Klauzule prijava odstetnih zahtjeva - Bosna RE
Klauzule prijava odstetnih zahtjeva - Bosna RE 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.
- Page 2 and 3: Program • Kratka prezentacija Mun
- Page 4 and 5: Osnovne brojke o Munich Re-u Osnova
- Page 6 and 7: Munich Re-ova usluga i dodatna vrij
- Page 8 and 9: Prijava odštetnih zahtjeva - zašt
- Page 10 and 11: Prijava odštetnih zahtjeva - kako?
- Page 12 and 13: 3. Indeksacija šteta - zašto i ka
- Page 14 and 15: Indeksacija šteta - kako? Ugovor o
- Page 16 and 17: Indeksacija šteta - kako? 16
- Page 18 and 19: Indeksacija šteta - Primjer Godina
- Page 20 and 21: Indeksacija šteta - zašto i kako?
- Page 22 and 23: Indeksacija šteta - zašto i kako?
<strong>Klauzule</strong> <strong>prijava</strong> odštetnih <strong>zahtjeva</strong> za<br />
reosiguranje<br />
i<br />
Indeksacija prioriteta i limita<br />
Georg Stein<br />
Seminar Zelena karta <strong>Bosna</strong> Re<br />
Sarajevo<br />
24. april 2008.
Program<br />
• Kratka prezentacija Munich Re-a<br />
• Prijava odštetnih <strong>zahtjeva</strong> reosiguravaču –zaštoikako?<br />
• Indeksacija šteta – zašto i kako?<br />
• Diskusija<br />
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1. Kratka prezentacija Munich Re-a<br />
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Osnovne brojke o Munich Re-u<br />
Osnovan: 1880.<br />
Tri stuba:<br />
Reosiguranje Osiguranje Upravljanje kapitalom<br />
Ključne brojke za Munich Re Grupu 2007.:<br />
Premija: Euro 37 mld (od toga 22 mld reosiguranje)<br />
Rezultat:Euro 3.9 mld<br />
Reosiguranje:<br />
~ 6.500 zaposlenih širom svijeta<br />
~ 5.000 klijenata<br />
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Munich Re-ova svjetska mreža za<br />
reosiguranje<br />
• Atlanta<br />
• Boston<br />
• Chicago<br />
• Columbus<br />
• Dallas<br />
• Hartford<br />
• Kansas City<br />
• Los Angeles<br />
• Montreal<br />
• New York<br />
• Philadelphia<br />
• Princeton<br />
• San Francisco<br />
• Seattle<br />
• Toronto<br />
• Vancouver<br />
• Waltham<br />
• München<br />
• Athen<br />
• Genf<br />
• London<br />
• Madrid<br />
• Mailand<br />
• Moskau<br />
• Paris<br />
• Warschau<br />
• Hongkong<br />
• Kalkutta<br />
• Kuala Lumpur<br />
• Mumbai<br />
• Peking<br />
• Schanghai<br />
• Seoul<br />
• Singapur<br />
• Taipeh<br />
• Tokio<br />
• Bogotá<br />
• Buenos Aires<br />
• Caracas<br />
• Mexiko<br />
• Santiago de Chile<br />
• São Paulo<br />
• Accra<br />
• Durban<br />
• Harare<br />
• Johannesburg<br />
• Kapstadt<br />
• Nairobi<br />
• Port Louis<br />
• Auckland<br />
• Brisbane<br />
• Melbourne<br />
• Perth<br />
• Sydney<br />
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Munich Re-ova usluga i dodatna<br />
vrijednost reosiguranicima<br />
Munich Re pruža<br />
• Usluge prema potrebama klijenata zasnovane na profesionalnoj stručnosti i<br />
iskustvu<br />
• Kapacitet uvezan sa inovativnošću, financijskom snagom<br />
• Pun spektar proizvoda i povezanih usluga (poput usluga upravljanja štetama), od<br />
tradicionalnog reosiguranja do alternativnog financiranja rizika i struktura prenosa<br />
rizika<br />
Munich Re daje operativnu i stratešku podršku i savjete putem<br />
• prilagođenih seminara i radionica<br />
• konferencija sa učesnicima visokog profila<br />
• tematskih i temeljitih publikacija<br />
• inteligentnih uslužnih alata<br />
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2. Prijava odštetnih <strong>zahtjeva</strong><br />
reosiguravaču<br />
– kako i zašto?<br />
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Prijava odštetnih <strong>zahtjeva</strong> – zašto?<br />
Omogućava reosiguravaču da<br />
•stekne znanje o pojedinoj šteti<br />
•postavi odgovarajuće rezerve<br />
•razvije znanje o tržištu<br />
•procijeni dugoročni razvoj i povećanje visine šteta<br />
•izračuna korektnu cijenu<br />
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Prijava odštetnih <strong>zahtjeva</strong> – zašto?<br />
Korist za obje strane, jer reosiguravač može<br />
•sarađivati sa osiguranikom<br />
•pružiti pomoć kod obrade <strong>zahtjeva</strong><br />
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Prijava odštetnih <strong>zahtjeva</strong> – kako?<br />
Promptno obavještavanje o štetama koje mogu pogoditi<br />
pokriće viška štete (XL)<br />
•već iznad prioriteta<br />
•ispod prioriteta, ali vjerovatno će ga preći tokom razvoja<br />
•određene povrede<br />
•plaćanje anuiteta<br />
Redovno i dovoljno ažuriranje<br />
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Prijava odštetnih <strong>zahtjeva</strong> – kako?<br />
Claim and Loss<br />
Reporting<br />
1 The Reinsured shall give immediate written notice to the Reinsurer<br />
of any individual claim or aggregation of claims provided for in this<br />
Contract made against the Reinsured in respect of business<br />
Reinsured thereunder or of its becoming aware of any circumstances<br />
which could give rise to such a claim or aggregation of claims where<br />
the same:<br />
(a)<br />
(b)<br />
Exceeds or may possibly exceed the percentage share<br />
specified in the RISK DETAILS of the Retention (irrespective of<br />
any question as to liability) [ here: 70% of deductible] or<br />
Relates to any bodily injury or disease which results or may<br />
result in any of the following:<br />
i) a permanent disability rating of 50% or more,<br />
ii)<br />
payment of an annuity or any other periodic payment,<br />
iii) an award which may be subject to augmentation at some<br />
future date other than on appeal or<br />
(c)<br />
Originates from any of the following:<br />
i) fatal injury,<br />
ii)<br />
iii)<br />
iv)<br />
brain damage,<br />
spinal injury resulting in partial or total paralysis,<br />
amputation,<br />
v) permanent loss of use of a limb,<br />
vi)<br />
blindness,<br />
vii) severe burns,<br />
viii) extensive scarring or severe facial disfigurement.<br />
2 Notice (in accordance with 1 above) shall include information about<br />
facts, legal assessment and estimated amount of loss. After such<br />
notice the Reinsured shall keep the Reinsurer informed about the<br />
development of any such claim or loss occurrence.<br />
3 The Reinsurer shall not be liable for any claim which has not been<br />
reported before the expiry of one year from the date upon which the<br />
Reinsured knew of a claim covered under this Contract.<br />
[here: degree of claims cooperation regulated in § claims settlement;<br />
full cooperation with leader]<br />
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3. Indeksacija šteta<br />
– zašto i kako?<br />
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Indeksacija šteta – zašto?<br />
Ugovor o reosiguranju Inflacija 25%<br />
Prioritet 200<br />
Limit 800<br />
Šteta 500 Inflatirana šteta 625<br />
Osiguravač 200 (40%) Osiguravač 200 (32%)<br />
Reosiguravač 300 (60%) Reosiguravač 425 (68%)<br />
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Indeksacija šteta – kako?<br />
Ugovor o reosiguranju Inflacija 25%<br />
Prioritet 200 Indeksirani Prioritet 250<br />
Limit 800 Indeksirani limit 1000<br />
Šteta 500 Inflatirana šteta 625<br />
Osiguravač 200 (40%) Osiguravač 250 (40%)<br />
Reosiguravač 300 (60%) Reosiguravač 375 (60%)<br />
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Indeksacija šteta – kako?<br />
Nominalni sloj: 800 xs 200<br />
Prioritet<br />
(Nominalna šteta / Nominalna šteta umanjena inflacijom) * Nominalni prioritet<br />
(625 / 500) * 200<br />
= 1,25 * 200 = 250<br />
Limit<br />
(Nominalna šteta / Nominalna šteta umanjena inflacijom) * Nominalni limit<br />
(625 / 500) * 800<br />
= 1,25 * 800 = 1000<br />
Indeksirani sloj: 1.000 xs 250<br />
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Indeksacija šteta – kako?<br />
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Indeksacija šteta – kako?<br />
Index Clause<br />
1. In the event of any loss hereunder the Deductible of the Reinsured and the limit of liability of the<br />
Reinsurers shall be adjusted by reference to an index, as hereinafter defined, applying at the<br />
month of January in the manner hereinafter set out. The index of the above-mentioned date<br />
shall be called the Base Index. [here: base date = contract year]<br />
2. In respect of each and every loss settlement made under this treaty, the Reinsured shall submit<br />
a list showing in respect of each and every loss, any settlement payments, indicating the<br />
amount(s) paid and the date(s) of payment, as well as any separately calculated loss reserve.<br />
The sum of each and every loss settlement payment, if any, plus the current loss reserve, if any,<br />
shall for the purpose of this clause be termed the “Actual Amount of Loss Development”.<br />
3. The “Adjusted Amount of Loss Development” shall be calculated individually for each and every<br />
loss settlement by the following means:<br />
(i) Paid Loss Base Index Adjusted Paid<br />
on Day “X” x Index on Day “X” = Loss<br />
(ii) Current O/S Base Index Current Adjusted<br />
Loss x Index on Current = O/S Loss<br />
Day<br />
(iii) All Adjusted Adjusted Amount<br />
Paid Losses +<br />
of Loss<br />
Current Adjusted = Development<br />
O/S Loss<br />
(where “X” designates the date of the respective payment and/or corresponding reserve, if any).<br />
However, the above calculation shall only apply in respect of those loss developments where<br />
there is a variation of more than 10% (ten percent) between the base index and the index on the<br />
date of the loss development. In respect of all other loss developments the "Adjusted Amount of<br />
Loss Development" shall always be equal to the “Actual Amount of Loss Development".<br />
The Deductible of the Reinsured and the limit of liability of the Reinsurers shall then be multiplied by<br />
the following fraction:<br />
Actual Amount of Loss Development<br />
Adjusted Amount of Loss Development<br />
4. Index:<br />
a) In respect of an award resulting in continuing regular payments the index or indices to the<br />
applied shall be that/those to which an award is linked.<br />
b) For all other loss developments the index to be applied shall be the Wage Index for the<br />
country in which the claim is settled appearing in the statistics published by the<br />
International Monetary Fund.<br />
In the event that the publications does not contain a Wage index for the territory<br />
concerned then the index to be applied shall be that for the Cost of Living or Retail<br />
Prices. If the publication does not contain any indices for the territory concerned, then an<br />
alternative publication shall be mutually agreed between the Reinsured and Reinsurers.<br />
c) The index at the date of loss development shall be the last available index appearing in<br />
the publications mentioned above for the month in which payment(s) is/are made.<br />
5. The date of loss development shall be deemed to be as follows:<br />
a) The date upon which a loss reserve is set.<br />
b) The date upon which a payment made by the Reinsured is accepted.<br />
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Indeksacija šteta – Primjer<br />
Godina štete<br />
Osnov indeksacije<br />
Prioritet<br />
2002<br />
juli 1999. 171.30%<br />
363,500<br />
Nom inalni zahtjev<br />
Prilagođeni zahtjev<br />
Distribucija <strong>zahtjeva</strong><br />
Godina Plaćeno Rezervirano Ukupno Indeks Plaćeno Rezervirano Ukupno % Plaćeno Rezervirano Ukupno<br />
2002 21,999 478,001 500,000 186.50% 20,206 439,043 459,249 79% 21,999 373,756 395,755 Osiguranik<br />
21% 0 104,245 104,245 Reosigurava<br />
2003 33,262 944,739 1,000,000 190.60% 29,894 849,076 899,175 40% 55,261 348,999 404,259 Osiguranik<br />
60% 0 595,741 595,741 Reosigurava<br />
2004 120,070 824,670 1,000,000 194.60% 105,693 725,930 881,723 41% 175,330 236,931 412,261 Osiguranik<br />
59% 0 587,739 587,739 Reosigurava<br />
2005 30,772 793,898 1,000,000 199.50% 26,422 681,678 863,893 42% 206,102 214,668 420,770 Osiguranik<br />
58% 0 579,230 579,230 Reosigurava<br />
2006 7,314 786,584 1,000,000 205.50% 6,097 655,678 843,990 43% 213,416 217,276 430,692 Osiguranik<br />
57% 0 569,308 569,308 Reosigurava<br />
2007 136,418 650,166 1,000,000 210.80% 110,856 528,337 827,505 44% 349,834 89,438 439,272 Osiguranik<br />
56% 0 560,728 560,728 Reosigurava<br />
Indeks<br />
Jul-86 100.00% Jul-00 175.30% (Nominalna šteta / Indeks na dan plaćanja) * Indeks na bazni datum<br />
Jul-87 103.50% Jul-01 181.00%<br />
Jul-88 106.40% Jul-02 186.50% 2002 (500.000 / 186,5%) * 171,3% = 459.249<br />
Jul-89 110.50% Jul-03 190.60% 363.500 / 459.249 = 79%<br />
Jul-90 118.30% Jul-04 194.60%<br />
Jul-91 127.50% Jul-05 199.50% 2003 plaćeno u 2002 (21.999 / 186,5%) * 171,3% = 20,206<br />
Jul-92 136.00% Jul-06 205.50% plaćeno u 2003 (33.262 / 190,6%) * 171,3% = 29,894<br />
Jul-93 142.40% Jul-07 210.80% rezervir. 2003: (944.739 / 190,6%) * 171,3% = 849,075<br />
Jul-94 147.90% 899,175<br />
Jul-95 153.50% 363.500 / 899.175 = 40%<br />
Jul-96 158.50%<br />
Jul-97 162.20%<br />
Jul-98 166.20%<br />
Jul-99 171.30%<br />
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Indeksacija šteta – zašto i kako?<br />
U poslovima sa dugim istekom kao što je autoodgovornost,<br />
zahtjevi se razvijaju kroz niz godina<br />
Tokom razvoja, cijene rastu<br />
Zahtjevi postaju sve skuplji<br />
Bez indeksacije, reosiguravač bi trebao nositi cjelokupni<br />
rast troška<br />
‣Sistem je potreban da bi osigurao da se inflatirani zahtjev<br />
dijeli na isti način na koji bi bio bez uticaja inflacije<br />
‣Indeksacija !!<br />
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Indeksacija šteta – zašto i kako?<br />
Indeksacija<br />
•omogućava osiguravaču i reosiguravaču da podijele<br />
efekte inflacije<br />
•zadržava fiksiranu proporciju u kojoj se zahtjevi dijele<br />
između osiguravača i reosiguravača tokom godina kroz<br />
koje se zahtjev razvija<br />
‣dogovoreni sloj reosiguranja zadržava svoju strukturu<br />
koja je originalno namjeravana<br />
Primjenjuje se na prioritet i limit; tj. fer efekt za obje strane<br />
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Indeksacija šteta – zašto i kako?<br />
prioritet i limit<br />
se povećavaju u skladu sa povećanjem određenog indeksa<br />
između baznog datuma (početak ugovora ili drugi datum)<br />
i datuma izmirenja štete<br />
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Indeksacija šteta – zašto i kako?<br />
Indeks<br />
treba odražavati inflaciju na najbolji mogući način<br />
Standard: IMF Indeks plaća<br />
Poželjno za odštetne zahtjeve po tjelesnim povredama:<br />
Indeks zdravstvene zaštite<br />
10% slobodne margine radi smanjenja administrativnog<br />
rada<br />
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Hvala vam na pažnji!<br />
Georg Stein<br />
Casualty Underwriting CEE<br />
Telefon: 0049 / 89 / 3891 – 9365<br />
e-Mail: gstein@munichre.com<br />
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