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Types of Insurers by Form of Ownership. 1. Capital stock companies 2. Mutual companies 3. Lloyd's associations 4. Health Expense Associations 5. Government Insurers. Capital Stock Insurers.
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Types of Insurers by Form of Ownership • 1. Capital stock companies • 2. Mutual companies • 3. Lloyd's associations • 4. Health Expense Associations • 5. Government Insurers
Capital Stock Insurers • 1. Organized as profit-making ventures with stockholders who assume the risk that is transferred by insureds. • 2. Premium charged by insurer is final--there is no form of contingent liability for policyholders. • 3. Board of directors is elected by stockholders. • 4. Earnings are distributed to stockholders as dividends on their stock.
Mutual Insurers • 1. Owned by policyholders • 2. Distinguishing characteristic is distribution of earnings. Money left after paying costs is returned to policyholders as a dividend.
Demutualization • In 1990s--a period of mergers and acquisitions --disadvantages of mutual form of organization became more apparent: • limited mechanisms for accessing capital • structure of mutuals not particularly flexible • mutuals cannot use stock for acquisitions • federal legislation to allow banks and insurers to affiliate requires a holding-company structure
Demutualization • A number of insurers have demutualized -- that is, converted from mutual to stock insurers (or in some cases to a modified proprietary form). • When demutualizing, a mutual insurer issues stock to policyholders, but also sells new stock. • Policyholders have a choice between stock in the new company or cash. • Some take stock and some take cash.
Lloyd’s Associations • 1. Named after London coffee house where modern marine insurance originated. • 2. Lloyds does not write insurance, but is like the New York Stock Exchange, where buyers and sellers transact business. • 3. Originally, insurance was written by over 30,000 “names,” with unlimited liability, usually as members of syndicates.
Health Expense Associations • 1. Originally, Blue Cross and Blue Shield plans were formed to allow prepayment of hospital and physicians services respectively. • 2. Now include Health Maintenance Organizations which provide a wide range of health care services in return for an annual membership fee. • 3. Physician-Hospital Organizations (AKA Provider-Sponsored Organizations) are provider-owned delivery systems being formed in many areas.
The Agent • The agent is the central figure in the marketing process. • The relationship between agents and the companies they represent varies. • Through a process of evolution, several marketing forms have evolved. • Each has as its goal efficiency in distribution and service.
Distinction Between Agent and Broker • Agent:an individual authorized by an insurer to create, modify, and terminate contracts of insurance. • Broker:a representative of the insured who solicits business from insurance buyers but who is compensated by the insurer. • The agent can “bind” an insurer to a risk. • A broker does not have binding authority.
Consultants and Financial Planners • In addition to agents and brokers, there is a growing number of risk management consultants who offer services on a fee basis. • In the personal lines field, there has been rapid growth in the personal financial planning field.
Rating Organizations (Advisory Organizations) • 1. Formerly called “rating bureaus” • 2. Operate in property and liability field • 3. Gather loss statistics and publish trended loss costs • 4. Major Advisory Organizations include • ISO Insurance Services Office • AAIS American Association of Insurance Services • NCCI National Council on Compensation Insurance
Government Insurers Defined • 1. Direct provision by the government • 2. Government reinsurance • 3. Does not include self-insurance of government exposures
Reasons for Government Insurance • 1. Fundamental risks that require compulsion and lack equity • 2. Hazard considered too great by private insurance • 3. Adverse selection against private insurers • 4. Tools of social change by government • 5. Mistaken notion that government can repeal the law of averages
Similarities in Various Fields of Insurance • 1. Although details of operation may vary, the programs discussed all use some form of pooling of exposure units. • 2. The possibility of loss is transferred from the individual to the group where losses are shared on some prescribed basis. • Basic concepts of pooling and sharing of losses and individual’s substitution of small, certain cost for large uncertain loss are fundamental to all the programs.
Functions of Insurers • 1. Ratemaking • 2. Production • 3. Underwriting • 4. Loss Settlement • 5. Investment
Basic Concepts in Ratemaking • Rate Price charged per unit of protection • Premium Determined by multiplying rate by units of protection purchased • Gross Rate Composed of two parts, designed to pay losses and expenses • Pure Premium Portion of the Gross Rate designed to pay losses • Loading Portion of Gross Rate designed to cover expenses of operation
Pure Premium • Total Losses . Exposure Units= Pure Premium • $3,000,000 . 100,000 = $30
Converting Pure Premium to Gross Rate • Expense part of the rateExpense Ratio: expressed as percentage of the final rate • Permissible Loss Ratio: 1 minus expense ratio • Pure Premium .Gross Rate: 1 _ expense ratio • $ 30 = 30 = $50 1 - .40 .60
Underwriting • 1. Basic purpose: avoid adverse selection • 2. Relationship of underwriting to adequacy of rates • 3. Exposure that is unacceptable at one rate may be acceptable at another
Sources of Underwriting Information • 1. The application • 2. Information from the agent or broker • 3. Investigations • 4. Information bureaus • 5. Physical examinations or inspections
Postselection Underwriting • 1. Postselection underwriting (or renewal underwriting) occurs when the insurer decides whether to continue insurance. • 2. Insurer may decline to renew insurance or may offer narrower coverage. • 3. Because cancellation or nonrenewal can impose hardship on insured, some states limit the insurer’s right to exercise these options. • 4. When the option of postselection underwriting is limited, insurers may be more selective in initial underwriting.
Adjusters • 1. Staff adjusters • 2. Adjusting bureaus • 3. Independent adjusters • 4. Public adjusters
Adjustment Process • 1. Notice • 2. Investigation • 3. Proof of loss • 4. Payment or denial
Composition of Insurers’ Investments • Life Property Type of Investment Insurers & Liability • Corporate Stocks 20.6% 21.2% • Corporate Bonds 41.0% 18.3% • Government Bonds 17.1% 51.2% • Mortgages 8.9% 0.4% • Real Estate 2.1% 1.3% • Policy Loans 4.3% • Miscellaneous 6.0% 7.6% • 100.0% 100.0%
Reinsurance • 1. Nature of reinsurance • 2. General approaches • facultative • treaty • 3. Types of treaties • facultative • automatic
Reinsurance in Property & Liability Insurance • 1. Proportional reinsurance • Quota-share • Surplus-share • 2. Excess-of-loss reinsurance
Reinsurance in Life Insurance • Term insurance approach • (reinsure difference between face value of policy and amount of reserves) • 2. Coinsurance approach (quota share)
Functions of Reinsurance • 1. Spreading of risk • 2. Financing function - surplus relief
Miscellaneous Insurer Functions • Legal • Accounting • Engineering