mardi 6 mars 2012
Goods and services. The insurance industry provides protection against financial losses resulting from a variety of hazards. By purchasing insurance policies, individuals and businesses can receive reimbursement for losses due to car accidents, theft of property, and fire and storm damage; medical expenses; and loss of income due to disability or death.
Industry organization. The insurance industry consists mainly of insurance carriers and insurance agencies and brokerages. In general, insurance carriers are large companies that provide insurance and assume the risks covered by the policy. Insurance agencies and brokerages sell insurance policies for the carriers. While some of agencies and brokerages are directly affiliated with a particular carrier and sell only that carrier's policies, many are independent and are thus free to market the policies of a variety of insurance carriers.
In addition to these two primary components, the insurance industry includes establishments that provide other insurance-related services, such as claims adjustment or third-party administration of insurance and pension funds. These other insurance industry establishments also include a number of independent organizations that provide a wide array of insurance-related services to carriers and their clients. One such service is the processing of claims forms for medical practitioners. Other services include loss prevention and risk management. Also, insurance companies sometimes hire independent claims adjusters to investigate accidents and claims for property damage and to assign a dollar estimate to the claim.
Insurance carriers assume the risk associated with annuities and insurance policies and assign premiums to be paid for the policies. In the policy, the carrier states the length and conditions of the agreement, exactly which losses it will provide compensation for, and how much will be awarded. The premium charged for the policy is based primarily on the amount to be awarded in case of loss and the likelihood that the insurance carrier will actually have to pay. In order to be able to compensate policyholders for their losses, insurance companies invest the money they receive in premiums, building up a portfolio of financial assets and income-producing real estate which can then be used to pay off any future claims that may be brought. There are two basic types of insurance carriers: primary and reinsurance. Primary carriers are responsible for the initial underwriting of insurance policies and annuities, while reinsurance carriers assume all or part of the risk associated with the existing insurance policies originally underwritten by other insurance carriers.
Primary insurance carriers offer a variety of insurance policies. Life insurance provides financial protection to beneficiaries—usually spouses and dependent children—upon the death of the insured. Disability insurance supplies a preset income to an insured person who is unable to work due to injury or illness, and health insurance pays the expenses resulting from accidents and illness. An annuity (a contract or a group of contracts that furnishes a periodic income at regular intervals for a specified period) provides a steady income during retirement for the remainder of one's life. Property-casualty insurance protects against loss or damage to property resulting from hazards such as fire, theft, and natural disasters. Liability insurance protects policyholders from financial responsibility for injuries to others or for damage to other people's property. Most policies, such as automobile and homeowner's insurance, combine both property-casualty and liability coverage. Companies that underwrite this kind of insurance are called property-casualty carriers.
Some insurance policies cover groups of people, ranging from a few to thousands of individuals. These policies usually are issued to employers for the benefit of their employees or to unions, professional associations, or other membership organizations for the benefit of their members. Among the most common policies of this nature are group life and health plans. Insurance carriers also underwrite a variety of specialized types of insurance, such as real-estate title insurance, employee surety and fidelity bonding, and medical malpractice insurance.
Other organizations in the industry are formed by groups of insurance companies, to perform functions that would result in a duplication of effort if each company carried them out individually. For example, service organizations are supported by insurance companies to provide loss statistics, which the companies use to set their rates.
Recent developments. The recent financial crisis has resulted in large losses for the insurance industry. Industry conditions in the near term remain tenuous, particularly as many companies will continue to experience declining revenues, investment losses, and credit rating downgrades, which can affect an insurer’s ability to repay debt by having to pay a higher interest rate. Additionally, insurance companies who were trading in credit default swaps and other risky instruments without sufficient hedging suffered especially hard, and some companies even became insolvent. Companies with prudent risk management strategies also suffered large losses, because most investment instruments owned by insurance companies experienced falling values as they were being sold or marked down as the stock market deteriorated in late 2008. Nonetheless, as insurers rebuild capital and adhere to stricter Federal regulations, the insurance industry is likely to stabilize.
Insurance carriers now sell products traditionally associated with other financial institutions, such as banks and securities firms. These products include securities, mutual funds, and various retirement plans. The Internet is an important tool for insurance carriers in reaching potential and existing customers. Carriers use the Internet to enable customers to access online account and billing information, submit claims, view insurance quotes, and purchase policies. In addition to individual carrier-sponsored Internet sites, several "lead-generating" sites have emerged. These sites allow potential customers to input information about their insurance policy needs. For a fee, the sites forward customer information to a number of insurance companies, which review the information and, if they decide to take on the policy, contact the customer with an offer. This practice gives consumers the freedom to accept the best rate.
Working ConditionsAbout this section
Hours. Many workers in the insurance industry—especially those in administrative support positions—work a 5-day, 40-hour week. Those in executive and managerial occupations often put in more than 40 hours. There are several occupations in the insurance industry where workers may work irregular hours outside of office settings. Those working in sales jobs need to be available for their clients at all times. This accommodation may result in these individuals working 50 to 60 hours per week. Also, call centers operate 24 hours a day, 7 days a week, so some of their employees must work evening and weekend shifts. The irregular business hours in the insurance industry provide some workers with the opportunity for part-time work. Part-time employees make up 8 percent of the workforce.
Work environment. Insurance employees working in sales jobs often visit prospective and existing customers' homes and places of business to market new products and provide services. Others working in the industry may need to frequently leave the office to inspect damaged property, and at times can be away from home for days, traveling to the scene of a disaster—such as a tornado, flood, or hurricane—to work with affected policyholders and various government officials.
A small, but increasing, number of insurance employees spend most of their time on the telephone working in call centers, answering questions and providing information to prospective clients or current policyholders. These jobs may include selling insurance, taking claims information, or answering medical questions.
EmploymentAbout this section
The insurance industry had about 2.3 million wage and salary jobs in 2008. Insurance carriers accounted for 61 percent of jobs, while insurance agencies, brokerages, and providers of other insurance-related services accounted for 39 percent of jobs.
The majority of establishments in the insurance industry were small; however, a few large establishments accounted for many of the jobs in this industry. Insurance carriers tend to be large establishments, often employing 250 or more workers, whereas agencies and brokerages tend to be much smaller, frequently employing fewer than 20 workers.
Many insurance carriers' home and regional offices are situated near large urban centers. Insurance workers who deal directly with the public are located throughout the country. Almost all of those working in sales work out of local company offices or independent agencies. Many others in the industry work for independent firms in small cities and towns throughout the country.
Occupations in the IndustryAbout this section
About 42 percent of insurance workers are in office and administrative support jobs such as those found in every industry (table 1). Many office and administrative support positions in the insurance industry, however, require skills and knowledge unique to the industry. About 29 percent of insurance workers are in management or business and financial operations occupations. About 17 percent of wage and salary employees in the industry are sales and related workers, selling policies to individuals and businesses. About 11 percent are in professional and related occupations, including many computer and mathematical science occupations.
Office and administrative support occupations. Office and administrative support occupations in this industry include secretaries,typists, word processors, bookkeepers, and other clerical workers. Secretaries and administrative assistants perform routine clerical and administrative functions such as drafting correspondence, scheduling appointments, organizing and maintaining paper and electronic files, or providing information to callers. Bookkeeping, accounting, and auditing clerks handle all financial transactions and recordkeeping for an insurance company. They compute, classify, update, and record numerical data to keep financial records complete and accurate.Insurance claims and policy processing clerks process new policies, modifications to existing policies, and claims forms. They review applications for completeness, compile data on policy changes, and verify the accuracy of insurance company records. Customer service representatives have duties similar to insurance claims and policy processing clerks, except they work directly with customers by processing insurance policy applications, changes, and cancellations over the phone. They may also process claims and sell new policies to existing clients. These workers recently are taking on increased responsibilities in insurance offices, such as handling most of the continuing contact with clients. A growing number of customer service representatives work in call centers that are open 24 hours a day, 7 days a week, where they answer clients' questions, update policy information, and provide potential clients with information regarding the types of policies the company issues.
Management, business, and financial operations occupations. Top executives direct the operations of an independent insurance agency, brokerage, or a large insurance carrier. Marketing managers direct carriers' development of new types of policies that might appeal to the public and strategies for selling them to customers. Sales managers direct the activities of the sales workers in local sales offices of insurance carriers and independent agencies. They sell insurance products, work with clients, and supervise staff. Other managers who work in their companies' home offices are in charge of functions such as actuarial calculations, policy issuance, accounting, and investments.
Claims adjusters, appraisers, examiners, and investigators decide whether claims are covered by the customer's policy, estimate and confirm payment, and, when necessary, investigate the circumstances surrounding a claim. Claims adjusters work for property and liability insurance carriers or for independent adjusting firms. They inspect property damage, estimate how much it will cost to repair, and determine the extent of the insurance company's liability; in some cases, they may help the claimant receive assistance quickly in order to prevent further damage and begin repairs. Adjusters plan and schedule the work required to process claims, which may include interviewing the claimant and witnesses and consulting police and hospital records. In some property-casualty companies, claims adjusters are called claims examiners, but in other companies, a claims examiner's primary job is to review claims to ensure that proper guidelines have been followed. Only occasionally—especially when disasters suddenly increase the volume of claims—do these examiners aid adjusters with complicated claims.
In the offices of life and health insurance carriers, claims examiners are the counterparts of the claims adjuster who works in a property and casualty insurance firm. Examiners in the health insurance carriers review health-related claims to see whether the costs are reasonable based on the diagnosis. Examiners check claim applications for completeness and accuracy, interview medical specialists, and consult policy files to verify information on a claim. Claims examiners in the life insurance carriers review causes of death and also may review new applications for life insurance to make sure that the applicants have no serious illnesses that would prevent them from qualifying for insurance.
Insurance investigators handle claims in which companies suspect fraudulent or criminal activity, such as suspicious fires, questionable workers' disability claims, difficult-to-explain accidents, and dubious medical treatment. Investigators usually perform database searches on suspects to determine whether they have a history of attempted or successful insurance fraud. Then, the investigators may visit claimants and witnesses to obtain a recorded statement, take photographs, inspect facilities, and conduct surveillance on suspects. Investigators often consult with legal counsel and are sometimes called to testify as expert witnesses in court cases.
Auto damage appraisers usually are hired by insurance companies and independent adjusting firms to inspect the damage to a motor vehicle after an accident and to provide unbiased estimates of repair cost. Claims adjusters and auto damage appraisers can work for insurance companies, or they can be independent or public adjusters. Insurance companies hire independent adjusters to represent their interests while assisting the insured, whereas public adjusters are hired to represent the insured's interests against insurance carriers.
Management analysts, often called loss control representatives in the insurance industry, assess various risks faced by insurance companies. These workers inspect the business operations of insurance applicants, analyze historical data regarding workplace injuries and automobile accidents, and assess the potential for natural hazards, dangerous business practices, and unsafe workplace conditions that may result in injuries or catastrophic physical and financial loss. They might then recommend, for example, that a factory add safety equipment, that a house be reinforced to withstand environmental catastrophes, or that incentives be implemented to encourage automobile owners to install air bags in their cars or take more effective measures to prevent theft. Because the changes they recommend can greatly reduce the probability of loss, loss control representatives are increasingly important to both insurance companies and the insured.
Underwriting is another important management and business and financial occupation in insurance. Underwriters evaluate insurance applications to determine the risk involved in issuing a policy. They decide whether to accept or reject an application, and they determine the appropriate premium for each policy.
Sales and related occupations. Insurance sales agents, also referred to as producers, may work as exclusive agents, or captive agents, selling for one company, or as independent agents selling for several companies. Through regular contact with clients, agents are able to update coverage, assist with claims, ensure customer satisfaction, and obtain referrals. Insurance sales agents may sell many types of insurance, including life, annuities, property-casualty, health, and disability insurance. Many insurance sales agents are involved in "cross-selling" or "total account development," which means that, besides offering insurance, they have become licensed to sell mutual funds, annuities, and other securities. These agents usually find their own customers and ensure that the policies sold meet the specific needs of their policyholders.
Professional and related occupations. The insurance industry employs relatively few people in professional and related occupations, but they are essential to company operations. For example, insurance companies' lawyers defend clients who are sued, especially when large claims may be involved. These lawyers also review regulations and policy contracts. Nurses and other medical professionals advise clients on wellness issues and on medical procedures covered by the company's managed-care plan. Computer systems analysts, computer software engineers and computer programmers, and computer support specialists are needed to analyze, design, develop, and program the systems that support the day-to-day operations of the insurance company.
Actuaries represent a relatively small proportion of employment in the insurance industry, but they are vital to the industry's profitability. Actuaries study the probability of an insured loss and determine premium rates. They must set the rates so that there is a high probability that premiums paid by customers will cover claims, but not so high that their company loses business to competitors.