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Chapter 7

Chapter 7

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Chapter # 7
Instructor: MAHWISH KHOKHAR







Insurance companies provide (sell & service)
insurance policies, which are legally binding
contracts for which the policyholders (or
owner) pays the insurance premiums.
According to the insurance contract, insurance
companies promise to pay specified sums
contingent on the occurrence of future
events, such as death or an automobile
accident.
Thus, insurance companies are Risk Bearers.
They accept or underwrite the risk in return
for an insurance premium.




The major part of the insurance company
underwriting process is deciding which
applications for insurance they should accept
and which one they should reject, and if they
accept, determining how much they should
charge for the insurance. Underwriting is
critical to an insurance company.
Premiums are fairly stable type of
revenue, however, payments to the
policyholders are the major expense of the


Life Insurance: For life insurance, the risk
insured against is death. Life insurance company
pays the beneficiary of the life insurance policy
in the event of the death of the insured. There are
several kinds of life insurance:
 Term insurance
 Whole life
▪ Fixed
▪ Variable

 Universal life
 Second to Die (Survivorship)




Health Insurance: In the case of health insurance, the
risk insured is medical treatment of the insured. The
health insurance company pays the insured all or a
portion of the cost of medical treatment by
doctors, hospitals, or others. This type of insurance has
undergone significant changes in the last decade.
Until the last decade, the major type of health insurance
available was indemnity insurance. Which says the
insurance company will indemnify (reimburse) the
amount spent on medical treatment of the patient.
Different kinds of health insurance are:
 Medical
 Dental
 Others


Property and causality insurance: The risk
insured by property and causality (P&C) is
damage to the various types of property.
Various types of insurance are:
 Property
▪ Automobile
▪ House (its contents)
▪ Other

 Liability
 Others
Ad

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Chapter 7

  • 1. Chapter # 7 Instructor: MAHWISH KHOKHAR
  • 2.     Insurance companies provide (sell & service) insurance policies, which are legally binding contracts for which the policyholders (or owner) pays the insurance premiums. According to the insurance contract, insurance companies promise to pay specified sums contingent on the occurrence of future events, such as death or an automobile accident. Thus, insurance companies are Risk Bearers. They accept or underwrite the risk in return for an insurance premium.
  • 3.   The major part of the insurance company underwriting process is deciding which applications for insurance they should accept and which one they should reject, and if they accept, determining how much they should charge for the insurance. Underwriting is critical to an insurance company. Premiums are fairly stable type of revenue, however, payments to the policyholders are the major expense of the
  • 4.  Life Insurance: For life insurance, the risk insured against is death. Life insurance company pays the beneficiary of the life insurance policy in the event of the death of the insured. There are several kinds of life insurance:  Term insurance  Whole life ▪ Fixed ▪ Variable  Universal life  Second to Die (Survivorship)
  • 5.   Health Insurance: In the case of health insurance, the risk insured is medical treatment of the insured. The health insurance company pays the insured all or a portion of the cost of medical treatment by doctors, hospitals, or others. This type of insurance has undergone significant changes in the last decade. Until the last decade, the major type of health insurance available was indemnity insurance. Which says the insurance company will indemnify (reimburse) the amount spent on medical treatment of the patient. Different kinds of health insurance are:  Medical  Dental  Others
  • 6.  Property and causality insurance: The risk insured by property and causality (P&C) is damage to the various types of property. Various types of insurance are:  Property ▪ Automobile ▪ House (its contents) ▪ Other  Liability  Others
  • 7.   Liability Insurance: Within liability insurance, the risk insured against is litigation (lawsuit), or the risk of lawsuits against the insured due to actions by the insured or others. Disability Insurance: Disability insurance insures against the inability of employed persons to earn an income either in their own occupation or any other occupation. Disability insurance is also divided between short-term and long-term disability, with six months being typical dividing time.
  • 8.  Long-Term Care Insurance: As individuals have been living longer, they have become concerned about outliving their assets and being able to care for themselves as they age. Thus, there have been increased demand to provide custodial care for the aged who are no longer able to care for themselves.
  • 9.  Structured Settlement: Structured settlements are fixed, guaranteed periodic payments over a long period of time, typically resulting from a settlement on a disability policy or other type of policy. For example, suppose an individual is hit by an automobile and, is unable to work for the rest of his/her life can sue P&C Company for future lost earnings and medical care.
  • 10.  Investment-Oriented Products: Insurance companies have increasingly sold the products that have significant investment component in addition to their insurance component. The first major investment-oriented product developed by an insurance company was Guaranteed Investment Contract (GIC). (Read from book, pg 99)
  • 11.   Annuity: Another insurance company investment product is an annuity. An annuity is often described as “a mutual fund in an insurance wrapper”. What does this means? To answer this question assume that an insurance company investment manager has two identical common stock portfolios, one a mutual fund and the other an annuity.
  • 12.  On the mutual fund, all income (that is the dividend) is taxable, and the capital gains (or losses) realized by the fund are also taxable, although at potentially different tax rates. The income and realized gains are taxable whether they are withdrawn by the mutual fund holder or not. There are no guarantees associated with the mutual fund; its performance depend solely on the portfolio performance.
  • 13.  Because of the insurance wrapper, the annuity is treated as an insurance product and as a result receives a preferential tax treatment. Specifically, the income and the realized gains are not taxable if not withdrawn from the annuity product. Thus, the inside buildup of the returns is not taxable on an annuity, as it is also not on other insurance product.
  • 14.    In concept these various types of insurance could be combined in different ways in actual companies, traditionally they have been packaged in companies in similar ways. Traditionally, life insurance and health insurance have occurred together in a life and health insurance company (L&H Company). And property and casualty insurance have been combined in a P&C insurance company.
  • 15.    Companies that provide insurance in both insurance products are called multiline insurance companies. There have been recent changes in the combinations of products by type of company, these regulations are due to federal regulation of the health insurance company. Health insurance has predominately, but not completely, separated from life insurance and become a separate industry, so is disability insurance.
  • 16.    The fundamental aspect of insurance industry results from the relationship between the revenue and costs. Example: A bread manufacturers profit margin. A insurance company on the other hand, collects its premium annually but the payments may occur in unpredictable manner. Consequently, payments are contingent on potential future events.
  • 17.  Thus, there are two very important differences between calculating profitability of bread manufacturer and insurance companies.  First, is that the timings and the magnitude of the payments are much less certain for an insurance company.  Second, is that there is a long lag between the receipts and payments of an insurance company, which introduces the importance of an investment portfolio.
  • 18.    According to McCarran Ferguson Act of 1945, the insurance industry is regulated by the individual states, not the federal government. Insurance companies whose stock are publically traded are also regulated by Security and Exchange Commission. Model laws and laws are developed by National Association of Insurance Commissioners (NAIC).
  • 19.    The relationship between the premium revenue and the eventual contingent contractual payments. Insurance companies are monitored by their accountants and auditors, their rating agencies and their government regulators. To ensure financial stability, these monitors require insurance companies to maintain reserves or surplus.
  • 20.  Based on previous discussion, insurance companies are really a composite of three companies.  First, there is a home office or actual insurance company. This company design the insurance contract and provides the backing for financial guarantees on the contract, that is, assure the policyholder that the contract will be paid off under the conditions of the contract.  This Company is called manufacturer and guarantor of the insurance policy.
  • 21.  Second, there is investment component that invests the premiums collected in the investment portfolio. This is the investment company.  The third element of the insurance company is the distribution component or the sales force. There are different kinds of distribution forces. ▪ AGENTS: They sell company’s own manufactured products. They are not typically employees of the company.
  • 22. ▪ BROKERS: They are also not typically associated with the company but sell the products of so many insurances companies. Brokers usually perform in a group called producer group. ▪ COMMERCIAL BANKS: As deregulation progresses, commercial banks have also become a natural mean of distribution for insurance and investment products and is frown considerably. This relationship is called bankassurance.