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Note 15 and 16 - Insurance and Reinsurance
12 Months Ended
Dec. 31, 2011
Financial Services, Insurance  
Insurance Disclosure [Text Block]

15.  Insurance Reserves

 

The Company maintains loss reserves to cover its estimated liability for unpaid losses and loss adjustment expenses, including legal and other fees and a portion of the Company's general expenses, for reported and unreported claims incurred as of the end of each accounting period. These loss reserves are based on actuarial assumptions and are maintained at levels that are in accordance with U.S. GAAP. Many factors could affect these reserves, including economic and social conditions, inflation, healthcare costs, changes in doctrines of legal liability and damage awards in litigation. Therefore, the Company's reserves are necessarily based on estimates, assumptions and analysis of historical experience. The Company's results depend upon the variation between actual claims experience and the assumptions used in determining reserves and pricing products. Reserve assumptions and estimates require significant judgment and, therefore are inherently uncertain. The Company cannot determine with precision the ultimate amounts that will be paid for actual claims or the timing of those payments.

 

Reserves are based on approved actuarial methods, but necessarily include assumptions about expenses, mortality, morbidity, lapse rates and future yield on related investments.

 

All of the Company's short-duration contracts are generated from its accident and health business, and are accounted for based on actuarial estimates of the amount of loss inherent in that period's claims, including losses incurred for which claims have not been reported. Short-duration contract loss estimates rely on actuarial observations of ultimate loss experience for similar historical events.

 

 

 

 

Year Ended

 

 

 

December 31,

 

 

 

2011

 

2010

 

 

 

(In thousands)

 

 

 

 

 

 

Balance at a beginning of period

 

$

22,009 

$

26,109 

Less: reinsurance recoverables

 

 

(2,811)

 

(2,805)

Net balance at beginning of period

 

 

19,198 

 

23,304 

Amount incurred:

 

 

 

 

 

 

Current year

 

 

49,018 

 

51,035 

 

Prior years

 

 

(1,250)

 

(809)

 

 

Total

 

 

47,768 

 

50,226 

Amount paid, related to:

 

 

 

 

 

 

 

Current year

 

 

32,530 

 

33,944 

 

 

Prior years

 

 

16,121 

 

20,388 

 

 

Total

 

 

48,651 

 

54,332 

Net balance at end of period

 

 

18,315 

 

19,198 

 

 

 

 

 

 

Plus: reinsurance recoverables

 

 

2,715 

 

2,811 

Balance at end of period

 

$

21,030 

22,009 

 

The preceding schedule reflects (i) due and unpaid claims, (ii) claims in the course of settlement, (iii) estimated incurred but not reported reserves and (iv) the present value of amounts not yet due on claims. The incurred and paid data above reflects all activity for the year.  The amount incurred in 2011 for prior years of $(1,250,000) is a result of a redundancy of $788,000 of fully insured health reserves, $225,000 of DBL reserves and $237,000 of medical stop-loss reserves.  The amount incurred in 2010 for prior years of $(809,000) is a result of a redundancy of $1,355,000 of fully insured health reserves and of $340,000 of DBL reserves, offset by the re-estimation of unpaid losses on medical stop-loss reserves of $886,000.  Fluctuations are generally the result of on-going analysis of recent loss development trends.

 

Medical stop-loss business is excess coverage with a short duration.  Predicting ultimate claims and estimating reserves in medical stop-loss is especially complicated due to the “excess of loss” nature of these products with very high deductibles applying to specific claims on any individual claimant and in the aggregate for a given group.  Fluctuations in results for specific coverage are primarily due to the severity and frequency of individual claims.  Due to the short-term nature of medical stop-loss, redundancies and deficiencies will typically emerge during the following year rather than over a number of years.