The Insurance Machine
Table of Contents
| Welcome | 
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| 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 | 
| Compensating Balance Plans, Paid-loss retro | 12 | 
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| Chapter Two: Controlling Loss | 13 | 
| Risk/Chance of Loss | 13 | 
| 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 | 
| Pricing | 23 | 
| Adverse Selection, actuarial equity | 24 | 
| Selective Underwriting | 26 | 
| The First Step in the Selection Process | 26 | 
| Level of Risk | 26 | 
| Standard risk | 26 | 
| 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 | 
| What are we Insuring Against? | 31 | 
| The Economic Burden of Risk | 33 | 
| Types of Risk | 33 | 
| Determining degrees of Risk | 34 | 
| Probability of Loss | 35 | 
| The Law of Large Numbers | 35 | 
| Risk Information | 35 | 
| 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 | 
| What Else is Available? | 43 | 
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| Chapter Four: Ratemaking | 45 | 
| 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 | 
| 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 | 
| The Role of Terrorism Insurance | 77 | 
| Policy Restrictions | 79 | 
| Business Interruption Insurance | 79 | 
| Example | 80 | 
| Workers Compensation & Other Coverage | 80 | 
| Coverage Under TRIA | 81 | 
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| Chapter Seven: Ethics | 86 | 
| “Agent, Protect Thyself” | 86 | 
| 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