Accident and Health Insurance

  • T. V. S. Ramamohan Rao


Individuals tend to seek insurance to pass some risks on to the insurer when they expect large losses in the use of assets. The insurer can make his activity sustainable by pooling risks. If individuals can be expected to bear a greater fraction of the loss due to failure, they will be more diligent in the use of assets and reduce risks for which they are responsible. Similarly, efficient insurance policies may motivate individuals to reduce some forms of systemic risk especially when they are predictable. However, the increase in costs, associated with risks and the fulfillment of covenants designed to reduce them, invariably increases costs, reduces the equilibrium insurance coverage, and increases premiums. The residual systemic risk that cannot be absorbed by these policies and the necessity to generate wider and superior insurance service are at the basis of the call for regulation of the insurance business. The attempt made in this study is to examine the nature of efficient insurance in the presence of both types of risk, regulatory policy, and individual adaptations to them. Sharing risks through self-selection, optimal regulatory oversight, and insurance policies designed on such a basis can be efficient and offer a fairly wide coverage only against some individual-specific and limited systemic risks. In several contexts systemic risks and their origin cannot be predicted in advance. Efficient design of insurance to counter such risks may never really be possible since it is an ex ante specification.


Risk Aversion Regulatory Policy Systemic Risk Adverse Selection Insurance Policy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Abbring JH, Chiappori PA, Heckman JJ, Pinquet J (2003) Adverse selection and moral hazard in insurance: can dynamic data help to distinguish? J Eur Econ Assoc 1:512–521CrossRefGoogle Scholar
  2. Blomquist A, Leger PT (2005) Information asymmetry, insurance, and the decision to hospitalize. J Health Econ 24:775–793CrossRefGoogle Scholar
  3. Boadway R, Marchand M, Sato M (2004) An optimal contract approach to hospital financing. J Health Econ 23:85–110CrossRefPubMedGoogle Scholar
  4. Bourgeon JM, Picard P, Pouyet J (2008) Providers’ affiliation, insurance and collusion. J Bank Financ 32:170–186CrossRefGoogle Scholar
  5. Chalkley M, McVicar D (2008) Choice of contracts in the British National Health Service: an empirical study. J Health Econ 27:1155–1167CrossRefPubMedGoogle Scholar
  6. Chiappori PA (2000) Econometric models of insurance under asymmetric information. In: Dionne G (ed) Handbook of insurance. Kluwer Academic Publishers, LondonGoogle Scholar
  7. Cochrane JH (2009) Health status insurance: how markets provide health security. Policy Anal 633:1–12Google Scholar
  8. Cowley A, Cummins JD (2005) Securitization of life insurance assets and liabilities. J Risk Insur 72:193–226CrossRefGoogle Scholar
  9. Crocker KJ, Moran JR (2002) Contracting with limited commitment: evidence from employment based health insurance contracts. Rand J Econ 34:694–718CrossRefGoogle Scholar
  10. Cummins JD (2005) Securitization of life insurance assets and liabilities. J Risk Insur 72:193–226CrossRefGoogle Scholar
  11. Felder S (2008) To wait or pay for medical treatment? Restraining ex post moral hazard in health insurance. J Health Econ 27:1418–1422CrossRefPubMedGoogle Scholar
  12. Fenn P, Gray A, Rickman N (2007) Liability, insurance, and medical practice. J Health Econ 26:1057–1070CrossRefPubMedGoogle Scholar
  13. Finkelstein A, Poterba J (2004) Adverse selection in insurance markets: policy holder evidence from the U.K. Annuity Market. J Polit Econ 112:188–208CrossRefGoogle Scholar
  14. Fuchs VR (2000) The future of health economics. J Health Econ 19:141–157CrossRefPubMedGoogle Scholar
  15. Hernandez MV (2003) Structural estimation of a principal-agent model: moral hazard in medical insurance. Rand J Econ 34:670–693CrossRefGoogle Scholar
  16. Jullien B, Salanie B, Salanie F (1999) Should more risk averse agents exert more effort? Geneva Pap Risk Insur Theory 24:19–28CrossRefGoogle Scholar
  17. Klein RW, Wong S (2009) Catastrophe risk financing in the United States and the European Union: a comparative analysis of alternative regulatory approaches. J Risk Insur 76:607–637CrossRefGoogle Scholar
  18. Nell M, Richter A, Schiller J (2009) When prices hardly matter: incomplete insurance contracts and markets for repair goods. Eur Econ Rev 53:343–354CrossRefGoogle Scholar
  19. Pauly MV, Blavin FE (2008) Moral hazard in insurance, value-based cost sharing and the benefits of blissful ignorance. J Health Econ 27:1407–1417CrossRefPubMedGoogle Scholar
  20. Rao TVSR (2009) Securitization, ratings, and regulatory policy. Presented at the fourth annual conference on public policy and management. IIM, Bangalore, 10–12 AprGoogle Scholar
  21. Rao TVSR (2010) Financial crisis, efficient bailouts, and regulatory policy. Macroecon Financ Emerg Market Econ 3(2):167–188Google Scholar
  22. Rutten F, Bleichrodt H, Brouwer M, Koopmanschap M, Schut E (2001) Handbook of health economics. J Health Econ 20:855–879CrossRefGoogle Scholar
  23. Snow A (2009) On the possibility of self-selection in competitive insurance markets. J Risk Insur 76:249–259CrossRefGoogle Scholar

Copyright information

© Springer India 2016

Authors and Affiliations

  • T. V. S. Ramamohan Rao
    • 1
  1. 1.Indian Institute of Technology KanpurKanpurIndia

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