5. Functions within insurance organisations Flashcards
What is the essential role of Underwriting?
To calculate the premiums to be charged for the risks to be insured and to create and control the extent of cover given under the policy.
What is an underwriting manual?
A guide used to control underwriting practices. It includes details on premiums categorised by risk factors.
In an underwriting a manual what does a ‘loading’ mean?
An additional charge added to an insurance premium to account for higher risk factors associated with the subject matter.
What is a ‘pure risk premium’?
The part of the premium necessary to pay for losses and
loss-related expenses only.
Give 4 examples of ‘loadings’
- Dangerous occupations
- Health conditions
- Whether or not the proposer is a smoker
- Proximity to a river or the coast
Give any example of why an underwriter may apply a discount to a property premium.
If building has a sprinkler system fitted.
What is the usual quotation process on the Internet?
The process is automated so there is no personal interaction with a broker or the proposer. The policyholder can print the policy wording and retain this for their records.
What is the usual quotation process over the telephone?
A call centre handles simple proposals by phone. The underwriting assistant collects details, provides a quote, and confirms cover if accepted. Complex cases go to a senior underwriter for review.
What is the quotation process for large commercial businesses?
The policyholder will be required to supply a comprehensive pack of information, usually to their broker, so that quotations can be obtained with full disclosure of material facts.
What are the 5 standard stages used by a risk management function?
- Identifying Strategic Objectives
- Risk Identification
- Risk Analysis
- Risk Reporting
- Monitoring and Iteration
What is a risk register?
A centralised record of identified risks is maintained by the risk management team, who update it and report key findings.
What is a risk matrix?
A quantified assessment used to assist in ranking risks according to materiality.
In risk assessment, what are inherent and residual risks?
Inherent risk is the risk before controls, while residual risk is the remaining risk after applying controls
In risk management, how is the RAG (Red Amber Green) rating system used?
A risk matrix provides a visual representation of severity, with red indicating high-risk areas requiring immediate action and green representing lower-risk concerns.
What is a claims philosophy?
Outlines the goals and targets for each stage of the claims process, setting key performance indicators for speed, efficiency, and service quality.
What are 7 stages in a claims process?
- Events Giving Rise to the Claim
- Claims Notification
- Claim Review
- Response to Claimant
- Claim Investigation
- Claim Negotiation and Settlement
- Claim Recoveries
What 6 points are involved in reviewing a claim?
- The Amounts Claimed
- The Information Provided at the Time the Insurance Was Purchased
- The Exact Terms of the Policy
- The Legal Requirements
- Market Practice
- The Insurance Company’s Claims Philosophy
What 3 choices does an insurer have in responding to a claim?
- Payment
- Negotiation
- Rejection
What 5 ways are claims negotiated?
- Negotiation with the customer
- Mediation
- Alterative dispute resolution
- Arbitration
5 Litigation
What is delegated authority?
When a higher authority grants another party the power to make decisions or take actions on its behalf, often within specific limits.
Give an example of a delegated authority agreement.
When an insurance company allows some form of
underwriting or policy administration to be carried out by outside entities
What is the name of the party to whom authority has been delegated?
The coverholder
What is the name of a delegated authority agreement?
A binding authority
What is the key role of a compliance department?
To ensure, as far as possible, that the operations of the firm are compliant with regulatory requirements.