Made available in DSpace on 2015-12-03T18:35:25Z (GMT). No. of bitstreams: 1 Antonio_Aurelio_Duarte.pdf: 1924489 bytes, checksum: 2f7c6abea0e711e944507874b1de384b (MD5) Previous issue date: 2013-07-03 / With the publication of IFRS 4, it was established that the Insurance Enterprises should submit their Technical Reserves to the Liability Adequacy Test - LAT. The Brazilian regulation for this test requires that the Current Estimate is discounted by a Term Structure of Interest Rates-TSIR. As the literature offers several methods for its construction, it will be necessary to choose among them and this condition the result of the LAT application. This paper aims to discuss and apply the interpolation technique by Cubic Spline, the parametric model of Svensson and the one-factor equilibrium model of Vasicek, the construction of TSIR which will be used to discount the Current Estimates of future cash flows under insurance contracts of life-contingent annuities and pensions. As a specific goal, we want to know and analyze the magnitude of the differences found in the results of the LAT from the use of different TSIR models. Rates traded on BM&FBOVESPA will be used to estimate the parameters that characterize each of the models presented. Finally, cash flows hypothetical and observed (Insurer practical case) will be used to perform robustness tests. The results indicate that: 1) The result of Liability Adequacy Test is sensitive to the choice of the model used in the construction of TSIR; 2) The sensitivity increases with the longevity of cash flow, to the extent that the current estimate is sensitive to average term of cash flow; 3) The LAT is an uncertain value in time, as TSIR depends on the macroeconomic factors prevailing at the time of its construction; 4) The adoption of an ultimate forward rate (UFR) for the Brazilian insurance market should be evaluated by the supervisor / Com a publica????o do IFRS 4, ficou estabelecido que as Companhias Seguradoras devem submeter suas Provis??es T??cnicas ao Teste de Adequa????o de Passivo  TAP. A regulamenta????o brasileira para este teste exige que a Estimativa Corrente seja descontada por uma Estrutura a Termo da Taxa de Juros ETTJ. Como a literatura especializada oferece diversas metodologias para sua constru????o, ser?? necess??rio optar por uma delas e, dessa forma, condicionar o resultado do TAP ?? sua aplica????o. Este trabalho tem como objetivo geral discutir e aplicar a t??cnica de interpola????o por Spline C??bico, o modelo param??trico de Svensson e o modelo de equil??brio unifatorial de Vasicek na constru????o da ETTJ que ser?? utilizada para descontar a Estimativa Corrente das obriga????es decorrentes dos contratos de seguros com cobertura por sobreviv??ncia. Como objetivo espec??fico, deseja-se conhecer e analisar a magnitude das diferen??as encontradas nos resultados do TAP decorrente da utiliza????o de diferentes modelos de ETTJ. As taxas negociadas nos preg??es da BM&FBOVESPA ser??o utilizadas para estima????o dos par??metros que caracterizam cada um dos modelos apresentados. Por fim, fluxos de caixa hipot??ticos e observados (caso pr??tico de uma Seguradora) ser??o utilizados para performar os testes de robustez. Os resultados indicam que: 1) O resultado do Teste de Adequa????o de Passivo ?? sens??vel ?? escolha do modelo utilizado na constru????o da ETTJ; 2) Esta sensibilidade aumenta com a longevidade do fluxo de caixa, na medida em que a Estimativa Corrente ?? sens??vel ao prazo m??dio dos pagamentos inerentes ao fluxo; 3) O TAP ?? um valor incerto no tempo, dado que a ETTJ depende dos fatores macroecon??micos vigentes na data de sua constru????o; 4) A ado????o de uma taxa a termo de longu??ssimo prazo (UFR) para o mercado segurador brasileiro deveria ser avaliada pelo regulador

In the UK and Saudi Arabia, it is necessary for the contracting parties in insurance contracts to comply with the requirement of the doctrine of utmost good faith. In recent years, the doctrine of utmost good faith and the mutual duties of the contracting parties have developed in different ways in each jurisdiction. Both jurisdictions provide consumer protection in insurance markets by Consumer Insurance (Disclosure and Representation) Act 2012 in the UK and Insurance Consumer Protection Principles 2014 in Saudi Arabia. However, there are many differences between the conduct of each jurisdiction since the coming into force of the Insurance Act 2015 in the UK, which revolutionised the insurance law in several key areas. This thesis particularly aims to critically analyse the reform of the doctrine of utmost good faith and looks at how the current reform impacts on the interpretation of this doctrine between the UK and Saudi jurisdictions. This study critically analyses the insureds’ pre-contractual duties for consumers and businesses in the UK with a comparison to Saudi law.

Régulièrement frappées par la violence de la vie en société, les victimes traumatisées recherchent, par le biais du droit de la responsabilité, un soutien pour leur permettre une juste réparation de leur préjudice. Si, auparavant, l’intérêt se portait essentiellement sur l’aspect corporel des atteintes portées par l’activité humaine, désormais il semble nécessaire de composer avec l’aspect psychologique des victimes. L’appréhension de ces préjudices est encore balbutiante en matière de droit de la responsabilité nécessitant une approche structurée pour répondre aux problématiques liées à leur mise en œuvre. La multiplication des évènements traumatisants – attentats, catastrophes, agressions physiques diverses, etc. – a contribué à la multiplication des préjudices psychologiques par la jurisprudence. Ce phénomène invite ainsi à réfléchir à la fois à une structuration théorique et une mise en œuvre pratique des préjudices psychologiques. Cette étude offrirait alors la possibilité de répondre aux interrogations régulières sur ce sujet. Quels sont les faits générateurs susceptibles de créer un traumatisme psychologique ? Peut-on envisager une notion unitaire de préjudice psychologique ? N’existe-t-il pas de complexité particulière liée à l’évaluation de ce préjudice ? Ou encore, la rétribution monétaire est-elle la seule réponse que le droit de la responsabilité civile puisse apporter à une victime qui demande la réparation de son préjudice psychologique ? Si les normes en vigueur semblent répondre en partie à ces interrogations, l’absence de structuration pousse à réfléchir à une approche nouvelle et cohérente afin de ne pas dénaturer le droit de la réparation / Regularly hit by the violence of life in society, traumatized victims look through tlegal liability, support to provide them fair compensation for their injuries. If earlier, interest has focused on the physical appearance of infringements by human activity, now it seems necessary to deal with the psychological aspect of the victims. The apprehension of these losses is still in its infancy in terms of liability law requiring a structured approach to address the problems related their implementation. The proliferation of traumatic events - terrorist attacks, disasters, various physical assaults, etc. - Has contributed to the proliferation of psychological harm by case law. This phenomenon then invited to reflect on both a theoretical structure and a sustainable practical implementation of psychological harm. This study would offer the opportunity to respond to regular questions on this subject. What are the operative events may create a psychological trauma ? Could there be a unitary concept of psychological harm ? Does not exist any particular complexity related to the assessment of that damage ? Or is it monetary compensation the only answer that the law of civil liability can make to a victim who seeks compensation for psychological harm ? If the standards in force seem to respond in part to these questions, the absence of structuring pushes to think about a new and coherent approach in order to not to distort the right to repair

私法上的法律行為必有其主體，並以意思表示為要素，而以發生私法上效果為其目的。其成立與否所須包涵之要素有三，即當事人、意思表示及標的三者。當事人，係指於法律行為中享受權利、負擔義務之人，且經由當事人意思表示始構成法律行為，缺此主體則法律行為失其附麗而無由成立；契約，則為雙方當事人以發生債之關係為目的，相互為對立的意思表示，趨於一致的法律行為。保險契約，亦屬於契約之一種，其成立與否，自應檢視是否包含當事人、意思表示及標的三者。我國保險法第1條規定：「本法所稱保險，謂當事人約定，一方交付保險費於他方，他方對於因不可預料，或不可抗力之事故所致之損害，負擔賠償財物之行為。」就上述三要件中，意思表示，一般情形下係指「要保」（要約）之意思表示，及「承保」（承諾）之意思表示合致，保險契約即為成立 ；而標的則係指法律行為的內容，保險標的之內容相當複雜，保險標的僅係其中一項，除此之外，尚包括保險金額、保險期間、保險事故、保險費及其他非屬必要之點者。關於此二要件，除了保險契約是否為要式契約或要物契約，仍受學者爭議外，一般而言並無太大問題。然而就保險契約之主體─當事人之角色，多數學者均僅依我國保險法第3條及第44條之規定，而逕認保險當事人係指保險人及要保人 ，而鮮少有對於保險當事人定位之問題提出質疑者。 事實上保險當事人之角色，於英美法系之制度，與大陸法系之制度迥然不同，前者以被保險人（the insured; the assured）與保險人（the insurer; the underwriter）為當事人；而後者則以要保人（the applicant; 日：保險契約者；德：der Versicherungsnehmer）與保險人（日：保險者；德：der Versicherer）為當事人。兩者對於保險當事人之定義及內涵，及其所扮演之角色各有不同之規定，然我國保險法學者則不分英美法系或大陸法系之學者，均認要保人及保險人為保險契約之當事人。此或係由於我國保險法第3條規定：「本法所稱要保人，指對保險標的具有保險利益，向保險人申請訂立契約，並負有交付保險費義務之人。」因此自然以訂立契約之人（為意思表示之人）為保險契約當事人之一方，而以而為承諾意思表示之保險人為他方當事人。若我國保險法僅對要保人做此定義，則此說應係相當合理且明確的解釋。然而相當值得玩味的是，保險法第4條另對於「被保險人」有所定義：「本法所稱被保險人，指於保險事故發生時，遭受損害，享有賠償請求權之人，要保人亦得為被保險人。」若將保險法第3條及第4條及同法其他相關規定合併觀之，則會發生許多混淆不清，及難以解決之問題。 本文即在對於保險契約當事人究應做何定位，就不同法系之規定加以比較與分析，並期望透過本文所建議之修法方式，使保險契約當事人之定位能臻於明確，以避免依現行法律及學說所造成之困擾與紛爭，以早日達成政府所規劃之「亞太營運中心」目標。

This research thesis is a policy assessment of the factors that contribute to the current status in treating autism. The policy assessment begins with a description of the key components that that influence policy outcomes in regard to autism. After developing a policy model that outlines various components of issues and approaches to the policy has on Autism, the paper examines several issues with regard to Autism policy, including the lack of insurance coverage, state legislation, waiting lists, evidence vs. non evidence treatments, and the high price for treatments. The paper also examines current approaches to Autism, and potential solutions. Solution analysis on current policy alternatives is provided and, this suggests that increasing knowledge and awareness of the affects of autism on society needs further attention along with proper funding for early treatment.

La santé est un risque. La raison d’être de l’assurance est de couvrir les individus contre les aléas de la vie. Pourtant, la nature économique de cette opération a conduit les assureurs à écarter de leur mutualité, de manière croissante, les plus hauts risques de survenance d’un sinistre. Cette pratique appelée la segmentation est parfaitement autorisée. L’assureur peut, au moment de la discussion précontractuelle, procéder à une évaluation du risque par des investigations sur la situation personnelle et intime du candidat à l’assurance. Plusieurs constats sont faits. Le fait justificatif de discrimination n’est plus précis. Les techniques de collecte de l’information s’émancipent d’un encadrement légal sécurisé. L’existence d’un risque aggravé a des conséquences déraisonnables sur le contrat d’assurance. En France, plus de 2,7 millions de personnes présentent, au sens des assureurs, un risque aggravé du fait de leur état de santé. Il s’agit aussi bien de personnes diabétiques, atteintes de la maladie de parkinson ou ayant développé une pathologie cancéreuse. Pour eux l’accès à l’assurance rime avec le refus, les exclusions ou les surprimes. Ce phénomène concourt à une véritable injustice sociale, particulièrement lorsque le contrat d’assurance conditionne l’octroi d’un crédit immobilier. Pour cette raison, et sous les pressions associatives, des mesures ont été prises visant à limiter l’intrusion de l’assureur dans la vie privée du preneur d’assurance et parallèlement à renforcer les obligations d’information, de conseil ou de mise en garde du professionnel préalablement à la souscription du contrat / Health is a risk. The main purpose of insurance is to cover individuals against life’s uncertainties. However, because of the economic nature of this activity, insurers discard more and more the highest risks from their mutuality. This practice, named segmentation, is perfectly allowed. The insurer may, at the time of precontractual discussions, carry out a risk assessment by investigating the personal and intimate situation of the applicant. Several observations can be made. Evidence of discrimination is no longer precise. The techniques for information gathering emancipate themselves from a secure legal framework. The existence of an increased risk has unreasonable consequences on the insurance contract. In France, more than 2.7 million people are, in the sense of insurers, increased risks profiles due to their health status. Those are people living with diabetes, Parkinson's disease or other cancerous pathologies. For them, access to insurance rhymes with refusal, exclusion or additional premia. This phenomenon contributes to a real social injustice, especially when the insurance contract is necessary to be granted a mortgage. For this reason, and under pressures from associations, some measures have been implemented to limit the intrusion of the insurer into the policyholder’s privacy; and in parallel, to strengthen the obligations lying on the professionals to provide information, advice and warning, prior to any contract subscription

An insurance contract is a contract of utmost good faith. The nature of the insurance bargain makes the duty a commercial necessity. Duties of disclosure and representation, which were two fundamental components of the principle of utmost good faith, operate in different ways in England and China. The insured and insurer in these two countries bears distinctive good faith related obligations pre- and post-contractually. English insurance law exercise considerable influence in most common law countries and some civil law jurisdictions. The separation between utmost good faith and the duty of fair presentation, with the abolition of the avoidance remedy, under the Insurance Act 2015 could influence other jurisdictions to alter their remedies. This thesis examines the application of the civil law notion of good faith and the common law duty of utmost good faith. It covers the operation of insured’s pre-contractual duties of disclosure and representation in both countries. The thesis considers the insurer’s duties as well as the continuing duties and the effect of utmost good faith taking in account the recent legislative changes on fraudulent claims and late payment. The thesis further examines the legal status of brokers and their disclosure duty in China and England. Finally, it also provides special considerations on consumers and micro-businesses.

The thesis deals with complex questions of life insurance primarily on the Czech insurance market. At the beginning of the work, life insurance is described from a theoretical point of view and its main characteristics and mechanisms are outlined. In the next step, the main topics, which have the most important place in life insurance, are analysed. It is comparison of the insurance in Europe. Then, it is current use of life insurance mainly for covering of the short-term income in case of health problems. It also deals with the opinion of young people on insurance and with approach of ordinary people to the health form connected with a new contract. For the savings, there are capital and investment life insurance mentioned. The investment life insurance is the very important part because of the problems, which it has created in the last 15 years. The thesis also speaks about the possibilities of insurance for athletes. Finally, a small questionnaire had been completed by people on the street. Own contribution of the thesis is to demonstrate problematic parts of life insurance for the clients and explanation why it is so.

Summaries in English and Afrikaans / Wanvoorstelling van wesenlike feite deur omiss/o aan 'n versekeraar kan tot gevolg he dat die versekeringskontrak ongeldig verklaar word ingevolge die gemene reg. In Mutual and Federal Insurance Co Ltd v Oudtshoorn Municipality 1985 (1) SA 419 (A) is beslis dat wesenlikheid bepaal moet word vanuit die oogpunt van die redelike man. In 'n paging om bewys van die wesenlikheid van feite te vermy, het versekeraars vereis dat aansoekers die voorstellings in die kontrak moat waarborg. Dit het tot gevolg gehad dat voorstellings wat in die kontrak gewaarborg is outomaties wesenlik was. Sedert die invoering van artikel 63(3) van die Versekeringswet 27 van 1943 deur die wetgewer gedurende 1969, is die wesenlikheid van voorstellings egter 'n vereiste, selfs waar dit in die kontrak gewaarborg is. Versekeraars sou dus in die toekoms nie agter kontraktuele wanvoorstellings kon skuil nie. Hierdie maatreel het meer beskerming aan die versekerde gebied. In Qilingele v South African Mutual Life Assurance Society 1993 (1) SA 69 (A) is die toets vir wesenlikheid, soos vereis deur artikel 63{3), aangespreek. Dit het die vraag laat ontstaan of daar twee aparte toetse vir wesenlikheid bestaan, naamlik gemeenregtelik en statuter, en of daar een algemene toets bestaan. / Misrepresentation by omissio of material facts to an insurer may lead to an insurance contract being declared invalid in terms of the common law. In Mutual and Federal Insurance v Oudtshoorn Municipality 1985 (1) SA 419 (A) it was decided to determine materiality in the eyes of the reasonable man. To avoid proving materiality of facts, the insurers required proposers to warrant the representations in the contract. This resulted in the facts automatically being material. In 1969 parliament, .however, enacted section 63(3) of the Insurance Act 27 of 1943 whereby materiality of presentations, even where it was warranted in the contract, became a requirement. Therefore insurers could in future not hide behind contractual misrepresentations. This provided more protection to the insured. Qilingele v SA Mutual Life Assurance Society 1993 (1) SA 69 (A) addresses the test for materiality as required by section 63(3). This resulted in the question whether two separate tests for materiality in terms of common law and statute, or only one exists. / Criminal and Procedural Law / LL.M.

Healthcare fraud is a major problem within the healthcare industry. The study examined medical fraud, its laws, and punishments on federal and state levels. It compared medical fraud to non-fraud crimes done in the healthcare industry. This comparison will be done on a state level. The study attempted to analyze the severity of fraud against non-fraud and that doctors would commit fraud offenses more often than non-fraud offenses.