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医疗事故行业动态.pdf

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医疗事故行业动态.pdf

1、Antitrust NoticeThe Casualty Actuarial Society is committed to adhering strictly to the letter and spirit of the antitrust laws.Seminars conducted under the auspices of the CAS are designed solely to provide a forum for the expression of various points of view on topics described in the programs or

2、agendas for such meetings.Under no circumstances shall CAS seminars be used as a means for competing companies or firms to reach any understanding expressed or implied that restricts competition or in any way impairs the ability of members to exercise independent business judgment regarding matters

3、affecting competition.It is the responsibility of all seminar participants to be aware of antitrust regulations,to prevent any written or verbal discussions that appear to violate these laws,and to adhere in every respect to the CAS antitrust compliance policy.Direct Written Premium by TypeHistoric

4、Levels of Capital Subsidize MPL Underwriting ResultsSource:ConningIndustry Overview Wide variation in limits purchased Tort Reform measures XPL Claims Occurrence vs Claims Made/Tail Organization size ranges Solo physician practice to consolidated healthcare systems ConsolidationConsolidation Physici

5、ans More than 100k physicians became employed 2019 2021 Groups of 50 or more increased to 17.2%nationwide(AMA)Increased risk tolerance More customized coverage Increasing buyer sophisticationInside Medical Liability,Q4,Strategies for Dealing with Healthcare Consolidation Emerging Issues in MPL Telem

6、edicine Clinical use of AI COVID-19 effects on loss development patterns Social inflation Economic inflationMPL Reinsurance9“In 50 years,I have never seen a market quite like this.The investor in whatever shape or size,whether it be private or public,have actually lost appetite in investing in the r

7、einsurance balance sheet.Stephen Catlin(03/06/2023)Executive Chairman of ConvexReinsurers Profits Declined Due to Investment LossesRoE Heading into 1/1/23 Renewals4.0%12.7%10.8%4.3%12.5%11.8%11.7%9.8%8.3%3.3%3.5%9.7%3.4%10.8%-2.2%-4%0%4%8%12%16%ROAEEQ&Tsunami in JPN,NZ EQ and THAI floodsHurricanes H

8、arvey,Irma,MariaCOVID-19Hurricane Ian,Investment LossesSource:Company Reports,Guy Carpenter Market IntelligenceNote:These results relate to Global Reinsurance composite companies onlyPoll Key=ZEZUHLabel=MPL Nuclear VerdictsMPL Jury Verdict SeverityNumber of Verdicts$25M or Greater01112131

9、4021222022 had the most verdicts of$25M or greater of any year since 20012023:14 verdicts of$25M+as of 5/25/2023Many Reinsurers are looking at 10+verdicts added to their portfolios in the past year alone 2018-2023 YTD combined for 9 verdicts over$100MJanuary 1,2023 Reinsurance ReviewCapac

10、ity ExecutionPricing Capacity was sufficient but also strained in certain segments(i.e.LTC,HPL,etc.)Minimal oversubscription Strong market appetite for physician class of business Continued push by reinsurers to bring down treaty limits Both occ and agg limits Less number of reinsurers writing the c

11、lass today Loss-free:flat to+5%Loss-impacted:+5%to 10+%Greater pricing ranges in HPL Reinsurers resistant to improved terms and conditions Pricing variables:Treaty experience/pending verdicts Underlying rate change Policy and reinsurance limits Venue 1/1/23 renewals were typically more orderly than

12、prior 18 months Alternative structures sometimes cost prohibitive Co-participation usage increasing Non-concurrent terms still the exceptionReinsurance Structures and Market AppetiteContract TypeMarket AppetiteCommentsPer claimProvides policy limit capacityFoundational reinsurance coverPer occ/clash

13、/Per EventTraditionally covers ECO/XPL and multi-insured lossesPressure to bring down supplemental limitAwards Made/Common LossProvides coverage for excess verdicts and systemic lossesMarket appetite waning in light of increased verdict activityQuota ShareProvides surplus reliefChallenge can be obta

14、ining ceding commission to cover expensesConsiderations Moving Forward1Firm Reinsurance Market reinsurers seeking to:Continue upward pressure on ratesReduce limits on unbalanced programsImplement loss caps/treaty aggregate limitsManage SAM exposure2MPL Segment Competing for Reinsurance Capital Alloc

15、ation3Diminished Reinsurer Appetite for Certain MPL Classes4Inflation(Core/Social)Impacting Reinsurance Pricing5Legislative ChangesFirm reinsurance market conditions expected to persist in 2023,but there are reasons for optimism moving forward:New market interest COVID less impactful than anticipate

16、d Approaching rate adequacy Poll Key=TWATXLabel=Pricing UncertaintyClaims Severity The Factors InvolvedFactor Potential ResultJury demographicsLongstanding defense strategies may no longer be effectiveCore inflationElevated CPI leads to increased medical inflationLife care plansEver-increasing valua

17、tions lead to higher payoutsHospital financialsCould reduce resources allocated to risk management/patient safetyReptile theoryContinued use by plaintiff attorneys can manipulate jury decisionsThird-party fundingPlaintiff attorneys may be emboldened to strategize for higher verdictsHow We Pick Trend

18、sIndemnity TrendALAE TrendEndEndBeginning2002120060.8%1.1%1.2%2.6%20070.6%0.9%1.1%2.7%20080.5%0.8%1.0%2.8%20090.0%0.5%0.8%2.9%20100.0%0.6%1.0%3.4%20110.0%0.8%1.1%4.0%20120.7%1.5%1.7%5.1%20132.6%3.1%3.1%6.9%20144.1%4.3%3.9%8.5%20154.9%4.8%4.1%10.1%20163.1%3.8%3.2%11.5%20179.1%6.3%4.1%15.6%

19、Other Considerations Current economic inflation environment Recent large verdicts Years included in selectionData Sources Client ground-up data Client actuarial report Industry data limitationsDifficulties Jurisdictional differences Differences by specialty Varying limits by specialtyRate ChangeRate

20、 change is becoming harder to quantify in the current market Changes in the use of Debits/Credits to achieve overall rate change goalChanging structures by accounts makes the rate change calculation more difficultAs-If analysis for exposures that are no longer written.What is the impact on rate chan

21、ge?Consolidation of insureds and the calculation of rate change for the combined entityDo We Need a Wider Range of ILFs?Currently most companies have multiple tiersDifferences in underlying trends by jurisdiction and facility typeActuarial considerations of credibility and homogeneity would come into play when considering additional ILF tiersLack of industry data sources would limit ability to implement additional ILF tiersWhile changes to ILF tiers may be challenging,it could provide an improvement in overall pricing

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医疗事故行业动态.pdf

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