Chapter 22 Reserves & solvency capital requirements Flashcards
Calculating reserves: reasons/purposes
Briefly list some of the reasons for calculating reserves (7)
- Determine liabilities for published accounts
- Determine liabilities for supervisory solvency
- Determine liabilities for internal management accounts
- Estimate cost of claims incurred in recent periods, hence provide base for future estimation
- Value insurer for merger or acquisition
- Influence investment strategy
- Assist with assessment of reinsurance arrangements
Calculating reserves: various basis/important factors
Briefly describe the basis/key points to consider when setting/calculating reserves for the following exercises
- published accounts (5)
- solvency/statutory accounts (2)
- internal management accounts (5)
- for investment strategy/reinsurance assessment (1)
- Published Accounts:
- should regard
- legislation and
- accounting principles of region.
- consider
- whether going concern,
- whether true and fair view and
- whether best estimate or other basis
- should regard
- Solvency Accounts:
- consider regulator rules.
- may require break-up or run-off basis/going-concern basis
- Internal Management Accounts:
- agreed with insurer.
- may want to be realistic
- will want to look at profitability, solvency, claims and exposure, expenses, reinsurance
- Investment Strategy and Reinsurance Assessment:
- typically best estimate
Health ins reserves: intro, long-term contracts
Briefly give an overview of the various things healthcare insurers may hold reserves for, and what methods maybe used to estimate them (5)
Consider
- CI policies (2)
- Policies providing annuity/income-type benefits (4)
- In most long-term insurance, benefit amount is known once claim is filed/submitted
- most of these provisions held are for futre claims, acknowledging that a level premium pays cover of increasing probability of claim
- actuaries may use deterministic or stochastic models to estimate potential claims outgo and set provisions.
- For CI
- insurer can hold a reserve for claim that has been notified but not settled using amounts in policy doc,
- and increase with inflation where appropriate
- For income benefit (annuity type contracts),
- period for which payments may carry on is not known
- can use statistical methods
- case estimates can be used only for small volumes of important claims whereby claims manager estimates likely claim duration
Health ins reserves: types, long-term contracts, intro
List the various types of reserves which may be found for healthcare insurance contracts which are long-term (12)
-
reserves for in-force policies
- typically discounted value of future expected claims, expenses and premium cashflows
-
claims reserves
- incurred but not reported reserves (IBNR) eg when policyholders didn’t know they had cover and logged claims late
- reported but not fully settled reserves (RBNS) eg disability claims, LTCI insurance claims
- options reserves additional costs set aside in case a particular option is in the money at exercise date
- investment mismatching reserves (sometimes a regulatory requirement)
- for group contracts
- unearned premium reserves (UPR) and
- unexpired risk reserves (URR)
Health ins reserves: intro, short-term
Briefly give an overview of the various things healthcare insurers may hold reserves for, and how what methods maybe used to estimate them (5)
Short-term healthcare contracts ie PMI, are indemnity:
- claim amount amount not known with certainty until course of treatment is complete.
-
statistical approach is used to estimate amount of claim.
- although certain large claims will warrant case-by-case reserving.
- this involves calculating expected total claim amounts for outstanding claims based on relevant past experience
- each claim is unique in that many different claim causes can arise, so cost of treatment can vary considerably.
Health ins reserves: types, short-term
What are the main prospective and retrospective reserves for short-term healthcare contracts (2)
- Retrospective: Unearned prem resrv (UPR)
- Prospective: Unexpired risk reserve (URR)
Health ins reserves: types, short-term
Briefly describe the main prospective and retrospective reserves for short-term healthcare contracts
UPR (4)
URR (3)
-
Retrospective: Unearned prem resrv (UPR)
- balance of premium received but period of insurance has not yet expired
- (proportion outstanding risk)*(risk related premium)
- premium covers claim payments, initial expenses, other expenses, profit.
- apart from initial expenses, all other parts earned with incidence of risk i.e. risk premium
-
Prospective: Unexpired risk reserve (URR)
- reserve for UPR where premium is inadequate
- UPR = m% of risk related premium where m% is the remaining percentage of the period
- if UPR is inadequate, consider what else is needed, esimate expected loss ratio
Health ins reserves: types, short-term
List the various types of reserves which may be found for healthcare insurance contracts which are short-term other than the UPR, and URR (9)
- Notified Outstanding Claims Reserve (NOCR) notified to insurer; not fully settled
- Incurred But Not Reported (IBNR) Reserves
-
Incurred But Not Enough Reported (IBNER):
- an adjustment to NOCR
- eg not enough detail submitted during claim process
- Equalisation Reserve: held if current year is atypical; helps to smooth profits
- Catastrophe Reserve funds set aside just in case of future catastrophe
- Claims in transit reserve: reported but not assessed/recorded; i.e. in the pipeline
- Investment Mismatching Reserves, may be a regularoty requirement
Reserve calcs: primary methods to calc health ins reserves
What two primary methods are used to calculate reserves? (2)
Which method is used in practice? (4)
Two primary methods to calculate reserves:
- Statistical Estimates
- Case Estimates
Method used depends on
- product characteristics, and
- purpose of exercise, and
- may be split into a
- technical part (assessing actual value of pmts),
- and a judgement part (deciding on level of margins)
Reserve calcs: case estimates, overview
What do we mean by using ‘case estimates’? (1)
What is the key requirement/downside to using case estimates? (1)
What factors will the claims manager/assessor consider when making case estimates? (6)
Case estimates meaning
- Claims manager will inspect claim and estimate ultimate outgo.
- Claim must be reported before case estimate can be used
Will consider the following:
- procedure type and cost,
- hospital to be used,
- name of surgeon,
- policy coverage,
- age/gender/past claims history,
- current medical inflation
Reserve calcs: case estimates, advantages disadvantages
Give the advantages (3) and disadvantages (6) of using case estimates to estimate reserves
Advantages:
- Only approach that makes use of all known data on oustanding claims
- Experienced claims assessor can allow for the various qualitative factors that can influence a claim
- Useful when statistical methods are unreliable
Disadvantages:
- May be time consuming and expensive, especially if there are plenty of outstanding claims
- Requires clinical expertise;
- subjective
- difficult to check
- Difficulty of accounting for inflation
- Only works for reported cases; IBNR reserves still need different method for estimation
Reserve calcs: stat estimates, intro
Under what circumstances is the use of statistical methods most appropriate? (3)
What data source is most often used when using statistical methods to estimate claims? (1)
Appropriate for
- particular types of homogeneous claims where portfolio is
- large enough and
- is deemed to have stable experience.
Data used
- most statistical methods work from tabulations of claims that have recently been paid.
Reserve calcs: stat estimates, description
Outline the overall procedeur involved in estimating outstanding claims using statistical methods (12)
Overall method
- claims are assessed en masse and statistical methods estimate outstanding claims for cohorts based on
- historical trends and patterns,
- and adjusting for known or anticipated future changes.
-
assumptions are made about
- the stability/smoothness of claim development and
- that past patterns will continue into the future.
-
statistical distribution is then fit to past experience
- premium is generally better exposure unit than man-years.
- current claim provisions derived by applying relevant premium, adjusting for trends
- portfolio might be split by
- contract type, distribution channel, location, etc.
- can reserve for IBNR (incurred but not reported)
Reserve calcs: stat estimates, main methods
Briefly list/descibe the main methods through which to derive of statistical estimates of outstanding claims (4)
What kind of variations may exist within the above methods of statistically estimating outstanding claims? (8)
Four methods of statistical estimate:
- chain ladder,
- average claim cost,
- loss ratio,
- blends
Main variations may exist with regards to the following:
- past inflation,
- claim cohort,
- different grossing up factors,
- choice of exposure,
- claim settlement expenses,
- hospital discounts,
- reinsurance recoveries,
- inflation assumptions
Basic chain ladder assumptions
Give an overview of the basic chain ladder method of estimating
- Uses development ratios weighted by cumulative claim values. Applied to unadjusted paid claims during treatment year.
- Many variants of this method exist
Reserve calcs: assumptions, basic chain ladder
What are the key assumptions which underlie the basic chain ladder method of estimating reserves? (4)
- Assumes amount of claims paid in each development year from each origin year is a constant proportion of the total claim amount from that origin year.
- ie claims/payments (Pi;j) (in monetary terms) in each development month/year (i) are constant proportion of total for treatment in that origin month/year (j) (in monetary terms)
- BCL assumes past inflation continues into the future.
- Inflation-adjusted BCL can be used.
Reserve calcs: steps, basic chain ladder
Outline the key steps involved in using the basic chain ladder approach to estimating reserves (13)
- Determine
- incremental run-off triangle
- then cumulative run-off triangle
- Development factor
- ri = SUMover all j (Pi;j) / SUMover j<span> to </span>n-1 (Pi-1;j)
- (i.e. per column in cumulative run-off triangle)
- Ultimate development factor:
- fi = PRODUCTover k, from i to n ( rk)
- Proportion paid =1/fi
- Proportion outstanding = 1-1/fi
- Ultimate loss Uj = SUMover all i ( Pi;j x fn-j )
- IBNRj= Uj - SUMover i (Pi;j)
- Sensitive to P0;j (So may need adjustment for number of payment runs in a month)
- Retrospective IBNR
- Can use to check actual IBNR and determine if previous IBNR estimate was close enough; IBNR now + claims payments since
Reserve calcs: steps, triangles, basic chain ladder
In the context of a table of claims, what do we meant by an incremental triangle (2) and cumulative triangle (2)?
Incremental Triangle:
- treatment months as rows and development months as columns.
- can assume that all claims are fully settled at end of certain month after treatment (e.g. 3 months)
Cumulative Triangle:
- shows cumulative claims paid by each development month.
- simply sum subsequent amounts in incremental triangle
Reserve calcs: steps, development factors, basic chain ladder
In the context of a table of claims, what do we meant by development factors? (3)
How do we calculate the ultimate development factors? (2)
How do we calculate the proportion of total claims paid from each development month? (1)
How do we calcualte the proportion of outstanding claims for each development month? (1)
Development Factor:
- can be thought of as the expected increase in claims from one development month to next
- to calculate:
- see example in notes.
- sum amounts in month 1 and divide by same sum in month 0 etc.
Ultimate Development Factor:
- total expected increase in claims paid thus far to end of development period for all claims outstanding.
- simply multiply development factor of this month by all factors of subsequent months
- Proportion paid: = 1/ultimate development factor
- Proportion outstanding: = 1 – proportion paid
Reserve calcs: steps, IBNR calculation, basic chain ladder
How do we calculate the IBNR using the basic chain ladder method, having caclulated the development factors necessary? (4)
What adjustments might be needed to the IBNR? (4)
IBNR Calculation:
- First need to calculate ultimate loss for each month.
- Ultimate loss = cumulative claims paid to date/relevant proportion paid percentage
- IBNR = ultimate loss – cumulative claims paid to date
- (claims paid is what’s paid. IBNR is what’s not paid yet)
Adjustment for IBNR may be needed for
- Inconsistent Number of Payment Runs
- IBNR is sensitive to amount of claims paid in month 0.
- If more/less payment runs in a month, amount in month 0 will change.
- Can scale down 5 weeks to 4 by x4/5 or similar adjustment
Reserve calcs: steps, retrospective IBNR calculation, basic chain ladder
How might we perform retrospective calculations of the IBNR? (2)
Retrospective IBNR Calculation:
- Can calculate current IBNR, add back actual payments and compare to old IBNR
- Differences can be used to reconcile effectiveness of old IBNR estimate
Reserve calcs: merits, Borhhuetter Ferguson, stat estimates,
Give an overview of the method behind the Bornhuetter Ferguson method of estimating oustanding claims (5)
Overview
- Combines estimate loss ratio with projection method (e.g. chain later)
- Determine initial method of ultimate claims from each treatment month using premium and loss ratios
- Multiply estimates by proportion outstanding (1-1/UDF). Then ad figures to claims paid to date to give estimate of ultimate loss for each treatment month
- Future Claims Development =
- Premium x Estimate Loss Ratio x (1-1/UDF) = IBNR
- Ultimate Loss = IBNR + Claims Paid to Date
Reserve calcs: steps, Borhhuetter Ferguson, stat estimates
Steps in calculating a reserve using BF method.
- Determine initial estimate of the total ultimate claims from each treatment month using premiums and initial expected loss ratios.
- Multipy these estimates by the proportion outstanding (1-1/f) determined from claims development table. These are estimates of the reserve for each treatment month.
- add these figures to the claims paid to date give an esitmate of the ultimate loss for treatment month.
Reserve calcs: assumptions, Borhhuetter Ferguson, stat estimates
Assumptions underlying the Bornhuetter Ferguson method (3)
What key benefit lies in using this method to estimate oustanding claims? (3)
Assumptions
- underlying method is same as BCL.
- together with that the estimated loss ratio is appropriate
- this method could be viewed as using a Bayesian approach.
Key benefit
- It improves on the crude use of a loss ratio by taking into account information provided by latest development.
Reserve calcs: stat methods, bootstrapping, overview
Explain boostrapping and what it is used for? (5)
- It can be used to estimate the variance of the IBNR reserve.
- Shows the extent to which a reserve can vary on either side of its mean.
- A reserve method is chosen and used to produce a fitted model for historical data.
- The residual values are re-sampled with replacement to generate a number of pseudo run-off triangles.
- These pseudo run-off triangles can then be used to estimate the distribution of IBNR values.