Description: This paper will develop an aggregate claim reserve methodology for health claims. The theoretical nature of the unpaid claim process is outlined and discussed. This is then used to develop a paradigm shift, which views the claim reserve estimation as a projection of claims from one period to another, rather than as a matter of estimating residual unpaid claims from observed paid claims.

Description: The article explores how integrating AI into insurer apps can address critical challenges in healthcare, such as patient no-shows, medication adherence, and cost management. These non-disruptive approaches aim to increase the effectiveness of patient interventions and improve medication adherence.

Description: The purpose of this paper is to demonstrate a simplified method of calculating adjusted benefit reserves for any line of life or health insurance. Specific examples are applied to individual hospital and major medical insurance. From Transactions of Society of Actuaries 1973 Vol. 25 Pt. 1 No. 73

Description: This paper includes three discussions. The first is about permanent type insurance used as a substitute for group term insurance. The second discussion is about long-term disability experience, offsets and underwriting. The third discussion is about medical care expense insurance including experience, trends, impact of Medicare and COB. From Transactions of Society of Actuaries 1968, Vol. 20 Pt. 2, No. 57

Description: This is a panel discussion about the future of health care and health care insurance. From Transactions of Society of Actuaries 1968, Vol. 20 Pt. 2, No. 58

Description: This paper discusses the insurance plan titled, Connecticut 65 Extended Health Insurance. From Transactions of Society of Actuaries 1961, Vol. 13, No. 37.

Description: ReMark's Global Consumer Study delivers 10 key insights to empower customers. Insurers can design products that meet customers' needs and enhance client experiences and add significant value to their business. At the same time with new products being launched seemingly continuously, it is important to take a step back and assess risk throughout the product management cycle.

Description: Learn more about interpretable machine learning techniques for health insurance fraud detection.

Description: This research material provides an evaluation and synthesis of the methodologies and data samples used on characterizing health care fraud

Description: This discussion examines miscellaneous topics. Topics include actuarial training, final salary pension plans and hospitalization and surgical insurance. From Transactions of Society of Actuaries 1960, Vol. 12, No. 34.