【保险学术前沿】 Journal of Insurance Regulation 2023年7月-2024年2月目录

声明：本系列文章基于原期刊目录和摘要内容整理而得，仅限于读者交流学习。如有侵权，请联系删除。

期刊介绍：

"Journal of Insurance Regulation"由美国保险监管协会（NAIC）出版发行，是一个专注于保险监管和相关政策领域的学术期刊。每年发表学术论文12篇左右。该期刊主要发表关于保险监管、法规、政策和相关实践的原创研究论文、评论文章和案例研究。它旨在为保险监管领域的研究人员、政策制定者和行业从业者提供一个交流和分享最新研究成果的平台。

本期看点：

● 社会通胀（Social inflation），是指不断变化的社会对企业和保险公司的态度导致保险公司超额支付索赔及发生不必要的损失调整费用，通常是在诉讼环境中。

● 人寿保险公司商业抵押贷款组合中的气候风险

● 无过失汽车保险是否真的效率更高、成本更低？

● 汽车保险中特定的监管属性会影响综合价格和理赔满意度等指标

Jill M. Bisco（阿克伦大学）; Suzanne Gradisher（阿克伦大学）; Jinjing Wang（阿克伦大学）

摘要：Life insurance is a non-probate contract that allows for a gratuitous transfer of funds to designated beneficiaries who receive the payment at the death of the insured. Given the importance of life insurance to replace income or to create an inheritance for heirs, ambiguity regarding beneficiary advice can cause catastrophic results and unintended consequences, ultimately resulting in a failure to meet objectives. Source material available to financial services professionals and consumers is vague and easy to misinterpret, specifically the per capita beneficiary option. To provide consumer protection, we recommend that a consumer guide comparing various per capita options, as well as other beneficiary options, be distributed to potential policyowners at the time of application. The guide should include illustrative charts of how proceeds will be distributed. We also recommend that the beneficiary designation forms include clear and explicit definitions of various beneficiary options available to the insurance policy.

人寿保险是一种非遗嘱认证合同，允许将资金无偿转移给指定受益人，指定受益人在被保险人死亡时获得支付。鉴于人寿保险在替代收入或为继承人创造遗产方面的重要性，对于受益人建议的模糊性可能会导致灾难性后果或意外结果，最终导致目标无法实现。金融服务专业人员和消费者可获得的原始材料很模糊、容易被误解，特别是按人均分配的受益人选择。为了提供消费者保护，我们建议在申请时向潜在的投保人分发一份比较各种人均选择以及其他受益人选择的消费者指南，该指南应包括收益如何分配的示意图。我们还建议，受益人指定表格应包括保险单中各种受益人选择的明确定义。

【注释】

Per stirpes：〈拉〉按家系。另一种受益人指定方式，通常被用于在多个人之间和跨代分配收益，在被继承人未立有遗嘱时，已死亡继承人的应继份额由其子女代位继承

Per capita：〈律〉（遗产、财产）按人均分

原文链接：

https://content.naic.org/sites/default/files/cipr-jir-2023-6.pdf

Asligul Erkan-Barlow（东卡罗来纳州立大学）；Brenda P. Wells-Dietel（东卡罗来纳州立大学）

摘要：This manuscript systematically reviews several strands of literature on cybersecurity and draws attention to the possible moral hazard problem associated with managers’ choices on information security-related investments. First, a careful synthesis of the literature shows that managers have incentives to behave myopically and to defer investments in data security to meet the financial market’s earnings expectations. Second, although adequate cyber risk management involves both risk mitigation and risk transfer, risk transfer through the purchase of cyber insurance is problematic. Despite the increase of insurers and written premiums suggesting growth in the cyber insurance industry, the most recent industry reports point out the increase in loss ratios, the decrease in available cyber insurance limits, and the implementation of more restrictive coverage as a sign of insurers controlling their risk exposure. Finally, existing regulatory frameworks in the U.S. and the European Union (EU) do not negate the trend of increasing numbers of cyberattacks. In conclusion, we argue that an optimal level of regulation is needed but has yet to be enacted to reduce the cyber risk exposure of businesses and insurers, as well as to protect consumers and the overall economy.

本文系统地回顾了几篇关于网络安全的文献，并提请人们关注管理者在信息安全相关投资选择上可能存在的道德风险的问题。首先，对文献的仔细综合表明，为满足金融市场的盈利预期，管理者有动机表现得迟缓，推迟对数据安全的投资。其次，尽管充分的网络风险管理涉及风险缓释和风险转移，但通过购买网络保险转移风险是有问题的。尽管保险公司和承保保费的增加表明了网络保险行业的增长，但最新的行业报告指出，损失率的增加、可用网络保险限额的降低以及更严格的保险范围的实施是保险公司控制其风险敞口的一个迹象。最后，美国和欧盟（EU）现有的监管框架并没有否认网络攻击数量增加的趋势。总之，我们认为，需要一个最佳的监管水平，以减少企业和保险公司的网络风险敞口，并保护消费者和整体经济，但其尚未颁布。

原文链接：

https://content.naic.org/sites/default/files/cipr-jir-2023-4.pdf

Kenneth S. Klein（加州西部法学院）

摘要：This paper explores whether regulators and legislators need more information before embracing the current argument that social inflation necessitates immediate legal system reforms to stabilize insurance markets. Social inflation is a term describing how insurers are overpaying claims and incurring unwarranted loss adjustment expenses (LAE), often in litigation settings where the problem is exacerbated by gullible jurors and changing societal attitudes toward businesses and insurance companies. Social inflation generally is thought to be caused by lawyers, litigation financers, contractors, and other opportunists, including perhaps policyholders themselves. In a variety of states, a connection is perceived between social inflation and some insurers either becoming insolvent or leaving markets entirely.

This article analyzes whether data presented in recent literature on social inflation is sufficient for regulators and legislators to adopt a new wave of requested legal system reforms. This paper explores several potential concerns of legal system reform: Whether the literature adequately models the possible benefits to insurers of legal system reforms, as well as the possible harm to consumers. Whether the literature adequately explains why the proposed reforms are likely to be more successful than prior reforms. And whether there is yet sufficient development of the social inflation argument to act on the asserted conclusion that suspect actors are illegitimately changing societal attitudes to achieve unwarranted results. This paper concludes that as yet, there is not enough data for a regulator or legislator to confidently embrace further legal system reform. The reforms may be advisable, but it is too soon to tell, and there is significant risk that the reforms would do more harm than good.

本文探讨了监管者和立法者在接受当前关于社会通胀需要立即进行法律制度改革以稳定保险市场的论点之前是否需要更多的信息。社会通胀是一个术语，用来描述保险公司如何超额支付索赔及发生不必要的损失调整费用（LAE），通常是在诉讼环境中，轻信陪审员和不断变化的社会对企业和保险公司的态度加剧了这一问题。社会通胀通常被认为是由律师、诉讼出资人、承包商和其他投机者造成的，其中可能也包括投保人本身。在许多州，人们认为社会膨胀与一些保险公司破产或完全退出市场之间存在联系。

本文分析了近期有关社会通胀的文献中提供的数据是否足以让监管者和立法者采取新一轮所要求的法律制度改革。本文探讨了法律制度改革的几个潜在问题：文献是否充分分析了法律制度改革对保险公司可能带来的利益，以及对消费者可能造成的损害；文献是否充分解释了为什么建议的改革可能比以往的改革更成功；社会通胀论证是否有足够的发展，以对可疑行为人非法改变社会态度以达到不正当结果的断言采取行动。本文的结论是，到目前为止，还没有足够的数据让监管者或立法者满怀信心地接受进一步的法律制度改革。改革可能是可取的，但现在下结论还为时过早，而且改革可能弊大于利。

原文链接：

https://content.naic.org/sites/default/files/cipr-jir-2023-7.pdf

Kyeonghee Kim（佛罗里达州立大学）, Xiao (Joyce) Lin（圣约翰大学）

摘要：In this paper, we explore the climate risk exposure of U.S. life insurers’ commercial mortgage loan portfolios, focusing on sea level rise (SLR) and flood risks. While vast literature and industry reports document the potential impact of climate change on the insurance industry, most focus on the property insurance market. Life insurers hold a significant number of commercial mortgages, representing approximately 15% of their assets by the end of 2021. These investments are susceptible to both physical and transitional risks of climate change and are much less researched or understood. From 2012 to 2019, we find that the size of newly issued commercial mortgages by life insurers in the U.S. grew from $37 billion to $56 billion (by 51%). We find heterogeneity across life insurers in terms of the average loan size, the loan origination frequency, as well as loan locations. In terms of locations, life insurers tend to originate loans in metropolitan areas, many of which are on the coast. Some life insurers focus on specific geographical areas that happen to be exposed to high levels of SLR or flood risks (e.g., Florida), while some diversify across metropolitan areas (coastal or noncoastal) in the U.S. Our findings have important policy implications for regulators and researchers.

本文探讨了美国寿险公司商业抵押贷款组合的气候风险暴露，重点关注海平面上升（SLR）和洪水风险。虽然大量文献和行业报告都记载了气候变化对保险业的潜在影响，但大多数都集中在财产保险市场。寿险公司持有大量商业抵押贷款，到 2021 年底约占其资产的 15%。这些投资很容易受到气候变化的物理风险和过渡风险的影响，但人们对此的研究和了解要少得多。我们发现，从 2012 年到 2019 年，美国寿险公司新发行的商业抵押贷款规模从 370 亿美元增长到 560 亿美元（增长了 51%）。我们发现，各寿险公司在平均贷款规模、贷款发放频率以及贷款地点方面存在异质性。在贷款地点方面，人寿保险公司倾向于在大都市地区发放贷款，其中许多位于沿海地区。一些人寿保险公司专注于特定的地理区域，而这些区域恰好面临着高水平的海平面上升或洪水风险（如佛罗里达州），而一些人寿保险公司则在美国的大都市地区（沿海或非沿海）进行多元化经营。我们的研究结果对监管机构和研究人员具有重要的政策意义。

原文链接：

https://content.naic.org/sites/default/files/cipr-jir-2023-8.pdf

Olivea Myers （美国保险监督官协会法律顾问）

摘要：The article provides summaries of significant cases related to the regulation of insurance in 2023, covering diverse legal issues from preemption challenges in Oklahoma to tax disputes in Michigan and New Jersey. Topics include ERISA and Medicare Part D preemption, taxation of health care service plans, license revocation under insurance laws, and disputes over fire insurance premium tax calculations.

本文介绍了2023年与保险监管有关的重大案例，涵盖了从俄克拉荷马州的优先购买权挑战到密歇根州和新泽西州的税务纠纷等各种法律问题。其主题涉及雇员退休收入保障法案（ERISA）和Medicare Part D优先购买权、医疗保健服务计划的税收、保险法下的执照吊销以及火灾保险费税收计算的争议等内容。

原文链接：

https://content.naic.org/sites/default/files/cipr-jir-abstracts-cases-2023.pdf

Patricia Born（佛罗里达州立大学），Robert W. Klein（天普大学），Lawrence S. Powell（阿拉巴马大学）

摘要：When Michigan instituted no-fault auto insurance in 1973, its proponents argued that it would be a more efficient and less costly system for administering auto insurance claims than tort liability. Unfortunately, the opposite eventually proved to be true. Michigan’s system was unique among states because it provided unlimited no-fault medical benefits, and insurers were severely constrained in their ability to control medical costs. By 2019, Michigan’s auto insurance claim costs and premiums were the highest in the nation. This motivated the state’s legislature and governor to significantly reform its no-fault law and tighten its regulation of auto insurance. While these reforms and regulatory changes are relatively nascent, there is considerable interest in knowing their effects, including the consequences of allowing consumers to choose their level of no-fault coverage, instituting medical cost controls for no-fault coverage, and tightening the regulation of insurance companies. In this paper, we evaluate the no-fault reforms and their impacts. We find some initial evidence that claims costs and premiums for many drivers decreased substantially due to the reforms. However, medical providers and trial attorneys are advocating for legislation that tempers the cost controls, arguing that they are too harsh and arbitrary and that the adequacy and quality of care received by auto accident victims have suffered as a result. Fundamentally, there is the issue of whether it is possible to design a no-fault system that is superior to tort liability and is fair to all of a state’s residents in terms of the benefits it provides and its premium costs. Michigan could be viewed as an experiment on both the promises and pitfalls of a grand vision for no-fault auto insurance. Our paper contributes to an important debate on whether no-fault auto insurance can be saved and if it is worth saving.

当密歇根州于1973年开始实行无过失汽车保险时，其支持者认为，与侵权责任相比，无过失汽车保险是一种效率更高、成本更低的汽车保险索赔管理制度。不幸的是，事实最终证明恰恰相反。密歇根州的制度在各州中是独一无二的，因为它提供无限额的无过失医疗赔付，因此保险公司控制医疗成本的能力受到严重限制。到 2019 年，密歇根州的车险理赔成本和保费都是全美最高的。这促使该州的立法机构和州长对无过失法律进行了重大改革，并加强了对汽车保险的监管。虽然这些改革和监管变化相对较新，但人们对了解其效果有着相当大的兴趣，包括允许消费者选择无过失保险的额度、对无过失保险实行医疗费用控制以及加强对保险公司的监管所产生的后果。在本文中，我们对无过失保险改革及其影响进行了评估。我们发现一些初步证据表明，由于改革，许多司机的索赔成本和保费大幅下降。然而，医疗服务提供者和出庭律师正在主张通过立法来缓和成本控制，认为成本控制过于苛刻和武断，而且车祸受害者所获得的医疗服务的充分性和质量也因此受到了影响。从根本上说，问题在于是否有可能设计出一种无过失制度，这种制度既优于侵权责任，又在提供的利益和保费成本方面对一个州的所有居民公平。密歇根州（的改革）可以被看作是一个实验，来实验无过失汽车保险宏大愿景的承诺和陷阱。我们的论文有助于就无过失汽车保险能否挽救以及是否值得挽救展开重要辩论。

原文链接：

https://content.naic.org/sites/default/files/cipr-jir-2023-10.pdf