风险管理和保险导论 英文版第6版PDF电子书下载

Chapter 1 FUNDAMENTALS AND TERMINOLOGY 1

Chapter Objectives 1

Introduction 2

Insurance Defined　 2

Financial Definition 3

Legal Definition 4

Loss，Chance of Loss，Peril，Hazard，and Proximate Cause 5

Loss 5Chance of Loss 5

Proximate Cause 6

Peril and Hazard 6

Risk 7

Risk Management 9

The Mathematical Basis for Insurance 9

Four Basic Components 10

Building Blocks of an Insurance Premium 10

A Mathematical Example of an Insurance System's Operations 10

Cash Flow Underwriting 11

ContentsPrefce 13

Benefits 13

Costs 13

The Benefits and Costs to Society of Insurance Systems 13

Arson：Who Really Pays for Insured Losses 14

Summary 16

Review 17

Review Terms 17

Suggestions for Further Study 18

Research Assignment 18

Discussion Questions 18

Chapter Objectives 21

Chapter 2 INSURABLE LOSS EXPOSURES 21

Gambling and Speculative Risks 22

Introduction 22

A Large Group of Similar Units Exposed to the Same Peril（s） 23

Ideally Insurable Loss Exposures 23

Losses Must be Accidental and Beyond the Insured's Control 24

Catastrophic Losses 25

Losses Must be Definite，Measurable，and of Sufficient Severity to Cause Economic Hardship 25

When Only the People Most Exposed to Loss Want Coverage，Insurance Becomes Unfeasible 29

Subsidization 31

Risk Classification 31

Adverse Selection 32

Principles of Risk Classification 33

AIDS （Acquired Immune Deficiency Syndrome） 34

Important Social Issues 34

Automobile Insurance 36

Pension Benefits 37

Branches of Insurance 38

Conclusion 38

Review Terms 40

Summary 40

Discussion Questions 41

Review 41

Suggestions for Further Study 42

Research Assignment 42

Chapter Objectives 43

Chapter 3 RISK MANAGEMENT 1：ESSENTIALS 43

The Risk Management Function 44

Introduction 44

Statement of Objectives and Principles 45

Risk Management Staff 45

Step One：Identification and Measurement of Exposures 47

The Risk Management Process 47

Direct Property Losses 48

Liability Losses 50

Loss of Income 50

Loss of Key Personnel 51

Emergency Planning—Disastor Recovery 52

Estimation of Maximum Loss 52

Step Two：Loss Control and Risk Financing53Loss Control 53

Risk Financing 55

Step Three：Regular Review of the Risk Management Program 61

Summary 63

Chicago Tunnel Collapse：A Risk Management Problem 63

Review Terms 65

Research Assignment：Case Study 66

Review 66

Appendix：Personal Risk Management 67

Suggestions for Further Study 67

Chapter Objectives 71

Chapter 4 RISK MANAGEMENT 2：ADVANCED TOPICS 71

Loss Data 72

Risk Management Information Systems（RMIS） 72

Introduction 72

Other Information 74

Deductibles and Policy Limits 75

Financial and Other Considerations 76

British Petroleum：A Case Study 78

International Risk Management 79

Identification and Measurement of Exposures 80

Regular Review and Evaluation 81

Development and Implementation of Plans 81

Foreign Insurance 82

Financial Risk Management 87

Summary 89

Review 90

Review Terms 90

Suggestions for Further Study 91

Research Assignment 91

Discussion Questions 91

The Story 92

Introduction 92

Case Study：Blue Star Airlines 92

The Risk Management Process 93

Facts and Assumptions 94

Assignment 95

Chapter Obiectives 99

Chapter 5 PRIVATE INSURANCE COMPANIES 99

Two Different Types of Insurance Companies 100

Introduction 100

Mutual Insurance Companies 101

Demutualization 103

Stock Versus Mutual：A Consumer's Viewpoint 103

Stock Insurance Companies 103

Lloyd's of London Is an Insurance Market 104

Lloyd's of London 104

Lloyd's History 105

Lloyd's and the Risk Management Function 106

Typical Transaction 106

The Reciprocal Exchange 107

Other Legal Forms of Insurance Companies 107

American Lloyds 107

Blue Cross and Blue Shield 108

Savings Bank Life Insurance 108

Fraternal Insurers 108

Health Maintenance Organizations（HMOs）and Preferred Provider Organizations（PPOs） 110

Industrial Organization 112

Insurance Industry 113

Summary 114

Discussion Questions 115

Review 115

Review Terms 115

Introduction 116

Appendix：Insurance and Private Enterprise：The Potential for Eastern Europe 116

Research Assignment 116

Suggestions for Further Study 116

Why Private Insurance？ 117

Why Insurance？ 117

Competition and Efficiency 118

The Requirements of a Private Insurance System 119

Essential Requirements of a Free Enterprise（Capitalist）System 119

Difficulties Starting a Private Insurance System in Eastern Europe 120

The Future 122

Chapter Objectives 123

Chapter 6 INSURANCE OCCUPATIONS 123

Agency Law 124

Insurance Agents and Brokers 124

Introduction 124

Insurance Brokers 126

Property and Liability Insurance Agents and Brokers 128

Licensing Requirements 128

Life Insurance Agents and Brokers 129

An Insurance Agent's Duties 130

Loss Adjuster 131

Employees，Independent Adjustment Bureaus，and Public Adjusters 133

Adjusters Are Agents 134

Underwriter 135

Property Insurance Underwriting 137

Underwriting and Privacy 138

Life Insurance Underwriting 138

Actuary 139

Finance 140

Attorney 140

Summary 141

Other Occupations 141

Review 142

Review Terms 142

Suggestions for Further Study 143

Research Assignment 143

Discussion Questions 143

Case 1 144

Appendix：Legal Issues Involving Insurance Agents and Brokers 144

Introduction 145

Appendix：The Ethical Choice 145

Case 2 145

Vocabulary 146

Ethical Norms 147

Three Practice Cases 149

Suggestions for Further Study 152

Chapter Objectives 153

Chapter 7 THE INSURANCE MARKET：THE ECONOMIC PROBLEM 153

Supply and Demand 154

Economic Theory 154

Introduction 154

Historical Problems 157

The Insurance Consumer 158

The Consumer's Choice：Company，Agent or Broker，Policy，Amount，and Price 159

The Courts 164

Consumer Protection：The Role of the Courts，the Law，and the Insurance Commissioner 164

The Insurance Commissioner 165

The Law 165

Summary 166

Discussion Questions 167

Review 167

Review Terms 167

Elasticity of Supply and Demand for Insurance 168

Appendix：Further Consideration of Supply and Demand 168

Research Assignment 168

Suggestions for Further Study 168

Shifting Supply and Demand Curues 170

Chapter Objectives 171

Chapter 8 INSURANCE REGULATION 171

Insurance Regulation 172

Introduction 172

Solvency 173

The Reasons for Insurance Regulation 173

Prices 174

Unequal Knowledge and Bargaining Power 174

The History of Insurance Regulation 175

Promotion of Social Goals 175

South-Eastern Underwriters Association（SEUA） 176

Armstrong and Merritt Investigations 176

Paulv．Virginia 176

State or Federal Regulation？ 177

The McCarran Act 177

The National Association of Insurance Commissioners （NAIC） 178

State Insurance Regulation 178

Repeal of P．L．-15 179

Both Sides of the Argument 180

Legal Reserves and Surplus 182

Regulated Activities 182

Regular Audits and Solvency Testing 185

Rate Regulations 187

Guaranty Funds 187

Investment Activities 188

Qualifications or Licenses for Companies，Agents，Brokers，Loss Adjusters，and Company Officers 189

Policy Form Approval and Expense Limitations 189

Consumer Complaints 190

Summary 191

Taxation 191

Review 192

Review Terms 192

Suggestions for Further Study 193

Research Assignment 193

Discussion Questions 193

Appendix：The McCarran Act（P．L．-15） 194

Chapter Objectives 197

Chapter 9 INSURANCE CONTRACTS 197

Contract Terminology 198

Introduction 198

Conditional Receipt 199

Binder 199

Consideration 200

Offer and Acceptance 200

Elements of a Valid Contract 200

Distinguishing Characteristics of Insurance Contracts 201

Legal Purpose 201

Capacity 201

Principle of Indemnity 202

Insurable Interest 203

Actual Cash Value 204

Subrogation 205

Contract of Adhesion 207

The Personal Feature 209

Utmost Good Faith（Latin：Uberrimae Fidei） 210

The Aleatory Feature 213

The Entire Contract andIncontestability Clauses 213

Discharge of Insurance Contracts 214

Summary 215

Review 216

Review Terms 216

Material Misrepresentation 217

Appendix：Cases for Discussion 217

Research Assignment 217

Suggestions for Further Study 217

Contract of Adhesion：The Metpath Case 218

Breach of Warranty：General Chicken Case 219

Chapter Objectives 221

Chapter 10 BASIC PROPERTY AND LIABILITY INSURANCE CONTRACTS 221

Introduction 222

Standard Policies 223

Insuring Agreement 224

Declarations 224

Basic Parts of an Insurance Policy 224

Deductibles 225

Exclusions 226

Definitions 226

Fraud 227

Conditions 227

Endorsements 227

Cancellation 229

Suspension of Coverage 229

Duties After a Loss 230

Other Insurance 230

Salvage 232

Appraisal 232

Summary 233

Conclusion 233

Claims Payment 233

Review 234

Review Terms 234

Suggestions for Further Study 235

Research Assignment 235

Case for Discussion：Vacancy Clause 235

Chapter Objectives 237

Chapter 11 HOMEOWNERS INSURANCE 237

Introduction 238

Policy Layout 239

A General Description of the HO Insurance Policies 239

Declarations 240

Definitions 242

Section 1—Property Coverages 243

Additional Coverage 245

Section 1—Perils Insured Against in the Broad Form，HO-2 246

Specified Perils 247

HO-2：Section 1—Exclusions 249

Other Exclusions 250

Ordinance-or-Law Exclusion 250

Replacement Cost and Coinsurance 251

Loss Settlement 251

Section 1—Conditions 251

Reasons for the Coinsurance Requirement 253

Mortgage Clause 254

Section 2—Liability Coverages 255

Section 2—Exclusions 256

Claims Not Covered Arising from Bodily Injury or Property Damage 256

Sections 1 and 2—Conditions 258

Summary 259

Reduction of Insurance Resulting from Previous Losses 259

Endorsements 259

Review 261

Review Terms 261

Practice Questions 262

Research Assignment 263

Appendix：Buying Homeowners Insurance 264

Suggestions for Further Study 264

Chapter Objectives 267

Chapter 12 THE PERSONAL AUTO POLICY 267

The Tort Liability System and Automobile Insurance：A Review Case 268

Introduction 268

The Personal Auto Policy Layout 269

Definitions 270

Part A—Liability 271

Limit of Liability 272

Exclusions 273

Insureds 273

Part B—Medical Payments 274

Coverage under the PAP 275

Part C—Uninsured Motorist Coverage 275

Contact or No-Contact Rules 276

Part D—Damage to Your Auto 277

Underinsured Motorists 277

The State's Response to Uninsured Motorists 277

Loss Settlement 278

Part E—Duties After an Acddent or Loss 279

Summary 280

Part F—General Provisions 280

Review 281

Review Terms 281

Practice Questions 282

Suggestions for Further Study 283

Research Assignment 283

Chapter Objectives 285

Chapter 13 COMMERCIAL PROPERTY INSURANCE 285

Property and Marine（Transportation）Insurance 286

Commercial and Personal Property Insurance 286

Introduction 286

Commercial Insurance 286

Commercial Package Policy 287

Property Covered 288

Building and Personal Property Form 288

The Insurance Services Office（ISO） 288

Perils Covered 289

Property Excluded from Coverage 289

Definition of Fire 290

Fire Insurance History 290

Reporting Forms 291

Business Income Coverage 292

Property Insurance Rating 293

Additional Forms 293

Ocean Marine Insurance 295

Transportation Insurance 295

Inland Marine Insurance 297

Aviation Insurance 301

Business Automobile Insurance 302

Automobile Property Insurance 302

Review Terms 304

Summary 304

Review 305

Suggestions for Further Study 306

Research Assignments 306

Discussion Questions 306

Chapter Objectives 307

Chapter 14 GENERAL LIABILITY INSURANCE 307

Legal Background 308

Introduction 308

Categories of Torts（Civil Wrongs） 309

Establishing Negligence and Damages 310

Negligence Lawsuits 310

Defenses in a Negligence Suit 314

Legal Judgements 315

Questions of Fact 315

The Relationship Between Negligence and Legal Liability Insurance 315

Ethics and Liability Insurance 316

The Facts 317

Social Host Liquor Liability：An Example 317

Business General Liabilihy Insurance 318

Categories of Liability Insurance 318

Business Liability Umbrella Policies 321

Automobile Liability Insurance 322

Review Terms 326

Summary 326

Review 327

Suggestions for Further Study 328

Research Assignment 328

Discussion Questions 328

Case for Discussion 328

Chapter Objectives 331

Chapter 15 SPECIAL LIABILITY INSURANCE 331

Claims-Made Policies 332

Claims-Made and Occurrence Policies 332

Introduction 332

Occurrence-Basis Policies 333

Environmental Impairment Liabilitv 334

Insurance History 335

Products Liability Insurance 337

Insurance Principles and EIL Coverage 337

Risk Management Strategy 337

The Continuing Controversy 339

Risk Management Strategy 339

What Is a Professional？ 340

Professional Liability Insurance 340

Types of Professional Liability Coverage 341

Claims Settlement 341

Coverage Clause 341

Employment Practices Liability 343

Nuclear Liability Insurance 345

Americans with Disabilities Act（ADA） 345

Summary 348

Review 349

Review Terms 349

Suggestions for Further Study 350

Research Assignments 350

Discussion Questions 350

Case Study：Sexual Harassment 352

Appendix 352

Case Study：Americans with Disabilities Act（ADA） 353

Chapter Objectives 355

Chapter 16 BONDING，CRIME INSURANCE，AND REINSURANCE 355

The Reasons for Surety Bonding 356

Introductory Terminology 356

Introduction 356

Surety Bonding 356

The Difference Between Suretyship and Insurance 357

Underwriting Bonds 358

Types of Bonds 359

Crime Insurance 360

Reinsurance Arrangements 361

Introductory Terminology 361

Reinsurance 361

Reinsurance Coverage 362

Reasons for Reinsurance 364

Providers of Reinsurance 365

Reinsurance and Risk Management 365

Summary 366

Concluding Comments 366

Discussion Questions 367

Review 367

Review Terms 367

Suggestions for Further Study 368

Research Assignment 368

Chapter Objectives 369

Chapter 17 LIFE INSURANCE POLICIES 369

Three Ways Life Insurance Is Distributed 370

Introduction 370

Group Life Insurance 371

Individual Life Insurance 372

Industrial Life Insurance 372

Types of Term Life Insurance 374

Term Insurance 374

Uses of Term Life Insurance 377

Cash Values 378

Whole Life Insurance 378

Types of Whole Life Policies 379

A Whole Life Ledger Sheet 381

Reasons for Saving with Life Insurance 381

The Uses of Whole Life Insurance 381

Buy Term and Invest the Difference：The Consumer's Viewpoint 382

Universal Life Insurance Policies 384

Universal Life Insurance 384

Universal Life Insurance Death Benefits 385

Ledger Sheet for Universal Life Insurance 386

Uses of Universal Life Insurance 386

Variable Life Insurance 387

Summary 388

Review 389

Review Terms 389

Research Assignment 390

Discussion Questions 390

Endowment Life Insurance 391

Appendix 391

Suggestions for Further Study 391

Chapter Objectives 393

Chapter 18 ANNUITIES 393

Definitions 394

Introduction 394

Beginning of Benefits 396

Method of Premium Payment 396

Classification of Annuities 396

Promises Purchased 398

Determination of Annuity Benefits 400

Number of Annuitants 400

Types of Benefits 401

Uses of Annuities 401

Taxation of Annuities 402

Withdrawals in Liquidation 403

Withdrawal before Liquidation 403

Review Terms 404

Summary 404

Research Assignment 405

Discussion Questions 405

Review 405

Suggestions for Further Study 406

Chapter Objectives 407

Chapter 19 LIFE INSURANCE PLANNING 407

The Economic Value of the Human Life 408

Introduction 408

The Needs-Based Purchase of Life Insurance 409

Planning Process 410

Life Insurance Planning 410

The Early Adult Years 411

Life Insurance Planning：A Case Study 412

Insurance for Wives，Children，and College Students 413

Life Insurance Planning：The Middle Years 417

Federal Estate Tax 418

Wills 418

Life Insurance Planning：The Later Years 418

Business Uses of Life Insurance 420

Funding Business Continuation Agreements with Life Insurance 421

Death Proceeds 422

The Taxation of Life Insurance 422

Summary 423

Living Benefits：Dividends，Savings，and Accelerated Death Benefits 423

Review 424

Review Terms 424

Research Assignment 425

Discussion Questions 425

Suggestions for Further Study 426

Facts and Data 426

Chapter Objectives 429

Chapter 20 STANDARD LIFE INSURANCE CONTRACT PROVISIONSAND OPTIONS 429

Beneficiary Designation 430

Insured，Owner，and Beneficiary 430

Introduction 430

General Life Insurance Policy Provisions 431

Grace Period 432

The Incontestable Clause 433

The Reinstatement Provision 433

Annual Apportionment of Divisible Surplus 434

The Misstatement-of-Age Provision 434

The Entire-Contract Provision 434

The Suicide Clause and Other Restrictive Clauses 436

Nonforfeiture Options 437

Dividend Options 437

Four Options Providing the Insured with Choices 437

Policyholder Loans 438

Settlement Options 439

Available Riders and Options 440

The Double-Indemnity Option 441

The Waiver-of-Premium Option 441

The Guaranteed-Insurability Option 441

Summary 442

Review 443

Review Terms 443

Discussion Questions 444

Suggestions for Further Study 445

Research Assignment 445

Chapter Objectives 447

Chapter 21 SIMPLIFIED LIFE INSURANCE MATHEMATICS 447

The 1980 CSO 448

Mortality Tables 448

Introduction 448

Some Simplifying Assumptions 453

Interpretation of Mortality Tables 453

Other Mortality Tables 453

Single-Premium，Five-Year Term Insurance 454

Single-Premium，One-Year Term Insurance 454

Single-Premium，Whole Life Insurance 459

Leveling the Whole Life Premium 463

A Complex Issue 465

The Cost of Life Insurance and Sales Illustrations 465

Interest-Adjusted Method 466

Traditional Calculation 466

The Sales Illustration Controversy 467

Review 468

Review Terms 468

Summary 468

Suggestions for Further Study 469

Research Assignment 469

Chapter Objectives 471

Chapter 22 MEDICAL EXPENSE AND DISABILITY INSURANCE 471

Introduction 472

Increasing Health Care Costs 473

Background Information 473

Medical Inflation 474

Cost Containment 475

Entire Contract 476

Common Contract Provisions 476

Legal Action 477

Physical Exam and Autopsy 477

Grace Period 477

Reinstatement 477

Incontestable Clause 477

Claims 477

Definitions and Exclusions 478

Optional Contract Provisions 478

Change of Beneficiary 478

Basic Medical Expense Insurance 479

Five Kinds of Health Insurance Coverage 479

Major Medical Insurance 480

Disability Income Insurance 481

Medicare Supplement Insurance 483

The Financial Problem 484

Demographics 484

Long-Term Care Insurance 484

Long-Term Care Policy Development 485

The Continuing Debate 486

Health Insurance Providers 487

Review Terms 489

Summary 489

Discussion Questions 490

Review 490

Suggestions for Further Study 491

Research Assignment 491

Chapter Objectives 493

Chapter 23 EMPLOYEE BENEFITS 493

Introduction 494

The Government 495

The Goals of the Government，Employer，and Employee 495

The Employee 497

The Employer 497

General Features 498

Qualification Rules 498

Insured Employee Benefits 498

Group Life Insurance 499

Long-Term Disability 501

Group Disability Income Insurance 501

Social Problems 502

Group Health Insurance 502

Health Insurance Contracts 503

Health Insurance Providers 503

General Provisions of Group Health Insurance Contracts 505

Two Federal Regulations 506

Introduction 507

Insured Pension Plans 507

Federal Regulation of Pension Plans 508

Requirements for Qualified Plans 508

The Role of Insurance in Pension Plans 509

Keogh Plans 511

403（b）Plans or Tax-Deferred Annuities （TDAs） 511

Profit-Sharing，401（k），403（b），Keogh，and Cafeteria Plans 511

Profit-Sharing Plans 511

401（K） Plans 511

Cafeteria Plans 512

Individual Retirement Account（IRA） 512

Eligibility for Deductible Contributions 512

Investment Alternative 513

Rollovers 513

Taxation 514

Summary 514

Review Terms 515

Review 515

Discussion Questions 516

Research Assignment 516

Suggestions for Further Study 516

Appendix：Tax Deferral 517

The Advantages of Tax Deferral 519

Chapter 24 SOCIAL SECURITY 521

Chapter Objectives 521

In troduction 522

Social Insurance Background 522

The History and Philosophy of the American Social Security System 524

Social Security Is Not a Public Assistance Program 524

Social Security and Private Insurance Are Different 525

Social Security Is an Insurance System 525

The Program Is Compulsory for Almost Every Worker 526

A Tax on Wages Is the Main Source of Funds 526

The Operation of the Social Security Program 526

Insured Status and Eligibility for Benefits 527

Quarters of Coverage 527

Benefits Are Not Fully Funded 527

Calculation of Benefits 528

Categories of Benefits 528

Retirement Benefits 529

Survivor Benefits 530

Disability Benefits 531

Medicare（Health Insurance for the Aged and Disabled） 533

Some Current Issues Facing the Social Security System 535

Will Social Security“Be There”for Young and Middle-Aged Americans？ 535

The Social Security Surplus and the Federal Deficit 536

Other Criticism 536

Summary 537

Review Terms 537

Review 538

Research Assignment 539

Suggestions for Further Study 539

Discussion Questions 539

Chapter 25 UNEMPLOYMENT AND WORKERS'COMPENSATION INSURANCE 541

Chapter Objectives 541

Introduction 542

Unemployment Insurance 542

Some Backround Information 543

Operations of the Unemployment Insurance Program 544

Is Unemployment Insurance Really Insurance？ 545

General Provisions of State Programs 546

Summary—Unemployment Insurance 546

Workers'Compensation 547

The Problem 547

The Solution 548

The Purposes of Workers'Compensation Laws 550

Operations of Workers'Compensation Systems 551

Current Concerns About Workers'Compensation 552

Summary—Worker's Compensation 554

Review Terms 555

Review 555

Research Assignment 556

Suggestions for Further Study 556

Discussion Questions 556

Glossary 557

Appendix A：Homeowner's Insu rance Policy 569

Appendix B：Personal Auto Policy 587

Appendix C：Sample Whole Life Insurance Policy and Application 599

Index 615