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This question is purely about the economical efficiency of insurance vs self-funding. My hunch is that it is not because not only does the insurance company have to pay medical bills, but they have to pay their own employees, and people taking advantage of insurance, and lawyers. If somebody knows the percentage of what somebody would pay with one method over another method, I would find that very enlightening.
Nearly all large corporations in the US commonly self-insure and then hire the insurance companies to handle the paperwork. This catchy little approach allows them to offer medical insurance and then unilaterally change the policy at will if they feel their employers are using a particular benefit too much. This was messy in the early days of AIDS when company's that had claimed they had $1M in covereage per employee would suddenly cap AIDS-related claims at $50,000. Affected employees sued--since it was now too late to get outside insurance and lost at the supreme court level.
In a pure economical sense, I suppose it would be best to self-insure most things if you have the funds. One place where it might make sense to purchase insurance is if you have a high probability of that event happening, over the rest of the population. High frequency events to the overall population are typically worked into the price of the premiums. If the frequency is low over the population, but high for you, insurance can be more cost effective. By self insuring, you avoid paying anything that the insurance company requires on top of the actual payment for the service (namely administrative costs and profit). Additionally, insurance companies must set their prices of offset "moral hazard" (the increased chance of loss due to policyholder extra risk arising from such things as undisclosed illness, etc...the policyholder has a better idea of whether or not they will need the policy) and "adverse selection" (policyholders may take out more insurance than normal because they may know they have a higher probability of using the insurance. Exactly what we were talking about above).
Depends on the type of insurance. Typically, for any liability type coverages, Atwater medical/health, the insurance is more economical, because there's NO CAP to how much you could be sued for, or how many accidents you could get into, or how sick you could get (unless you count death as a cap!). So very, very wealthy people will self insure their property, because you know up front, that the most you could lose, is the $500,000 house, or the $50,000 car, or the $20,000 boat. But they will STILL carry liability policies on these, for what people can sue them for, because there's no limit to the number of claims that can be filed. **I've insured "self insured" larger corporations. Most of the big dogs, will "self insure" the first $100,000 of an auto accident, or the first $250,000 of workers compensation, or the first $500,000 of general liability, and then buy coverage Atwater EXCESS of that, in case they have a really really bad incident. Then they hire a company - like an insurance company - to adjust the claims for them, they just pay the bill up to the "self insured" amount.**
Good question. Another question is "would you be ok if you had to use these funds or would you rather hang onto them or have them for a loved one in the future? Are you using these funds now or are they sitting idle? have you learned how to have your own banking ststem with a whole life policy that allows you to use the money [about 60-70% immediately] and still have full coverage?