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For example, when a claim is first reported, a $100 payment might be made, and a $900 case reserve might be established, for a total initial reported amount of $1000. However, the claim may later settle for a larger amount, resulting in $2000 of payments from the insurer to the claimant before the claim is closed.
Loss reserving is the calculation of the required reserves for a tranche of insurance business, [1] including outstanding claims reserves.. Typically, the claims reserves represent the money which should be held by the insurer so as to be able to meet all future claims arising from policies currently in force and policies written in the past.
Ultimate loss amounts are necessary for determining an insurance company's carried reserves. They are also useful for determining adequate insurance premiums, when loss experience is used as a rating factor [4] [5] [6] Loss development factors are used in all triangular methods of loss reserving, [7] such as the chain-ladder method.
The chain-ladder or development [1] method is a prominent [2] [3] actuarial loss reserving technique. The chain-ladder method is used in both the property and casualty [1] [4] and health insurance [5] fields. Its intent is to estimate incurred but not reported claims and project ultimate loss amounts. [5]
For insurance, the loss ratio is the ratio of total losses incurred (paid and reserved) in claims plus adjustment expenses divided by the total premiums earned. [1] For example, if an insurance company pays $60 in claims for every $100 in collected premiums, then its loss ratio is 60% with a profit ratio/gross margin of 40% or $40.
A balance sheet is often described as a "snapshot of a company's financial condition". [1] It is the summary of each and every financial statement of an organization. Of the four basic financial statements, the balance sheet is the only statement which applies to a single point in time of a business's calendar year. [2]
The loss experience used in determining the modifier typically comprises three years but excluding the immediate past year. For instance, if a policy expired on January 1, 2018, the period reflected by the experience modifier would run from January 1, 2014 to January 1, 2017.
Reserves for the remainder of the insurance are calculated as if they are for the same insurance minus the first year. This method usually decreases reserves in the first year sufficiently to allow payment of first year expenses for low-premium plans, but not high-premium plans such as limited-pay whole life. [2]