风险与保险原理复习文档.doc

风险与保险原理
第一章：
Risk is a condition in which there is a possibility of an adverse deviation from a desired outcome that is expected or hoped for.（风险这里指的是可能受到下行损失的概率，有三个特征）
1. Risk not subjective - a state of the real world
2. Risk can exist whether or not it is perceived
3. Risk can be imagined where possibility of loss does not exist
Uncertainty refers to a state of mind characterized by a lack of knowledge or doubt about the future.（不确定性指的是缺乏了解、怀疑未来的一种心理状态）
The degree of risk： 分为必然、不可能和可能事件
Peril: the cause of loss（损失的原因）
Hazard: a condition that creates or increases the chance of loss（导致损失概率变化的条件）
Hazard分为（Physical实质性的Moral道德上的Morale心理层次的legal法律上的）
第一层：风险的分类
1. Financial and non-financial（财务和非财务的）
2. Static and dynamic（静态和动态的）
3. Fundamental and particular（基本和特定的）
4. Pure and speculative（纯粹的和投机）
第二层：Pure and speculative（重点考察）
1. Speculative risks involve the possibility of loss or gain. They are voluntarily accepted because of the possibility of gain.（投机风险是自找的，有可能获利有可能损失，自愿接受）
2. Pure risks involve the possibility of loss or no loss only. （只可能损失）
3. In general, insurance deals with pure risks only.（保险只解决纯粹风险）
第三层：纯粹风险的分类
1. Personal risks（个人风险）
2. Property risks（财产风险）
3. Liability risks（责任风险，是我国的新晋风险）指的是现有资产或者未来收入损失的概率，也就是因为有意或无意的损害或者对他人权利的侵犯而导致被估损失或者法律责任增加。
4. Risks arising out of failure of others（因他人失败而产生的信用风险）
第四层：（个人风险）
Personal risks consist of the possibility of loss of income or assets as a result of the loss of the ability to earn income. （失去收入能力而引起收入或财产受损的风险）
In general, earning power is subject to four perils:
1. premature death, （早逝风险）
2. dependent old age, （年老风险）
3. sickness or disability（生病和残疾风险）
4. Unemployment.（失业风险）

第二章 ：
Risk management is a scientific approach to the problem of dealing with the pure risks facing individuals and organizations.风险管理的定义：解决个人或者组织所面对纯粹风险的科学办法，即预测风险，最小化损失。
保险起源于 corporate insurance buying（公司保险购买），如今风险管理包括decision theory, risk financing, and risk control. （决策理论、风险融资、风险控制）
风险管理工具（Risk Management Tools）
1.Risk Control风险控制：广义上包括减少组织所面临风险导致的损失
Avoidance（规避）
avoidance takes place when decisions are made that prevent a risk from even coming into existence.（即风险决策使得风险无法生成）
Reduction（减少）
define a broad set of efforts aimed at minimizing risk. （致力于最小化风险的努力）

2. Risk Financing风险融资（保证资金足够应对损失）
guarantee the availability of funds to meet those losses that do occur.
l Retention（自留）：exposures that are not avoided, reduced, or transferred are retained. （没有被规避，减少或者转移的风险成为自留风险）
分为Intentional / Unintentional（非/故意）：通常是没有意识到风险的存在，往往都是不好的
Voluntary / Involuntary Retention（非/自愿）：一般是有办法解决风险，除非不可能规避减少转移
Funded / Unfunded（非/筹资）
l Transfer（转移）通常用
1.Purchase of insurance 买保险
2.Hedging对冲
3.Hold harmless agreements免责协议
4.Subcontracting certain activities分包
5.Surety bonds保证书
l Risk sharing 风险分担（特殊的自留和转移）
finance, insurance and risk control金融、保险、风险控制是风险管理的核心

The Risk Management Process风险管理的步骤
1. Determination of objectives确定目标
2. Identification of risks风险确认
3. Evaluation of risks风险评估
4. Consideration of alternatives - selection of the tool工具选择
5. Implementing the decision决策实施
6. Evaluation and review评估

第三章
insurance has two fundamental characteristics:什么是保险
1.Transfer of risk from the individual to the group.转移风险从个体到群体
2.Sharing of losses on some equitable basis.平摊损失，分摊风险
Individual Perspective个人角度定义保险
Use a small certain cost to cover a large uncertain financial loss.用小成本覆盖大不确定损失
The law of large numbers 大数定律（必考）
作用：预测准确性；用大数定律去实践

Social Perspective社会角度定义保险
Eliminate risk by combining a large number of homogeneous exposures to make the losses predictable. 通过集成大数风险使得损失可预测来降低风险

risk transfer emphasizes the individual’s substitution of a small certain cost for large uncertain loss.风险转移强调个人以小成本规避大风险
pooling or risk sharing emphasizes the role of reducing risk in the aggregate.
风险分摊强调通过大数减少风险

Elements of an Insurable Risk可保风险的要素
1. Large numbers of exposure units大量风险单位
2. Definite and measurable loss损失可测量
3. The loss must be fortuitous损失是偶然的
4. The loss must not be catastrophic不能是巨灾的

Classification of Private Insurance私人保险的分类
1. Life Insurance寿险
2. Accident and health Insurance意外健康险
3. Property and liability insurance财产责任险

第四章
Minimax Regret Strategy最小化最大遗憾策略
这个策略里不考虑概率，适用于不买保险时最坏结果难以被接受的情况
Risk Characteristics as Determinants of Tool风险管理工具决策模型

High Frequency

Low Frequency

High
Severity

Avoid
Reduce

Transfer
Low
Severity

Reduce
Retain

Retain

第五章
Types of Company by Product保险公司的分类，依据产品
1. Life insurers 寿险
2. Property and Liability insurers 财产与责任险
3. Health and Accident insurers健康意外险
Distinction Between Agent and Broker代理人和经纪人的区别
Agent代理人：an individual authorized by an insurer to create, modify, and terminate contracts of insurance.（保险公司的代表，代理人帮助保险公司创造、修订和终止保险合约，有权暂时缔结风险合同，出现问题保险公司负责）
Broker经纪人：a representative of the insured who solicits business from insurance buyers but who is compensated by the insurer.（投保人的代表，站在客户的立场上以自己的能力为受托人行事，出现损失，承担责任）

Cash-Flow Underwriting现金流量承保的意义
指的是有些保险公司承保过程是亏损的，但是因为投资收益较大，因此仍然带来收益。

第六章
Market failure
Economic Theories of Regulation监管的经济学理论
1. Market Failure Theory（市场失灵理论）
2. Capture Theory
3. Public Choice Theory
Areas Regulated被监管的领域
1. Solvency 偿付能力监管，各类储备金
2. Market Regulation 市场监管
3. Rates 比率监管
Solvency Regulation – Reserves偿付能力监管之储备金（三类储备金）
l Life insurance policy reserves 寿险储备金
l P&C unearned premium reserves 从P&C中为赚的储备金
l Loss reserves损失储备金（分为）
Reported but not paid 登记但未支付
Incurred but not reported 已付但未登记

第七章
Functions of Insurers 保险公司的功能
1. Ratemaking评级
2. Production开发产品
3. Underwriting 挑选购买者
4. Loss Settlement 理赔
5. Investment 将保费拿去投资

Basic Concepts in Ratemaking评级的基本概念
Rate 费率 Price charged per unit of protection（保险单位的价格）
Premium 保费 Determined by multiplying rate by units of protection purchased
Gross Rate 净费率Composed of two parts, designed to pay losses and expenses
Pure Premium 净保费Portion of the Gross Rate designed to pay losses
Loading 负载 Portion of Gross Rate designed to cover expenses of operation
净费率所覆盖的风险
Underwriting Classes - Life Insurance（寿险的卖出分类）
Standard（标准）
Preferred（偏好）
Substandard (rated)（次级）
Uninsurable（不可保）
公估人 公估过程
1. Staff adjusters 1. Notice 引起注意
2. Adjusting bureaus 2. Investigation 介入调查
3. Independent adjusters 3. Proof of loss 损失证据
4. Public adjusters 4. Payment or denial 赔付或者拒绝
两种情况下会拒绝：1）损失没有发生；2）保险政策没有覆盖到这一部分的损失

第九章enforceable contract 可执行要约
1. Offer and acceptance 要约和可接受条款offer通常是申请人拟定
2. Consideration对价，给别人钱
3. Legal object合法目的
4. Competent parties法定能力
5. Legal form合法形式
无效合同void and voidable
A “Binder” is a temporary contract (oral or written) pending issuance of a policy
Binder是一个暂时未决的协议
保险的结构
1. Declarations 声明 3. Exclusions 例外
2. Insuring agreement 保险协定 4. Conditions 条件

Special Characteristics of Insurance Contracts保险合同的特殊性质
1. Insurance is a contract of indemnity. 补偿性的
2. Insurance is a personal contract.个人的
3. Insurance is a unilateral contract.单方面的
4. Insurance is a conditional contract.有条件的
5. Insurance is a contract of adhesion.有附着力的
6. Insurance is an aleatory contract.偶然的
7. Insurance is a contract of utmost good faith.最大信用
※Insurance is a Contract of Indemnity为什么保险是补偿性的（解答题）
1. Indemnity means that the insured should not be permitted to profit from existence of insurance.既然是补偿性，那么保险人就不允许从保险中获利
2. The principle of indemnity is enforced by the following doctrines:要符合
l insurable interest 可保险的利益
l actual cash value 实际的现金价值
l “other insurance” provisions 其他的保险条款
l Subrogation代位求偿权

ü 对于Insurable Interest而言，a relationship between the insured and the subject of insurance such that the insured will suffer financial loss in the event of damage to or destruction of the property.
保险人和保险对象的关系，就是当保险人在事件伤害或者财产损害中遭受财务损失
1. In life insurance, insurable interest must exist at the inception of the policy.可保利益在之前就存在
2. In property and liability insurance, the insurable interest must exist at the time of the loss.
在损失的阶段也还是存在。
ü Actual Cash Value 是传统可测量的财务损失，等于替代成本减去折旧，基本原理就是不能获利。也有特殊情况，需要支付全部损失，例如：
1. 一些财产条款覆盖了替代成本；2. 在价值政策下，承保人同意支付全部损失；3.支付损失的面值；4.支付事前约定的数额
ü Subrogation代位求偿权
1. Subrogation is the assignment of an insured’s rights against a third party.
保险人对第三方的权利
2. Assignment is required only to the extent of the amount paid by the insurer.
多是由保险公司使用代位权求偿权
3. Prevents the insured from collecting twice for the same loss.
防止遭受双重损失
4. Applicable mainly in property insurance but sometimes in health insurance.
在财产险中多用，也有健康险的

第十章
Risks Arising From Uncertainty of Time of Death 因死亡时间不确定产生的风险
1. Premature death (death while others remain dependent on individual’s income)
早死，其他人还仰仗他的收入
2. Superannuation (the risk of retiring without adequate assets to cover living expenses during retirement)晚挂，退休了却没有钱养老
这两个时间是相互对立的，exclusive
如何测量早挂风险，两个办法
1. human life value 生命价值，based on the individual’s income earning ability，
基于收入能力，因为死亡失去收入的现值。
2. Need analysis 需求分析法， identify the allocation of that income and the purposes for which it would have been used. 基于确定损失收入的分配以及用处
三个步骤确定需求分析
1. Identify the needs that would arise or continue following death of the individual
确定需求在死亡发生后
2. Identify resources that would be available (social insurance benefits, employer-provided benefits, savings)确定死亡后可能存在的补贴，包括保险、员工福利等
3. Measure difference between 1. and 2. Above计算二者的差距，用需求减去剩余补贴
Risks Associated with Disability残疾相关的风险
1. Unlike the case in life insurance, disability income need is not limited to those with dependents.不像寿险，残疾后的收入需求是无限的
2. Income need may even be greater for the person without a spouse (no second income, need to hire a care provider).对于没有配偶的，收入要求更高
3. If breadwinner dies, income stops but expenses also decline.收入没了，花销也少了
4. In event of disability, income stops and expenses will likely increase.
收入没了，花销却有可能更大

第十二章
Unique Characteristics of Life Insurance寿险的特殊特点
1. The event insured is an eventual certainty and the probability of loss increases from year to year.保险事件是一个最终结果确定的事件，但是每年发生的概率又都不一样
2. Life insurance does not violate requisites of an insurable risk; it is not the possibility of death that is insured, but of untimely death.保险的对象是不合乎时宜的死亡，或者说是过早的死亡
3. There is no possibility of partial loss. Therefore all policies are cash payment policies.没有部分损失，因此都是现金赔付政策。

Current Life Insurance Products现在的寿险产品
Universal Life万能险
Variable Life Insurance变额寿险

第十三章
Life Insurance Premium Computation寿险保费的计算
1年的政策交多少钱

5年的费用等于过去5年的总折现值除以第一年活着的人数

※储备金等于未来收益的现值减去未来保费的现值

第十四章
Incontestable Clause不可抗辩条款
1. Insurer cannot contest the policy after it has been in effect for two years during the lifetime of the insured.在保险实施两年后不可以解除合同（抗辩）
2. After insurer has had a reasonable opportunity to investigate validity of the contract, social advantages outweigh undesirable consequences.当公司有足够的机会发现而未发现，过期，社会将关注被保人利益，而非公司，即使此时能証明有欺诈早已存在！
Grace Period宽限期
1. A grace period of 31 days after the due date is allowed for the payment of a premium.
保费支付后的31天内
2. If insured dies during the grace period, the premium is deducted from the benefits paid to the beneficiary. 宽限期内被保险人挂了，保费就从收益里面扣
Reinstatement复议
1. If a lapsed policy has not been surrendered for its cash value, it may be reinstated within 5 years from the date of lapse.5年内可复议，如果利益低于现值
2. Reinstatement requires that the insured
provide evidence of insurability要提供可保证据
pay overdue premiums plus interest
reinstate any indebtedness with interest
Suicide Clause自杀条款
1. Death by suicide is excluded only during the first two years of the contract.
前两年挂掉，无效
2. Some companies limit exclusion to one year.有的时候一年
第十五章
不丧失现金价值Non-Forfeiture Values
当保单正式生效并经过一段时间后，投保人因为种种原因，不愿意或者不能继续持续交费，保单此时已经产生的现金价值，不会因此而消失，仍旧属于投保人。
1. Cash option 用保单已经产生的现金来交保费
2. Paid-up reduced amount 保额降低
3. Extended term insurance 相当于保险期限变短

共同灾难条款Common Disaster Clause
where the insured and the beneficiary have died and there is no evidence that they died other than simultaneously, life insurance proceeds shall be distributed as if the insured survived the beneficiary.
如果保险人与受益人同时挂掉，判定保险人先挂
如果有证据表明受益人比保险人活得久，哪怕一丢丢也算，也算受益人的
政策贷款条款
1. Insured may obtain a loan from the insurer equal to the policy cash value
被保险人可以从保险公司获得一笔等价于现金价值的贷款