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103-776: Phoenix Group Holdings plc (formerly Pearl Group plc ) is a provider of insurance services based in London , England. It is listed on the London Stock Exchange and is a constituent of the FTSE 100 Index . The company was founded in 1857 as The Pearl Loan Company and operated from the Royal Oak public house opposite the Whitechapel Bell Foundry . It changed its name to The Pearl Assurance Company in 1914, when it moved to 252 High Holborn where it
206-684: A Nerva–Antonine dynasty -era tablet from the ruins of the Temple of Antinous in Antinoöpolis , Aegyptus . The tablet prescribed the rules and membership dues of a burial society collegium established in Lanuvium , Italia in approximately 133 AD during the reign of Hadrian (117–138) of the Roman Empire . In 1851 AD, future U.S. Supreme Court Associate Justice Joseph P. Bradley (1870–1892 AD), once employed as an actuary for
309-416: A contract , called the insurance policy , which details the conditions and circumstances under which the insurer will compensate the insured, or their designated beneficiary or assignee. The amount of money charged by the insurer to the policyholder for the coverage set forth in the insurance policy is called the premium . If the insured experiences a loss which is potentially covered by the insurance policy,
412-592: A sea captain , ship-manager , or ship charterer that saved a ship from total loss was only required to pay one-half the value of the ship to the ship-owner . In the Digesta seu Pandectae (533), the second volume of the codification of laws ordered by Justinian I (527–565), a legal opinion written by the Roman jurist Paulus in 235 AD was included about the Lex Rhodia ("Rhodian law"). It articulates
515-458: A claim arises on the occurrence of a specified event). There are generally three types of insurance contracts that seek to indemnify an insured: From an insured's standpoint, the result is usually the same: the insurer pays the loss and claims expenses. If the Insured has a "reimbursement" policy, the insured can be required to pay for a loss and then be "reimbursed" by the insurance carrier for
618-448: A claim. Adjusting liability-insurance claims is particularly difficult because they involve a third party, the plaintiff , who is under no contractual obligation to cooperate with the insurer and may in fact regard the insurer as a deep pocket . The adjuster must obtain legal counsel for the insured—either inside ("house") counsel or outside ("panel") counsel, monitor litigation that may take years to complete, and appear in person or over
721-407: A combination of regulation and insurance equalization pool . Moral hazard is avoided by mandating that insurance companies provide at least one policy that meets a government set minimum standard level of coverage, and all adult residents are obliged by law to purchase this coverage from an insurance company of their choice. All insurance companies receive funds from the equalization pool to help cover
824-601: A combined ratio over 100% may nevertheless remain profitable due to investment earnings. Insurance companies earn investment profits on "float". Float, or available reserve, is the amount of money on hand at any given moment that an insurer has collected in insurance premiums but has not paid out in claims. Insurers start investing insurance premiums as soon as they are collected and continue to earn interest or other income on them until claims are paid out. The Association of British Insurers (grouping together 400 insurance companies and 94% of UK insurance services) has almost 20% of
927-455: A company insures an individual entity, there are basic legal requirements and regulations. Several commonly cited legal principles of insurance include: To "indemnify" means to make whole again, or to be reinstated to the position that one was in, to the extent possible, prior to the happening of a specified event or peril. Accordingly, life insurance is generally not considered to be indemnity insurance, but rather "contingent" insurance (i.e.,
1030-777: A comprehensive public health insurance scheme run by the National Health Authority called the Ayushman Bharat Yojana or a private health insurance scheme providing comprehensive coverage and that is tightly regulated by the Insurance Regulatory and Development Authority of India . There are three major types of insurance programs available in Japan: Employee Health Insurance (健康保険 Kenkō-Hoken), National Health Insurance (国民健康保険 Kokumin-Kenkō-Hoken), and
1133-491: A doctor visit, €0.50 for each box of medicine prescribed, and a fee of €16–18 per day for hospital stays and for expensive procedures. An important element of the French insurance system is solidarity: the more ill a person becomes, the less the person pays. This means that for people with serious or chronic illnesses, the insurance system reimburses them 100% of expenses, and waives their co-pay charges. Finally, for fees that
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#17327975834861236-516: A fund at risk of "adverse selection", attracting a disproportionate number of members from other funds, or from the pool of intending members who might otherwise have joined other funds. It would also attract people with existing medical conditions, who might not otherwise have taken out insurance at all because of the denial of benefits for 12 months due to the PEA Rule. The benefits paid out for these conditions would create pressure on premiums for all
1339-427: A lawsuit in federal court. Health insurance can be combined with publicly funded health care and medical savings accounts . The individual insured person's obligations may take several forms: Prescription drug plans are a form of insurance offered through some health insurance plans. In the U.S., the patient usually pays a copayment and the prescription drug insurance part or all of the balance for drugs covered in
1442-413: A minimum, the following elements: identification of participating parties (the insurer, the insured, the beneficiaries), the premium, the period of coverage, the particular loss event covered, the amount of coverage (i.e., the amount to be paid to the insured or beneficiary in the event of a loss), and exclusions (events not covered). An insured is thus said to be " indemnified " against the loss covered in
1545-453: A more active role in loss mitigation, such as through building codes . According to the study books of The Chartered Insurance Institute, there are variant methods of insurance as follows: Insurers may use the subscription business model , collecting premium payments periodically in return for on-going and/or compounding benefits offered to policyholders. Insurers' business model aims to collect more in premium and investment income than
1648-640: A national health policy for public insurance. There are two types of health insurance – tax payer-funded and private-funded. A private-funded insurance plan example includes an employer-sponsored self-funded ERISA (Employee Retirement Income Security Act of 1974) plan. Typically, these companies promote themselves as having ties to major insurance providers. However, in the context of an ERISA plan, these insurance companies do not actively participate in insurance practices; instead, they handle administrative tasks. Consequently, ERISA plans are exempt from state regulations and fall under federal jurisdiction, overseen by
1751-487: A paid internship during their stay. In that case, they'll need to take out the compulsory basic package of Dutch health insurance. Additional insurance is optional, depending on the student's personal needs. Since 1974, New Zealand has had a system of universal no-fault health insurance for personal injuries through the Accident Compensation Corporation (ACC). The ACC scheme covers most of
1854-410: A person's previous medical history, the current state of health, or (generally speaking) their age (but see Lifetime Health Cover below). Balancing this are waiting periods, in particular for pre-existing conditions (usually referred to within the industry as PEA, which stands for "pre-existing ailment"). Funds are entitled to impose a waiting period of up to 12 months on benefits for any medical condition
1957-590: A policy, or charge anything other than their nationally set and published standard premiums. Therefore, every person buying insurance will pay the same price as everyone else buying the same policy, and every person will get at least the minimum level of coverage. This applies to all people permanently living and working in the Netherlands. International students that move to the Netherlands for study purposes have to take out compulsory Dutch health insurance if they also decide to work (zero-hour contracts included) or do
2060-399: A portion of their income to a not-for-profit health insurance fund, which mutualises the risk of illness, and which reimburses medical expenses at varying rates. Children and spouses of insured people are eligible for benefits, as well. Each fund is free to manage its own budget, and used to reimburse medical expenses at the rate it saw fit, however following a number of reforms in recent years,
2163-631: A premium paid independently of loans began in Belgium about 1300 AD. Separate insurance contracts (i.e., insurance policies not bundled with loans or other kinds of contracts) were invented in Genoa in the 14th century, as were insurance pools backed by pledges of landed estates. The first known insurance contract dates from Genoa in 1347. In the next century, maritime insurance developed widely, and premiums were varied with risks. These new insurance contracts allowed insurance to be separated from investment,
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#17327975834862266-697: A relatively few claimants – and for overhead costs. So long as an insurer maintains adequate funds set aside for anticipated losses (called reserves), the remaining margin is an insurer's profit . Policies typically include a number of exclusions, for example: Insurers may prohibit certain activities which are considered dangerous and therefore excluded from coverage. One system for classifying activities according to whether they are authorised by insurers refers to "green light" approved activities and events, "yellow light" activities and events which require insurer consultation and/or waivers of liability, and "red light" activities and events which are prohibited and outside
2369-556: A separation of roles that first proved useful in marine insurance . The earliest known policy of life insurance was made in the Royal Exchange, London , on 18 June 1583, for £383, 6s. 8d. for twelve months on the life of William Gibbons. Insurance became far more sophisticated in Enlightenment-era Europe , where specialized varieties developed. Property insurance as we know it today can be traced to
2472-399: A staff of records management and data entry clerks . Incoming claims are classified based on severity and are assigned to adjusters, whose settlement authority varies with their knowledge and experience. An adjuster undertakes an investigation of each claim, usually in close cooperation with the insured, determines if coverage is available under the terms of the insurance contract (and if so,
2575-518: A stay in ward B2 or C in a Public hospital. For the hospitalization in a Private hospital, or in ward A or B1 in Public hospital, MediShield Life coverage is pegged to B2 or C ward prices and insured is required to pay the remaining bill amount. This remaining bill amount can be paid using MediSave but limits are applied on the MediSave usage. MediShield Life does not cover overseas medical expenses and
2678-649: A tradition of welfare programs in Prussia and Saxony that began as early as in the 1840s. In the 1880s Chancellor Otto von Bismarck introduced old age pensions, accident insurance and medical care that formed the basis for Germany's welfare state . In Britain more extensive legislation was introduced by the Liberal government in the National Insurance Act 1911 . This gave the British working classes
2781-572: A univariate analysis could produce confounded results. Other statistical methods may be used in assessing the probability of future losses. Upon termination of a given policy, the amount of premium collected minus the amount paid out in claims is the insurer's underwriting profit on that policy. Underwriting performance is measured by something called the "combined ratio", which is the ratio of expenses/losses to premiums. A combined ratio of less than 100% indicates an underwriting profit, while anything over 100 indicates an underwriting loss. A company with
2884-418: Is an employer or a community organization). The contract can be renewable (annually, monthly) or lifelong in the case of private insurance. It can also be mandatory for all citizens in the case of national plans. The type and amount of health care costs that will be covered by the health insurance provider are specified in writing, in a member contract or "Evidence of Coverage" booklet for private insurance, or in
2987-495: Is covered by the employer and basically covers all risks for commuting to work and at the workplace. The National Health System in Greece covers both out and in-patient treatment. The out-patient treatment is carried out by social administrative structures as following: The in-patient treatment is carried out by: In Greece anyone can cover the hospitalization expenses using a private insurance policy, that can be bought by any of
3090-408: Is designed for people who are age 75 and older. National Health Insurance is organised on a household basis. Once a household has applied, the entire family is covered. Applicants receive a health insurance card, which must be used when receiving treatment at a hospital. There is a required monthly premium, but co-payments are standardized so payers are only expected to cover ten to thirty percent of
3193-522: Is distributed to insurance companies for each person they insure under the required policy. However, high-risk individuals get more from the pool, and low-income persons and children under 18 have their insurance paid for entirely. Because of this, insurance companies no longer find insuring high-risk individuals an unappealing proposition, avoiding the potential problem of adverse selection. Insurance companies are not allowed to have co-payments, caps, or deductibles, or deny coverage to any person applying for
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3296-426: Is financed via general taxation and reimburses at a higher rate than the profession-based system for those who cannot afford to make up the difference. Finally, to counter the rise in health care costs, the government has installed two plans, (in 2004 and 2006), which require insured people to declare a referring doctor in order to be fully reimbursed for specialist visits, and which installed a mandatory co-pay of €1 for
3399-629: Is funded by a 2% tax levy on all taxpayers, an extra 1% levy on high income earners, as well as general revenue. The private health system is funded by a number of private health insurance organizations. The largest of these is Medibank Private Limited , which was, until 2014, a government-owned entity, when it was privatized and listed on the Australian Stock Exchange . Australian health funds can be either 'for profit' including Bupa and nib ; 'mutual' including Australian Unity ; or 'non-profit' including GMHBA , HCF and
3502-409: Is paid out in losses, and to also offer a competitive price which consumers will accept. Profit can be reduced to a simple equation: Insurers make money in two ways: The most complicated aspect of insuring is the actuarial science of ratemaking (price-setting) of policies, which uses statistics and probability to approximate the rate of future claims based on a given risk. After producing rates,
3605-426: Is the materialized utility of insurance; it is the actual "product" paid for. Claims may be filed by insureds directly with the insurer or through brokers or agents . The insurer may require that the claim be filed on its own proprietary forms, or may accept claims on a standard industry form, such as those produced by ACORD . Insurance-company claims departments employ a large number of claims adjusters, supported by
3708-680: The Great Fire of London , which in 1666 devoured more than 13,000 houses. The devastating effects of the fire converted the development of insurance "from a matter of convenience into one of urgency, a change of opinion reflected in Sir Christopher Wren 's inclusion of a site for "the Insurance Office" in his new plan for London in 1667." A number of attempted fire insurance schemes came to nothing, but in 1681, economist Nicholas Barbon and eleven associates established
3811-742: The HBF Health Insurance . Some, such as Police Health, have membership restricted to particular groups, but the majority have open membership. Membership to most health funds is now also available through comparison websites. These comparison sites operate on a commission-basis by agreement with their participating health funds. The Private Health Insurance Ombudsman also operates a free website that allows consumers to search for and compare private health insurers' products, which includes information on price and level of cover. Most aspects of private health insurance in Australia are regulated by
3914-537: The Health Insurance Association of America , health insurance is defined as "coverage that provides for the payments of benefits as a result of sickness or injury. It includes insurance for losses from accident, medical expense, disability, or accidental death and dismemberment". A health insurance policy is a insurance contract between an insurance provider (e.g. an insurance company or a government) and an individual or his/her sponsor (that
4017-742: The Mutual Benefit Life Insurance Company , submitted an article to the Journal of the Institute of Actuaries . His article detailed an historical account of a Severan dynasty -era life table compiled by the Roman jurist Ulpian in approximately 220 AD that was also included in the Digesta . Concepts of insurance has been also found in 3rd century BC Hindu scriptures such as Dharmasastra , Arthashastra and Manusmriti . The ancient Greeks had marine loans. Money
4120-630: The Private Health Insurance Act 2007 . Complaints and reporting of the private health industry is carried out by an independent government agency, the Private Health Insurance Ombudsman . The ombudsman publishes an annual report that outlines the number and nature of complaints per health fund compared to their market share The private health system in Australia operates on a "community rating" basis, whereby premiums do not vary solely because of
4223-584: The Royal Canadian Mounted Police , the armed forces, and Members of Parliament). Consequently, each province administers its own health insurance program. The federal government influences health insurance by virtue of its fiscal powers – it transfers cash and tax points to the provinces to help cover the costs of the universal health insurance programs. Under the Canada Health Act , the federal government mandates and enforces
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4326-496: The formulary of the plan. Such plans are routinely part of national health insurance programs. For example, in the province of Quebec, Canada, prescription drug insurance is universally required as part of the public health insurance plan, but may be purchased and administered either through private or group plans, or through the public plan. Some, if not most, health care providers in the United States will agree to bill
4429-617: The general average principle of marine insurance established on the island of Rhodes in approximately 1000 to 800 BC, plausibly by the Phoenicians during the proposed Dorian invasion and emergence of the purported Sea Peoples during the Greek Dark Ages (c. 1100–c. 750). The law of general average is the fundamental principle that underlies all insurance. In 1816, an archeological excavation in Minya, Egypt produced
4532-663: The Health Care for the Aged Law of 1982. It allowed many health insurance systems to offer financial assistance to elderly people. There is a medical coverage fee. To be eligible, those insured must be either: older than 70, or older than 65 with a recognized disability. The Late-stage Elderly Medical System includes preventive and standard medical care. Due to Japan's aging population , the Late-stage Elderly Medical System represents one third of
4635-474: The Late-stage Elderly Medical System (後期高齢医療制度 Kouki-Kourei-Iryouseido). Although private health insurance is available, all Japanese citizens, permanent residents, and non-Japanese with a visa lasting one year or longer are required to be enrolled in either National Health Insurance or Employee Health Insurance. National Health Insurance is designed for those who are not eligible for any employment-based health insurance program. The Late-stage Elderly Medical System
4738-554: The Standard Life business three years previously. Phoenix Group comprises a number of regulated life companies in the UK: plus other unregulated businesses: Insurance Insurance is a means of protection from financial loss in which, in exchange for a fee, a party agrees to compensate another party in the event of a certain loss, damage, or injury. It is a form of risk management , primarily used to protect against
4841-407: The U.S. (nearly 16% of GDP). Germans are offered three kinds of social security insurance dealing with the physical status of a person and which are co-financed by employer and employee: health insurance, accident insurance, and long-term care insurance. Long-term care insurance ( Gesetzliche Pflegeversicherung ) emerged in 1994 and is mandatory. Accident insurance (gesetzliche Unfallversicherung)
4944-741: The US Department of Labor (USDOL). Specific details about benefits or coverage can be found in the Summary Plan Description (SPD). Should there be a need for an appeal, the process typically involves initiating it through the insurance company and then reaching out to the Employer's Plan Fiduciary. If a resolution is still not achieved, the decision can be escalated to the USDOL for review to ensure compliance with ERISA regulations, and, if necessary, legal action can be taken by filing
5047-455: The United States (5 to 6 days). Part of the difference is that the chief consideration for hospital reimbursement is the number of hospital days as opposed to procedures or diagnosis. Drug costs have increased substantially, rising nearly 60% from 1991 through 2005. Despite attempts to contain costs, overall health care expenditures rose to 10.7% of GDP in 2005, comparable to other western European nations, but substantially less than that spent in
5150-591: The business was acquired by the Liberty Acquisition Holdings (International) Company (a vehicle controlled by billionaire Nicolas Berggruen ), which subsequently renamed itself Pearl Group. In 2010, Pearl Group rebranded as Phoenix Group Holdings. In March 2014, the business sold Ignis Asset Management to Standard Life Investments, the asset management arm of Standard Life . In 2018, Phoenix Group agreed to acquire Standard Life Assurance from Standard Life Aberdeen for £2.9 billion. As part of
5253-439: The cost of this government-mandated coverage. This pool is run by a regulator which collects salary-based contributions from employers, which make up about 50% of all health care funding, and funding from the government to cover people who cannot afford health care, which makes up an additional 5%. The remaining 45% of health care funding comes from insurance premiums paid by the public, for which companies compete on price, though
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#17327975834865356-688: The cost, depending on age. If out-of-pocket costs exceed pre-determined limits, payers may apply for a rebate from the National Health Insurance program. Employee Health Insurance covers diseases, injuries, and death regardless of whether an incident occurred at a workplace. Employee Health Insurance covers a maximum of 180 days of medical care per year for work-related diseases or injuries and 180 days per year for other diseases or injuries. Employers and employees must contribute evenly to be covered by Employee Health Insurance. The Late-stage Elderly Medical System began in 1983 following
5459-667: The costs of related to treatment of injuries acquired in New Zealand (including overseas visitors) regardless of how the injury occurred, and also covers lost income (at 80 percent of the employee's pre-injury income) and costs related to long-term rehabilitation, such as home and vehicle modifications for those seriously injured. Funding from the scheme comes from a combination of levies on employers' payroll (for work injuries), levies on an employee's taxable income (for non-work injuries to salary earners), levies on vehicle licensing fees and petrol (for motor vehicle accidents), and funds from
5562-464: The countries surveyed, the results indicated that people in the United States had more out-of-pocket expenses, more disputes with insurance companies than other countries, and more insurance payments denied; paperwork was also higher although Germany had similarly high levels of paperwork. The Australian public health system is called Medicare , which provides free universal access to hospital treatment and subsidised out-of-hospital medical treatment. It
5665-484: The country's total healthcare cost. When retiring employees shift from Employee Health Insurance to the Late-stage Elderly Medical System, the national cost of health insurance is expected to increase since individual healthcare costs tend to increase with age. In 2006, a new system of health insurance came into force in the Netherlands. This new system avoids the two pitfalls of adverse selection and moral hazard associated with traditional forms of health insurance by using
5768-446: The demand for marine insurance . In the late 1680s, Edward Lloyd opened a coffee house , which became the meeting place for parties in the shipping industry wishing to insure cargoes and ships, including those willing to underwrite such ventures. These informal beginnings led to the establishment of the insurance market Lloyd's of London and several related shipping and insurance businesses. Life insurance policies were taken out in
5871-401: The different health care funds (there are five: General, Independent, Agricultural, Student, Public Servants) now all reimburse at the same rate. Secondly, since 2000, the government now provides health care to those who are not covered by a mandatory regime (those who have never worked and who are not students, meaning the very rich or the very poor). This regime, unlike the worker-financed ones,
5974-791: The early 18th century. The first company to offer life insurance was the Amicable Society for a Perpetual Assurance Office , founded in London in 1706 by William Talbot and Sir Thomas Allen . Upon the same principle, Edward Rowe Mores established the Society for Equitable Assurances on Lives and Survivorship in 1762. It was the world's first mutual insurer and it pioneered age based premiums based on mortality rate laying "the framework for scientific insurance practice and development" and "the basis of modern life assurance upon which all life assurance schemes were subsequently based." In
6077-695: The event of general average. In 1873 the "Association for the Reform and Codification of the Law of Nations", the forerunner of the International Law Association (ILA), was founded in Brussels. It published the first YAR in 1890, before switching to the present title of the "International Law Association" in 1895. By the late 19th century governments began to initiate national insurance programs against sickness and old age. Germany built on
6180-706: The first contributory system of insurance against illness and unemployment. This system was greatly expanded after the Second World War under the influence of the Beveridge Report , to form the first modern welfare state . In 2008, the International Network of Insurance Associations (INIA), then an informal network, became active and it has been succeeded by the Global Federation of Insurance Associations (GFIA), which
6283-472: The first fire insurance company, the "Insurance Office for Houses", at the back of the Royal Exchange to insure brick and frame homes. Initially, 5,000 homes were insured by his Insurance Office. At the same time, the first insurance schemes for the underwriting of business ventures became available. By the end of the seventeenth century, London's growth as a centre for trade was increasing due to
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#17327975834866386-419: The float method is difficult to carry out in an economically depressed period. Bear markets do cause insurers to shift away from investments and to toughen up their underwriting standards, so a poor economy generally means high insurance-premiums. This tendency to swing between profitable and unprofitable periods over time is commonly known as the underwriting, or insurance, cycle . Claims and loss handling
6489-410: The form of a payment to the insurer (a premium) in exchange for the insurer's promise to compensate the insured in the event of a covered loss. The loss may or may not be financial, but it must be reducible to financial terms. Furthermore, it usually involves something in which the insured has an insurable interest established by ownership, possession, or pre-existing relationship. The insured receives
6592-664: The fund's members, causing some to drop their membership, which would lead to further rises in premiums, and a vicious cycle of higher premiums-leaving members would ensue. The Australian government has introduced a number of incentives to encourage adults to take out private hospital insurance. These include: As per the Constitution of Canada , health care is mainly a provincial government responsibility in Canada (the main exceptions being federal government responsibility for services provided to aboriginal peoples covered by treaties,
6695-474: The general taxation pool (for non-work injuries to children, senior citizens, unemployed people, overseas visitors, etc.) Rwanda is one of a handful of low income countries that has implemented community-based health insurance schemes in order to reduce the financial barriers that prevent poor people from seeking and receiving needed health services. This scheme has helped reach 90% of the country's population with health care coverage. Singaporeans have one of
6798-633: The government account for nearly 30 percent of total health care spending. In 2005, the Supreme Court of Canada ruled, in Chaoulli v. Quebec , that the province's prohibition on private insurance for health care already insured by the provincial plan violated the Quebec Charter of Rights and Freedoms, and in particular, the sections dealing with the right to life and security , if there were unacceptably long wait times for treatment, as
6901-612: The individual's income, private health insurance contributions are based on the individual's age and health condition. Reimbursement is on a fee-for-service basis, but the number of physicians allowed to accept Statutory Health Insurance in a given locale is regulated by the government and professional societies. Co-payments were introduced in the 1980s in an attempt to prevent over utilization. The average length of hospital stay in Germany has decreased in recent years from 14 days to 9 days, still considerably longer than average stays in
7004-447: The insurance carrier can generally either "reimburse" or "pay on behalf of", whichever is more beneficial to it and the insured in the claim handling process. An entity seeking to transfer risk (an individual, corporation, or association of any type, etc.) becomes the "insured" party once risk is assumed by an "insurer", the insuring party, by means of a contract , called an insurance policy . Generally, an insurance contract includes, at
7107-427: The insurance company if patients are willing to sign an agreement that they will be responsible for the amount that the insurance company does not pay. The insurance company pays out of network providers according to "reasonable and customary" charges, which may be less than the provider's usual fee. The provider may also have a separate contract with the insurer to accept what amounts to a discounted rate or capitation to
7210-774: The insurance company. Insurance scholars have typically used moral hazard to refer to the increased loss due to unintentional carelessness and insurance fraud to refer to increased risk due to intentional carelessness or indifference. Insurers attempt to address carelessness through inspections, policy provisions requiring certain types of maintenance, and possible discounts for loss mitigation efforts. While in theory insurers could encourage investment in loss reduction, some commentators have argued that in practice insurers had historically not aggressively pursued loss control measures—particularly to prevent disaster losses such as hurricanes—because of concerns over rate reductions and legal battles. However, since about 1996 insurers have begun to take
7313-420: The insured submits a claim to the insurer for processing by a claims adjuster. A mandatory out-of-pocket expense required by an insurance policy before an insurer will pay a claim is called a deductible (or if required by a health insurance policy, a copayment ). The insurer may hedge its own risk by taking out reinsurance , whereby another insurance company agrees to carry some of the risks, especially if
7416-409: The insurer will use discretion to reject or accept risks through the underwriting process. At the most basic level, initial rate-making involves looking at the frequency and severity of insured perils and the expected average payout resulting from these perils. Thereafter an insurance company will collect historical loss-data, bring the loss data to present value , and compare these prior losses to
7519-470: The investments in the London Stock Exchange . In 2007, U.S. industry profits from float totaled $ 58 billion. In a 2009 letter to investors, Warren Buffett wrote, "we were paid $ 2.8 billion to hold our float in 2008". In the United States , the underwriting loss of property and casualty insurance companies was $ 142.3 billion in the five years ending 2003. But overall profit for the same period
7622-620: The late 19th century "accident insurance" began to become available. The first company to offer accident insurance was the Railway Passengers Assurance Company, formed in 1848 in England to insure against the rising number of fatalities on the nascent railway system. The first international insurance rule was the York Antwerp Rules (YAR) for the distribution of costs between ship and cargo in
7725-456: The local or multinational insurance companies that operate in the region (e.g. Metlife, Interamerican, Aetna, IMG). In India, provision of healthcare services and their efficiency varies state-wise. Public health services are prominent in most of the regions with the national government playing an important role in funding, framing and implementing policies and operating public health insurances. The vast majority of Indians are covered by either
7828-469: The longest life expectancy at birth in the world. During this long life, encountering uncertain situations requiring hospitalization are inevitable. Health insurance or medical insurance cover high healthcare costs during hospitalization. Health insurance for Singapore Citizens and Permanent Residents MediShield Life , is a universal health insurance covering all Singapore Citizens and Permanent Residents. MediShield Life covers hospitalization costs for
7931-443: The loss and out of pocket costs including, with the permission of the insurer, claim expenses. Under a "pay on behalf" policy, the insurance carrier would defend and pay a claim on behalf of the insured who would not be out of pocket for anything. Most modern liability insurance is written on the basis of "pay on behalf" language, which enables the insurance carrier to manage and control the claim. Under an "indemnification" policy,
8034-612: The losses that only some insureds 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. Risk which can be insured by private companies typically share seven common characteristics: When
8137-409: The majority of funds provide the same level of reimbursement and benefits. The government has two responsibilities in this system. Today, this system is more or less intact. All citizens and legal foreign residents of France are covered by one of these mandatory programs, which continue to be funded by worker participation. However, since 1945, a number of major changes have been introduced. Firstly,
8240-588: The mandatory system does not cover, there is a large range of private complementary insurance plans available. The market for these programs is very competitive, and often subsidised by the employer, which means that premiums are usually modest. 85% of French people benefit from complementary private health insurance. Germany has the world's oldest national social health insurance system, with origins dating back to Otto von Bismarck 's Sickness Insurance Law of 1883. Beginning with 10% of blue-collar workers in 1885, mandatory insurance has expanded; in 2009, insurance
8343-421: The other countries. One difference between the U.S. and the other countries in the study is that the U.S. is the only country without universal health insurance coverage. The Commonwealth Fund completed its thirteenth annual health policy survey in 2010. A study of the survey "found significant differences in access, cost burdens, and problems with health insurance that are associated with insurance design". Of
8446-419: The overall risk of health risk and health system expenses over the risk pool, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax , to provide the money to pay for the health care benefits specified in the insurance agreement. The benefit is administered by a central organization, such as a government agency, private business, or not-for-profit entity. According to
8549-414: The policy. When insured parties experience a loss for a specified peril, the coverage entitles the policyholder to make a claim against the insurer for the covered amount of loss as specified by the policy. The fee paid by the insured to the insurer for assuming the risk is called the premium. Insurance premiums from many insureds are used to fund accounts reserved for later payment of claims – in theory for
8652-406: The premium collected in order to assess rate adequacy. Loss ratios and expense loads are also used. Rating for different risk characteristics involves—at the most basic level—comparing the losses with "loss relativities"—a policy with twice as many losses would, therefore, be charged twice as much. More complex multivariate analyses are sometimes used when multiple characteristics are involved and
8755-448: The primary insurer deems the risk too large for it to carry. Methods for transferring or distributing risk were practiced by Chinese and Indian traders as long ago as the 3rd and 2nd millennia BC, respectively. Chinese merchants travelling treacherous river rapids would redistribute their wares across many vessels to limit the loss due to any single vessel capsizing. Codex Hammurabi Law 238 (c. 1755–1750 BC) stipulated that
8858-537: The provider's standard charges. It generally costs the patient less to use an in-network provider. The Commonwealth Fund, in its annual survey, "Mirror, Mirror on the Wall", compares the performance of the health care systems in Australia, New Zealand, the United Kingdom, Germany, Canada and the U.S. Its 2007 study found that, although the U.S. system is the most expensive, it consistently under-performs compared to
8961-666: The public health plans do not cover (for example, semi-private or private rooms in hospitals and prescription drug plans). Four provinces allow insurance for services also mandated by the Canada Health Act, but in practice, there is no market for it. All Canadians are free to use private insurance for elective medical services such as laser vision correction surgery, cosmetic surgery, and other non-basic medical procedures. Some 65% of Canadians have some form of supplementary private health insurance; many of them receive it through their employers. Private-sector services not paid for by
9064-429: The public provincial health insurance systems in Canada are frequently referred to as Medicare . This public insurance is tax-funded out of general government revenues, although British Columbia and Ontario levy a mandatory premium with flat rates for individuals and families to generate additional revenues – in essence, a surtax. Private health insurance is allowed, but in six provincial governments only for services that
9167-404: The reasonable monetary value of the claim), and authorizes payment. Policyholders may hire their own public adjusters to negotiate settlements with the insurance company on their behalf. For policies that are complicated, where claims may be complex, the insured may take out a separate insurance-policy add-on, called loss-recovery insurance, which covers the cost of a public adjuster in the case of
9270-435: The requirement that all people have free access to what are termed "medically necessary services," defined primarily as care delivered by physicians or in hospitals, and the nursing component of long-term residential care. If provinces allow doctors or institutions to charge patients for medically necessary services, the federal government reduces its payments to the provinces by the amount of the prohibited charges. Collectively,
9373-419: The risk of a contingent or uncertain loss. An entity which provides insurance is known as an insurer , insurance company , insurance carrier , or underwriter . A person or entity who buys insurance is known as a policyholder , while a person or entity covered under the policy is called an insured . The insurance transaction involves the policyholder assuming a guaranteed, known, and relatively small loss in
9476-456: The scope of insurance cover. Insurance can have various effects on society through the way that it changes who bears the cost of losses and damage. On one hand it can increase fraud; on the other it can help societies and individuals prepare for catastrophes and mitigate the effects of catastrophes on both households and societies. Insurance can influence the probability of losses through moral hazard , insurance fraud , and preventive steps by
9579-507: The signs and symptoms of which existed during the six months ending on the day the person first took out insurance. They are also entitled to impose a 12-month waiting period for benefits for treatment relating to an obstetric condition, and a 2-month waiting period for all other benefits when a person first takes out private insurance. Funds have the discretion to reduce or remove such waiting periods in individual cases. They are also free not to impose them, to begin with, but this would place such
9682-481: The telephone with settlement authority at a mandatory settlement-conference when requested by a judge. Health insurance Health insurance or medical insurance (also known as medical aid in South Africa) is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses . As with other types of insurance, risk is shared among many individuals. By estimating
9785-415: The transaction Standard Life Aberdeen retained a stake in the combined group. In 2020, Phoenix completed the acquisition of fellow closed book specialist ReAssure Group from Swiss Re. In 2021, it was announced that Phoenix had acquired the rights to the Standard Life brand and had undertaken additional steps to simplify the relationship with Standard Life Aberdeen that had developed since the acquisition of
9888-414: The variation between the various competing insurers is only about 5%. However, insurance companies are free to sell additional policies to provide coverage beyond the national minimum. These policies do not receive funding from the equalization pool but cover additional treatments, such as dental procedures and physiotherapy, which are not paid for by the mandatory policy. Funding from the equalization pool
9991-452: Was $ 68.4 billion, as the result of float. Some insurance-industry insiders, most notably Hank Greenberg , do not believe that it is possible to sustain a profit from float forever without an underwriting profit as well, but this opinion is not universally held. Reliance on float for profit has led some industry experts to call insurance companies "investment companies that raise the money for their investments by selling insurance". Naturally,
10094-485: Was advanced on a ship or cargo, to be repaid with large interest if the voyage prospers. However, the money would not be repaid at all if the ship were lost, thus making the rate of interest high enough to pay for not only for the use of the capital but also for the risk of losing it (fully described by Demosthenes ). Loans of this character have ever since been common in maritime lands under the name of bottomry and respondentia bonds. The direct insurance of sea-risks for
10197-1179: Was alleged in this case. The ruling has not changed the overall pattern of health insurance across Canada, but has spurred on attempts to tackle the core issues of supply and demand and the impact of wait times. In 2020 in Cyprus introduced the General Healthcare System (GHS, also known as GESY) which is an independent insurance fund through which clinics, private doctors, pharmacists, laboratories, microbiological laboratories, and physiotherapists will be paid so that they can offer medical care to permanent residents of Cyprus who will be paying contributions to this fund. In addition to GESY, more than 12 local and international insurance companies (e.g. Bupa , Aetna, Cigna , Metlife ) provide individual and group medical insurance plans. The plans are divided into two main categories plans providing coverage from inpatient expenses (i.e. hospitalization, operations) and plans covering inpatient and outpatient expenses (such as doctor visits, medications, physio-therapies). The national system of health insurance
10300-623: Was based until moving its head office to Peterborough in 1989. In 1990, it was acquired by the Australian insurance group, AMP , and in 2003, Pearl, NPI and London Life Association were demerged from AMP to become part of Henderson Group . In 2005, the Pearl Group was bought from Henderson Group by Sun Capital Partners (a business in which Hugh Osmond is a leading partner) and TDR Capital . It acquired Resolution Life (including its Phoenix Assurance operations) in 2008. In 2009,
10403-492: Was formally founded in 2012 to aim to increase insurance industry effectiveness in providing input to international regulatory bodies and to contribute more effectively to the international dialogue on issues of common interest. It consists of its 40 member associations and 1 observer association in 67 countries, which companies account for around 89% of total insurance premiums worldwide. Insurance involves pooling funds from many insured entities (known as exposures) to pay for
10506-570: Was instituted in 1945, just after the end of the Second World War. It was a compromise between Gaullist and Communist representatives in the French parliament. The Conservative Gaullists were opposed to a state-run healthcare system, while the Communists were supportive of a complete nationalisation of health care along a British Beveridge model. The resulting programme is profession-based: all people working are required to pay
10609-504: Was made mandatory on all citizens, with private health insurance for the self-employed or above an income threshold. As of 2016, 85% of the population is covered by the compulsory Statutory Health Insurance (SHI) ( Gesetzliche Krankenversicherung or GKV ), with the remainder covered by private insurance ( Private Krankenversicherung or PKV ). Germany's health care system was 77% government-funded and 23% privately funded as of 2004. While public health insurance contributions are based on
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