease and workers' compensation: coverage, costs, and consequences.

PubMed

Leigh, J Paul; Robbins, John A

2004-01-01

Most of the costs of occupational disease are not covered by workers' compensation. First, the authors estimated the deaths and costs for all occupational disease in 1999, using epidemiological studies. Among the greatest contributors were job-related cancer, chronic respiratory disease, and circulatory disease. Second, the authors estimated the number of workers' compensation cases, costs, and deaths for 1999, using data from up to 16 states representing all regions of the country. Unlike the epidemiological studies that emphasized fatal diseases, the workers' compensation estimates emphasized nonfatal diseases and conditions like tendonitis and hernia. Comparisons of the epidemiological and workers' compensation estimates suggest that in 1999, workers' compensation missed roughly 46,000 to 93,000 deaths and 8 billion US dollars to 23 billion US dollars in medical costs. These deaths and costs represented substantial cost shifting from workers' compensation systems to individual workers, their families, private medical insurance, and taxpayers (through Medicare and Medicaid). Designing policies to reduce the cost shifting and its associated inefficiency will be challenging.

20 CFR 703.302 - Application for authority to become a self-insurer; how filed; information to be submitted; other...

Code of Federal Regulations, 2010 CFR

2010-04-01

...' COMPENSATION ACT AND RELATED STATUTES INSURANCE REGULATIONS Authorization of Self-Insurers § 703.302 Application for authority to become a self-insurer; how filed; information to be submitted; other requirements... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Application for authority to become a self...

31 CFR 50.35 - Entities that share profits and losses with private sector insurers.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 false Entities that share profits and losses with private sector insurers. 50.35 Section 50.35 Money and Finance: Treasury Office of the...' Compensation Funds § 50.35 Entities that share profits and losses with private sector insurers. (a) Treatment...

31 CFR 50.35 - Entities that share profits and losses with private sector insurers.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance: Treasury 1 2012-07-01 2012-07-01 false Entities that share profits and losses with private sector insurers. 50.35 Section 50.35 Money and Finance: Treasury Office of the...' Compensation Funds § 50.35 Entities that share profits and losses with private sector insurers. (a) Treatment...

31 CFR 50.35 - Entities that share profits and losses with private sector insurers.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance: Treasury 1 2013-07-01 2013-07-01 false Entities that share profits and losses with private sector insurers. 50.35 Section 50.35 Money and Finance: Treasury Office of the...' Compensation Funds § 50.35 Entities that share profits and losses with private sector insurers. (a) Treatment...

31 CFR 50.35 - Entities that share profits and losses with private sector insurers.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Entities that share profits and losses with private sector insurers. 50.35 Section 50.35 Money and Finance: Treasury Office of the...' Compensation Funds § 50.35 Entities that share profits and losses with private sector insurers. (a) Treatment...

31 CFR 50.35 - Entities that share profits and losses with private sector insurers.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance: Treasury 1 2014-07-01 2014-07-01 false Entities that share profits and losses with private sector insurers. 50.35 Section 50.35 Money and Finance: Treasury Office of the...' Compensation Funds § 50.35 Entities that share profits and losses with private sector insurers. (a) Treatment...

Employer health insurance and local labor market conditions.

PubMed

Marquis, M S; Long, S H

2001-01-01

Theory suggests that an employer's decisions about the amount of health insurance included in the compensation package may be influenced by the practices of other employers in the market. We test the role of local market conditions on decisions of small employers to offer insurance and their dollar contribution to premiums using data from two large national surveys of employers. These employers are more likely to offer insurance and to make greater contributions in communities with tighter labor markets, less concentrated labor purchasers, greater union penetration, and a greater share of workers in big business and a small share in regulated industries. However, our data do not support the notion that marginal tax rates affect employers' offer decision or contributions.

29 CFR 500.122 - Adjustments in insurance requirements when workers' compensation coverage is provided under State...

Code of Federal Regulations, 2010 CFR

2010-07-01

... (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR REGULATIONS MIGRANT AND SEASONAL AGRICULTURAL WORKER PROTECTION Motor Vehicle Safety and Insurance for Transportation of Migrant and Seasonal Agricultural Workers, Housing Safety and Health for Migrant Workers Insurance § 500.122 Adjustments in insurance requirements...

Everything You Ought to Know About the Liability Insurance Crisis but Didn't Know How to Ask.

ERIC Educational Resources Information Center

Direnfeld-Michael, Bonnie; Michael, David R.

1987-01-01

A great deal of the current liability insurance crisis can be attributed to the industry itself. This article discusses insurance cyles, cash flow underwriting, reinsurance, company "capacity", rates determination, "claims-made" coverage of accidents, and regulation of the industry. (JD)

How useful are Swiss flood insurance data for flood vulnerability assessments?

NASA Astrophysics Data System (ADS)

Röthlisberger, Veronika; Bernet, Daniel; Zischg, Andreas; Keiler, Margreth

2015-04-01

The databases of Swiss flood insurance companies build a valuable but to date rarely used source of information on physical flood vulnerability. Detailed insights into the Swiss flood insurance system are crucial for using the full potential of the different databases for research on flood vulnerability. Insurance against floods in Switzerland is a federal system, the modalities are manly regulated on cantonal level. However there are some common principles that apply throughout Switzerland. First of all coverage against floods (and other particular natural hazards) is an integral part of every fire insurance policy for buildings or contents. This coupling of insurance as well as the statutory obligation to insure buildings in most of the cantons and movables in some of the cantons lead to a very high penetration. Second, in case of damage, the reinstatement costs (value as new) are compensated and third there are no (or little) deductible and co-pay. High penetration and the fact that the compensations represent a large share of the direct, tangible losses of the individual policy holders make the databases of the flood insurance companies a comprehensive and therefore valuable data source for flood vulnerability research. Insurance companies not only store electronically data about losses (typically date, amount of claims payment, cause of damage, identity of the insured object or policyholder) but also about insured objects. For insured objects the (insured) value and the details on the policy and its holder are the main feature to record. On buildings the insurance companies usually computerize additional information such as location, volume, year of construction or purpose of use. For the 19 (of total 26) cantons with a cantonal monopoly insurer the data of these insurance establishments have the additional value to represent (almost) the entire building stock of the respective canton. Spatial referenced insurance data can be used for many aspects of

Financial Training for Exonerees Awaiting Compensation: A Case Study

ERIC Educational Resources Information Center

Page, Jaimie

2013-01-01

A modified version of the Federal Deposit Insurance Corporation's Money Smart financial training program was provided for 14 exonerees in an urban Texas setting, in preparation for receiving their compensation awards relating to their wrongful convictions. Researchers sought to investigate the usefulness of the modified program in assisting in the…

31 CFR 50.19 - General disclosure requirements for State residual market insurance entities and State worker's...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 false General disclosure requirements for State residual market insurance entities and State worker's compensation funds. 50.19 Section 50.19 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM RISK INSURANCE PROGRAM...

31 CFR 50.19 - General disclosure requirements for State residual market insurance entities and State worker's...

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance: Treasury 1 2013-07-01 2013-07-01 false General disclosure requirements for State residual market insurance entities and State worker's compensation funds. 50.19 Section 50.19 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM RISK INSURANCE PROGRAM...

31 CFR 50.19 - General disclosure requirements for State residual market insurance entities and State worker's...

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance: Treasury 1 2014-07-01 2014-07-01 false General disclosure requirements for State residual market insurance entities and State worker's compensation funds. 50.19 Section 50.19 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM RISK INSURANCE PROGRAM...

31 CFR 50.19 - General disclosure requirements for State residual market insurance entities and State worker's...

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance: Treasury 1 2012-07-01 2012-07-01 false General disclosure requirements for State residual market insurance entities and State worker's compensation funds. 50.19 Section 50.19 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM RISK INSURANCE PROGRAM...

29 CFR 15.102 - May an insurance company file an FTCA administrative claim on behalf of a claimant?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 1 2014-07-01 2013-07-01 true May an insurance company file an FTCA administrative claim... the Federal Tort Claims Act § 15.102 May an insurance company file an FTCA administrative claim on behalf of a claimant? (a) A claim for loss wholly compensated by an insurance company may be presented by...

29 CFR 15.102 - May an insurance company file an FTCA administrative claim on behalf of a claimant?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 1 2013-07-01 2013-07-01 false May an insurance company file an FTCA administrative claim... the Federal Tort Claims Act § 15.102 May an insurance company file an FTCA administrative claim on behalf of a claimant? (a) A claim for loss wholly compensated by an insurance company may be presented by...

Work-related accidents among the Iranian population: a time series analysis, 2000–2011

PubMed Central

Karimlou, Masoud; Imani, Mehdi; Hosseini, Agha-Fatemeh; Dehnad, Afsaneh; Vahabi, Nasim; Bakhtiyari, Mahmood

2015-01-01

Background Work-related accidents result in human suffering and economic losses and are considered as a major health problem worldwide, especially in the economically developing world. Objectives To introduce seasonal autoregressive moving average (ARIMA) models for time series analysis of work-related accident data for workers insured by the Iranian Social Security Organization (ISSO) between 2000 and 2011. Methods In this retrospective study, all insured people experiencing at least one work-related accident during a 10-year period were included in the analyses. We used Box–Jenkins modeling to develop a time series model of the total number of accidents. Results There was an average of 1476 accidents per month (1476·05±458·77, mean±SD). The final ARIMA (p,d,q) (P,D,Q)s model for fitting to data was: ARIMA(1,1,1)×(0,1,1)12 consisting of the first ordering of the autoregressive, moving average and seasonal moving average parameters with 20·942 mean absolute percentage error (MAPE). Conclusions The final model showed that time series analysis of ARIMA models was useful for forecasting the number of work-related accidents in Iran. In addition, the forecasted number of work-related accidents for 2011 explained the stability of occurrence of these accidents in recent years, indicating a need for preventive occupational health and safety policies such as safety inspection. PMID:26119774

Environmental pollution liability insurance in China: in need of strong government backing.

PubMed

Feng, Yan; Mol, Arthur P J; Lu, Yonglong; He, Guizhen; van Koppen, C S A

2014-09-01

Environmental pollution liability insurance was officially introduced in China only in 2006, as part of new market-based approaches for managing environmental risks. By 2012, trial applications of pollution insurance had been launched in 14 provinces and cities. More than ten insurance companies have entered the pollution insurance market with their own products and contracts. Companies in environmentally sensitive sectors and high-risk industries bought pollution insurance, and a few successful compensation cases have been reported. Still, pollution insurance faces a number of challenges in China. The absence of a national law weakens the legal basis of pollution insurance, and poor technical support stagnates further implementation. Moreover, current pollution insurance products have limited risk coverage, high premium rates, and low loss ratios, which make them fairly unattractive to polluters. Meanwhile, low awareness of environmental and social liabilities leads to limited demand for pollution insurance products by industrial companies. Hence, the pollution insurance market is not yet flourishing in China. To improve this situation, this economic instrument needs stronger backing by the Chinese state.

26 CFR 1.123-1 - Exclusion of insurance proceeds for reimbursement of certain living expenses.

Code of Federal Regulations, 2010 CFR

2010-04-01

... reimbursement of certain living expenses. 1.123-1 Section 1.123-1 Internal Revenue INTERNAL REVENUE SERVICE... of living during the loss period. (3) This exclusion does not apply to an insurance recovery for the loss of rental income. Nor does the exclusion apply to any insurance recovery which compensates for the...

The three essentials for accident prevention.

PubMed

Eastman, Crystal

2014-11-01

This article was written by Crystal Eastman when she was Secretary of the New York Commission on Employers' Liability and Causes of Industrial Accidents, Unemployment, and Lack of Farm Labor. It was published in July of 1911, in Volume 38, Number 1 of the Annals of the American Academy of Political and Social Science, pages 98-107. The issue title was "Risks in Modern Industry." Eastman calls for the prevention of workplace accidents through three essentials: injury surveillance/reporting (with annual public reporting of the data); government enforcement of accident prevention laws, via departments with well-paid and well-trained officials and inspectors, fines that are high enough to be a deterrence to employers, and the power to have police shut down a factory if preventive measures are not installed; and a workers' compensation system-"a system of liability by which an employer can reduce his accident costs, not by hiring a more unscrupulous attorney and a more hard-hearted claim agent, but only by reducing his accidents."

Occupational Accidents with Agricultural Machinery in Austria.

PubMed

Kogler, Robert; Quendler, Elisabeth; Boxberger, Josef

2016-01-01

The number of recognized accidents with fatalities during agricultural and forestry work, despite better technology and coordinated prevention and trainings, is still very high in Austria. The accident scenarios in which people are injured are very different on farms. The common causes of accidents in agriculture and forestry are the loss of control of machine, means of transport or handling equipment, hand-held tool, and object or animal, followed by slipping, stumbling and falling, breakage, bursting, splitting, slipping, fall, and collapse of material agent. In the literature, a number of studies of general (machine- and animal-related accidents) and specific (machine-related accidents) agricultural and forestry accident situations can be found that refer to different databases. From the database Data of the Austrian Workers Compensation Board (AUVA) about occupational accidents with different agricultural machinery over the period 2008-2010 in Austria, main characteristics of the accident, the victim, and the employer as well as variables on causes and circumstances by frequency and contexts of parameters were statistically analyzed by employing the chi-square test and odds ratio. The aim of the study was to determine the information content and quality of the European Statistics on Accidents at Work (ESAW) variables to evaluate safety gaps and risks as well as the accidental man-machine interaction.

Employment-Related Health Insurance: Federal Agencies' Roles in Meeting Data Needs

PubMed Central

Wiatrowski, William; Harvey, Holly; Levit, Katharine R.

2002-01-01

Employer-sponsored health insurance accounts for almost one-third of all health care spending. As health care cost growth accelerates affecting the availability of employer-sponsored insurance and depth of coverage, the importance of timely and accurate information for measuring and monitoring these changes and formulating policy options increases. Identifying a growing gap between the need for and availability of data to inform policy on employment-related health insurance issues, the Office of Management and Budget (OMB) established a committee of Federal agency representatives to evaluate and advise data collection efforts. This article reports on the committee's current efforts, focusing on evaluation of results from the Medical Expenditure Panel Survey-Insurance Component (MEPS-IC) and the National Compensation Survey (NCS). PMID:12500352

Employment-related health insurance: federal agencies' roles in meeting data needs.

PubMed

Wiatrowski, William; Harvey, Holly; Levit, Katharine R

2002-01-01

Employer-sponsored health insurance accounts for almost one-third of all health care spending. As health care cost growth accelerates affecting the availability of employer-sponsored insurance and depth of coverage, the importance of timely and accurate information for measuring and monitoring these changes and formulating policy options increases. Identifying a growing gap between the need for and availability of data to inform policy on employment-related health insurance issues, the Office of Management and Budget (OMB) established a committee of Federal agency representatives to evaluate and advise data collection efforts. This article reports on the committee's current efforts, focusing on evaluation of results from the Medical Expenditure Panel Survey-Insurance Component (MEPS-IC) and the National Compensation Survey (NCS).

International survey of nephrologists' perceptions and attitudes about rewards and compensations for kidney donation.

PubMed

Ghahramani, Nasrollah; Karparvar, Zahra; Ghahramani, Mehrdad; Shadrou, Shahrouz

2013-06-01

Payment for organ donation, whether in the form of incentives, rewards or compensation is highly debated and has been denounced by many professional and legislative bodies. Despite the passionate discussion in the literature, there is very limited data on attitudes and perceptions of physicians about providing rewards or compensation to organ donors. We investigated the relationship between demographic and practice characteristics of nephrologists and their perceptions and attitudes about rewards and compensations for organ donation. Using a web-based survey, we explored the views of nephrologists around the world about rewards and compensations for kidney donation. The relationship between attitudes and demographic characteristics of 1280 nephrologists from 74 countries was examined by univariate and multivariable analyses. Seventy-five percent agreed with donor health insurance, 26% favored direct financial compensation and 31% agreed with financial rewards for unrelated donors. Sixty-six percent believed that rewards will lead to increased donation. Seventy-three percent indicated that rewards will lead to exploitation of the poor and 78% agreed with legislation prohibiting organ sales. Thirty-seven percent believed that rewards will negatively impact deceased-donor transplantation. Nephrologists from India/Pakistan and the Middle East had more favorable views about rewards, while respondents from Latin America and Europe, older than 50, female nephrologists and those practicing in rural areas had less favorable views. We conclude that a minority of nephrologists favor rewards for donation, many agree with some compensation and a considerable majority favor donor health insurance. Perceptions of nephrologists about rewards and compensation are influenced by age, sex, urban versus rural location and geographic region of practice.

Wildfire risk adaptation: propensity of forestland owners to purchase wildfire insurance in the southern United States

Treesearch

Jianbang Gan; Adam Jarrett; Cassandra Johnson Gaither

2014-01-01

Economic and ecological damages caused by wildfire are alarming, and such damages are expected to rise with changes in wildfire regimes, calling for more effective wildfire mitigation and adaptation strategies. Among wildfire adaptation options for forestland owners is purchasing wildfire insurance, which provides compensation to those insured if a wildfire damages...

Cost of work-related injuries in insured workplaces in Lebanon.

PubMed Central

Fayad, Rim; Nuwayhid, Iman; Tamim, Hala; Kassak, Kassem; Khogali, Mustafa

2003-01-01

OBJECTIVE: To estimate the medical and compensation costs of work-related injuries in insured workplaces in Lebanon and to examine cost distributions by worker and injury characteristics. METHODS: A total of 3748 claims for work injuries processed in 1998 by five major insurance companies in Lebanon were reviewed. Medical costs (related to emergency room fees, physician consultations, tests, and medications) and wage and indemnity compensation costs were identified from the claims. FINDINGS: The median cost per injury was US dollars 83 (mean, US dollars 198; range, US dollars 0-16,401). The overall cost for all 3748 injuries was US dollars 742,100 (76% of this was medical costs). Extrapolated to all injuries within insured workplaces, the overall cost was US dollars 4.5 million a year; this increased to US dollars 10 million-13 million when human value cost (pain and suffering) was accounted for. Fatal injuries (three, 0.1%) and those that caused permanent disabilities (nine, 0.2%) accounted for 10.4% of the overall costs and hospitalized injuries (245, 6.5%) for 45%. Cost per injury was highest among older workers and for injuries that involved falls and vehicle incidents. Medical, but not compensation, costs were higher among female workers. CONCLUSION: The computed costs of work injuries--a fraction of the real burden of occupational injuries in Lebanon--represent a considerable economic loss. This calls for a national policy to prevent work injuries, with a focus on preventing the most serious injuries. Options for intervention and research are discussed. PMID:12973643

Managed Care: The Key to Affordable College Health Insurance.

ERIC Educational Resources Information Center

Gallese, Lucile O.; Steele, Brenton H.

1994-01-01

Notes that rapid escalation of health care costs is growing concern for college health administrators charged with negotiating contracts for student health and accident insurance policies. Argues that student health service can serve same function as health maintenance organization, offering students range of services available and referring to…

48 CFR 1352.271-79 - Liability and insurance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Insurance (APR 2010) (a) The contractor shall exercise reasonable care and use its best efforts to prevent accidents, injury or damage to all employees, persons and property, in and about the work, and to the vessel... at the plant or elsewhere, arising or growing out of the performance of the work, except where the...

Pet insurance--essential option?

PubMed

Stowe, J D

2000-08-01

As Hawn (2) says, "insurance is about risk and peace of mind." She reports that the American Humane Society supports pet insurance because companion animals are able to be treated for disease or accidents that are life-threatening where, otherwise, they would have been euthanized. For veterinarians, she suggests that pet insurance allows them to practice veterinary medicine "as if it were free." It is inevitable that pet insurance will grow as a recourse for veterinary fees. This may be a savior to some families whose budget is stretched to the limit at a critical moment in the health care of their cherished pet. We in the veterinary profession have an advantage over other professions. We have seen the good, the bad, and the ugly of insurance, as it applies to human health and dental care. If we work hand-in-hand with our own industries, collectively we may be able to develop a system that wins for everyone, with fees that allow practice to thrive and growth strategies that accommodate new treatment and diagnostic modalities, as well as consistent and exemplary customer service. The path ahead is always fraught with bumps and potholes. We can be a passive passenger and become a victim of the times or an active driver to steer the profession to a clearer route. Pet insurance is but one of the solutions for the profession; the others are a careful assessment of our fees--charging what we are worth, not what we think the client will pay; business management; customer service; leadership of our health care team; lifelong learning; and more efficient delivery systems. Let us stop being a victim, stop shooting ourselves in the professional foot, and seize the day!

26 CFR 46.4371-2 - Imposition of tax on policies issued by foreign insurers; scope of tax.

Code of Federal Regulations, 2013 CFR

2013-04-01

... a nonresident alien individual, a foreign partnership, or a foreign corporation, as insurer (unless... “indemnity bond,” see section 4372(c). (b) Life insurance, sickness, and accident policies, and annuity... or an annuity contract is made, continued, or renewed, if issued: (1) By a nonresident alien...

[Contentious diseases--a medico-social phenomenon from an insurance medicine perspective].

PubMed

Regenauer, A

2008-03-01

A group of illnesses that are difficult to assess objectively, comprising such conditions as fibromyalgia, chronic fatigue syndrome, attention-deficit hyperactivity disorder, whiplash injury, and last but not least a multitude of somatoform disorders, has become a growing concern to Western health care systems and insurance industries. Thus far, the medical literature has failed to provide informative overviews of this group, which at first glance admittedly seems to be rather heterogeneous. If at all, the disorders have been grouped together under the term ,,controversial illnesses" to differentiate them from other diseases. The insurance industry - and claims departments, in particular - are increasingly having to deal with this rapidly growing phenomenon, which affects not only life business, but also health, worker's compensation and motor third-party liability. When paying compensation and settling claims, insurers are often left with a feeling that the illness may have been ,,imaginary" or aggravated. Is there a common basis for this new disorder mega-trend - independent of the recognition of the conditions by medical associations? This article aims at providing an overview of the common characteristics of the group of disorders, including a description of the key physical, psychological and social aspects. In particular, it is intended to deepen insurers' understanding of the risks arising from social change. The article also examines the disorder prevalence in Western societies and the possible causes of the significant increase.

Compensating wage differentials and the impact of health insurance in the public sector on wages and hours.

PubMed

Qin, Paige; Chernew, Michael

2014-12-01

This paper examines the trade-off between wages and employer spending on health insurance for public sector workers, and the relationship between coverage and hours worked. Our primary approach compares trends in wages and hours for public employees with and without state/local government provided health insurance using individual-level micro-data from the 1992-2011 CPS. To adjust for differences between insured and uninsured public sector employees, we create a matched sample based on an employee's propensity to receive health insurance. We assess the relationship between state contribution to the health plan premium, state-level healthcare spending, and the wages and hours of state and local government employees. We find modest reductions in wages are associated with having employer-sponsored health insurance (ESHI), although this effect is not precisely measured. The reduction in wages associated with having ESHI is larger among non-unionized workers. Further, we find little evidence that provision of health insurance increases hours worked. Copyright © 2014 Elsevier B.V. All rights reserved.

[Options for a future risc structure compensation in Germany].

PubMed

Greiner, W

2006-07-01

AIM OF THE ARTICLE: The risc structure compensation scheme within the German compulsory health insurance system is intended to enforce the principle of solidarity all over the statutory health insurance and not only within the different sickness funds. Differences in the contribution rates should not reflect different risc profiles, but the differences of the efficiency in social care. The criticism against the current adjustment system in Germany is multifarious and points e. g. on the missing orientation to morbidity. This article follows the question, whether this criticism is valid. The variables and methods, which are currently used to calculate the risc structure adjustment are discussed and compared to an alternative proposal for the future form of the risc structure adjustment, which includes both a higher orientation to riscs and incentives for social health insurance funds to decline the costs for the social care system on long-term. Currently, for the calculation of the risc structure adjustment the following variables are used: age, sex, income, number of family members who are exempted from contributions and persons who get occupational disability pension, and number of insured persons who are registered to an accredited Disease-Management-Program (DMP). Especially the last variable includes a high control effort, because the higher co-payments of the adjustment system are aligned to the voluntariness of participation and active collaboration of the patients in DMP. The argument, a further development to a morbidity-oriented risc structure adjustment leads to less cost management of the sickness funds is not totally correct, because not actual, but standardised costs are the basis for compensation. On the other hand the morbidity determined cost components should not totally be adjusted, as a proper distribution of savings to the risc structure adjustment and the single funds would still be an incentive for cost management and prevention. An ongoing

An overview of New Zealand's trauma system.

PubMed

Paice, Rhondda

2007-01-01

Patterns of trauma and trauma systems in New Zealand are similar to those in Australia. Both countries have geographical considerations, terrain and distance, that can cause delay to definitive care. There are only 7 hospitals in New Zealand that currently manage major trauma patients, and consequently, trauma patients are often hospitalized some distance from their homes. The prehospital services are provided by one major provider throughout the country, with a high level of volunteers providing these services in the rural areas. New Zealand has a national no-fault accident insurance system, the Accident Compensation Corporation, which funds all trauma-related healthcare from the roadside to rehabilitation. This insurance system provides 24-hour no-fault personal injury insurance coverage. The Accident Compensation Corporation provides bulk funding to hospitals for resources to manage the care of trauma patients. Case managers are assigned for major trauma patients. This national system also has a rehabilitation focus. The actual funds are managed by the hospitals, and this allows hospital staff to provide optimum care for trauma patients. New Zealand works closely with Australia in the development of a national trauma registry, research, and education in trauma care for patients in Australasia (the islands of the southern Pacific Ocean, including Australia, New Zealand, and New Guinea).

[Fatal occupational accidents in Lombardy].

PubMed

Pianosi, G

1995-01-01

All fatal occupational accidents compensated in Lombardy from 1984 to 1989 were analyzed (1259 cases): significant differences between geographical distribution of fatal occupational accidents and workers were observed. Males accounted for about 95% of fatalities; an excess of cases was shown in both young and elderly workers. Death was the consequence of injuries involving most frequently the head, thorax and spinal cord. An excess of fatalities was observed in agriculture and, at a lower level, in manufacturing industries; small enterprises were involved in approximately 25% of fatalities occurring in the manufacturing industries and services. Employers were the victims of fatal accidents in 50% of cases in agriculture and in 70% of cases in craft industries. Construction, agriculture and transport accounted for about 50% of all fatalities. About 50% of fatal occupational accidents were related to vehicle use: the victim was the driver in the majority of cases, sometimes the victim was run over by a vehicle or fell from a vehicle. The results agree with some previous observations (e.g.: sex and age distribution; construction, agriculture and transport as working activities at high accident risk); but some original observations have emerged, in particular about the frequency of employers as victims and the role of vehicles in the genesis of fatal occupational accidents. If further studies confirm these latter observations, important developments could follow in preventive action design and implementation.

Disease management programs in Germany's statutory health insurance system.

PubMed

Busse, Reinhard

2004-01-01

The introduction in 1996 of free choice among sickness funds in Germany was accompanied by a "risk structure compensation" (RSC) mechanism based on average spending by age and sex. Because chronically ill people were not adequately taken into account, competition for newly insured consumers concentrated on the healthy. The introduction in 2002 of disease management programs addresses this problem: Insured people in such programs are treated as a separate RSC category, making them a more "attractive" group that no longer generates a deficit. The degree of sickness fund activities and the fierce dispute with physicians are valid indicators that the incentives work.

International survey of nephrologists' perceptions and attitudes about rewards and compensations for kidney donation

PubMed Central

Ghahramani, Nasrollah; Karparvar, Zahra; Ghahramani, Mehrdad; Shadrou, Shahrouz

2013-01-01

Background Payment for organ donation, whether in the form of incentives, rewards or compensation is highly debated and has been denounced by many professional and legislative bodies. Despite the passionate discussion in the literature, there is very limited data on attitudes and perceptions of physicians about providing rewards or compensation to organ donors. We investigated the relationship between demographic and practice characteristics of nephrologists and their perceptions and attitudes about rewards and compensations for organ donation. Methods Using a web-based survey, we explored the views of nephrologists around the world about rewards and compensations for kidney donation. The relationship between attitudes and demographic characteristics of 1280 nephrologists from 74 countries was examined by univariate and multivariable analyses. Results Seventy-five percent agreed with donor health insurance, 26% favored direct financial compensation and 31% agreed with financial rewards for unrelated donors. Sixty-six percent believed that rewards will lead to increased donation. Seventy-three percent indicated that rewards will lead to exploitation of the poor and 78% agreed with legislation prohibiting organ sales. Thirty-seven percent believed that rewards will negatively impact deceased-donor transplantation. Nephrologists from India/Pakistan and the Middle East had more favorable views about rewards, while respondents from Latin America and Europe, older than 50, female nephrologists and those practicing in rural areas had less favorable views. Conclusions We conclude that a minority of nephrologists favor rewards for donation, many agree with some compensation and a considerable majority favor donor health insurance. Perceptions of nephrologists about rewards and compensation are influenced by age, sex, urban versus rural location and geographic region of practice. PMID:23780679

[Incentive for Regional Risk Selection in the German Risk Structure Compensation Scheme].

PubMed

Wende, Danny

2017-10-01

The introduction of the new law GKV-FQWG strengthens the competition between statutory health insurance. If incentives for risk selection exist, they may force a battle for cheap customers. This study aims to document and discuss incentives for regional risk selection in the German risk structure compensation scheme. Identify regional autocorrelation with Moran's l on financial parameters of the risk structure compensation schema. Incentives for regional risk selection do indeed exist. The risk structure compensation schema reduces 91% of the effect and helps to reduce risk selection. Nevertheless, a connection between regional situation and competition could be shown (correlation: 69.5%). Only the integration of regional control variables into the risk compensation eliminates regional autocorrelation. The actual risk structure compensation is leading to regional inequalities and as a consequence to risk selection and distortion in competition. © Georg Thieme Verlag KG Stuttgart · New York.

41 CFR 301-10.451 - May I be reimbursed for the cost of collision damage waiver (CDW) or theft insurance?

Code of Federal Regulations, 2011 CFR

2011-07-01

... ALLOWABLE TRAVEL EXPENSES 10-TRANSPORTATION EXPENSES Special Conveyances Rental Automobiles § 301-10.451 May... Government includes full coverage insurance for damages resulting from an accident while performing official... cause extreme difficulty for an employee involved in an accident. ...

41 CFR 301-10.451 - May I be reimbursed for the cost of collision damage waiver (CDW) or theft insurance?

Code of Federal Regulations, 2013 CFR

2013-07-01

... ALLOWABLE TRAVEL EXPENSES 10-TRANSPORTATION EXPENSES Special Conveyances Rental Automobiles § 301-10.451 May... Government includes full coverage insurance for damages resulting from an accident while performing official... cause extreme difficulty for an employee involved in an accident. ...

41 CFR 301-10.451 - May I be reimbursed for the cost of collision damage waiver (CDW) or theft insurance?

Code of Federal Regulations, 2012 CFR

2012-07-01

... ALLOWABLE TRAVEL EXPENSES 10-TRANSPORTATION EXPENSES Special Conveyances Rental Automobiles § 301-10.451 May... Government includes full coverage insurance for damages resulting from an accident while performing official... cause extreme difficulty for an employee involved in an accident. ...

41 CFR 301-10.451 - May I be reimbursed for the cost of collision damage waiver (CDW) or theft insurance?

Code of Federal Regulations, 2014 CFR

2014-07-01

... ALLOWABLE TRAVEL EXPENSES 10-TRANSPORTATION EXPENSES Special Conveyances Rental Automobiles § 301-10.451 May... Government includes full coverage insurance for damages resulting from an accident while performing official... cause extreme difficulty for an employee involved in an accident. ...

41 CFR 301-10.451 - May I be reimbursed for the cost of collision damage waiver (CDW) or theft insurance?

Code of Federal Regulations, 2010 CFR

2010-07-01

... ALLOWABLE TRAVEL EXPENSES 10-TRANSPORTATION EXPENSES Special Conveyances Rental Automobiles § 301-10.451 May... Government includes full coverage insurance for damages resulting from an accident while performing official... cause extreme difficulty for an employee involved in an accident. ...

Geographic variation in health insurance benefits in Qianjiang District, China: a cross-sectional study.

PubMed

Wu, Yue; Zhang, Liang; Liu, Xuejiao; Ye, Ting; Wang, Yongfei

2018-02-05

Health insurance contributes to reducing the economic burden of disease and improving access to healthcare. In 2016, the Chinese government announced the integration of the New Cooperative Medical Scheme (NCMS) and Urban Resident Basic Medical Insurance (URBMI) to reduce system segmentation. Nevertheless, it was unclear whether there would be any geographic variation in health insurance benefits if the two types of insurance were integrated. The aim of this study was to identify the potential geographic variation in health insurance benefits and the related contributing factors. This cross-sectional study was carried out in Qianjiang District, where the NCMS and URBMI were integrated into Urban and Rural Resident Basic Medical Insurance Scheme (URRBMI) in 2010. All beneficiaries under the URRBMI were hospitalized at least once in 2013, totaling 445,254 persons and 65,877 person-times, were included in this study. Town-level data on health insurance benefits, healthcare utilization, and socioeconomic and geographical characteristics were collected through health insurance system, self-report questionnaires, and the 2014 Statistical Yearbook of Qianjiang District. A simplified Theil index at town level was calculated to measure geographic variation in health insurance benefits. Colored maps were created to visualize the variation in geographic distribution of benefits. The effects of healthcare utilization and socioeconomic and geographical characteristics on geographic variation in health insurance benefits were estimated with a multiple linear regression analysis. Different Theil index values were calculated for different towns, and the Theil index values for compensation by person-times and amount were 2.5028 and 1.8394 in primary healthcare institutions and 1.1466 and 0.9204 in secondary healthcare institutions. Healthcare-seeking behavior and economic factors were positively associated with health insurance benefits in compensation by person-times significantly

20 CFR 726.6 - The Office of Workers' Compensation Programs.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false The Office of Workers' Compensation Programs. 726.6 Section 726.6 Employees' Benefits EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF LABOR FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED BLACK LUNG BENEFITS; REQUIREMENTS FOR COAL MINE OPERATOR'S INSURANCE General § 726.6 The...

Relationship between stressfulness of claiming for injury compensation and long-term recovery: a prospective cohort study.

PubMed

Grant, Genevieve M; O'Donnell, Meaghan L; Spittal, Matthew J; Creamer, Mark; Studdert, David M

2014-04-01

Each year, millions of persons worldwide seek compensation for transport accident and workplace injuries. Previous research suggests that these claimants have worse long-term health outcomes than persons whose injuries fall outside compensation schemes. However, existing studies have substantial methodological weaknesses and have not identified which aspects of the claiming experience may drive these effects. To determine aspects of claims processes that claimants to transport accident and workers' compensation schemes find stressful and whether such stressful experiences are associated with poorer long-term recovery. Prospective cohort study of a random sample of 1010 patients hospitalized in 3 Australian states for injuries from 2004 through 2006. At 6-year follow-up, we interviewed 332 participants who had claimed compensation from transport accident and workers' compensation schemes ("claimants") to determine which aspects of the claiming experience they found stressful. We used multivariable regression analysis to test for associations between compensation-related stress and health status at 6 years, adjusting for baseline determinants of long-term health status and predisposition to stressful experiences (via propensity scores). Disability, quality of life, anxiety, and depression. Among claimants, 33.9% reported high levels of stress associated with understanding what they needed to do for their claim; 30.4%, with claim delays; 26.9%, with the number of medical assessments; and 26.1%, with the amount of compensation they received. Six years after their injury, claimants who reported high levels of stress had significantly higher levels of disability (+6.94 points, World Health Organization Disability Assessment Schedule sum score), anxiety and depression (+1.89 points and +2.61 points, respectively, Hospital Anxiety and Depression Scale), and lower quality of life (-0.73 points, World Health Organization Quality of Life instrument, overall item), compared

Influence of flood risk characteristics on flood insurance demand: a comparison between Germany and the Netherlands

NASA Astrophysics Data System (ADS)

Seifert, I.; Botzen, W. J. W.; Kreibich, H.; Aerts, J. C. J. H.

2013-07-01

The existence of sufficient demand for insurance coverage against infrequent losses is important for the adequate function of insurance markets for natural disaster risks. This study investigates how characteristics of flood risk influence household flood insurance demand based on household surveys undertaken in Germany and the Netherlands. Our analyses confirm the hypothesis that willingness to pay (WTP) for insurance against medium-probability medium-impact flood risk in Germany is higher than WTP for insurance against low-probability high-impact flood risk in the Netherlands. These differences in WTP can be related to differences in flood experience, individual risk perceptions, and the charity hazard. In both countries there is a need to stimulate flood insurance demand if a relevant role of private insurance in flood loss compensation is regarded as desirable, for example, by making flood insurance compulsory or by designing information campaigns.

5 CFR 870.401 - Withholdings and contributions for Basic insurance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... employing agency must contribute an amount equal to one-half the amount withheld from the employee's pay... individual's pay, annuity, or compensation, the agency must submit an amount equal to the sum of the... between the insured individual and the Government. The employee pays two-thirds of the cost, and the...

InWiM: knowledge management for insurance medicine.

PubMed

Bleuer, Juerg P; Bösch, Kurt; Ludwig, Christian A

2008-01-01

Suva (Swiss National Accident Insurance Fund) is the most important carrier of obligatory accident insurance in Switzerland. Its services not only comprise insurance but also prevention, case management and rehabilitation. Suva's medical division supports doctors in stationary and ambulatory care with comprehensive case management and with conciliar advice. Two Suva clinics provide stationary rehabilitation. Medicine in general, including insurance medicine, faces the problem of a diversity of opinions about the facts of a case. One of the reasons is a diversity of knowledge. This is the reason why Suva initiated a knowledge management project called InWiM. "InWiM" is the acronym for "Integrierte Wissensbasen der Medizin" which can be translated as "Integrated Knowledge Bases in Medicine". The project is part of an ISO 9001 certification program and comprises the definition and documentation of all processes in the field of knowledge management as well as the development of the underlying ITC infrastructure. The knowledge representation model used for the ICT implementation considers knowledge as a multidimensional network of interlinked units of information. In contrast to the hyperlink technology in the World Wide Web, links between items are bidirectional: the target knows the source of the link. Links are therefore called cross-links. The model allows annotation for the narrative description of the nature of the units of information (e.g. documents) and the cross-links as well. Information retrieval is achieved by means of a full implementation of the MeSH Index, the thesaurus of the United States National Library of Medicine (NLM). As far as the authors are aware, InWiM is currently the only implementation worldwide - with the exception of the NLM and its national representatives - which supports all MeSH features for in-house retrieval.

Incidence of workers compensation indemnity claims across socio-demographic and job characteristics.

PubMed

Du, Juan; Leigh, J Paul

2011-10-01

We hypothesized that low socioeconomic status, employer-provided health insurance, low wages, and overtime were predictors of reporting workers compensation indemnity claims. We also tested for gender and race disparities. Responses from 17,190 (person-years) Americans participating in the Panel Study of Income Dynamics, 1997-2005, were analyzed with logistic regressions. The dependent variable indicated whether the subject collected benefits from a claim. Odds ratios for men and African-Americans were relatively large and strongly significant predictors of claims; significance for Hispanics was moderate and confounded by education. Odds ratios for variables measuring education were the largest for all statistically significant covariates. Neither low wages nor employer-provided health insurance was a consistent predictor. Due to confounding from the "not salaried" variable, overtime was not a consistently significant predictor. Few studies use nationally representative longitudinal data to consider which demographic and job characteristics predict reporting workers compensation indemnity cases. This study did and tested some common hypotheses about predictors. Copyright © 2011 Wiley-Liss, Inc.

Financial impact of radiological reports on medical-legal evaluation of compensation for meniscal lesions.

PubMed

Lelario, M; Ciuffreda, P; Lupo, P; Bristogiannis, C; Vinci, R; Stoppino, L P; De Filippo, M; Macarini, L

2013-08-01

To evaluate any discrepancy between radiological reports for clinical purposes and for medicolegal purposes and to quantify its economic impact on repayments made by private insurance companies for meniscal injuries of the knee. The medical records obtained pertaining to 108 knee injury patients (mean age 43.3 years) assessed over a period of 12 months were analysed. Clinical medical reports, aimed at assessing the lesion, and medicolegal reports, drawn up with a view to quantifying compensation, were compared. Unlike reports for clinical purposes in reports for medicolegal purposes, in the evaluation of meniscal lesions, in addition to morphological features of lesions, chronological, topographical, severity and exclusion criteria were applied. To estimate the economic impact resulting from the biological damage, we consulted an actuarial table based on the 9-point minor incapacity classification system. Meniscal lesions not compatible with a traumatic event and therefore not eligible for an insurance payout were found in 56 patients. Of these, 37 failed exclusion criteria, while 19 failed to meet chronological criteria. This difference resulted in a reduction in compensation made by private insurance companies with savings estimated with a saving between euro 203,715.41 and euro 622,315.39. The use of a clinical report for medicolegal purposes can be a source of valuation error, as chronological and/or dynamic information regarding the trauma mechanism may be lacking. Therefore, the use of a full radiological appraisal allows a better damage's assessment and an adequate compensation for injuries.

How insurance affects altruistic provision in threshold public goods games.

PubMed

Zhang, Jianlei; Zhang, Chunyan; Cao, Ming

2015-03-13

The occurrence and maintenance of cooperative behaviors in public goods systems have attracted great research attention across multiple disciplines. A threshold public goods game requires a minimum amount of contributions to be collected from a group of individuals for provision to occur. Here we extend the common binary-strategy combination of cooperation and defection by adding a third strategy, called insured cooperation, which corresponds to buying an insurance covering the potential loss resulted from the unsuccessful public goods game. Particularly, only the contributing agents can opt to be insured, which is an effort decreasing the amount of the potential loss occurring. Theoretical computations suggest that when agents face the potential aggregate risk in threshold public goods games, more contributions occur with increasing compensation from insurance. Moreover, permitting the adoption of insurance significantly enhances individual contributions and facilitates provision, especially when the required threshold is high. This work also relates the strategy competition outcomes to different allocation rules once the resulted contributions exceed the threshold point in populations nested within a dilemma.

Insuring the uninsured: potential impact of Health Care Reform Act of 2010 on trauma centers.

PubMed

Shafi, Shahid; Ogola, Gerald; Fleming, Neil; Rayan, Nadine; Kudyakov, Rustam; Barnes, Sunni A; Ballard, David J

2012-11-01

Viability of trauma centers is threatened by cost of care provided to patients without health insurance. The health care reform of 2010 is likely to benefit trauma centers by mandating universal health insurance by 2014. However, the financial benefit of this mandate will depend on the reimbursement provided. The study hypothesis was that compensation for the care of uninsured trauma patients at Medicare or Medicaid rates will lead to continuing losses for trauma centers. Financial data for first hospitalization were obtained from an urban Level I trauma center for 3 years (n = 6,630; 2006-2008) and linked with clinical information. Patients were grouped into five payments categories: commercial (29%), Medicaid (8%), Medicare (20%), workers' compensation (6%), and uninsured (37%). Prediction models for costs and payments were developed for each category using multiple regression models, adjusting for patient demographics, injury characteristics, complications, and survival. These models were used to predict payments that could be expected if uninsured patients were covered by different insurance types. Results are reported as net margin per patient (payments minus total costs) for each insurance type, with 95% confidence intervals, discounted to 2008 dollar values. Patients were typical for an urban trauma center (median age of 43 years, 66% men, 82% blunt, 5% mortality, and median length of stay 4 days). Overall, the trauma center lost $5,655 per patient, totaling $37.5 million over 3 years. These losses were encountered for patients without insurance ($14,343), Medicare ($4,838), and Medicaid ($15,740). Patients with commercial insurance were profitable ($5,295) as were those with workers' compensation ($6,860). Payments for the care of the uninsured at Medicare/Medicaid levels would lead to continued losses at $2,267 to $4,143 per patient. The health care reforms of 2010 would lead to continued losses for trauma centers if uninsured are covered with Medicare

Do claim factors predict health care utilization after transport accidents?

PubMed

Elbers, Nieke A; Cuijpers, Pim; Akkermans, Arno J; Collie, Alex; Ruseckaite, Rasa; Bruinvels, David J

2013-04-01

Injured people who are involved in compensation processes have less recovery and less well-being compared to those not involved in claims settlement procedures. This study investigated whether claim factors, such as no-fault versus common law claims, the number of independent medical assessments, and legal disputes, predict health care utilization after transport accidents. The sample consisted of 68,911 claimants who lodged a compensation claim at the Transport Accident Commission (TAC) in Victoria, Australia, between 2000 and 2005. The main outcome measure was health care utilization, which was defined as the number of visits to health care providers (e.g. general practitioners, physiotherapists, psychologists) during the 5 year period post-accident. After correction for gender, age, role in accident, injury type, and severity of injury, it was found that independent medical assessments were associated with greater health care utilization (β=.36, p<.001). Involvement in common law claims and legal disputes were both significantly related to health care utilization (respectively β=.05, p<.001 and β=-.02, p<.001), however, the standardized betas were negligible, therefore the effect is not clinically relevant. A model including claim factors predicted the number of health care visits significantly better (ΔR(2)=.08, p<.001) than a model including only gender, age, role in accident, injury type, and severity of injury. The positive association between the number of independent medical assessments and health care utilization after transport accidents may imply that numerous medical assessments have a negative effect on claimants' health. However, further research is needed to determine a causal relationship. Copyright © 2013 Elsevier Ltd. All rights reserved.

[Introduction of disease management programmes in Germany as reflected by differing interests of health insurance companies and the federal association of statutory health insurance physicians].

PubMed

Erler, A

2002-11-01

On 1st January 2002 a law was enacted by the German Federal Government reorganising the reinsurance pool known as the "risk compensation scheme" (RSA) of the German health insurance system. This enactment contemplates a gradual restructuring of the RSA to shift from a system that considered only certain demographic criteria to one that reflects actual morbidity rates, with the shift to be phased in before full implementation by 2007. The enactment also introduced disease management programmes (DMP) for patients with certain chronic illnesses. Insurance companies will now receive additional payments from the RSA for patients with a chronic condition who are enrolled in a DMP. The intent is to improve the poor medical care for chronically ill patients in Germany - as had been stated by the advisory council of the Concerted Action in Health Care - and to reduce the natural tendency of insurance companies to prefer young healthy members over chronically ill patients. Possible consequences of the legal changes are discussed from the point of view of the various insurance companies as well as the Federal Association of Statutory Health Insurance Physicians.

The role of independent agents in the success of health insurance market reforms.

PubMed

Hall, M A

2000-01-01

The impact of reforms on the health insurance markets cannot be understood without more information about the role played by insurance agents and a closer analysis of their contribution. An in-depth, qualitative study of insurance-market reforms in seven illustrative states forms the basis for this report on how agents help to shape the efficiency and fairness of insurance markets. Different types of agents relate to insurers in their own ways and are compensated differently. This study shows agents to be almost uniformly enthusiastic about guaranteed-issue requirements and other components of market reforms. Although insurers devise strategies for manipulating agents in order to avoid undesirable business, these opportunities are limited and do not appear to be seriously undermining the effectiveness of market reforms. Despite the layer of cost that agents add to the system, they play an important role in making market reforms work, and they fill essential information and service functions for which many purchasers have no ready substitute.

The Role of Independent Agents in the Success of Health Insurance Market Reforms

PubMed Central

Hall, Mark A.

2000-01-01

The impact of reforms on the health insurance markets cannot be understood without more information about the role played by insurance agents and a closer analysis of their contribution. An in-depth, qualitative study of insurance-market reforms in seven illustrative states forms the basis for this report on how agents help to shape the efficiency and fairness of insurance markets. Different types of agents relate to insurers in their own ways and are compensated differently. This study shows agents to be almost uniformly enthusiastic about guaranteed-issue requirements and other components of market reforms. Although insurers devise strategies for manipulating agents in order to avoid undesirable business, these opportunities are limited and do not appear to be seriously undermining the effectiveness of market reforms. Despite the layer of cost that agents add to the system, they play an important role in making market reforms work, and they fill essential information and service functions for which many purchasers have no ready substitute. PMID:10834080

Occupational exposure to Mycobacterium tuberculosis. Legal issues in workers' compensation.

PubMed

Evenson, W

1999-08-01

Occupational exposure to TB remains a significant threat in select high risk occupations despite 5 years of declining disease incidence rates in the United States. TB kills more people on a global scale than any other infectious disease. One third of the global population is currently infected with TB. Workers' compensation insurance may be inadequate to cover lost wages and medical bills in cases of occupational exposure to TB if the source patient is unknown. There is a need to reform state laws for workers' compensation so TB infections in high risk employees are presumed to be work related unless a community exposure to the disease is identified.

The role of OSHA violations in serious workplace accidents.

PubMed

Mendeloff, J

1984-05-01

California accident investigations for 1976 show that violations of the Occupational Safety and Health Administration's safety standards were a contributing factor in 13% to 19% of the 645 deaths reported to the workers' compensation program during that year. However, a panel of safety engineers judged that only about 50% of these violations could have been detected if an inspector had visited the day before the accident. These findings indicate that the potential gains from stronger enforcement of current standards are limited but not insignificant. The likelihood that a violation contributed to a serious accident varied considerably among accident types, industries, and size classes of plants. These findings can be used to increase the efficiency and effectiveness of the OSHA program by means of better targeting of inspections and accident investigations, more intelligent assessment of which violations should be penalized most heavily, and the provision of information to employers and workers about which violations are most consequential.

Scenario analysis of freight vehicle accident risks in Taiwan.

PubMed

Tsai, Ming-Chih; Su, Chien-Chih

2004-07-01

This study develops a quantitative risk model by utilizing Generalized Linear Interactive Model (GLIM) to analyze the major freight vehicle accidents in Taiwan. Eight scenarios are established by interacting three categorical variables of driver ages, vehicle types and road types, each of which contains two levels. The database that consists of 2043 major accidents occurring between 1994 and 1998 in Taiwan is utilized to fit and calibrate the model parameters. The empirical results indicate that accident rates of freight vehicles in Taiwan were high in the scenarios involving trucks and non-freeway systems, while; accident consequences were severe in the scenarios involving mature drivers or non-freeway systems. Empirical evidences also show that there is no significant relationship between accident rates and accident consequences. This is to stress that safety studies that describe risk merely as accident rates rather than the combination of accident rates and consequences by definition might lead to biased risk perceptions. Finally, the study recommends using number of vehicle as an alternative of traffic exposure in commercial vehicle risk analysis. The merits of this would be that it is simple and thus reliable; meanwhile, the resulted risk that is termed as fatalities per vehicle could provide clear and direct policy implications for insurance practices and safety regulations.

Mesothelioma incidence surveillance systems and claims for workers' compensation. Epidemiological evidence and prospects for an integrated framework.

PubMed

Marinaccio, Alessandro; Scarselli, Alberto; Merler, Enzo; Iavicoli, Sergio

2012-07-05

Malignant mesothelioma is an aggressive and lethal tumour strongly associated with exposure to asbestos (mainly occupational). In Italy a large proportion of workers are protected from occupational diseases by public insurance and an epidemiological surveillance system for incident mesothelioma cases. We set up an individual linkage between the Italian national mesothelioma register (ReNaM) and the Italian workers' compensation authority (INAIL) archives. Logistic regression models were used to identify and test explanatory variables. We extracted 3270 mesothelioma cases with occupational origins from the ReNaM, matching them with 1625 subjects in INAIL (49.7%); 91.2% (1,482) of the claims received compensation. The risk of not seeking compensation is significantly higher for women and the elderly. Claims have increased significantly in recent years and there is a clear geographical gradient (northern and more developed regions having higher claims rates). The highest rates of compensation claims were after work known to involve asbestos. Our data illustrate the importance of documentation and dissemination of all asbestos exposure modalities. Strategies focused on structural and systematic interaction between epidemiological surveillance and insurance systems are needed.

Mesothelioma incidence surveillance systems and claims for workers’ compensation. Epidemiological evidence and prospects for an integrated framework

PubMed Central

2012-01-01

Background Malignant mesothelioma is an aggressive and lethal tumour strongly associated with exposure to asbestos (mainly occupational). In Italy a large proportion of workers are protected from occupational diseases by public insurance and an epidemiological surveillance system for incident mesothelioma cases. Methods We set up an individual linkage between the Italian national mesothelioma register (ReNaM) and the Italian workers’ compensation authority (INAIL) archives. Logistic regression models were used to identify and test explanatory variables. Results We extracted 3270 mesothelioma cases with occupational origins from the ReNaM, matching them with 1625 subjects in INAIL (49.7%); 91.2% (1,482) of the claims received compensation. The risk of not seeking compensation is significantly higher for women and the elderly. Claims have increased significantly in recent years and there is a clear geographical gradient (northern and more developed regions having higher claims rates). The highest rates of compensation claims were after work known to involve asbestos. Conclusions Our data illustrate the importance of documentation and dissemination of all asbestos exposure modalities. Strategies focused on structural and systematic interaction between epidemiological surveillance and insurance systems are needed. PMID:22545679

The Application Law of Large Numbers That Predicts The Amount of Actual Loss in Insurance of Life

NASA Astrophysics Data System (ADS)

Tinungki, Georgina Maria

2018-03-01

The law of large numbers is a statistical concept that calculates the average number of events or risks in a sample or population to predict something. The larger the population is calculated, the more accurate predictions. In the field of insurance, the Law of Large Numbers is used to predict the risk of loss or claims of some participants so that the premium can be calculated appropriately. For example there is an average that of every 100 insurance participants, there is one participant who filed an accident claim, then the premium of 100 participants should be able to provide Sum Assured to at least 1 accident claim. The larger the insurance participant is calculated, the more precise the prediction of the calendar and the calculation of the premium. Life insurance, as a tool for risk spread, can only work if a life insurance company is able to bear the same risk in large numbers. Here apply what is called the law of large number. The law of large numbers states that if the amount of exposure to losses increases, then the predicted loss will be closer to the actual loss. The use of the law of large numbers allows the number of losses to be predicted better.

Audit of litigation against the accident and emergency radiology department.

PubMed

Cantoni, S; De Stefano, F; Mari, A; Savaia, F; Rosso, R; Derchi, L

2009-09-01

The aims of this study were to reduce and monitor litigation due to failure to diagnose a fracture, to evaluate whether the cases were due to radiological error or other problems in the diagnostic and therapeutic management of patients and to identify organisational, technical or functional changes or guidelines to improve the management of patients with suspected fracture and their expectations. We analysed the litigation database for the period 2004-2006 and extracted all episodes indicating failure to diagnose a fracture at the accident and emergency radiology department of our centre. The radiographs underwent blinded review by two experts, and each case was jointly analysed by a radiologist and a forensic physician to see what led to the compensation claim. We identified 22 events (2004 seven cases; 2005 eight cases; 2006 seven cases). Six cases were unrelated to radiological error. Six were due to imperceptible fractures at the time of the examination. These were accounted for by the presence of a major lesion distracting the examiner's attention from a less important associated lesion in one case, a false negative result in a patient examined on a incompletely radiolucent spinal board and underexposure of the coccyx region in an obese patient. Six cases were related to an interpretation error by the radiologist. In the remaining cases, the lesion being referred to in the compensation claim could either not be established or the case was closed by the insurance company without compensation. Corrective measures were adopted. These included planning the purchase of a higher performance device, drawing up a protocol for imaging patients on spinal boards, reminding radiologists of the need to carefully scrutinise the entire radiogram even after having identified a lesion, and producing an information sheet explaining to patients the possibility of false negative results in cases of imperceptible lesions and inviting them to return to the department if symptoms

29 CFR 778.214 - Benefit plans; including profit-sharing plans or trusts providing similar benefits.

Code of Federal Regulations, 2010 CFR

2010-07-01

... fide plan for providing old age, retirement, life, accident, or health insurance or similar benefits for employees * * *.” Such sums may not, however, be credited toward overtime compensation due under... matching employee contributions or otherwise encourages thrift or savings. Where such a plan or trust is...

The Perceived Socioeconomic Status Is an Important Factor of Health Recovery for Victims of Occupational Accidents in Korea.

PubMed

Seok, Hongdeok; Yoon, Jin-Ha; Lee, Wanhyung; Lee, June-Hee; Jung, Pil Kyun; Roh, Jaehoon; Won, Jong-Uk

2016-02-01

We aimed to examine whether there is a correlation between the health recovery of industrial accident victims and their perceived socioeconomic status. Data were obtained from the first Panel Study of Worker's Compensation Insurance, which included 2,000 participants. We performed multivariate regression analysis and determined the odds ratios for participants with a subjectively lower socioeconomic status and for those with a subjectively lower middle socioeconomic status using 95% confidence intervals. An additional multivariate regression analysis yielded the odds ratios for participants with a subjectively lower socioeconomic status and those with a subjectively upper middle socioeconomic class using 95% confidence intervals. Of all participants, 299 reported a full recovery, whereas 1,701 did not. We examined the odds ratio (95% confidence intervals) for participants' health recovery according to their subjective socioeconomic status while controlling for sex, age, education, tobacco use, alcohol use, subjective state of health prior to the accident, chronic disease, employment duration, recovery period, accident type, disability status, disability rating, and economic participation. The odds of recovery in participants with a subjectively lower middle socioeconomic status were 1.707 times greater (1.264-2.305) than that of those with a subjectively lower socioeconomic status. Similarly, the odds of recovery in participants with a subjectively upper middle socioeconomic status were 3.124 times greater (1.795-5.438) than that of those with a subjectively lower socioeconomic status. Our findings indicate that participants' perceived socioeconomic disparities extend to disparities in their health status. The reinforcement of welfare measures is greatly needed to temper these disparities.

Can medical insurance coverage reduce disparities of income in elderly patients requiring long-term care? The case of the People's Republic of China.

PubMed

Zhang, Zhenyu; Wang, Jianbing; Jin, Mingjuan; Li, Mei; Zhou, Litao; Jing, Fangyuan; Chen, Kun

2014-01-01

The People's Republic of China's population is aging rapidly, partly because of the impact of the one-child policy and improvements in the health care system. Caring for bedridden seniors can be a challenge for many families in the People's Republic of China. To identify the inequality of income among different age groups and social statuses, and evaluate the medical burden and health insurance compensation in the People's Republic of China. We measured income inequality and insurance compensation levels among bedridden patients in Zhejiang province, People's Republic of China. Factor analysis and Gini coefficients were used to evaluate degree of income inequality and insurance compensation level. We found distinct regional disparities in Zhejiang province, including the aspects of income, expenses, and time. Gini coefficients of older adults with long-term care needs in urban and rural areas were 0.335 and 0.602, respectively. In all age groups, Gini coefficients increased after adjustment for medical expenditures, and the inequality persisted after insurance reimbursement was taken into consideration. A significant income disparity between rural and urban areas was observed. Inequality increased with age, and medical expenditure is a huge burden for older people with long-term care needs. Health insurance does not play an important role in reducing inequalities among patients who need long-term care services.

Estimating cost ratio distribution between fatal and non-fatal road accidents in Malaysia

NASA Astrophysics Data System (ADS)

Hamdan, Nurhidayah; Daud, Noorizam

2014-07-01

Road traffic crashes are a global major problem, and should be treated as a shared responsibility. In Malaysia, road accident tragedies kill 6,917 people and injure or disable 17,522 people in year 2012, and government spent about RM9.3 billion in 2009 which cost the nation approximately 1 to 2 percent loss of gross domestic product (GDP) reported annually. The current cost ratio for fatal and non-fatal accident used by Ministry of Works Malaysia simply based on arbitrary value of 6:4 or equivalent 1.5:1 depends on the fact that there are six factors involved in the calculation accident cost for fatal accident while four factors for non-fatal accident. The simple indication used by the authority to calculate the cost ratio is doubted since there is lack of mathematical and conceptual evidence to explain how this ratio is determined. The main aim of this study is to determine the new accident cost ratio for fatal and non-fatal accident in Malaysia based on quantitative statistical approach. The cost ratio distributions will be estimated based on Weibull distribution. Due to the unavailability of official accident cost data, insurance claim data both for fatal and non-fatal accident have been used as proxy information for the actual accident cost. There are two types of parameter estimates used in this study, which are maximum likelihood (MLE) and robust estimation. The findings of this study reveal that accident cost ratio for fatal and non-fatal claim when using MLE is 1.33, while, for robust estimates, the cost ratio is slightly higher which is 1.51. This study will help the authority to determine a more accurate cost ratio between fatal and non-fatal accident as compared to the official ratio set by the government, since cost ratio is an important element to be used as a weightage in modeling road accident related data. Therefore, this study provides some guidance tips to revise the insurance claim set by the Malaysia road authority, hence the appropriate method

Road accidents caused by drivers falling asleep.

PubMed

Sagberg, F

1999-11-01

About 29600 Norwegian accident-involved drivers received a questionnaire about the last accident reported to their insurance company. About 9200 drivers (31%) returned the questionnaire. The questionnaire contained questions about sleep or fatigue as contributing factors to the accident. In addition, the drivers reported whether or not they had fallen asleep some time whilst driving. and what the consequences had been. Sleep or drowsiness was a contributing factor in 3.9% of all accidents, as reported by drivers who were at fault for the accident. This factor was strongly over-represented in night-time accidents (18.6%), in running-off-the-road accidents (8.3%), accidents after driving more than 150 km on one trip (8.1%), and personal injury accidents (7.3%). A logistic regression analysis showed that the following additional factors made significant and independent contributions to increasing the odds of sleep involvement in an accident: dry road, high speed limit, driving one's own car, not driving the car daily, high education, and few years of driving experience. More male than female drivers were involved in sleep-related accidents, but this seems largely to be explained by males driving relatively more than females on roads with high speed limits. A total of 10% of male drivers and 4% of females reported to have fallen asleep while driving during the last 12 months. A total of 4% of these events resulted in an accident. The most frequent consequence of falling asleep--amounting to more than 40% of the reported incidents--was crossing of the right edge-line before awaking, whereas crossing of the centreline was reported by 16%. Drivers' lack of awareness of important precursors of falling asleep--like highway hypnosis, driving without awareness, and similar phenomena--as well as a reluctance to discontinue driving despite feeling tired are pointed out as likely contributors to sleep-related accidents. More knowledge about the drivers' experiences immediately

77 FR 31879 - Comment Request for Information Collection for 1205-0179: Unemployment Compensation for Federal...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-30

... Collection for 1205-0179: Unemployment Compensation for Federal Employees Handbook No. 391, Extension Without... assessed. Currently, ETA is soliciting comments concerning the collection of data about Unemployment... comments to Scott Gibbons, Office of Unemployment Insurance, Employment and Training Administration, U.S...

[Objective functional compensation in NHIL: INAIL prosthesic protocol in Lombardy, 2007-2010].

PubMed

Calcinoni, O; Polo, L

2011-01-01

Even if NHIL gives already right to economic compensation, our Insurance aimed to real functional compensation, to reduce handicap in everyday life. Together with Professor Giordano, Audioprosthesists' Association and Manufacturers' representatives, INAIL Medical Superintendence started in 2003 a study on this problem, involving some of his forensic physician and ENT staff; in 2007-2009 INAIL issued directives innovating and planning the rules in prosthesis provision, not only acoustical ones. In 2010 started an experimental protocol to rule hearing aid provision in all INAIL centers, throughout Italy. Authors present first results of this protocol in Lombardy, related to previous and national ones.

Can medical insurance coverage reduce disparities of income in elderly patients requiring long-term care? The case of the People’s Republic of China

PubMed Central

Zhang, Zhenyu; Wang, Jianbing; Jin, Mingjuan; Li, Mei; Zhou, Litao; Jing, Fangyuan; Chen, Kun

2014-01-01

Background The People’s Republic of China’s population is aging rapidly, partly because of the impact of the one-child policy and improvements in the health care system. Caring for bedridden seniors can be a challenge for many families in the People’s Republic of China. Objective To identify the inequality of income among different age groups and social statuses, and evaluate the medical burden and health insurance compensation in the People’s Republic of China. Methods We measured income inequality and insurance compensation levels among bedridden patients in Zhejiang province, People’s Republic of China. Factor analysis and Gini coefficients were used to evaluate degree of income inequality and insurance compensation level. Results We found distinct regional disparities in Zhejiang province, including the aspects of income, expenses, and time. Gini coefficients of older adults with long-term care needs in urban and rural areas were 0.335 and 0.602, respectively. In all age groups, Gini coefficients increased after adjustment for medical expenditures, and the inequality persisted after insurance reimbursement was taken into consideration. Conclusion A significant income disparity between rural and urban areas was observed. Inequality increased with age, and medical expenditure is a huge burden for older people with long-term care needs. Health insurance does not play an important role in reducing inequalities among patients who need long-term care services. PMID:24855346

The effort to rehabilitate workers' compensation.

PubMed

Barth, P S

1976-06-01

State workers' compensation laws have been subjected to criticism since their inception; pressure to change them is now increasing. Most of the current challenge arise from dissatisfaction with the level of benefits available to disabled workers or their survivors, and, to a lesser degree, with the extent of program coverage. In response to this challenge, changes will occur that my range from reform-simply raising benefit levels and extending coverage-to program redesign, implying major structural revisions or abolishment of the system. For several reasons, including public apathy, the role of interest groups, and experience with other social insurance programs, it seems likely that basic structural shifts will not occur in the near future. While the criticism of these state laws is widespread, the problems can be dealt with in the existing framework. One area, however, could conceivably arouse sufficient public and legislative interest to upset this forecast. If it develops that the system is excluding large numbers of individuals disabled or killed by occupational diseases, workers' compensation laws could be placed in jeopardy. While evidence on this is scarce, it is clear that the current system compensates only a small number of serious cases of disability arising from occupational diseases.

Increasing farmers' adoption of agricultural index insurance: The search for a better index

NASA Astrophysics Data System (ADS)

Muneepeerakul, C. P.

2015-12-01

The weather index insurance promises to provide farmers' financial resilience when struck by adverse weather conditions, owing to its minimal moral hazard, low transaction cost, and swift compensation. Despite these advantages, the index insurance has so far received low level of adoption. One of the major causes is the presence of "basis risk"—the risk of getting an insurance payoff that falls short of the actual losses. One source of this basis risk is the production basis risk—the probability that the selected weather indexes and their thresholds do not correspond to actual damages. Here, we investigate how to reduce this production basis risk, using current knowledge in non-linear analysis and stochastic modeling from the fields of ecology and hydrology. We demonstrate how the inclusion of rainfall stochasticity can reduce production basis risk while identifying events that do not need to be insured. Through these findings, we show how much we can improve farmers' adoption of agricultural index insurance under different design contexts.

Analysis of the Uniform Accident And Sickness Policy Provision Law: lessons for social work practice, policy, and research.

PubMed

Cochran, Gerald

2010-01-01

The Uniform Accident and Sickness Policy Provision Law (UPPL) is a state statute that allows insurance companies in 26 states to deny claims for accidents and injuries incurred by persons under the influence of drugs or alcohol. Serious repercussions can result for patients and health care professionals as states enforce this law. To examine differences within the laws that might facilitate amendments or reduce insurance companies' ability to deny claims, a content analysis was carried out of each state's UPPL law. Results showed no meaningful differences between each state's laws. These results indicate patients and health professionals share similar risk related to the UPPL regardless of state.

15 CFR 8a.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Health and insurance benefits and services. 8a.440 Section 8a.440 Commerce and Foreign Trade Office of the Secretary of Commerce... benefits and services. Subject to § 8a.235(d), in providing a medical, hospital, accident, or life...

Patterns and Predictors of Failed and Sustained Return-to-Work in Transport Injury Insurance Claimants.

PubMed

Gray, Shannon E; Hassani-Mahmooei, Behrooz; Cameron, Ian D; Kendall, Elizabeth; Kenardy, Justin; Collie, Alex

2018-02-12

Purpose To determine the incidence of employed people who try and fail to return-to-work (RTW) following a transport crash. To identify predictors of RTW failure. A historical cohort study was conducted in the state of Victoria, Australia. People insured through the state-based compulsory third party transport accident compensation scheme were included. Inclusion criteria included date of crash between 2003 and 2012 (inclusive), age 15-70 years at the time of crash, sustained a non-catastrophic injury and received at least 1 day of income replacement. A matrix was created from an administrative payments dataset that mapped their RTW pattern for each day up to 3 years' post-crash. A gap of 7 days of no payment followed by resumption of a payment was considered a RTW failure and was flagged. These event flags were then entered into a regression analysis to determine the odds of having a failed RTW attempt. 17% of individuals had a RTW fail, with males having 20% lower odds of experiencing RTW failure. Those who were younger, had minor injuries (sprains, strains, contusions, abrasions, non-limb fractures), or were from more advantaged socio-economic group, were less likely to experience a RTW failure. Most likely to experience a RTW failure were individuals with whiplash, dislocations or particularly those admitted to hospital. Understanding the causes and predictors of failed RTW can help insurers, employers and health systems identify at-risk individuals. This can enable earlier and more targeted support and more effective employment outcomes.

Dental treatment injuries in the Finnish Patient Insurance Centre in 2000-2011.

PubMed

Karhunen, Sini; Virtanen, Jorma I

2016-01-01

Objective The Patient Insurance Centre in Finland reimburses patients who sustained injuries associated with medical and dental care without having to demonstrate malpractice. The aim was to analyse all dental injuries claimed through the Patient Insurance Centre over a 12-year period in order to identify factors affecting reimbursement of claims. Methods This study investigated all dental patient insurance claims in Finland during 2000-2011. The injury cases were grouped as (K00-K08) according to the International Classification of Diseases (ICD-10). Calendar year, claimant's age and gender, dental disease group and health service sector were the explanatory factors and the outcome was the decision of a claim. Multiple logistic regression modelling was used in the statistical analyses. Results The total number of decisions related to dental claims at the PIC in 2000-2011 was 7662, of which women claimed a clear majority (72%). Diseases of the pulp and periapical tissues (K04) and dental caries (K02) were the major disease groups (both 29%). Of the claims 40% were eligible for reimbursement, 27% were classified as insignificant or unavoidable injuries and 32% were rejected for other reasons. The proportion of reimbursed claims declined during the period. Patients from the private sector were more likely to be eligible for compensation than were those from the public sector (OR = 1.89, 95% CI = 1.71-2.10). Conclusions The number of dental patient insurance claims in Finland clearly rose, while the proportion of reimbursed claims declined. More claims received compensation in the private sector than in the public sector.

Cost of compensated injuries and occupational diseases in agriculture in Finland.

PubMed

Rautiainen, Risto H; Ohsfeldt, Robert; Sprince, Nancy L; Donham, Kelley J; Burmeister, Leon F; Reynolds, Stephen J; Saarimäki, Pentti; Zwerling, Craig

2005-01-01

Although agriculture is one of the most hazardous industries, the costs of agricultural injuries and illnesses are not well known. This study aimed to determine the cost burden from compensated injuries and occupational diseases in Finnish agriculture using workers compensation records. The incidence rates in 1996 were 7.4/100 for injuries and 0.61/100 for occupational diseases. Men had a higher risk of injury (RR = 1.89; 95% CI: 1.81-1.97), but a lower risk of an occupational disease (RR = 0.68; 95% CI: 0.60-0.78), compared to women. The total cost burden was 75 (Euros) per person in 1983, increasing to 215 in 1999. The total insurance cost in 1996 was 23.5 million consisting of medical care (16%), per diem (lost time compensation within one year from the incident) (37%), pension (lost time compensation after one year from the incident) (23%), survivors pension (3%), impairment allowance (7%), rehabilitation (6%), and other costs (9%). The total cost was 0.7% of the national gross farm income and 2.2% of the net farm income. The mean cost of 1996 cases was 1340 for injuries and 6636 for occupational diseases. Injuries represented 92% of the claims and 71% of the total costs. Occupational diseases represented 8% of the claims and 29% of the costs. Twenty percent of the most severe claims represented 79.5% of the total insurance costs. Injuries and occupational diseases result in significant costs in agriculture. Lost time was the largest cost item. Overall, injuries were more costly than occupational diseases. This study indicates that the 20%-80% rule applies to agricultural injury and illness costs, and from the cost standpoint, it is important to focus prevention efforts on the most severe incidents.

78 FR 19735 - Announcement Regarding a Change in Eligibility for Unemployment Insurance (UI) Claimants in...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-02

... Eligibility for Unemployment Insurance (UI) Claimants in Alaska, Georgia, Louisiana, Maryland, Mississippi, Missouri, Montana, Ohio, South Carolina and Texas in the Emergency Unemployment Compensation 2008 (EUC08... Administration, Labor. ACTION: Notice. SUMMARY: Announcement regarding a change in eligibility for Unemployment...

Content analysis to locate assistive technology in Queensland's motor injury insurance rehabilitation legislation and guidelines.

PubMed

Steel, Emily J

2018-06-08

Reforms to Australia's disability and rehabilitation sectors have espoused the potential of assistive technology as an enabler. As new insurance systems are being developed it is timely to examine the structure of existing systems. This exploratory study examined the policies guiding assistive technology provision in the motor accident insurance sector of one Australian state. Policy documents were analyzed iteratively with set of qualitative questions to understand the intent and interpretation of policies guiding assistive technology provision. Content analysis identified relevant sections and meaningful terminology, and context analysis explored the dominant perspectives informing policy. The concepts and language of assistive technology are not part of the policy frameworks guiding rehabilitation practice in Queensland's motor accident insurance sector. The definition of rehabilitation in the legislation is consistent contemporary international interpretations that focus on optimizing functioning in interaction with the environment. However, the supporting documents are focused on recovery from injuries where decisions are guided by clinical need and affordability. The policies frame rehabilitation in a medical model that assistive technology provision from the rehabilitation plan. The legislative framework provides opportunities to develop and improve assistive technology provision as part of an integrated approach to rehabilitation.

The economic costs of traffic accidents in Spain.

PubMed

Bastida, Julio López; Aguilar, Pedro Serrano; González, Beatriz Duque

2004-04-01

This study aimed to evaluate the economic impact of traffic accidents in Spain during 1997. The cost-of-illness method was used. Direct costs were divided into health services costs, insurance administration costs, and the costs of the material damages to the vehicles. Indirect costs were obtained through transformation of physical units into monetary units using the approach based on the human capital theory. The total cost of traffic accidents was 6,280.36 million euros, which amounts to 157.59 euros for each inhabitant in Spain and represents 1.35% of the gross national product. The total direct cost was 3,397.00 million euros, representing 54.1% of the total cost. The total indirect cost was 2,883.36 million euros, accounting for 45.9% of the total cost. The high socioeconomic cost of traffic accidents clearly indicates the need for the different administrations in Spain to collaborate in implementing preventive measures.

Occupational Psychiatric Disorders in Korea

PubMed Central

Kang, Seong-Kyu

2010-01-01

We searched databases and used various online resources to identify and systematically review all articles on occupational psychiatric disorders among Korean workers published in English and Korean before 2009. Three kinds of occupational psychiatric disorders were studied: disorders related to job stress and mental illness, psychiatric symptoms emerging in victims of industrial injuries, and occupational psychiatric disorders compensated by Industrial Accident Compensation Insurance (IACI). Korea does not maintain official statistical records for occupational psychiatric disorders, but several studies have estimated the number of occupational psychiatric disorders using the Korea Workers' Compensation and Welfare Service (COMWEL, formerly KLWC) database. The major compensated occupational psychiatric disorders in Korea were "personality and behavioral disorders due to brain disease, damage, and dysfunction", "other mental disorders due to brain damage and dysfunction and to physical diseases", "reactions to severe stress and adjustment disorders", and "depressive episodes". The most common work-related psychiatric disorders, excluding accidents, were "neurotic, stress-related, and somatoform disorders" followed by "mood disorders". PMID:21258596

Unemployment Insurance Financing, Short-Time Compensation, and Labor Demand. Background Paper No. 17.

ERIC Educational Resources Information Center

Hamermesh, Daniel S.

Legislated and administrative changes in the unemployment insurance system during the 1980s probably reduced the program's detrimental effects on labor market efficiency. They did so without changing the nature of the federal-state relationship that makes the program so unusual. Regrettably, though, they hurt the labor market status of low-wage…

Access to health insurance at small establishments: what can we learn from analyzing other fringe benefits?

PubMed

Abraham, Jean Marie; DeLeire, Thomas; Royalty, Anne Beeson

2009-01-01

Workers employed at small establishments are less likely to be offered health insurance than workers in larger establishments. They are also paid less and are less likely to be offered pensions, paid sick leave, and paid vacations. Using the Medical Expenditure Panel Survey, we examine the relationship between health insurance and other components of workers' compensation. We also propose an approach for identifying and prioritizing the reasons why workers in small establishments are less likely to be offered employer health insurance by comparing the provision of health insurance and how it changes with establishment size to the provision of these other fringe benefits and how they change with establishment size. We find that workers in larger establishments are not only more likely to be offered health insurance by their employer, but also are more likely to be offered retirement and paid vacation benefits. The results of our benefits comparison analysis suggest an important role for administrative costs as an obstacle to offering health insurance.

Weaknesses in the USACE Defense Base Act Insurance Program Led to as Much as $58.5 Million in Refunds Not Returned to the U.S. Government and Other Problems

DTIC Science & Technology

2011-07-28

compensation insurance for their employees who work overseas. DBA insurance carriers provide disability and medical benefits to employees for work... insurance carriers provide disability and medical benefits to employees for work-related injuries and death benefits to eligible survivors for work-related...program to determine if contracting with a single DBA insurance provider would help control costs. Under a single provider model , contractors must use

Commuting by bike in Belgium, the costs of minor accidents.

PubMed

Aertsens, Joris; de Geus, Bas; Vandenbulcke, Grégory; Degraeuwe, Bart; Broekx, Steven; De Nocker, Leo; Liekens, Inge; Mayeres, Inge; Meeusen, Romain; Thomas, Isabelle; Torfs, Rudi; Willems, Hanny; Int Panis, Luc

2010-11-01

Minor bicycle accidents are defined as "bicycle accidents not involving death or heavily injured persons, implying that possible hospital visits last less than 24 hours". Statistics about these accidents and related injuries are very poor, because they are mostly not reported to police, hospitals or insurance companies. Yet, they form a major share of all bicycle accidents. Official registrations underestimate the number of minor accidents and do not provide cost data, nor the distance cycled. Therefore related policies are hampered by a lack of accurate data. This paper provides more insight into the importance of minor bicycle accidents and reports the frequency, risk and resulting costs of minor bicycle accidents. Direct costs, including the damage to bike and clothes as well as medical costs and indirect costs such as productivity loss and leisure time lost are calculated. We also estimate intangible costs of pain and psychological suffering and costs for other parties involved in the accident. Data were collected during the SHAPES project using several electronic surveys. The weekly prospective registration that lasted a year, covered 1187 persons that cycled 1,474,978 km. 219 minor bicycle accidents were reported. Resulting in a frequency of 148 minor bicycle accidents per million kilometres. We analyzed the economic costs related to 118 minor bicycle accidents in detail. The average total cost of these accidents is estimated at 841 euro (95% CI: 579-1205) per accident or 0.125 euro per kilometre cycled. Overall, productivity loss is the most important component accounting for 48% of the total cost. Intangible costs, which in past research were mostly neglected, are an important burden related to minor bicycle accidents (27% of the total cost). Even among minor accidents there are important differences in the total cost depending on the severity of the injury. 2010 Elsevier Ltd. All rights reserved.

The Effect of Disability Insurance on Health Investment: Evidence from the Veterans Benefits Administration's Disability Compensation Program

ERIC Educational Resources Information Center

Singleton, Perry

2009-01-01

I examine whether individuals respond to monetary incentives to detect latent medical conditions. The effect is identified by a policy that deemed diabetes associated with herbicide exposure a compensable disability under the Veterans Benefits Administration's Disability Compensation program. Since a diagnosis is a requisite for benefit…

The evolution of altruism in spatial threshold public goods games via an insurance mechanism

NASA Astrophysics Data System (ADS)

Zhang, Jianlei; Zhang, Chunyan

2015-05-01

The persistence of cooperation in public goods situations has become an important puzzle for researchers. This paper considers the threshold public goods games where the option of insurance is provided for players from the standpoint of diversification of risk, envisaging the possibility of multiple strategies in such scenarios. In this setting, the provision point is defined in terms of the minimum number of contributors in one threshold public goods game, below which the game fails. In the presence of risk and insurance, more contributions are motivated if (1) only cooperators can opt to be insured and thus their contribution loss in the aborted games can be (partly or full) covered by the insurance; (2) insured cooperators obtain larger compensation, at lower values of the threshold point (the required minimum number of contributors). Moreover, results suggest the dominance of insured defectors who get a better promotion by more profitable benefits from insurance. We provide results of extensive computer simulations in the realm of spatial games (random regular networks and scale-free networks here), and support this study with analytical results for well-mixed populations. Our study is expected to establish a causal link between the widespread altruistic behaviors and the existing insurance system.

Benzodiazepine-like hypnotics and the associated risk of road traffic accidents.

PubMed

Orriols, L; Philip, P; Moore, N; Castot, A; Gadegbeku, B; Delorme, B; Mallaret, M; Lagarde, E

2011-04-01

The aim of the study was to investigate the association between the use of benzodiazepine or benzodiazepine-like hypnotics and the risk of road traffic accidents. Data from three French national databases were matched: the health-care insurance database, police reports, and the police database of injury-related traffic accidents. A total of 72,685 drivers involved in injury-related road traffic accidents in France, from 2005 to 2008, were included in the study. The risk of being responsible for a traffic accident was higher in users of benzodiazepine hypnotics (odds ratio (OR) = 1.39 (1.08-1.79)) and in the 155 drivers to whom a dosage of more than one pill of zolpidem a day had been dispensed during the 5 months before the collision (OR = 2.46 (1.70-3.56)). No association was found between the use of zopiclone and risk of traffic accidents. Although this study did not find any association between the use of zolpidem as recommended and causation of traffic accidents, the potential risk related to possible abuse of the drug and risky driving behaviors should be further investigated. The results related to benzodiazepine hypnotics are consistent with those of previous studies.

[Work-related accidents in traditional fishermen from the Medium Araguaia River region, Tocantins, Brazil].

PubMed

Garrone Neto, Domingos; Cordeiro, Ricardo Carlos; Haddad, Vidal

2005-01-01

This is a cross-sectional study of work-related accidents among traditional fishermen in the Medium Araguaia River region of Tocantins, Brazil. From June to August 2002, fishermen from the Municipality of Araguacema were interviewed about the organization of their work activities and work-related accidents during the previous six months. Of the 92 participating fishermen, 56 reported having suffered a work-related accident (annual incidence was 82.6%). Some 95.7% of those interviewed did not regularly pay social security insurance as self-employed workers and were not aware of their social rights and duties. For fishermen reporting accidents, this proportion was 98.2%. Approximately 23.0% had another work activity, mainly as construction workers (47.6%) or sport-fishing guides (23.9%). Injuries inflicted by aquatic animals were the main form of accidents (about 86.0%). From these results, it is apparent that accidents from aquatic animals are an important health hazard, in some cases causing temporary work incapacity.

Compensation, benefits, and satisfaction: the Longitudinal Emergency Medical Technician Demographic Study (LEADS) Project.

PubMed

Brown, William E; Dawson, Drew; Levine, Roger

2003-01-01

To determine the compensation, benefit package, and level of satisfaction with the benefits of nationally registered emergency medical technicians (NREMTs) in 2001. The Longitudinal EMT Attribute Demographic Study (LEADS) Project included an 18-question snapshot survey on compensation with the 2001 core survey. This survey was sent to 4,835 randomly selected NREMTs. A total of 1,718 NREMT-Basics and NREMT-Paramedics, from 1,317 different postal zip codes, responded to the survey. Most NREMTs in the survey (86% of the compensated NREMT-Basics and 85% of the compensated NREMT-Paramedics) were employed primarily as patient care providers. For their emergency medical services (EMS) work in the previous 12 months, compensated NREMT-Basics had mean earnings of 18,324 US dollars (standard error, 978 US dollars) and compensated NREMT-Paramedics had mean earnings of 34,654 US dollars (standard error, 646 US dollars). At least 26% of compensated NREMT-Basics and 9% of compensated NREMT-Paramedics had no health insurance. The majority of compensated NREMTs (62% of the Basics and 57% of the Paramedics) reported their retirement plans were not adequate to meet their financial needs. EMTs are not satisfied with the appreciation and recognition they receive from EMS employers. About one-third (35% of the compensated NREMT-Basics and 30% of the compensated NREMT-Paramedics) were not satisfied with all of the benefits they receive from their EMS employer. Nearly all (94% of both compensated NREMT-Basics and NREMT-Paramedics) believed that EMTs should be paid more for the job that they do. The adequacy of EMT compensation and benefit packages is an area of concern. It is not unreasonable to believe that these factors are associated with EMT retention and attrition. Additional longitudinal EMT information on compensation and benefits are anticipated to determine the extent to which compensation and benefits are factors in EMT retention.

Working on reform. How workers' compensation medical care is affected by health care reform.

PubMed

Himmelstein, J; Rest, K

1996-01-01

The medical component of workers' compensation programs-now costing over $24 billion annually-and the rest of the nation's medical care system are linked. They share the same patients and providers. They provide similar benefits and services. And they struggle over who should pay for what. Clearly, health care reform and restructuring will have a major impact on the operation and expenditures of the workers' compensation system. For a brief period, during the 1994 national health care reform debate, these two systems were part of the same federal policy development and legislative process. With comprehensive health care reform no longer on the horizon, states now are tackling both workers' compensation and medical system reforms on their own. This paper reviews the major issues federal and state policy makers face as they consider reforms affecting the relationship between workers' compensation and traditional health insurance. What is the relationship of the workers' compensation cost crisis to that in general health care? What strategies are being considered by states involved in reforming the medical component of workers compensation? What are the major policy implications of these strategies?

Assessing trends in insured losses from floods in Spain 1971-2008

NASA Astrophysics Data System (ADS)

Barredo, J. I.; Saurí, D.; Llasat, M. C.

2012-05-01

Economic impacts from floods have been increasing over recent decades, a fact often attributed to a changing climate. On the other hand, there is now a significant body of scientific scholarship all pointing towards increasing concentrations and values of assets as the principle cause of the increasing cost of natural disasters. This holds true for a variety of perils and across different jurisdictions. With this in mind, this paper examines the time history of insured losses from floods in Spain between 1971 and 2008. It assesses whether any discernible residual signal remains after adjusting the data for the increase in the number and value of insured assets over this period of time. Data on insured losses from floods were sourced from Consorcio de Compensación de Seguros (CCS). Although a public institution, CCS compensates homeowners for the damage produced by floods, and thus plays a role similar to that of a private insurance company. Insured losses were adjusted using two proxy measures: first, changes in the total amount of annual surcharges (premiums) paid by customers to CCS, and secondly, changes in the total value of dwellings per year. The adjusted data reveals no significant trend over the period 1971-2008 and serves again to confirm that at this juncture, societal influences remain the prime factors driving insured and economic losses from natural disasters.

[Diagnosis and treatment of diving accidents. New German guidelines for diving accidents 2014-2017].

PubMed

Jüttner, B; Wölfel, C; Liedtke, H; Meyne, K; Werr, H; Bräuer, T; Kemmerer, M; Schmeißer, G; Piepho, T; Müller, O; Schöppenthau, H

2015-06-01

In 2015 the German Society for Diving and Hyperbaric Medicine (GTÜM) and the Swiss Underwater and Hyperbaric Medical Society (SUHMS) published the updated guidelines on diving accidents 2014-2017. These multidisciplinary guidelines were developed within a structured consensus process by members of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI), the Sports Divers Association (VDST), the Naval Medical Institute (SchiffMedInst), the Social Accident Insurance Institution for the Building Trade (BG BAU), the Association of Hyperbaric Treatment Centers (VDD) and the Society of Occupational and Environmental Medicine (DGAUM). This consensus-based guidelines project (development grade S2k) with a representative group of developers was conducted by the Association of Scientific Medical Societies in Germany. It provides information and instructions according to up to date evidence to all divers and other lay persons for first aid recommendations to physician first responders and emergency physicians as well as paramedics and all physicians at therapeutic hyperbaric chambers for the diagnostics and treatment of diving accidents. To assist in implementing the guideline recommendations, this article summarizes the rationale, purpose and the following key action statements: on-site 100% oxygen first aid treatment, still patient positioning and fluid administration are recommended. Hyperbaric oxygen (HBO) recompression remains unchanged the established treatment in severe cases with no therapeutic alternatives. The basic treatment scheme recommended for diving accidents is hyperbaric oxygenation at 280 kPa. For quality management purposes there is a need in the future for a nationwide register of hyperbaric therapy.

District Costs for Teacher Health Insurance: An Examination of the Data from the BLS and Wisconsin. The Productivity for Results Series No. 8

ERIC Educational Resources Information Center

Costrell, Robert M.

2015-01-01

Rising health insurance costs have been a source of fiscal distress for school districts. In this paper, I closely examine data from the National Compensation Survey (NCS) of the Bureau of Labor Statistics (BLS) to address a few basic questions: (1) Are district costs for teachers' health insurance higher, on average, than employer costs for…

Satisfaction of staff of Swiss insurance companies with medical appraisals: a cross sectional study.

PubMed

Eichler, Klaus; Imhof, Daniel; Bollag, Yvonne; Stöhr, Susanna; Gyr, Niklaus; Auerbach, Holger

2011-03-28

A high quality of timely delivered medical appraisals is crucial for social and other insurances to judge possible occupational reintegration measures for patients with medical conditions who are in danger to lose their job. However, little is known about the satisfaction of staff of insurance companies with medical appraisals that they have commissioned.Our questionnaire survey prospectively included all medical appraisals arriving at Swiss insurances from FEB to APR 2008. We assessed the satisfaction of the commissioner with medical appraisals performed by medical assessors. In addition, we evaluated the contribution of several factors to overall satisfaction. The unit of sample was the medical appraisal. We analysed 3165 medical appraisals, 2444 (77%) of them from the public disability insurance, 678 (22%) from private accident, liability and loss of income insurances and 43 (1%) from other insurances. Overall satisfaction of staff of insurance companies in Switzerland was high, but satisfaction of the disability insurance with appraisals was generally lower compared to satisfaction of private insurances. The staff of the disability insurance judged time for preparation as too long in 30%. For staff of private insurance companies 20% of appraisals were not "worth its price". Well-grounded and comprehensible conclusions were the single most important factor for high overall satisfaction (OR 10.1; 95%-CI: 1.1-89.3). From the viewpoint of staff of insurance companies, a relevant part of medical appraisals arrives too late. Medical assessors have to take the specific needs of insurances into account, to perform more appraisals with sound conclusions in due time.

Satisfaction of staff of Swiss insurance companies with medical appraisals: a cross sectional study

PubMed Central

2011-01-01

Background A high quality of timely delivered medical appraisals is crucial for social and other insurances to judge possible occupational reintegration measures for patients with medical conditions who are in danger to lose their job. However, little is known about the satisfaction of staff of insurance companies with medical appraisals that they have commissioned. Our questionnaire survey prospectively included all medical appraisals arriving at Swiss insurances from FEB to APR 2008. We assessed the satisfaction of the commissioner with medical appraisals performed by medical assessors. In addition, we evaluated the contribution of several factors to overall satisfaction. The unit of sample was the medical appraisal. Findings We analysed 3165 medical appraisals, 2444 (77%) of them from the public disability insurance, 678 (22%) from private accident, liability and loss of income insurances and 43 (1%) from other insurances. Overall satisfaction of staff of insurance companies in Switzerland was high, but satisfaction of the disability insurance with appraisals was generally lower compared to satisfaction of private insurances. The staff of the disability insurance judged time for preparation as too long in 30%. For staff of private insurance companies 20% of appraisals were not "worth its price". Well-grounded and comprehensible conclusions were the single most important factor for high overall satisfaction (OR 10.1; 95%-CI: 1.1-89.3). Conclusions From the viewpoint of staff of insurance companies, a relevant part of medical appraisals arrives too late. Medical assessors have to take the specific needs of insurances into account, to perform more appraisals with sound conclusions in due time. PMID:21443762

[Fatal occupational accidents: estimates based on more data sources].

PubMed

Baldasseroni, A; Chellini, E; Zoppi, O; Giovannetti, L

2001-01-01

The data reported by INAIL (Istituto Nazionale Assicurazione Infortuni sul Lavoro) on fatal occupational injuries have always been considered complete and reliable. The authors of this article verified the completeness of this information source crossing it with data bases existing in different registration systems (Regional Mortality Registry of Tuscany--RMR; registers and data of the Operative Units of Prevention, Hygiene and Safety in the Workplace--UOPISLL) for the period between 1992 and 1996. In the five years concerned, a total of 458 cases were reported. These cases could be considered fatal injuries at work without taking into account traffic accidents, which were not included in the present study. The results show that the most complete information source was RMR, reporting 80% of the total data, while INAIL reports only 62.2% of the total cases. On the contrary, the UOPISLL source is the least reliable. Using the capture/recapture method, the estimate of events in the period concerned (1992-1996) amounts to nearly 500 (499.8 LC 475.9-523.7), while the three sources systematically explored for the whole period (INAIL, RMR, UOSPILL) report 458 cases. An additional information source, the daily press, which could be systematically tested only two months for each of the five years, reports 10 additional cases, which were ignored by the 3 other sources, indirectly confirming in this way how reliable the performed estimate was. The main cases among the 157 fatal accidents reported by RMR, but not by INAIL, occurred among farmers (70), most of them already retired, but there were several fatal accidents reported in the construction sector (30). Other categories were included only in the RMR data because, in the period concerned, they were not covered by INAIL insurance (18 cases in the Army and Police, 7 on the railways). The survey that was carried out confirms the essential importance of INAIL data for the surveillance system applied to this phenomenon. This

Patients transferred for emergency upper extremity evaluation: does insurance status matter?

PubMed

Eberlin, Kyle R; Hartzell, Tristan L; Kuo, Phoebe; Winograd, Jonathan; Day, Charles

2013-03-01

Academic institutions receive many patients transferred specifically for hand surgery evaluation. The purpose of this study was to evaluate the demographics and insurance status of patients transferred for this reason. A retrospective review was performed of 155 transferred and 1017 nontransferred patients with a primary hand diagnosis during 3 summer months at two urban academic institutions. Patients were evaluated for insurance status/type, medical comorbidities, employment status, and reason for transfer. Insurance was defined as present/absent and favorable/unfavorable, with unfavorable defined as Medicaid or state-sponsored insurance. Reason for transfer or presenting diagnosis was separated by category. The mean age was similar between groups, but a higher percentage of transfer patients were men (69.9 percent versus 59.7 percent; p < 0.05). The percentage of insured patients was similar (92.9 percent versus 93.2 percent), but the number with no insurance or undesirable insurance was greater for transferred patients (30.1 percent versus 22.9 percent; p < 0.05). Patients with poor or no insurance were twice as likely to be inappropriately transferred (OR, 2.17; p = 0.03). Transferred patients were less likely to be employed (55.1 percent versus 64.8 percent; p < 0.05); however, the percentages of workers' compensation (13.5 percent versus 14.6 percent) and diabetes (6.41 percent versus 6.10 percent) cases were similar. Common reasons for transfer were closed fractures/dislocations (21.9 percent), infection (17.4 percent), and amputation/devascularization (17.4 percent). Patients transferred to tertiary care centers for emergency upper extremity evaluation have a higher rate of undesirable or no insurance and are more likely to be male or unemployed.

78 FR 51211 - Announcement Regarding a Change in Eligibility for Unemployment Insurance (UI) Claimants in...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-20

... Eligibility for Unemployment Insurance (UI) Claimants in Louisiana, Maine, New Jersey, West Virginia and the Virgin Islands in the Emergency Unemployment Compensation 2008 (EUC08) Program AGENCY: Employment and... unemployment rate (TUR) in Louisiana was 6.5 percent, exceeding the 6.0 percent trigger rate threshold to...

A structural econometric model of family valuation and choice of employer-sponsored health insurance in the United States.

PubMed

Vanness, David J

2003-09-01

This paper estimates a fully structural unitary household model of employment and health insurance decisions for dual wage-earner families with children in the United States, using data from the 1987 National Medical Expenditure Survey. Families choose hours of work and the breakdown of compensation between cash wages and health insurance benefits for each wage earner in order to maximize expected utility under uncertain need for medical care. Heterogeneous demand for the employer-sponsored health insurance is thus generated directly from variations in health status and earning potential. The paper concludes by discussing the benefits of using structural models for simulating welfare effects of insurance reform relative to the costly assumptions that must be imposed for identification. Copyright 2003 John Wiley & Sons, Ltd.

Motor vehicle crashes in roadway construction workzones: an analysis using narrative text from insurance claims.

PubMed

Sorock, G S; Ranney, T A; Lehto, M R

1996-01-01

Motor vehicle travel through roadway construction workzones has been shown to increase the risk of a crash. The number of workzones has increased due to recent congressional funding in 1991 for expanded roadway maintenance and repair. In this paper, we describe the characteristics and costs of motor vehicle crashes in roadway construction workzones. As opposed to using standard accident codes to identify accident types, automobile insurance claims files from 1990-93 were searched to identify records with the keyword "construction" in the accident narrative field. A total of 3,686 claims were used for the analysis of crashes. Keywords from the accident narrative field were used to identify five pre-crash vehicle activities and five crash types. We evaluated misclassification error by reading 560 randomly selected claims and found it to be only 5%. For each of four years, 1990-93, there was a total of 648,996,977 and 1,065 crashes, respectively. There was a 70% increase in the crash rate per 10,000 personal insured vehicles from 1990-93 (2.1-3.6). Most crashes (26%) involved a stopped or slowing vehicle in the workzone. The most common crash (31%) was a rear-end collision. The most costly pre-crash activity was a major judgment error on the part of a driver (n = 120, median cost = $2,628). An overturned vehicle was the most costly crash type (n = 16, median cost = $4,745). In summary, keyword text analysis of accident narrative data used in this study demonstrated its utility and potential for enhancing injury epidemiology. The results suggest interventions are needed to respond to growing traffic hazards in construction workzones.

20 CFR 10.718 - Are payments to a beneficiary as a result of an insurance policy which the beneficiary has...

Code of Federal Regulations, 2010 CFR

2010-04-01

... OWCP or SOL? 10.718 Section 10.718 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS... reported to OWCP or SOL? Since payments received by a FECA beneficiary pursuant to an insurance policy...

Site restoration: Estimation of attributable costs from plutonium-dispersal accidents

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chanin, D.I.; Murfin, W.B.

1996-05-01

A nuclear weapons accident is an extremely unlikely event due to the extensive care taken in operations. However, under some hypothetical accident conditions, plutonium might be dispersed to the environment. This would result in costs being incurred by the government to remediate the site and compensate for losses. This study is a multi-disciplinary evaluation of the potential scope of the post-accident response that includes technical factors, current and proposed legal requirements and constraints, as well as social/political factors that could influence decision making. The study provides parameters that can be used to assess economic costs for accidents postulated to occurmore » in urban areas, Midwest farmland, Western rangeland, and forest. Per-area remediation costs have been estimated, using industry-standard methods, for both expedited and extended remediation. Expedited remediation costs have been evaluated for highways, airports, and urban areas. Extended remediation costs have been evaluated for all land uses except highways and airports. The inclusion of cost estimates in risk assessments, together with the conventional estimation of doses and health effects, allows a fuller understanding of the post-accident environment. The insights obtained can be used to minimize economic risks by evaluation of operational and design alternatives, and through development of improved capabilities for accident response.« less

Atrial fibrillation, CHA2DS2-VASc score, antithrombotics and risk of traffic accidents: A population-based cohort study.

PubMed

Lai, Hui-Chin; Chien, Wu-Chien; Chung, Chi-Hsiang; Lee, Wen-Lieng; Wang, Kuo-Yang; Wu, Tsu-Juey; Liu, Chia-Ning; Liu, Tsun-Jui

2015-10-15

Traffic accidents account for a substantial proportion of premature disabilities and deaths. Whether atrial fibrillation (AF) provokes while antithrombotics prevent from such events remains un-investigated. All patients ≥40years with newly diagnosed AF in 2005 were scrutinized from the "Longitudinal Health Insurance Database 2005" (1 million beneficiaries) of Taiwan's National Health Insurance Institute as the AF group. Four-fold number of age-, gender-, and comorbidity-matched patients but without AF served as the Non-AF controls. Patients were followed till occurrence of hospitalization-requiring traffic injury, death, withdrawal from insurance, or the end of 2010. Cumulative incidence of traffic accidents was compared between groups, and predictors and preventive role of antithrombotics for these accidents were identified by Cox regression analysis. Within a mean follow-up of 4.3years, traffic injury occurred significantly more often in patients with AF (N=1724) than those without it (N=6896) (5.4 vs. 4.9 per 1000 person-years, log-rank p=0.012, HR 1.110, 95% CI 1.013-1.572). Cox models identified age ≧65years, hypertension, coronary artery disease, stroke, liver cirrhosis and CHADS2VASC score≧1 as risk factors for traffic injury in AF patients, whereas oral anticoagulants (HR 0.576, 95% CI 0.285-0.791, p=0.002) used in patients with CHADS2VASC score ≧1 but not antiplatelet therapy (p=0.197) as negative predictors. Patients with AF are more vulnerable to traffic accidents especially when with higher CHADS2VASC scores and other comorbidities. This tendency to traffic accidents, however, could be ameliorated by oral anticoagulation in specialized cases but not by antiplatelet therapy. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

5 CFR 894.304 - Am I eligible to enroll if I'm retired or receiving workers' compensation?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Am I eligible to enroll if I'm retired or receiving workers' compensation? 894.304 Section 894.304 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE...

5 CFR 894.304 - Am I eligible to enroll if I'm retired or receiving workers' compensation?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Am I eligible to enroll if I'm retired or receiving workers' compensation? 894.304 Section 894.304 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE...

Do Zero-Cost Workers’ Compensation Medical Claims Really Have Zero Costs?

PubMed Central

Asfaw, Abay; Rosa, Roger; Mao, Rebecca

2015-01-01

Objective Previous research suggests that non–workers’ compensation (WC) insurance systems, such as group health insurance (GHI), Medicare, or Medicaid, at least partially cover work-related injury and illness costs. This study further examined GHI utilization and costs. Methods Using two-part model, we compared those outcomes immediately after injuries for which accepted WC medical claims made zero or positive medical payments. Results Controlling for pre-injury GHI utilization and costs and other covariates, our results indicated that post-injury GHI utilization and costs increased regardless of whether a WC medical claim was zero or positive. The increases were highest for zero-cost WC medical claims. Conclusion Our national estimates showed that zero-cost WC medical claims alone could cost the GHI $212 million per year. PMID:24316724

Willingness to use safety belt and levels of injury in car accidents.

PubMed

de Lapparent, Matthieu

2008-05-01

In this article, we develop a bivariate ordered Probit model to analyze the decision to fasten the safety belt in a car and the resulting severity of accidents if it happens. The approach takes into account the fact that the decision to fasten the safety belt has a direct causal effect on the category of injury if an accident happens. Our application to a sample drawn from the database of French accident reports in 2003 for three populations of car users (drivers, front passengers, rear passengers) shows that fastening the safety belt is significantly related to a decrease in severe injuries but it shows also that these car users compensate partly for this safety benefit. Furthermore, it is observed that demographic characteristics of car users, as well as transport facilities, play important roles in decisions to fasten safety belts and in the eventual resulting accident injuries.

Working on reform. How workers' compensation medical care is affected by health care reform.

PubMed Central

Himmelstein, J; Rest, K

1996-01-01

The medical component of workers' compensation programs-now costing over $24 billion annually-and the rest of the nation's medical care system are linked. They share the same patients and providers. They provide similar benefits and services. And they struggle over who should pay for what. Clearly, health care reform and restructuring will have a major impact on the operation and expenditures of the workers' compensation system. For a brief period, during the 1994 national health care reform debate, these two systems were part of the same federal policy development and legislative process. With comprehensive health care reform no longer on the horizon, states now are tackling both workers' compensation and medical system reforms on their own. This paper reviews the major issues federal and state policy makers face as they consider reforms affecting the relationship between workers' compensation and traditional health insurance. What is the relationship of the workers' compensation cost crisis to that in general health care? What strategies are being considered by states involved in reforming the medical component of workers compensation? What are the major policy implications of these strategies? Images p13-a p14-a p15-a p16-a p18-a p19-a p20-a p22-a p24-a PMID:8610187

Lessons to be learned: a retrospective analysis of physiotherapy injury claims.

PubMed

Johnson, Gillian M; Skinner, Margot A; Stephen, Rachel E

2012-08-01

Retrospective, descriptive analysis. To describe the prevalence and nature of insurance claims for injuries attributed to physiotherapy care. In New Zealand, a national insurance scheme, the Accident Compensation Corporation, provides comprehensive, no-fault personal injury coverage. The patterns of injury sustained during physiotherapy care have not previously been described. De-identified data for all injuries registered with the Accident Compensation Corporation from 2005 to 2010 and attributed to physiotherapy were accessed. Prevalence patterns (percentages) of new-claim data were determined for physiotherapy intervention category, injury site, nature of injury, age, and sex. A subcategory, exercise-related injuries, was analyzed according to injury site and whether the injury was related (primary) or unrelated (secondary) to the intended therapeutic goal. There were 279 claims related to physiotherapy care filed with the Accident Compensation Corporation during the studied reporting period. Injury was attributed predominantly to exercise (n = 88, 31.5% of cases) and manual therapy (n = 74, 26.5% of cases). The prevalence of events categorized as exercise related was greatest in those who were 55 to 59 years of age (n = 14, 16.3%) and greater in females (n = 47, 54.7%). Of the exercise-related injuries, 39.8% were in the lower-limb region and 35.2% were categorized as sprains/strains. Injuries attributed to exercise exceeded those linked to other therapies provided by physiotherapists, yet exercise therapy rarely features as a cause of adverse events reported to the physiotherapy profession. The proportion of exercise-related injury events underlines the need for ensuring safe and careful consideration of exercise prescription. Harm, level 4.

20 CFR 726.103 - Application for authority to self-insure; effect of regulations contained in this part.

Code of Federal Regulations, 2014 CFR

2014-04-01

...; effect of regulations contained in this part. 726.103 Section 726.103 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED BLACK LUNG BENEFITS; REQUIREMENTS FOR COAL MINE OPERATOR'S INSURANCE Authorization of Self...

20 CFR 726.103 - Application for authority to self-insure; effect of regulations contained in this part.

Code of Federal Regulations, 2013 CFR

2013-04-01

...; effect of regulations contained in this part. 726.103 Section 726.103 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED BLACK LUNG BENEFITS; REQUIREMENTS FOR COAL MINE OPERATOR'S INSURANCE Authorization of Self...

20 CFR 726.103 - Application for authority to self-insure; effect of regulations contained in this part.

Code of Federal Regulations, 2011 CFR

2011-04-01

...; effect of regulations contained in this part. 726.103 Section 726.103 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, AS AMENDED BLACK LUNG BENEFITS; REQUIREMENTS FOR COAL MINE OPERATOR'S INSURANCE Authorization of Self...

Neuro-ophthalmic manifestations of cerebrovascular accidents.

PubMed

Ghannam, Alaa S Bou; Subramanian, Prem S

2017-11-01

Ocular functions can be affected in almost any type of cerebrovascular accident (CVA) creating a burden on the patient and family and limiting functionality. The present review summarizes the different ocular outcomes after stroke, divided into three categories: vision, ocular motility, and visual perception. We also discuss interventions that have been proposed to help restore vision and perception after CVA. Interventions that might help expand or compensate for visual field loss and visuospatial neglect include explorative saccade training, prisms, visual restoration therapy (VRT), and transcranial direct current stimulation (tDCS). VRT makes use of neuroplasticity, which has shown efficacy in animal models but remains controversial in human studies. CVAs can lead to decreased visual acuity, visual field loss, ocular motility abnormalities, and visuospatial perception deficits. Although ocular motility problems can be corrected with surgery, vision, and perception deficits are more difficult to overcome. Interventions to restore or compensate for visual field deficits are controversial despite theoretical underpinnings, animal model evidence, and case reports of their efficacies.

Compensation for subjects of medical research: the moral rights of patients and the power of research ethics committees.

PubMed Central

Guest, S

1997-01-01

Awareness of the morally significant distinction between research and innovative therapy reveals serious gaps in the legal provision for compensation in the UK for injured subjects of medical research. Major problems are limitations inherent in negligence actions and a culture that emphasises indemnifying researchers before compensating victims. Medical research morally requires compensation on a no-fault basis even where there is proper consent on the part of the research subject. In particular, for drug research, there is insufficient provision in the current patient guidelines of the Association of the British Pharmaceutical Industry, since they make "no legal commitment" to paying compensation for injury to patient subjects. There is a need for the provision of both adequate insurance and contractual arrangements for making payments. The solution is for Local Research Ethics Committees (LRECs) to make use of their power to withhold approval of medical research where compensation is not legally enforceable. PMID:9220333

Giving back the pen: disclosure, apology and early compensation discussions after harm in the healthcare setting.

PubMed

Pelletier, Elaine; Robson, Rob

2008-01-01

In her recently published book After Harm, Nancy Berlinger shares a story about Bishop Desmond Tutu as he comments on the importance of restitution or compensation after an event that has led to harm. Transparency and disclosure are very much on the healthcare agenda in Canada. The increased interest in training providers for difficult conversations and disclosure is a positive sign. Using honest disclosure and apology as important interventions, organizations are beginning to adopt a more open approach to the concept of rebuilding trust after a patient has been harmed. But there continues to be significant reluctance to take the next logical step to solidify the fiduciary relationship between provider and patient - the willingness to enter into early discussions about compensation, non-monetary and otherwise. The Winnipeg Regional Health Authority has developed, with the participation of the facility insurers, a process to identify those cases in which it would be appropriate not only to offer an apology of responsibility but also to initiate discussions around the questions of restitution and compensation. The article describes the steps that led to the development of a detailed process map for such cases and shares the algorithm that has been adopted. As well, the potential challenges associated with such an approach when there are multiple liability and insurance providers are discussed.

Tools for improving safety management in the Norwegian Fishing Fleet occupational accidents analysis period of 1998-2006.

PubMed

Aasjord, Halvard L

2006-01-01

Reporting of human accidents in the Norwegian Fishing Fleet has always been very difficult because there has been no tradition in making reports on all types of working accidents among fishermen, if the accident does not seem to be very serious or there is no economical incentive to report. Therefore reports are only written when the accidents are serious or if the fisherman is reported sick. Reports about an accident are sent to the insurance company, but another report should also be sent to the Norwegian Maritime Directorate (NMD). Comparing of data from one former insurance company and NMD shows that the real numbers of injuries or serious accidents among Norwegian fishermen could be up to two times more than the numbers reported to NMD. Special analyses of 1690 accidents from the so called PUS-database (NMD) for the period 1998-2002, show that the calculated risk was 23.6 accidents per 1000 man-years. This is quite a high risk level, and most of the accidents in the fishing fleet were rather serious. The calculated risks are highest for fishermen on board the deep sea fleet of trawlers (28.6 accidents per 1000 man-years) and also on the deep sea fleet of purse seiners (28.9 accidents per 1000 man-years). Fatal accidents over a longer period of 51.5 years from 1955 to 2006 are also roughly analysed. These data from SINTEF's own database show that the numbers of fatal accidents have been decreasing over this long period, except for the two periods 1980-84 and 1990-94 where we had some casualties with total losses of larger vessels with the loss of most of the crew, but also many others typical work accidents on smaller vessels. The total numbers of registered Norwegian fishermen and also the numbers of man-years have been drastically reduced over the 51.5 years from 1955 to 2006. The risks of fatal accidents have been very steady over time at a high level, although there has been a marked risk reduction since 1990-94. For the last 8.5-year period of January 1998

Scientific relevance of Swiss property insurance data on flood risks and losses

NASA Astrophysics Data System (ADS)

Röthlisberger, Veronika; Bernet, Daniel; Keiler, Margreth

2015-04-01

The databases of Swiss flood insurance companies build a valuable but to date rarely used source of information for flood risk research. Detailed insights into the Swiss flood insurance system are crucial to evaluate the potential of the different databases for scientific analysis. Even though the flood insurance system modalities are mainly regulated on cantonal level there are some common principles that apply throughout Switzerland. First of all coverage against floods (and other particular natural hazards) is an integral part of every fire insurance policy for buildings or contents in Switzerland. This coupling of insurance as well as the statutory obligation to insure buildings in most of the cantons and movables in some of the cantons lead to a very high penetration. Second, in case of damage, the reinstatement costs (value as new) are compensated and third there are no (or little) deductible and co-pay. Thus the different datasets of the flood insurance companies would allow a very comprehensive data analysis. Moreover, insurance companies not only store electronically data about losses (typically date, amount of claims payment, cause of damage, identity of the insured object or policyholder) but also about insured objects. For insured objects the (insured) value and the details on the policy and its holder are the main feature to record. On buildings the insurance companies usually computerize additional information such as location, volume, year of construction or purpose of use. For the 19 (of total 26) cantons with a cantonal monopoly insurer the data of these insurance establishments have the additional value to represent (almost) the entire building stock of the respective canton. However, scientists face a wide range of the opportunities and challenges when using insurance data for flood research. The origin of flood insurance data implies that they are not generated for research but for business management. The presentation will highlighted pro and

Administrative compensation of medical injuries: a hardy perennial blooms again.

PubMed

Barringer, Paul J; Studdert, David M; Kachalia, Allen B; Mello, Michelle M

2008-08-01

Periods in which the costs of personal injury litigation and liability insurance have risen dramatically have often provoked calls for reform of the tort system, and medical malpractice is no exception. One proposal for fundamental reform made during several of these volatile periods has been to relocate personal injury disputes from the tort system to an alternative, administrative forum. In the medical injury realm, a leading incarnation of such proposals in recent years has been the idea of establishing specialized administrative "health courts." Despite considerable stakeholder and policy-maker interest, administrative compensation proposals have tended to struggle for broad political acceptance. In this article, we consider the historical experience of administrative medical injury compensation proposals, particularly in light of comparative examples in the context of workplace injuries, automobile injuries, and vaccine injuries. We conclude by examining conditions that may facilitate or impede progress toward establishing demonstration projects of health courts.

Filing for workers' compensation among Ontario cases of mesothelioma.

PubMed

Payne, Jennifer Isabelle; Pichora, Erin

2009-01-01

For many types of cancer, disease attribution to occupational exposures is difficult. Mesothelioma, however, is a 'sentinel' occupational cancer associated with asbestos exposure. The present study linked workers' compensation claims data with cancer registry data to explore the completeness of reporting of mesothelioma to the Ontario Workplace Safety and Insurance Board (WSIB) according to characteristics of cases diagnosed among Ontario residents. Two data sources were linked at the person level: the WSIB Occupational Disease Information and Surveillance System and the Ontario Cancer Registry. Filing rates were calculated as the proportion of Ontario Cancer Registry mesothelioma cases (International Classification of Diseases - Oncology code 905) that linked to a WSIB-filed cancer claim. Filing rates were calculated for the period 1980 to 2002, and trends were calculated by year, age and county of residence at diagnosis. The filing rate for compensation has increased little over the past 20 years, reaching a high of 43% in 2000. Overall, filing rates were highest among pleural mesothelioma cases among men (range 27% to 57%). Filing rates were highest among individuals 50 to 59 years of age and declined substantially throughout the retirement years. There was substantial variation in filing rates by area of residence, with the highest rate being in Lambton County, Ontario. The filing rate for compensation in Ontario was much lower than the estimated proportion of cases eligible for compensation. The increased filing rate in Lambton County was likely related to this community's awareness of the association between asbestos and mesothelioma. Physicians can play an important role in educating patients of their potential entitlement to compensation benefits.

Filing for workers’ compensation among Ontario cases of mesothelioma

PubMed Central

Payne, Jennifer Isabelle; Pichora, Erin

2009-01-01

BACKGROUND/OBJECTIVE: For many types of cancer, disease attribution to occupational exposures is difficult. Mesothelioma, however, is a ‘sentinel’ occupational cancer associated with asbestos exposure. The present study linked workers’ compensation claims data with cancer registry data to explore the completeness of reporting of mesothelioma to the Ontario Workplace Safety and Insurance Board (WSIB) according to characteristics of cases diagnosed among Ontario residents. METHODS: Two data sources were linked at the person level: the WSIB Occupational Disease Information and Surveillance System and the Ontario Cancer Registry. Filing rates were calculated as the proportion of Ontario Cancer Registry mesothelioma cases (International Classification of Diseases – Oncology code 905) that linked to a WSIB-filed cancer claim. Filing rates were calculated for the period 1980 to 2002, and trends were calculated by year, age and county of residence at diagnosis. RESULTS: The filing rate for compensation has increased little over the past 20 years, reaching a high of 43% in 2000. Overall, filing rates were highest among pleural mesothelioma cases among men (range 27% to 57%). Filing rates were highest among individuals 50 to 59 years of age and declined substantially throughout the retirement years. There was substantial variation in filing rates by area of residence, with the highest rate being in Lambton County, Ontario. CONCLUSION: The filing rate for compensation in Ontario was much lower than the estimated proportion of cases eligible for compensation. The increased filing rate in Lambton County was likely related to this community’s awareness of the association between asbestos and mesothelioma. Physicians can play an important role in educating patients of their potential entitlement to compensation benefits. PMID:19851532

Workers' compensation loss prevention representative contact and risk of lost-time injury in construction policyholders.

PubMed

Schofield, Katherine E; Alexander, Bruce H; Gerberich, Susan G; MacLehose, Richard F

2017-09-01

Insurance loss prevention (LP) representatives have access and contact with businesses and employees to provide targeted safety and health resources. Construction firms, especially those smaller in size, are a high-risk population. This research evaluated the association between LP rep contact and risk for lost-time injuries in construction policyholders. Workers' compensation data were utilized to track LP rep contact with policyholders and incidence of lost-time injury over time. Survival analysis with repeated events modeling calculated hazard ratios (HR) and 95% confidence intervals (CI). Compared no LP contact, one contact was associated with a 27% reduction of risk (HR=0.73, CI=0.65-0.82), two with a 41% (HR=0.59, CI=0.51-0.68), and three or more contacts with a 28% reduction of risk (HR=0.72, CI=0.65-0.81). LP reps appear to be a valuable partner in efforts to reduce injury burden. Their presence or contact with policyholders is consistent with reduction in overall incidence of lost-time injuries. Reduction in lost-time injuries, resulting in reduced workers' compensation costs for policyholders and insurance companies, builds a business-case for safety and injury prevention. LP reps are often a low or no-cost benefit for insurance policyholders and may be an important injury prevention resource for small firms and/or those with lack of safety resources and staff. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Accident rates and types among self-employed private forest owners.

PubMed

Lindroos, Ola; Burström, Lage

2010-11-01

Half of all Swedish forests are owned by private individuals, and at least 215,000 people work in these privately owned forest holdings. However, only lethal accidents are systematically monitored among self-employed forest workers. Therefore, data from the registries of the Swedish Work Environment Authority, the Labor Insurance Organization and the regional University Hospital in Umeå were gathered to allow us to perform a more in-depth assessment of the rate and types of accidents that occurred among private forest owners. We found large differences between the registries in the type and number of accidents that were reported. We encountered difficulties in defining "self-employed forest worker" and also in determining whether the accidents that did occur happened during work or leisure time. Consequently, the estimates for the accident rate that we obtained varied from 32 to > or = 4300 injured persons per year in Sweden, depending on the registry that was consulted, the definition of the sample population that was used, and the accident severity definition that was employed. Nevertheless, the different registries gave a consistent picture of the types of accidents that occur while individuals are participating in self-employed forestry work. Severe accidents were relatively common, as self-employed forestry work fatalities constituted 7% of the total number of fatalities in the work authority registry. Falling trees were associated with many of these fatal accidents as well as with accidents that resulted in severe non-fatal injuries. Thus, unsafe work methods appeared more related to the occurrence of an accident than the equipment that was being used at the time of the accident (e.g., a chainsaw). Improvement of the workers' skills should therefore be considered to be an important prevention measure that should be undertaken in this field. The challenges in improving the safety in these smallest of companies, which fall somewhere between the purview of

Accident epidemiology and the U.S. chemical industry: accident history and worst-case data from RMP*Info.

PubMed

Kleindorfer, Paul R; Belke, James C; Elliott, Michael R; Lee, Kiwan; Lowe, Robert A; Feldman, Harold I

2003-10-01

This article reports on the data collected on one of the most ambitious government-sponsored environmental data acquisition projects of all time, the Risk Management Plan (RMP) data collected under section 112(r) of the Clean Air Act Amendments of 1990. This RMP Rule 112(r) was triggered by the Bhopal accident in 1984 and led to the requirement that each qualifying facility develop and file with the U.S. Environmental Protection Agency a Risk Management Plan (RMP) as well as accident history data for the five-year period preceding the filing of the RMP. These data were collected in 1999-2001 on more than 15,000 facilities in the United States that store or use listed toxic or flammable chemicals believed to be a hazard to the environment or to human health of facility employees or off-site residents of host communities. The resulting database, RMP*Info, has become a key resource for regulators and researchers concerned with the frequency and severity of accidents, and the underlying facility-specific factors that are statistically associated with accident and injury rates. This article analyzes which facilities actually filed under the Rule and presents results on accident frequencies and severities available from the RMP*Info database. This article also presents summaries of related results from RMP*Info on Offsite Consequence Analysis (OCA), an analytical estimate of the potential consequences of hypothetical worst-case and alternative accidental releases on the public and environment around the facility. The OCA data have become a key input in the evaluation of site security assessment and mitigation policies for both government planners as well as facility managers and their insurers. Following the survey of the RMP*Info data, we discuss the rich set of policy decisions that may be informed by research based on these data.

24 CFR 266.602 - Mortgage insurance premium: Insured advances.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Mortgage insurance premium: Insured... Contract Rights and Obligations Mortgage Insurance Premiums § 266.602 Mortgage insurance premium: Insured.... On each anniversary of the initial closing, the HFA shall pay an interim mortgage insurance premium...

24 CFR 266.602 - Mortgage insurance premium: Insured advances.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Mortgage insurance premium: Insured... Contract Rights and Obligations Mortgage Insurance Premiums § 266.602 Mortgage insurance premium: Insured.... On each anniversary of the initial closing, the HFA shall pay an interim mortgage insurance premium...

Development and enrolee satisfaction with basic medical insurance in China: A systematic review and stratified cluster sampling survey.

PubMed

Jing, Limei; Chen, Ru; Jing, Lisa; Qiao, Yun; Lou, Jiquan; Xu, Jing; Wang, Junwei; Chen, Wen; Sun, Xiaoming

2017-07-01

Basic Medical Insurance (BMI) has changed remarkably over time in China because of health reforms that aim to achieve universal coverage and better health care with adequate efforts by increasing subsidies, reimbursement, and benefits. In this paper, we present the development of BMI, including financing and operation, with a systematic review. Meanwhile, Pudong New Area in Shanghai was chosen as a typical BMI sample for its coverage and management; a stratified cluster sampling survey together with an ordinary logistic regression model was used for the analysis. Enrolee satisfaction and the factors associated with enrolee satisfaction with BMI were analysed. We found that the reenrolling rate superficially improved the BMI coverage and nearly achieved universal coverage. However, BMI funds still faced dual contradictions of fund deficit and insured under compensation, and a long-term strategy is needed to realize the integration of BMI schemes with more homogeneous coverage and benefits. Moreover, Urban Resident Basic Medical Insurance participants reported a higher rate of dissatisfaction than other participants. The key predictors of the enrolees' satisfaction were awareness of the premium and compensation, affordability of out-of-pocket costs, and the proportion of reimbursement. These results highlight the importance that the Chinese government takes measures, such as strengthening BMI fund management, exploring mixed payment methods, and regulating sequential medical orders, to develop an integrated medical insurance system of universal coverage and vertical equity while simultaneously improving enrolee satisfaction. Copyright © 2017 John Wiley & Sons, Ltd.

26 CFR 46.4371-2 - Imposition of tax on policies issued by foreign insurers; scope of tax.

Code of Federal Regulations, 2012 CFR

2012-04-01

... indemnity, fidelity, or surety bond is made, continued, or renewed, if issued: (1) By a nonresident alien... section 4372(c). (b) Life insurance, sickness, and accident policies, and annuity contracts. Unless the... contract is made, continued, or renewed, if issued: (1) By a nonresident alien individual, a foreign...

26 CFR 46.4371-2 - Imposition of tax on policies issued by foreign insurers; scope of tax.

Code of Federal Regulations, 2011 CFR

2011-04-01

... indemnity, fidelity, or surety bond is made, continued, or renewed, if issued: (1) By a nonresident alien... section 4372(c). (b) Life insurance, sickness, and accident policies, and annuity contracts. Unless the... contract is made, continued, or renewed, if issued: (1) By a nonresident alien individual, a foreign...

26 CFR 46.4371-2 - Imposition of tax on policies issued by foreign insurers; scope of tax.

Code of Federal Regulations, 2010 CFR

2010-04-01

... indemnity, fidelity, or surety bond is made, continued, or renewed, if issued: (1) By a nonresident alien... section 4372(c). (b) Life insurance, sickness, and accident policies, and annuity contracts. Unless the... contract is made, continued, or renewed, if issued: (1) By a nonresident alien individual, a foreign...

Unreported workers' compensation claims to the BLS Survey of Occupational Injuries and Illnesses: Establishment factors.

PubMed

Wuellner, Sara E; Adams, Darrin A; Bonauto, David K

2016-04-01

Studies suggest employers underreport injuries to the Bureau of Labor Statistics Survey of Occupational Injuries and Illnesses (SOII); less is known about reporting differences by establishment characteristics. We linked SOII data to Washington State workers' compensation claims data, using unemployment insurance data to improve linking accuracy. We used multivariable regression models to estimate incidence ratios (IR) of unreported workers' compensation claims for establishment characteristics. An estimated 70% of workers' compensation claims were reported in SOII. Claims among state and local government establishments were most likely to be reported. Compared to large manufacturing establishments, unreported claims were most common among small educational services establishments (IR = 2.47, 95%CI: 1.52-4.01) and large construction establishments (IR = 2.05, 95%CI: 1.77-2.37). Underreporting of workers' compensation claims to SOII varies by establishment characteristics, obscuring true differences in work injury incidence. Findings may differ from previous research due to differences in study methods. © 2016 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.

Etiology of work-related electrical injuries: a narrative analysis of workers' compensation claims.

PubMed

Lombardi, David A; Matz, Simon; Brennan, Melanye J; Smith, Gordon S; Courtney, Theodore K

2009-10-01

The purpose of this study was to provide new insight into the etiology of primarily nonfatal, work-related electrical injuries. We developed a multistage, case-selection algorithm to identify electrical-related injuries from workers' compensation claims and a customized coding taxonomy to identify pre-injury circumstances. Workers' compensation claims routinely collected over a 1-year period from a large U.S. insurance provider were used to identify electrical-related injuries using an algorithm that evaluated: coded injury cause information, nature of injury, "accident" description, and injury description narratives. Concurrently, a customized coding taxonomy for these narratives was developed to abstract the activity, source, initiating process, mechanism, vector, and voltage. Among the 586,567 reported claims during 2002, electrical-related injuries accounted for 1283 (0.22%) of nonfatal claims and 15 fatalities (1.2% of electrical). Most (72.3%) were male, average age of 36, working in services (33.4%), manufacturing (24.7%), retail trade (17.3%), and construction (7.2%). Body part(s) injured most often were the hands, fingers, or wrist (34.9%); multiple body parts/systems (25.0%); lower/upper arm; elbow; shoulder, and upper extremities (19.2%). The leading activities were conducting manual tasks (55.1%); working with machinery, appliances, or equipment; working with electrical wire; and operating powered or nonpowered hand tools. Primary injury sources were appliances and office equipment (24.4%); wires, cables/cords (18.0%); machines and other equipment (11.8%); fixtures, bulbs, and switches (10.4%); and lightning (4.3%). No vector was identified in 85% of cases. and the work process was initiated by others in less than 1% of cases. Injury narratives provide valuable information to overcome some of the limitations of precoded data, more specially for identifying additional injury cases and in supplementing traditional epidemiologic data for further

5 CFR 870.502 - Basic insurance: Waiver/cancellation of insurance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... insurance: Waiver/cancellation of insurance. (a) An insured individual may cancel his/her Basic insurance at... cancel the insurance. (b) An individual who cancels his/her Basic insurance automatically cancels all...

Biological accidents in last-year medical students from three hospitals in Lima Peru.

PubMed

Charca-Benavente, Lilyan Consuelo; Huanca-Ruelas, Grozny Howell; Moreno-Loaiza, Oscar

2016-08-11

To determine the frequency and characteristics of biological accidents in last-year medical students from three hospitals in Lima. Cross-sectional study performed at three Public Health Insurance hospitals in Lima, in December 2014. The study population comprised last-year medical interns. Biological accidents were recorded with a questionnaire of exposure to blood and body fluids based on the formats used by the Exposure Prevention Information Network system and the Centers for Disease Control and Prevention. We inquired about occurrence and number of biological accidents as well as the characteristics of the last accident. Categorical data are presented as absolute and percentage frequencies and numeric data, as median and interquartile ranges. We collected 100 respondents; 85% of them had had a biological accident during the last year, with a median of 2 and interquartile range of 3. The most frequent type of exposure was percutaneous (71.8%) and the most common device was the hollow needle (54.1%). The most frequent place of occurrence and activities at the moment of exposure were at the delivery room (44.7%), while supervising a vaginal delivery (24.7%), and during suturing (24.7%). Three accidents involved high-risk patients, but only one student received antiviral prophylaxis; 49.4% attributed the cause of the accident to fatigue, and 75.3% of accidents are not reported. Gloves are the most used protective barrier (95%). The frequency of biological accidents among last-year medical students is high. Underreporting and inappropriate use of protective barriers increase the risk of medical students for biological accidents.

Injuries to New Zealanders participating in adventure tourism and adventure sports: an analysis of Accident Compensation Corporation (ACC) claims.

PubMed

Bentley, Tim; Macky, Keith; Edwards, Jo

2006-12-15

The aim of this study was to examine the involvement of adventure tourism and adventure sports activity in injury claims made to the Accident Compensation Corporation (ACC). Epidemiological analysis of ACC claims for the period, July 2004 to June 2005, where adventure activities were involved in the injury. 18,697 adventure tourism and adventure sports injury claims were identified from the data, representing 28 activity sectors. Injuries were most common during the summer months, and were most frequently located in the major population centres. The majority of injuries were incurred by claimants in the 20-50 years age groups, although claimants over 50 years of age had highest claims costs. Males incurred 60% of all claims. Four activities (horse riding, mountain biking, tramping/hiking, and surfing) were responsible for approximately 60% of all adventure tourism and adventure sports-related injuries. Slips, trips, and falls were the most common injury initiating events, and injuries were most often to the back/spine, shoulder, and knee. These findings suggest the need to investigate whether regulatory intervention in the form of codes of practice for high injury count activities such as horse riding and mountain biking may be necessary. Health promotion messages and education programs should focus on these and other high-injury risk areas. Improved risk management practices are required for commercial adventure tourism and adventure sports operators in New Zealand if safety is to be improved across this sector.

Social Work and the Uniform Accident and Sickness Policy Provision Law: A Pilot Project

ERIC Educational Resources Information Center

Cochran, Gerald; Davis, King

2012-01-01

The Uniform Accident and Sickness Policy Provision Law (UPPL) is a statute existing in 26 states that permits health insurance companies to deny payment for claims made by individuals who have sustained injuries as a result of drug or alcohol use. This law presents a series of complicated clinical and ethical dilemmas for social workers and other…

Compensation for injured study subjects in clinical trials: an ethical obligation in human subjects research.

PubMed

Buechner, Bianca

2012-01-01

The Presidential Commission for the Study of Bioethical Issues suggested in its report "Research Across Borders: Proceedings of the International Research Panel of the Presidential Commission for the Study of Bioethical Issues" that the United States should implement a system to compensate research subjects for research-related injuries. This article not only analyzes the Commission's recommendation critically, but also discusses if an ethical obligation exists to compensate study subjects for research-related injuries. In addition, the article compares the status quo of the United States to the one in Germany. Germany is one of the countries, which has an established insurance system for research-related injuries based on a non-fault system.

Research paradigms in psychosomatic medicine with special emphasis on whiplash - cervical hyperextension flexion injury (CHFI).

PubMed

Merskey, Harold

2003-01-01

There have been a number of attempts, particularly in the last five decades to understand the origins of pain in terms of psychological or psychosomatic patterns. These include psychoanalytic explanations relying on hysterical mechanisms, and psychophysiological proposals. The occurrence of pain in the course of psychiatric illness and its remission after the illness, has long been known and is not a controversial issue. However, the reported explanations of pain without overt and obvious prior psychiatric illness have largely failed to convince a significant portion of the professional establishment. These explanations have very often coincided with the interests of insurance companies, whether those insurance companies were providing medical benefits, disability insurance or workers' or accident compensation. Critical examination of the evidence generated by insurance company related research indicates profound weaknesses in it.

The Role of Spatial Disorientation in Fatal General Aviation Accidents

NASA Technical Reports Server (NTRS)

Scheuring, RIchard

2005-01-01

In-flight Spatial Disorientation (SD) in pilots is a serious threat to aviation safety. Indeed, SD may play a much larger role in aviation accidents than the approximate 6-8% reported by the National Transportation Safety Board (NTSB) each year, because some accidents coded by the NTSB as aircraft control-not maintained (ACNM) may actually result from SD. The purpose of this study is to determine whether SD is underestimated as a cause of fatal general aviation (GA) accidents in the NTSB database. Fatal GA airplane accidents occurring between January 1995 and December 1999 were reviewed from the NTSB aviation accident database. Cases coded as ACNM or SD as the probable cause were selected for review by a panel of aerospace medicine specialists. Using a rating scale, each rater was instructed to determine if SD was the probable cause of the accident. Agreement between the raters and agreement between the raters and the NTSB were evaluated by Kappa statistics. The raters agreed that 11 out of 20 (55%) accidents coded by the NTSB as ACNM were probably caused by SD (p less than 0.05). Agreement between the raters and the NTSB did not reach significance (p greater than 0.05). The 95% C.I. for the sampling population estimated that between 33-77% of cases that the NTSB identified as ACNM could be identified by aerospace medicine experts as SD. Aerospace medicine specialists agreed that some cases coded by the NTSB as ACNM were probably caused by SD. Consequently, a larger number of accidents may be caused by the pilot succumbing to SD than indicated in the NTSB database. This new information should encourage regulating agencies to insure that pilots receive SD recognition training, enabling them to take appropriate corrective actions during flight. This could lead to new training standards, ultimately saving lives among GA airplane pilots.

Major workplace related accidents in Singapore: A major trauma centre's experience.

PubMed

Ng, Zhi Xu; Teo, Li Tserng; Go, Karen T S; Yeo, Yen Teng; Chiu, Ming Terk

2010-12-01

Major workplace related accidents pose a significant healthcare resource challenge in Singapore. Our study looks at the epidemiology of patients who were admitted for workplace related accidents, in a single institution, with an Injury Severity Score of >9. There were 196 cases of major workplace related accidents admitted between January 2006 and December 2007. The median age of patients admitted was 37 years with a large percentage being males (95.4%) and non-residents (57.1%). The most common ethnic group was Chinese (53.1%) followed by Indians (23.5%). The most common mechanism of injury was fall from height (66.3%) followed by injuries as a result of falling objects at work (21.9%). The percentage of patients who required surgical intervention was 69.9%. Patients admitted for major workplace related accidents had a median length of stay of 5 days in the hospital, a median length of 24 days of medical leave (ML), certifying them unfit for duty and the average cost of stay for each patient was S$11,000. We have a better understanding of the epidemiology and socio-economic impact of workplace related accidents through this study. Workplace related accidents result in significant number of man-days lost from work and monetary cost to employers, medical insurance and the hospital. With an improved understanding, we propose methods to prevent and reduce such accidents in future. A direct consequence of which will be the possible reduction of hospitalisation costs and better allocation of healthcare resources in the future.

[Prevention of Occupational Injuries Related to Hands: Calculation of Subsequent Injury Costs for the Austrian Social Occupational Insurance Institution (AUVA)].

PubMed

Rauner, M S; Mayer, B; Schaffhauser-Linzatti, M M

2015-08-01

Occupational injuries cause short-term, direct costs as well as long-term follow-up costs over the lifetime of the casualties. Due to shrinking budgets accident insurance companies focus on cost reduction programmes and prevention measures. For this reason, a decision support system for consequential cost calculation of occupational injuries was developed for the main Austrian social occupational insurance institution (AUVA) during three projects. This so-called cost calculation tool combines the traditional instruments of accounting with quantitative methods such as micro-simulation. The cost data are derived from AUVA-internal as well as external economic data sources. Based on direct and indirect costs, the subsequent occupational accident costs from the time of an accident and, if applicable, beyond the death of the individual casualty are predicted for the AUVA, the companies in which the casualties are working, and the other economic sectors. By using this cost calculation tool, the AUVA classifies risk groups and derives related prevention campaigns. In the past, the AUVA concentrated on falling, accidents at construction sites and in agriculture/forestry, as well as commuting accidents. Currently, among others, a focus on hand injuries is given and first prevention programmes have been initiated. Hand injuries represent about 38% of all casualties with average costs of about 7,851 Euro/case. Main causes of these accidents are cutting injuries in production, agriculture, and forestry. Beside a low, but costly, number of amputations with average costs of more than 100,000 Euro/case, bone fractures and strains burden the AUVA-budget with about 17,500 and 10,500 € per case, respectively. Decision support systems such as this cost calculation tool represent necessary instruments to identify risk groups and their injured body parts, causes of accidents, and economic activities, which highly burden the budget of an injury company, and help derive

Individual insurance: health insurers try to tap potential market growth.

PubMed

November, Elizabeth A; Cohen, Genna R; Ginsburg, Paul B; Quinn, Brian C

2009-11-01

Individual insurance is the only source of health coverage for people without access to employer-sponsored insurance or public insurance. Individual insurance traditionally has been sought by older, sicker individuals who perceive the need for insurance more than younger, healthier people. The attraction of a sicker population to the individual market creates adverse selection, leading insurers to employ medical underwriting--which most states allow--to either avoid those with the greatest health needs or set premiums more reflective of their expected medical use. Recently, however, several factors have prompted insurers to recognize the growth potential of the individual market: a declining proportion of people with employer-sponsored insurance, a sizeable population of younger, healthier people forgoing insurance, and the likelihood that many people receiving subsidies to buy insurance under proposed health insurance reforms would buy individual coverage. Insurers are pursuing several strategies to expand their presence in the individual insurance market, including entering less-regulated markets, developing lower-cost, less-comprehensive products targeting younger, healthy consumers, and attracting consumers through the Internet and other new distribution channels, according to a new study by the Center for Studying Health System Change (HSC). Insurers' strategies in the individual insurance market are unlikely to meet the needs of less-than-healthy people seeking affordable, comprehensive coverage. Congressional health reform proposals, which envision a larger role for the individual market under a sharply different regulatory framework, would likely supersede insurers' current individual market strategies.

[Harmonisation of personal injury compensation in the European Union. Application to medical liability case law].

PubMed

Hureau, Jacques

2006-03-01

Harmonisation of personal injury compensation in the European Union (EU) is crucial. Continuing on from the work begun by the European Federation of Medical Academies, a working party of the XVth Committee of the French National Academy of Medicine has sought to go beyond the restrictive framework of automobile accident compensation in order to address more universal concerns, regardless of the causes and effects of bodily injury. The specific situation of injuries resulting from medical acts was considered, both for its medicolegal complexity and its potential human consequences. After recalling relevant European legislation, the authors consider the different philosophies of medical liability and health care systems in Europe. Methodological convergence is required to achieve harmonisation of personal injury compensation regimes, and especially for the classification of different types of bodily injury, the role of social services, and the establishment of a reference for medical evaluation of injury with built-in compensation levels. The doctrines and concepts of all EU member states (civil law, common law, Nordic medical liability regimes, etc.) are discussed, together with means of facilitating their harmonisation.

Insuring against health shocks: Health insurance and household choices.

PubMed

Liu, Kai

2016-03-01

This paper provides empirical evidence on the role of public health insurance in mitigating adverse outcomes associated with health shocks. Exploiting the rollout of a universal health insurance program in rural China, I find that total household income and consumption are fully insured against health shocks even without access to health insurance. Household labor supply is an important insurance mechanism against health shocks. Access to health insurance helps households to maintain investment in children's human capital during negative health shocks, which suggests that one benefit of health insurance could arise from reducing the use of costly smoothing mechanisms. Copyright © 2016 Elsevier B.V. All rights reserved.

The Influence of Supportive and Ethical Work Environments on Work-Related Accidents, Injuries, and Serious Psychological Distress among Hospital Nurses

PubMed Central

Tei-Tominaga, Maki; Nakanishi, Miharu

2018-01-01

The healthcare industry in Japan has experienced many cases of work-related injuries, accidents, and workers’ compensation claims because of mental illness. This study examined the influence of supportive and ethical work environments on work-related accidents, injuries, and serious psychological distress among hospital nurses. Self-reported questionnaires were distributed to nurses (n = 1114) from 11 hospitals. Valid responses (n = 822, 93% women, mean age = 38.49 ± 10.09 years) were used for analyses. The questionnaire included items addressing basic attributes, work and organizational characteristics, social capital and ethical climate at the workplace, psychological distress, and experience of work-related accidents or injuries in the last half year. The final model of a multivariate logistic regression analysis revealed that those who work less than 4 h of overtime per week (OR = 0.313), those who work on days off more than once per month (OR = 0.424), and an exclusive workplace climate (OR = 1.314) were significantly associated with work-related accidents or injuries. Additionally, an exclusive workplace climate (OR = 1.696) elevated the risk of serious psychological distress. To prevent work-related compensation cases, which are caused by these variables, strengthening hospitals’ occupational health and safety is necessary. PMID:29385044

The Influence of Supportive and Ethical Work Environments on Work-Related Accidents, Injuries, and Serious Psychological Distress among Hospital Nurses.

PubMed

Tei-Tominaga, Maki; Nakanishi, Miharu

2018-01-31

The healthcare industry in Japan has experienced many cases of work-related injuries, accidents, and workers' compensation claims because of mental illness. This study examined the influence of supportive and ethical work environments on work-related accidents, injuries, and serious psychological distress among hospital nurses. Self-reported questionnaires were distributed to nurses ( n = 1114) from 11 hospitals. Valid responses ( n = 822, 93% women, mean age = 38.49 ± 10.09 years) were used for analyses. The questionnaire included items addressing basic attributes, work and organizational characteristics, social capital and ethical climate at the workplace, psychological distress, and experience of work-related accidents or injuries in the last half year. The final model of a multivariate logistic regression analysis revealed that those who work less than 4 h of overtime per week (OR = 0.313), those who work on days off more than once per month (OR = 0.424), and an exclusive workplace climate (OR = 1.314) were significantly associated with work-related accidents or injuries. Additionally, an exclusive workplace climate (OR = 1.696) elevated the risk of serious psychological distress. To prevent work-related compensation cases, which are caused by these variables, strengthening hospitals' occupational health and safety is necessary.

Modeling Flood Insurance Penetration in the European Non-Life Market: An Overview

NASA Astrophysics Data System (ADS)

Mohan, P.; Thomson, M.-K.; Das, A.

2012-04-01

Non-life property insurance plays a significant role in assessing and managing economic risk. Understanding the exposure, or property at risk, helps insurers and reinsurers to better categorize and manage their portfolios. However, the nature of the flood peril, in particular adverse selection, has led to a complex system of different insurance covers and policies across Europe owing to its public and private distinctions based on premiums provided as ex ante or ex post, socio-economic characterization and various compensation schemes. To model this significant level of complexity within the European flood insurance market requires not only extensive data research, close understanding of insurance companies and associations as well as historic flood events, but also careful evaluation of the flood hazard in terms of return periods and flood extents, and the economic/ financial background of the geographies involved. This abstract explores different approaches for modeling the flood insurance penetration rates in Europe depending on the information available and complexity involved. For countries which have either a regulated market with mandatory or high penetration rate, as for example found in the UK, France and Switzerland, or indeed countries with negligible insurance cover such as Luxembourg, assumptions about the penetration rates can be made at country level. However, in countries with a private insurance market, the picture becomes inherently more complex. For example in both Austria and Germany, flood insurance is generally restricted, associated with high costs to the insured or not available at all in high risk areas. In order to better manage flood risk, the Austria and German government agencies produced the risk classification systems HORA and ZÜRS, respectively, which categorize risk into four risk zones based on the exceedance probability of a flood occurrence. Except for regions that have preserved mandatory flood inclusion from past policies

Major differences in rates of occupational accidents between different nationalities of seafarers.

PubMed

Hansen, Henrik L; Laursen, Lise Hedgaard; Frydberg, Morten; Kristensen, Soeren

2008-01-01

Earlier studies and statistics have shown that merchant seafarers from the South East Asia had considerable lower accident rates when compared with seafarers from Western Europe. The purposes of the study were to investigate whether the earlier observations were sustained if further sources on occurrence of accidents were used and to identify specific causes of excess accident rates among certain nationalities. Occupational accidents aboard Danish merchant ships during one year were identified from four different sources. These included accidents reported to the maritime authorities, accidents reported to a mutual insurance company, files on medical costs reimbursed by the government and finally, accidents in which there has been contact to the radio medical service. Time at risk aboard was obtained from a register on all employment periods aboard merchant ships. A total of 943 accidents causing personal injury to a seafarer directly caused by work aboard were identified. Among these accidents, 499 had taken place aboard cargo ships in international trade. Only these were used in the detailed analysis. The accident rate for all identified accidents aboard cargo ships were 84 accidents per 1,000 years aboard. The crude incidence rate ratio (IRR) for East European seafarers was 0.88 and for South East Asians 0.38 using West European seafarers as reference. In a Poisson regression analysis, the IRR for South East Asians was 0.29 (0.22-0.38). In an analysis including only more serious accidents, IRR for South East Asians rose to 0.36 (0.26-0.48). This study indicates that seafarers from South East Asia, mainly the Philippines, may have a genuine lower risk of occupational accidents in comparison with seafarers from Western and Eastern Europe. Differences in approach to safety and risk taking between South East Asian and European seafarers should be identified and positives attitudes included in accident preventing programmes. Main messages Seafarers from South East

A Follow-Up Study on Return to Work in the Year After Reporting an Occupational Injury Stratified by Outcome of the Workers' Compensation System.

PubMed

Rudbeck, Marianne; Johansen, Jens Peter; Omland, Øyvind

2018-06-01

The aim of this study was to compare return rates to work between different groups according to the decision from the workers' compensation. Register data on disability benefits were used to describe return rates to work in Kaplan-Meier curves and association with decision on compensation claims. Disability benefits were granted by the municipalities independently of any compensation claim if sick-listed. Claimants with ongoing claims were the group with the largest proportion remaining on disability benefits. Claimants with rejected claims returned to work at the same rate (occupational disease) or slower (industrial accident) than claimants with recognized claim without compensation the subsequent year and at a faster rate after decision. Compensation claims and proceedings of the workers' compensation system probably increase time to return to work; other factors such as health and social difficulties, however, may explain some of these differences.

Exploring health insurance services in Sudan from the perspectives of insurers.

PubMed

Salim, Anas Mustafa Ahmed; Hamed, Fatima Hashim Mahmoud

2018-01-01

It has been 20 years since the introduction of health insurance in Sudan. This study was the first one that explored health insurance services in Sudan from the perspectives of the insurers. This was a qualitative, exploratory, interview study. The sampling frame was the list of Social Health Insurance and Private Health Insurance institutions in Sudan. Participants were selected from the four Social Health Insurance institutions and from five Private Health Insurance companies. The study was conducted in January and February 2017. In-depth individual interviews were conducted with a convenient sample of key executives from the different health insurers. Ideas and themes were identified and analysed using thematic analysis. The result showed that universal coverage was not achieved despite long time presence of Social Health Insurance and Private Health Insurance in Sudan. All participants described their services as comprehensive. All participants have good perception of the quality of the services they provide, although none of them investigated customer satisfaction. The main challenges facing Social Health Insurance are achieving universal coverage, ensuring sustainability and recruitment of the informal sector and self-employed population. Consumers' affordability of the premiums is the main obstacle for Private Health Insurance, while rising healthcare cost due to economic inflation is a challenge facing both Social Health Insurance and Private Health Insurance. In spite of the presence of Social Health Insurance and Private Health Insurance in Sudan, the country is still far from achieving universal coverage. Moreover, the sustainability of health insurance is questionable. The main reasons include low governmental financial resources and lack of affordability by beneficiaries especially for Private Health Insurance. This necessitates finding solutions to improve them or trying other types of health insurance. The quality of services provided by Social

[Disease management programs from a health insurer's point of view].

PubMed

Szymkowiak, Christof; Walkenhorst, Karen; Straub, Christoph

2003-06-01

Disease Management Programmes represent a great challenge to the German statutory health insurance system. According to politicians, disease management programmes are an appropriate tool for increasing the level of care for chronically ill patients significantly, while at the same time they can slow down the cost explosion in health care. The statutory health insurers' point of view yields a more refined picture of the chances and risks involved. The chances are that a medical guideline-based, evidence-based, co-operative care of the chronically ill could be established. But also, there are the risks of misuse of disease management programmes and of misallocation of funds due to the ill-advised linkage with the so-called risk compensation scheme (RSA) balancing the sickness funds' structural deficits through redistribution. The nation-wide introduction of disease management programmes appears to be a gigantic experiment whose aim is to change the care of chronically ill patients and whose outcome is unpredictable.

24 CFR 266.600 - Mortgage insurance premium: Insurance upon completion.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Mortgage insurance premium... MULTIFAMILY PROJECT LOANS Contract Rights and Obligations Mortgage Insurance Premiums § 266.600 Mortgage insurance premium: Insurance upon completion. (a) Initial premium. For projects insured upon completion, on...

24 CFR 266.600 - Mortgage insurance premium: Insurance upon completion.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Mortgage insurance premium... MULTIFAMILY PROJECT LOANS Contract Rights and Obligations Mortgage Insurance Premiums § 266.600 Mortgage insurance premium: Insurance upon completion. (a) Initial premium. For projects insured upon completion, on...

The effect of cost-sharing in private health insurance on the utilization of health care services between private insurance purchasers and non-purchasers: a study of the Korean health panel survey (2008-2012).

PubMed

Choi, Young; Kim, Jae-Hyun; Yoo, Ki-Bong; Cho, Kyoung Hee; Choi, Jae-Woo; Lee, Tae Hoon; Kim, Woorim; Park, Eun-Cheol

2015-10-28

Private health insurance in South Korea mainly functions as supplementary and complementary health insurance that compensates for insufficient coverage by National Health Insurance. However, full private coverage of public sector cost-sharing led to the problem of encouraging moral hazard-induced utilization, resulting in a policy change that occurred in October 2009. At that time, the Korean government introduced a minimum cost-sharing policy for indemnity health insurance. The purpose of this study was to analyze the effect of cost-sharing in private health insurance on health care utilization. We analyzed data collected from the Korean Health Panel Survey from October 2008 to December 2011. We restricted the two groups to 803 purchasers with indemnity health insurance and 7023 non-purchasers who did not obtain any private health insurance. A difference-in-difference analysis was used to evaluate the effect of the 2009 policy. After the policy change, the utilization of outpatient visits by purchasers gradually decreased more than non-purchasers (0.015 in 2009 [p = 0.758], -0.117 in 2010 [p < 0.016], and -0.140 in 2011 [p = 0.004]). However, utilization of inpatient services was not statistically significant. Notably, the magnitude of the cost-sharing effect in indemnity health insurance was stronger for those receiving medical aid. Among this group, utilization of outpatient services (after the policy change in 2009) decreased more so than non-purchasers. Patients with three or more chronic diseases have not changed their health care utilization. Our results implied meaningful lessons for decision-makers and future health insurance policies in Korea and other countries in terms of cost-sharing in medical care. When policy makers intend to implement the cost-sharing, a different copayment scheme is needed according to the socioeconomic status or disease severity.

Innovation in drought risk management: exploring the potential of weather index insurance

NASA Astrophysics Data System (ADS)

Iglesias, E.; Baez, K.

2012-04-01

Many family farming and indigenous communities depend on grazing livestock activities and are particularly prone to drought risks. Vulnerability to drought limits the ability of these households to exit poverty and in many cases leads to environmental degradation. It is well known that uninsured exposure exacerbates income inequality in farming systems and eventually results in welfare losses for rural families. The advantages of farmers who have access to financial tools have been widely acknowledged. However, high administrative costs of traditional insurance hinder small farmers' access to risk management tools. One of the main problems in insurance design relates to the lack of quality data to estimate the risk premium. In rural areas where there are no historical records of farm production data on adverse events such as drought. New technologies such as remote sensing help to overcome this problem and generate information from these areas that otherwise would be impossible or too expensive to obtain. In this paper, we use a satellite based vegetation index (NDVI) and develop a stochastic model to analyse the potential of index insurance to address the risk of drought in Chilean grazing lands. Our results suggest that contract design is a key issue to improve the correlation of the index with individual farm losses, thus reducing basis risk. In particular, we find that the definition of homogeneous areas and the selection of the triggering index threshold are critical issues and show the incidence of different contract designs on (i) the probability that the farmer experience losses but does not receive compensation (false negative) and (ii) the probability that the index triggers compensation but the farmer does not experience drought losses (false negative). Both aspects are key issues to offer the farmer an adequate protection against droughts and guarantee the affordability of the risk premium.

The impact of health insurance reform on insurance instability.

PubMed

Freund, Karen M; Isabelle, Alexis P; Hanchate, Amresh D; Kalish, Richard L; Kapoor, Alok; Bak, Sharon; Mishuris, Rebecca G; Shroff, Swati M; Battaglia, Tracy A

2014-02-01

We investigated the impact of the 2006 Massachusetts health care reform on insurance coverage and stability among minority and underserved women. We examined 36 months of insurance claims among 1,946 women who had abnormal cancer screening at six community health centers pre-(2004-2005) and post-(2007-2008) insurance reform. We examined frequency of switches in insurance coverage as measures of longitudinal insurance instability. On the date of their abnormal cancer screening test, 36% of subjects were publicly insured and 31% were uninsured. Post-reform, the percent ever uninsured declined from 39% to 29% (p .001) and those consistently uninsured declined from 23% to 16%. To assess if insurance instability changed between the pre- and post-reform periods, we conducted Poisson regression models, adjusted for patient demographics and length of time in care. These revealed no significant differences from the pre- to post-reform period in annual rates of insurance switches, incident rate ratio 0.98 (95%- CI 0.88-1.09). Our analysis is limited by changes in the populations in the pre- and post-reform period and inability to capture care outside of the health system network. Insurance reform increased stability as measured by decreasing uninsured rates without increasing insurance switches.

The Impact of Heat Waves on Occurrence and Severity of Construction Accidents.

PubMed

Rameezdeen, Rameez; Elmualim, Abbas

2017-01-11

The impact of heat stress on human health has been extensively studied. Similarly, researchers have investigated the impact of heat stress on workers' health and safety. However, very little work has been done on the impact of heat stress on occupational accidents and their severity, particularly in South Australian construction. Construction workers are at high risk of injury due to heat stress as they often work outdoors, undertake hard manual work, and are often project based and sub-contracted. Little is known on how heat waves could impact on construction accidents and their severity. In order to provide more evidence for the currently limited number of empirical investigations on the impact of heat stress on accidents, this study analysed 29,438 compensation claims reported during 2002-2013 within the construction industry of South Australia. Claims reported during 29 heat waves in Adelaide were compared with control periods to elicit differences in the number of accidents reported and their severity. The results revealed that worker characteristics, type of work, work environment, and agency of accident mainly govern the severity. It is recommended that the implementation of adequate preventative measures in small-sized companies and civil engineering sites, targeting mainly old age workers could be a priority for Work, Health and Safety (WHS) policies.

The Impact of Heat Waves on Occurrence and Severity of Construction Accidents

PubMed Central

Rameezdeen, Rameez; Elmualim, Abbas

2017-01-01

The impact of heat stress on human health has been extensively studied. Similarly, researchers have investigated the impact of heat stress on workers’ health and safety. However, very little work has been done on the impact of heat stress on occupational accidents and their severity, particularly in South Australian construction. Construction workers are at high risk of injury due to heat stress as they often work outdoors, undertake hard manual work, and are often project based and sub-contracted. Little is known on how heat waves could impact on construction accidents and their severity. In order to provide more evidence for the currently limited number of empirical investigations on the impact of heat stress on accidents, this study analysed 29,438 compensation claims reported during 2002–2013 within the construction industry of South Australia. Claims reported during 29 heat waves in Adelaide were compared with control periods to elicit differences in the number of accidents reported and their severity. The results revealed that worker characteristics, type of work, work environment, and agency of accident mainly govern the severity. It is recommended that the implementation of adequate preventative measures in small-sized companies and civil engineering sites, targeting mainly old age workers could be a priority for Work, Health and Safety (WHS) policies. PMID:28085067

Unreported workers’ compensation claims to the BLS Survey of Occupational Injuries and Illnesses: Establishment factors

PubMed Central

Adams, Darrin A.; Bonauto, David K.

2016-01-01

Background Studies suggest employers underreport injuries to the Bureau of Labor Statistics Survey of Occupational Injuries and Illnesses (SOII); less is known about reporting differences by establishment characteristics. Methods We linked SOII data to Washington State workers’ compensation claims data, using unemployment insurance data to improve linking accuracy. We used multivariable regression models to estimate incidence ratios (IR) of unreported workers’ compensation claims for establishment characteristics. Results An estimated 70% of workers’ compensation claims were reported in SOII. Claims among state and local government establishments were most likely to be reported. Compared to large manufacturing establishments, unreported claims were most common among small educational services establishments (IR = 2.47, 95%CI: 1.52–4.01) and large construction establishments (IR = 2.05, 95%CI: 1.77–2.37). Conclusions Underreporting of workers’ compensation claims to SOII varies by establishment characteristics, obscuring true differences in work injury incidence. Findings may differ from previous research due to differences in study methods. Am. J. Ind. Med. 59:274–289, 2016. © 2016 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc. PMID:26792563

Exploring health insurance services in Sudan from the perspectives of insurers

PubMed Central

Salim, Anas Mustafa Ahmed; Hamed, Fatima Hashim Mahmoud

2018-01-01

Background: It has been 20 years since the introduction of health insurance in Sudan. This study was the first one that explored health insurance services in Sudan from the perspectives of the insurers. Methods: This was a qualitative, exploratory, interview study. The sampling frame was the list of Social Health Insurance and Private Health Insurance institutions in Sudan. Participants were selected from the four Social Health Insurance institutions and from five Private Health Insurance companies. The study was conducted in January and February 2017. In-depth individual interviews were conducted with a convenient sample of key executives from the different health insurers. Ideas and themes were identified and analysed using thematic analysis. Results: The result showed that universal coverage was not achieved despite long time presence of Social Health Insurance and Private Health Insurance in Sudan. All participants described their services as comprehensive. All participants have good perception of the quality of the services they provide, although none of them investigated customer satisfaction. The main challenges facing Social Health Insurance are achieving universal coverage, ensuring sustainability and recruitment of the informal sector and self-employed population. Consumers’ affordability of the premiums is the main obstacle for Private Health Insurance, while rising healthcare cost due to economic inflation is a challenge facing both Social Health Insurance and Private Health Insurance. Conclusion: In spite of the presence of Social Health Insurance and Private Health Insurance in Sudan, the country is still far from achieving universal coverage. Moreover, the sustainability of health insurance is questionable. The main reasons include low governmental financial resources and lack of affordability by beneficiaries especially for Private Health Insurance. This necessitates finding solutions to improve them or trying other types of health insurance

Time to death analysis of road traffic accidents in relation to delta V, drunk driving, and restraint systems.

PubMed

Ju, Yonghan; Sohn, So Young

2014-01-01

The main goal of this research is to identify variables related to the expected time to death due to road traffic accidents (RTAs). Such research is expected to be useful in improving safety laws and regulations and developing new safety systems. The resulting information is crucial not only for reducing accident fatalities but for assessing related insurance policies. In this article, we analyze factors that are potentially associated with variation in the expected survival time after a road traffic accident using Weibull regression. In particular, we consider the association with alcohol involvement, delta V, and restraint systems. Our empirical results, obtained based on the NASS-CDS, indicate that the expected survival time for non-alcohol-impaired drivers is 3.23 times longer at a delta V of 50 km/h than that for alcohol-impaired drivers under the same conditions. In addition, it was observed that, even when occupants were alcohol-impaired, if they were protected by both air bags and seat belts, their expected survival time after an RTA increased 2.59-fold compared to alcohol-impaired drivers who used only seat belts. Our findings may be useful in improving road traffic safety and insurance policies by offering insights into the factors that reduce fatalities.

Managing uncertainty: information and insurance under the risk of starvation.

PubMed Central

Dall, Sasha R X; Johnstone, Rufus A

2002-01-01

In an uncertain world, animals face both unexpected opportunities and danger. Such outcomes can select for two potential strategies: collecting information to reduce uncertainty, or insuring against it. We investigate the relative value of information and insurance (energy reserves) under starvation risk by offering model foragers a choice between constant and varying food sources over finite foraging bouts. We show that sampling the variable option (choosing it when it is not expected to be good) should decline both with lower reserves and late in foraging bouts; in order to be able to reap the reduction in uncertainty associated with exploiting a variable resource effectively, foragers must be able to afford and compensate for an initial increase in the risk of an energetic shortfall associated with choosing the option when it is bad. Consequently, expected exploitation of the varying option increases as it becomes less variable, and when the overall risk of energetic shortfall is reduced. In addition, little activity on the variable alternative is expected until reserves are built up early in a foraging bout. This indicates that gathering information is a luxury while insurance is a necessity, at least when foraging on stochastic and variable food under the risk of starvation. PMID:12495509

Claims, errors, and compensation payments in medical malpractice litigation.

PubMed

Studdert, David M; Mello, Michelle M; Gawande, Atul A; Gandhi, Tejal K; Kachalia, Allen; Yoon, Catherine; Puopolo, Ann Louise; Brennan, Troyen A

2006-05-11

In the current debate over tort reform, critics of the medical malpractice system charge that frivolous litigation--claims that lack evidence of injury, substandard care, or both--is common and costly. Trained physicians reviewed a random sample of 1452 closed malpractice claims from five liability insurers to determine whether a medical injury had occurred and, if so, whether it was due to medical error. We analyzed the prevalence, characteristics, litigation outcomes, and costs of claims that lacked evidence of error. For 3 percent of the claims, there were no verifiable medical injuries, and 37 percent did not involve errors. Most of the claims that were not associated with errors (370 of 515 [72 percent]) or injuries (31 of 37 [84 percent]) did not result in compensation; most that involved injuries due to error did (653 of 889 [73 percent]). Payment of claims not involving errors occurred less frequently than did the converse form of inaccuracy--nonpayment of claims associated with errors. When claims not involving errors were compensated, payments were significantly lower on average than were payments for claims involving errors (313,205 dollars vs. 521,560 dollars, P=0.004). Overall, claims not involving errors accounted for 13 to 16 percent of the system's total monetary costs. For every dollar spent on compensation, 54 cents went to administrative expenses (including those involving lawyers, experts, and courts). Claims involving errors accounted for 78 percent of total administrative costs. Claims that lack evidence of error are not uncommon, but most are denied compensation. The vast majority of expenditures go toward litigation over errors and payment of them. The overhead costs of malpractice litigation are exorbitant. Copyright 2006 Massachusetts Medical Society.

Characteristics of, and insurance payments for, injuries to cyclists in Tasmania, 1990-2010.

PubMed

Hitchens, P L; Palmer, A J

2012-11-01

To describe the characteristics and costs of injuries to cyclists resulting in a 3rd party insurance claim in Tasmania. Data on injuries to cyclists were obtained from the Motor Accident Insurance Board (MAIB) for the period 1990-2010. Frequency and insurance costs of injuries to cyclists were compared to injuries incurred by other road users. Descriptive analyses of cycling injuries and insurance costs by year, age and sex of claimant, and type and location of injury are presented. Annual costs of insurance claims by cyclists averaged AUD 3.9 million. There was a significant decrease in the frequency of claims made by all road users combined over the study period, but not for cyclists. Cycling injuries made up 2.0% of claims but accounted for 3.4% of the total costs and were among the road user groups with the highest mean costs per claim. Fractures (20.7%) were the most common cycling injury. Brain injuries led to the highest mean claim costs (AUD 1,559,032), and accounted for 66.8% of claim costs made by cyclists. Mean costs per claim for cycling injuries are high compared to those made by most other road users. The costs of these injuries impose a substantial burden on insurance payers. The high costs and severity of claims by cyclists compared to other road users demonstrates the high vulnerability of cyclists, and lends support to increasing separation of cyclists from motor vehicles. Copyright © 2012 Elsevier Ltd. All rights reserved.

[Hospital risk management from the viewpoint of insurers].

PubMed

Gausmann, Peter; Petry, Franz Michael

2004-10-01

The present article deals with the significance of risk management in hospitals from the viewpoint of liability insurers. From the perspective of insurance companies, the liability risk of a hospital and its personnel has considerably increased during the past 25 years. The present risk situation is characterized by a growing number of reported liability cases, as well as by an enormous increase of average compensation claims. This development has led some insurance companies to financial deficits in the segment of hospital liability. While some insurers have withdrawn their activities from this market segment, others have reacted by raising their premiums. Since in Germany the premiums usually depend on the number of beds held by a hospital, the problem of rising premiums is exacerbated by the general increase of the number of clinical cases in the face of a parallel reduction of the number of beds. In the process of finding new criteria or methods for adequate premium calculation, a key role will be played by the individual future risk development of a hospital and by the evaluation of this risk by its insurance company. An extensive system of clinical quality management supported by elements of risk management will have persistent positive effects on the development of individual insurance premiums and on the insurability of clinical liability. Risk management is defined as the totality of measures taken by a company to identify risks that could lead to reduced success. Clinical risk management must be regarded in the context of a general trend that is not limited to the field of health service. In this process, the handling of errors and their causes plays a central role. Further variants of hospital risk management are the technical and economic risk management, both of which are increasingly important and are in part implemented in the German legislation. Clinical risk management has originated from the U.S., where as early as in the nineteen

5 CFR 894.701 - May I keep my dental and/or vision coverage when I retire or start receiving workers' compensation?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false May I keep my dental and/or vision... DENTAL AND VISION INSURANCE PROGRAM Annuitants and Compensationers § 894.701 May I keep my dental and/or vision coverage when I retire or start receiving workers' compensation? (a) Your FEDVIP coverage...

5 CFR 894.701 - May I keep my dental and/or vision coverage when I retire or start receiving workers' compensation?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false May I keep my dental and/or vision... DENTAL AND VISION INSURANCE PROGRAM Annuitants and Compensationers § 894.701 May I keep my dental and/or vision coverage when I retire or start receiving workers' compensation? (a) Your FEDVIP coverage...

Collective Bargaining and District Costs for Teacher Health Insurance: An Examination of the Data from the BLS and Wisconsin

ERIC Educational Resources Information Center

Costrell, Robert M.

2015-01-01

District costs for teachers' health insurance are, on average, higher then employer costs for private-sector professionals. How much of this is attributable to collective bargaining? This article examines the question using data from the National Compensation Survey (NCS) of the Bureau of Labor Statistics (BLS) and the state of Wisconsin. In…

Insurance premiums and insurance coverage of near-poor children.

PubMed

Hadley, Jack; Reschovsky, James D; Cunningham, Peter; Kenney, Genevieve; Dubay, Lisa

States increasingly are using premiums for near-poor children in their public insurance programs (Medicaid/SCHIP) to limit private insurance crowd-out and constrain program costs. Using national data from four rounds of the Community Tracking Study Household Surveys spanning the seven years from 1996 to 2003, this study estimates a multinomial logistic regression model examining how public and private insurance premiums affect insurance coverage outcomes (Medicaid/SCHIP coverage, private coverage, and no coverage). Higher public premiums are significantly associated with a lower probability of public coverage and higher probabilities of private coverage and uninsurance; higher private premiums are significantly related to a lower probability of private coverage and higher probabilities of public coverage and uninsurance. The results imply that uninsurance rates will rise if both public and private premiums increase, and suggest that states that impose or increase public insurance premiums for near-poor children will succeed in discouraging crowd-out of private insurance, but at the expense of higher rates of uninsurance. Sustained increases in private insurance premiums will continue to create enrollment pressures on state insurance programs for children.