Klauzule prijava odstetnih zahtjeva - Bosna RE

Klauzule prijava odštetnih zahtjeva za
reosiguranje
i
Indeksacija prioriteta i limita
Georg Stein
Seminar Zelena karta Bosna Re
Sarajevo
24. april 2008.

Program
• Kratka prezentacija Munich Re-a
• Prijava odštetnih zahtjeva reosiguravaču –zaštoikako?
• Indeksacija šteta – zašto i kako?
• Diskusija
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1. Kratka prezentacija Munich Re-a
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Osnovne brojke o Munich Re-u
Osnovan: 1880.
Tri stuba:
Reosiguranje Osiguranje Upravljanje kapitalom
Ključne brojke za Munich Re Grupu 2007.:
Premija: Euro 37 mld (od toga 22 mld reosiguranje)
Rezultat:Euro 3.9 mld
Reosiguranje:
~ 6.500 zaposlenih širom svijeta
~ 5.000 klijenata
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Munich Re-ova svjetska mreža za
reosiguranje
• Atlanta
• Boston
• Chicago
• Columbus
• Dallas
• Hartford
• Kansas City
• Los Angeles
• Montreal
• New York
• Philadelphia
• Princeton
• San Francisco
• Seattle
• Toronto
• Vancouver
• Waltham
• München
• Athen
• Genf
• London
• Madrid
• Mailand
• Moskau
• Paris
• Warschau
• Hongkong
• Kalkutta
• Kuala Lumpur
• Mumbai
• Peking
• Schanghai
• Seoul
• Singapur
• Taipeh
• Tokio
• Bogotá
• Buenos Aires
• Caracas
• Mexiko
• Santiago de Chile
• São Paulo
• Accra
• Durban
• Harare
• Johannesburg
• Kapstadt
• Nairobi
• Port Louis
• Auckland
• Brisbane
• Melbourne
• Perth
• Sydney
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Munich Re-ova usluga i dodatna
vrijednost reosiguranicima
Munich Re pruža
• Usluge prema potrebama klijenata zasnovane na profesionalnoj stručnosti i
iskustvu
• Kapacitet uvezan sa inovativnošću, financijskom snagom
• Pun spektar proizvoda i povezanih usluga (poput usluga upravljanja štetama), od
tradicionalnog reosiguranja do alternativnog financiranja rizika i struktura prenosa
rizika
Munich Re daje operativnu i stratešku podršku i savjete putem
• prilagođenih seminara i radionica
• konferencija sa učesnicima visokog profila
• tematskih i temeljitih publikacija
• inteligentnih uslužnih alata
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2. Prijava odštetnih zahtjeva
reosiguravaču
– kako i zašto?
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Prijava odštetnih zahtjeva – zašto?
Omogućava reosiguravaču da
•stekne znanje o pojedinoj šteti
•postavi odgovarajuće rezerve
•razvije znanje o tržištu
•procijeni dugoročni razvoj i povećanje visine šteta
•izračuna korektnu cijenu
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Prijava odštetnih zahtjeva – zašto?
Korist za obje strane, jer reosiguravač može
•sarađivati sa osiguranikom
•pružiti pomoć kod obrade zahtjeva
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Prijava odštetnih zahtjeva – kako?
Promptno obavještavanje o štetama koje mogu pogoditi
pokriće viška štete (XL)
•već iznad prioriteta
•ispod prioriteta, ali vjerovatno će ga preći tokom razvoja
•određene povrede
•plaćanje anuiteta
Redovno i dovoljno ažuriranje
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Prijava odštetnih zahtjeva – kako?
Claim and Loss
Reporting
1 The Reinsured shall give immediate written notice to the Reinsurer
of any individual claim or aggregation of claims provided for in this
Contract made against the Reinsured in respect of business
Reinsured thereunder or of its becoming aware of any circumstances
which could give rise to such a claim or aggregation of claims where
the same:
(a)
(b)
Exceeds or may possibly exceed the percentage share
specified in the RISK DETAILS of the Retention (irrespective of
any question as to liability) [ here: 70% of deductible] or
Relates to any bodily injury or disease which results or may
result in any of the following:
i) a permanent disability rating of 50% or more,
ii)
payment of an annuity or any other periodic payment,
iii) an award which may be subject to augmentation at some
future date other than on appeal or
(c)
Originates from any of the following:
i) fatal injury,
ii)
iii)
iv)
brain damage,
spinal injury resulting in partial or total paralysis,
amputation,
v) permanent loss of use of a limb,
vi)
blindness,
vii) severe burns,
viii) extensive scarring or severe facial disfigurement.
2 Notice (in accordance with 1 above) shall include information about
facts, legal assessment and estimated amount of loss. After such
notice the Reinsured shall keep the Reinsurer informed about the
development of any such claim or loss occurrence.
3 The Reinsurer shall not be liable for any claim which has not been
reported before the expiry of one year from the date upon which the
Reinsured knew of a claim covered under this Contract.
[here: degree of claims cooperation regulated in § claims settlement;
full cooperation with leader]
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3. Indeksacija šteta
– zašto i kako?
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Indeksacija šteta – zašto?
Ugovor o reosiguranju Inflacija 25%
Prioritet 200
Limit 800
Šteta 500 Inflatirana šteta 625
Osiguravač 200 (40%) Osiguravač 200 (32%)
Reosiguravač 300 (60%) Reosiguravač 425 (68%)
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Indeksacija šteta – kako?
Ugovor o reosiguranju Inflacija 25%
Prioritet 200 Indeksirani Prioritet 250
Limit 800 Indeksirani limit 1000
Šteta 500 Inflatirana šteta 625
Osiguravač 200 (40%) Osiguravač 250 (40%)
Reosiguravač 300 (60%) Reosiguravač 375 (60%)
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Indeksacija šteta – kako?
Nominalni sloj: 800 xs 200
Prioritet
(Nominalna šteta / Nominalna šteta umanjena inflacijom) * Nominalni prioritet
(625 / 500) * 200
= 1,25 * 200 = 250
Limit
(Nominalna šteta / Nominalna šteta umanjena inflacijom) * Nominalni limit
(625 / 500) * 800
= 1,25 * 800 = 1000
Indeksirani sloj: 1.000 xs 250
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Indeksacija šteta – kako?
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Indeksacija šteta – kako?
Index Clause
1. In the event of any loss hereunder the Deductible of the Reinsured and the limit of liability of the
Reinsurers shall be adjusted by reference to an index, as hereinafter defined, applying at the
month of January in the manner hereinafter set out. The index of the above-mentioned date
shall be called the Base Index. [here: base date = contract year]
2. In respect of each and every loss settlement made under this treaty, the Reinsured shall submit
a list showing in respect of each and every loss, any settlement payments, indicating the
amount(s) paid and the date(s) of payment, as well as any separately calculated loss reserve.
The sum of each and every loss settlement payment, if any, plus the current loss reserve, if any,
shall for the purpose of this clause be termed the “Actual Amount of Loss Development”.
3. The “Adjusted Amount of Loss Development” shall be calculated individually for each and every
loss settlement by the following means:
(i) Paid Loss Base Index Adjusted Paid
on Day “X” x Index on Day “X” = Loss
(ii) Current O/S Base Index Current Adjusted
Loss x Index on Current = O/S Loss
Day
(iii) All Adjusted Adjusted Amount
Paid Losses +
of Loss
Current Adjusted = Development
O/S Loss
(where “X” designates the date of the respective payment and/or corresponding reserve, if any).
However, the above calculation shall only apply in respect of those loss developments where
there is a variation of more than 10% (ten percent) between the base index and the index on the
date of the loss development. In respect of all other loss developments the "Adjusted Amount of
Loss Development" shall always be equal to the “Actual Amount of Loss Development".
The Deductible of the Reinsured and the limit of liability of the Reinsurers shall then be multiplied by
the following fraction:
Actual Amount of Loss Development
Adjusted Amount of Loss Development
4. Index:
a) In respect of an award resulting in continuing regular payments the index or indices to the
applied shall be that/those to which an award is linked.
b) For all other loss developments the index to be applied shall be the Wage Index for the
country in which the claim is settled appearing in the statistics published by the
International Monetary Fund.
In the event that the publications does not contain a Wage index for the territory
concerned then the index to be applied shall be that for the Cost of Living or Retail
Prices. If the publication does not contain any indices for the territory concerned, then an
alternative publication shall be mutually agreed between the Reinsured and Reinsurers.
c) The index at the date of loss development shall be the last available index appearing in
the publications mentioned above for the month in which payment(s) is/are made.
5. The date of loss development shall be deemed to be as follows:
a) The date upon which a loss reserve is set.
b) The date upon which a payment made by the Reinsured is accepted.
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Indeksacija šteta – Primjer
Godina štete
Osnov indeksacije
Prioritet
2002
juli 1999. 171.30%
363,500
Nom inalni zahtjev
Prilagođeni zahtjev
Distribucija zahtjeva
Godina Plaćeno Rezervirano Ukupno Indeks Plaćeno Rezervirano Ukupno % Plaćeno Rezervirano Ukupno
2002 21,999 478,001 500,000 186.50% 20,206 439,043 459,249 79% 21,999 373,756 395,755 Osiguranik
21% 0 104,245 104,245 Reosigurava
2003 33,262 944,739 1,000,000 190.60% 29,894 849,076 899,175 40% 55,261 348,999 404,259 Osiguranik
60% 0 595,741 595,741 Reosigurava
2004 120,070 824,670 1,000,000 194.60% 105,693 725,930 881,723 41% 175,330 236,931 412,261 Osiguranik
59% 0 587,739 587,739 Reosigurava
2005 30,772 793,898 1,000,000 199.50% 26,422 681,678 863,893 42% 206,102 214,668 420,770 Osiguranik
58% 0 579,230 579,230 Reosigurava
2006 7,314 786,584 1,000,000 205.50% 6,097 655,678 843,990 43% 213,416 217,276 430,692 Osiguranik
57% 0 569,308 569,308 Reosigurava
2007 136,418 650,166 1,000,000 210.80% 110,856 528,337 827,505 44% 349,834 89,438 439,272 Osiguranik
56% 0 560,728 560,728 Reosigurava
Indeks
Jul-86 100.00% Jul-00 175.30% (Nominalna šteta / Indeks na dan plaćanja) * Indeks na bazni datum
Jul-87 103.50% Jul-01 181.00%
Jul-88 106.40% Jul-02 186.50% 2002 (500.000 / 186,5%) * 171,3% = 459.249
Jul-89 110.50% Jul-03 190.60% 363.500 / 459.249 = 79%
Jul-90 118.30% Jul-04 194.60%
Jul-91 127.50% Jul-05 199.50% 2003 plaćeno u 2002 (21.999 / 186,5%) * 171,3% = 20,206
Jul-92 136.00% Jul-06 205.50% plaćeno u 2003 (33.262 / 190,6%) * 171,3% = 29,894
Jul-93 142.40% Jul-07 210.80% rezervir. 2003: (944.739 / 190,6%) * 171,3% = 849,075
Jul-94 147.90% 899,175
Jul-95 153.50% 363.500 / 899.175 = 40%
Jul-96 158.50%
Jul-97 162.20%
Jul-98 166.20%
Jul-99 171.30%
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Indeksacija šteta – zašto i kako?
U poslovima sa dugim istekom kao što je autoodgovornost,
zahtjevi se razvijaju kroz niz godina
Tokom razvoja, cijene rastu
Zahtjevi postaju sve skuplji
Bez indeksacije, reosiguravač bi trebao nositi cjelokupni
rast troška
‣Sistem je potreban da bi osigurao da se inflatirani zahtjev
dijeli na isti način na koji bi bio bez uticaja inflacije
‣Indeksacija !!
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Indeksacija šteta – zašto i kako?
Indeksacija
•omogućava osiguravaču i reosiguravaču da podijele
efekte inflacije
•zadržava fiksiranu proporciju u kojoj se zahtjevi dijele
između osiguravača i reosiguravača tokom godina kroz
koje se zahtjev razvija
‣dogovoreni sloj reosiguranja zadržava svoju strukturu
koja je originalno namjeravana
Primjenjuje se na prioritet i limit; tj. fer efekt za obje strane
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Indeksacija šteta – zašto i kako?
prioritet i limit
se povećavaju u skladu sa povećanjem određenog indeksa
između baznog datuma (početak ugovora ili drugi datum)
i datuma izmirenja štete
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Indeksacija šteta – zašto i kako?
Indeks
treba odražavati inflaciju na najbolji mogući način
Standard: IMF Indeks plaća
Poželjno za odštetne zahtjeve po tjelesnim povredama:
Indeks zdravstvene zaštite
10% slobodne margine radi smanjenja administrativnog
rada
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Hvala vam na pažnji!
Georg Stein
Casualty Underwriting CEE
Telefon: 0049 / 89 / 3891 – 9365
e-Mail: gstein@munichre.com
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