Title: Insurance and Risk Finance 640
1Insurance and RiskFinance 640
- Class 11
- October 27, 2004
2Types of Personal Auto Coverage
- Third party liability
- First party medical payments
- In no-fault states PIP coverage for medical
expenses and lost income - Uninsured and underinsured motorists
- Physical damage
3Basic Part of Personal Auto Policy
- Part A Liability Coverage
- Part B Medical Payments Coverage
- Part C Uninsured Motorists Coverage
- Part D Coverage for Damage to Your Auto
- Part E Duties After an Accident or Loss
- Part F General Provisions
4Part A Liability Coverage
- Insuring Agreement
- Insurer promises to
- Pay damages for which an insured person is
legally liable because of an auto accident - Defend the Insured
- Pay the costs of defense
5Liability Coverage
- Single limit known as a combined single limit
- Split limits
- Example
-
- 100,000 per person for bodily injury
- 300,000 per accident for bodily injury
- 50,000 per accident for property damage
- No annual aggregate limit
6Liability Coverage
- Compulsory liability
- Most states make minimum limits mandatory
- Financial responsibility laws
- Penalize negligent drivers who cannot pay minimum
damage amount - All states have such laws
- Liability insurance satisfies laws
7Ohios Financial Responsibility Law
- Ohio does not require drivers or owners to buy
car insurance. - Instead, you are required to have a guaranteed
way to pay for injuries or damages that result
from - Your negligence as a driver, or
- The negligence of anyone operating an auto that
you may own. - This guarantee is known as proof of financial
responsibility.
8Ohio Proof of Financial Responsibility
- Insurance with minimum limits of
- 12,500 to Bodily Injury to one person in any one
accident - 25,000 Bodily Injury to two or more persons in
any one accident - 7,500 Property Damage for injury to property of
others in an accident - 30,000 bond issued by a surety company
- Certificate of bond in the amount of 30,000
- Signed by two individuals
- Who own real estate having equity totaling at
least 60,000 - Certificate of the Treasurer of the State
evidencing the deposit of 30,000 in money and
securities.
9Liability Coverage
- Who is insured and when?
- Named insured plus
- resident spouse
- other family members
- others who use the covered auto with permission
- Covered auto is vehicle listed on the policy plus
- newly acquired vehicles
- temporary substitute vehicles
10Liability Coverage Types of exclusions
- Intentional injury or damage
- Injury to an employee covered under WC
- Using vehicle as a public or livery conveyance
- Vehicles used in auto business
- Vehicles with less than 4 wheels
- Vehicles furnished or available for the insured
or family members regular use
11Liability CoverageSupplementary Payments
- In addition to policy limits, payments for
- Bail bond up to 250
- Premiums on appeal and release of attachments
bonds - Interest on the judgment
- Loss of earnings up to 50 day to attend a
hearing or trial - Other reasonable expenses incurred at the request
to the insurer
12Medical Payments Coverage
- In tort liability states
- Optional
- Limits are generally low (e.g., 1,000 - 2,500)
- Payments regardless of fault
- Payments not coordinated with other medical
expense insurance - could collect twice
13Medical Payments Coverage (cont.)
- Insured persons are
- Named insured and family members
- While occupying a motor vehicle
- When struck by a motor vehicle while walking
- Other persons while driving a covered auto
14Medical Payments Coverage
- In no-fault states
- Personal injury protection (PIP)
- Often compulsory
- Also provides limited loss of income coverage
15Uninsured and Underinsured Motorists Coverage
- Coverage if liable party has no or insufficient
coverage - Coverage for all damages that otherwise would
have been paid - medical expenses
- lost income
- pain and suffering
- Compulsory in many states
- Applicants wishing to decline UM/UIM may be
required to sign a waiver form.
16Uninsured and Underinsured Motorists Coverage
(cont.)
- Uninsured Vehicles
- Vehicles with no applicable BI liability coverage
- Vehicles with coverage less that the amount
required by the states financial responsibility
or compulsory insurance law - Hit and run vehicles
- Vehicles where the bonding or insurance company
is insolvent
17Uninsured and Underinsured Motorists Coverage
(cont.)
- Underinsured Motorist Coverage
- Applies when other driver has liability insurance
limit that is less than your actual damages
18Physical Damage Coverage
- Collision
- Covers damage from collisions and rollovers
- Other-than-collision (comprehensive)
- Covers damage from
- falling objects, explosions, glass breakage,
- earthquake, windstorms, hail,
- contact with an animal
- Deductibles generally used for both
19Physical Damage Coverage (cont.)
- Payment of loss
- Company will pay the lesser of
- Actual cash value or,
- The cost to repair or
- The cost to replace
- Less any applicable deductible.
- Loss to a non-owned trailer is limited to 500
20Auto Insurance Price Increases
21Average Auto Insurance Expenditures by State
22Rating Factors
- Driver characteristics
- Age
- Gender
- Marital status
- Use of the auto
- Number of autos
- Other factors
- Driving Record
- Territory
23Bodily Injury Claim Frequency
24Restrictions on Rating Factors
- Examples
- Gender
- Marital status
- Use driving experience instead of age (MA)
- Territory
25Underwriting
- Insurers have discretion to deny coverage in most
states - Underwriting criteria
- Typically, lower rates are associated with more
stringent underwriting criteria - Example
- deny if potential insured drinks alcohol
- charge lower rates than competitors who do not
use this criteria
26Government Restrictions on Underwriting
- Some states require insurers to accept all
applicants, I.e., no underwriting - Underwriting restrictions are generally related
to rating restrictions - otherwise rating restrictions can be circumvented
- Disadvantages of restrictions (see Ch. 8)
- Prices do not reflect expected costs as closely
distorts behavior - Costly to enforce
27Residual Markets
- Provide insurance at a regulated price to those
who otherwise would find it difficult to buy
insurance - All states have one
- Market shares vary widely
- Higher market share in states with
- more restrictions on rating and underwriting
- more regulation of rate changes
28Residual Market Share by State
29Types of Residual Market Plans
- Assigned risk plans
- Most states
- Applicants assigned to insurers in proportion to
their market share - Insurer receives the (regulated) premium and pays
claims
30Types of Residual Market Plans
- Reinsurance facilities
- Each insurer sells to all applicants
- Insurer can reinsure unwanted insureds to state
reinsurer - Deficit of reinsurer is paid
- by all insurers in proportion to their market
share - by all policyholders (recoupment fee)
31Types of Residual Market Plans
- Joint underwriting associations
- State hires several insurers to insure unwanted
policyholders - Agents submit applications to these insurers
- Deficit is paid by all insurers in proportion to
their market share - State insurer (MD)
- Deficit is paid by all insurers in proportion to
their market share
32Economic Rationale for Compulsory Auto Insurance
- Without it, accident costs will not be borne by
those who cause accidents - Uninsured do not bear the full cost of their
driving -
- some drive even though benefits of driving
- Uninsured do not bear the full cost of decisions
to drive less safely - drive less safely than if forced to purchase
insurance with experience rating
33Criticisms of Compulsory Insurance
- Its regressive
- I.e., it disproportionately hurts low income
people - Forces them to buy insurance to protect other
people - Weak enforcement
- Better to allow people to opt out by making a
contribution to the state (VA, SC)
34No-fault versus Tort Liability
- Tort liability
- Drivers that cause accidents can be sued for the
losses incurred by others - Pure no-fault
- Drivers pay their own costs regardless of fault
- No law suits
- No state has pure no-fault
- Tort liability is restricted, not eliminated
35No-fault Laws
- Mandatory PIP coverage
- Varies across states
- Under 10,000 in MA, unlimited in MI
- Limitations on suits
- Cannot sue for losses covered by mandatory PIP
- Cannot sue for pain and suffering unless
- losses exceed a monetary threshold
- losses meet verbal threshold
36Arguments For and Against No-fault
- For
- More efficient compensation system
- Less pain suffering compensation
- Faster compensation
- Lower legal costs
- Against
- Reduces safety
- Not fair
37Effect of No-fault on Premiums
- Depends on
- Limitations on tort liability
- Level of mandatory PIP coverage
38Homeowners Insurance Types of Policies
- Multiple-line
- 1st party property
- 3rd party liability
- 3rd party medical expense
- Multiple-peril
- Fire, windstorms, theft, etc.
- Named peril versus open peril policies
- Standard policy forms (HO3 form most common)
39Major Coverages
- Type of Coverage Amount of Coverage in HO3
Policy - A. Dwelling Chosen by policyholder
- B. Other Structures 10 percent of dwelling
coverage - C. Unscheduled Personal Property 50 percent
of dwelling coverage - D. Loss of Use (e.g., additional
- living expenses if dwelling
- cannot be occupied) 20 percent of dwelling
coverage - E. Personal liability 100,000 (can be
increased) - F. Medical payments to others 1,000 per
person(can be increased) - 25,000 aggregate limit (can be
increased)
40Insuring Agreements Section II
- Personal Liability Coverage E
- Has a single limit of 100,000 per occurrence
- Can be increased by payment of additional premium
- Applies to any claim or suit for damages
- Because bodily injury or property damage
- Caused by an insureds personal activities.
41Insuring Agreements Section II (cont)
- Medical Payments to Others Coverage F
- Pays up to 1000 for medial bills of someone who
is accidentally injured - On the premises of an insured or,
- By the activities of an insured
- A residence employee or,
- By an animal owned or cared for by an insured
- This limit can be increased
42Persons Insured Homeowners Section II
- Name Insured and Spouse
- Resident Relatives
- Any person under age 21 in the care of the
insured - Any student enrolled in school full time, who was
a resident of the household before moving out to
attend school, provided the student is under the
age of - 24 and your relative
- 21 and in the care of the insured, spouse or
resident relatives
43Persons Insured Homeowners Section II(cont.)
- Any person or organization responsible for
covered animals or watercraft owned by an insured - With respect to a covered vehicle, any person
acting in the employment of an insured
44Excluded Perils
- Intentional acts
- Normal wear and tear
- Changes in laws
- Earthquakes
- Floods
- Nuclear accidents
- War
45Homeowners Special Limits
- 200 on money, bank notes, bullion, coins and
medals - 1500 on securities, valuable papers, stamp
collections - 1500 on watercraft, including trailers and
equipment - 1,500 for theft of jewelry, watches, furs,
precious and semi-precious stones - 2,500 for theft of firearms and related
equipment
46Homeowners Special Limits (cont.)
- 2,500 for theft of silverware, goldware,
pewterware, etc. - 2,500 on property, on residence premises, used
for business - 500 on property, away from residence premises,
sued for business - 1,500 on certain electronic apparatus while in
or upon a motor vehicle - 1,500 on certain electronic apparatus used
primarily for business, while away from the
residence premises and not in or upon a vehicle.
47Endorsement to Section II Coverages
- Business pursuits designed to cover certain
occupations for legal liability arising out of
business activities - Sales representatives
- Teachers
- Messengers
- Collectors
- Office employees
- Personal Injury
- False arrest, detention or imprisonment,
malicious prosecution - Libel, slander, defamation of character
- Invasion of privacy, wrongful eviction, wrongful
entry
48Section II Endorsements (cont.)
- Watercraft and recreational vehicles Separate
endorsements are needed for each - Watercraft endorsement Provides liability and
medical payment coverage - On any inboard or outboard powered watercraft,
- Sailing vessels 26 feet or more in length and
- Watercraft powered by outboard motors exceeding
25 total horsepower
49Property Loss Settlement
- Per occurrence deductible
- Methods of valuing property
- Like-kind replacement cost
- Actual cash value
- replacement cost - depreciation
- Guaranteed replacement cost
- Functional replacement cost
50Pricing
- Premium (insured value) x rate
- Estimation of insured value
- square footage
- dwelling type
- construction grade
- construction material
- location
- Factors affecting the rate
- location
- construction materials
51Personal Umbrella Policies
- Excess liability coverage
- Limits 1 million
- Applies once losses exceed limits on other
policies - auto liability
- homeowners
52Coverage of Catastrophic Perils
- Earthquake
- Offered by most homeowners insurers
- required in CA
- Deductible of home value
- Flood (NFIP)
- Purchased through private insurers
- Risk borne by federal government (taxpayers)
- Some policies are subsidized
- Moral hazard
- Many exposed homeowners go w/o coverage
53Residual Market Plans
- Fair Plans
- Created following urban riots in 1967-68
- Subsidized coverage for urban property
- CA expanded scope between 94-96
- 28 states have plans
- Beach and Windstorm Plans
- Subsidized coverage for coastal property
- 7 states have plans
54Policies in Beach and Windstorm Plans
55Hurricane Andrew
- 16 billion in insured losses
- Insurers attempted to (1) reduce exposure and (2)
increase price - FL restricted both activities
- Still many homeowners could not find coverage
- Beach windstorm plan exposure increased
- FL created new residual market plan in 1993 (JUA)
- Merged beach windstorm plan with JUA in 2002
- Created Hurricane Catastrophe Fund in 1993
- Investment earnings not taxed
56Northridge Earthquake
- 12.5 billion in insured losses
- Insurers attempted to (1) reduce exposure to
earthquakes and (2) stop selling homeowners
coverage - CA restricted ability to cancel or fail to renew
coverage - Created CA Earthquake Authority (CEA)
- Insurers could satisfy its requirement to sell
earthquake coverage by offering a CEA policy
57Government Reinsurance Arrangements
- FL, CA, and HA have reinsurance plans
- Proposals have been introduced for federal plan
- Advantages
- Preferential tax treatment of investment earnings
on capital set aside to fund future losses - Governments can facilitate risk pooling over time
- Potential disadvantages
- Inadequate pricing
- Raid funds for other purposes
58New Capital Market Instruments
- Examples
- Catastrophe bonds
- Insurer issues bonds
- If cat occurs, insurer does not have to repay
interest and/or principal - Contingent equity
- Insurer has option to issue new stock at
pre-arranged price if a catastrophe occurs - Potential advantages
- Insurer can hold less equity capital
- Lower tax and agency costs