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CPCU 520 Chapter 5
CPCU 520 Chapter 5 Risk Control and Premium Auditing
Term | Definition |
---|---|
Moral hazard | a condition that increases the likelihood that a person will intentionally cause or exaggerate a loss |
Morale hazard | a condition of carelessness or indifference that increases the frequency or severity of loss |
Exposure unit | a fundamental measure of the loss exposure assumed by an insurer |
Experience modification | a rate multiplier derived from the experience rating computations |
Exposure unit (unit of exposure) | the unit of measure (i.e. area, gross receipts, payroll) used to determine an insurers policy premium |
Test audit | an audit conducted by an insurance advisory organization or bureau to check the accuracy of insurers’ premium audits |
Premium pay (shift differential) | a payroll system that increases the regular hourly wage rate for the night shift or other special conditions |
Deposit premium | the amount the primary insurer pays the reinsurer pending the determination of the actual reinsurance premium owed |
Primary purpose of risk control function | evaluate loss exposures to assist with underwriting decisions |
Insurer risk control goals | earn a profit; meet customer needs; comply with legal requirements; fulfill duty to society |
Types of risk control services | conducting physical surveys; performing risk analysis and improvements; developing safety managment programs |
Factors affecting risk control service levels | line of insurance; commercial insured size; types of loss exposures insured; potential legal liability |
Departments risk control cooperates with | underwriting; marketing and sales; premium auditing; claims, producers |
Reasons for premium audits | determine correct premiums; collect ratemaking data; meet regulatory requirements; deter and detect fraud; reinsurance insured's confidence; obtain additional information |
Premium audit process | planning; reviewing operations; determining employment relationships; finding/evaluating books and records; auditing books or records; analyzing and verifying premium related data; reporting the findings |
Premium audit contributions | ability to properly classify accounts; conducted in timely manner; verify employment classification regarding claims; provide information for risk control |