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Risk Management and the Insurance Industry Chapter 22. ©2005, Thomson/South-Western. Chapter Objectives . Indicate the size of the insurance industry Describe how the insurance business is divided between the private and public sectors

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chapter objectives
Chapter Objectives
  • Indicate the size of the insurance industry
  • Describe how the insurance business is divided between the private and public sectors
  • Explain why personal insurance has a larger premium volume than property insurance
  • Identify and explain the differences between stock companies, mutual companies, Lloyd’s associations, and reciprocal insurers
  • Indicate which types of insurance have the largest volume
  • Explain how insurance guaranty funds operate
  • Describe how insurance is distributed from insurers to consumers and list the differences between types of agents and brokers in insurance
  • Described the global nature of risk management and the insurance industry
the field of insurance
The Field of Insurance
  • Insurance coverages can be divided into various opposing categories
    • Personal (life and health) vs property (buildings, homes, autos)
    • Government (flood insurance) vs private (product liability)
    • Involuntary (Social Security) vs voluntary (fire insurance)
  • The categories are not mutually exclusive and they overlap
  • Figure 22-1 depicts the major classifications of insurance and what they have in common with each other
personal coverages
Personal Coverages
  • Those related directly to the individual
  • The risk they cover is the possibility that some peril may interrupt the individual’s income, such as
    • Death, accidents and sickness, unemployment, and old age
    • Insurance is written on each
      • Private insurers are active in providing insurance for death, accidents and sickness, and old age
      • Governmental units are active in all categories
property coverages
Property Coverages
  • Directed against perils that may destroy property
  • Property insurance is distinguished from personal insurance
    • Personal insurance covers perils that may prevent one from earning money with which to acquire property in the future
    • Whereas property insurance covers property that is already acquired
      • Property insurance as used here includes fire, marine, liability, casualty, and surety insurance
  • Sometimes referred to as general insurance, property/liability insurance, or property and casualty insurance
private and public insurance
Private and Public Insurance
  • Private insurance consists of all types of coverage written by privately organized groups
    • Consists of associations of individuals, stockholders, policyholders, or some combination of these
  • Public insurance includes all types of coverage written by government bodies or operated by private agencies under government supervision
voluntary and involuntary coverages
Voluntary and Involuntary Coverages
  • Most private insurance comes under the rubric of voluntary coverage
  • A major part of government insurance is involuntary coverage
    • It is required by law that insurance be purchased by certain groups and under certain conditions
      • Examples of required insurance include automobile liability insurance and workers’ compensation insurance
voluntary and involuntary coverages9
Voluntary and Involuntary coverages
  • Table 22-1 shows the importance of private passenger auto insurance
  • Table 22 -2 shows that PPA made up 33.1 percent of total premiums in 1980 although there has been a relative decline since 2000
    • Due to the dramatic increases in commercial lines insurance premiums during the hard insurance market
stock companies
Stock Companies
  • A corporation organized as a profit-making venture in the field of insurance
  • For companies organized in the United States
    • A minimum amount of capital and surplus is prescribed by state law to serve as a fund for the payment of losses and for the protection of policyholders’ funds paid in advance as premiums
  • Organized with authority to conduct certain types of insurance business
  • Some pay dividends to policyholders on certain types of insurance
  • Never issue what is called an assessible policy
    • The insured can not assess an additional premium if the company’s loss experience is excessive
  • The stockholders are expected to bear any losses
    • And they also reap any profits from the enterprise
mutual companies
Mutual Companies
  • Organized under the insurance code of each state as a nonprofit corporation owned by the policyholders
  • Has no stockholders
  • No profits are made
    • Because any excess income is returned to the policyholder-owners as dividends
      • Or is used to reduce premiums, or retained to finance future growth
  • The company is managed by a board of directors elected by policyholders
  • Many types of mutual organizations exist and operate under different laws and with different types of businesses
class mutuals
Class Mutuals
  • Operate in only a particular class of insurance
    • Such as farm and property, lumber mills, factories, or hardware risks
  • Farm mutuals
    • Specialize in farm property insurance
    • Insure a large portion of farm property in some states, primarily because of the specialized nature of the risks
  • Factory mutuals
    • Specialize in insuring factories
    • Place emphasis on loss control
    • Generally do not solicit small risks due to the relatively high cost of inspection, engineering services, surveys, and consultations that are provided by the organization in an attempt to prevent losses before they occur
general writing mutuals
General Writing Mutuals
  • One that accepts many types of insureds
  • Require an advanced premium calculated on roughly the same basis as that of a stock insurer
  • Operate in several states or even internationally
  • May or may not pay a refund of the portion of the premium of the dividend if experience warrants it
  • Many mutuals insist on relatively high underwriting standards
    • Taking only the best risks so that a dividend will more likely be paid
  • Some mutuals are both participating and deviating
    • They plan to cut the initial rate somewhat below stock company levels and to pay dividend if warranted
fraternal carriers
Fraternal Carriers
  • Designed as a nonprofit corporation, society, or voluntary association, without capital stock, organized and carried on solely for the benefit of its members and their beneficiaries
  • Have a lodge system with a ritualistic form of operation and a representative form of government that provides for the payment of benefits in accordance with definite provisions in the law
  • As charitable, benevolent associations, they usually are exempt from taxation
  • Some of the largest mutual insurers have converted to stock firms including
    • Metropolitan, Prudential, and John Hancock
  • Sometimes called an interinsurance exchange
  • Like a mutual in that both are formed for the purpose of making the insurance contract available to policyholders at cost
  • Basic differences exist between the legal control and capital requirements of reciprocals and mutuals
    • In a reciprocal, the owner-policyholders appoint an individual or a corporation known as an attorney-in-fact to operate that company, as opposed to the board of directors
    • A mutual is incorporated with a stated amount of capital and surplus
      • Whereas a reciprocal is unincorporated with no capital as such
  • Operate mainly in the field of automobile insurance
lloyd s associations
Lloyd’s Associations
  • An organization of individuals joined together to underwrite risks on a cooperative basis
  • Each member assumes risks personally and does not bind the organization for these obligations
  • Each investor is individually liable for losses on the risks assumed to the fullest extent of personal assets
    • Unless the liability is intentionally limited
  • Similar to reciprocals in that each underwriter is an insurer
    • However, a reciprocal is composed of individuals who are both insurers and insureds at the same time
      • Whereas a Lloyd’s association is a proprietary organization operated for profit
london lloyd s
London Lloyd’s
  • Lloyd’s started in 1688 in London as an informal group of merchants taking marine risks
  • Their operations are now worldwide
    • Operate extensively in the United States largely in the surplus line market
      • Consist of risks that domestic insurers have rejected for one reason or another
  • In 2004 nearly 66 underwriting syndicates existed
    • Groups of names that combine their resources and employee manager
      • Who determines which risks to insure
relative importance of private insurers
Relative Importance of Private Insurers
  • Thousands of insurance companies operate in the United States
  • However, most of that business is done by relatively few insurers
  • The leading states for property-liability insurers are Vermont, Texas, New York, and Pennsylvania
    • For life insurers the leading states are Arizona, Texas, and New York
relative importance of private insurers21
Relative Importance of Private Insurers
  • Stock companies tend to dominate as underwriters of various lines of property-liability insurance
  • Mutuals enjoy their greatest markets in the fields of personal automobile and workers’ compensation insurance
  • Lloyd’s and reciprocals account for only a small share of the total property-liability insurance market
  • In the field of life and health insurance, there are more than twelve times the number of stock companies than mutuals
  • In property-liability insurance, mutual companies have grown more rapidly than stock insurers
    • Mutuals have tended to specialize in types of insurance for which the markets have been growing most rapidly
    • Mutuals have used cost-cutting methods that generally have made the product available at lower rates
insolvency of insurers
Insolvency of Insurers
  • Insurance institutions are not backed by a federal agency in the same way bank deposits are protected
  • The danger of loss from insolvent property-liability insurers has been recognized by the establishment in all states of guaranty funds
    • These funds must reimburse the policyholders for any losses caused by bankrupt insurers
      • Subject to stated deductibles and maximum loss limits that vary from state to state
      • The funds are supported by assessments against other insurers operating in the same state
insolvency of insurers23
Insolvency of Insurers
  • Various reasons exist for property-liability insolvencies including
    • Inadequate pricing
      • Usually discovered when loss reserves are insufficient to pay claims
    • Rapid growth
    • Fraud
    • Overstatement of the value of certain assets
employment in insurance
Employment in Insurance
  • The insurance industry employed approximately 2,222,000 persons in 2002
  • Most of the jobs are salaried positions
  • Fewer than 1/3 are in marketing or distribution
    • This contradicts the frequently-held opinion that most jobs in insurance are in sales
ownership of insurance
Ownership of Insurance
  • Data from the Insurance Information Institute reveals that the property-liability insurance industry has been able to reach most U.S. citizens who own homes or autos
  • Roughly 95 percent of homeowners indicated that they had purchased property or liability insurance on their homes and possessions
  • Some type of life insurance is owned by approximately 75 percent of Americans
direct distribution in life insurance
Direct Distribution in Life Insurance
  • Life insurance is distributed in two main ways
    • Salaried group insurance representatives
    • Individual insurance agents who usually work on commission
  • Life insurance is also sold by direct contact with the consumers in advertising, mail order, or the internet
    • The insurer maintains a one-on-one relationship with the insured
      • Independent intermediaries usually are not involved
group insurance
Group Insurance
  • Life insurers offer many of their products on a group basis
    • Under contracts covering groups of persons rather than individuals
  • Customers from group coverage are generally business firms
  • Persons employed to sell and service businesses usually receive a salary and bonus
individual agents
Individual Agents
  • Policies sold to individuals are usually handled by persons known as agents, underwriters, or financial planners
  • The agent or underwriter contacts the ultimate consumer and reports directly to the insurer or intermediary who in turn reports to the insurer
  • The authority of the underwriter or agent is limited
individual agents29
Individual Agents
  • A general agent in life insurance is an individual employed to hire, train, and supervise agents at lower levels
    • Sometimes collects premiums and remits them to the insurer’s home office
    • Not an independent intermediary in the sense that a typical wholesaler is
      • General agent does not exercise final control over the issuance terms of the contract
        • The company normally is not bound by the general agent in putting a contract in force
      • The general agent exercises no control over the amount of premium, has no investment in inventory, does not own any business written, and has no legal right to exercise any control over policyholders once he or she leaves the employment of the company
reasons for direct distribution in life insurance
Reasons for Direct Distribution in Life Insurance
  • The system of direct distribution has grown up in life insurance because of several basic factors
    • The insurer’s need to maintain close control over the policy product
    • The insurer’s need to exercise control over sales promotion and competition
    • The infrequent purchase of life insurance
    • The agent’s ability to make a better living through specialization
the changing environment in the life insurance company
The Changing Environment in the Life Insurance Company
  • From the 1950s to 1987 individual life insurance new premiums maintained respectable growth greater than, or equal to, the rate of inflation
    • Real growth in new premiums was occurring
  • Beginning in 1987 that pattern ceased
    • In 1988 new premiums actually declined
  • Changes in U.S. demographics have contributed to the shifting of business volume away from individual life insurance
    • As the overall population aged, people became more interested in financial products that were accumulation centered
      • Rather than protection and accumulation
      • These changes have meant that life insurers increasingly find themselves competing with banks and mutual fund companies for consumers’ investment dollars
direct writing in property liability insurance
Direct Writing in Property-Liability Insurance
  • In some lines, independent intermediaries have been eliminated
    • Contract is marketed directly from the insurer to the insured through either exclusive agents or employees who work on salary and commission
      • They solicit prospects, take care of paperwork, and serve as the insurer’s direct contact with the insured
direct writing in property liability insurance33
Direct Writing in Property-Liability Insurance
  • An exclusive agent of a direct writer represents only one insurer
    • Does not own business written and generally does not handle loss claims or collect premiums
    • Receives a commission but it is a lower percentage than the commissions allowed independent agents
    • The main tasks of the exclusive agent are to
      • Sell new business
      • Keep in contact with customers
      • Served as a communications link between the insurer and the insured
direct writing in property liability insurance34
Direct Writing in Property-Liability Insurance
  • Direct writers have their greatest volume in the field of automobile insurance
  • They have been able to sell insurance at lower cost to the final consumer
  • Innovations have occurred in automobile insurance including
    • Continuous policies, lower agents’ commissions, direct billing from the insurer to the customer and specialized adjusting offices to handle claims
indirect distribution american agency system
Indirect Distribution (American Agency System)
  • The insurance is not sold directly by the insured to the policyholder but rather is sold through a system of intermediaries
    • Comparable to the wholesaler-retailer system in tangible goods marketing
  • The independent agent is an autonomous, local intermediary in the property insurance business
    • As the “retailer,” the independent agent deals with the final consumer of insurance
    • The independent agent usually represents 10 to 30 or more separate insurers and has authority to bind these insurers on most of the contracts written
brokers vs agents
Brokers vs Agents
  • Brokers operate in a manner similar to local agents
    • Legally brokers represent the consumer, not the insurer
  • If the customer asks a broker to obtain insurance, the broker must contact with the insurer before coverage is binding
  • Agents may bind coverage immediately
    • Because they are the legal representatives of the insurer
    • Many brokers also hold agency contracts
is the american agency system doomed
Is the American Agency System Doomed?
  • Those insurers and their agents committed to the traditional long channel of distribution have become concerned over the future of their business
    • Since direct writers have been growing in market share until recently
  • Table 22-3 shows that while direct writers have taken a significant portion of the personal lines market
    • Insurers using independent agents have maintained their dominance in commercial insurance lines
  • Although the volume of business undertaken by local independent agents is usually relatively small this is not the case for national brokers
    • Table 22-4 shows the name and size of the five largest brokers
outlook for the agency system and direct writing
Outlook for the Agency System and Direct Writing
  • Direct writing has grown fastest in lines for which there is a mass market for a standardized product that requires little continuous service
    • These conditions do not exist in all areas of insurance, particularly in the commercial market
      • Thus, it is extremely doubtful that direct writers will capture that market
  • It seems unlikely that the independent agency system will be replaced by direct writing unless the property insurance business becomes much more concentrated than it is now
  • While direct writers continue to gain market share in the property-liability field, the life insurance industry is going in the opposite direction
direct response
Direct Response
  • Some insurance is sold without agents or other intermediaries through the direct response technique
    • Customers are found through advertising on television, radio, newspapers, magazines, direct mail, etc.
    • This is the area where the internet appears to have the greatest potential
    • No sales agents are employed
    • The policies tend to be fairly standardized and more specialized and less costly
      • Examples include accident insurance, hospital indemnity, term life, automobile, homeowners, and short-term disability income contracts
mass merchandising
Mass Merchandising
  • A method of distributing property-liability insurance directly to consumers through employer payroll deduction
  • Premiums are usually cheaper because of various economies in mass merchandising
  • Employers do not normally contribute to the premium on behalf of employees
  • They have not become extremely popular
    • Independent agents have generally opposed the adoption of such plans
      • Because many agents depend on individually issued personal-lines business for their livelihood
    • The element of adverse selection exists
      • Which has often produced poor underwriting experiences
globalization of risk management and the insurance industry
Globalization of Risk Management and the Insurance Industry
  • A globalization of business has occurred due to
    • Advances in technology and improvement in transportation
    • Reduced trade barriers in many countries
  • Firms and organizations that do business internationally face differences in their loss exposure and in the risk-handling methods they use
  • Globalization and differences in future growth potential have led many insurers to reevaluate the focus of their business and to consider expansion overseas
global risk management
Global Risk Management
  • Almost all organizations have some employees who travel overseas
  • These activities can give rise to unique exposures that are not faced if the firm operates exclusively within its own home country
    • Exporting goods and services overseas
    • Manufacturing or importing products from overseas
    • Hiring part-time or permanent employees overseas
global risk exposure
Global Risk Exposure
  • Some kinds of risk exposure faced by international firms are the same as those faced by firms that do business only in their home country
    • For example, fire, natural disasters, or damage to goods in transit
  • Many of these exposures can be altered in both frequency and severity by differences in various parts of the world
    • Most of the deaths from natural disasters are in developing countries
      • While most of the property damage resulting from natural disasters occurs in industrial nations
    • Fire loss potential is much greater in countries with poor infrastructure and lower-quality building standards
global risk exposure46
Global Risk Exposure
  • Global firms also face unique kinds of loss exposure that arise as a result of conducting business in multiple countries, including
    • Terrorism, kidnapping, political instability, uncertain legal environment, currency risk, import/export restrictions, technology and communications, financial markets’ weaknesses, and substandard infrastructure
  • The inability to assess risk accurately due to an absence of information in some underdeveloped countries can be one of the biggest challenges that a risk manager of a global firm faces
    • Additionally, the lack of a well-developed insurance industry can lead to an absence of high quality risk management services such as
      • Claims handling, loss assessment, loss control
global risk exposure47
Global Risk Exposure
  • The rate of insurance in business and the use of insurance by individuals can differ dramatically around the globe
  • Tax treatment of insurance differs from country to country
  • Local laws in some countries require the purchase of certain types of insurance
    • And it either requires that insurance be purchased from a locally admitted insurer or disallows tax-favored treatment if the insurance is purchased from a nonadmitted insurer
  • The attitude toward risk management can also differ
  • Customary limits of coverage can vary significantly
  • Some religious beliefs discourage arrangements involving the payment of interest and often limit the purchase of insurance
  • Significant reliance upon government social insurance programs reduces the demand for private life and health insurance and annuity products in a number of countries
global insurance programs
Global Insurance Programs
  • A global firm can rely primarily on nonadmitted insurance on a worldwide basis
    • Buy insurance in their home country and arrange for coverage wherever they do business
      • Easy to administer and leaves the decision-making in the home country
      • Disadvantages include
        • It may be illegal in some countries
        • Favored tax treatment of insurance premiums and loss payments may be lost
        • The insured does not have a local insurer to provide claims and other services overseas
global insurance programs49
Global Insurance Programs
  • A global firm can leave the insurance program design and the purchase of insurance to the firm’s management in each of the countries in which it does business
    • Has the advantage of meeting any local laws regarding admitted insurance and compulsory coverage requirements
      • Can preserve favorable tax treatment for premium and loss payments
    • Has the disadvantage in that the approach tends to lead to a very inefficient program structure if the firm does business in a number of countries
      • Also, coverage limits and terms often differ significantly across countries and can lead to to important gaps in protection
global insurance programs50
Global Insurance Programs
  • A global firm can use a global controlled master program
    • A global insurer works through its own subsidiaries or partner insurers in each of the countries in which the insured corporation does business to provide unified coverage
    • Will involve locally admitted subsidiaries or partners which assures that the program meets the laws and requirements related to compulsory and admitted insurance
      • These subsidiaries or partners provide local expertise in managing claims and assessing risk
globalization of the insurance business
Globalization of the Insurance Business
  • Table 22-5 provides market share data for the six largest insurance markets in the world
  • Perhaps the biggest driver of the increasing international focus of the insurance business is
    • The globalization of the firms that buy insurance and purchase risk management services from insurers
  • Multinational firms are becoming increasingly sophisticated regarding risk management practices
    • They demand the ability to combine and integrate their risk management programs on a global basis
    • They increasingly demand high quality risk management services wherever they do business
      • Such as claims management and loss control
globalization of the insurance business53
Globalization of the Insurance Business
  • An additional important factor in the expansion of U.S. and European insurers overseas
    • The recognition that insurance markets in industrial countries do not offer the same opportunities for growth in the next ten years
    • The emerging economies in eastern Europe and the Pacific Rim offer double-digit growth potential in insurance demand