Valued Policy Law and Total Loss

inredisputesblog | May 21, 2019

Typically, a fire insurance policy pays a policyholder for the actual cash value or the replacement value of the property destroyed.  But in 20 states, if there is a total loss, the amount the insurer must pay is equal to the value of the property at the time the insurance policy was issued.  What happens if the policy covers a multi-building complex and one of the buildings is destroyed?  The Eighth Circuit Court of Appeals recently addressed this issue. In Norwood-Redfield Apartments Limited Partnership v. American Family Mutual Ins. Co., No. 18-2618 (8th Cir. May 16, 2019)(Unpublished), the appeals court affirmed a judgment in favour of the insurance company denying the policyholder’s claim to recover the full value listed on the policy of an entire complex of buildings when only one of the buildings was destroyed.  The policyholder sued its insurance carrier after a fire destroyed one of the buildings out of 32 in the complex.  The insurance carrier paid nearly $3 million for the loss, but the policyholder wanted the policy limits of over $31 million.

Spotlight

For the past few years, Artificial Intelligence (AI) has been rolled out with spectacular speed in an increasing number of areas, such as medicine, the auto industry, finance, manufacturing, agriculture, and marketing. This expansion lies at the crossroads of three major technological developments: the emergence of big data, the normalization of the interconnection between humans and machines, and advances in machine learning (technology that enables machines to learn from experience). AI is progressively transforming the way in which the economy and society operate. The insurance industry is concerned by these changes on two fronts. Firstly, new risks associated with AI must be assessed, quantified, insured and mitigated against. The increasing use of AI raises numerous risk questions.


Other News
HEALTH INSURANCE

HealthSmart® Launches DFW SmartCare™ Health Plan

HealthSmart | May 20, 2022

HealthSmart, one of the nation's largest third party administrators of health plans for employers and plan sponsors, announced the launch of DFW SmartCare™, a comprehensive level-funded health plan that offers market leading discounts to DFW-area small to mid-sized employers. The plan offers significant savings and protection for plan sponsors and features access to the Baylor Scott & White Quality Alliance (BSWQA), inclusive of Catalyst Health Network (CHN). BSWQA is a clinically integrated network of hospitals, facilities, and doctors that members can access through Employers Health Network (EHN). DFW SmartCare delivers a transparent, all-inclusive model that offers predictable costs through a level-funded plan with no additional risk for employers and significantly lower premiums than mainstream fully-insured programs. The program also offers financial security with stop loss coverage to protect plans from catastrophic claims. In addition to a comprehensive health benefits plan, DFW SmartCare boasts a superior member experience through its Concierge Advisor Team who works to guide members and help them navigate their healthcare journey every step of the way. This new health plan designed especially for the DFW Metroplex is a perfect example of how HealthSmart approaches our organizational mission of reducing costs for plan sponsors and delivering premium healthcare solutions to our members, This program demonstrates an innovative approach to help plan sponsors in North Texas control their health benefit costs by providing deeply discounted access to the BSWQA clinically integrated network through EHN.This is big news for DFW small and medium employer groups and DFW SmartCare is truly a game-changer for our broker community in terms of providing quality healthcare options with deep discounts." Craig Julien, CEO for HealthSmart. Plan sponsors typically must work with several players to build their health plans, By bringing together experts in the areas of most concern to small and mid-sized plan sponsors, we have created a one-stop solution that offers a top-quality, focused provider network, critical stop loss coverage, and comprehensive third-party administration services, relieving area health plan sponsors of the burden of shopping for these services individually." Omar Haedo, president of Elan Insurance Group About HealthSmart HealthSmart is one of the largest third party administrators in the country and the premier provider of innovative, customizable and scalable healthcare solutions for employers, brokers and payers. We partner with plan sponsors to provide key services needed to reduce healthcare costs and manage members with dignity and respect. HealthSmart is the one-stop source for health plan needs, including health plan benefit administration, pharmacy benefit management, care management and wellness programs and provider networks.

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INSURANCE TECHNOLOGY

One Concern Partners with WTW to Bring Climate Resilience Scores to the U.S. Insurance Market

One Concern | June 17, 2022

Today, One Concern, a climate analytics company, announced a strategic alliance with WTW (NASDAQ: WTW), a leading global advisory, broking and solutions company. The two companies are providing the U.S. insurance market with One Concern Resilience ScoreTM (1CRX™) to facilitate a better understanding of dependency risk and accelerate the adoption of parametric insurance. The One Concern Resilience Score indicates the vulnerability a business has concerning downtime arising from the fragility of the infrastructure a business relies upon, such as the power grid, transportation infrastructure, and related community areas, in addition to direct property damage. Incorporating resilience scores into WTW's client-facing analytical platforms, along with the broking workflow, will present a complete picture of existing building damage analyses, with the potential impact of vulnerable external dependencies. We're thrilled to incorporate our resilience score into WTW's cutting-edge analytical solutions and demonstrate to clients that the biggest threats to their business derive from climate-related dependency risk, WTW's ability to apply the latest in disaster science will enhance their clients' decision-making process in choosing how best to integrate physical climate risk into their resilience strategy." Ahmad Wani, Co-Founder and CEO, One Concern. One Concern's analytics will support and augment WTW clients' risk analyses and decision-making regarding specific mitigation steps, costs, and benefits, including alternative risk transfer mechanisms. For example, risk managers and WTW risk advisors can use One Concern insights to suggest pricing adjustments, advise on risk mitigation activities, increase their business resilience to minimize the adverse impact of natural disasters, and secure parametric insurance covers to fill the protection gap they experience when faced with a natural catastrophe. About One Concern We're a technology company building the digital infrastructure for global risk. We map, analyze and monitor every piece of the world's built environment and its connection to the global economy. About WTW At WTW (NASDAQ: WTW), we provide data-driven, insight-led solutions in the areas of people, risk and capital. Leveraging the global view and local expertise of our colleagues serving 140 countries and markets, we help you sharpen your strategy, enhance organizational resilience, motivate your workforce and maximize performance.

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INSURANCE TECHNOLOGY

Socotra Acquires Avolanta to Add Unified Agent and Customer Portal to Its Advanced Policy Core

Socotra | May 21, 2022

Socotra, the partner of choice for innovative insurers, today announced the acquisition of Avolanta, a software startup offering the only unified portal purpose-built for the insurance industry. As part of the acquisition, the Avolanta team will join Socotra and Avolanta’s technology will become Socotra Unified Portal. Insurance companies are struggling to deliver the types of digital user experiences that are now common in other industries. Many insurance customers are still forced to fill out paper applications with agents and brokers manually entering customer data into outdated web portals. Avolanta enables insurers to solve these issues by seamlessly connecting agents, brokers, and customers with its unified portal. Avolanta provides the only unified portal purpose-built for insurance Avolanta was founded in 2018 by insurtech entrepreneur, Chuck Wilson, and insurance veteran, Gavin Dean. With decades of experience in the industry, the founders created Avolanta to provide insurers a better way to streamline processes and create user experiences. The cloud-native platform allows insurers to rapidly innovate and deploy new products with a unified portal. Agents can collaborate with customers through secure, shared online applications to reduce manual entry. As a result, insurers can deliver customized experiences, automate data capture and analytics, and ultimately drive more conversions and revenue. Joining Socotra is an exciting next chapter for Avolanta, Avolanta’s frontend technology focused on the user experience is the perfect extension to Socotra’s backend policy core. The combined platform will help insurers quickly develop new insurance products with more convenient buying experiences for any distribution channel—whether it’s agent, embedded, or direct-to-consumer. We can’t wait to see how insurers will leverage Socotra to innovate.” Chuck Wilson, CEO and co-founder of Avolanta. The acquisition of Avolanta is a perfect complement to Socotra’s industry-leading policy core, Socotra and Avolanta share a mission to modernize the insurance industry with open APIs, true cloud, and off-the-shelf capabilities that accelerate innovation and speed-to-market. Together, we now offer the complete front-to-back platform that moves the insurance industry forward.” Dan Woods, founder and CEO of Socotra. About Socotra Socotra is bringing unparalleled speed and ease to insurance technology. With Socotra’s modern core platform, global insurers and insurtech MGAs can accelerate product development, reduce maintenance costs, and improve customer experiences. Socotra provides open APIs, a product-agnostic data model, and out-of-the-box capabilities to manage the entire policy lifecycle, making insurance innovation faster, easier, and more affordable.

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CORE INSURANCE

Improving the Canadian insurance industry through big data

Canadian Institute of Actuaries | July 07, 2022

A new statement from the Canadian Institute of Actuaries (CIA), Big data and risk classification: Understanding the actuarial and social issues, says that using big data derived from new technologies can contribute to the healthy functioning of insurance markets. Insurance companies establish different classes of risks to determine the availability and pricing of insurance coverage. This ensures that policy owners have coverage that appropriately matches their level of risk. “As big data becomes increasingly available through new technologies, insurers can use it to further refine their classes of risks and offer insurance that is more aligned with the different needs and situations of policy owners,” says Matthew Buchalter, FCIA, Co-Champion of the CIA’s task force on this issue. “As big data becomes increasingly available through new technologies, insurers can use it to further refine their classes of risks and offer insurance that is more aligned with the different needs and situations of policy owners,” says Matthew Buchalter, FCIA, Co-Champion of the CIA’s task force on this issue. The CIA believes that the use of big data is appropriate in insurance ratemaking, and that access to such data creates improved insight about risk and its contributing factors. Conversely, restricting access to this data could adversely impact the availability or price of insurance for individuals. “The foundation of actuarial work is to analyze risks based on complex datasets. Access to more data means insurance ratemaking can be based on more appropriate factors, ultimately reducing risk and setting more refined insurance costs,” says Emile Elefteriadis, FCIA, task force Co-Champion. Canada’s actuaries stress that big data – like all data used in ratemaking – is subject to the ethical data collection practices, privacy laws, and information security requirements necessary to protect consumers. “We believe in thoughtful innovation and evolution in the use of big data, while ensuring that the public interest is at the forefront of insurance and policymaking,” says Hélène Pouliot, FCIA, CIA President.

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Spotlight

For the past few years, Artificial Intelligence (AI) has been rolled out with spectacular speed in an increasing number of areas, such as medicine, the auto industry, finance, manufacturing, agriculture, and marketing. This expansion lies at the crossroads of three major technological developments: the emergence of big data, the normalization of the interconnection between humans and machines, and advances in machine learning (technology that enables machines to learn from experience). AI is progressively transforming the way in which the economy and society operate. The insurance industry is concerned by these changes on two fronts. Firstly, new risks associated with AI must be assessed, quantified, insured and mitigated against. The increasing use of AI raises numerous risk questions.

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