What’s Next for Medical Professional Liability Writers?...What’s Next for Medical Professional...
Transcript of What’s Next for Medical Professional Liability Writers?...What’s Next for Medical Professional...
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What’s Next for Medical Professional Liability Writers?
2014 Casualty Loss Reserve SeminarSeptember 16th, 2014
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Overview
• The profit cycle– Why it happens– Why it is particularly harsh for MPL– Where we are now in the cycle
• Surviving the profit cycle– New techniques for the reserving actuary
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The P&C Profit Cycle• Soft Market
– Slow erosion of profitability by loss trend– May be accompanied by decreases in rates, but not necessarily– Continued reliance on release of prior years’ reserves to bolster P&L– Eventually inadequate reserves are booked– This inadequacy is increased until it can no longer be considered ‘reasonable’
• Hard Market– Premium increases occur suddenly, and dramatically to redundant levels (in comparison
with the long term return requirements) in order to save the company.– While reserves are still largely deficient, the reserve hole begins to get filled in from the
additional premium– With rates at redundant levels, eventually the reserve hole is filled in, and reserves
begin to build to redundant levels
• Repeat
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Why does the cycle persist?
• Uncertainty in reserves• Makes possible the inadequacy and redundancy in reserves
• This in turn, drives the need for changes in premium levels
• Once the cycle sets in, it is difficult for a company to fight it, especially when it takes over a decade from peak to peak
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Medical Malpractice
• Enough multi‐line participants (and reinsurers), that the cycles are synchronized with regard to timing
• The severe nature of medical malpractice claims increases the uncertainty of reserves
• This results in a generally more severe profit cycle than most other lines of business
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Company Level Review
• Analysis of 100 companies’ Annual Statements as of Year‐End 2013
• Represents roughly 70% of the marketplace• Independently developed rough estimates of reserve need for each
• Restated history to show the true dynamics of the cycle, and where we are now
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40%
45%
50%
55%
60%
65%
70%
75%
80%
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
Loss Ratio
Selected Companies
Cal Yr
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40%
45%
50%
55%
60%
65%
70%
75%
80%
85%
2005
2006
2007
2008
2009
2010
2011
2012
2013
Selected Companies
Company AY Est Cal Yr
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40%
45%
50%
55%
60%
65%
70%
75%
80%
85%
2005
2006
2007
2008
2009
2010
2011
2012
2013
Selected Companies
Margin Build Margin Release Cal Yr Company AY Est
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40%
45%
50%
55%
60%
65%
70%
75%
80%
2005
2006
2007
2008
2009
2010
2011
2012
2013
Selected Companies
Margin Build Margin Release Cal Yr My AY Est
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Hindsight View of Reserve Margin
• NAIC Annual Statement Schedule P – Part 2 provides the information
• Using the most current view of a Company’s results by year, past reserve levels are indicated as being inadequate or redundant
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Indicated Reserve Margin for Selected Companies
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1
2
3
4
5
6
7
8
9
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
$Billions of R
eserve M
argin
Hindsight Reserve Margin
Using 2013 CompanyBooked
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Indicated Reserve Margin for Selected Companies
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1
2
3
4
5
6
7
8
9
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
$Billions of R
eserve
Margin
Hindsight Reserve Margin
Using 2013 CompanyBooked
Using My Estimate
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2
4
6
8
10
12$ Billion
s
Earned Premium
CY Loss
Company AY EstimateBooked 2013
My AY Estimate
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Who’s Right?
• My opinion is just that, there are certainly others. Why should you believe me?
• Not going to get into loss development factors, Bornhuetter‐Ferguson ratios, etc. here.
• Looking at a broad section of the industry, looking at the trend of actual loss payments is useful for assessing reasonableness of reserves.
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0
1
2
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6
7
2004 2005 2006 2007 2008 2009 2010 2011 2012
$ Billion
s
Payments
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10
15
20
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30$ Billion
sBooked Reserves
Hindsight ReserveNeed ‐ Based on 2013Booked
Hindsight ReserveNeed ‐ My Estimate
Payments
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0
5
10
15
20
25
30$ Billion
sBooked Reserves
Hindsight ReserveNeed ‐ Based on 2013Booked
Hindsight ReserveNeed ‐ My Estimate
Payments
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0
5
10
15
20
25
30$ Billion
sBooked Reserves
Hindsight ReserveNeed ‐ Based on 2013Booked
Hindsight ReserveNeed ‐ My Estimate
Payments
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0.0%10.0%20.0%30.0%40.0%50.0%60.0%70.0%80.0%90.0%
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
Hindsight Reserve Margin as % of Premium
Company
My Estimate
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0%
5%
10%
15%
20%
25%
30%
Percen
tage
of S
elected Co
mpa
nies
Company Reserve Margin as a Percent of 2013 Company Premium
Reserve Margin/Prem: Distribution by Company
By number of Companies
By Premium
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An end to the cycle?
• Possibly – This cycle does appear fairly unique compared to the past, with reserve margin remaining high longer.
• My view – It’s just prolonged– The previous soft market was generally not about rate decreases, but
about steady erosion of profitability from loss trend.– Loss trend appears very low from historical standpoint. Will it remain
that way? Tort reform reversals? Impact of ACA? Increased Inflation down the road from QE?
– Either way, the temptation is too great for market participants who may wish to pick up significant market share by reducing profitability, funded by reserve margin.
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Conclusions about the Cycle
• The good news‐– Rates, while at lower levels than at the past, are still providing true AY loss ratios of around 60%.
• The bad news‐– True profitability is going to continue to deteriorate for quite some time, perhaps five to ten years, before a hard market will occur. The speed of this deterioration will likely depend on loss trend.
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Navigating the Cycle
• Understand the cycle and estimate when it will turn• Be careful with acquisitions in a soft market• Watch the business like a hawk
– Changing rates– Changing class mix– Changing deductibles– Impact on loss ratio and development
• We need new methods. Triangles are not enough.
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Claim Life Cycle Model
• Analyze individual claim emergence and development as a predictive modeling exercise using available claim and exposure characteristics
• Simulate future emergence and development using these models
• Provides a wealth of predictive information about the business
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Claim activity from the beginning of the quarter to the end of the quarter
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Did the Claim Close?
Does the Claim Have a New Value?
Is there a Payment?
What is the New Value?
How much is the Payment?
Arrows indicate dependency on other results
A number of available claim or exposure characteristics may have predictive value for any of these questions.
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Simulate Going Forward
• Claim Development– Start with current inventory of open claims– For each open claim simulate a number of potential outcomes for the next time‐step (using the claims’ characteristics)
– For those simulated claim‐paths that are still open simulate forward another time‐step.
– Continue until all simulated claim‐paths are closed
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Severity Description 1
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Severity Description 1
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Severity Description 1
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Severity Description 2
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Severity Description 2
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Severity Description 2
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Changes that could impact reserves
• Deductible/Limit• Geography• Changes in reinsurance program• Class mix• Doctor characteristics• Types of claims/claimants
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Summary
• The softening in the market is likely to remain for some time to come
• MPL writers will need to tread carefully in the next few years
• Actuaries need to be more aware of changes in the book of business when looking at reserves.
• Predictive modeling techniques in reserving can help