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Managing moral hazard in motor vehicle accident insurance claims

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Abstract

Motor vehicle accident (MVA) insurance in Canada is based primarily on two different compensation systems: (i) no-fault, in which policyholders are unable to seek recovery for losses caused by other parties (unless they have specified dollar or verbal thresholds) and (ii) tort, in which policyholders may seek general damages. As insurance companies pay for MVA-related health care costs, excess use of health care services may occur as a result of consumers’ (accident victims) and/or producers’ (health care providers) behavior – often referred to as the moral hazard of insurance. In the United States, moral hazard is greater for low dollar threshold no-fault insurance compared with tort systems. In Canada, high dollar threshold or pure no-fault versus tort systems are associated with faster patient recovery and reduced MVA claims. These findings suggest that high threshold no-fault or pure no-fault compensation systems may be associated with improved outcomes for patients and reduced moral hazard.

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References

  • Cassidy, D., Carroll, L.J., Cote, P., Lemstra, M., Berglund, A. and Nygren, A. (2000) Effect of eliminating compensation for pain and suffering on the outcome of insurance claims for whiplash injury. New England Journal of Medicine 342 (16): 1179–1186.

    Article  Google Scholar 

  • Spitzer, W.O. et al (1995) Scientific monograph of the Quebec task force on whiplash-associated disorders: Redefining ‘whiplash’ and its management. Spine 20 (8 Suppl): 1S–73S.

    Google Scholar 

  • Schrader, H. et al (1996) Natural evolution of late whiplash syndrome outside the medicolegal context. Lancet 347 (9010): 1207–1211.

    Article  Google Scholar 

  • Scholten-Peeters, G.G.M. et al (2003) Prognostic factors of whiplash-associated disorders: A systematic review of prospective cohort studies. Pain 104 (1–2): 303–322.

    Article  Google Scholar 

  • Cote, P., Cassidy, D., Carroll, L. and Frank, J.W. et al (2001) A systematic review of the prognosis of acute whiplash and a new conceptual framework to synthesize the literature. Spine 26 (19): E445–E58.

    Article  Google Scholar 

  • Carroll, S., Abrahamse, A. and Viana, M. (1995) The costs of excess medical claims for automobile personal injuries. Santa Monica, CA: RAND Institute for Civil Justice, pp. 1–25.

    Google Scholar 

  • Lemstra, M. and Olszynski, W.P. (2005) The influence of motor vehicle legislation on injury claim incidence. Canadian Journal of Public Health 96 (1): 65–68.

    Google Scholar 

  • Anderson, J.M., Heaton, P. and Carroll, S.J. (2010) The U.S. Experience With No-Fault Automobile Insurance – A Retrospective. Santa Monica, CA: RAND Institute for Civil Justice.

    Google Scholar 

  • RAND. (1996) How Big Is the Price Tag For Excess Auto Injury Claims? Santa Monica, CA: RAND Institute for Civil Justice.

  • Morris, S., Devlin, N. and Parkin, D. (2007) Economic Analysis in Healthcare. West Sussex, UK: John Wiley & Sons.

    Google Scholar 

  • Malleson, A. (2005) Whiplash and Other Useful Illnesses. Montreal, Canada: McGill-Queen's University Press.

    Google Scholar 

  • Cummins, D. and Tennyson, S. (1996) Moral hazard in insurance claiming: Evidence from automobile insurance. Journal of Risk and Uncertainty 12 (1): 29–50.

    Article  Google Scholar 

  • Carroll, S., Abrahamse, A., Marquis, S. and Viana, M. (1995) Liability System Incentives to Consume Excess Medical Care. Santa Monica, CA: RAND Institute for Civil Justice.

  • The National Association of Insurance Commissioners. (1995) State Average Expenditures and Premiums for Personal Automobile Insurance in 1993. Kansas City, MO: The National Association of Insurance Commissioners.

  • RAND. (2010) What Happened to No-Fault Automobile Insurance?. Santa Monica, CA: RAND Institute for Civil Justice.

  • Insurance Bureau of Canada. (2011) Car Insurance Where You Live, http://www.ibc.ca/en/Car_Insurance/Car_Insurance_Where_You_Live.asp, accessed 23 July 2011.

  • Obelieniene, D., Schrader, H., Bovim, G., Miseviciene, I. and Sand, T. (1999) Pain after whiplash – A prospective controlled inception cohort study. Journal of Neurology Neurosurgery Psychiatry 66 (3): 279–283.

    Article  Google Scholar 

  • Cameron, I. et al (2008) Legislative change is associated with improved health status in people with whiplash. Spine 33 (3): 250–254.

    Article  Google Scholar 

  • Boyer, M. and Schiller, J. (2003) Merging Automobile Insurance Regulatory Bodies: The Case of Atlantic Canada. Montreal, Canada: CIRANO.

    Google Scholar 

  • Government of Saskatchewan. (2002) Choice in auto insurance, http://www.gov.sk.ca/news?newsId=964645f5-7543-4e25-9deb-14e9670466b0&newsPN=Shared, accessed 27 August 2011.

  • Marone, J.A. (1988) The long rise and fast fall of healthcare competition. Bulletin of the New York Academy of Medicine 64 (1): 101–116.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Clinical Epidemiology and Biostatistics, McMaster University, HHC 2C, 1280 Main Street West, Hamilton, L8S 4K1, ON, Canada

    Shanil Ebrahim, Jason W Busse, Gordon H Guyatt & Stephen Birch

  2. Department of Anesthesia, McMaster University, Hamilton, ON, Canada

    Jason W Busse

  3. Department of Medicine, McMaster University, Hamilton, ON, Canada

    Gordon H Guyatt

  4. Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada

    Stephen Birch

Authors
  1. Shanil Ebrahim
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  2. Jason W Busse
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  3. Gordon H Guyatt
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  4. Stephen Birch
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Corresponding author

Correspondence to Shanil Ebrahim.

Additional information

Does the type of motor vehicle accident insurance affect driver behavior and the number of accidents? The authors use the variety of insurance systems in Canada and the United States to explore this question.

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Ebrahim, S., Busse, J., Guyatt, G. et al. Managing moral hazard in motor vehicle accident insurance claims. J Public Health Pol 34, 320–329 (2013). https://doi.org/10.1057/jphp.2013.11

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  • DOI: https://doi.org/10.1057/jphp.2013.11

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