The Private Insurance Industry.ppt
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1、The Private Insurance Industry,Measured by any one of a number of standards, the insurance industry in the U.S. is significant. 1. 7,900 insurance companies (insurers) 2. 2.1 million persons employed 3. $3.1 trillion in assets 4. 13.6% of Gross National Product,Types of Company by Product,1. Life in
2、surers write life, annuities, and health insurance about 2,000 companies in 19982. Property and Liability insurers write property & casualty (including health) about 3,900 companies in 19983. Health and Accident insurers400 monoline health insurers69 Blue Cross & Blue Shield organizations 1,600 capi
3、tating providers (HMOs and PSOs),Types of Insurers by Form of Ownership,1. Capital stock companies2. Mutual companies3. Reciprocals-attorney in fact4. Lloyds associations 5. Health Expense Associations6. Government Insurers,Capital Stock Insurers,1. Organized as profit-making ventures with stockhold
4、ers who assume the risk that is transferred by insureds. 2. Premium charged by insurer is final-there is no form of contingent liability for policyholders. 3. Board of directors is elected by stockholders. 4. Earnings are distributed to stockholders as dividends on their stock.,Mutual Insurers,1. Ow
5、ned by policyholders 2. Distinguishing characteristic is distribution of earnings. Money left after paying costs is returned to policyholders as a dividend. 3. Broadly speaking, mutuals are divided into three classes pure assessment mutual advance premium with assessable policies advance premium non
6、assessable mutuals,Demutualization,In 1990s-a period of mergers and acquisitions -disadvantages of mutual form of organization became more apparent: limited mechanisms for accessing capital structure of mutuals not particularly flexible mutuals cannot use stock for acquisitions federal legislation t
7、o allow banks and insurers to affiliate requires a holding-company structure,Demutualization,A number of insurers have demutualized - that is, converted from mutual to stock insurers (or in some cases to a modified proprietary form). When demutualizing, a mutual insurer issues stock to policyholders
8、, but also sells new stock. Policyholders have a choice between stock in the new company or cash. Some take stock and some take cash.,Mutual Holding Company Structure,Besides demutualization, some insurers have opted for a different approach, under state mutual insurance holding company laws. Mutual
9、 converts to a stock insurer owned by a holding company that is organized as a mutual. Policyholders own mutual holding company and their contractual rights as insureds remain in the stock insurance company. holding company can own subsidiaries, and raise capital by selling stock in subsidiaries. St
10、ate laws generally require that voting control remain with the holding company.,Reciprocal Insurers,1. Also called “interinsurance exchange” 2. Unincorporated aggregation of individuals, called subscribers, who exchange risks 3. Each member is both insured and insurer 4. In a mutual, policyholders a
11、ssume liability collectively; in a reciprocal, subscribers assume liability severally 5. Administrator of the program is known as the attorney-in-fact,Lloyds Associations,1. Lloyds of London 2. American Lloyds,Lloyds Associations,1. Named after London coffee house where modern marine insurance origi
12、nated. 2. Lloyds does not write insurance, but is like the New York Stock Exchange, where buyers and sellers transact business. 3. Originally, insurance was written by over 30,000 “names,” with unlimited liability, usually as members of syndicates.,Reconstruction and Renewal Plan - 1995,Lloyds manne
13、r of operating changed after losses in 1980s led to suits against Lloyds by members Reconstruction and Renewal Plan: 1. Settlement offer to members 2. Reinsurance of pre-1992 losses (Equitas) 3. Revision of financial standards at Lloyds corporate entities limited liability increased financial requir
14、ements,American Lloyds,American Lloyds are U.S. organizations whose operations are patterned after Lloyds of London.,Insurance Exchanges,States of Florida, Illinois, and New York enacted legislation authorizing “insurance exchanges” patterned after Lloyds in 1979.Florida and New York exchanges encou
15、ntered financial difficulty and failed.Illinois exchange continues to operate successfully.,Health Expense Associations,1. Originally, Blue Cross and Blue Shield plans were formed to allow prepayment of hospital and physicians services respectively. 2. Now include Health Maintenance Organizations wh
16、ich provide a wide range of health care services in return for an annual membership fee. 3. Physician-Hospital Organizations (AKA Provider-Sponsored Organizations) are provider-owned delivery systems being formed in many areas.,Health Expense Associations,1. Terminology in this area is changing due
17、to the various proposals for reform in health care delivery system.2. Physician Hospital Organizations (PHOs) also sometimes called Integrated Delivery Systems (IDS).3. Medicare reforms in the Balanced Budget Act of 1997 introduced the term “Provider Sponsored Organization” (PSO).,Government Insurer
18、s Defined,1. Direct provision by the government 2. Government reinsurance 3. Does not include self-insurance of government exposures,Reasons for Government Insurance,1. Fundamental risks that require compulsion and lack equity 2. Hazard considered too great by private insurance 3. Adverse selection
19、against private insurers 4. Tools of social change by government 5. Mistaken notion that government can repeal the law of averages,Federal Private (Voluntary) Programs,1. War Risk Insurance (WW I, WW II)2. Nuclear Energy Liability (1957-1975) 3. Federal Riot Reinsurance Program (1968-1983)4. Post Of
20、fice Insurance coverages5. Federal Crop Insurance6. Mortgage Loan Insurance (FHA, VA)7. National Flood Insurance Program8. Federal Crime Insurance Program (1971-1996)9. SBA surety bonds 10. Federal Fidelity Bonding Program 11. Export-Import bank 12. Overseas Private Investor Corporation 13. Servicem
21、ens and Veterans Life Insurance,State Private (Voluntary) Programs,1. State workers compensation programs2. Wisconsin State Life Insurance Fund3. Title insurance funds4. Maryland State Automobile Insurance Fund,The Agent,The agent is the central figure in the marketing process. The relationship betw
22、een agents and the companies they represent varies. Through a process of evolution, several marketing forms have evolved. Each has as its goal efficiency in distribution and service.,Distinction Between Agent and Broker,Agent: an individual authorized by an insurer to create, modify, and terminate c
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