The Evolution Of Health Insurance Legislation In Europe: Past And Present

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The Evolution Of Health Insurance Legislation In Europe: Past And Present

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By Charmaine Barbara Charmaine Barbara Scilit Preprints.org Google Scholar 1, Dominic Cortis Dominic Cortis Scilit Preprints.org Google Scholar 2, 3, * , Roberta Perotti Roberta Perotti Scilit Preprints.org Google Scholar 4, Claudia Sammut Claudia Sammut Scilit Preprints.org Google Scholar 4 and Antoine Vella Antoine Vella Scilit Preprints.org Google Scholar 3

Received: November 3, 2016 / Revised: May 15, 2017 / Accepted: May 19, 2017 / Published: May 31, 2017

Why Do Employers Provide Health Care In The First Place?

The insurance industry plays an important role in European economic stability and the threats and opportunities it faces should be carefully identified. In this paper, we highlight the main challenges of using a Political, Economic, Social and Technological (PEST) analysis. This work applies conventional actuarial thinking in this area by focusing exclusively on the European sector.

A healthy insurance industry is important for a proper economic system, economic growth and promotion of higher employment among other factors. Should such a system be uneven, especially in the non-life insurance sector, it could lead to higher risks in the financial decisions made by companies and individuals. Therefore, the insurance industry is beneficial to the economic system as a whole as it allows for the transfer, pooling and mutualization of risks, helping to keep a country economically stable (CEA 2006).

Linder and Ronkainen (2004) provide an important assessment of why the insurance and pensions industry is important to the EU: it employs over a million Europeans, it is the largest institutional investor and it provides cover against a variety of risks to a wide range of clients . For example, in 2013 an average of EUR 1883 was spent per inhabitant in 34 European countries (Insurance Europe 2014).

Risk reduction is at the heart of the insurance industry, and it is therefore very vulnerable to a number of external forces. During our lifetime, we have been exposed to certain events that have changed the financial services industry. Some examples include the terrorist attacks of September 2001, flooding across Europe and the financial crisis of 2008. These events, among others, have significantly shaken the insurance industry. In addition, with the growing popularity of bancassurance, the distinction between the insurance industry and the banking industry is becoming increasingly thin, and therefore the connection between these two industries must be constantly monitored (Schiro 2006).

Eligible Healthcare Professionals’ Organisations

Given the major impact that such events have on the worldwide economy and the financial industry in general, the insurance industry must be adequately prepared. The ultimate goal of an insurance policy is to return policyholders to the same situation they were in before the events that gave rise to a loss occurred. If claims arise, the companies must have sufficient liquidity to be able to compensate for these losses. During catastrophic events affecting the insurance industry, insurers may experience an influx of claims and as such must be prepared for such circumstances.

On the other hand, investments are one of the insurance industry’s main sources of income. However, the companies must ensure that they find the right balance between investments and liquidity. In the event of major economic events, investments can be significantly affected. Furthermore, given the liquidity requirements faced by the insurance industry, the investments must be sufficiently liquid to ensure that the company remains solvent throughout its lifetime.

This article intends to evaluate the risks posed by external factors in the European insurance industry, using a political, economic, social and technological (PEST) analysis as a tool to identify these risks. PEST analysis represents a framework of external macroeconomic factors that may have an effect on the topic at hand. It can be used to assess the external pressures on a business unit, project or even an industry. PEST analysis is usually used in conjunction with a SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis when evaluating a project or company. Since SWOT incorporates internal factors (strengths and weaknesses), we believe it would be inappropriate to apply it to an entire industry. In our opinion, it would be useful to use SWOT when comparing different types of insurance companies (eg mutual insurance companies) rather than when assessing external pressures.

PEST analysis has been applied to the insurance industry in educational settings. For example, both the Institute and Faculty of Actuaries (London, UK) and the Society of Actuaries (Schaumburg, IL, USA) include this analysis in their Business Awareness (CT9) and Fundamentals of Actuarial Practice curricula, respectively. Indeed, we do not intend to reinvent the wheel, but we need to update these and apply them at a more European level. We have developed a PEST analysis after discussions with professionals and an in-depth literature review.

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The next section discusses Solvency II regulation as well as other regulatory reasons that may affect this industry. In a political and regulatory sense, we interpret this as any decision made by a government or administration in a jurisdiction that may directly or indirectly affect the insurance industry.

A number of economic factors such as economic growth, interest rates, exchange rates and inflation influence the future outcomes and results of insurance companies. For example, high interest rate fluctuations will ultimately affect the size of the company’s capital growth. Therefore, in order to predict the cash flow of a business, certain factors must be assessed in advance, such as investment earnings and inflation rates (Garrett 2013). Another example is the tendency for high unemployment rates during recessions. This can cause a higher level of claims under employers’ liability insurance or any personal accident policies to compensate injured workers who cannot return to work due to not being able to find a replacement job (Shepherd 2010). Recession causes households and businesses to decrease their demand for insurance coverage and in turn causes lower premium rates (Liedtke and Schanz 2010). Furthermore, the economic and business environmental effects on the European insurance industry are discussed in the next section by focusing on financial crises, interest rates, inflation, exchange rates, demographic and economic changes and the insurance cycle.

This is followed by a discussion of how societal and cultural changes have and will continue to affect this industry. Finally, the effects of changes in the physical environment and technological advances are assessed.

Policy interventions have been seen as necessary to ensure the stabilization of the financial sector against a number of risks due to the economic importance of this industry. One of the most effective ways in which political factors have affected the financial sector is through the introduction of stricter regulation across the entire industry. Taking into account recent economic events (such as the 2007 financial crisis) that have affected the entire European economy, political forces have sought to harmonize EU legislation so that there will be a common basis on which the financial sector is regulated.

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One such example is the introduction of Solvency II (SII), an EU directive codifying and harmonizing the regulatory framework for insurance and reinsurance companies. The main objectives of such a directive include:

The SII is based on three pillars. The first pillar lays down the quantitative requirements for an insurance company to be able to function. This is assessed as a Value-at-Risk at a 99.5% percentile target over one year. Value-at-Risk can be derived using a standard formula or internal model. The second pillar defines the risk management control in an insurance company, while the third pillar requires additional disclosure (Linder and Ronkainen 2004).

The introduction of such legislation can be considered fruitful for the European financial services industry as it reduces regulatory arbitrage, but it could also be argued that SII was a very expensive undertaking based on the proportion of insurance services that are cross-border. Stricter legislation imposes an additional burden on insurers, especially captives.1 SII

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