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Risk and Risk Management

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Risk

Risk is defined as the potential for, or uncertainty of, loss. There are two types of risk: speculative risk and pure risk.

Speculative risk is a risk that presents the chance for both loss and gain. Speculative risks are not insurable. For example, investing in the stock market and gambling are speculative risks. Individuals can realize financial gains, or they can lose all of their money.

Pure risks present a potential for loss only. Pure risks do not have any possibility of gain. Only pure risks are insurable. For example, injuries, illnesses, and death represent pure risks because an individual can only suffer a loss in the form of missed work and medical bills or burden survivors through the untimely loss of life.

CharacteristicPure RiskSpeculative Risk
DefinitionPossibility of loss only, no chance of gainInvolves a chance for both loss AND gain
InsurabilityInsurableNot insurable
Examples in Life and Health InsuranceInjuries, illnesses, disability, deathInvesting in the stock market, gambling
Key Exam PointIf the only possible outcome is loss, it's a pure riskIf there's any possibility of gain, it's a speculative risk
Exam Tip

Most state exam questions about risk types focus on identifying whether a scenario represents a pure or speculative risk. When answering questions about risk types, first ask yourself: "Can this situation result in a gain?" If yes, it's speculative and not insurable. If no, it's pure risk and potentially insurable. Insurance companies only insure pure risks.

Elements of an Insurable Risk

It's impossible to insure every type of risk. For a pure risk to be insurable, it must involve a chance of accidental, measurable, and definable loss. General elements of insurable risk include:

  • An insurable loss must be due to chance (accidental) — "Chance" means that it's outside an insured's control. In this sense, the individual insured (loss exposure unit) that suffers the loss is randomly selected. This characteristic helps insurers avoid adverse selection. For example, an insured catches a cold.
  • An insurable loss must be definite and measurable — "Definite and measurable" means that the time, place, amount, and whether the claim is payable can be documented. For example, the insured's automobile accident occurred at 2:00 p.m. on Friday and caused $2,000 in damage.
  • An insurable loss must be predictable — The term "predictable" means that the (estimated) average frequency and severity of future losses can be calculated. There must be a sufficient number of homogeneous loss exposure units to effectively allow insurers to apply the law of large numbers. For example, 18% of accidents involve distracted driving.
  • An insurable loss cannot be catastrophic — The term "catastrophic" is from the perspective of the insurer. This is meant to indicate that it's too big and uncertain to be insured. The loss exposure must be reasonable. For example, a war, a nuclear disaster, or a $1 trillion life insurance policy is not reasonable loss exposure.
  • The number of loss exposures (units) to be insured must be substantial — The carrier's actuaries must be able to apply the law of large numbers to help the insurance company predict loss.
  • The premium cost must be economically feasible — A premium is "feasible" when it's affordable. Also, the premium must be small in comparison to the loss exposure being insured. For example, a healthy 45-year-old male could probably qualify for a 20-year term life insurance policy with a $250,000 face amount for less than $500 per year.

Insurance Risk Classifications

As will be described later in this course, insurers use various underwriting techniques to evaluate risks and assign risk classifications. Insurers place risk exposures into one of three risk classifications: standard risk, substandard risk, or preferred risk.

  • Standard risks are considered to have an average potential for loss. Standard risks are typically insured in return for a predetermined standard premium.
  • Substandard risks are judged to be a poor risk for an insurance company and have a higher-than-average potential for loss. Substandard risks may be insured for an increased premium, covered with a lower benefit, or declined altogether.
  • Preferred risks are judged to be better than average risks for an insurance company. Preferred risks have a lower potential for loss. Insurers offer coverage to preferred risks for a lower-than-average premium.

Risk Management

The process of analyzing exposures that create risk and designing programs to handle them is referred to as risk management. Risk management may be accomplished by:

  • Detecting the potential loss exposure
  • Selecting a method or tool in order to reduce risk
  • Executing a course of action
  • Periodically reviewing the measures taken

The risk may be reduced or managed by purchasing an insurance contract, known as risk transfer. In addition to risk transfer, there are other ways to manage risk.

Methods of Handling Risk Quick Reference Chart

MethodDescriptionExamplesBest Used When
Risk sharingSpreads risk among multiple partiesCoinsurance in a major medical insurance policyMultiple parties can share the risk.
Risk transferTransfers risk from one party to another via legal contractBuying insurance, incorporation, hold-harmless clausesRisk can be transferred. (Cost effective, large loss potential.)
Risk avoidanceEliminating an activity or condition that exposes to lossNot building in a flood zone, not skydivingRisk is too high. (Loss potential severe, no other solution viable.)
Risk reductionDeliberate actions to reduce likelihood or severity of lossSafety systems, training, maintenanceRisk cannot be avoided. (Controls are cost effective, multiple exposures exist.)
Risk retentionMaintaining personal reserves to address costs of lossDeductibles, self-insurance, no insuranceLosses are small. (Frequent losses, predictable losses.)

Risk sharing spreads risk among multiple parties. Each party assumes a portion of the risks that are covered by the arrangement. Reciprocal insurance companies (e.g., USAA in San Antonio, Texas) — also referred to as inter-insurance exchanges — are one type of risk sharing arrangement. An example of risk-sharing is the use of coinsurance in a major medical insurance policy. If the coinsurance split is 80% / 20%, then the insurance company carries 80% of the risk, and the insured carries 20%. Often, this risk-sharing mechanism is used in conjunction with the risk retention mechanism that's referred to as a deductible.

Risk transfer features a legal contract that transfers risk from one party to another. In general, insurance contracts are risk transfer arrangements. They transfer the risk of loss defined in the policy to the insurer in exchange for a known fee or premium. Buying insurance is the best way to transfer risk. Additional examples include incorporation and hold-harmless clauses in contracts. Reinsurance is one method that insurers use to prevent a catastrophic loss. Reinsurance is defined as transferring risk from one insurer to one or more other insurers. Many insurers can minimize exposure to substantial loss by reinsuring risks.

Risk avoidance means that risk can be avoided by eliminating an activity or condition that exposes a person to a type of loss or specific perils. Avoidance is the most complete form of risk management. For example, a company decides not to build in a flood zone and completely eliminates the risk of flood loss.

Risk reduction is the process by which a person takes deliberate actions to reduce the likelihood or frequency of a loss, or the severity of a loss if it should occur. This is different from risk avoidance since the risk is not completely eliminated. For example, installing smoke alarms and a sprinkler system reduces the risk of death and will reduce the amount of property loss in a building fire.

Risk retention is a conscious strategy in which a person maintains a certain amount of reserves to address unexpected expenses that are caused by insurable losses. Some forms of risk retention are limited, such as the deductibles in a health insurance plan or personal automobile insurance. Some large companies that have highly predictable patterns of loss also self-insure. Choosing not to purchase insurance at all is also a form of risk retention. For example, a person with a $1,000 deductible on their automobile insurance policy retains $1,000 of any risk if their car is damaged in an accident.

It's essential to know that "self-insurance" is much different from "no insurance." The former is a planned strategy that's based on holding reserves and self-financing losses. The latter is simply a refusal to acknowledge the reality of risk and the possibility of financial loss.

Exam Tip

One way to remember these risk-handling methods is to use the acronym STARR (Sharing, Transfer, Avoidance, Reduction, and Retention).

Loss Prevention

Another risk management tool available is loss prevention. Loss prevention involves taking actions to eliminate damage or loss. In fact, it's a method used to identify and analyze risk and to control losses. For example, constructing a building with masonry rather than wood, removing flammable materials from a premise, or de-icing an aircraft's wings before takeoff are loss-prevention steps.