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Learning Objectives :

       Understand

       1. Type of Insurance Organizations
       2. Organizational Structure of Insurance Companies
       3. Functions of Insurers

Structure :
       1.1 Type of Insurance Organizations
       1.2 Organizational Structures of Insurance Companies
       1.3 Functions of Insurers
       1.4 Key Terms
       1.5 Activity
       1.6 Summary
       1.7 Suggested Readings
Types of Insurance Organizations :

Insurance organizations are classified by

       basis of risk coverage โ€“ life, general
       [health, property, auto].
       their        agency           system   [independent,
       exclusive, direct selling]
       formation from legal point of view โ€“
       stock or mutual.
Types of Insurance Organizations :

Stock Companies

       owned & controlled by common stock
       holders.
       they appoint board of directors who in
       turn engage officers to run operations.
       profits    distributed    among   stock
       holders.
       normally policy holders are eligible
       for   benefit    contracted   but   not
       dividends.
Types of Insurance Organizations :

Mutual Companies

       normally non-profit organizations.
       owned by policy holders.
       initial contribution arranged by them
       or a financial intermediary which must
       be repaid.
       surplus          generated    is   shared   by
       paying dividends or reducing premiums.
Types of Mutual Companies :
a] Assessment Mutuals -
      Policy holders may not pay a premium
      when policy begins.
      They are responsible for a premium
      based on their share of expenses &
      losses at the end of the period.
      If an exposure is based on product
      sales or payrolls, the exact exposure
      is not known at the start of the
      policy.
      Thus policy holders pay their fair
      share
Types of Mutual Companies :
b] Advance Premium Mutuals โ€“


      Policy holders pay a premium when
      policy    begins.
      They are eligible for dividend at the
      end of the period.
      Their exposure is based on a stable
      product   where exposure does       not
      change during the life of the policy.
      Increased dividends accrue from less
      than expected expenses ; investment
      earnings [loss].
Types of Mutual Companies :
c] Factory      Mutuals โ€“

      Factory mutuals provide substantial
      loss prevention services for insured
      premises.
      Those   meeting   strict   safety   and
      construction standards can qualify for
      coverage.
      Large up-front and multi year deposits
      are made which generally tie up funds.
      If companies qualify, the costs can be
      reasonable.
Types of Mutual Companies :
d] Farm     Mutuals โ€“

      Farm mutuals serve insurance needs of
      local      home     owners,   farm   &   other
      business operators.
      They are community based.
      Are owned by policy holders.
      And are run by a board of directors who
      are policy holders.
Types of Mutual Companies :
e] Perpetual       Mutuals โ€“

     Perpetual mutuals charge a single large
     advance premium
     This premium earns enough investment
     income to cover all future losses and
     expenses.
f] Fraternal Mutuals
     These      are     primarily     social
     organizations
     They    serve   particular    religion,
     nationality or labour groups.
Reciprocal or Inter-Insurance Exchanges :

โ€ข This     exchange   is    a    not   for   profit,
unincorporated association of individuals.

โ€ข   Its members exchange insurance.

โ€ข An individual or a corporation is granted the
legal ability to transact business for the group.

โ€ข This attorney-in-fact carries [and is paid for]
all administrative services including underwriting &
selling.

โ€ข Initial capital is obtained from i} prepayment of
premiums by members or ii} sub-ordinated loans from
attorney-in-fact. He is paid a % of premiums.
Lloydโ€™s of London :

Lloydโ€™s of London is not a company but an
association and its members engage in
insurance. It is the largest & worldโ€™s best
known insurer. Because
     Its   underwriters   insure   โ€œunusualโ€
     exposures, which gives it a lot of
     publicity.
     It settles, even largest claims, fairly
     and promptly.
     It has financial capacity to handle
     large exposures.
     It has reputation for innovation &
     expertise in many technical areas.
โ€ข
Selecting the form of Organization :



   Selection is governed by the laws of the
region.

   In India insurer has to register under
Companies Act 1956 and obtain license from
โ€œInsurance Regulatory & Development
Authorityโ€

   Various arguments              exist favoring stock
insurer or mutuals                as better form of
organization.
Selecting the form of Organization :

    Arguments favoring stock insurer -

       1] capital contribution by owners adds
       to the funds available to absorb
       unfavorable operations.

       2] profit motive of stock       companies
       makes operations effective.

       3] independent agents carry operations
       in the interest of clients.

       4] initial premiums tend to be lower.
Selecting the form of Organization :

    Arguments favoring mutuals -

       1] being non profit organizations. They
       provide economic premiums in the long
       run.

       2] policy holders share the results of
       favorable operations.

       3] since dividends are not paid to
       โ€œoutsidersโ€, they provide insurance
       more cheaply.
Selecting the form of Organization :

       Demutualization โ€“

Sometimes mutual insurance company converts
itself into a stock insurance company. This
process is termed demutualization.

The rationale for demutualization โ€“

       1] tax advantages.

     2] opportunity to raise funds from the
market   and   thus   stabilize   financial
strengths.
Selecting the form of Organization :
    Demutualization โ€“ the rationale โ€“ contd.

     3] secure flexibility in designing
capital structure.
     4]    scope for setting down stream
holding companies
The process faces problems related to legal,
cost,    regulatory,   tax   and   accounting
aspects.
     Though demutualization of insurance
       companies is not seen in India,
    demutualization of stock exchanges is
                   visible.
Organizational Structure of Insurance Companies :

    Must coincide with business model of the
insurer. It depends on parameters like

              coverage
              location
              stock or mutual
              level of authority
              legal restrictions

Board of Directors is in overall charge of
the   company  and   provides  all  policy
decisions.
Organizational Structure of Insurance Companies :

The Board of Directors                 is     assisted   by
several officers like

              General Manager.
              Company Secretary.
              Head Management Services
              Investment Committee or Manager
              HR Manager

It has offices at HQ, Regions, Main & Sub
branches whose number depend upon size and
geographic coverage of operations.
Organizational Structure of Insurance Companies :

The Board of Directors is further assisted
by several heads of functions like

              Actuary.
              Agency.
              Legal
              Finance
              Advertising.
              Medical.
              Accounting.
              Underwriting.

and other important functions.
Organizational Structure of Insurance Companies :
Various arguments exist favoring centralized
or decentralized forms of organization
๎ “ Centralized Organization
Advantages :
โ™ฃ Uniformity of Policy.
โ™ฃ Most economic use of mechanized methods.
โ™ฃ Branches relieved of routines & focus on
     selling.
Disadvantages :
โ™ฃ Higher costs.
โ™ฃ Poor services as administration away from
policy holders.
Organizational Structure of Insurance Companies :
Various arguments exist favoring centralized
or decentralized forms of organization
๎ “ Decentralized Organization
Advantages :
โ™ฃ Good local service provided.
โ™ฃ Local officials best understand local
conditions.
โ™ฃ Branch staff become more knowledgeable.
Disadvantages :
โ™ฃ Many experts required & hence high costs.
โ™ฃ Branches drowned in routine work.
Functions of Insurers :

๎ “ Various tasks in insurance   organization

โ™ฃ function, including sales, underwriting,
administration, claims etc.
โ™ฃ product, including life, property, and
liability, marine insurance etc.
โ™ฃ   territory  including   local, regional,
national & international.
โ™ฃ customer type, including individuals,
commercial     enterprises,     private    or
government institutions etc.
โ™ฃ specialists complementing insurance like
general   counsel,   actuarial,   statistics,
engineering & administration.
Functions of Insurers :

๎ “ Following departments execute insurerโ€™s
  functions.

1. Actuarial.
  Is concerned with all the financial
  functions   {  calculation   of  premiums,
  policy reserves, non-forfeiture values and
  dividends] of life or health insurance and
  with rate making in property and liability
  insurance.
Functions of Insurers :

๎ “    Underwriting.

    This   department   is   responsible   for
    selecting, classifying and rating risks.

    The major goal of the function is to
    select   a   portfolio   of   risks   that
    contributes to the profits & surplus of
    the insurer at an optimum level to achieve
    equity among policy holders.
Functions of Insurers :

๎ “   Sales & Marketing.
Insurance business is a business of law of
  large numbers. Marketing function arranges
  to   attract    a  sufficient  number   of
  exposures    to   allow   credible   ratio
  prediction.
Insurance,   being   a  service  business,
  requires marketing department to play a
  key role in delivery.
Functions of Insurers :
๎ “   Accounting
Insurance accounting is a complex function
  regulated by laws of the respective
  countries. The difficult job is to create
  โ€œreserves for contingenciesโ€ which are
  probabilistic  and   hence   difficult  to
  predict.
IRDA has issued formats in which financial
  statements are to be prepared by insurance
  companies.
Functions of Insurers :
๎ “   Investing & Financing.
Insurance companies are referred to as
  โ€œclosed end investment trusts engaged in
  the underwriting of risks as a means of
  obtaining funds for investment.โ€
Large size of investment portfolio provides
  vital importance to this function.
It   has   to  serve   twin   objectives of
  optimizing income and capital gains plus
  minimizing risks.
Functions of Insurers :

๎ “   Legal

Insurance, being a contract essentially
  requires   legal   department   in   every
  assurance organization to maintain order
  in the multitude of conflicting statutes &
  court rulings.
It is responsible for compliance of various
  laws including IRDA rules & regulations.
Functions of Insurers :

๎ “    Claims

Handling    claims   is   also    a    social
  responsibility of insurance company.

In case of Life the job is not as complex as
  with property liability where losses are
  have higher frequency, predominance of
  partial losses and uncertainty of quantum
  of loss.
Functions of Insurers :

๎ “    Others โ€“ Engineering, Administration,
    Personnel, Statistical etc.

The insurance engineer deals with loss
  control   and    prevention.  Engineering
  services are required largely in property
  & liability insurance.

The Administration Manger performs an array
  of functions from purchasing to mail rooms
  to storage, office routines to inventory,
  house keeping, property maintenance etc.
Functions of Insurers :

๎ “    Others โ€“ Engineering, Administration,
    Personnel, Statistical etc.


    The    statistician    is    an  important
    technician      within     the    company,
    particularly   in   property   & liability
    insurance. Their coding and statistical
    output are important to both actuary and
    underwriter.
Key terms :
Assessment Mutuals.       Farm Mutuals.

Advance Premium Mutuals   Factory Mutuals.

Perpetual Mutuals.        Fraternal Mutuals

Reciprocal Exchanges.     Lloydโ€™s of London

Organization Structure.   Insurer Functions
Activity :
Visit nearby office of an insurance
company to find out the organization
structure with emphasis on

   its different departments.
   their activities
   designations of senior managers.


- On return draw organization chart of that
                                   company.
To conclude:

๎ “ Insurance organizations can assume varied
  types of structures. They can be stocks or
  mutuals. Local laws govern the selection.
  Mutuals are non-profit organizations owned
  by policy holders. A stock insurer is
  owned and controlled by stock holders on
  business lines.

๎ “ Mutuals offer better premiums in the long
  run while stock companies are commercial,
  have large expansion capabilities and are
  normally run efficiently
Suggested Reading
Fundamentals of Insurance โ€“ by Mack S.
          Dorfman, Prentice-Hall, 2002.

Perspectives of Insurance โ€“ by Irving
          Pfeffer and David R Klock,
          Prentice-Hall, 1974.

Captive Insurance Companies; Establishment,
          Operational Management โ€“ by PA
          Bawcutt, Woodhead Falkner Ltd.
          1982.
The End !

 Next Chapter Two
      Product Design &
          Development

            Good Luck!
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Functions and Organisations of Insurance

  • 1. Learning Objectives : Understand 1. Type of Insurance Organizations 2. Organizational Structure of Insurance Companies 3. Functions of Insurers Structure : 1.1 Type of Insurance Organizations 1.2 Organizational Structures of Insurance Companies 1.3 Functions of Insurers 1.4 Key Terms 1.5 Activity 1.6 Summary 1.7 Suggested Readings
  • 2. Types of Insurance Organizations : Insurance organizations are classified by basis of risk coverage โ€“ life, general [health, property, auto]. their agency system [independent, exclusive, direct selling] formation from legal point of view โ€“ stock or mutual.
  • 3. Types of Insurance Organizations : Stock Companies owned & controlled by common stock holders. they appoint board of directors who in turn engage officers to run operations. profits distributed among stock holders. normally policy holders are eligible for benefit contracted but not dividends.
  • 4. Types of Insurance Organizations : Mutual Companies normally non-profit organizations. owned by policy holders. initial contribution arranged by them or a financial intermediary which must be repaid. surplus generated is shared by paying dividends or reducing premiums.
  • 5. Types of Mutual Companies : a] Assessment Mutuals - Policy holders may not pay a premium when policy begins. They are responsible for a premium based on their share of expenses & losses at the end of the period. If an exposure is based on product sales or payrolls, the exact exposure is not known at the start of the policy. Thus policy holders pay their fair share
  • 6. Types of Mutual Companies : b] Advance Premium Mutuals โ€“ Policy holders pay a premium when policy begins. They are eligible for dividend at the end of the period. Their exposure is based on a stable product where exposure does not change during the life of the policy. Increased dividends accrue from less than expected expenses ; investment earnings [loss].
  • 7. Types of Mutual Companies : c] Factory Mutuals โ€“ Factory mutuals provide substantial loss prevention services for insured premises. Those meeting strict safety and construction standards can qualify for coverage. Large up-front and multi year deposits are made which generally tie up funds. If companies qualify, the costs can be reasonable.
  • 8. Types of Mutual Companies : d] Farm Mutuals โ€“ Farm mutuals serve insurance needs of local home owners, farm & other business operators. They are community based. Are owned by policy holders. And are run by a board of directors who are policy holders.
  • 9. Types of Mutual Companies : e] Perpetual Mutuals โ€“ Perpetual mutuals charge a single large advance premium This premium earns enough investment income to cover all future losses and expenses. f] Fraternal Mutuals These are primarily social organizations They serve particular religion, nationality or labour groups.
  • 10. Reciprocal or Inter-Insurance Exchanges : โ€ข This exchange is a not for profit, unincorporated association of individuals. โ€ข Its members exchange insurance. โ€ข An individual or a corporation is granted the legal ability to transact business for the group. โ€ข This attorney-in-fact carries [and is paid for] all administrative services including underwriting & selling. โ€ข Initial capital is obtained from i} prepayment of premiums by members or ii} sub-ordinated loans from attorney-in-fact. He is paid a % of premiums.
  • 11. Lloydโ€™s of London : Lloydโ€™s of London is not a company but an association and its members engage in insurance. It is the largest & worldโ€™s best known insurer. Because Its underwriters insure โ€œunusualโ€ exposures, which gives it a lot of publicity. It settles, even largest claims, fairly and promptly. It has financial capacity to handle large exposures. It has reputation for innovation & expertise in many technical areas. โ€ข
  • 12. Selecting the form of Organization : Selection is governed by the laws of the region. In India insurer has to register under Companies Act 1956 and obtain license from โ€œInsurance Regulatory & Development Authorityโ€ Various arguments exist favoring stock insurer or mutuals as better form of organization.
  • 13. Selecting the form of Organization : Arguments favoring stock insurer - 1] capital contribution by owners adds to the funds available to absorb unfavorable operations. 2] profit motive of stock companies makes operations effective. 3] independent agents carry operations in the interest of clients. 4] initial premiums tend to be lower.
  • 14. Selecting the form of Organization : Arguments favoring mutuals - 1] being non profit organizations. They provide economic premiums in the long run. 2] policy holders share the results of favorable operations. 3] since dividends are not paid to โ€œoutsidersโ€, they provide insurance more cheaply.
  • 15. Selecting the form of Organization : Demutualization โ€“ Sometimes mutual insurance company converts itself into a stock insurance company. This process is termed demutualization. The rationale for demutualization โ€“ 1] tax advantages. 2] opportunity to raise funds from the market and thus stabilize financial strengths.
  • 16. Selecting the form of Organization : Demutualization โ€“ the rationale โ€“ contd. 3] secure flexibility in designing capital structure. 4] scope for setting down stream holding companies The process faces problems related to legal, cost, regulatory, tax and accounting aspects. Though demutualization of insurance companies is not seen in India, demutualization of stock exchanges is visible.
  • 17. Organizational Structure of Insurance Companies : Must coincide with business model of the insurer. It depends on parameters like coverage location stock or mutual level of authority legal restrictions Board of Directors is in overall charge of the company and provides all policy decisions.
  • 18. Organizational Structure of Insurance Companies : The Board of Directors is assisted by several officers like General Manager. Company Secretary. Head Management Services Investment Committee or Manager HR Manager It has offices at HQ, Regions, Main & Sub branches whose number depend upon size and geographic coverage of operations.
  • 19. Organizational Structure of Insurance Companies : The Board of Directors is further assisted by several heads of functions like Actuary. Agency. Legal Finance Advertising. Medical. Accounting. Underwriting. and other important functions.
  • 20. Organizational Structure of Insurance Companies : Various arguments exist favoring centralized or decentralized forms of organization ๎ “ Centralized Organization Advantages : โ™ฃ Uniformity of Policy. โ™ฃ Most economic use of mechanized methods. โ™ฃ Branches relieved of routines & focus on selling. Disadvantages : โ™ฃ Higher costs. โ™ฃ Poor services as administration away from policy holders.
  • 21. Organizational Structure of Insurance Companies : Various arguments exist favoring centralized or decentralized forms of organization ๎ “ Decentralized Organization Advantages : โ™ฃ Good local service provided. โ™ฃ Local officials best understand local conditions. โ™ฃ Branch staff become more knowledgeable. Disadvantages : โ™ฃ Many experts required & hence high costs. โ™ฃ Branches drowned in routine work.
  • 22. Functions of Insurers : ๎ “ Various tasks in insurance organization โ™ฃ function, including sales, underwriting, administration, claims etc. โ™ฃ product, including life, property, and liability, marine insurance etc. โ™ฃ territory including local, regional, national & international. โ™ฃ customer type, including individuals, commercial enterprises, private or government institutions etc. โ™ฃ specialists complementing insurance like general counsel, actuarial, statistics, engineering & administration.
  • 23. Functions of Insurers : ๎ “ Following departments execute insurerโ€™s functions. 1. Actuarial. Is concerned with all the financial functions { calculation of premiums, policy reserves, non-forfeiture values and dividends] of life or health insurance and with rate making in property and liability insurance.
  • 24. Functions of Insurers : ๎ “ Underwriting. This department is responsible for selecting, classifying and rating risks. The major goal of the function is to select a portfolio of risks that contributes to the profits & surplus of the insurer at an optimum level to achieve equity among policy holders.
  • 25. Functions of Insurers : ๎ “ Sales & Marketing. Insurance business is a business of law of large numbers. Marketing function arranges to attract a sufficient number of exposures to allow credible ratio prediction. Insurance, being a service business, requires marketing department to play a key role in delivery.
  • 26. Functions of Insurers : ๎ “ Accounting Insurance accounting is a complex function regulated by laws of the respective countries. The difficult job is to create โ€œreserves for contingenciesโ€ which are probabilistic and hence difficult to predict. IRDA has issued formats in which financial statements are to be prepared by insurance companies.
  • 27. Functions of Insurers : ๎ “ Investing & Financing. Insurance companies are referred to as โ€œclosed end investment trusts engaged in the underwriting of risks as a means of obtaining funds for investment.โ€ Large size of investment portfolio provides vital importance to this function. It has to serve twin objectives of optimizing income and capital gains plus minimizing risks.
  • 28. Functions of Insurers : ๎ “ Legal Insurance, being a contract essentially requires legal department in every assurance organization to maintain order in the multitude of conflicting statutes & court rulings. It is responsible for compliance of various laws including IRDA rules & regulations.
  • 29. Functions of Insurers : ๎ “ Claims Handling claims is also a social responsibility of insurance company. In case of Life the job is not as complex as with property liability where losses are have higher frequency, predominance of partial losses and uncertainty of quantum of loss.
  • 30. Functions of Insurers : ๎ “ Others โ€“ Engineering, Administration, Personnel, Statistical etc. The insurance engineer deals with loss control and prevention. Engineering services are required largely in property & liability insurance. The Administration Manger performs an array of functions from purchasing to mail rooms to storage, office routines to inventory, house keeping, property maintenance etc.
  • 31. Functions of Insurers : ๎ “ Others โ€“ Engineering, Administration, Personnel, Statistical etc. The statistician is an important technician within the company, particularly in property & liability insurance. Their coding and statistical output are important to both actuary and underwriter.
  • 32. Key terms : Assessment Mutuals. Farm Mutuals. Advance Premium Mutuals Factory Mutuals. Perpetual Mutuals. Fraternal Mutuals Reciprocal Exchanges. Lloydโ€™s of London Organization Structure. Insurer Functions
  • 33. Activity : Visit nearby office of an insurance company to find out the organization structure with emphasis on its different departments. their activities designations of senior managers. - On return draw organization chart of that company.
  • 34. To conclude: ๎ “ Insurance organizations can assume varied types of structures. They can be stocks or mutuals. Local laws govern the selection. Mutuals are non-profit organizations owned by policy holders. A stock insurer is owned and controlled by stock holders on business lines. ๎ “ Mutuals offer better premiums in the long run while stock companies are commercial, have large expansion capabilities and are normally run efficiently
  • 35. Suggested Reading Fundamentals of Insurance โ€“ by Mack S. Dorfman, Prentice-Hall, 2002. Perspectives of Insurance โ€“ by Irving Pfeffer and David R Klock, Prentice-Hall, 1974. Captive Insurance Companies; Establishment, Operational Management โ€“ by PA Bawcutt, Woodhead Falkner Ltd. 1982.
  • 36. The End ! Next Chapter Two Product Design & Development Good Luck!
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