Principles of insurance
Commercially insurable
risks typically share seven common characteristics.[1]
- A large number of
homogeneous exposure units. The vast
majority of insurance policies are provided for
individual members of very large classes.
Automobile insurance, for example, covered about
175 million automobiles in the United States in
2004.[2]
The existence of a large number of homogeneous
exposure units allows insurers to benefit from
the so-called ¡°law
of large numbers,¡± which in effect states
that as the number of exposure units increases,
proportionally the actual results are
increasingly likely to become close to expected
proportions. There are exceptions to this
criterion.
Lloyd's of London is famous for insuring the
life or health of actors, actresses and sports
figures. Satellite Launch insurance covers
events that are infrequent. Large commercial
property policies may insure exceptional
properties for which there are no ¡®homogeneous¡¯
exposure units. Despite failing on this
criterion, many exposures like these are
generally considered to be insurable.
- Definite Loss.
The event that gives rise to the loss that is
subject to the insured, at least in principle,
take place at a known time, in a known place,
and from a known cause. The classic example is
death of an insured person on a life insurance
policy. Fire, automobile accidents, and worker
injuries may all easily meet this criterion.
Other types of losses may only be definite in
theory. Occupational disease, for instance, may
involve prolonged exposure to injurious
conditions where no specific time, place or
cause is identifiable. Ideally, the time, place
and cause of a loss should be clear enough that
a reasonable person, with sufficient
information, could objectively verify all three
elements.
- Accidental Loss.
The event that constitutes the trigger of a
claim should be fortuitous, or at least outside
the control of the beneficiary of the insurance.
The loss should be ¡®pure,¡¯ in the sense that it
results from an event for which there is only
the opportunity for cost. Events that contain
speculative elements, such as ordinary business
risks, are generally not considered insurable.
- Large Loss. The
size of the loss must be meaningful from the
perspective of the insured. Insurance premiums
need to cover both the expected cost of losses,
plus the cost of issuing and administering the
policy, adjusting losses, and supplying the
capital needed to reasonably assure that the
insurer will be able to pay claims. For small
losses these latter costs may be several times
the size of the expected cost of losses. There
is little point in paying such costs unless the
protection offered has real value to a buyer.
- Affordable Premium.
If the likelihood of an insured event is so
high, or the cost of the event so large, that
the resulting premium is large relative to the
amount of protection offered, it is not likely
that anyone will buy insurance, even if on
offer. Further, as the accounting profession
formally recognizes in financial accounting
standards, the premium cannot be so large that
there is not a reasonable chance of a
significant loss to the insurer. If there is no
such chance of loss, the transaction may have
the form of insurance, but not the substance.
(See the U.S.
Financial Accounting Standards Board
standard number 113)
- Calculable Loss.
There are two elements that must be at least
estimable, if not formally calculable: the
probability of loss, and the attendant cost.
Probability of loss is generally an empirical
exercise, while cost has more to do with the
ability of a reasonable person in possession of
a copy of the insurance policy and a proof of
loss associated with a claim presented under
that policy to make a reasonably definite and
objective evaluation of the amount of the loss
recoverable as a result of the claim.
- Limited risk of
catastrophically large losses. The essential
risk is often aggregation. If the same event can
cause losses to numerous policyholders of the
same insurer, the ability of that insurer to
issue policies becomes constrained, not by
factors surrounding the individual
characteristics of a given policyholder, but by
the factors surrounding the sum of all
policyholders so exposed. Typically, insurers
prefer to limit their exposure to a loss from a
single event to some small portion of their
capital base, on the order of 5
percent. Where the loss can be aggregated,
or an individual policy could produce
exceptionally large claims, the capital
constraint will restrict an insurer's appetite
for additional policyholders. The classic
example is earthquake insurance, where the
ability of an underwriter to issue a new policy
depends on the number and size of the policies
that it has already underwritten. Wind insurance
in hurricane zones, particularly along coast
lines, is another example of this phenomenon. In
extreme cases, the aggregation can affect the
entire industry, since the combined capital of
insurers and reinsurers can be small compared to
the needs of potential policyholders in areas
exposed to aggregation risk. In commercial fire
insurance it is possible to find single
properties whose total exposed value is well in
excess of any individual insurer¡¯s capital
constraint. Such properties are generally shared
among several insurers, or are insured by a
single insurer who syndicates the risk into the
reinsurance market.
Indemnification
The technical definition of
"indemnity" means to make whole again. There are two
types of insurance contracts;
- an "indemnity" policy
and
- a "pay on behalf" or
"on behalf of"[3]
policy.
The difference is
significant on paper, but rarely material in
practice.
An "indemnity" policy will
never pay claims until the insured has paid out of
pocket to some third party; for example, a visitor
to your home slips on a floor that you left wet and
sues you for $10,000 and wins. Under an "indemnity"
policy the homeowner would have to come up with the
$10,000 to pay for the visitor's fall and then would
be "indemnified" by the insurance carrier for the
out of pocket costs (the $10,000)[4].
Under the same situation, a
"pay on behalf" policy, the insurance carrier would
pay the claim and the insured (the homeowner) would
not be out of pocket for anything. Most modern
liability insurance is written on the basis of "pay
on behalf" language[5].
An entity seeking to
transfer risk (an individual, corporation, or
association of any type, etc.) becomes the 'insured'
party once risk is assumed by an 'insurer', the
insuring party, by means of a
contract, called an insurance 'policy'.
Generally, an insurance contract includes, at a
minimum, the following elements: the parties (the
insurer, the insured, the beneficiaries), the
premium, the period of coverage, the particular loss
event covered, the amount of coverage (i.e., the
amount to be paid to the insured or beneficiary in
the event of a loss), and exclusions (events not
covered). An insured is thus said to be "indemnified"
against the loss covered in the policy.
When insured parties
experience a loss for a specified peril, the
coverage entitles the policyholder to make a 'claim'
against the insurer for the covered amount of loss
as specified by the policy. The fee paid by the
insured to the insurer for assuming the risk is
called the 'premium'. Insurance premiums from many
insureds are used to fund accounts reserved for
later payment of claims¡ªin theory for a relatively
few claimants¡ªand for
overhead costs. So long as an insurer maintains
adequate funds set aside for anticipated losses
(i.e., reserves), the remaining margin is an
insurer's
profit.
Insurers' business model
Underwriting and investing
The business model can be
reduced to a simple equation: Profit =
earned premium + investment income - incurred
loss - underwriting expenses.
Insurers make money in two
ways:
- Through
underwriting, the process by which insurers
select the risks to insure and decide how much
in premiums to charge for accepting those risks;
- By
investing the premiums they collect from
insured parties.
The most complicated aspect
of the insurance business is the
underwriting of policies. Using a wide
assortment of data, insurers predict the likelihood
that a claim will be made against their policies and
price products accordingly. To this end, insurers
use
actuarial science to quantify the risks they are
willing to assume and the premium they will charge
to assume them. Data is analyzed to fairly
accurately project the rate of future claims based
on a given risk. Actuarial science uses
statistics and
probability to analyze the risks associated with
the range of perils covered, and these scientific
principles are used to determine an insurer's
overall exposure. Upon termination of a given
policy, the amount of premium collected and the
investment gains thereon minus the amount paid out
in claims is the insurer's
underwriting profit on that policy. Of course,
from the insurer's perspective, some policies are
"winners" (i.e., the insurer pays out less in claims
and expenses than it receives in premiums and
investment income) and some are "losers" (i.e., the
insurer pays out more in claims and expenses than it
receives in premiums and investment income);
insurance companies essentially use actuarial
science to attempt to underwrite enough "winning"
policies to pay out on the "losers" while still
maintaining profitability.
An insurer's underwriting
performance is measured in its combined ratio. The
loss ratio (incurred losses and loss-adjustment
expenses divided by net earned premium) is added to
the expense ratio (underwriting expenses divided by
net premium written) to determine the company's
combined ratio. The combined ratio is a reflection
of the company's overall
underwriting profitability. A combined ratio of
less than 100 percent indicates underwriting
profitability, while anything over 100 indicates an
underwriting loss.
Insurance companies also
earn
investment profits on ¡°float¡±. ¡°Float¡± or
available reserve is the amount of money, at hand at
any given moment, that an insurer has collected in
insurance premiums but has not been paid out in
claims. Insurers start investing insurance premiums
as soon as they are collected and continue to earn
interest on them until claims are paid out. The
Association of British Insurers (gathering 400
insurance companies and 94% of UK insurance
services) has almost 20% of the investments in the
London Stock Exchange.[6]
In the
United States, the underwriting loss of
property and
casualty insurance companies was $142.3 billion
in the five years ending 2003. But overall profit
for the same period was $68.4 billion, as the result
of float. Some insurance industry insiders, most
notably
Hank Greenberg, do not believe that it is
forever possible to sustain a profit from float
without an underwriting profit as well, but this
opinion is not universally held. Naturally, the
¡°float¡± method is difficult to carry out in an
economically depressed period. Bear markets do cause
insurers to shift away from investments and to
toughen up their underwriting standards. So a poor
economy generally means high insurance premiums.
This tendency to swing between profitable and
unprofitable periods over time is commonly known as
the "underwriting" or
insurance cycle.
[7]
Property and casualty
insurers currently make the most money from their
auto insurance line of business. Generally better
statistics are available on auto losses and
underwriting on this line of business has benefited
greatly from advances in computing. Additionally,
property losses in the
United States, due to unpredictable natural
catastrophes, have exacerbated this trend.
Claims
Claims and loss handling is
the materialized utility of insurance; it is the
actual "product" paid for, though one hopes it will
never need to be used. Claims may be filed by
insureds directly with the insurer or through
brokers or agents. The insurer may require that the
claim be filed on its own proprietary forms, or may
accept claims on a standard industry form such as
those produced by
ACORD.
Insurance company claim
departments employ a large number of
claims adjusters supported by a staff of
records management and
data entry clerks. Incoming claims are
classified based on severity and are assigned to
adjusters whose settlement authority varies with
their knowledge and experience. The adjuster
undertakes a thorough investigation of each claim,
usually in close cooperation with the insured,
determines if coverage is available under the policy
terms, what its reasonable monetary value is, and
authorizes payment. Adjusting liability insurance
claims is particularly difficult because there is a
third party involved the claimant(in the event the
claim is escalated to a court setting they are
refered to as the plaintiff) is under no contractual
obligation to cooperate with the insurer and in fact
may regard the insurer as a
deep pocket. The adjuster must obtain legal
counsel for the insured (either inside "house"
counsel or outside "panel" counsel), monitor
litigation that may take years to complete, and
appear in person or over the telephone with
settlement authority at a mandatory settlement
conference when requested by the judge.
In managing the claims
handling function, insurers seek to balance the
elements of customer satisfaction, administrative
handling expenses, and claims overpayment leakages.
As part of this balancing act,
fraudulent insurance practices are a major
business risk that must be managed and overcome.
Disputes between insurers and insureds over the
validity of claims or claims handling practices
occasionally escalate into litigation; see
insurance bad faith.
History of insurance
In some sense we can say
that insurance appears simultaneously with the
appearance of human society. We know of two types of
economies in human societies: money economies (with
markets, money, financial instruments and so on) and
non-money or natural economies (without money,
markets, financial instruments and so on). The
second type is a more ancient form than the first.
In such an economy and community, we can see
insurance in the form of people helping each other.
For example, if a house burns down, the members of
the community help build a new one. Should the same
thing happen to one's neighbour, the other
neighbours must help. Otherwise, neighbours will not
receive help in the future. This type of insurance
has survived to the present day in some countries
where modern money economy with its financial
instruments is not widespread.
Turning to insurance in the
modern sense (i.e., insurance in a modern money
economy, in which insurance is part of the financial
sphere), early methods of transferring or
distributing risk were practised by
Chinese and
Babylonian traders as long ago as the
3rd and
2nd
millennia BC, respectively.[8]
Chinese merchants travelling treacherous river
rapids would redistribute their wares across many
vessels to limit the loss due to any single vessel's
capsizing. The Babylonians developed a system which
was recorded in the famous
Code of Hammurabi, c. 1750 BC, and practised by
early
Mediterranean sailing
merchants. If a merchant received a loan to fund
his shipment, he would pay the lender an additional
sum in exchange for the lender's guarantee to cancel
the loan should the shipment be stolen or lost at
sea.
Achaemenian monarchs of Ancient Persia were the
first to insure their people and made it official by
registering the insuring process in governmental
notary offices. The insurance tradition was
performed each year in Norouz (beginning of the
Iranian New Year); the heads of different ethnic
groups as well as others willing to take part,
presented gifts to the monarch. The most important
gift was presented during a special ceremony. When a
gift was worth more than 10,000 Derrik (Achaemenian
gold coin) the issue was registered in a special
office. This was advantageous to those who presented
such special gifts. For others, the presents were
fairly assessed by the confidants of the court. Then
the assessment was registered in special offices.
The purpose of registering
was that whenever the person who presented the gift
registered by the court was in trouble, the monarch
and the court would help him. Jahez, a historian and
writer, writes in one of his books on
ancient Iran: "[W]henever the owner of the
present is in trouble or wants to construct a
building, set up a feast, have his children married,
etc. the one in charge of this in the court would
check the registration. If the registered amount
exceeded 10,000 Derrik, he or she would receive an
amount of twice as much."[1]
A thousand years later, the
inhabitants of
Rhodes invented the concept of the 'general
average'. Merchants whose goods were being
shipped together would pay a proportionally divided
premium which would be used to reimburse any
merchant whose goods were jettisoned during storm or
sinkage.
The
Greeks and
Romans introduced the origins of health and life
insurance c. 600 AD when they organized guilds
called "benevolent societies" which cared for the
families and paid
funeral expenses of members upon
death.
Guilds in the
Middle Ages served a similar purpose. The
Talmud deals with several aspects of insuring
goods. Before insurance was established in the
late 17th century, "friendly societies" existed in
England, in which people donated amounts of money to
a general sum that could be used for emergencies.
Separate insurance
contracts (i.e., insurance policies not bundled with
loans or other kinds of contracts) were invented in
Genoa in the 14th century, as were insurance
pools backed by pledges of landed estates. These new
insurance contracts allowed insurance to be
separated from investment, a separation of roles
that first proved useful in marine insurance.
Insurance became far more sophisticated in post-Renaissance
Europe, and specialized varieties developed.
Some forms of insurance had
developed in London by the early decades of the
seventeenth century. For example, the will of the
English colonist
Robert Hayman mentions two "policies of
insurance" taken out with the diocesan Chancellor of
London, Arthur Duck. Of the value of £100 each, one
relates to the safe arrival of Hayman's ship in
Guyana and the other is in regard to "one hundred
pounds assured by the said Doctor Arthur Ducke on my
life". Hayman's will was signed and sealed on 17
November 1628 but not proved until 1633.[9]
Toward the end of the seventeenth century, London's
growing importance as a centre for trade increased
demand for marine insurance. In the late 1680s,
Edward Lloyd opened a coffee house that became a
popular haunt of ship owners, merchants, and ships¡¯
captains, and thereby a reliable source of the
latest shipping news. It became the meeting place
for parties wishing to insure cargoes and ships, and
those willing to underwrite such ventures. Today,
Lloyd's of London remains the leading market
(note that it is not an insurance company) for
marine and other specialist types of insurance, but
it works rather differently than the more familiar
kinds of insurance.
Insurance as we know it
today can be traced to the
Great Fire of London, which in 1666 devoured
more than 13,000 houses. The devastating effects of
the fire converted the development of insurance
"from a matter of convenience into one of urgency, a
change of opinion reflected in Sir Christopher
Wren's inclusion of a site for 'the Insurance
Office' in his new plan for London in 1667."[10]
A number of attempted fire insurance schemes came to
nothing, but in 1681
Nicholas Barbon, and eleven associates,
established England's first fire insurance company,
the 'Insurance Office for Houses', at the back of
the Royal Exchange. Initially, 5,000 homes were
insured by Barbon's Insurance Office.[11]
The first insurance company
in the
United States underwrote fire insurance and was
formed in Charles Town (modern-day
Charleston),
South Carolina, in 1732.
Benjamin Franklin helped to popularize and make
standard the practice of insurance, particularly
against
fire in the form of
perpetual insurance. In 1752, he founded the
Philadelphia Contributionship for the Insurance of
Houses from Loss by Fire. Franklin's company was
the first to make contributions toward fire
prevention. Not only did his company warn against
certain
fire hazards, it refused to insure certain
buildings where the risk of fire was too great, such
as all wooden houses. In the United States,
regulation of the insurance industry is highly
Balkanized, with primary responsibility assumed
by individual
state insurance departments. Whereas insurance
markets have become centralized nationally and
internationally, state insurance commissioners
operate individually, though at times in concert
through a
national insurance commissioners' organization.
In recent years, some have called for a dual state
and federal regulatory system (commonly referred to
as the
Optional federal charter (OFC)) for insurance
similar to that which oversees state banks and
national banks.
Types of insurance
Any risk that can be
quantified can potentially be insured. Specific
kinds of risk that may give rise to claims are known
as "perils". An insurance policy will set out in
detail which perils are covered by the policy and
which are not. Below are (non-exhaustive) lists of
the many different types of insurance that exist. A
single policy may cover risks in one or more of the
categories set out below. For example, auto
insurance would typically cover both property risk
(covering the risk of theft or damage to the car)
and liability risk (covering legal claims from
causing an accident). A
homeowner's insurance policy in the U.S.
typically includes property insurance covering
damage to the home and the owner's belongings,
liability insurance covering certain legal claims
against the owner, and even a small amount of
coverage for medical expenses of guests who are
injured on the owner's property.
Business insurance can be any kind of insurance
that protects businesses against risks. Some
principal subtypes of business insurance are (a) the
various kinds of professional liability insurance,
also called professional indemnity insurance,
which are discussed below under that name; and (b)
the business owner's policy (BOP), which bundles
into one policy many of the kinds of coverage that a
business owner needs, in a way analogous to how
homeowners insurance bundles the coverages that a
homeowner needs.[12]
Auto
insurance
Auto insurance protects you
against financial loss if you have an accident. It
is a contract between you and the insurance company.
You agree to pay the premium and the insurance
company agrees to pay your losses as defined in your
policy. Auto insurance provides property, liability
and medical coverage:
- Property coverage pays
for damage to or theft of your car.
- Liability coverage
pays for your legal responsibility to others for
bodily injury or property damage.
- Medical coverage pays
for the cost of treating injuries,
rehabilitation and sometimes lost wages and
funeral expenses.
An auto insurance policy
comprises six kinds of coverage. Most countries
require you to buy some, but not all, of these
coverages. If you're financing a car, your lender
may also have requirements. Most auto policies are
for six months to a year.
In the
United States, your insurance company should
notify you by mail when it¡¯s time to renew the
policy and to pay your premium.
[13]
Home
insurance
Main article:
Home insurance
Home insurance provides
compensation for damage or destruction of a home
from disasters. In some geographical areas, the
standard insurances exclude certain types of
disasters, such as flood and earthquakes, that
require additional coverage. Maintenance-related
problems are the homeowners' responsibility. The
policy may include inventory, or this can be bought
as a separate policy, especially for people who rent
housing. In some countries, insurers offer a package
which may include liability and legal responsibility
for injuries and property damage caused by members
of the household, including pets.[14]
Health
Health insurance policies
by the
National Health Service in the
United Kingdom (NHS) or other publicly-funded
health programs will cover the cost of medical
treatments. Dental insurance, like medical
insurance, is coverage for individuals to protect
them against dental costs. In the U.S., dental
insurance is often part of an employer's benefits
package, along with health insurance.
Accident, Sickness and Unemployment Insurance
-
Disability insurance policies provide
financial support in the event the policyholder
is unable to work because of disabling illness
or injury. It provides monthly support to help
pay such obligations as
mortgages and
credit cards.
-
Disability overhead insurance allows
business owners to cover the overhead expenses
of their business while they are unable to work.
-
Total permanent disability insurance
provides benefits when a person is permanently
disabled and can no longer work in their
profession, often taken as an adjunct to life
insurance.
-
Workers' compensation insurance replaces all
or part of a worker's
wages lost and accompanying medical expenses
incurred because of a job-related injury.
Casualty
Casualty insurance insures
against accidents, not necessarily tied to any
specific property.
Life
Main article:
Life insurance
Life insurance provides a
monetary benefit to a decedent's family or other
designated beneficiary, and may specifically provide
for income to an insured person's family,
burial,
funeral and other final expenses. Life insurance
policies often allow the option of having the
proceeds paid to the beneficiary either in a lump
sum cash payment or an annuity.
Annuities provide a stream of payments and are
generally classified as insurance because they are
issued by insurance companies and regulated as
insurance and require the same kinds of actuarial
and investment management expertise that life
insurance requires. Annuities and
pensions that pay a benefit for life are
sometimes regarded as insurance against the
possibility that a
retiree will outlive his or her financial
resources. In that sense, they are the complement of
life insurance and, from an underwriting
perspective, are the mirror image of life insurance.
Certain life insurance
contracts accumulate
cash values, which may be taken by the insured
if the policy is surrendered or which may be
borrowed against. Some policies, such as annuities
and
endowment policies, are financial instruments to
accumulate or
liquidate
wealth when it is needed.
In many countries, such as
the U.S. and the UK, the
tax law provides that the interest on this cash
value is not taxable under certain circumstances.
This leads to widespread use of life insurance as a
tax-efficient method of
saving as well as protection in the event of
early death.
In U.S., the tax on
interest income on life insurance policies and
annuities is generally deferred. However, in some
cases the benefit derived from tax deferral may be
offset by a low return. This depends upon the
insuring company, the type of policy and other
variables (mortality, market return, etc.).
Moreover, other income tax saving vehicles (e.g.,
IRAs, 401(k) plans, Roth IRAs) may be better
alternatives for value accumulation.
Property
Property insurance provides
protection against risks to property, such as fire,
theft or
weather damage. This includes specialized forms
of insurance such as
fire insurance,
flood insurance,
earthquake insurance,
home insurance, inland marine insurance or
boiler insurance.
-
Automobile insurance, known in the
UK as motor insurance, is probably
the most common form of insurance and may cover
both legal
liability claims against the
driver and loss of or damage to the
insured's
vehicle itself. Throughout the
United States an auto insurance policy is
required to legally operate a motor vehicle on
public roads. In some jurisdictions, bodily
injury compensation for automobile accident
victims has been changed to a
no-fault system, which reduces or eliminates
the ability to sue for compensation but provides
automatic eligibility for benefits. Credit card
companies insure against
damage on rented cars.
- Driving School
Insurance insurance provides cover for any
authorized driver whilst undergoing tuition,
cover also unlike other motor policies
provides cover for instructor liability
where both the pupil and driving instructor
are equally liable in the event of a claim.
-
Aviation insurance insures against hull,
spares, deductibles, hull wear and liability
risks.
-
Boiler insurance (also known as boiler and
machinery insurance or equipment breakdown
insurance) insures against accidental physical
damage to equipment or machinery.
-
Builder's risk insurance insures against the
risk of physical loss or damage to property
during construction. Builder's risk insurance is
typically written on an "all risk" basis
covering damage due to any cause (including the
negligence of the insured) not otherwise
expressly excluded. Builder's risk insurance is
coverage that protects a person's or
organization's insurable interest in materials,
fixtures and/or equipment being used in the
construction or renovation of a building or
structure should those items sustain physical
loss or damage from a covered cause.[15]
-
Crop insurance "Farmers use crop insurance
to reduce or manage various risks associated
with growing crops. Such risks include crop loss
or damage caused by weather, hail, drought,
frost damage, insects, or disease, for
instance."[16]
-
Earthquake insurance is a form of property
insurance that pays the policyholder in the
event of an
earthquake that causes damage to the
property. Most ordinary
homeowners insurance policies do not cover
earthquake damage. Most earthquake insurance
policies feature a high
deductible. Rates depend on location and the
probability of an earthquake, as well as the
construction of the home.
- A
fidelity bond is a form of casualty
insurance that covers policyholders for losses
that they incur as a result of fraudulent acts
by specified individuals. It usually insures a
business for losses caused by the dishonest acts
of its employees.
-
Flood insurance protects against property
loss due to flooding. Many insurers in the U.S.
do not provide flood insurance in some portions
of the country. In response to this, the federal
government created the
National Flood Insurance Program which
serves as the insurer of last resort.
- Home insurance or
homeowners' insurance: See "Property insurance".
-
Landlord insurance is specifically designed
for people who own properties which they rent
out. Most house insurance cover in the UK will
not be valid if the property is rented out
therefore landlords must take out this
specialist form of home insurance.
-
Marine insurance and marine cargo insurance
cover the loss or damage of ships at sea or on
inland waterways, and of the cargo that may be
on them. When the owner of the cargo and the
carrier are separate corporations, marine cargo
insurance typically compensates the owner of
cargo for losses sustained from fire, shipwreck,
etc., but excludes losses that can be recovered
from the carrier or the carrier's insurance.
Many marine insurance underwriters will include
"time element" coverage in such policies, which
extends the indemnity to cover loss of profit
and other business expenses attributable to the
delay caused by a covered loss.
-
Surety bond insurance is a three party
insurance guaranteeing the performance of the
principal.
-
Terrorism insurance provides protection
against any loss or damage caused by
terrorist activities.
- Volcano insurance is
an insurance that covers volcano damage in
Hawaii.
- Windstorm insurance is
an insurance covering the damage that can be
caused by hurricanes and tropical cyclones.
Liability
Liability insurance is a
very broad superset that covers legal claims against
the insured. Many types of insurance include an
aspect of liability coverage. For example, a
homeowner's insurance policy will normally include
liability coverage which protects the insured in the
event of a claim brought by someone who slips and
falls on the property; automobile insurance also
includes an aspect of liability insurance that
indemnifies against the harm that a crashing car can
cause to others' lives, health, or property. The
protection offered by a liability insurance policy
is twofold: a legal defense in the event of a
lawsuit commenced against the policyholder and
indemnification (payment on behalf of the insured)
with respect to a settlement or court verdict.
Liability policies typically cover only the
negligence of the insured, and will not apply to
results of wilful or intentional acts by the
insured.
- Public
liability insurance covers a business
against claims should its operations injure a
member of the public or damage their property in
some way.
-
Directors and officers liability insurance
protects an organization (usually a corporation)
from costs associated with litigation resulting
from mistakes made by directors and officers for
which they are liable. In the industry, it is
usually called "D&O" for short.
- Environmental
liability insurance protects the insured from
bodily injury, property damage and cleanup costs
as a result of the dispersal, release or escape
of pollutants.
- Errors and omissions
insurance: See "Professional liability
insurance" under "Liability insurance".
-
Prize indemnity insurance protects the
insured from giving away a large prize at a
specific event. Examples would include offering
prizes to contestants who can make a half-court
shot at a basketball game, or a hole-in-one at a
golf tournament.
-
Professional liability insurance, also
called professional indemnity insurance,
protects insured professionals such as
architectural corporation and medical practice
against potential negligence claims made by
their patients/clients. Professional liability
insurance may take on different names depending
on the profession. For example, professional
liability insurance in reference to the medical
profession may be called malpractice
insurance. Notaries public may take out
errors and omissions insurance (E&O). Other
potential E&O policyholders include, for
example, real estate brokers, Insurance agents,
home inspectors, appraisers, and website
developers.
Credit
Credit insurance repays
some or all of a
loan when certain things happen to the borrower
such as
unemployment,
disability, or
death.
-
Mortgage insurance insures the lender
against default by the borrower. Mortgage
insurance is a form of credit insurance,
although the name credit insurance more
often is used to refer to policies that cover
other kinds of debt.
- Many credit cards
offer payment protection plans which are a form
of credit insurance.
Other
types
-
Collateral protection insurance or CPI,
insures property (primarily vehicles) held as
collateral for loans made by lending
institutions.
- Defense Base Act
Workers' compensation or DBA Insurance provides
coverage for civilian workers hired by the
government to perform contracts outside the U.S.
and Canada. DBA is required for all U.S.
citizens, U.S. residents, U.S. Green Card
holders, and all employees or subcontractors
hired on overseas government contracts.
Depending on the country, Foreign Nationals must
also be covered under DBA. This coverage
typically includes expenses related to medical
treatment and loss of wages, as well as
disability and death benefits.
-
Expatriate insurance provides individuals
and organizations operating outside of their
home country with protection for automobiles,
property, health, liability and business
pursuits.
- Financial loss
insurance or Business Interruption Insurance
protects individuals and companies against
various financial risks. For example, a
business might purchase coverage to protect
it from loss of
sales if a fire in a
factory prevented it from carrying out its
business for a time. Insurance might also cover
the failure of a
creditor to pay
money it owes to the insured. This type of
insurance is frequently referred to as "business
interruption insurance."
Fidelity bonds and
surety bonds are included in this category,
although these products provide a benefit to a
third party (the "obligee") in the event the
insured party (usually referred to as the
"obligor") fails to perform its obligations
under a contract with the obligee.
-
Kidnap and ransom insurance
-
Legal Expenses Insurance covers
policyholders against the potential costs of
legal action against an institution or an
individual.
-
Locked funds insurance is a little-known
hybrid insurance policy jointly issued by
governments and banks. It is used to protect
public funds from tamper by unauthorized
parties. In special cases, a government may
authorize its use in protecting semi-private
funds which are liable to tamper. The terms of
this type of insurance are usually very strict.
Therefore it is used only in extreme cases where
maximum security of funds is required.
- Media Insurance is
designed to cover professionals that engage in
film, video and TV production.
- Nuclear incident
insurance covers damages resulting from an
incident involving radioactive materials and
is generally arranged at the national level. See
the
Nuclear exclusion clause and for the United
States the
Price-Anderson Nuclear Industries Indemnity Act)
-
Pet insurance insures pets against accidents
and illnesses - some companies cover
routine/wellness care and burial, as well.
- Pollution Insurance
which consists of first-party coverage for
contamination of insured property either by
external or on-site sources. Coverage for
liability to third parties arising from
contamination of air, water, or land due to the
sudden and accidental release of hazardous
materials from the insured site. The policy
usually covers the costs of cleanup and may
include coverage for releases from underground
storage tanks. Intentional acts are specifically
excluded.
- Purchase insurance is
aimed at providing protection on the products
people purchase. Purchase insurance can cover
individual purchase protection, warranties,
guarantees, care plans and even mobile
phone insurance. Such insurance is normally
very limited in the scope of problems that are
covered by the policy.
-
Title insurance provides a guarantee that
title to
real property is vested in the purchaser
and/or
mortgagee, free and clear of
liens or encumbrances. It is usually issued
in conjunction with a search of the public
records performed at the time of a
real estate transaction.
-
Travel insurance is an insurance cover taken
by those who travel abroad, which covers certain
losses such as medical expenses, loss of
personal belongings, travel delay, personal
liabilities, etc.
Insurance financing vehicles
- Fraternal insurance is
provided on a cooperative basis by
fraternal benefit societies or other social
organizations.[17]
-
No-fault insurance is a type of insurance
policy (typically automobile insurance) where
insureds are indemnified by their own insurer
regardless of fault in the incident.
- Protected
Self-Insurance is an alternative risk financing
mechanism in which an organization retains the
mathematically calculated cost of risk within
the organization and transfers the catastrophic
risk with specific and aggregate limits to an
insurer so the maximum total cost of the program
is known. A properly designed and underwritten
Protected Self-Insurance Program reduces and
stabilizes the cost of insurance and provides
valuable risk management information.
-
Retrospectively Rated Insurance is a method
of establishing a premium on large commercial
accounts. The final premium is based on the
insured's actual loss experience during the
policy term, sometimes subject to a minimum and
maximum premium, with the final premium
determined by a formula. Under this plan, the
current year's premium is based partially (or
wholly) on the current year's losses, although
the premium adjustments may take months or years
beyond the current year's expiration date. The
rating formula is guaranteed in the insurance
contract. Formula: retrospective premium =
converted loss + basic premium ¡Á tax multiplier.
Numerous variations of this formula have been
developed and are in use.
- Formal
self insurance is the deliberate decision to
pay for otherwise insurable losses out of one's
own money. This can be done on a formal basis by
establishing a separate fund into which funds
are deposited on a periodic basis, or by simply
forgoing the purchase of available insurance and
paying out-of-pocket. Self insurance is usually
used to pay for high-frequency, low-severity
losses. Such losses, if covered by conventional
insurance, mean having to pay a premium that
includes loadings for the company's general
expenses, cost of putting the policy on the
books, acquisition expenses, premium taxes, and
contingencies. While this is true for all
insurance, for small, frequent losses the
transaction costs may exceed the benefit of
volatility reduction that insurance otherwise
affords.
-
Reinsurance is a type of insurance purchased
by insurance companies or self-insured employers
to protect against unexpected losses.
Financial reinsurance is a form of
reinsurance that is primarily used for capital
management rather than to transfer insurance
risk.
-
Social insurance can be many things to many
people in many countries. But a summary of its
essence is that it is a collection of insurance
coverages (including components of life
insurance, disability income insurance,
unemployment insurance, health insurance, and
others), plus retirement savings, that requires
participation by all citizens. By forcing
everyone in society to be a policyholder and pay
premiums, it ensures that everyone can become a
claimant when or if he/she needs to. Along the
way this inevitably becomes related to other
concepts such as the justice system and the
welfare state. This is a large, complicated
topic that engenders tremendous debate, which
can be further studied in the following articles
(and others):
- Stop-loss insurance
provides protection against catastrophic or
unpredictable losses. It is purchased by
organizations who do not want to assume 100% of
the liability for losses arising from the plans.
Under a stop-loss policy, the insurance company
becomes liable for losses that exceed certain
limits called deductibles.
Some communities prefer to
create virtual insurance amongst themselves by other
means than contractual risk transfer, which assigns
explicit numerical values to risk. A number of
religious groups, including the
Amish and some
Muslim groups, depend on support provided by
their
communities when
disasters strike. The risk presented by any
given person is assumed collectively by the
community who all bear the cost of rebuilding lost
property and supporting people whose needs are
suddenly greater after a loss of some kind. In
supportive communities where others can be trusted
to follow community leaders, this tacit form of
insurance can work. In this manner the community can
even out the extreme differences in insurability
that exist among its members. Some further
justification is also provided by invoking the
moral hazard of explicit insurance contracts.
In the
United Kingdom,
The Crown (which, for practical purposes, meant
the
Civil service) did not insure property such as
government buildings. If a government building was
damaged, the cost of repair would be met from public
funds because, in the long run, this was cheaper
than paying insurance premiums. Since many UK
government buildings have been sold to property
companies, and rented back, this arrangement is now
less common and may have disappeared altogether.
Insurance companies
Insurance companies may be
classified into two groups:
- Life insurance
companies, which sell life insurance, annuities
and pensions products.
- Non-life,
General, or Property/Casualty
insurance companies, which sell other types of
insurance.
General insurance companies
can be further divided into these sub categories.
- Standard Lines
- Excess Lines
In most countries, life and
non-life insurers are subject to different
regulatory regimes and different
tax and
accounting rules. The main reason for the
distinction between the two types of company is that
life, annuity, and pension business is very
long-term in nature ¡ª coverage for life assurance or
a pension can cover risks over many
decades. By contrast, non-life insurance cover
usually covers a shorter period, such as one year.
In the United States,
standard line insurance companies are "mainstream"
insurers. These are the companies that typically
insure autos, homes or businesses. They use pattern
or "cookie-cutter" policies without variation from
one person to the next. They usually have lower
premiums than excess lines and can sell directly to
individuals. They are regulated by state laws that
can restrict the amount they can charge for
insurance policies.
Excess line insurance
companies (also known as Excess and Surplus)
typically insure risks not covered by the standard
lines market. They are broadly referred as being all
insurance placed with non-admitted insurers.
Non-admitted insurers are not licensed in the states
where the risks are located. These companies have
more flexibility and can react faster than standard
insurance companies because they are not required to
file rates and forms as the "admitted" carriers do.
However, they still have substantial regulatory
requirements placed upon them. State laws generally
require insurance placed with surplus line agents
and brokers not to be available through standard
licensed insurers.
Insurance companies are
generally classified as either
mutual or stock companies. Mutual
companies are owned by the policyholders, while
stockholders (who may or may not own policies) own
stock insurance companies.
Demutualization of mutual insurers to form stock
companies, as well as the formation of a hybrid
known as a mutual holding company, became common in
some countries, such as the United States, in the
late 20th century.
Other possible forms for an
insurance company include
reciprocals, in which policyholders
'reciprocate' in sharing risks, and Lloyd's
organizations.
Insurance companies are
rated by various agencies such as
A. M. Best. The ratings include the company's
financial strength, which measures its ability to
pay claims. It also rates financial instruments
issued by the insurance company, such as bonds,
notes, and securitization products.
Reinsurance companies are insurance
companies that sell policies to other insurance
companies, allowing them to reduce their risks and
protect themselves from very large losses. The
reinsurance market is dominated by a few very large
companies, with huge reserves. A reinsurer may also
be a direct writer of insurance risks as well.
Captive insurance companies may be defined
as limited-purpose insurance companies established
with the specific objective of financing risks
emanating from their parent group or groups. This
definition can sometimes be extended to include some
of the risks of the parent company's customers. In
short, it is an in-house self-insurance vehicle.
Captives may take the form of a "pure" entity (which
is a 100% subsidiary of the self-insured parent
company); of a "mutual" captive (which insures the
collective risks of members of an industry); and of
an "association" captive (which self-insures
individual risks of the members of a professional,
commercial or industrial association). Captives
represent commercial, economic and tax advantages to
their sponsors because of the reductions in costs
they help create and for the ease of insurance risk
management and the flexibility for cash flows they
generate. Additionally, they may provide coverage of
risks which is neither available nor offered in the
traditional insurance market at reasonable prices.
The types of risk that a
captive can underwrite for their parents include
property damage, public and product liability,
professional indemnity, employee benefits,
employers' liability, motor and medical aid
expenses. The captive's exposure to such risks may
be limited by the use of reinsurance.
Captives are becoming an
increasingly important component of the risk
management and risk financing strategy of their
parent. This can be understood against the following
background:
- heavy and increasing
premium costs in almost every line of coverage;
- difficulties in
insuring certain types of fortuitous risk;
- differential coverage
standards in various parts of the world;
- rating structures
which reflect market trends rather than
individual loss experience;
- insufficient credit
for deductibles and/or loss control efforts.
There are also companies
known as 'insurance consultants'. Like a mortgage
broker, these companies are paid a fee by the
customer to shop around for the best insurance
policy amongst many companies. Similar to an
insurance consultant, an 'insurance broker' also
shops around for the best insurance policy amongst
many companies. However, with insurance brokers, the
fee is usually paid in the form of commission from
the insurer that is selected rather than directly
from the client.
Neither insurance
consultants nor insurance brokers are insurance
companies and no risks are transferred to them in
insurance transactions. Third party administrators
are companies that perform underwriting and
sometimes claims handling services for insurance
companies. These companies often have special
expertise that the insurance companies do not have.
The financial stability and
strength of an insurance company should be a major
consideration when buying an insurance contract. An
insurance premium paid currently provides coverage
for losses that might arise many years in the
future. For that reason, the viability of the
insurance carrier is very important. In recent
years, a number of insurance companies have become
insolvent, leaving their policyholders with no
coverage (or coverage only from a government-backed
insurance pool or other arrangement with less
attractive payouts for losses). A number of
independent rating agencies provide information and
rate the financial viability of insurance companies.
Global insurance industry
Global insurance premiums
grew by 3.4% in 2008 to reach $4.3 trillion. For the
first time in the past three decades, premium income
declined in inflation-adjusted terms, with non-life
premiums falling by 0.8% and life premiums falling
by 3.5%. The insurance industry is exposed to the
global economic downturn on the assets side by the
decline in returns on investments and on the
liabilities side by a rise in claims. So far the
extent of losses on both sides has been limited
although investment returns fell sharply following
the bankruptcy of Lehman Brothers and bailout of AIG
in September 2008. The financial crisis has shown
that the insurance sector is sufficiently
capitalised. The vast majority of insurance
companies had enough capital to absorb losses and
only a small number turned to government for
support.
Advanced economies account
for the bulk of global insurance. With premium
income of $1,753bn, Europe was the most important
region in 2008, followed by North America $1,346bn
and Asia $933bn. The top four countries generated
more than a half of premiums. The US and Japan alone
accounted for 40% of world insurance, much higher
than their 7% share of the global population.
Emerging markets accounted for over 85% of the
world¡¯s population but generated only around 10% of
premiums. Their markets are however growing at a
quicker pace.
[18]
Controversies
Religious concerns
Muslim scholars have
varying opinions about insurance. Insurance policies
that earn interest are generally considered to be a
form of
riba[19]
(usury) and some consider even policies that do not
earn interest to be a form of gharar
(speculation). Some argue that gharar is not
present due to the actuarial science behind the
underwriting.[20]
Jewish rabbinical scholars
also have expressed reservations regarding insurance
as an avoidance of God's will but most find it
acceptable in moderation.[21]
Some Christians believe
insurance represents a lack of faith[22]
and there is a long history of resistance to
commercial insurance in
Anabaptist communities (Mennonites,
Amish,
Hutterites,
Brethren in Christ) but many participate in
community-based self-insurance programs that spread
risk within their communities.[23][24][25]
Insurance insulates too much
By creating a "security
blanket" for its insureds, an insurance company may
inadvertently find that its insureds may not be as
risk-averse as they might otherwise be (since, by
definition, the insured has transferred the risk to
the insurer), a concept known as
moral hazard. To reduce their own financial
exposure, insurance companies have contractual
clauses that mitigate their obligation to provide
coverage if the insured engages in behavior that
grossly magnifies their risk of loss or liability.[citation
needed]
For example, life insurance
companies may require higher premiums or deny
coverage altogether to people who work in hazardous
occupations or engage in dangerous sports. Liability
insurance providers do not provide coverage for
liability arising from
intentional torts committed by or at the
direction of the insured. Even if a provider were so
irrational as to want to provide such coverage, it
is against the public policy of most countries to
allow such insurance to exist, and thus it is
usually illegal.[citation
needed]
Complexity of insurance policy contracts
Insurance policies can be
complex and some policyholders may not understand
all the fees and coverages included in a policy. As
a result, people may buy policies on unfavorable
terms. In response to these issues, many countries
have enacted detailed statutory and regulatory
regimes governing every aspect of the insurance
business, including minimum standards for policies
and the ways in which they may be
advertised and sold.
For example, most insurance
policies in the English language today have been
carefully drafted in
plain English; the industry learned the hard way
that many courts will not enforce policies against
insureds when the judges themselves cannot
understand what the policies are saying.
Many institutional
insurance purchasers buy insurance through an
insurance broker. While on the surface it appears
the broker represents the buyer (not the insurance
company), and typically counsels the buyer on
appropriate coverage and policy limitations, it
should be noted that in the vast majority of cases a
broker's compensation comes in the form of a
commission as a percentage of the insurance premium,
creating a conflict of interest in that the broker's
financial interest is tilted towards encouraging an
insured to purchase more insurance than might be
necessary at a higher price. A broker generally
holds contracts with many insurers, thereby allowing
the broker to "shop" the
market for the best rates and coverage possible.
Insurance may also be
purchased through an agent. Unlike a broker, who
represents the policyholder, an agent represents the
insurance company from whom the policyholder buys.
An agent can represent more than one company.
An independent insurance
consultant advises insureds on a fee-for-service
retainer, similar to an attorney, and thus offers
completely independent advice, free of the financial
conflict of interest of brokers and/or agents.
However, such a consultant must still work through
brokers and/or agents in order to secure coverage
for their clients.
Redlining
Redlining is the practice of denying insurance
coverage in specific geographic areas, supposedly
because of a high likelihood of loss, while the
alleged motivation is unlawful discrimination.
Racial profiling or
redlining has a long history in the property
insurance industry in the United States. From a
review of industry underwriting and marketing
materials, court documents, and research by
government agencies, industry and community groups,
and academics, it is clear that race has long
affected and continues to affect the policies and
practices of the insurance industry.[26]
In July, 2007, The Federal
Trade Commission released a report presenting the
results of a study concerning credit-based insurance
scores and automobile insurance. The study found
that these scores are effective predictors of the
claims that consumers will file.
[2]
All states have provisions
in their rate regulation laws or in their fair trade
practice acts that prohibit unfair discrimination,
often called redlining, in setting rates and making
insurance available.[27]
In determining premiums and
premium rate structures, insurers consider
quantifiable factors, including location,
credit scores,
gender,
occupation,
marital status, and
education level. However, the use of such
factors is often considered to be unfair or
unlawfully
discriminatory, and the reaction against this
practice has in some instances led to political
disputes about the ways in which insurers determine
premiums and regulatory intervention to limit the
factors used.
An insurance underwriter's
job is to evaluate a given risk as to the likelihood
that a loss will occur. Any factor that causes a
greater likelihood of loss should theoretically be
charged a higher rate. This basic principle of
insurance must be followed if insurance companies
are to remain solvent.[citation
needed] Thus, "discrimination" against
(i.e., negative differential treatment of) potential
insureds in the risk evaluation and premium-setting
process is a necessary by-product of the
fundamentals of insurance underwriting. For
instance, insurers charge older people significantly
higher premiums than they charge younger people for
term life insurance. Older people are thus treated
differently than younger people (i.e., a distinction
is made, discrimination occurs). The rationale for
the differential treatment goes to the heart of the
risk a life insurer takes: Old people are likely to
die sooner than young people, so the risk of loss
(the insured's death) is greater in any given period
of time and therefore the risk premium must be
higher to cover the greater risk. However, treating
insureds differently when there is no actuarially
sound reason for doing so is unlawful
discrimination.
What is often missing from
the debate is that prohibiting the use of
legitimate, actuarially sound factors means that an
insufficient amount is being charged for a given
risk, and there is thus a deficit in the system.[citation
needed] The failure to address the
deficit may mean insolvency and hardship for all of
a company's insureds.[citation
needed] The options for addressing the
deficit seem to be the following: Charge the deficit
to the other policyholders or charge it to the
government (i.e., externalize outside of the company
to society at large).[citation
needed]
Insurance patents
New assurance products can
now be protected from copying with a
business method patent in the
United States.
A recent example of a new
insurance product that is patented is
Usage Based
auto insurance. Early versions were
independently invented and patented by a major U.S.
auto insurance company,
Progressive Auto Insurance (U.S.
Patent 5,797,134) and a Spanish independent
inventor, Salvador Minguijon Perez (EP patent 0700009).
Many independent inventors
are in favor of patenting new insurance products
since it gives them protection from big companies
when they bring their new insurance products to
market. Independent inventors account for 70% of the
new U.S. patent applications in this area.
Many insurance executives
are opposed to patenting insurance products because
it creates a new risk for them.
The Hartford insurance company, for example,
recently had to pay $80 million to an independent
inventor, Bancorp Services, in order to settle a
patent infringement and theft of trade secret
lawsuit for a type of corporate owned life insurance
product invented and patented by Bancorp.
There are currently about
150 new patent applications on insurance inventions
filed per year in the United States. The rate at
which patents have issued has steadily risen from 15
in 2002 to 44 in 2006.
[28]
Inventors can now have
their insurance U.S. patent applications reviewed by
the public in the
Peer to Patent program.[29]
The first insurance patent application to be posted
was
US2009005522 ¡°Risk assessment company¡±. It was
posted on March 6, 2009. This patent application
describes a method for increasing the ease of
changing insurance companies.[30]
The insurance industry and rent seeking
Certain insurance products
and practices have been described as
rent seeking by critics.[citation
needed] That is, some insurance
products or practices are useful primarily because
of legal benefits, such as reducing taxes, as
opposed to providing protection against risks of
adverse events. Under United States tax law, for
example, most owners of
variable annuities and
variable life insurance can invest their premium
payments in the stock market and defer or eliminate
paying any taxes on their investments until
withdrawals are made. Sometimes this tax deferral is
the only reason people use these products.[citation
needed] Another example is the legal
infrastructure which allows life insurance to be
held in an irrevocable trust which is used to pay an
estate tax while the proceeds themselves are
immune from the estate tax.