Case Study Index

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Administrative Rate Hearings

Pinnacle has developed an excellent working knowledge of state rate regulatory requirements and in challenging states such as California, Florida and Texas.

In California, Pinnacle has provided expert witness testimony in support of insurer rate requests on numerous occasions, covering issues such as the treatment of reinsurance costs in catastrophe ratemaking, auto classification plans and appropriate trends for auto insurance.

In Florida, Pinnacle consultants have assisted insurers with homeowner rate filings before the Office of Insurance Regulation addressing such issues as territorial ratemaking, catastrophe loads and appropriate trend selections.

In Texas, Pinnacle provided expert witness testimony to the Insurance Commissioner as part of the 2003 rate regulatory reforms. Since then, Pinnacle has assisted insurers with contested personal lines rate requests.

Asbestos Liabilities

In 2009, Pinnacle provided expert testimony about the evolution of insurance industry asbestos liabilities in an arbitration hearing among several insurance companies and a pool manager. This assignment drew on our knowledge of the history of insurance industry asbestos liabilities, e.g., the evolution of the legal aspects surrounding coverage determinations, the interplay of primary, excess and reinsurance contracts, the history of failed attempts to control the problem and the impact of bankruptcies among other factors. The assignment also drew on our mass tort / latent liability reserving expertise.

Audit Support & Risk Transfer

Pinnacle provides audit support for captive insurers to a major accounting/audit firm. The audit support typically includes a review of the actuarial report and supporting documents to determine if the actuarial report adheres to professional standards and provides a reasonable estimate of held reserves. As part of this support we interact with the actuaries who developed the report in order to answer any relevant questions. Another frequent element of audit support engagements is risk transfer analysis. Pinnacle has developed a state-of-the-art approach to risk transfer modeling; our publications and presentations at industry trade shows have been well received. Ultimately, Pinnacle produces a report with relevant comments and our conclusions that provide the necessary documentation for the auditing firm.

Baltimore Territory Issues

In 2006, Pinnacle was retained by a group of several automobile insurance companies representing a significant share of the Maryland automobile insurance market to conduct an independent actuarial analysis of the Abell Foundation report, Actuarial Discrimination: City Residents Pay Up To 198% More For Car Insurance Than County Residents (Abell report). This report discusses many factors which contribute to higher automobile insurance rates in urban areas than rural areas with particular emphasis on Baltimore and attempts to quantify the magnitude of this as noted by the title of his report.

Bermuda SAO

Pinnacle provides the loss reserve analysis and statement of actuarial opinion to the Bermuda-domiciled captive of a major national long haul trucking company for over a decade. This reserve analysis examined the captive's coverages for excess automobile liability coverage, deductible reimbursement under a large deductible workers compensation policy and cargo liability and physical damage coverages. The analysis utilized both company loss development triangles and industry benchmarks. Once the reserve analysis was completed and discussed with the client, the statement of actuarial opinion was produced to comply with regulatory requirements. Our excellent working relationship with the captive’s auditors simplifies the work of both firms on behalf of the captive.

Capital Allocation

A reinsurer wanted to compare technical treaty prices using varying capital allocation methodologies. A Pinnacle actuary assisted in the design of a model that used standard allocation methodologies, capital allocation based on marginal impacts to rating agency required capital, and recent ideas in capital consumption / utility theory. The result was a pricing model that highlighted the sensitivity of expected ROEs to the chosen capital allocation method and allowed underwriters to make more informed decisions.

Captive Dividend Assessment

An onshore, single parent captive was concerned with the amount of retained earnings and wanted to establish a policy for the minimum capital for the program to trigger dividend distributions. Pinnacle compared the program’s capitalization to a wide variety of industry standards for similar programs from rating agencies, regulators, and other sources. The results of this analysis lead to a recommended board policy regarding a minimum capital threshold for dividend distributions and ultimately to a significant dividend being declared to the parent company.

Captive Feasibility Study

When a regional physicians group, with a moderate deductible program realized they were not getting due credit for more than a decade of exceptional loss experience, they decided to explore other options.

They chose Pinnacle specifically due to our expertise in captive and self-insurance programs.

Initially, Pinnacle discussed options including segregated cell captives, single parent captives, and even risk retention groups once they began to consider marketing the program to other similar regional physician groups.

While the customer was considering the structural alternatives, Pinnacle pursued a funding analysis. Credibility weighting the customer’s experience with industry benchmark data, produced estimates of expected losses and loss variability in several different loss layers. This not only showed the additional risk associated with higher limits of self-insurance, but was also tremendously valuable in negotiations with fronting carriers and reinsurers.

The client decided to increase the deductible on the coverage provided by their insurer, which offered more responsive pricing due to Pinnacle’s funding analysis and to form an off-shore captive providing deductible buyback coverage.  The comfort level our client had with the insured’s services also influenced the decision.

Pinnacle also worked with the captive manager to develop the feasibility study and pro forma financial statements that become the foundation of the captive application. The application was approved as submitted and the captive is running quite successfully.

Catastrophic Risks

Pinnacle was retained by an insurance company specializing in catastrophic risk to identify and test alternative sources of risk financing capacity including traditional reinsurance and catastrophe bonds. In order to complete the project, Pinnacle designed a dynamic financial model to determine the cost/benefit of alternate risk financing strategies.

Cayman Captive

Pinnacle serves many of the largest group captives in the world, many of them domiciled in the Cayman Islands. These reserve analyses are typically produced twice a year and serve multiple purposes. First, they provide a range of reasonable estimates which management uses to determine their best estimate of ultimate losses and unpaid claims liabilities. Second, these reserve estimates can then be allocated to individual members to determine the outstanding liabilities and potential future assessments, if any. Finally, the allocated ultimate losses become the basis for renewal pricing estimates for each member. Pinnacle’s approach to estimating and allocating reserves in group captives is unique in the industry and sets our alternative practice apart with its efficiency and accuracy.

Claims

Pinnacle was approached by a regional insurer that wanted to develop a predictive model that estimated the time that a claim would be open based on what is known at the first notice of loss. The company felt like this would allow them to more effectively manage their caseload and handle claims more proactively. Pinnacle, through the use of predictive modeling, assisted the carrier in designing a model which predicted cycle time based on the FNOL. Not only did this give the company a better understanding of its claims, but also assisted them in understanding their claims data better and improving their data collection.

Colorado Automobile No-Fault Impact Analyses

Pinnacle Actuarial Resources prepared an independent actuarial analysis on behalf of the Colorado Auto Insurance Working Group to determine the cost implications of changes to the Colorado no-fault law. One of the scenarios analyzed was the complete repeal of the no-fault law, replacing it with medical payments coverage.

The analysis employed data from a recent study by the Insurance Research Council (IRC) to assess the impact of a $2,500 economic loss threshold relative to BI losses. Loss and trend information from the Fast-Track monitoring system was reviewed to estimate the impact of implementing no-fault systems from other jurisdictions. Moreover, the Fast Track data was evaluated to assess the impact on costs of other jurisdictions that had previously repealed their no-fault systems.

Lastly, the indicated cost estimates for the state of Colorado were compared to those of tort states in order to assess the reasonableness of the study’s outcomes. The results from this study were used to support rate filings of several of our clients in support of the reforms.

Commercial Lines

Pinnacle was approached by a national insurer that wanted to develop a more sophisticated commercial automobile rating program. Their current commercial automobile plan was a traditional rating approach and did not take full advantage of driver, credit scoring or vehicle characteristics and the company felt they could take advantage of a significant opportunity in the market. Pinnacle, through the use of predictive modeling, assisted the carrier in designing a new rating and tiering structure, which included modifications of the rating plan, the introduction of underwriting scoring, and new territory definitions. This new structure allowed the company to have more precise rating, more adequate and yet competitive rates for a broader spectrum of risks.

Company Valuation Model

An international financial services holding company wished to become the sole owner of a company in which they had a substantial minority interest. One of our consultants designed a stochastic valuation model projecting dividend streams several decades into the future. One of the more interesting features of this model is that it did not merely arrive at a point estimate of the value of the firm but applied various assumptions to calculate a range of values. The assumptions were discussed in advance with management and the model produced a probability distribution of the value of the firm. This allowed the client to determine the likely return for a given purchase price, improving the decision making process that led to the holding company obtaining full ownership of the subsidiary.

Comparative / Contributory Negligence

In 2009, we were retained by a lawyers’ association to evaluate the historical impact of contributory negligence and comparative negligence tort systems on personal automobile insurance.

Competitive Analysis - Commercial Lines

Pinnacle was approached by a major national commercial lines insurer to provide comprehensive competitive analysis of the businessowners policy (BOP) and commercial automobile insurance market places. Pinnacle’s analysis began with a comprehensive review of the products filed by the leading twenty insurers of these products examining coverage features, rating elements, tiering and scoring elements, unique coverage features and several other key product development elements. Following this initial step, Pinnacle performed detailed territory and premium comparisons for several states using a dynamic premium comparison engine that allowed investigation at the class, coverage amount and territory level of detail. The company used a batch rating feature to develop indicated rate level estimates. Mapping features looking at ranking and pricing differences were also produced. All of this information was incorporated into a countrywide overhaul of the company’s products and pricing.

Competitive Analysis - Personal Lines

A strong commercial lines company wanted to expand their personal lines writings in the Midwest. They wanted to have a competitive analysis system to track their competitors’ rates and review along with their latest rate change indications. Pinnacle developed a competitive analysis engine showing their competitive position including color-coded maps for a market basket of representative risks.

Contractor's Liability

Pinnacle was asked to provide a legislative costing analysis and expert testimony regarding proposed legislation that would substantially expand coverage for construction defects in Oregon. Pinnacle’s study and testimony focused not only on the current conditions of the contractors’ liability insurance market compared to other states, but also the historical changes seen when other states made similar changes. Our analysis also focused on the relationship between home warranties and commercial general liability insurance policies and how these risk mitigation techniques differ over time after a home is completed.

Dedicated Fund Review

Pinnacle was asked by a State Insurance Department to review the financial soundness of a State controlled, dedicated fund. The review consisted of establishing the State’s outstanding liabilities and future funding needs. Detailed historic exposure and loss experience were not readily available from the State because the program was administered by individual insurers. Pinnacle designed and conducted an industry data call on behalf of the State. The collected data was then used by Pinnacle in support of their analysis. As the data was still somewhat limited, additional industry data was gathered from other states to supplement Pinnacle’s analysis. Pinnacle then provided the State with a report detailing the determination of the estimated liabilities, the indicated rate changes, and recommendations on data capturing for enhancement on future studies.

DFA Model

Pinnacle was asked by a regional insurer to help build a customized financial model for use in strategic decision making and in determining economic capital needs. The model reflected current and potential underwriting operations. It also incorporated economic scenario generators, capital allocation, catastrophe model results, regulatory and rating agency metrics such as risk-based capital (RBC) and Best’s Capital Adequacy Ratings (BCAR), as well as loss reserve variability. The model was designed to be used to evaluate a variety of strategic decisions, particularly related to underwriting, reinsurance, macro investment allocation, and capital allocation decisions.

Farmowners Product Development

Pinnacle was approached by a leading farmowners insurer to review their current farmowners program. Pinnacle conducted a comprehensive review of competitor's manuals to determine if any additional rate factors needed to be included our client’s current program. Based upon our review, Pinnacle made a number of suggestions including incorporating new rate factors and changing their rating algorithm to a scorecard approach that has been successful in many other lines of business. Pinnacle used its expertise in farmowners product development and cutting edge pricing techniques to improve our clients farmowners product.

Florida Automobile No-Fault Impact Analyses

In 2006 and 2007, Pinnacle was retained by Floridians for Lower Insurance Costs (FLIC) to conduct independent actuarial studies to determine the cost implications on the Florida Health Care system from various changes to the Florida No Fault Law.

First in 2006 we conducted an independent actuarial study to determine the cost implications of repealing Florida’s current no-fault law. Pinnacle also priced first party medical payments benefits of $2,500, $5,000 and $10,000 as replacements for current personal injury protection (PIP) benefits.

Then in 2007, Pinnacle determined the impact that would result from the sunset of Florida’s current no fault law. Pinnacle also determined what current PIP insurance costs will be absorbed by other insurance programs compared to costs that will go unreimbursed since the current PIP coverage will be eliminated at the time that no fault is sunset. Pinnacle testified before the Florida House Committee Working Group on Insurance in support of the analysis. The Florida No Fault Law was sunset only to be reenacted immediately thereafter.

Florida Department of Financial Services

The Florida Department of Financial Services (DOFS) oversees and administers the runoff of domestic Florida insurance companies in rehabilitation. Typically, when a company's financial condition is perilous, the DOFS obtains court orders to oversee the company’s administration and manage the orderly adjudication of all unpaid claims liabilities.

Measuring the extent of those claims liabilities involves uncertainty as to the number and severity of those claims. Further complicating the issue relates to the attitudes of claimants and their attorneys as regards to settlement of such claims knowing the company itself is under regulatory supervision. 

We assisted the DOFS in a formal way with the runoff of three nonstandard auto writers, all part of a company group. The nature of the exposure was such that the unpaid claims were dominated by bodily injury and property damage liability claims. Our modeling of the anticipated future settlements considered input from company claims representatives, the DOFS itself and the company’s auditors.

At the outset of the assignment, the company’s surplus was impaired significantly. During the process, the DOFS was able to achieve significant concessions on the part of claimants given the uncertain financial condition of the carriers involved. The outcome was when the last claim was paid, the company shell that remained had a positive surplus balance. 

Formation

In an effort to attract and retain quality physicians, a large integrated healthcare system operating in the Midwest decided to create a physician’s professional liability insurance (PPLI) alternative to the commercial markets. After a comprehensive feasibility analysis, an offshore captive insurance company (CIC) was capitalized and formed. Pinnacle actuaries were engaged to assist in the feasibility analysis and implementation of this strategy. Pinnacle’s involvement began by assisting the captive manager to develop appropriate assumptions that were incorporated into the CIC’s proposed business plan and filed with regulators. Initially, Pinnacle performed a comprehensive analysis of the current PPLI market to develop base rates, rating factors and underwriting guidelines. On an annual basis, Pinnacle re-evaluates the base rates and rating factors and recommends adjustments to reflect current trends in the market as well as credible indications borne out of the CIC’s experience. In addition to maintaining adequate rates for the program, Pinnacle has also been retained to perform the annual analysis of unpaid loss and expense reserves. The CIC’s annual reserve analysis includes a review of policies written, premium collected and claims incurred by the CIC at the close of each fiscal reporting period. Management relies on Pinnacle’s analyses to ensure the financial health of this strategic venture.

Funding Study

Pinnacle was approached by an aircraft manufacturer to provide recommended funding for various aviation and liability coverages. Pinnacle’s initial steps included discussing coverages to be provided and what data was available to complete the funding study. The captive was a start-up with no loss information on which to determine appropriate funding levels. Pinnacle was able to determine that the National Transportation Safety Board (NTSB) had a database of aircraft incidents that recorded both the manufacturer and model of the aircraft involved in the incident. Since the manufacturer was able to provide the number of units produced, Pinnacle was able to determine the frequency and severity of the incidents and project ultimate funding levels. The captive is currently operational after receiving regulatory approval.

Legislative / Regulatory Impacts

A state medical society asked Pinnacle to evaluate the impact of a change in the state’s damage caps for non-economic damages for medical professional liability. Pinnacle worked with the medical society to identify the most appropriate claims databases to assess the legislation’s potential impact. Our detailed analysis not only considered data from that state, but several others to stress test the results and provide a range of reasonable outcomes. In addition, we performed a thorough analysis of how the state compared to other states in terms of the availability and affordability of medical professional liability insurance coverage, insurer operating results for the line, and access to healthcare in the states. Through this industry analysis, we identified differences well beyond a simple loss limitation and provide a more complete review of potential environmental changes that could be expected in the state.

Liquidation - Workers Compensation

Pinnacle was retained by the liquidator of a monoline workers' compensation carrier to estimate outstanding liabilities and provide expert testimony in support of the loss reserve estimation.

Low Cost Auto

Pinnacle was retained by an industry trade organization to provide an independent review of the proposed costing of a new private passenger auto insurance program for low income insureds. The project included working in an open session with legislators and public members to arrive at a workable rate and classification plan for the new program.

Management Consulting

Pinnacle was approached by a major regional, predominantly commercial lines insurer to perform a holistic review of the insurer’s overall operations with an emphasis on determining the company’s personal lines strategy. The review included an historic analysis of industry profitability by line of insurance including various risk diversification scenarios. In addition, we performed a review of the company’s organizational structure with particular focus on the company’s marketing and distribution systems. Pinnacle’s recommendations provided a roadmap which would allow the company to grow more profitably, improve retentions, operate more efficiently and assure that the right personnel were in the right places within the organization.

Medical Malpractice Damage Caps

A state insurance regulator asked Pinnacle to determine the potential impact of several proposed tort reforms, including a change to non-economic damage caps for medical professional liability claims. Pinnacle worked with medical society to identify the most appropriate claims databases for assessing the potential legislative change. Our detailed analysis not only considered data from that state, but several others to stress test the results and provide a range of reasonable outcomes. In many cases, the specific reform’s effect, for example “I’m Sorry” legislation, was very difficult to isolate. Through this industry analysis, we identified differences well beyond a simple loss limitation to provide a more complete review of potential environmental changes that could be expected in the state.

This comprehensive analysis helped our client identify the effect of various legislative options, which empowered them to be a strong voice in the legislative debate and to influence policymaking in the state.

Medical Malpractice PCF

Pinnacle has developed an excellent working knowledge of patient compensation and birth-related injury funds in many jurisdictions, including Florida, Indiana, New Mexico, Ohio, Virginia, and Wisconsin. In several of these states, we not only complete regular rate indications and loss reserve analyses, we are frequently involved in legislative costing of proposed laws that may impact the fund. These proposed laws have included addition, modification and removal of damage caps, changes to primary coverage limits, revisions to program eligibility or mandatory coverage requirements, and program benefits changes. In all of these states, policymakers have benefitted from Pinnacle’s expert analysis, understandable reports and insightful advice.

Minnesota Automobile No-Fault Impact Analyses

The Insurance Federation of Minnesota retained Pinnacle in 2006 to conduct an independent actuarial study to determine the possible cost implications of changing Minnesota’s current no-fault law. The scenarios were:

  • A complete repeal of the no-fault law, which would be replaced with a tort system including mandatory liability insurance. We also priced first party medical payments benefits of $2,500, $5,000 and $10,000 as replacements for current personal injury protection (PIP) benefits.
  • Implementing a medical fee schedule. This option would consider two different fee schedules: the Minnesota Worker’s Compensation fee schedule, and 115% of the Medicare fee schedule.
  • Introducing a Michigan-style verbal threshold implementation with several PIP limit options.
  • Capping treatments on soft tissue injuries to $2,500.
  • Making alternative care optional for an additional premium.
  • Reducing the PIP benefit limit from $20,000 each for the separate medical and non-medical limits (with $40,000 of coverage total) to $10,000 for each separate sub-limit. This would also include an additional $10,000 of coverage for “trauma care.” 

New Jersey Automobile No-Fault Impact Analyses

Save Choices for New Jersey Drivers (SCNJD), an ad-hoc coalition of insurers, trade and business associations asked Pinnacle to determine how proposed legislation would affect drivers.

The New Jersey Auto Cost Reduction Act eliminated the judicial requirement that permanent injuries that do not meet the other eligibility criteria for tort claims in no fault cases must have a “serious impact” on the claimant’s life. Pinnacle evaluated the affect of eliminating this requirement and determined the law would “significantly increase “losses eligible for tort recovery. Hence, Bodily Injury (BI) Liability and Uninsured/Underinsured Motorist Coverage (UM/UIM) costs and premiums would increase for drivers selecting the verbal threshold.

On June 14, 2005, two years after Pinnacle conducted its analysis, the New Jersey Supreme Court concluded does not imply a "serious impact" requirement for those seeking damages for non-economic losses (Octavio Serrano v. Jacqueline Serrano, et al. (A-99-03) and DiProspero v. Penn, et al., (A-66-03). As a result, injured claimants may seek recompense from the at-fault party for losses such as pain and suffering. SCNJD hired Pinnacle again to update the analysis based upon the later Insurance Research Council (IRC) data, which became available subsequent to the release of its 2003 report. 

Optimization of Assets and Liabilities

An international insurance and reinsurance company wanted to design an optimization model to be used for both asset and liability decisions. Pinnacle actuaries were able to demonstrate to company management that their initial approach was both practically and theoretically unsound and prevented them from implementing a flawed decision making procedure. We were also able to suggest approaches that were more sound and would allow them to design a model that performed as desired.

Personal Lines

Pinnacle was approached by a national insurer that wanted to develop a more sophisticated homeowners rating program. Their current homeowners plan was a traditional rating approach and was only based on a few factors, and the company felt they were not taking full advantage of the potential in the homeowners market. Pinnacle, through the use of predictive modeling, assisted the carrier in designing a new rating and tiering structure, which included the introduction of by-peril rating and new territory definitions. This new structure allowed the company to be more precise in rating homeowners, resulting in more adequate and competitive rates for a broader spectrum of risks.

Portfolio Aggregation

A reinsurer wanted to combine the results of their pricing and reserving models for individual treaties - from diverse lines of business and treaty structures - to produce an annual return distribution for the company. This was a part of their ERM framework and the genesis of their economic capital modeling process. After reviewing treaty wordings and pricing and reserving models, we designed a model that reflected dependency amongst the treaties and produced an annual return distribution. Furthermore, the model was designed to allow users of the model output to easily see how sensitive the results were to the assumed dependency structures.

Product Development

Pinnacle was retained to develop a long haul trucking pricing model for risks with more than 100 powered units. Using publicly available information, a model that incorporated elements of both exposure and experience rating was developed that incorporated differences in geographic location, cargo and trailer type, radius of operations, driver characteristics, prior claims experience, prior insurer, self insured retention, driver characteristics and several other elements. The program was implemented and has become an essential part of a very successful program.

Product Management

One of our long-standing regional carriers had entered into a new market and asked for Pinnacle’s assistance in bringing their product and processes up-to-date. With Pinnacle’s product, pricing and product management expertise, we were able to provide a wide range of services to our client. Not only did we develop a new rating plan, we also drafted a completely new rate manual and rate pages. Pinnacle also reviewed their Underwriting guidelines and worked with the client to draft new guidelines consistent with the new rating plan and client risk appetite. Pinnacle followed the review through to reviewing system specifications, forms and competitive position and preparing the rate filings. In addition, Pinnacle was able to provide suggestions on customer notifications, agent notifications and ways to track the progress of the new program.

Rate Filing Review

Pinnacle typically provides state regulators expert review of company and bureau rate change filings. In a recent review of a Company’s automobile rate filing Pinnacle was able to confirm that the filed rates met the State’s rating laws and Department’s filing requirements. Using a procedure developed by Pinnacle specifically to review rate filings, the Company filing was reviewed against generally accepted actuarial principles. The Company was questioned on certain rating procedures and was able to support their procedures and selections with additional documentation to the filing. Pinnacle was then able to affirm to the Regulator that the filed rates were not excessive, inadequate, nor unfairly discriminatory and that the new rates would not produce any major policyholder dislocations. The Regulator was then able to acknowledge the Company’s filing with confidence that the Regulator had carried out his charge of providing service and protection both to consumers and to the insurance industry.

Rate Indications / Filings

A regional carrier came to Pinnacle wanting to implement an insurance score program along with rate indications for home, auto and farm. Pinnacle developed rate indications for each line, and developed an underwriting scorecard rating approach using insurance score as a critical component. The combination of implementing appropriate rates and the new rating plan enabled this company to turn their business around, become profitable and rebuild their surplus position.

Reinsurance Loss Reserving

Pinnacle provides a reinsurance reserving analysis to an offshore reinsurer, which includes the year-end Statement of Actuarial Opinion (SAO) to fulfill the offshore regulatory authority’s requirements. We began with quarterly reviews to gather and review all information on newly written reinsurance contracts, including a review of the new contracts to determine unique coverage terms and underlying exposures. Pinnacle also discusses with the company any important events in the prior quarter that may have affected reserves, such as major catastrophes, new major claims, whether individual contracts have paid their limit, and/or any new treaty commutations. Pinnacle’s review provides the company with the quarterly reserve requirements and the necessary SAO for the year end financial reporting.

Reinsurance Price Optimization

Pinnacle was approached by an insurance company to provide an independent review of their reinsurance program. The first step was to review historic ceded premiums and losses by treaty layer to determine the overall reinsurer profitability. Pinnacle then independently priced the existing reinsurance program to benchmark the current market pricing. Finally, Pinnacle provided a cost benefit analysis to help the client determine the optimal retention levels for its insurance program. With this information in hand and our support, our client was able to negotiate better terms for their reinsurance program.

Retention Analysis

Pinnacle was asked by a large self-insured regional transportation authority to assess the impact of increasing their self-insured retentions for both workers compensation and automobile liability. We developed a stochastic simulation analysis, based on the program’s historical claims experience and industry benchmarks, that examined not only the increase in expected losses but the program’s additional potential loss variability. Finally, we discussed with the customer the relationship between their current capital position, as well as the current reinsurance market, to ensure the retention they selected for their program was appropriate for them. The authority ultimately increased their retentions, put some of their excess capital to work, and realized substantial savings in their reinsurance costs.

Risk Management Assessment

Pinnacle was asked by a state department of corrections to provide a comprehensive, independent review of the adequacy of their property and casualty insurance plan. The independent insurance plan review was necessary for compliance purposes with state insurance regulators. The facility had even stricter self-imposed standards for their insurance plan. It was Pinnacle’s job to review the guidelines for reasonableness and appropriateness as part of an overall risk management strategy. Pinnacle reviewed and adhered to the state code as well as the additional standards provided by the facility. Moving through each line of insurance coverage, Pinnacle offered recommendations and approval notations. The result was an increased level of risk control for the facility, and subsequently led to a follow up review by Pinnacle at the next required consultation.

Risk Transfer

Pinnacle can provide an evaluation of risk transfer for reinsurance contracts. Pinnacle’s experience includes the review of all types of traditional and non-traditional reinsurance treaties.

Pinnacle’s review of risk transfer in reinsurance contracts is consistent with both Statement of Statutory Principles No. 62, “Property and Casualty Reinsurance,” and Financial Accounting Board Statement No. 113, “Accounting and Reporting for Reinsurance of Short-Duration and Long-Duration Contracts.”

Self Insured Dividend / Assessment Analysis

A large group self insurance program was concerned with the amount of retained earnings and wanted to establish a policy for the minimum capital for the program to trigger dividend distributions. Pinnacle compared the program’s capitalization to a wide variety of industry standards for similar programs from rating agencies, regulators, and other sources. The results of this analysis lead to a recommended board policy regarding a minimum capital threshold for dividend distributions and ultimately to the development of an actuarially sound dividend distribution plan.

Self Insured Loss Reserve Analysis

Pinnacle was approached by a major, national manufacturer to perform a loss reserve analysis of their retained workers compensation, auto liability, general liability and products liability loss exposures. The previous actuary worked for a large broker which the customer felt presented a conflict of interest. In addition, the actuary used industry benchmarks that the customer felt did not accurately represent their loss development behavior. Pinnacle worked with the customer to better understand their loss exposures, claims handling practices, and corporate risk management philosophy. We worked with the company to gather better internal data and refine the industry benchmarks to better reflect their third party administrator, industry focus and geographic mix. These refinements, and many others, led to a more accurate analysis of the company’s retained loss exposures, a reduced provision for unpaid claims on their balance sheet, and reduced collateral requirements from their fronting carrier.

Staffing Self Insured Reserve Analysis

Pinnacle was retained by a group of staffing companies with large self-insured retentions for their workers compensation loss exposures to perform quarterly loss reserve analyses and annual funding studies. Pinnacle initially used customized benchmarks for the staffing as the basis for our analyses. However, it became apparent that the benchmarks were not reflective of the unique characteristics of this program. Pinnacle worked with the third party administrator (TPA) for the program to gather additional historical experience for the program, as well as consolidated experience for several similar programs administered by the TPA. Using the results of our analysis of the TPA’s previous experience for this program and others like it, we were able to develop benchmark loss development assumptions that tracked much more closely with the program’s actual loss emergence.

Territory / Summit Analysis

The insurer had not reviewed or adjusted their territorial boundaries in several years; and their current territories were not based upon an analysis of their underlying loss experience.

Pinnacle began with an evaluation of available insurer and external industry data at the ZIP code level as well as their current and future policy processing capabilities. After all of the experience data was adjusted to a common base level, we used our Summit® software product to smooth the data to develop an initial adjusted pure premium by ZIP code to reflect both experience in a ZIP code and in neighboring ZIP codes. The number of additional neighboring ZIP codes used was dependent upon attaining a sufficient exposure level.

The smoothed data was then clustered using Summit® on both a contiguous and non-contiguous basis. The insurer needed to decide whether to maintain relatively contiguous definitions or use more granular and theoretically accurate non-contiguous definitions. Using statistical measures, we identified and graphed optimal definition sets. Non-contiguous definitions were selected by the client. To minimize the number of territories with a limited geographic area or only a few ZIP codes, some manual combination of “outlying” ZIP codes with territories (clusters) with similar adjusted pure premiums was performed.

Finally, we assisted the insurer in developing the necessary filing support material to gain approval. The new program is generating new business in areas of historical profitability but previously less than average competiveness. 

U S Domestic Statement of Actuarial Opinion

Domestic U.S. property/casualty insurers and risk retention groups are required to file an Annual Statement with state regulators each year by March 1. Part of that filing includes the submission of a formal Statement of Actuarial Opinion (SAO) by a qualified Appointed Actuary as to the reasonableness of held loss and loss adjustment expense reserves. The SAO must be one of five types:

  • Reasonable
  • Inadequate/Deficient
  • Excessive/Redundant
  • Qualified
  • No Opinion

In addition to the SAO, most jurisdictions require an Actuarial Opinion Summary (AOS) providing more detail on the Appointed Actuary’s specific findings by March 15. Lastly, a formal report narrative in support of the SAO and AOS is required to be available by May 1.

As the SAO is a compliance document, the primary audience is state regulators but the individual company must arrange for the service to be provided.

A recent SAO for one of our clients touched on many of the required disclosures:

  1. The adequacy of held reserves on a net basis were below the low end of our range of reasonable reserves until we took into account anticipated salvage and subrogation recoveries.
  2. The unearned premium reserves for long duration contracts were substantial and we conducted a review to determine they were adequate
  3. The Company held material loss and loss adjustment expense reserves for pools and associations. In order avoid having to issue a Qualified Opinion, we separately computed indicated reserves for two of the pools/associations, and obtained an SAO from the Appointed Actuary for the National Workers Compensation Reinsurance Pool.
  4. Reinsurance recoveries were in doubt for certain carriers as balance were sometimes overdue by more than 90 days. After reviewing the reinsurers’ A. M. Best ratings, we made the required disclosures about reinsurance collectability. 

Underwriting & Tiering Analysis

A single state auto insurance writer hired Pinnacle to address its current rating and tiering program. We removed unnecessary underwriting restrictions and more adequately priced risk classes, which allowed the insurer to experience significant, profitable growth.

When we began, the company’s existing tiering design was only based on a few factors, including ones that significantly overlapped with the rating plan. When combined with the underwriting rules, the design was punitive and limited writable business. Through predictive modeling, we helped design a new tiering structure and applied an underwriting scoring approach to eliminate rating plan overlap and remove the overly punitive parts of the plan.
 

Vehicle Rating

Pinnacle was approached by a major national personal lines insurer to develop a vehicle rating program to replace the use of the ISO symbol product. Pinnacle, through the use of predictive modeling, assisted the carrier in designing a new vehicle rating program which made use of the vehicle’s actual physical characteristics for both the liability and physical damage coverages. The data used for the analysis was the company’s VIN data supplemented with industry VIN data and appended for vehicle characteristics from an external third party vendor. The resultant program completely eliminated the need for use of the ISO symbol and exhibited greater predictive power than the prior ISO based system.

Workers' Compensation

Pinnacle was retained by a major national political organization to investigate the impact of several workers compensation reforms including: implementation of mandatory managed care, privatization of state workers compensation insurance funds and the permitting of private insurers to enter previously monopolistic workers compensation states. Our analysis looked at state-level differences in rate levels, insurer experience, coverage competition, the mix of medical and indemnity claims and numerous other metrics. The study was extremely well received and ultimately presented to more than half of the nation’s governors.

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