In a fragmented and competitive industry, it is likely for the smaller roleplayer to be challenged in terms of competitiveness and market share. It is, therefore, important for the smaller organisation to etch its position in the market, by increasing its competitive advantage. In a milieu where there is a shift in distribution dynamics and the balance of power, and an increase in consumerism, the need to react is a pressing issue to be addressed by the smaller player. In the context of this study, the small and medium-low-impact intermediary in the South African short-term insurance industry is under pressure from, among others, direct distribution models and the increasing volume of the medium-high and high-impact intermediaries. It is determined in this study that the intermediary is challenged by all five market forces, as postulated by Porter in the model of “the five forces that shape industry competition”. The intermediary organisation must adopt positioning strategies, and differentiate its offering, in order to stay relevant in the industry. The short-term insurance intermediate industry is classified as a service industry; and therefore, it has unique factors to attend to. The positioning and differentiation strategies must be implemented without compromising the service quality levels. Furthermore, in the development of positioning strategies, it is essential to investigate the traditional marketing mix, while amplifying the mix with contemporary views of the subject. These form the basis of the positioning strategy; and from there, differentiation offerings can be shaped. A survey analysis of the product suppliers aims to identify the most important strategies for success. The study relies on the industry knowledge of the executives of these organisations, to steer the positioning strategies of the intermediary to fit in with their own positioning in the marketplace.

South Africa possesses a highly fragmented health system with wide disparities in health spending and inequitable distribution of both health care professionals and resources. The national health system (NHI) of South Africa consists of a large public sector and small private sectors which are overused and under resourced and a smaller private sector which is underused and over resourced. In broad terms, the NHI promises a health care system in which everyone, regardless of income level, can access decent health services at a cost that is affordable to them and to the country as a whole. The relevance of this study is to contribute to the NHI debate while simultaneously providing insights from other countries which have implemented national health care systems. As such, the South African government can then appropriately implement as well as finance the new NHI system specific to South Africa’s current socio-economic status. The objective of this study was to examine health care financing models in different countries in order to draw lessons for South Africa when implementing the NHI. A case study was conducted by examining ten countries with a national health insurance system, in order to evaluate the health financing models in each country. The following specific objectives are pursued: firstly, to review the current health management system and the policy proposed for NHI; secondly, to examine health financing models in a selected number of countries around the world and lastly to draw lessons to inform the South African NHI policy debate. The main findings were firstly, wealthier nations tend to have a much healthier population; this is the result of these developed countries investing significantly in their public health sectors. Secondly, the governments in developing nations allocate a smaller percentage of their GDP and government expenditure on health care. Lastly, South Africa is classified as an upper middle income developing country; however, the health status of South Africans mirrors that of countries which perform worse than South Africa on health matters. In other words the health care in South Africa is not operating at the standard it should be given the resources South Africa possesses. The cause of this may be attributed to South Africa being stuck in what is referred to as the “middle income trap” amongst other reasons.

Thesis (MA)--Stellenbosch University, 2001. / ENGLISH ABSTRACT: This thesis focuses on the extent to which the South African social security system succeeds in providing protection in the vulnerable periods of the life-cycle and against the major contingencies of unemployment, disability and disease. Through a detailed examination of the different social insurance and assistance programmes, it isolates which particular population segments (by occupation, income quintile and race group) "fall through the cracks" in the provision of income security. It does not look only at the articulation between different social insurance and social assistance programmes, but also acknowledges how social security complements other governmental interventions, such as social services, and non-state sources of income security, such as those provided by the private insurance market and the family and community. Part One of the thesis is devoted to an examination of social insurance in South Africa, in other words, to those programmes that seek to compensate for a loss of income in the event of particular contingencies and that are funded by contributions from employers and employees. In addition, theoretical perspectives on social security, and social insurance in particular, are provided, with a discussion of the various economic arguments in favour of and against the provision of social security. Part Two of the thesis examines the range of non-contributory social assistance - cash benefits paid form general revenue - that are available to South Africans who qualify in terms of the means tests. Each chapter provides an analysis of the extent to which the social assistance programme under analysis provides a safety net for the relevant category of vulnerable people. It does this by examining the appropriateness of the programme structure, take-up rates and the fiscal sustainability of the programmes. In addition, the budgetary process by which revenue is allocated to social assistance programmes and expenditure trends are examined. The thesis concludes that although the South African social security system has achieved a fairly advanced level of development and covers a fairly wide range of risks, there are a number of constraints facing its further expansion. Social insurance schemes provide generous benefits, but their membership is restricted to the employed. Expanding coverage by social insurance would require substantial growth in remunerative employment which, given prevailing labour market conditions, seems unlikely. The provision of more generous social assistance programmes catering for a broader range of contingencies is severely curtailed by already high fiscal expenditure on welfare and macroeconomic constraints. Moreover, changing demography, household structures and dependency burdens, especially as the HIV/AIDS epidemic spreads, seem likely to increase demands on social assistance programmes. Consequently, until employment can be expanded so that more people can contribute to their own income security, the informal social security provided by the family and/or community will remain the first line of support for many. / AFRIKAANSE OPSOMMING: In hierdie tesis word gefokus op die mate waartoe die Suid-Afrikaanse bestaansbeveiligingstelsel daarin slaag om ondersteuning tydens kwesbare periodes in die lewensiklus en beskerming teen groot gebeurlikhede soos werkloosheid, ongeskiktheid of langdurige siekte te bied. Daardie bevolkingsegmente (volgens beroep, inkomstegroep of ras) wat nie volledig toegang tot inkomstesekuriteit het nie, word uitgesonder deur 'n gedetaileerde ondersoek van die verskillende maatskaplike versekerings- en bystandsprogramme. Daar word ook gekyk na die artikulasie tussen die verskillende programme sowel as na hoe ander regeringsintervensies (bv. verskaffing van maatskaplike dienste) en private bronne van inkomstesekuriteit - verskaf deur die privaat versekeringsmark, die gemeenskap en die familie - deur maatskaplike bystand aangevul word. Deel Een word gewyaan 'n ondersoek van maatskaplike versekering in Suid-Afrika - daardie programme wat vir inkomsteverlies weens spesifieke gebeurlikhede probeer kompenseer en wat tipies deur bydraes van werkgewers en werknemers befonds word. Teoretiese perspektiewe op bestaansbeveiliging in die algemeen en maatskaplike versekering in besonder word ook verskaf en argumente vir en teen die verskaffing van bestaansbeveiliging word bespreek. Deel Twee ondersoek die reeks nie-bydraende bestaansbeveiligingsprogramme wat uit algemene owerheidsinkomste befonds word, asook bestedingstendense in maatskaplike bystand. Die tesis kom tot die gevolgtrekking dat, alhoewel Suid-Afrikaanse bestaansbeveiliging 'n redelik gevorderde vlak van ontwikkeling bereik het en 'n wye reeks risiko's dek, daar 'n aantal beperkinge op verdere uitbreiding is. Maatskaplike versekeringskemas bied uitgebreide voordele, maar lidmaatskap is tot indiensgeneemdes beperk. Uitbreiding van dekking vereis beduidende groei in formele indiensneming, wat onwaarskynlik lyk, gegewe huidige arbeidsmarktendense. Die verskaffing van gunstiger maatskaplike bystandsprogramme gemik op meer gebeurlikhede word ernstig deur reeds hoë fiskale uitgawes op welsyn en deur makroekonomiese oorweginge beperk. Verder sal veranderende demografiese strukture, huishoudingstrukture en afhanklikheidslaste, veral teen die agtergrond van die toename in HIVNIGS, aansprake op maatskaplike bystandsprogramme vergroot. Gevolglik sal die informele inkomstesekuriteit gebied deur die familie en/of gemeenskap die eerste of enigste ondersteuning vir groot dele van die bevolking bly, totdat indiensneming genoeg uitgebrei kan word sodat meer mense tot hul eie inkomstesekuriteit kan bydra.

This study investigates the extent to which South African short-term insurance companies manage climate change risk, as evidenced in their annual and sustainability reporting. The study context takes into account the fact that the world’s climate has been changing at a more accelerated rate since the early 1970s, causing disasters that have negatively affected world economies in the last ten years. Insurers, due to their huge financial resource base, long history of spurring innovation around risk and encouraging loss-reducing behaviour as well as high levels of vulnerability, have been identified as one industry that could lead societies in finding solutions to climate change risk. A key element of such a corporate resolve involves taking a leadership position which makes business sense for insurers. As such, this research analyses how innovative solutions to change-related problems could result in reduced exposure to climate change in line with corporate triple bottom line objectives. Based on a purposive sampling of short-term insurance companies operating in the South African market during the 2007 financial year, the study uses the companies’ annual and sustainability reports in order to critically assess evidence of climate change-related performance. The assessment is undertaken against the best practice indicators of climate change risk management, as defined by Ceres – a global researcher on climate change management in the business context. The data analysis is largely qualitative, consisting of a narrative presentation of the results and a conceptual application of the results to the triple bottom line which forms the theoretical framework of this study. The study finds that the South African short-term insurers were generally not living up to the climate change management ideals, in comparison to their multinational counterparts. For the South African short-term insurers, corporate strategic product innovation and planning was insignificant. Also negligible was board involvement, as well as CEO involvement, though in at least one case of the 4 local short-term insurance, there was evidence of extensive CEO involvement in climate change risk management. On the whole, these findings represent a lapse in corporate governance inasmuch as climate change risk management is concerned. Local short-term insurers generally performed well in the area of public disclosure, with their scores ranging from insignificant to extensive. In contrast, multinational short-term insurers’ performance with regard to climate change risk intervention ranged from insignificant tointegrated, across the five governance areas of board oversight, management execution, public disclosure, emissions accounting and strategic planning. As such, the study broadly recommends that short-term insurers in South Africa should make climate change part of their overall risk management strategies in order for them to remain competitive in an environment of increased climate change-related risk. More specifically, the research project recommends that the local insurers should proactively lead climate change mitigation measures through, for instance, investing in clean energy projects and incentivising their clients’ participation in the carbon market to prepare themselves for possible regulatory restrictions after the Copenhagen climate change conference planned for December 2009. This study also challenges insurers to help communities and as well as other businesses in their value chain to reduce their negative impacts on the world’s climate and to be more resilient against disasters which may arise from the high levels of greenhouse gases already in the atmosphere. Further, it recommends that insurers should create internal board and executive level climate change-related structures, as these will facilitate the integration of the proposed initiatives into their overall sustainability strategies. Above all, the study recommends that insurers should enhance the reporting of their climate change-related risk, opportunities and initiatives to improve their integrity.

Thesis (MPhil)--Stellenbosch University, 2009. / ENGLISH ABSTRACT: The objective of this study is to provide an overview of the South African financial mechanisms of protection available to people with disabilities, and to project possible future trends in providing these levels of cover. Alternative future scenarios that could pan out over the long-term are sketched to help understand the various external factors that could have an impact on disability risk protection in South Africa. The main classifications of the various benefits are split into social assistance and social insurance measures. The future landscape for each is explored by reviewing the associated social security and private insurance reforms currently envisaged. A key expected driver of private insurance reform is the introduction of a formal contributory system of social security in South Africa. The provision of disability cover in such a system is reviewed separately through proposals for a new mandatory system of retirement and risk benefit management in the country. Recommendations for a more coherent framework amongst the various mechanisms of disability protection and their designs are made. This is done within the context of the social model of disability that has developed in recent years. / AFRIKAANSE OPSOMMING: Hierdie verslag gee ‘n oorsig van die Suid-Afrikaanse finansiële beskermings meganismes wat beskikbaar is vir mense met gestremdhede. Dit lig veral moontlike tendense vir die toekoms van sulke vorme van ongeskiktheids-dekking uit deur sekere vooruitskattings te maak. Daar is verskeie maniere waarop hierdie, en moontlik nuwe, meganismes kan ontwikkel met tyd. Dit is belangrik om te verstaan hoe sekere omgewingsfaktore ‘n rol speel in die bestuur van ongeskiktheids risiko’s. Die verslag klassifiseer die meganismes in twee kategorieë, staatstoelae en privaat versekerings-voordele. Ondersoek word ingestel na die toekomstige ontwikkeling van hierdie voordele deur huidige hervormings te oorweeg. Een van hierdie hervormings wat tot grootskaalse verandering kan lei is die inwerkingstelling van ’n nasionale pensionfonds waartoe alle Suid-Afrikaners verpligte bydraes sal maak. Die meriete van die verskaffing van ’n ongeskiktheidsvoordeel deur so ’n fonds word onder andere ondersoek. Voorstelle vir ‘n beter samehangende raamwerk waarbinne die reeks voordele verskaf kan word, word ook gemaak. Die algemene tendens vir ’n meer sosiale inslag in die ontleding van gestremdheid gee ’n bepaalde konteks aan die debat.

Thesis (MBA)--Stellenbosch University, 2007. / AFRIKAANSE OPSOMMING: In Februarie 2000 het die Minister van Finansies aangekondig dat die regering besluit het om 'n inflasie teiken van 3 tot 6 persent vir 2002 daar te stel en het dus 'n beleid om 'n bepaalde inflasiekoers na te streef, aangeneem. 'n Eksplisiete lae inflasiekoersteiken is gestel as deel van die regering se ekonomiese beleid. Dit is 'n aanvaarde aanname dat hierdie teikenkoers vir die afsienbare toekoms sal geld. Veranderinge in die inflasiekoers, ongeag of dit na hoer of laer vlakke beweeg, het 'n invloed op hoe bateklasse reageer. Dit is dus belangrik dat beleggers die dinamika van inflasie verstaan en hoe dit beleggingsopbrengste bernvloed. Dit sal hulle help om deurdagte beleggingsbesluite te neem en om realistiese verwagtinge van be leggings - en polisopbrengste te he. Vir verskaffers van beleggingsprodukte in Suid-Afrika, veral die lewensversekeringsindustrie, is daar twee beduidende uitdagings in die huidige omgewing van lae rentekoerse en lae inflasie: om 'n winsgewende kontantvloei te genereer en om aan kliente se verwagtinge te valdoen. Volgens kliente is daar in die onlangse verlede nie aan hul verwagtinge valdoen nie, aangesien il1lustratiewe uitkeerwaardes wat gekwoteer is toe die polis uitgeneem is, nie geldig is in die huidige lae-inflasie omgewing nie. Kliente is ook teleurgesteld met huidige nomina Ie opbrengste wat laer is wat voorheen bereik is. Alhoewe[ dit algemeen aanvaar word dat 'n lae en stabiele inflasiekoers 'n voorvereiste is vir volhoubare ekonomiese groei en vooruitgang. verander dit die beleggingsomgewing vir private beleggers, verskaffers van beleggingsprodukte en beheerliggame. Hierdie verslag ondersoek die impak van lae inflasie op beleggingsopbrengste asook die implikasie daarvan vir beleggers, beleggingsproduk-verskaffers en beheerliggame in die finansiele dienstesektor in Suid-Afrika.

Thesis (MBA)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: The medical scheme industry of South Africa has been exposed to fundamental changes during the last decade. We have been witness to various amalgamations and scheme closures as a result of financial pressure and changes to legislation. Never before has it been more important for medical scheme administrators to become more customer focused and find solutions for medical schemes to stay viable into the future. Relationship marketing, a widely acknowledged concept, has been recognised as an appropriate tool to manage relationships and improve customer loyalty over a long-term period. A number of studies have investigated the viability of relationship marketing strategies across different industries. No such studies have however been performed for the medical scheme industry of South Africa. The study therefore aims to investigate how loyalty between medical schemes and their respective administrators is currently maintained. It further aims to determine if the medical scheme industry would benefit from relationship marketing initiatives to encourage long-term loyalty. An in-depth literature study was performed. The underlying aspects under investigation include relationship marketing, customer relationship management (CRM) and customer loyalty. It is thus important to investigate the influence of these three components on the strength of relationships and customer retention. The second phase of the study consisted of in-depth semi-structured interviews with various scheme representatives from the industry. This study is based on an exploratory case and the qualitative data was analysed using pattern finding techniques and qualitative content analysis. The study investigated the factors that have an impact on loyalty in the medical scheme industry. It was determined that relationships between administrators and medical schemes are multilevel and although relationship marketing literature indicates that key account managers are essential for the successful use of relationship based strategies, it was evident that expertise needs to extend beyond only those in key customer management positions. It is evident from the findings of this study that the medical scheme industry of South Africa could benefit hugely from correctly implemented and well researched relationship marketing strategies. This study may therefore be useful to the medical scheme industry in that it provides insight into relationship marketing in the South African context.

Thesis (PhD (Accounting))--University of Stellenbosch, 2005. / ENGLISH ABSTRACT: The South African long-term insurance industry is currently believed to be at an important crossroads in its existence. The industry is haunted by concerns about high cost structures, a lack of transparency in disclosure to policyholders, unfulfilled expectations of policyholders and the proliferation of available investment vehicles in the market. These concerns are exerting pressure on the existing products and practices of South African long-term insurers. The audits of these insurers are of a complex and high-risk nature as a result of the complexity of their operations and, in particular, the highly complex actuarial valuation process in respect of policy liabilities. The prevailing auditing standards in South Africa require auditors to include policy liabilities in the ambit of their audit opinions. Recent investigations into failed long-term insurers and their audits, including those of local Fedsure Life, British Equitable Life Assurance Society and Australian HIH Insurance, demonstrate the high risk involved in the audits of long-term insurers. Against this background, the objective of this research was to develop a best practice framework for the formulation of overall audit strategies for policy liabilities arising under insurance contracts and the related earnings of listed South African long-term insurers. To justify the focus of the research on the abovementioned components of the financial statements of listed South African long-term insurers, a questionnaire was developed and sent to auditors of all long-term insurers listed on the JSE Securities Exchange South Africa for completion. Responses were processed to calculate a Relative Inherent Risk Index specifically developed for use in this research, ranking various industry-specific account balances and classes of transactions on the basis of their potential exposure to inherent risk. The results of this process provided significant support for the hypotheses that policy liabilities and the related earnings are potentially exposed to the highest levels of inherent risk. The remainder of the research consequently focused on these components. A further very comprehensive questionnaire was developed to collect data with respect to respondents’ views of potential best practices for the audit of various aspects relating to policy liabilities arising under insurance contracts and the related earnings of listed South African long-term insurers, on the basis of their extensive experience in the industry. This questionnaire was sent to experienced auditors responsible for the audits of the five largest listed long-term insurers in South Africa for completion. Responses were received from four of the five potential respondents, resulting in an 80% response rate, enabling meaningful analysis and interpretation of the data. Responses were analysed, interpreted and documented in the form of a detailed best practice framework for the formulation of overall audit strategies for policy liabilities arising under insurance contracts and the related earnings. The lack of a fifth response was compensated for by a review of the research findings by experienced auditors of Deloitte and the provision of their opinions thereon. Deloitte was selected for this purpose as the fact that this auditing firm is the only one of the so-called “Big Four” auditing firms that does not act as auditor of one of the selected target long-term insurers, resulted in the initial exclusion of the firm’s views from the research. The framework was updated to reflect these opinions and now incorporates input from all of the so-called “Big Four” auditing firms. The framework provides a comprehensive discussion of all possible types of audit procedures that may be relevant to the audit of all aspects of policy liabilities arising under insurance contracts and the related earnings of listed South African long-term insurers. As no such framework existed prior to this research, the development thereof made a significant contribution to existing knowledge. This contribution is the result of, inter alia, the method followed in designing the framework, resulting in it representing a synthesis of, inter alia, the following: • existing international and limited local guidance for auditors and, in particular, auditors of long-term insurers, customised for the South African environment; • best practices currently in use on the audits of listed South African long-term insurers; and • views of experienced practitioners on the abovementioned types of best practices that might not be employed at the moment, but that should, in their views, be employed in future. The valuable contribution of this research to existing knowledge is clear from the fact that numerous publications in popular professional as well as accredited academic journals, plus a paper delivered at a conference have resulted from it (refer to the source list and Appendix A). Furthermore, the South African Institute of Chartered Accountants has approved a project to update existing South African guidance for auditors of long-term insurers on the basis of the findings of this research.

South Africa possesses a highly fragmented health system with wide disparities in health spending and inequitable distribution of both health care professionals and resources. The national health system (NHI) of South Africa consists of a large public sector and small private sectors which are overused and under resourced and a smaller private sector which is underused and over resourced. In broad terms, the NHI promises a health care system in which everyone, regardless of income level, can access decent health services at a cost that is affordable to them and to the country as a whole. The relevance of this study is to contribute to the NHI debate while simultaneously providing insights from other countries which have implemented national health care systems. As such, the South African government can then appropriately implement as well as finance the new NHI system specific to South Africa’s current socio-economic status. The objective of this study was to examine health care financing models in different countries in order to draw lessons for South Africa when implementing the NHI. A case study was conducted by examining ten countries with a national health insurance system, in order to evaluate the health financing models in each country. The following specific objectives are pursued: firstly, to review the current health management system and the policy proposed for NHI; secondly, to examine health financing models in a selected number of countries around the world and lastly to draw lessons to inform the South African NHI policy debate. The main findings were firstly, wealthier nations tend to have a much healthier population; this is the result of these developed countries investing significantly in their public health sectors. Secondly, the governments in developing nations allocate a smaller percentage of their GDP and government expenditure on health care. Lastly, South Africa is classified as an upper middle income developing country; however, the health status of South Africans mirrors that of countries which perform worse than South Africa on health matters. In other words the health care in South Africa is not operating at the standard it should be given the resources South Africa possesses. The cause of this may be attributed to South Africa being stuck in what is referred to as the “middle income trap” amongst other reasons.

South Africa has a complex healthcare system. The provision and financing of health care in South Africa occur within two fundamentally different systems: the public healthcare sector and non-governmental not-for-profit organisations, on the one hand, and the private healthcare system, on the other hand. The socioeconomic status of an individual in South Africa is the primary determinant of the system through which he or she will receive access to healthcare. The healthcare services provided by the public and private sectors are perceived to be unequal. The introduction of healthcare reforms by the South African government through the National Health Insurance (NHI) aims to address these disparities. The primary objective of this study was to contribute to the successful implementation of the proposed South African NHI by identifying critical success factors that would impact such implementation. A sample of managerial representatives of the following healthcare institutions in the Nelson Mandela Bay Municipality (NMBM) was drawn: Large private hospitals groups; Eastern Cape Department of Health; Independent medical practitioners groups; South African Dental Association; Pharmacy Association of South Africa; Optometrist Association of South Africa. A total of 250 questionnaires were distributed among these institutions and approximately 233 usable questionnaires were returned (response rate 93.2 percent). A literature review was conducted to identify the various viewpoints (critical success factors, as well as positive and negative perceptions) on NHIs in other countries, as well as the proposed one in South Africa. About 43 of such viewpoints were identified. The 233 respondents were surveyed on these 43 viewpoints. The empirical results revealed the following three critical success factors for the successful implementation of the South African NHI: The projected benefits for stakeholders, with specific reference to medical aid schemes; the projected benefits to the private healthcare sector in servicing the public sector; and strategic leadership. The empirical results also showed that the healthcare managers, who serve the poor versus the affluent geographical areas of the NMBM, differ with regard to their projected success of the NHI. Finally, the study highlighted these health managers’ general perceptions about the envisaged benefits and shortcomings of the NHI.