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Insurance, in law
and economics,
is a form of
risk management primarily used to
hedge against the
risk of a contingent loss. Insurance is defined as the equitable transfer of
the risk of a loss, from one entity to another, in exchange for a premium.
Insurer, in economics, is the company that sells the insurance. Insurance
rate is a factor used to determine the amount, called the premium, to
be charged for a certain amount of insurance coverage.
Risk management, the practice of appraising and controlling risk, has
evolved as a discrete field of study and practice. Commercially insurable
risks typically share seven common characteristics.
- 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.
- 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.
- 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.
- 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.
- 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.
- Calculable Loss. There are two elements that must be at least
estimatable, 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.
- 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%. 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.
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