ALBERT

Description: This paper analyses disclosure duties in insurance contract law in Germany on the basis of questions developed in preparation of the World Congress of the International Insurance Law Association (AIDA) 2018. As risk factors are within the policyholder’s sphere of knowledge, the insurer naturally depends on gaining such knowledge from its policyholder in order to calculate and evaluate premium and risk. Legal approaches as to how the insurer may obtain relevant information and the legal consequences differ in national insurance contract laws around the globe. Taking part in this legal comparison, the paper describes the key elements of such a mechanism from a German perspective and comprises both duties of the policyholder and duties of the insurer. As for the policyholder, these issues are differences between a duty to (spontaneously) disclose and a duty not to misrepresent as a reaction to questions of the insurer, the prerequisites and remedies of such duty, the subjective standard of the disclosure duty and a duty to notify material changes during the contract term. On the other hand, the paper also addresses an insurer’s duty to investigate, a duty to ascertain the policyholder’s understanding of the policy and a duty to inform during the contract term or after the occurrence of an insured event. In doing so, the paper offers a comprehensive and critical overview on the transfer of knowledge in the insurance (pre-)contractual relationship.

Description: Corporate governance is the set of rules, be they legal or self-regulatory, practices and processes pursuant to which an insurance undertaking is administrated. Good corporate governance is not only key to establishing oneself and succeeding in a competitive environment but also to safeguarding the interests of all stakeholders in an insurance undertaking. It is insofar not surprising that mandatory requirements on the administration of insurance undertakings have become rather prolific in recent years, in an attempt by regulators to protect especially policyholders against perceived risks hailing from improperly governed insurance undertakings. In Germany this has been regarded by many undertakings as an overly paternalistic approach of the legislator, especially considering that the German insurance sector has experienced for decades if not centuries a remarkably low number of insolvencies and that German insurers were neither the trigger nor the (especially) endangered actors in the financial crisis commencing in 2007. Notwithstanding the true core of this criticism, that the insurance industry was taken to a certain degree hostage by the shortcomings within the banking sector, the reform of German Insurance Supervisory Law via implementation of the Solvency II-System has brought many advances in the sense of better governance of insurance undertakings and has also brought to light many deficiencies that the administration of some insurance undertakings may have suffered from in the past, which are now more properly addressed.

Description: New technologies influence the insurance sector in Germany in many ways. This is also reflected in changes in the legal framework. For example, the German legislator has introduced new rules for highly and fully automated driving. In the future, autonomous driving will raise the question of the effects of the fact that there is no longer a driver on liability and insurance. The article shows that the German system of owner (“holder” or “keeper”) liability in combination with compulsory liability insurance also offers a convincing solution for this challenge, especially with regard to an effective protection of traffic victims. Another field is cyber risks. They have led to the development of a new insurance cover. Digitalisation presents new opportunities for the contract conclusion process and the regulation of insurance claims, but there are also some legal challenges to be addressed. Last but not least, the use of robots and nanotechnology is leading to new types of risks and to modified coverage concepts. This article deals with current developments in Germany.

Description: With health prevention campaigns health insurance providers can increase the perception of health risks among customers in order to promote healthy behaviour. The presentation format of health information has a significant influence on the health-related behaviour of customers. We investigate in our experimental study the impact of positive vs. negative presentation (message framing) as well as the presentation of health vs. social consequences in health prevention campaigns on health risk perception. The results reveal that loss- (vs. gain-) framed messages and the presentation of health (vs. social) consequences increase health risk perception more strongly. This effect is mediated by a stronger perceived severity of health (vs. social) consequences. Women perceive health (vs. social) consequences more likely and closer in time than men. Our findings show the importance of increasing health risk perception in order to promote healthy behaviour intentions.

Description: Zusammenfassung Kaum eine Rechtsordnung kennt Regeln für die Schadenaggregation in der Rückversicherung. Eine Ausnahme bietet das englische Recht, wo sich diesbezüglich eine reiche Rechtsprechung entwickelt hat. Eine Analyse dieser Rechtsprechung zeigt, dass im Bereich der Schadenaggregation in der Rückversicherung terminologische Unsicherheiten bestehen und dass die von der Rechtsprechung entwickelten Beurteilungsmassstäbe nicht geeignet sind, Rechtssicherheit herzustellen. Dieser Zustand wird der Bedeutung der nichtproportionalen Rückversicherung nicht gerecht. Mit dem Ziel, den Rückversicherungsmärkten mehr Rechtssicherheit zu bieten, schlägt Kapitel 5 der Principles of Reinsurance Contract Law (PRICL) neu konzipierte Regeln zur Schadenaggregation vor.

Description: The digital transformation is of increasing relevance for insurance companies’ business models. It leads to opportunities as well as challenges, especially for IT departments as core enablers or preventers. Against this background, the aim of this paper is to provide a comprehensive overview of digital technologies (e.g., artificial intelligence, cloud computing) and the resulting use cases for the insurance industry. To this end, we conduct a review of academic articles, industry studies and publications of the supervisory authorities. We point to the resulting requirements for an insurer’s IT and find many interdependencies between the digital technologies. Our results therefore emphasize the importance of a holistic digital strategy.

Description: ZusammenfassungIn einem viel erwarteten Urteil stellte der EuGH nunmehr seine Rechtsauffassung hinsichtlich der subjektiven Erfassung von Versicherten unter einem Großrisikovertrag durch eine dort enthaltene Gerichtsstandsklausel klar. Für Kenner der Materie wenig überraschend, hielt der EuGH in der Balta-Entscheidung an seiner Position unter der Peloux-Entscheidung fest, und urteilte, dass solche Gerichtsstandsklauseln grundsätzlich Verträge zu Lasten Dritter wären, würde man sie in der Gestalt auf Versicherte erstrecken – die der Klausel nicht formgültig zugestimmt haben –, dass diese dadurch der Internationalen Zuständigkeit von Gerichten verlustig gingen, die sie ansonsten hätten anrufen können. Der EuGH wendet diesen Grundsatz nunmehr unbedingt auch auf Großrisikoverträge an und weigert sich zudem kategorisch eine Ausnahme zu machen, selbst wenn der Versicherte keine wirtschaftlich schwächere Partei ist, die des Schutzes bedarf, es sei denn, der Versicherte ist selbst ein Gewerbetreibender im Versicherungsbereich. Während dies, eher noch milde ausgedrückt, schwer nachvollziehbar erscheint, verbleiben Möglichkeiten diese untaugliche Rechtsprechung auszuhebeln, um das Rechtsprodukt und die zugrundeliegenden Berechnungsgrundlagen nicht zu gefährden.

Description: ZusammenfassungIn einem viel erwarteten Urteil stellte der EuGH nunmehr seine Rechtsauffassung hinsichtlich der subjektiven Erfassung von Versicherten unter einem Großrisikovertrag durch eine dort enthaltene Gerichtsstandsklausel klar. Für Kenner der Materie wenig überraschend, hielt der EuGH in der Balta-Entscheidung an seiner Position unter der Peloux-Entscheidung fest und urteilte, dass solche Gerichtsstandsklauseln grundsätzlich Verträge zu Lasten Dritter wären, würde man sie in der Gestalt auf Versicherte erstrecken – die der Klausel nicht formgültig zugestimmt haben –, dass diese dadurch der Internationalen Zuständigkeit von Gerichten verlustig gingen, die sie ansonsten hätten anrufen können. Der EuGH wendet diesen Grundsatz nunmehr unbedingt auch auf Großrisikoverträge an und weigert sich zudem kategorisch eine Ausnahme zu machen, selbst wenn der Versicherte keine wirtschaftlich schwächere Partei ist, die des Schutzes bedarf, es sei denn, der Versicherte ist selbst ein Gewerbetreibender im Versicherungsbereich. Während dies, eher noch milde ausgedrückt, schwer nachvollziehbar erscheint, verbleiben Möglichkeiten diese untaugliche Rechtsprechung auszuhebeln, um das Rechtsprodukt und die zugrundeliegenden Berechnungsgrundlagen nicht zu gefährden.

Description: The aim of this paper is to provide an overview of relevant sustainability risks and opportunities in the insurance industry, where we address the asset side, the liability side, and a broader corporate perspective. Furthermore, we discuss approaches on how insurers can deal with these sustainability risks and opportunities, and provide selected empirical insight from the literature and (industry) surveys on current practices mostly for the European market. Our study emphasizes that while climate change represents an important factor in this context, it is by far not the only one. Insurers should thus take a broader approach on managing sustainability risks and opportunities. Furthermore, key barriers include a lack of data and knowledge, which impede transparency between firms with respect to their sustainable management approach.

Description: ZusammenfassungIn dieser Arbeit werden die Indikationskriterien zu humangenetischen Leistungen aus evidenzbasierter fachlicher Sicht dargestellt und die Pflicht zur Kostenübernahme oder die Berechtigung zu deren Ablehnung auf der Basis der gesetzlichen Grundlagen und der Rechtsprechung beleuchtet. Sie soll als eine Handlungsempfehlung sowohl für die indikationsstellende als auch für die gutachtlich tätige ärztliche Person dienen und als ein Appell an den Gesetzgeber, die Ungleichbehandlungen bezüglich humangenetischer Leistungen zu beseitigen.

Description: Digital transformation affects almost every area in societies and has consequences for incumbent companies. With qualitative research, we explore the influencing factors for digital transformation in the financial services sector. We use a PEST-model and Porter’s Five Forces as the underlying structure for our analysis. Our interviews and findings show that the financial services sector face the same current challenges, but their impact is perceived higher in the banking than in the insurance sector concerning social factors and bargaining power of buyers. The character of the current development is evolutionary rather than disruptive. Almost all incumbents currently focus on modernizing and consolidating their backend-systems. The aim is to enable them for new customer-oriented services. A primary driver for the digital transformation is the threat of a broader market entry by BigTechs. Our research provides a comprehensive overlook about the influencing factors of digital transformation using statements from experts in the field.

Description: “Protection of the environment“ and “sustainability“ are more significant than ever. The legal system contributes an important share to the protection of the environment. However, an overview of the German private environmental liability law shows that conventional tort law is not a suitable basis for civil liability for the environmental consequences of officially approved emissions of greenhouse gases. In general, one of the main problems of private environmental liability law lies in proving the individual causality of the conduct of an emitter, as the lawsuit of a Peruvian homeowner against a German energy company pending before the Higher Regional Court of Hamm illustratively demonstrates. The outcome of this lawsuit, which may have an outstanding significance for the status and development of private environmental liability law in Germany, is awaited with great anticipation. The article also briefly examines recent developments in private environmental liability law outside Germany and the question to what extent insurance can be an instrument to protect the environment.

Description: We study yield spreads between government bonds in the European Monetary Union. This segment of the global fixed income market is of particular importance for insurance companies in Europe. Our empirical research strategy is inspired by Gunay (2020) who has analyzed the relationship between credit and liquidity risk in the United States using Granger causality tests. More specifically, we employ the procedure developed by Toda and Yamamoto (1995) to test for Granger causality among yield spreads in five different member countries of the European Monetary Union (namely Austria, Belgium, France, Italy and Ireland) relative to Germany. We examine interest rate data from bonds with three different maturities (5, 10 and 30 years). Given the importance of long-term bonds as asset class for European life insurers and pension funds, the empirical results from the often ignored market for government bonds with a maturity of 30 years should be of interest. With regard to long-term sovereign debt, there is no evidence for Granger causality among the time series examined here. Consequently, the risk premia required by investors to hold government bonds of one specific member country of the EMU do not help to forecast the risk premia that have to be paid by other countries. Given the structure of their liabilities, this empirical finding should be of high relevance for portfolio and risk managers in the European life insurance industry and in pension funds. With regard to the yield spreads to be observed in the market for 10-year government bonds, there seems to be no clear picture. Focusing on fixed income securities with a maturity of 5 years, there is one very interesting empirical finding. The test results reported here seem to imply that there is unidirectional Granger causality running from the yield spreads in all other four countries to Austria. Given that Austria is a comparably small country which is assumed to be in a fiscally stable position, this result could be interpreted as evidence for credit risk premia as being helpful to forecast liquidity risk premia in the market for medium-term government bonds issued by member states of the European Monetary Union.

Description: ZusammenfassungDie Möglichkeit einer Prämienanpassung in der deutschen PKV ist vom Wert des sogenannten auslösenden Faktors abhängig, der mittels einer linearen Extrapolation der Schadenquotienten der vergangenen drei Jahre berechnet wird. Seine frühzeitige, verlässliche Vorhersage ist aus Sicht des Risikomanagements von großer Bedeutung. Wir untersuchen deshalb vielfältige Vorhersageansätze, die von klassischen Zeitreihenansätzen und Regression über neuronale Netze bis hin zu hybriden Modellen reichen. Während bei den klassischen Methoden Regression mit ARIMA-Fehlern am besten abschneidet, zeigt ein neuronales Netz, das mit Zeitreihenvorhersage kombiniert oder auf desaisonalisierten und trendbereinigten Daten trainiert wurde, das insgesamt beste Verhalten.