CHAPTER 2 : THE UNDERWITING POSITION

 CHAPTER 2 

THE UNDERWRITING POSITION

After studying this chapter, you should able to..
  • list the primary activities of an underwriter and a chief underwriter (menyebutkan aktivitas utama dari underwriter dan chief underwriter)
  • describe the job competencies necessary to be a successful underwriter
  • Identify the specific components of initial (awal) and ongoing (berkelanjutan) training of underwriter
  • Identify an underwriter's decision options
  • Describe how insurers establish authority levels for underwriters
  • Distinguish between the case assignment (penugasan khusus) system and the work division (pembagian kerja) system for organizing  underwriting work
  • Describe how underwriters interact with producers, vendors, reinsurance companies, and other functional areas of the insurance company
The Job of an underwriter entails being part detective, part medical student, part financial analyst, part salesperson, and part diplomat. 
(pekerjaan seorang underwriter mencakup pekerjaan seorang detektif, mahasiswa kedokteran, analis keuangan, penjual, dan diplomat)

Underwriting Job Position (urutan)

  1. Underwriting Trainee
  2. Junior underwriter 
  3. Intermediate underwriter 
  4. Senior underwriter 
  5. Chief Underwriter
The creteria for promotion from one rank to the next typically include the level of underwriting knowledge, skills and abilities, as well as the length of time spent in each rank.
In addition, many insurers give consideration to obtaining professional designations, such as 

  • Life : AAAIJ dan AAIJ
  • General : AAAIK dan AAIK

The primary activities of underwriters at all level, other than the chief underwriter, include (Chapter 4)
  • Reviewing and analyzing insurance application
  • Requesting and analyzing additional information
  • Determining the presence or absence of insurable interest and anti-selection
  • Approving, rating, or declining the coverage
  • Communicating the underwriter decision to the producer
The highest ranking underwriter in an insurance company usually is called the chief underwriter. 
This person oversees (mengawasi) an insurer's underwriting activities and is a specialist in risk selection and strong generalist in customer service and claim.
The chief underwriter's responsibilities typically (exclusive) include
  • Establishing (menetapkan) the insurer's Underwriting philosophy and guideline
  • Monitoring the cost and quality of underwriting
  • Assisting (membantu) with underwriting large or unusually difficult cases
  • Deciding which products, services, and vendors to use 
  • Overseeing (mengawasi) the training of all underwriters
  • Reviewing contestable claims
  • Serving as a liaison (PIC) with the insurer's other functional areas
  • Works with the insurer's legal staff to create contract wording, the information technology staff to develop underwriting systems, and actuaries to establish appropriate (sesuai) pricing, preferred risk criteria, and other product characteristic
  • Involved (terlibat) with the negotiation and administration of reinsurance agreements

Job Competencies of a Successful Underwriter

To excel as an underwriter, an individual must have certain job competencies, which are the knowledge, skills and abilities that quality an individual to perform as job.
However, the one essential characteristic of an underwriter that pervades all underwriting activities is a high level of personal integrity. (satu karakteristik penting seorang underwriter yang mendalami semua aktivitas underwriting adalah integritas pribadi yang tinggi)
An underwriter who makes sound, ethical decision will offer appropriate coverage to proposed insureds and will deny coverage only to person or group that represent a level of risk too great to match the insurer's established underwriting guidelines. (seorang underwriter yang membuat keputusan yang baik akan menawarkan coverage yang sesuai kepada proposed insured dan akan meolaj coverage hanya kepada person atau group yang memperlihatkan tingkat risiko yang terlalu tinggi untuk dicockkan dengan underwriting guidelines yang telah ditetapkan insurer)

Knowledge Required for Underwriting

  • Medical knowledge
    • Circulatory system disorders (sistem peredaran darah)
    • Neurological disorders (otak dan sistem syaraf)
    • Endocrine and metabolic disorders (kelenjar dan metabolis)
    • Respiratory disorders (pernafasan)
    • Urinary and reproductive system disorders (pembuangan dan reproduksi)
    • Musculoskeletal disorders (sendi, ligamen,otot)
    • Digestive system disorders  (lambung)
    • Eye, ear, nose, and throat disorders
    • Blood disorders
    • Psychiatric disorders
    • Neoplasms (tumors)
    • Pharmacology
    • Alcoholism and drug addition
  • Financial assessment knowledge 
    • underwriters need to know how to assess financial information provided by an applicant.
    • In group underwriting, the underwriter must be able to assess the financial stability of an employer or other organization that applies for group insurance.
  • Personal factors knowledge
    • underwriter must be familiar with the element of risk involved insured's personal factors, such as occupations and avocations (kegemaran)
  • Industry knowledge
    • underwriters need to understand the insurance industry, including basic concepts of insurance, their company's competitor, and the laws and regulatory requirements that affect underwriting
  • Company knowledge
    • Underwriters must have an understanding of their company, including the design, pricing and distribution of its products, as well as (serta) the insurer's underwriting philosophy and underwriting guidelines.

Skills and Abilities Required for Underwriting

  1. Making challenging Decisions (Membuat keputusan yang berani)
  2. Managing Multiple Assignments (Me-manage banyak tugas)
  3. Delivering Top-Quality Customer Service (Memberikan pelayanan yang berkualitas)
Making Challenging Decisions
If every underwriting decision were simple and could be expressed quickly as a clear-cut "yes" or "no", insurance companies would not underwriters.
Because each proposed insured presents a unique mixture of characteristic, underwriters must engage (terlibat) in critical thinking and must be able to weigh (menimbang) all the evidence to arrive at a sound decision that is logical and equitable to the insurer and proposed insured.
In making underwriting decision, an underwriter needs an investigative mind - one that can gather information from several sources, integrate the information, reconcile conflicting data, and arrive at a conclusion quickly and accurately.
The goal of underwriting is neither to deny proposed insured who have impairment nor to check every statement presented on application.(..bukan untuk menolak proposed insured yang memiliki penilaian yang buruk maupun melakukan pemeriksaan setiap pernyataan yang ada pada permohonan)
The goal of underwriting is to analyze as much information as seems necessary to reach a sound decision.
Thus, underwriters must be able to process carefully each piece of information while seeing the broad picture painted by the information taken as a whole. 
As underwriters become more skilled in their decision-making capabilities, they are assigned more challenging cases. 

Managing Multiple Assignments
Underwriter would be simpler if an underwriter only one or two cares each day to examine (meneliti) and handle.
The reality of underwriting, however, is that every day brings new cases and new information.
An underwriter's computer may store information about dozen of cases, and her desk may be staked high with supporting case file. (penuh dengan file).

Delivering Top-Quality Customer Service
In the course of a simple day, an underwriter typically speaks with or sends electronic messages to a wide variety of people both inside and outside the insurance company.

Underwriting Training

  • Initial Training of an Underwriter
    • learning and honing (mengasah) the knowledge, skills, and abilities required to handle complex (difficult cases)
    • at class sessions led by director, senior underwriter 
    • observing (mengamati) underwriter doing
    • how he handles various types of case
    • how he gathers and evaluates underwriting information
    • how he coordinates the work of underwriting with the work of other areas of the insurance company
    • explains the basis for various underwriting decision 
    • helps begin to understand the insurer's underwriting philosophy and guidelines
  • Ongoing Training of an Underwriter (pelatihan berkelanjutan)
    • staff meetings
    • classroom training
    • underwriting bulletins
    • departmental newslatters
    • bulletins from reinsurers

Decision Options and Authority Levels of Underwriter 

forth an underwriter's various decision options (Chap 1)
  • Issue the insurance as applied for
  • Issue the applied-for insurance with a modification in the premium rate
  • Issue the applied-for insurance with a modification in coverage
  • decline to issue the insurance or postpone making the decision
Underwriters have varying levels of authority to make these decisions. (underwriter mempunyai level authority yang bervariasi untuk membuat keputusan-keputusan ini)
In general, an underwriter's authority to rate or decline an application increases with the person's level of experience and education. (secara umum. underwriter's authority untuk menilai atau menolak suatu permohonan meningkat seiring dengan tingkat pengalaman dan pendidikan orang tersebut)
Underwriters gradually receive more case approval authority as they demonstrate their knowledge, skills and abilities and as the quality of their judgment improves. (Underwriter secara bertahap menerima banyak kasus untuk di approval sebagaimana merekan menunjukkan knowledge, skill dan abilities serta  kualitas dari prbaikan penilaian )
While new life insurance underwriters typically examine and approve only small-amount cases with more experienced underwriters reviewing their work, experienced life insurance underwriters and chief underwriters usually have the authority to approve large-amount cases and to make decisions on more difficult, detailed cases without review by another underwriter. (ketika underwriter asuransi jiwa yang baru meneliti dan menyetujui kasus-kasus dengan nilai kecil , underwriter yang berpengalaman akan mereviw pekerjaan mereka, experienced life insurance underwriters dan chief underwriter biasanya mempunyai otoritas untuk menyetujui kasus dengan nilai besar dan membuat keputusan yang lebih sulit, merinci kasus tanpa review dari underwriter lainnya.)
Less experienced health underwriter may receive cleaner cases with very few medical conditions indicated on the application, and more experienced health underwriters may handle cases with more complex medical histories.

Typically, an underwriter's level of authority is specified by:
  1. the maximum coverage amount that  the underwriter may approve and (jumlah maximum coverage yang dapat disetujui)
  2. the degree to which the underwriter may rate or decline a policy without approval or review by a more experienced underwriter (sejauh mana underwriter dapat menilai atau menolak policy tanpa persetujuan atau review oleh underwriter yang lebih berpengalaman)
For example, an underwriter may be permitted to approve up to $500.000 of life insurance coverage without approval or review by a more experienced underwriter.

In addition to assigning each underwriter an approval limit, some insurers also assign each underwriter an authority limit, which is the maximum amount of applied for coverage that an underwriter is allowed to review. (selain menetapkan batas persetujuan underwriter, insurer juga menetapkan batas persetujuan maximum amount setiap underwriter utk coverage dimana underwrtiter diizinkan untuk mereview)
A more senior underwriter must review and approve issuance of coverage within the underwriter's approval limit. (setiap senior underwriter harus mereview dan menyetujui penerbitan coverage dalam batas persetujuan underwriter)
For example, an underwriter may have an authority limit of $500.000 and an approval limit of 
250.000. (contoh, seorang underwriter mungkin memiliki authority limit $ 500.000 dan approval limit $ 250.000)
If the underwriter decides that $300.000 of coverage actually should be issued, a more senior underwriter must review and approve this coverage amount (Jika underwriter memutuskan $300.000 coverage harus diterbitkan, senior underwriter harus mereview dan menyetujui coverage amount ini)

Authority to Approve Specified Coverage Limits (Otoritas utk menyetujui coverage limit tertentu)

Most life insurers develop charts or schedules of underwriting authority to specify the largest amount of coverage that each level underwriter is authorized to approve. (banyak life insurer membuat chart atau schedule underwriting authority untuk setiap level underwrtiter yang berwenang menyetujui).
Notice that, in general, underwriters at each level may approve a larger amount of standard coverage that substandard coverage.  (perhatikan bahwa, secara umum, underwriter disetiap tingakt bisa menyetujui jumlah pertanggungan standar yang lebih besar dari pertanggungan di bawah standar)

The approval authority of disability income underwriters may be based on the monthly benefit amount applied for. (Kewenangan persetujuan dari disability incomve underwriters didasarkan pada jumlah pendapatan bulanan yang diterima)
For example, disability income underwriters may have the following authorization limits whether the coverage is to be issued standard or substandard: (contoh: disability income underwriter mungkin memiliki authorization limit berikut apakah coverage akan diterbitkan standar atau substandar)
Level of Underwriting        Monthly Benefit Limits
Junior                                    up to $ 2.000
Intermediate                          up tp $ 5.000
Senior                                    up tp $ 8.000
Cheief                                    All amount
Other health insurance underwriters typically have product type authority limits rather than monetary authority limits. (Health insurance underwriters lainnya bisanya memiliki batasarn otoritas jenis produk daripada batasan otoritas moneter)

Authority to Rate or Decline Cases
Some insurers require every underwriter's decision to rate or decline a case to be reviewed and approved by an underwriter with a higher level of authority, even if the first underwriter has the authority to approve a case of the amount. (Beberapa insurer mengharuskan setiap keputusan dari underwriter untuk menilai atau menolak suatu case harus ditinjau atau disetujui oleh underwriter dengan tingkat otoritas yang lebih tinggi, walaupun underwriter pertama memiliki wewenang utk menyetujui nya.)
In some insurance companies, an underwriter one level higher than the original underwriter reviews all rated and declined case. (Di beberapa perusahaan asuransi, seorang underwriter satu tingkat lebih tinggi dari orginal underwriter yang meninjau semua kasus yang dinilai dan ditolak)
Other insurers require the chief underwriter to perform this kind of review. (insurer lain meminta chief underwriter untuk melakukan ulasan seperti ini)
The review is performed not only to ensure that the original underwriting decision is appropriate, but also to ensure the consistency of underwriting actions, to serve as a method of evaluating an underwriter's job performance, and to enhance producers' confidence in the insurer's underwriting practices. (peninjauan dilakukan tidak hanya untuk memastikan bahwa original underwriting decision sudah tepat, tetapi juga untuk memastikan tindakan konsitensi dari underwriting, untuk melayani metode dari evaluasi job performance underwriter dan untuk meningkatkan kepercayaan produsen dalam underwriting practive perusahaan asuransi)

Organization of Underwriting Unit

Some insurers establish separate underwriting units to handle various types of applications - for life, disability income, medical expense, and other types of coverage. (beberapa perusahaan asuransi menetapkan unit2 terpisah untuk menghandle jenis-jenis pengajuan yang bervariasi-untuk life, disability income, medical expense dan types of coverage lainnya)
Within those units, insurers generally organize the work of underwriting according to a case assignment system, a work division system, or a combination of the two system. (dalam unit2 itu, secara umum insurer mengorganize pekerjaan underwriting menurut sistem penugasan, sistem pembagian kerja, atau kombinasi dari kedua sustem.

  • Case Assignment System (penugasan)

  • A case assignment system is a method of assigning cases to underwriters that enables an underwriter to specialize in certain types of cases. (Sistem penugasan kasus adalah suatu metode  penugasan kasus kepada underwriter yang memungkinkan underwriter mengkhususkan pada jenis kasus tertentu) 
  • The basis used to assign case files to underwriters varies depending on the size of the insurer, the number of applications usually received, and the difficulty of the cases to be underwritten. (dasar yang digunakan untuk memberikan file kasus kepada underwriter bervariasi tergantung pada size of the insurer, the number of application yang bisanya diterima, dan kesulitan dari kasus kasus yang di underwriter.)
  • Most case assignment system distribute case files according to :(sebagian besar case assin  gment system mendistribusikan case file sesuai dengan  :
    • Type of Applications or Policy Change Requested (jenis perngajuan atau permintaan perubahan polis)
      • When cases are assigned based in the type of application or on a type of change requested - usually an increase in the coverage amount or the addition of a rider - certain underwriters are assigned to handle only a specific type of application or a certain type of policy change request.
      • For example, one life insurance underwriter may work only on applications that do not involve medical reports, while another underwriter may handle only applications requiring a medical examinations report. A third underwriter may only on requests for policy reinstatements.
      • Health insurers typically assign cases to underwriters based on the type of coverage involved.
      • For example, junior underwriters will most often handle accident only, hospital and surgical (bedah), or specific benefit policies, while senior underwriters will handle major medical policies.
    • Geographic Origin (wilayah awal)
      • If geographic origin is the basis of an insurer's case assignment system, the underwriting department is divided into regional section, and each section handles applications submitted from a specific geographic area. 
    • Producer Submitting Applications (Producer yang mengirim aplikasi)
      • Some insurers assign specific underwriters to handle all applications submitted by specific producers, regardless of (tanpa memperdulikan) the producers' or applicants' geographic location.
      • This case assignment method enables an underwriter to become familiar with quality of the assigned producers' business and to develop effective working relationship with those producers
    • Group Policyholder (kelompok pemegang polis)
      • Sometimes a large group policyholder will have several national or international offices.
      • In such cases, the insurer may organizes its group underwriting unit so that each policyholder is assigned to a specific underwriter. 
      • As when underwriters are assigned to specific producers, this method of organization allows underwriters to better understand the nuances of the groups and develop effective working relationship with the large group policyholder.

  • Work Division System (Sistem pembagian pekerjaan)

  • A work division system is a method of assigning cases to underwriters that divides cases according to the person or group that underwriters them. 
  • Types of work division systems include :
    • Independent Underwriting 
      • In many insurance companies, applications are assigned according to a work division approach known as independent underwriting in which underwriters work alone to assess each risk.
      • Some insurers assign to independent underwriters only cases requiring extensive research. 
    • Team Underwriting
      • A work division approach in which underwriters are divided into small groups is known as team underwriting.
      • The team usually includes one or more senior underwriters who handle large-amount or complex cases and one or more lower-level underwriters who handle simple cases.
      • Underwriting clerks usually assist the team by performing preliminary application processing and by ordering specific types of additional information.
    • Jet Unit Underwriting
      • Designed to underwriter simple cases quickly, jet unit underwriting is a work division approach in which a separate group of employees are authorized to approve types of individual insurance applications for immediate policy issue.
      • A jet unit usually is not authorized to rate or decline an applications except when certain specified impairment (gangguan) are present.
      • All applications that are not issued for immediate coverage are sent from the jet unit to other underwriting staff, who gather underwriting information and decide on the cases.
      • Some insurers use jet issue electronic systems that further speed underwriting by reviewing all applications and issuing policies that meet the jet issue qualifications without human interventions
    • Committee Underwriting
      • Cases involving large coverage amount or special problems, such as combinations of impairments or anusual occupations, may require committee evaluation.
      • Committee underwriting is a work division approach in which a committee of highly qualified people from inside and outside the underwriting unit are called together for case assessment.
      • Usually the committee is composed of the chief underwriter, the medical director, and representative from the law, actuarial, and producer functions.

  • Combination System

  • Some insurers combine a case assignment system with a work division system. 
  • For example, a jet unit may handle only applications for health coverage under one type of individual policy, or an underwriting team may handle only individual term life insurance application from a specific geographic area.

The Relationship of Underwriting to Other Insurance Functions

Underwriters typically work with other individuals and entities from both inside and outside the insurance company to process applications.
In addition (selain itu), underwriters aid others in their functional capacities.
In this section, we introduce these individuals, entities, and functional areas, and throughout this textbook, we discuss their interactions with underwriters

Outside Individuals and Entities
  1. The producer
  2. Vendor
  3. Reinsurer
  • The producer
    • Underwriters traditionally have relied on (mengandalkan) producers - whether they are independent contractors or employees of the insurer - to gather the initial information use in the underwriting process.
    • Thus, producers are sometimes known as field underwriter in the US.
    • Field underwriting is the procedure of gathering initial information about applicants and proposed insureds and screening proposes insured to determine if they are likely to be approved for a specific type of coverage.
    • Field underwriting help ensure that underwriters have the information they need to assess each proposed risk and that applicants are applying for appropriate amount and type of coverage at an appropriate premium. (...mengajukan jumlah dan coverage yang sesuasi dengan premi)
    • The producer gathers medical, financial, and personal information about a proposed insured (and financial information about an applicant if the proposed insured is not the applicant) and submits that information to the underwriter for risk analysis.
    • In addition (selain itu), the producer can provide the underwriter with valuable input as to the possible risk factors posed by the applicant and proposed insured or group. (..memberikan input yang berharga kepada underwriter mengenai kemungkinan faktor faktor risiko yang ditimbulkan oleh pemohon dan proposed insured serta group)
    • Note that some insurer prefer to gather own underwriting information. (tele-underwriting)
  • Vendors
    • Vendors, also known as service providers or solution providers, are third parties that an insurer hires to perform specific task or provide specific services.
    • Insurers often hire vendors to perform time-consuming tasks that can be done more effectively and cost-effectively by an entity specializing in a particular task than by an insurance company's staff or producers.
    • In the underwriting area, vendors may perform many types of tasks.
    • Insurers often contract with vendors that perform various medical tests and medical exams.
    • For instance, an insurer might hire a vendor company to administer and report the result of proposed insureds' blood tests, urine analysis, and electrocardiograms.
    • Such vendors typically employ physicians, nurses, or other health professionals to perform these test and report the results to underwriters.
    • Some insurers hire vendors that provide outsourcing of underwriting services.
    • Outsourcing is the practice of hiring an external vendor to perform specified company operations that traditionally have been performed by company employees.
  • Reinsurers
    • Underwriting is only one of the tools insurers use to control their exposure to risk.
    • Insurers also control their risk exposure by purchasing reinsurance.
    • Reinsurance is insurance that one insurance company - known as the direct writer or ceding company - purchases from another insurance company - known as reinsurer, reinsurance company or assuming company - to transfer risks on insurance policies the direct writer issued. (reasuransi adalah asuransi yang dibeli oleh perusahaan asuransi - dikenal sebagai direct writer atau ceding company - dari perusahaan asuransi lain - yang dikenal sebagai reinsurer, perusahaan reasuransi - untuk mengalihkan risiko atas polis-pois asuransi yang diterbitkan direct writer)
    • To cede insurance business is to obtain reinsurance on that business by transferring all or part the insured risk to a reinsurer. (me-sesikan bisnis asuransi untuk memperoleh reasuransi atas bisnis dengan mengalihakan semua atau sebagian risiko tertanggung kepada reinsurer.)
    • Although some companies provide only reinsurance, other companies both issue insurance coverage directly and assume reinsured cases from other insurers.
    • Reinsurance can be divided into two broad classification:
      • Assumption reinsurance is reinsurance designed to permanently and entirely transfer blocks of existing insurance business from one insurance company to another. 
      • The reinsurer assumes the entire legal obligation formerly borne by the insurer that issued the business. Reinsurer menanggung seluruh kewajiban hukum yang sebelumnya ditanggung oleh insurer yang menerbitkan bisnis)
      • The reinsurer new insurance certificates, known as assumption certificates, to all affected policyowner.
      • Once the business is transferred, the contract between the direct writer and the reinsurer is fulfilled.
      • Indemnity reinsurance is a reinsurance arrangement used to transfer a portion of a direct writer's accepted risk on an ongoing basis. (Indemnity reinsurance adalah peraturan reasuransi yang digunakan untuk mengalihkan sebagian dari risiko yang diaksep oleh direct writer secara berkelanjutan)
      • Typically, indemnity reinsurance is purchased to transfer risk on a direct writer's new business rather than its in-force business.
      • Such arrangement create an ongoing contractual relationship between the direct writer and the reinsurer. (pengaturan tersebut menciptakan hubungan kontrak antara direct writer dan reinsurer)
      • The arrangement, however, is not disclosed to owners of policies that have been reinsured, and policyowners typically are unaware of the reinsurance arrangement.
    • In this text, we are concerned with only indemnity reinsurance agreements.
    • Under an indemnity reinsurance arrangement, the direct writer collects the premiums on policies that have been reinsured, and it pays the policy benefits to the proper recipient when due. (Dalam pengaturan indemnity reinsurance, the direct writer mengumpulkan premi atas polis-polis yang telah di reasuransikan, dan membayar policy benefit kepada penerima yang tepat pada saat jatuh tempo)
    • After the direct writer pay the policy benefits, the reinsurer then reimburses the direct writer for the portion of the policy benefit that was reinsured. (setelah direct writer membayar policy benefits, reinsurer kemudian reimburses direct writer untuk portion dari policy benefits yang telah direasuransikan)
    • Indemnity reinsurance agreements take a variety of forms and typically include provisions that affect the direct writer's underwriting process. (indemnity reinsurance agreement mempunyai berbagai bentuk dan biasanya mencakup ketentuan yang mempengaruhi proses underwriting dari direct writer)
    • The types of reinsurance arrangement that a direct writer enter into determine the extent to which its underwriting process is affected by the arrangement. (jenis-jenis pengaturan reasuransi yang dilakukan direct underwriter menentukan sejauh mana underwriting proses dipengaruhi oleh pengaturan tersebut)
    • Under some arrangements, for example, the direct writer underwrites each case without input from the reinsurer's underwriters. (Dalam beberapa pengaturan, contoh, direct writer meng-underwrite setiap kasus tanpa masukan dari reinsurer's underwriters)
    • The reinsurance agreement, however, specifies the underwriting guidelines that the direct writer must follow. (.. menetapkan underwriting guidelines yang harus diikuti oleh direct writer)
    • In all cases, the direct writer and reinsurer follow stated procedures to process new business and coordinate their operations to ensure that they comply with (mengikuti) the terms of their reinsurance arrangement. 
Other Functional Areas Within an Insurance Company
The functional areas within an insurance company that most often interact with underwriters are :
  • Medical Staff
    • Most insurance companies employ physicians (dokter) who provide the underwriting staff with expert medical opinions and guidance, particularly in handling complex or unusual cases.
    • Large insurers usually appoint a medical director to lead a medical underwriting staff composes of physicians, nurses and nurse practitioners, specialist in medical testing, and other medical personnel.
    • Besides advising underwriters, the medical staff also may be responsible for medical training of the underwriters, as well as (serta) developing and updating the insurer's medical underwriting guidelines.
  • Marketing
    • Marketing is the functional area of an insurer that has primary responsibility for identifying the insurer's customers and what they want, as well as planning the promotion and distribution of the insurer's product. 
    • In addition, marketing seeks to enhance the insurer's competitive position by: (marketing berusaha meningkatkan competitive position perusahaan asuransi dengan)
      1. gathering information about the insurer's business environment, including data on its competitors, and
      2. assessing the insurer's sales performance in marketplace. 
    • Underwriters and the marketing staff must communicate on a ongoing basis so that each understand the other's goals
  • Reinsurance
    • Reinsurance is the functional area of an insurer that obtains reinsurance coverage from a reinsurer and handles the administration of the insurer's reinsurance arrangements.
    • Note that smaller companies may not have a separate (tersendiri) reinsurance area, and actuaries may be responsible for acquiring reinsurance coverage.
    • Underwriters cooperate with reinsurance staff members to request reinsurance coverage and to help select that coverage. 
    • Underwriters also work with reinsurance staff to develop the underwriting guidelines that are included in reinsurance arrangements.
  • Claims
    • Claims is the functional area of an insurer that evaluate and processes claims presented (disampaikan) by policyowner or beneficiaries.
    • If problems arise in handling a given claim, the underwriters help claim analysist by reviewing the way in which the case was underwritten.
    • For instance, underwriters typically review any death claim that has been submitted during an individual life insurance policy's contestable period. 
  • Customers Service
    • Customer service is the functional area of an insurer that perform a broad range of activities to keep customer satisfied so that they will continue doing with the company and speak positively about it to other potential customers.
    • At its most basic level, customer service involves answering customer's questions, providing requested information, and processing transactions.
    • Customers can include producers, applicants,    policyowners, insured, beneficiaries, and group policyholders, among others.
  • Actuarial
    • An actuary is a technical expert in insurance, annuities, and financial instruments who applies mathematical knowledge to industry and company statistic to calculate various financial values. 
    • An insurer's actuarial staff:
      • Uses mathematical principles to predict the rates of illness, injury, disability and death among insureds
      • calculates legal service liabilities for insurance products
      • develops new insurance products
      • calculate the premium rate for insurance products
      • conducts research on trends in mortality and morbidity rates, policy lapses, policy loans, company expenses, and interest rates.
  • Accounting 
    • The functional area of an insurance company that collects, analyzes, and report data above a company's financial conditions is known as accounting.
    • The accounting staff in an insurance company develops information that is used throughout the company to make decisions and to satisfy financial reporting requirements.
    • Underwriting may be responsible for submitting statistical reports to the accounting area for inclusion in company-wide reports.
    • Insurance company accountants use the information provided by underwriters to compute the cost of underwriting and to help manage underwriting expenses.
    • For example, an accountant might calculate how much money the insurer spends on vendor service, such as obtaining attending physician's statements.
    • The accountant further separates the total cost for vendor services according to geographic region or by product line.
    • The insurer's management uses such information to monitor underwriting costs and make adjustments to products or underwriting requirements as necessary to keep cost at an appropriate (sesuai) level.
    • Accountants also can help underwriters interpret and analyze complicated financial statements submitted for underwriting.
    • Especially for large-amount or difficult cases, an accountant can help an underwriter understand an applicant's complete financial situation.
  • Law
    • The law or legal, function helps the insurer comply with the laws and regulations affecting the insurer's relationship with customers, prospective customers, employees, producers, other insurers, reinsurers, vendors, and governmental agencies. 
    • An insurer's law function protects the insurer's legal rights and review company activities to be certain the insurer fulfills its legal responsibilities.
    • Many insurers have established compliance functions, which may be past of the law function or may operate independently of it.
    • Compliance is the function responsible for ensuring that insurer and its producers follow all applicable insurance law and regulatory requirements.
    • The law department keeps underwriters informed of new laws and changes to existing laws, advises underwriters on how to comply with laws, and ensures that forms used in underwriting meet current regulatory requirements
    • The law department also helps underwriters interpret policy language.
    • Underwriting and legal staff may work together when the insurer decides to reform (revise) or rescind (void) a policy.
    • Insurers rarely take such legal actions, but when they do, underwriters may be asked to give her opinion of the case as it was originally underwritten.
    • Information provided by the underwriter helps the legal staff decide how to proceed with the case.
    • The legal staff also discusses with underwriters contested claims and possible legal actions involving such claim, and the legal helps underwriters prepare to testify during a deposition or trial related to a disputed claim
  • Human Resources
    • Human resources monitors the availability of qualified workers, recruits and screen applicants, helps select qualified employee; plans and present appropriate orientation, training, and development for each employee, and administer employee benefit programs.
    • The underwriting department tells human resources the qualities of a successful underwriter, so that human resources staff will seek these qualities in job applicants.
    • Human resources also guides an insurer's management in conducting performance appraisals of employees and in determining compensation levels for various jobs.
    • Finally, human resources assists with employee separations resulting from registration, layoff, retirement, or discharge.
  • Information Systems
    • The function called information systems facilitates data processing and enables the resulting information to be made available to employees who need it.
    • Most insurance companies use computers and other electronic devices to enhance (meningkatkan) the speed, accuracy, efficiency of work activities.
    • An automated office system an insurer to perform task that otherwise would be done manually or would be performed by outside vendors.
    • Because the computer systems used in underwriting are critical the success of risk assessment and policy issue, underwriters interact with staff from information system to obtain update and revision to the programmed software and to learn how to use new technologies.
    • Underwriters collaborate with staff in information systems to troubleshoot systems problems and share ideas for new or improved systems.
    • The rapid pace of change in technology requires underwriters and information system staff to communicate frequently and effectively.









Comments

Popular posts from this blog

Pengertian Morf, Morfem, Alomorf, dan Kata

CODE SWITCHING, CODE MIXING, AND INTERFERENCE

Pengenalan Morfem (prinsip-prinsip pengenalan Morfem)