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Explore Insurance Products, Processes, and Practices

Learning Objectives

After completing this unit, you’ll be able to:

  • Describe how insurance companies make money.
  • Describe how insurance brokers make money.
  • Identify common sales processes.
  • Identify common service processes.
  • Explain how market models impact key processes.

How Insurance Companies Make Money

Insurance companies make money because, in any given year, they only need to compensate a small percentage of their customers for losses. Here are the main money making methods.

Method
Description

Sell policies to large groups.

Insurance companies sell policies to large groups of people. The larger the customer base, the more easily the customers who don’t need compensation can subsidize the customers who do.

Collect premiums.

Customers pay for the insurance whether they need compensation or not. Often they can choose to pay monthly, quarterly, or annually.

Invest premium funds.

Premium funds can earn interest, increasing the profit margin and making more money available to compensate customers if the need arises.

Renew and retain customers.

Renewals ensure that the income from premiums continues to flow in.

Keep the claims ratio low.

Insurance companies pay out less in compensation than they make in premiums. Though a few customers require a lot of compensation, on average, customers pay more in premiums than they require in compensation.

Although insurance companies strive to keep total premiums above total compensation, they aim to compensate customers fairly and most try to provide the best service they can. This is essential for customer retention and for acquiring new customers by having a good reputation.

How Brokers Make Money

Brokers make money from commissions on the premiums they sell as the broker of record. They also charge for specific services such as compliance audits, Affordable Care Act audits, handbook reviews, consolidated billing, and COBRA administration. Brokers have a view of retention that differs from insurance companies. They won’t hesitate to place a client with a different insurance carrier if it’s in the client’s best interest. Above all, they want to keep clients happy so they get more future business.

Common Sales Processes

Brokers and captive agents have different ways of selling insurance. While brokers work for their customers and use company-independent sales processes, captive agents work for companies and use company-specific sales processes. Managing general agents (MGAs) have underwriting and binding authority from the insurance companies they represent, so they’re somewhat like brokers and somewhat like captive agents. MGAs use both company-independent and company-specific sales processes.

Brokers and managing general agents (MGAs) use these sales processes.

  • Assess the needs of the customer: Brokers and MGAs work with multiple insurance companies, but they work for the customer. So their first priority is to find out about the risks a customer faces so they can recommend appropriate coverage.
  • Look at the insurance landscape: To offer customers the best choices, brokers and MGAs need to know about all the options available. This includes keeping up with trends in the industry.
  • Advise what coverage is needed: Brokers and MGAs match the needs of the customer with what’s available in the insurance industry.
  • Compare rates from different insurance companies: If more than one insurance company offers a policy that meets a customer’s needs, the broker or MGA can help the customer choose the policy with the best rate.

Captive agents and MGAs use these sales processes.

  • Quote to bind: First, they collect customer data so they can generate a quote. The quote includes the policy coverages and the price. If the customer accepts the offer, the quote becomes a policy in a process called binding.
  • Underwriting: An underwriter determines the coverage and premium to offer a customer based on the customer’s risks. For simple cases, underwriting can be automated.
  • Payment and billing preferences: A customer can choose monthly, quarterly, or annual premium charges. They can also opt for mail or email billing or to have payments deducted automatically from an account or credit card.

Common Service Processes

Service processes range from simple things a customer can do for themselves, such as changing their phone number, to complex processes requiring the help of a trained professional. 

The most common service processes at insurance companies are:

  • Information modifications: Some changes to customer data are separate from the conditions of the policy, such as changing the address, phone number, or beneficiary.
  • Policy modifications: Changes that affect the policy include endorsements, renewals, and cancellations. For example, adding a teenage driver who just got their license to an auto insurance policy is an endorsement.
  • Claims: Settling a claim involves gathering information about the event and determining who needs to be paid for which services or products. For example, information in an auto accident claim includes the model and year of the car, the damage to the car, the circumstances of the accident, and the shop responsible for repairs.
  • Managing the book of business: Some processes require aggregated policy data. For example, an auto insurance company might offer a discount to all customers with no accidents in the last five years.

How Market Models Impact Key Processes

Remember those insurance company business units and what they do? All of them want to optimize their processes to achieve these goals.

Department
Goals

Products

Product teams want to launch new products to market quickly and easily.

Sales and marketing

Captive agents want to make the quote-to-bind process more efficient and customer-friendly.

Underwriting

Underwriters want to make their work more efficient by automating manual tasks for employees and customers.

Claims

Claims adjusters want to promote customer satisfaction and operational efficiency. In addition, they want auto-adjudication for simple issues so they can focus on the more complex claims.

Customer service

Customer service representatives want to ensure customer satisfaction and retention, while maximizing operational efficiency.

Accounting and finance

Accountants want to monitor indicators of the company’s financial health in real time, such as the claims ratio and investment returns.

Information technology (IT)

The IT department wants to reduce operating costs, increase revenue, increase employee and customer satisfaction, and keep up with tech trends in the industry.

Now you know more about how insurance companies acquire and take care of their customers. Let’s move on and take a closer look at how the industry is changing.

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