Insurance is the equitable transfer
of the risk of a loss, from one entity to another in exchange for payment. It
is a form of risk
management primarily used to hedge against the
risk of a contingent, uncertain loss.
An insurer, or insurance
carrier, is a company selling the insurance; the insured, or policyholder, is
the person or entity buying the insurance policy. The amount of money to be charged for a certain amount of
insurance coverage is called the premium. Risk management, the
practice of appraising and
controlling risk, has evolved as a discrete field of study and practice.
The transaction involves the
insured assuming a guaranteed and known relatively small loss in the form of
payment to the insurer in exchange for the insurer's promise to compensate (indemnify) the insured
in the case of a financial (personal) loss. The insured receives a contract, called
the insurance
policy, which details the conditions and circumstances under which
the insured will be financially compensated.
Principles
Insurance involves pooling funds from many insured
entities (known as exposures) to pay for the losses that some may incur. The
insured entities are therefore protected from risk for a fee, with the fee
being dependent upon the frequency and severity of the event occurring. In
order to be an insurable
risk, the risk insured against must meet certain characteristics.
Insurance as a financial intermediary is a commercial enterprise and a major
part of the financial services industry, but individual entities can also self-insure through
saving money for possible future losses.
Insurability
Risk which can be insured by
private companies typically shares seven common characteristics:
1. Large number of similar
exposure units: Since
insurance operates through pooling resources, the majority of insurance
policies are provided for individual members of large classes, allowing
insurers to benefit from the law
of large numbers in which predicted losses are similar to the
actual losses. Exceptions include Lloyd's
of London, which is famous for insuring the life or health of
actors, sports figures, and other famous individuals. However, all exposures
will have particular differences, which may lead to different premium rates.
2. Definite loss: The loss takes place at a
known time, in a known place, and from a known cause. The classic example is
death of an insured person 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.
3. 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 or even
purchasing a lottery ticket, are generally not considered insurable.
4. 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 hardly any point in paying such costs unless the protection
offered has real value to a buyer.
5. 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, then it is not
likely that the insurance will be purchased, even if on offer. Furthermore, as
the accounting profession formally recognizes in financial accounting
standards, 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, then
the transaction may have the form of insurance, but not the substance.
6. Calculable loss: There are two elements that
must be at least estimable, 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.
7. Limited risk of
catastrophically large losses: Insurable losses are ideally independent and non-catastrophic, meaning that the
losses do not happen all at once and individual losses are not severe enough to
bankrupt the insurer; insurers may prefer to limit their exposure to a loss
from a single event to some small portion of their capital base. Capital constrains
insurers' ability to sell earthquake
insurance as well as wind insurance in hurricane zones.
In the US, flood
risk is insured by the federal government. 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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