Most motor bodily injury (BI) claims are settled by negotiation, with fewer than 5% of cases going to court. A well-defined negotiation strategy is thus very useful for insurance companies. In this paper we assume that the monetary compensation awarded in court is the upper amount to be offered...

Automobile bodily injury (BI) claims remain unsettled for a long time after the accident. The estimation of an accurate reserve for Reported But Not Settled (RBNS) claims is therefore vital for insurers. In accordance with the recommendation included in the Solvency II project (CEIOPS, 2007) a...

Selection bias results from a discrepancy between the range of estimation of a statistical model and its range of application. This is the case for fraud risk models, which are estimated on audited claims but applied on incoming claims in the design of auditing strategies. Now audited claims are...

Our objective is to analyse fraud as an operational risk for the insurance company. We study the effect of a fraud detection policy on the insurer's results account, quantifying the loss risk from the perspective of claims auditing. From the point of view of operational risk, the study aims to...

The decision to settle a motor insurance claim by either negotiation or trial is analysed. This decision may depend on how risk and confrontation adverse or pessimistic the claimant is. The extent to which these behavioural features of the claimant might influence the final compensation amount...

Los sistemas occidentales de pensiones, y especialmente el español, se van a ver notablemente afectados por el proceso de envejecimiento poblacional que se está produciendo. Este artículo propone un modelo de pensiones para España que implica profundas reformas estructurales que garanticen...

Les biais de sélection sont créés par des disparités entre le domaine d'estimation d'un modèle statistique et son domaine d'application. C'est le cas pour les modèles évaluant le risque de fraude, qui sont estimés sur les seuls sinistres audités mais appliqués sur tous les sinistres...

The paper examines the distribution function of settlements over time in an attempt to explain the time it takes to negotiate the claim compensation in the context of motor disputes. Competing risk models are applied to a Spanish motor insurance database. The empirical analysis yielded two main...

This paper presents a case study of a portfolio of individual long-term insurance contracts sold by a Spanish mutual company. We describe the risk levels, the rating structure and the implied cross-subsidies on a portfolio of policies providing health, life and long-term care insurance. We show...