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| Insurance In the United
States |
Principles of insurance
Commercially insurable risks typically
share seven common characteristics.
1.A
large number of homogeneous exposure units. The vast majority of insurance
policies are provided for individual members of very large classes. Automobile
insurance, for example, covered about 175 million automobiles in the United
States in 2004.The existence of a large number of homogeneous exposure units
allows insurers to benefit from the so-called “law of large
numbers ” which in effect states that as the number of exposure units
increases, the actual results are increasingly likely to become close to
expected results. There are exceptions to this criterion.Lloyd's of
London
is famous for insuring the life or health of actors, actresses and sports
figures. Satellite Launch insurance covers events that are infrequent. Large
commercial property policies may insure exceptional properties for which there
are no ‘homogeneous’ exposure units. Despite failing on this criterion, many
exposures like these are generally considered to be insurable.
2.Definite Loss. The event that gives rise to the loss that
is subject to insurance should, at least in principle, take place at a known
time, in a known place, and from a known cause. The classic example is death of
an insured on a life insurance policy. Fire, automobile accidents, and worker
injuries may all easily meet this criterion. Other types of losses may only be
definite in theory. Occupational disease, for instance, may involve prolonged
exposure to injurious conditions where no specific time, place or cause is
identifiable. Ideally, the time, place and cause of a loss should be clear
enough that a reasonable person, with sufficient information, could objectively
verify all three elements.
3.Accidental Loss. The event that
constitutes the trigger of a claim should be fortuitous, or at least outside the
control of the beneficiary of the insurance. The loss should be ‘pure,’ in the
sense that it results from an event for which there is only the opportunity for
cost. Events that contain speculative elements, such as ordinary business risks,
are generally not considered insurable.
4.Large Loss. The size of the
loss must be meaningful from the perspective of the insured. Insurance premiums
need to cover both the expected cost of losses, plus the cost of issuing and
administering the policy, adjusting losses, and supplying the capital needed to
reasonably assure that the insurer will be able to pay claims. For small losses
these latter costs may be several times the size of the expected cost of losses.
There is little point in paying such costs unless the protection offered has
real value to a buyer.
5.Affordable Premium. If the likelihood of an insured event
is so high, or the cost of the event so large, that the resulting premium is
large relative to the amount of protection offered, it is not likely that anyone
will buy insurance, even if on offer. Further, as the accounting profession
formally recognizes in financial accounting standards (See FAS 113 for example),
the premium cannot be so large that there is not a reasonable chance of a
significant loss to the insurer. If there is no such chance of loss, the
transaction may have the form of insurance, but not the substance.
6.Calculable Loss. There are two elements that must be at least
estimable, if not formally calculable: the probability of loss, and the
attendant cost. Probability of loss is generally an empirical exercise, while
cost has more to do with the ability of a reasonable person in possession of a
copy of the insurance policy and a proof of loss associated with a claim
presented under that policy to make a reasonably definite and objective
evaluation of the amount of the loss recoverable as a result of the claim.
7.Limited risk of catastrophically large losses. The essential risk
is often aggregation. If the same event can cause losses to numerous
policyholders of the same insurer, the ability of that insurer to issue policies
becomes constrained, not by factors surrounding the individual characteristics
of a given policyholder, but by the factors surrounding the sum of all
policyholders so exposed. Typically, insurers prefer to limit their exposure to
a loss from a single event to some small portion of their capital base, on the
order of 5 percent . Where the loss can be aggregated, or an
individual policy could produce exceptionally large claims, the capital
constraint will restrict an insurers appetite for additional policyholders. The
classic example is earthquake insurance, where the ability of an underwriter to
issue a new policy depends on the number and size of the policies that it has
already underwritten. Wind insurance in hurricane zones, particularly along
coast lines, is another example of this phenomenon. In extreme cases, the
aggregation can affect the entire industry, since the combined capital of
insurers and reinsurers can be small compared to the needs of potential
policyholders in areas exposed to aggregation risk. In commercial fire insurance
it is possible to find single properties whose total exposed value is well in
excess of any individual insurer’s capital constraint. Such properties are
generally shared among several insurers, or are insured by a single insurer who
syndicates the risk into the reinsurance market.