The dissertation consists of two essays on insurance markets and regulation. The first essay studies the timing of state-level tort reform enactments between 1971 and 2005. Using discrete time hazard models, we find the level of litigation activity---as measured by incurred liability insurance losses, the number of lawyers, and tort cases commenced---to be the most important and robust determinant of tort reform adoption. Political-institutional factors and regional effects---such as Republican control of the state government, single party control of the legislature and governorship, and a (relatively) conservative political ideology among a state’s Democrats---are also associated with quicker reform adoption. In the second essay, we identify the effect of public guarantees on market discipline by exploiting the rich variation in U.S. state guarantees of property-liability insurer obligations. We find government guarantees significantly reduce the sensitivity of premium growth to changes in financial strength ratings, and that this reduced sensitivity applies to both price and volume changes. The effects are concentrated among insurers rated A- or lower by A.M. Best, the leading financial strength rating agency in the insurance industry. For downgraded insurers, we find that premium growth in business not covered by state guarantees falls in relation to growth in its covered business, with the estimate of the difference being as high as 15% for A- rated insurers and 10% for insurers rated below A-.

Thesis (M.S.)--University of Michigan, 1997. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Dealing with uncertainty is at the heart of financial risk management and asset pricing. This cumulative dissertation consists of four independent research papers that study various aspects of uncertainty, from estimation and model risk over the volatility risk premium to the measurement of unobservable variables. In the first paper, a non-parametric estimator of conditional quantiles is proposed that builds on methods from the machine learning literature. The so-called leveraging estimator is discussed in detail and analyzed in an extensive simulation study. Subsequently, the estimator is used to quantify the estimation risk of Value-at-Risk and Expected Shortfall models. The results suggest that there are significant differences in the estimation risk of various GARCH-type models while in general estimation risk for the Expected Shortfall is higher than for the Value-at-Risk. In the second paper, the leveraging estimator is applied to realized and implied volatility estimates of US stock options to empirically test if the volatility risk premium is priced in the cross-section of option returns. A trading strategy that is long (short) in a portfolio with low (high) implied volatility conditional on the realized volatility yields average monthly returns that are economically and statistically significant. The third paper investigates the model risk of multivariate Value-at-Risk and Expected Shortfall models in a comprehensive empirical study on copula GARCH models. The paper finds that model risk is economically significant, especially high during periods of financial turmoil, and mainly due to the choice of the copula. In the fourth paper, the relation between digitalization and the market value of US insurers is analyzed. Therefore, a text-based measure of digitalization building on the Latent Dirichlet Allocation is proposed. It is shown that a rise in digitalization efforts is associated with an increase in market valuations.:1 Introduction 1.1 Motivation 1.2 Conditional quantile estimation via leveraging optimal quantization 1.3 Cross-section of option returns and the volatility risk premium 1.4 Marginals versus copulas: Which account for more model risk in multivariate risk forecasting? 1.5 Estimating the relation between digitalization and the market value of insurers 2 Conditional Quantile Estimation via Leveraging Optimal Quantization 2.1 Introduction 2.2 Optimal quantization 2.3 Conditional quantiles through leveraging optimal quantization 2.4 The hyperparameters N, λ, and γ 2.5 Simulation study 2.6 Empirical application 2.7 Conclusion 3 Cross-Section of Option Returns and the Volatility Risk Premium 3.1 Introduction 3.2 Capturing the volatility risk premium 3.3 Empirical study 3.4 Robustness checks 3.5 Conclusion 4 Marginals Versus Copulas: Which Account for More Model Risk in Multivariate Risk Forecasting? 4.1 Introduction 4.2 Market risk models and model risk 4.3 Data 4.4 Analysis of model risk 4.5 Model risk for models in the model confidence set 4.6 Model risk and backtesting 4.7 Conclusion 5 Estimating the Relation Between Digitalization and the Market Value of Insurers 5.1 Introduction 5.2 Measuring digitalization using LDA 5.3 Financial data & empirical strategy 5.4 Estimation results 5.5 Conclusion

Background. In average hypertensive patients m China, approximately 3-4 major cardiovascular disease (CVD) events can be prevented in 100 treated with anti-hypertensive drugs for 5 years. Previous cross-sectional studies in healthy individuals showed that their willingness to payout of pocket for anti-hypertensive drugs dropped substantively after they were informed of the quantitative benefits, harms and costs of the treatment. These findings suggest, importantly, that patients should be provided with evidence and engaged in decision making for such conditions as hypertension in order to make decisions that will satisfy patients. This large effect of evidence-informed decision making found in the cross-sectional study has, however, not been confirmed in more rigorous studies and in diagnosed hypertensive patients in the country. We therefore conducted this randomized controlled trial to assess the effect of individualized, evidence-based counseling on medicine-using behaviors of hypertensive patients. / Methods. This is a randomized controlled trial with 210 patients with mild hypertension and free of CVD recruited in two primary care centers in Shenzhen, China. Individualized, evidence-based counseling on antihypertensive treatment and general counseling on lifestyle modifications (103 patients) were compared with general counseling alone (107 patients). The counseling was provided face-to-face and reinforced by a telephone call a week later. The key information provided in the intervention group included the lO-year CVD risk estimated based on an individual's risk factors, individualized benefit expressed in the absolute risk reduction, side effects, and costs of antihypertensive drugs. Medication use and good adherence at 6-month follow up were used as the primary outcomes. / Results. At baseline, the mean age of patients was 54.3 (SD=7.8) years, 49% were men, 62.4% were currently taking antihypertensive medicines which was all covered by health insurance. The overall attrition rate was 8.6%. At six months, the rate of medication use was marginally higher in the intervention group than that in the control group (65.0% vs 57.9%; odds ratio (OR) = l.35, 95% confidence interval (Cl): [0.77, 2.36]; P value= 0.290). The rate of good adherence in the intervention group was also slightly higher than that in the control group (43.7% vs 40.2%; OR= 1.15, 95% Cl: [0.67, 2.00]; P value= 0.607). The difference in medication use and good adherence between the intervention and control groups was however not statistically significant. The results remained unchanged in multivariate and sensitivity analyses. / Conclusions. The individualized, evidence-based counseling made little difference to the use of and adherence to anti-hypertensive medications in insured patients with mild hypertension in China. The lack of effect of informed decision making is likely a result of persistence of entrenched practice in particular for insured clinical conditions. The finding of this study raises important questions as to whether insurance policies and clinical guidelines reflect the true needs and opinions of the patients, and about the usefulness of informing and engaging patients in decision-making under such circumstances. / 背景：對100 例一般中國高血壓患者，進行持續5 年的降壓藥物治療，可預防心腦血管事件3-4 例。健康人群中進行的橫斷面調查結果顯示，研究對象在獲得降塵藥物治療量化的收益、副作用和花費的信息後，其支付意願明顯下降。此結果的重要提示是，應向患者提供此類信息，並且患者參與自身的醫療決策，使其能夠做出符合其價值觀等的決定。然而，目前尚未在中國開展相闊的隨機對照試驗。上述知情決策的顯著效果亦尚未在患者中得到證實。在此項隨機對照試驗中，我們蚣評價個體化、循證諮詢對高血壓患者服藥情況的影響。 / 方法：這是一項雙中心的隨機對照試驗。研究共納入輕度高血壓患者210例，這些患者均無心腦血管病。干預組患者(共103 例)接受關於降壓藥物的個體化、循證諮詢和生活習慣調整的一般諮詢，對照組患者(共107 例)僅接受一般諮詢。我們為每組患者均提供當面諮詢，並於一周後通過電話進行加強。為干預組患者提供的主要信息包括:基於每例患者危險因素評估的10 年心血管病風險，降塵藥物治療的收益、副作用及花費。其中收益以絕對風險降低表示。以諮詢結束後六個月時患者服藥和良好依從性作為主要結局指標。 / 結果：基線調查中，患者的平均年齡為54. 3 (標準差為7.8) 歲，有49% 的患者為男性， 62. 峭的患者目前正在服用降塵藥物，所有患者的降塵藥物花費均由醫療保險全部或部分支付。研究中總失訪率為8.6% 。諮詢結束後六個月，干預組患者整體服藥率較對照組患者稍高(干預組65.0% 對照組57.9%比值比:1.35，95%可信區問: [0.77 ，2.36];p=0.290) 。干預組患者中，良好依從性的比例亦稍高於對照組(干預組43.7%，對照組40.2%:比值比:1.15 , 95%可信區問: [0.67，2.00]; p= 0.607)。在多因素分析和敏感性分析中，上述結果均無顯著變化。 / 結論：個體化、循證諮詢並未明顯改變中國醫療保險覆蓋下輕度高血壓患者的服藥情況。知情決策無明顯效果很可能由固定化的醫療實踐導致，這種情況對醫療保險覆蓋的治療尤其突出。此研究的發現還引出了兩個重要問題:現行的醫療保險制度和臨床指南是否反映患者的真實需要和想法，患者知情並參與決策是否必要。 / Di, Mengyang. / Thesis Ph.D. Chinese University of Hong Kong 2015. / Includes bibliographical references (leaves 127-139). / Abstracts also in Chinese; some appendixes in Chinese. / Title from PDF title page (viewed on 06, October, 2016). / Di, Mengyang. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only.