Tag Archives: insurance program

First Step to a New, Successful Program

Editor’s Note: This is the second in a series of posts in which CJ Lotter, a 15-year industry veteran, shares lessons learned in the form of guidance to MGAs on the steps required to build a successful program. The first post is here.

The trend in insurance today is toward large volumes of policies with very little human intervention. Although the cost benefits may be attractive, this movement is leading us toward a commoditization of the industry where the only differentiator is price. Any business-minded person will tell you this is not a good position to be in. Ideally, you want to sell unique solutions that are difficult to replicate, raising the barrier to entry.

There is an alternative to commodity products. It’s called programs. The best program business is difficult to understand, labor-intensive and hard to automate. Unique underwriting expertise is required, and it should be hard to find and difficult to train. The role of technology in this market is to assist the process and provide the flexibility to adapt to unique risks, not to replace human ingenuity with mass automation.

For an MGA seeking to launch a new program, there are three types of opportunity that provide the greatest potential: a distressed class, a perceived distressed class and an underserved class.

A distressed class is one that most underwriters don’t understand or for which losses are difficult to predict. To underwrite this business, you need unique underwriting skills – an understanding of the nuances of the class and of the characteristics of the risk that could produce significant losses. Clever underwriting and careful selection of risks is key to remaining profitable in this niche. Heavy loss control may be required here, too. Your ability to make this riskier class safer is your competitive advantage.

See also: 10 Steps to Successful Insurance Program  

Nuclear plants are one example of a distressed business class. The dynamics of radioactive materials and the consequences of their incorrect handling are complicated. Losses are catastrophic and will most likely include loss of life, millions of dollars of property losses and loss of business income. Underwriting this class calls for highly trained underwriters who know a good risk from a bad one. These are specialists who can assess, for example, whether safety manuals and procedures are sufficient to minimize the potential for losses.

A perceived distressed class refers to business that potential competitors shy away from because their underwriters perceive it as too risky. By careful analysis, a clever underwriter can discover that what others thought were drivers of claims were indeed not so.

Ski resorts are one example of perceived distress. Underwriters may avoid this class because of the downhill ski exposure, while the real claims drivers are slips and falls in the restaurant. This is an extreme example, but it illustrates the point.

The underserved class is another spin on program opportunities. The less competition in a class, the better the chances for a successful program. There are many reasons markets avoid certain classes. It may be that the specific geographic territory is overly litigious or that the universe for this specific class is small. Whatever the reason, once you identify the issue and find a solution or compromise, you will have uncovered a program opportunity with little competition.

The class may also be underserved because a traditional “old school” risk taker with archaic systems is the only alternative for this specific class of risk. By providing modern technology with automation that makes it easy to do business, you can outperform the competition and capture your fair share of the market.

An example of this kind of risk may be trash truck operators in the boroughs of New York City. It’s a tough jurisdiction to write trash hauling insurance. A longtime traditional insurance company may have locked up the market. But at the same time, pricing may have crept up over the years, and customer service and loss control may be stale.

There is no meaningful competition in this space, and it’s ripe for the introduction of an MGA program. Start with an updated product offering that includes new coverages like data destruction and privacy, and dynamic pricing tuned to the characteristics of each individual risk. Round off the offering with quick quote turnaround, killer personalized service and fast and fair claims handling, and you’ve got a program that will attract business from the incumbents.

See also: Is There a Future for MGAs?  

So, there you have it – three scenarios that provide the first ingredients for building a new insurance program. Whichever you choose, when you create your program, ask the following question: “Will my program be so different that it will be difficult to duplicate, and so appreciated by buyers that price will not be the focus?” If your answer is “yes,” you have taken the first step to a successful program.

Excerpted with permission from Instec. A complete collection of Instec’s insurance industry insights can be found here.

10 Steps to Successful Insurance Program

This is the first in a series of posts in which CJ Lotter, a 15-year industry veteran, shares lessons learned in the form of guidance to MGAs on the steps required to build a successful program.

Creating a successful insurance program requires the execution of 10 essential steps that take advantage of market conditions, skills, partnerships and technologies.

Spinning up an insurance program is a lot like baking a cake. A good cake requires the right ingredients, the right amount of time to bake and meticulous crafting to ensure it looks and tastes great. Creating an insurance program is similar. It takes a combination of ripe market conditions, the right amount of time to grow and the skills to execute. In this post, we introduce the 10 steps to creating a successful program.

1. Size the Market

Prior to starting any program, it’s important to size the entire market. How many companies make up the market? How much premium is floating around your target market segment? How many agencies serve this segment? Spare no expense to gather the most current and accurate data you can find. And tap underwriting experts to find adjacent markets you may be able to enter quickly.

2. Analyze the Competitive Environment

Scan the competitive landscape to determine how easily you can enter the market. How is the market segment being served today? What kind of programs are already in the space? What other MGAs serve this market? To continue making a viable case for your program, you need to ensure there’s enough space for your solution. Ideally, you want to compete against an old school company that can’t rapidly adjust.

See also: Insurance Innovation’s Growth Challenge  

3. Profile the Industry’s Characteristics

Establishing the industry’s characteristics is much like Step One but at a much more granular level. Analyze the perceived threats and challenges. Examine as many dimensions as you can. How will the economy affect this market? Is climate change a key a factor? Is technology a potential catalyst for disruption? You’re looking for clues that suggest an industry with unique needs. You don’t want to create an insurance program for a commodity that is easy to insure. This would only lead to competition on price rather than service.

4. Spot and Attack ‘Perceived Distress’

Good, profitable programs are generally made up of difficult-to-insure business challenges. Ideally, you are looking for a distressed industry to serve, specifically a distressed class code. Perceived distress is the key here. Perceived distress essentially boils down to a gap in the insurance offerings available to your market that can be exploited by technology, underwriting advantage or better customer service.

5. Assemble Relevant Expertise

Identifying a strategic direction for your program establishes your road map. You hope you can bolster that through agency expertise. Your analysis of industry characteristics will give you the background you need to staff your program through internal or external hires. Assigning or hiring the right expertise can make or break a program. Ideally, you want underwriters with direct experience in the industry you are targeting.

6. Select the Right Technology

Of the many dimensions a company can compete on, technology may offer the biggest opportunity to differentiate in the Darwinian economy. Partnering with companies that do what you want to do and do it well is crucial. Competing on better technology can reduce your time to market so you can capitalize on perceived distress sooner than your competition – especially if the competition is a big, slow-moving, legacy insurance company.

7. Establish the Distribution Network

You’ve chosen your market, sized the competition, analyzed the industry and determined how to leverage expertise and tech. So, how do you sell this new thing? Start with the competition. How are they selling? Do they use agents? Do they have a dedicated team? Look for gaps in your competitors’ ability to deliver. Do they take three days to provide a quote? Use your superior technology and processes to deliver in one.

8. Build the Product

At this point, you have an idea of what the program offering will look like. But you still have a few critical questions to consider. Foremost is whether the product will be admitted or non-admitted. As a rule, you want to do as much admitted business as possible. If even one competitor provides an admitted option, you have no choice but to offer an admitted product.

9. Set the Pricing

Understanding the price elasticity in your market will help determine what it will take for your potential customers to leave their current provider. What can you offer or give them that is of more value? Can you underwrite more efficiently to lower the price? If you can maintain the customer experience while offering a price reduction from incumbent providers, you are in a sweet spot for program launch.

See also: Is Buying Insurance Like Ordering Food?  

10. Choose a Carrier

As an MGA, choosing the right carrier partner can make or break a program. Recent industry developments have made programs a strategic priority for carriers, and MGAs that underwrite and distribute profitably are in demand. If you can’t find a carrier partner, consider alternative capital sources such as pension funds and hedge funds, coupled with a fronting arrangement. This is a model that is growing in popularity as players along the value chain attempt to engage more directly with the policyholder.

This has been a brief overview of the 10-step process to bake a new insurance program. We will revisit this topic in future posts, providing a deeper look at the steps. Creating profitable programs is a vital skill in the new insurance world, and those that do it well will never have trouble finding work. You may not be able to bake a cake, but, with the profits your successful program delivers, you can just go out and buy one.

Excerpted with permission from Instec. A complete collection of Instec’s insurance industry insights can be found here.

How to Develop Plan on Terrorism Risks

Terrorist and other mass violence attacks, which occur with alarming regularity around the world, can threaten your people, operations and assets. Many companies look to insurance — mainly property terrorism and political violence coverage – to help manage the financial impact of these risks, which can include property damage and business interruption losses.

Terrorism Insurance or Political Violence Coverage?

Property terrorism insurance provides coverage for the physical damage and business interruption that can result from acts that are motivated by politics, religion or ideology. Political violence insurance provides coverage related to war, civil war, rebellion, insurrection, coup d’état and other civil disturbances.

Choosing which coverage – or combination – is best for your organization can be tricky. The line between what is considered “terrorism” and what is considered “political violence” is often blurry. For example, should attacks by particular groups be classified as acts of terrorism, or another form of political violence?

To help determine the best insurance program to manage these risks, here are a few things to think about:

  • Ensure the limits of insurance that you buy provide enough protection for multiple loss scenarios.
  • Review the location of your assets to determine the appropriate insurance solution.
  • Understand the policy terms, conditions and limitations of terrorism and political violence insurance.
  • Work with your advisers to understand your property and employee exposures so you can make an informed decision or mitigate potential losses.

Addressing the Risks

Along with insurance considerations, of course, you need to ensure the safety of your employees with integrated and well-practiced crisis and continuity plans in the event of a disaster. Events from terrorist attack to natural catastrophes can cause significant business interruption (BI) losses. Steps to take to manage BI risk include:

  • Develop and test business continuity plans.
  • Conduct scenario testing.
  • Coordinate BI insurance with other coverages, including political violence and terrorism insurance.
  • Be prepared to gather appropriate information in the event of a claim, including recording damage via photographs and video.
  • Maintain separate accounting codes to identify all costs associated with the potential damage.

For more information on these topics, read Marsh’s 2015 Terrorism Risk Insurance Report and our political risk insurance report, Strong Capacity Drives Buyer’s Market for Political Risk Insurance.

Owner Controlled Insurance Program Liability Claims Challenges, Part 5

This is the fifth article in an 11-part series on Owner Controlled Insurance Programs. Preceding and subsequent articles in this series can be found here: Part 1, Part 2, Part 3, Part 4, Part 6, Part 7, Part 8, Part 9, Part 10, and Part 11.

Owner Controlled Insurance Programs From The Perspective Of Liability Claims (continued)

Covered Damage
The first issue that the carrier and the policyholders must address is whether the loss resulted in “covered damage.” However, with an Owner Controlled Insurance Program, the analysis with regard to the particular insured is critical. There are numerous exclusions in the commercial general liability coverage form that apply differently, depending on whether the named insured enrolled contractor is an owner, general contractor, or subcontractor. The following exclusions illustrate why the policy may provide coverage or not, depending on which insured is seeking coverage:

Expected or Intended Injury Exclusion

This insurance does not apply to:

a) Expected or Intended Injury

“Bodily injury” or “property damage” expected or intended from the standpoint of the insured …

Use of the phrase “the insured” refers to the insured seeking coverage. This phrase is contrasted to an exclusion that applies to an injury which is expected or intended from the standpoint of “an” or “any” insured, which would preclude coverage entirely under the policy if an insured or any insured intended the act. (See, e.g., National Union Fire Insurance Company vs. Lynette C. (1991) 228 Cal.App.3d 1073 — a wife who negligently failed to prevent molestation by her husband was covered; Fire Insurance Exchange vs. Altieri (1991) 235 Cal.App.3d 1352 — parents sued in connection with their son’s arson of a school building.) The phrase “the insured” also is contrasted to exclusions that apply to “you,” which is the named insured. In the context of an Owner Controlled Insurance Program, where virtually every contractor is an insured, particular attention has to be paid to whether the claims of “supervision,” “vicarious liability,” or other non-direct liability could create coverage where the exclusions apply to “the insured.”

For example, in a claim that a contractor’s employee intentionally damaged another contractor’s work, the employee would be an insured, but the exclusion would bar coverage. His employer, assuming it was enrolled, would likely be a named insured; the exclusion would not apply to the employer, or any other enrolled contractor on the project.

Contractual Liability Exclusion
A second example is the contractual liability exclusion, which provides:

This insurance does not apply to: …

b) Contractual Liability

“Bodily injury” or “property damage” for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages: …

(2) Assumed in a contract or agreement that is an “insured contract” …

The typical construction project contains indemnity flowing uphill in favor of the owner and general contractor. The liability of the owner or general contractor is generally passed down to the lowest level subcontractor.

Under contractual liability coverage, the Owner Controlled Insurance Program assumes every enrolled contractor’s indemnity obligations upward to the general contractor and owner. Contractual liability coverage allows owners/sponsors to settle claims with third parties and seek recovery from responsible subcontractors under the indemnity agreement. Thus, the insurance company must be mindful that any enrolled contractor may be both an insured as well as a claimant against the downhill subcontractors for any uncovered damages.

Damage to Project Work
The next series of exclusions are those dealing with damage to the work which is the subject of the Owner Controlled Insurance Program:

This insurance does not apply to: …

j. Damage to Property

“Property Damage”

1) Property you own, rent or occupy; …

4) Personal property in the care, custody or control of the insured;

5) That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf or performing operations, if the “property damage” arises out of those operations; or

6) That particular part of any property that must be restored, repaired or replaced because “your work” was incorrectly performed on it.

Paragraph 6 of this exclusion does not apply to “property damage” included in the “Products-Completed Operations Hazard.”

k. Damage to Your Product

“Property Damage” to “your product” arising out of it or any part of it.

l. Damage to Your Work

“Property Damage” to “your work” arising out of it or any part of it, and included in the “Products-Completed Operations Hazard.”

This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor.1

With regard to property damage claims arising out of “operations” (as distinct from “completed operations”), Exclusion “j.” is critical. In light of the “separation of insureds” condition, Exclusion j(1) would exclude coverage to the program sponsor for damages occurring to the construction project itself. (Assuming the sponsor is the owner.)

Exclusions j(5) and j(6) preclude coverage for damage to the construction project, but not entirely. Viewing the construction project from the standpoint of a general contractor, the entire project is “real property” on which the named insured (defined alternatively as “you”) or its subcontractors are performing operations. As to the owner or general contractor, virtually any damage would be excluded if it is within the basic scope of the construction project and the project is not completed.

However, each enrolled contractor must be viewed separately. If there is an allegation of damage caused by a subcontractor to work other than its own, this exclusion would not bar coverage. An example would be a residential developer with an Owner Controlled Insurance Program covering its projects that experiences a fire at a home under construction caused by the negligence of the roofer. As to the owner/developer, exclusion j. precludes coverage entirely. As to the roofer, exclusion j. only precludes coverage for damage to the roofer’s own work, but not resulting property damage caused by the roofer, i.e., the burned down home.

This scenario constitutes the primary overlap with builders risk coverage. The owner/ general contractor may pursue a subcontractor for negligence arising out of performance of work under its contract, and the subcontractor’s liability will be covered by the Owner Controlled Insurance Program. This gap presents an exposure to the liability Owner Controlled Insurance Program insurer for the builders risk deductible (since the amount is not covered by builders risk insurance).

This scenario also illustrates that for owners or insurance companies, the proper analysis is to review any “operations” loss — those that occur while the project is under construction — first from the perspective of the responsible contractor (from the bottom up) rather than from the perspective of the owner (from the top down).

1 The terms “you” and “your” refer to the named insured, not to anyone qualifying as an insured.

Owner Controlled Insurance Program Liability Claims Challenges, Part 4

This is the fourth article in an 11-part series on Owner Controlled Insurance Programs. Preceding and subsequent articles in this series can be found here: Part 1, Part 2, Part 3, Part 5, Part 6, Part 7, Part 8, Part 9, Part 10, and Part 11.

Owner Controlled Insurance Programs From The Perspective Of Liability Claims

An Owner Controlled Insurance Program general liability policy is, in most respects, similar to the industry standard general liability policy. An Owner Controlled Insurance Program claim is analyzed by taking the same systematic approach that is used with other insurance claims. Companies and insureds alike should resist the temptation to treat the Owner Controlled Insurance Program differently and/or disregard the policy language. Only in taking consistent approaches will the insurance company make sure that the most appropriate legal and business decisions are made.

From a legal perspective, the insurance company will be questioned on its policy interpretation and claims handling. The insurer’s obligation to the insured to defend and indemnify is measured by the policy as issued. Coverage under the policy is not based on side agreements, or understandings between the sponsor, the broker, and the underwriters. If there are unintended claims being paid, the underwriters need to be alerted and the policy language changed.

An insurance company can waive reliance on a restrictive policy and provide greater benefits than the contract provides. Waller v. Fire Insurance Exchange (1995) 11 Cal.4th 1. However, the company may not unilaterally narrow the coverage and provide less than that provided by the policy. The exception to this rule is, of course, if there is proof that the policy as issued failed to comply with the mutual intent of the parties, in which case the policy may be reformed. (See, e.g., Cal. Civ. Code Sec. 3399; Truck v. Wilshire Insurance (1970) 8 Cal.App.3d 553.) The following are some of the highlights of the commercial general liability form that are particularly applicable to construction claims involving Owner Controlled Insurance Programs.

Separation of Insureds
A general liability policy contains a condition, titled “Separation of Insureds.” That provision provides:

Except with respect to the limits of insurance, and any rights and duties specifically assigned in this coverage part to the first Named Insured, this insurance applies:

a) As if each Named Insured were the only Named Insured; and

b) Separately to each Insured against whom claim is made or “suit” is brought.

In the typical Owner Controlled Insurance Program, each contractor and subcontractor qualifies as a “named insured.” The insurance company must view each named insured separately, as if that contract were the only contract to apply. Each named insured under the policy is given equal coverage. The carrier’s duty to provide a defense and indemnity exists separate and distinct from every other contractor under the policy. Each named insured has an obligation to tender the loss to the insurer and must cooperate with the insurer in the investigation of the claim or suit, and in its own defense.