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Actuary An actuary analyzes, evaluates and manages statistical information to determine rates.
Top Admitted Insurance Company A company is admitted when it has been licensed and accepted by the appropriate governmental regulator of a state. In determining its financial condition a ceding insurer is allowed to take credit for the unearned premiums and unpaid claims on the risks reinsured if the reinsurance is placed in an admitted reinsurance company. Top Alternative Risk Transfer Alternative risk transfer (ART) is an alternative to traditional insurance. A company’s risks are funded by means other than the purchase of insurance through an agent broker from an admitted insurer. ART forms include surplus lines placement, self-insured trusts, risk retention groups and captives. The alternative market seeks to avoid costs associated with insurance brokerage and allow a business to finance its own risk. Top Arbitration Clause Language providing a means of resolving differences between the reinsurer and the reinsured without litigation. Usually, each party appoints an arbiter. The two thus appointed select a third arbiter, or umpire, and a majority decision of the three becomes binding on the parties to the arbitration proceedings. Top Association Any legal organization of sole proprietorships, corporations, partnerships, limited liability companies or associations that has been in continuous existence for at least one year and has the power to vote all of the outstanding voting securities for its captive. Top Attachment Point The dollar amount under an excess of loss reinsurance contract at which a ceding (primary) insurer's retention requirements have been met, and the point at which the reinsurance will respond to a loss. Top Bordereau (plural Bordereaux) A form providing premium or loss data with respect to identified specific risks which is furnished the reinsurer by the reinsured. Top Burning Cost A term most frequently used in spread loss property reinsurance to express pure loss cost or more specifically the ratio of incurred losses within a specified amount in excess of the ceding company’s retention to its gross premiums over a stipulated number of years. Top Cancellation (a) Run-off basis means that the liability of the reinsurer under policies, which became effective under the treaty prior to the cancellation date of such treaty, shall continue until the expiration date of each policy; (b) Cut-off basis means that the liability of the reinsurer under policies, which became effective under the treaty prior to the cancellation date of such treaty, shall cease with respect to losses resulting from accidents taking place on and after said cancellation date. Usually the reinsurer will return to the company the unearned premium portfolio, unless the treaty is written on an earned premium basis. Top Capacity Capacity is determined by the amount of surplus an insurer is willing to put at risk for the payment of losses experienced by their insureds. An insurer has a fixed amount of premium they are willing to write associated with their capacity. Top Catastrophe Reinsurance A form of reinsurance that indemnifies the ceding company for the accumulation of losses in excess of a stipulated sum arising from a catastrophic event such as conflagration, earthquake or windstorm. Catastrophe loss generally refers to the total loss of an insurance company arising out of a single catastrophic event. Top Cede To cede is to transfer part or all of a risk to another company (reinsurer). A fee is charged for the service of accepting that risk. Top Ceding Commission The cedant’s acquisition costs and overhead expenses, taxes, licenses and fees, plus a fee representing a share of expected profits - sometimes expressed as a percentage of the gross reinsurance premium. Top Ceding Company The original or primary insurer; the insurance company which purchases reinsurance. Top Claims-Made Basis A form of reinsurance under which the date of the claim report is deemed to be the date of the loss event. Claims reported during the term of the reinsurance agreement are therefore covered, regardless of when they occurred. A claims made agreement is said to “cut off the tail” on liability business by not covering claims reported after the term of the reinsurance agreement - unless extended by special agreement. See Occurrence Basis. Top Commission In reinsurance, the primary insurance company usually pays the reinsurer its proportion of the gross premium it receives on a risk. The reinsurer then allows the company a ceding or direct commission allowance on such gross premium received, large enough to reimburse the company for the commission paid to its agents, plus taxes and its overhead. The amount of such allowance frequently determines profit or loss to the reinsurer. Top Commutation Clause A clause in a reinsurance agreement, which provides for estimation, payment and complete discharge of all future obligations for reinsurance losses incurred regardless of the continuing nature of certain losses such as unlimited medical and lifetime benefits for Workers’ Compensation. Top Contingent Commissions (or Profit Commission) An allowance payable to the ceding company in addition to the normal ceding commission allowance. It is a pre-determined percentage of the reinsurer’s net profits after a charge for the reinsurer’s overhead, derived from the subject treaty. Top Contributing Excess Where there is more than one reinsurer sharing a line of insurance on a risk in excess of a specified retention, each such reinsurer shall contribute towards any excess loss in proportion to his original participation in such risk. Example: Retention $100,000, Reinsurer A accepts one-half contributing share part of $1,000,000 in excess of said $100,000. Reinsurer B accepts remaining one-half contribution share part of $1,000,000. Top Domicile “Domicile” means the state or area where the captive resides. So, the captive is domiciled (or governed by the laws and formed) in that state. Top Earned Premium (1) That part of the premium applicable to the expired part of the policy period, including the short-rate premium on cancellation, the entire premium on the amount of loss paid under some contracts, and the entire premium on the contract on the expiration of the policy. (2) That portion of the reinsurance premium calculated on a monthly, quarterly or annual basis which is to be retained by the reinsurer should there cession be canceled. (3) When a premium is paid in advance for a certain time, the company is said to “earn” the premium as the time advances. For example, a policy written for three years and paid for in advance would be one-third “earned” at the end of the first year. Top Errors and Omissions Clause A provision in reinsurance agreements which is intended to neutralize any change in liability or benefits as a result of an inadvertent error by either party. Top Excess of Loss A form of reinsurance under which recoveries are available when a given loss exceeds the cedant’s retention defined in the agreement. Top Ex Gratia Payment A payment made for which the company is not liable under the terms of its policy. Usually made in lieu of incurring greater legal expenses in defending a claim. Rarely encountered in reinsurance as the reinsurer by custom and for practical reasons follows the fortunes of the ceding company. Top Expense Ratio The percentage of premium used to pay all the costs of acquiring, writing and servicing insurance and reinsurance. Top Experience (1) The loss record of an insured or of a class of coverage. (2) Classified statistics of events connected with insurance, of outgo, or of income, actual or estimated. (3) What figures show to have happened in the past.Experience may be compiled on different bases to provide various means of appraisal, viz. Accident Year, Calendar Year, or Policy Year, but, for underwriting purposes, should always compare earned premium with incurred losses after the latter have been modified by an allowance for loss development and incurred but not reported losses (I.B.N.R.). Top Extra Contractual Obligations (ECO) A generic term that, when used in reinsurance agreements, refers to damages awarded by a court against an insurer which are outside the provisions of the insurance policy, due to the insurer’s bad faith, fraud, or gross negligence in the handling of a claim. Examples are punitive damages and losses in excess of policy limits. Top Expense Ratio The percentage of premium not directed to the coverage of losses but rather to the payment of expenses associated with writing and servicing the risk. Top Facultative Facultative coverage is a form of reinsurance where the reinsurer accepts or rejects individual risks. If a member of a group captive has an individual need for additional coverages not shared by the group, these coverages can be placed facultatively with the captive’s reinsurance treaty. Top Federal Risk Retention Act Revised and enacted in 1981, this law makes allowances for captive and risk retention groups to form and operate. The legislation preempts restrictive and prohibitive state laws that would preclude insurers from giving preferential rates, terms and conditions to groups seeking liability insurance coverage. The act provides definitions to aid in gaining an understanding of RRGs. Top Financial Reinsurance A form of reinsurance which considers the time value of money and has loss containment provisions. One of its objectives is the enhancement of the cedant’s financial statements or operating ratios, e.g., the combined ratio; loss portfolio transfers; and financial quota shares are examples. Top Flat Rate In reinsurance, a percentage rate applied to a ceding company’s premium writings for the classes of business reinsured to determine the reinsurance premiums to be paid the reinsurer. Top Following the Fortunes The clause stipulating that once a risk has been ceded by the reinsured, the reinsurer is bound by the same fate thereon as experienced by the ceding company. Top Fronting/Issuing Company A fronting company is a commercial insurance company licensed and admitted in the state(s) where a risk to be insured is located. The captive contracts with the front to issue its policy to the insured(s). The front then transfers all that risk to the captive and/or reinsurers through a reinsurance agreement known as a fronting agreement. Fronting companies provide various levels of involvement from simply providing the paper for the policies to complete underwriting and issuance. Of course, their fees vary to match the depth of their services. The result is insurance policies issued on admitted paper, but with the risk associated with the coverage retained by the captive. Top Incurred Loss Ratio The percentage of losses incurred to premiums earned. (See Experience.) Top Indemnify Indemnify means “to make whole,” or return one to the state that occurred before the loss incident. Insurers generally indemnify two parties: persons damaged by a liability loss, and the insured damaged by a property loss. Top Industrial Insured An insured which procures the insurance of any risk or risks by use of the services of a full-time employee acting as an insurance manager or buyer. An industrial insured must have aggregate annual premiums for insurance on all risks totaling at least $25,000 and have at least 25 full-time employees. Top Inflation Factor A loading to provide for increased medical costs and loss payments in the future due to inflation. Top Intermediary A third party in the design, negotiation, and administration of a reinsurance agreement. Intermediaries recommend to cedants the type and amount of reinsurance to be purchased and negotiate the placement of coverage with reinsurers. Top Intermediary Clause A provision in reinsurance agreements which identifies the intermediary negotiating the agreement. Most intermediary clauses shift all credit risk to reinsurers by providing that: 1. the cedant’s payments to the intermediary are deemed payments to the reinsurer; and 2. the reinsurer’s payments to the intermediary are not payments to the cedant until actually received by the cedant. This clause is mandatory in some states. Top Layer A horizontal segment of the liability insured, e.g., the second $100,000 of a $500,000 liability is the first layer if the cedant retains $100,000 but a higher layer if it retains a lesser amount. Top Lead Reinsurer The reinsurer who negotiates the terms, conditions, and premium rates and first signs on to the slip; reinsurers who subsequently sign on to the slip under those terms and conditions are considered following reinsurers. Top Letter of Credit A financial guaranty issued by a bank that permits the party to which it is issued to draw funds from the bank in the event of a valid unpaid claim against the other party; in reinsurance, typically used to permit reserve credit to be taken with respect to non-admitted reinsurance; and alternative to funds withheld and modified coinsurance. Top Loss Adjustment Expense LAE means all expenditures of an insurer associated with the adjustment, recording and settlement of claims other than the indemnity itself. There are two types of LAE. Allocated Loss Adjustment Expense (ALAE) is identified by the claim file in the insurers record, such as attorney’s fees. (ULAE) Unallocated Loss Adjustment Expense is the fixed cost an insurer bears to be able to process claims regardless of the individual claims. Top Loss Development The difference between the original loss as originally reported to the reinsurer and its subsequent evaluation at a later date or at the time of its final disposal. A serious problem to reinsurers who, being involved in the more serious cases, must frequently wait many years for the final disposition of a loss. Top Loss Event The total losses to the ceding company or to the reinsurer resulting from a single cause such as a windstorm. Top Loss Ratio The loss ratio is the incurred losses of a captive compared to the earned premiums expressed as a percentage. Top
Glossary of Captive Insurance Terms
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