Basic Principles of Life and Health Insurance

Role of insurance

transfer risk of loss from an individual or business to an insurance company

Industry overview: social aspect

provides employment for thousands involved in transacting contracts and thousands more in servicing and adjusting losses covered by insurance

Industry overview: economic aspect

insurance is 2nd only to commercial banking industry as a source of investment funds

Private insurers

funded by premiums; may offer many lines of insurance formed as stock, mutual, reciprocals, or fraternal insurers; must be authorized by state

Government insurers

provides insurance where private insurer cannot/will not; called social insurance (medicare, social security, federal crop, national flood); funded with taxes, serves national and state social purposes

Admitted

qualified and received certificate of authority from department of insurance to transact insurance in the state

Independent rating services

financial strength based on prior claims experience, investment earnings, level or reserves, management (AM Best, Fitch, Standard & Poor's, Moody's, Weiss)

Independent agency/American agency system

1 independent agent represents several companies, non-exclusive, commissions on personal sales, business renewal with any company

Exclusive agency system/captive agents

1 agent represents 1 company, exclusive, compensation and commissions, appoints subagents

General agency system

general agent-entrepreneur represents 1 company, exclusive, compensation and commissions, appoints subagents

Managerial system

branch manager (supervises agents) salaried, agents can be insurer's employees or independent contractors

Direct response marketing system

no agents, company advertises directly to the consumers (TV, mail, etc.), consumers apply directly to the company

Law of large numbers

the larger the # of similar exposure units considered, the more closely the losses reported will equal the underlying probability of loss

Pure risk

situations that can only result in a loss or no chance, no opportunity for financial gain, only type of insurable risk

Speculative risk

opportunity for either loss or gain (gambling), not insurable

Peril

cause of loss (collision)

Hazard

risky behavior (physical, moral, morale)

Methods of handling risk

avoidance; retention: planned assumption of risk through deductions, co-payments, of self-insurance; sharing; reduction; transfer

Elements of insurable interest

loss must be 1) due to chance 2) definite and measurable 3) statistically predictable 4) not catastrophic 5) not be mandatory