Chapter 23 - reserving Flashcards
The purpose of calculating reserves
ARMIC
- determine liabilities to show in published accounts
- determine liabilities to be shown in supervisory accounts (if separate accounts have to be prepared)
- to determine liabilities to be shown in internal management accounts
- assist with assessment of reinsurance arrangements
- value the insurer for merger or acquisition
- influence investment strategy
- estimate the cost of claims incurred in recent periods and hence provide a base for estimating future premiums required to attain a given level of profitability
Reserves for short-term
- UPR
- URR
- IBNR
- claims in transit
- outstanding claims reserve
- incurred but not enough reported
- equalisation or catastrophe reserve
- investment mismatch
UPR
The balance of premiums received in respect of periods of insurance not yet expired
URR
- reserve in respect of the above unexpired insurance premium where it is felt that the premium basis is inadequate to meet future claims and expenses.
- URR is an estimate of what is actually needed to provide for the unexpired risk
- calculated by estimating the future loss ratio and applying it to the proportion of premium unexpired
Claims in transit
reserve in respect of claims reported but not assessed or recorded
Outstanding claims reserve
reserve in respect of claims notified to the insurer but not fully settled
IBNER
- reserve for outstanding reported claims
- adjustment to existing outstanding claims reserve
Equalisation or catastrophe reserve
reserves where it is felt that the current year and abnormal amounts will have to be held back for abnormal events.
Methods to calculate reserves
- case estimates
- statistical estimates
when would you use statistical estimates for long-term?
Usually used where benefits are paid as an income
When would you use case estimates for long-term?
Would only be used for very small volumes of claims, where the reserve can be determined by asking the claims manager to estimate the likely duration of each claim (where claims payments form a known income)
When would you use statistical estimates for short-term?
PMI (although certain large or unusual claims will warrant reserves on a case-by-case basis)
- statistical estimation involves calculating the expected total claim amounts for outstanding claims based on relevant past experience.
Claims estimates
claims manager inspects claims papers and estimates the ultimate outgo for each case individually
What factors for PMI will be taken into account when calculating claims estimates?
- procedure type
- hospital to be used
- name of surgeon, consultant, or other medical principal
- policy coverage
- age, gender, past claims history
- current levels of medical inflation
Disadvantages of claim estimates
- cannot be used to produce estimates for claims that have not been reported
- relies on skill and judgement of individuals
- assessors may be naturally conservative or optimistic in their assessment
- case estimates are extremely difficult to check
- if estimates used for negotiation with claimants, there may be a tendency for the estimate to be biased to the lower end
- might be thousands of outstanding claims and will take many person-hours in total to estimate each claim amount individually making method very expensive
- assessors may not use consistent rates of inflation
- in some cases, estimates of outstanding claim reserves will need to be made by outsiders who don’t have access to all the data
Advantages of claim estimates
- only approach that can make use of all known data on outstanding claims
- there are qualitative factors that influence the amount of a claim
- can be applicable when statistical methods are not reliable