The Insurance Machine
Table of Contents
| 
   Welcome  | 
  
   
  | 
 
| 
   Chapter One: Insurers  | 
  
   Page 1  | 
 
| 
   Government Sponsorship  | 
  
   1  | 
 
| 
   Private Sponsorship  | 
  
   1  | 
 
| 
   Private Insurers  | 
  
   2  | 
 
| 
   Stock Companies  | 
  
   2  | 
 
| 
   Financial Soundness  | 
  
   3  | 
 
| 
   Capital Stock, surplus, surplus to policyholders  | 
  
   3  | 
 
| 
   Lloyds of London  | 
  
   5  | 
 
| 
   Transacting Lloyds of London Business  | 
  
   7  | 
 
| 
   Excess business, surplus insurance  | 
  
   8  | 
 
| 
   Self-Insurance  | 
  
   8  | 
 
| 
   Excess loss, share basis  | 
  
   9  | 
 
| 
   Captive Insurance Companies  | 
  
   10  | 
 
| 
   Risk-Retention Groups (RRG)  | 
  
   11  | 
 
| 
   Alternatives  | 
  
   12  | 
 
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   Compensating Balance Plans, Paid-loss retro  | 
  
   12  | 
 
| 
   
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   Chapter Two: Controlling Loss  | 
  
   13  | 
 
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   Risk/Chance of Loss  | 
  
   13  | 
 
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   Loss frequency, loss-severity  | 
  
   13  | 
 
| 
   Loss Control  | 
  
   14  | 
 
| 
   Engineering Approaches  | 
  
   15  | 
 
| 
   Human Approaches  | 
  
   16  | 
 
| 
   Prevention  | 
  
   16  | 
 
| 
   Risk Awareness  | 
  
   19  | 
 
| 
   Application of Loss Prevention  | 
  
   21  | 
 
| 
   Pre-Contact  | 
  
   21  | 
 
| 
   Contact  | 
  
   22  | 
 
| 
   Post-Contact  | 
  
   22  | 
 
| 
   
  | 
  
   
  | 
 
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   Chapter Three: Underwriting & Reinsurance  | 
  
   23  | 
 
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   Pricing  | 
  
   23  | 
 
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   Adverse Selection, actuarial equity  | 
  
   24  | 
 
| 
   Selective Underwriting  | 
  
   26  | 
 
| 
   The First Step in the Selection Process  | 
  
   26  | 
 
| 
   Level of Risk  | 
  
   26  | 
 
| 
   Standard risk  | 
  
   26  | 
 
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   Preferred risk, Sub-standard risk  | 
  
   27  | 
 
| 
   Post-Selection  | 
  
   27  | 
 
| 
   Adverse Selection  | 
  
   28  | 
 
| 
   Moral Hazard  | 
  
   28  | 
 
| 
   Morale Hazard  | 
  
   29  | 
 
| 
   Example  | 
  
   29  | 
 
| 
   Competing in the Marketplace  | 
  
   29  | 
 
| 
   Redlining  | 
  
   30  | 
 
| 
   Example  | 
  
   30  | 
 
| 
   The Underwriting Cycle  | 
  
   30  | 
 
| 
   Example  | 
  
   31  | 
 
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   What are we Insuring Against?  | 
  
   31  | 
 
| 
   The Economic Burden of Risk  | 
  
   33  | 
 
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   Types of Risk  | 
  
   33  | 
 
| 
   Determining degrees of Risk  | 
  
   34  | 
 
| 
   Probability of Loss  | 
  
   35  | 
 
| 
   The Law of Large Numbers  | 
  
   35  | 
 
| 
   Risk Information  | 
  
   35  | 
 
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   The Insurer’s View & The Consumer’s View  | 
  
   36  | 
 
| 
   Line limits  | 
  
   37  | 
 
| 
   Deductible Clauses  | 
  
   37  | 
 
| 
   Reinsurance  | 
  
   38  | 
 
| 
   Why is Reinsurance Used?  | 
  
   39  | 
 
| 
   Pro Rata & Excess of Loss  | 
  
   40  | 
 
| 
   Pro Rata  | 
  
   40  | 
 
| 
   Excess of Loss  | 
  
   41  | 
 
| 
   Shopping for Reinsurance  | 
  
   41  | 
 
| 
   Brokers  | 
  
   43  | 
 
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   What Else is Available?  | 
  
   43  | 
 
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   Chapter Four: Ratemaking  | 
  
   45  | 
 
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   What is Ratemaking?  | 
  
   45  | 
 
| 
   A Matter of Class  | 
  
   46  | 
 
| 
   Territory Risk Groupings  | 
  
   47  | 
 
| 
   Special Aspects of Ratemaking  | 
  
   47  | 
 
| 
   Catastrophes  | 
  
   47  | 
 
| 
   Minimum Premiums  | 
  
   48  | 
 
| 
   Merit Rating  | 
  
   48  | 
 
| 
   Prospective Experience Rating  | 
  
   49  | 
 
| 
   Retrospective Experience Rating  | 
  
   50  | 
 
| 
   Fire Insurance  | 
  
   51  | 
 
| 
   Construction  | 
  
   51  | 
 
| 
   Occupancy  | 
  
   52  | 
 
| 
   Exposure  | 
  
   52  | 
 
| 
   Protection  | 
  
   52  | 
 
| 
   Where is the Structure Located?  | 
  
   53  | 
 
| 
   Time of Loss  | 
  
   53  | 
 
| 
   Following Proper Procedures Essential  | 
  
   53  | 
 
| 
   Schedule-rated risks  | 
  
   54  | 
 
| 
   
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   Chapter Five: Insurance Regulation  | 
  
   56  | 
 
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   Do We Need So Many Hoops?  | 
  
   56  | 
 
| 
   How Do These Traditions Come About?  | 
  
   59  | 
 
| 
   Paul versus Virginia  | 
  
   60  | 
 
| 
   How Does State Regulation Work?  | 
  
   61  | 
 
| 
   The Commissioner’s Primary Powers Include …  | 
  
   64  | 
 
| 
   Insurance: A Regulated Business  | 
  
   65  | 
 
| 
   What Do the States Do?  | 
  
   65  | 
 
| 
   Insurance Classes  | 
  
   66  | 
 
| 
   Taxation  | 
  
   66  | 
 
| 
   Regulating Agents & Brokers  | 
  
   68  | 
 
| 
   Premium Rates  | 
  
   70  | 
 
| 
   Prior Approval, Modified Prior Approval  | 
  
   71  | 
 
| 
   File-an-Use, Open Competition  | 
  
   71  | 
 
| 
   Insurer Assets  | 
  
   72  | 
 
| 
   
  | 
  
   
  | 
 
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   Chapter Six: Terrorism Risk Insurance Act  | 
  
   75  | 
 
| 
   Defining “Act of Terrorism”  | 
  
   75  | 
 
| 
   TRIA  | 
  
   75  | 
 
| 
   President Bush Signs the Act  | 
  
   77  | 
 
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   The Role of Terrorism Insurance  | 
  
   77  | 
 
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   Policy Restrictions  | 
  
   79  | 
 
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   Business Interruption Insurance  | 
  
   79  | 
 
| 
   Example  | 
  
   80  | 
 
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   Workers Compensation & Other Coverage  | 
  
   80  | 
 
| 
   Coverage Under TRIA  | 
  
   81  | 
 
| 
   
  | 
  
   
  | 
 
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   Chapter Seven: Ethics  | 
  
   86  | 
 
| 
   “Agent, Protect Thyself”  | 
  
   86  | 
 
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   Why Would an Agent be Sued?  | 
  
   88  | 
 
| 
   What Are the Agent’s Professional Responsibilities?  | 
  
   90  | 
 
| 
   Example  | 
  
   91  | 
 
| 
   E & O Insurance  | 
  
   91  | 
 
| 
   Claims-Made Versus Occurrence Policies  | 
  
   92  | 
 
| 
   Example  | 
  
   92  | 
 
| 
   On the Personal Side of Ethics  | 
  
   93  | 
 
| 
   Example  | 
  
   94  | 
 
| 
   Valuing Human Relationships  | 
  
   95  | 
 
| 
   Truly Ethical or Simply Ethical for Show?  | 
  
   95  | 
 
| 
   Example  | 
  
   96  | 
 
| 
   Example  | 
  
   97  | 
 
| 
   Justice for All  | 
  
   98  | 
 
| 
   Objectivist Ethics: Preserve Life  | 
  
   99  | 
 
| 
   What is Really Ethical?  | 
  
   102  | 
 
| 
   Just the Facts  | 
  
   102  | 
 
| 
   Cultural Relativism, Moral Reformers  | 
  
   103  | 
 
| 
   Moral Skepticism  | 
  
   105  | 
 
| 
   Viewing from a Different Angle  | 
  
   107  | 
 
| 
   Mores  | 
  
   110  | 
 
| 
   Example  | 
  
   110  | 
 
| 
   Relativism  | 
  
   112  | 
 
| 
   “Ought Implies Can”  | 
  
   113  | 
 
| 
   Example  | 
  
   114  | 
 
| 
   Personal Conditioning  | 
  
   115  | 
 
| 
   Example  | 
  
   116  | 
 
| 
   Example  | 
  
   116  | 
 
| 
   Example  | 
  
   117  | 
 
| 
   Example  | 
  
   118  | 
 
| 
   Example  | 
  
   119  | 
 
| 
   The Legal System  | 
  
   120  | 
 
| 
   Example  | 
  
   121  | 
 
| 
   Example  | 
  
   122  | 
 
| 
   Determining Right From Wrong  | 
  
   123  | 
 
| 
   Twisting & Churning  | 
  
   125  | 
 
| 
   Ethics & Premiums  | 
  
   125  | 
 
| 
   Ethics & Redlining  | 
  
   127  | 
 
United Insurance Educators, Inc.
PO Box 1030
Eatonville, WA 98328
(253) 846-1155