Life-Course Control via Accident- and Health Insurance. From Controlling to Advising Practice in the Regulation of Insurance Claims

Team: Prof. Dr. Rainer Müller, Prof. Dr. Dietrich Milles, Dr. Thomas Behrens, Dipl.-Soz. Marcus Kahrs, Dr. Gerd Marstedt, Dipl.-Soz. Renate Niedermeier, Dr. Thomas Schulz, Dr.des. Rebecca Schwoch

During the previous research phases, the projects C1 and D1 assessed concepts and strategies of action within institutions of the German Social Security System (health and accident insurance). During the final period we would like to examine the previous findings of the two projects in terms of their transinstitutional validity and scope (relating to the various insurers). At the same, time we intend to focus systematically on sociopolitical risks and control mechanisms of Social Security institutions that had been studied in the other Sfb-projects. The studies of the co-operative project C1/D1 aim at a profound differentiation between secular trends - especially in the sense of a life-course policy and the establishment of a new "welfare-culture" that is oriented according to needs - and partial paths of development that only apply to specific organisations and institutions, or particular groups of clients. In this context, we intend to contribute four relevant statements to the sociopolitical discussion:

• On life-course policy in the different social-welfare institutions: We would like to achieve a trans-institutional assessment of tendencies of change in the risk evalua-tion in other social welfare systems. Can we generally observe tendencies of a life-course policy and new welfare culture that is breaking with traditional principles?
• On historical changes of primary and secondary risks: We intend to perform a historical-comparative and trans-institu-tional analysis of the guiding principles, risk concepts, and patterns of regulation in the institutions of the social health- and accidentinsurance organisations. In addition, we would like to assess the stability and capability of expansion of the German social welfare model by comparing it to new developments and structural features of the health-insurance systems in other countries (Netherlands, Great Britain, USA) based on previously published studies and reports.
• On learning processes and modernisation strategies in the organisations of the social health insurance system: The findings on changing concepts of control and how various health-insurance plans and accident insurers conceive themselves, reveal the opportunity to analyse the organisational base of such changes in order to detect evidence for the explanation of nonsimultaneous developments within the organisations of the health insurers and relative to the accident insurance.
• On changing norms of life-course planning: In this field we intend to assess the results that have been achieved during the questionnaires of insured persons (project C1) as well as through the procedural analyses of individual demand and needs towards the Social Security System and the insurer organisations (project D1), and contrast these findings with other (previously published) data.