Every time insurance industry profits decline sharply, the industry declares an “insurance crisis” – rates go up sharply, deductibles rise and underwriting guidelines tighten.
Insurance Premiums have risen much faster than claims.
Median medical malpractice payments rose 35 Percent from 1997 to 2001 (an average of 8.5% a year).Average premiums for single health insurance coverage increased 39 percent over that time period (9.5% per year). (Source: National Practitioner Database)
A small number of insured may be responsible for a large percentage of losses.
National Practitioners Database:
For example, in Florida, 6% of the doctors were found to be responsible for 51% of the malpractice claims. 2,674 out of 44,747 doctors have paid two or more malpractice payments. These doctors are responsible for 51% of total malpractice payments.
24 Florida physicians have paid 10 or more malpractice settlements since 1990.
Needless to say, the 94% pay for the poor claims experience of the 6%.ART Strategies
Conventional insurance markets are one-year indemnity contracts designed to transfer specific hazard risks. Typical features of an ART strategy are:
- Multi-year, multi-line coverage
- Coverage tailored to special need of insured
- Provides coverage not generally available in the marketplace
- Risk retention by insured
There is a multifarious trade-off between risk retention, complexity and cost among the various different ART strategies. Not surprisingly, the plans with the least risk, complexity and expense generally provide the least benefit. As more risk is retained, the greater and greater benefits can be obtained. Of course, complexity and administrative expenses grow as well. Windward Harbor can help you find, execute and manage the right strategy for you. We have listed the basic ART strategies below.
Guaranteed Cost Insurance Plans
Traditional insurance coverage.
Loss Sensitive Insurance Plans
Insurance coverage for a specific insured where the final premium is based on the insured’s losses.
Risk Purchasing Groups (RP’s)
Risk Purchasing Groups were created by the Liability Risk Retention Act of 1986. The purpose of the act was to break through the myriad of state insurance regulation in the hopes of making it easier for groups to purchase liability insurance. The act allows groups of individuals combine to purchase liability insurance while prohibiting states (regulators) or insurance companies from discriminating against them.
Self-Insured Retention Plans (SIRS)
The primary difference between a deductible and a self-insured retention is that a deductible amount counts against the total limits of the policy, reducing total coverage, whereas a self-insured retention plan provides limits of coverage in excess of the self-insured retention so that the amount payable under the policy is not reduced by the amount of the retention.
Protected Cell Captives (Segregated Portfolio Companies)
PCCs (SPC’s in certain domiciles) are essentially rent-a-captive companies that ensure complete separation among program participants. According to the laws of specific domiciles, PCCs or SPC’s generally guarantee complete separation of each cell’s assets, capital, and surplus from each other. Because they can achieve economies of scale, rent-a-captives make captive insurance affordable for companies that would not otherwise be large enough to profitably own and operate their own captive.Windward Harbor LLC owns a BVI licensed Segregated Portfolio Company – Windward Harbor SPC Ltd, which provides rent-a-captive services for selected clients on an annual fee basis. Each segregated portfolio has its own economic ownership, tax Id number and files a separate tax return.
Self-Insured Groups & Pools (SIG’s)
While the concept differs slightly from state to state, SIGs work similarly in the nearly 40 states in which they are legal. A group of employers form a nonprofit corporation or trust and hire a professional to manage it. This new entity then purchases the insurance, meaning the SIG members essentially “own” their own workers’ comp company.
The group pools the money it otherwise would pay an insurer, earning investment income on funds held in reserve. If a SIG program cuts down on workplace injuries and claim costs, the surplus, or “dividend,” from premiums is returned to members.
Of course, if a company or the group as a whole has catastrophic losses, members pay the difference, up to a limit. Above that point, the group buys excess insurance to offset a single large loss or a combination of losses.
Captives (See Captive Services)
A captive insurance company is an insurance company that is owned and controlled by its insureds. According to Captive Insurance Companies Association (CICA), the first captive ever formed was in the late 1800s, and was designed to write more cost effective fire insurance policies for New England textile manufacturers that were hit hard by increasing market rates.
Captives gained popularity in the 1980s as a result of the US liability crisis, particularly in the medical arena.
As captives have continued to grow over time, employers are considering employee benefits as a new or expanded coverage. The more recent hard market and changing economy is expected to spur even more and rapid industry growth yet this year.
Single Parent (Pure) Captive: A single parent captive is owned and controlled by one owner, typically the parent organization, and is formed as a subsidiary company. The captive subsidiary underwrites policies for the parent, and solely bears the risks of the parent.
A group captive is owned and controlled by multiple insureds. They may or may not be related entities or a part of a homogeneous group like industry or trade groups. Typically, companies of similar size pool their risks in an industry captive with customized insurance plans. Similarly, companies of similar size in different industries can also form group captives to enjoy the benefits of a captive model. More recently, associations have been forming association captive insurance companies to offer captive services as part of their membership benefits.
Agency captives are companies typically owned by groups of brokers or other insurance intermediaries and are typically structured like rent-a-captives.
Risk Retention Groups
Risk Retention Groups were also created by the Liability Risk Retention Act of 1986, which provides for streamlined regulation. A RRG is an insurance company in every regard but has one very important regulatory distinction. Every RRG chooses a single state in which to be domiciled and regulated. The act provides that the RRG is then eligible to do business in all states.
Program Business Captives
Associations, regional producers and corporations who desire to assume some selected third-party exposure.
Wayne Walker, Windward Harbor Insurance Management LLCWindward Harbor LLC 2004
Windward Harbor Insurance Management LLC is a licensed insurance manager in the British Virgin Islands with office in Pinehurst, NC, Atlanta, GA, and St Petersburg, FL.