Riassunto esame Insurance, Prof. Capizzi Vincenzo, libro consigliato Insurance, Mario Valletta

Rischi e contratto di assicurazione

1 Parleremo di rischi, ma, rispetto a risk management, in una prospettiva diversa perché, anziché occuparci dei rischi speculativi e della gestione interna ad un intermediario finanziario, parliamo di rischi puri, cioè quelli che non possono comportare come esito un arricchimento del soggetto che ne è esposto e che devono, quindi, essere gestiti con un approccio metodologico diverso da quello utilizzato dalle banche nell’ambito della loro attività di impresa.

[Esame: scritto, 6 domande, 1 ora + esercizi].

We introduce some basic concepts in order to explain the working of the insurance mechanisms…

Definizione del contratto di assicurazione

First of all, we can refer to the definition of the insurance contract and we have to understand what parties are involved in an insurance company.

It’s important to have a clear idea of what an insurance contract is because insurance is a regulated activity in the sense that it can be carried out only through the signing of specific/typical contracts (differently from banking contracts).

Of course, these contracts are regulated in different ways by different countries but, at the EU level, we have a common discipline of the insurance business.

Now, we refer to a specific article of the Italian Civil Code, art. 1882, according to which “insurance is”… 1 But the payment of this amount of money (from the insurer) is [punto 1]… “policyholder”… conditional on the occurrence of a certain event, which is the insured event…

… So, according to this article, this payment may consist of “an indemnity” … [punto 1 del punto 1]… “event”… And this is the case of non-life insurance.

For instance, I can subscribe an insurance company, I will receive an indemnity in case my house is damaged by fire: therefore, in this example, I act as the policyholder and as the beneficiary of the contract at the same time.

The insurance object is my house and the insured event is the fire (not the fire with whichever characteristic, but the fire with the characteristics that are carefully described in the contract).

So, I’m the policyholder [contraente], I have to pay an amount of money to the insurer (the premium) but the premium is paid in advance.

And I will receive a payment in the future by the insurer only if my house is actually damaged by fire and the amount of money I will receive is limited by 2 conditions:

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• First of all, this amount of money depends on the value I have assured (therefore, if I decide that the maximum coverage of this insurance contract is 100.000, I will have to make a payment which will be linked to this amount and I will receive 100.000 at maximum); and
• In any case, the payment on the part of the insurer will only take place if a fire has actually damaged my house. And, in any case, I will not receive an amount of money which is greater than the damage I have actually suffered.

So, the 2 limits for the payment on the part of the insurer are the maximum amount which will be insured and the actual value of the damage.

So, the principle of indemnity is very important in non-life insurance because insurance can’t be used as a vehicle to achieve an undue enrichment: we may not consider insurance as a mean to achieve a net benefit/profit because, with non-life insurance, we just receive the coverage of the damage that we suffered.

The other part of the insurance contract can be a life insurance contract.

In this case, the insurer, in exchange of the payment of a certain premium, obliges himself to pay to beneficiary “an income or”… [punto 2 del punto 1]… “life insurance”… In this case, what is paid by the insurer, once the life-related event occurs, is an amount of money which has ? [33.20] to do with the value of the human life.

So, the amount that is paid by the insurer in this type of contracts is not an indemnity, but it’s a flat payment (!) which only depends on the size of the premium that has been paid by the policyholder.

The possible life-related events are just 2:

• Death; or
• Survival.

So, “insurance is an aleatory contract”… because the payment of the premium on the part of the policyholder is certain (it always occurs), but, on the other end, it’s not sure that the insurer

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will have to make a payment because the obligation of the insurer materializes only if the insured event occurs… …[punto 2]… And, taking into account that the insured event is a future event that is not certain, this aleatory contract is “synallagmatic” because, in any case, we have a balance between the obligation which is accepted by the insurer and the one paid by the policyholder and, therefore, if I pay a premium to be covered against a certain risk, at the time I’m paying the premium, I’m immediately getting something from the insurer, that is I’m obtaining and enjoying a guarantee, regardless (!) of the actual occurrence of the insured event.

Quando io stipulo in veste di contraente un contratto con un’impresa di assicurazioni, è vero che io, nel momento in cui firmo il contratto, devo pagare il premio (perché, altrimenti, il contratto non avrebbe alcuna efficacia), ma, dall’altra parte, invece, l’assicuratore dovrà erogare una somma di denaro soltanto se l’evento assicurato si realizzerà.

Ma, quand’anche l’evento assicurato non dovesse realizzarsi, io contraente ho già ottenuto qualcosa pagando il premio: la garanzia (!) del fatto che, qualora dovesse verificarsi l’evento assicurato, io sarò indennizzato (!).

Parti coinvolte nel contratto di assicurazione

So, who are the parties involved in the insurance contract?...

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We underlined the fact that an insurance company is an undertaking [Insurer]… “of premiums”… which has been authorized in carrying out insurance activity with regards to well-defined risks.

If the insurance company wants to offer both third party liabilities coverage and fire coverage, it has to be authorized for each (!) of these classes of risk.

Non è che una compagnia di assicurazione è un’impresa che è stata genericamente autorizzata dall’autorità di competenza a svolgere attività assicurativa. No, l’autorizzazione è relativa a specifici (!) rami.

And there is one limitation as regards the activity that can be carried out by the European insurance company, that is to say that nowadays EU-established insurance companies can’t (!) be authorized to perform both life and non-life insurance.

But we know that there are certain important Italian companies that actually do that. This is true but that’s simply because they have been authorized before the new EU law came into force.

There is only one exception to this rule of separation which has to do with insurance products which cover from the damages of sickness, that is to say life insurance companies are allowed to offer insurance products for sickness.

An example of an Italian insurer which is mutual is Reale [Insurer]… “(by shareholders)”… Assicurazioni. Quindi, “mutual” vuol dire che coloro che sono gli azionisti della società sono al tempo stesso sottoscrittori delle polizze.

An example of an insurer which is proprietary is Generali.

Then, the counterparty of the insurer is the policyholder.

It is the “person”… [Policyholder]… “from the contract”… For instance, it is the policyholder who is entitled to designate the beneficiary of the amount that will be eventually paid by the insurer.

And it is the policyholder who has the right to decide whether to “redeem” the policy or not (che è il diritto di chiedere il riscatto della polizza).

The beneficiary is… in case the insured event materializes. [Beneficiary]… “insurance benefits”…

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Then, the insured is: therefore, in life insurance, he is the… [Insured]… “ “insurable interest” ”… person to whom the insured life-related event is referred.

In the case of non-life insurance, we are not free to insure against whatever event because the law states that an “insurable interest” should exist before an insurance contract is designed.

So, the insured is the person who holds the “insurable interest”/who has a legitimate interest as regards the occurrence of the event.

In life insurance, instead, the insured is the… slide.

So, in principle, we find these 4 actors.

Even if one person sometimes could be play more than 1 role in the contract. For instance… [no ultimo punto] Cioè, se stipulo un’assicurazione in caso morte sulla mia vita, [punto 1]… “be the beneficiary”… siccome l’assicuratore è tenuto ad effettuare una certa prestazione se io muoio, non posso aver la pretesa ovviamente di essere al tempo stesso anche il beneficiario della polizza.

Restando in tema di assicurazione vita, Emanuele potrebbe stipulare una polizza vita in base alla quale lui riceve del capitale se io (!) sarò in vita il 23 febbraio del 2032. Lui può farlo senza dirmi niente (!).

Però, Emanuele ha stipulato una polizza caso morte in cui l’assicurato sono io.

Allora, Emanuele non può stipulare una polizza in base alla quale l’assicuratore gli paga la prestazione se io muoio nell’arco dei prossimi 10 anni: può farlo soltanto se c’è il mio consenso scritto (!).

Tipologie di rischi coperti dagli assicuratori

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Which kind of risks are covered by insurers?

First of all, as already said, we remind that the object of the insurance is represented typically by pure risks (as opposed to speculative), that is to say risks which exposes a person or an organization to a potential loss but not to a potential benefit (that is to say, the outcome of the risk event can only be negative). So, pure risks can be...

in which case the damage consists in the For [Personal risks]… “loss of income”… slide… “earn income”… instance, as far as insurance products which cover accidences are concerned, the indemnity is meant to override [56.15] a partial compensation for the ? capital that is lost because of the temporary inability to work.

Quindi, le assicurazioni infortuni e (anche) malattia non hanno come oggetto tipico il rimborso delle spese dei medicinali, ma è quello di offrire una copertura (perlomeno parziale) per una perdita di reddito conseguente al fatto che una persona (almeno temporaneamente) è impossibilitata a svolgere la sua attività.

Questi sono i rischi di responsabilità civile… [Liability risks]… “of others”…

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… E, quindi, quanto, per effetto di un danno provocato ad altri, sei tenuto a risarcire.

Per esempio, nell’RC auto, infatti, se io ho provocato un danno e arrecato a qualcun altro, io sarei tenuto a risarcirlo, ma, invece, interviene l’impresa di assicurazioni che effettua il risarcimento al posto del suo assicurato.

TPL = Third Party Liabilities. Quindi, responsabilità civile verso terzi.

Per esempio, l’assicurazione contro il rischio di credito. [Risks arising from failure of others]… “as agreed”…

In this case, we have fire insurance, theft insurance, etc… [Property risks]… “loss)”…

… Now, we find this distinction between direct and indirect losses.

Just imagine a company whose machineries and equipment are destroyed or damaged by fire.

What about the direct loss? The direct loss is the market value of those machineries and equipment which has been damaged.

The indirect loss is linked to the fact that probably, for a certain number of days, the production has to be stopped: therefore, will lose income and the turnover of the firm will decrease or collapse. Moreover, at the same time, the firm must pay fixed costs (electricity, for instance).

Insurance companies provide the coverage against indirect loss too. And this coverage is often included in a specific insurance policy which is the policy against fire risks.

Disciplina europea e autorizzazioni

Let’s focus on insurers.

If we consider the EU discipline, … [del punto 2, solo i punti numerati]

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So, again, each kind of insurer’s businesses referring [punto (b) del punto 2. del punto 2]… “authorised”… to different type of risks have to be specifically authorized.

And the competent authority is the authority of the home country of the insurance undertaking [impresa di assicurazione].

In all the directives of the EU Department that have to do with insurance we always have a dual reference: they always quote insurance and re-insurance [riassicurazione].

Quest’ultima è l’attività assicurativa rivolta ad imprese di assicurazione (!)…

Coinsurance e riassicurazione

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… In the upper part of the slide, we have a representation of what coinsurance is: it consists in “a contract”… slide… “it has insured”… For instance, let’s imagine that Juventus Football Club wants to subscribe policy insurance against accidence occurring to Belotti: …

… it would be hard to find a single insurance company that is willing to take this risk (also because this is a very strange case of insurance because, as we will see, the functioning of the insurance mechanism is based on the capability of the insurer to create a pool of insured who are exposed to the same risk and, therefore, it’s hard to find a pool of players with the same qualities of Belotti).

So, it’s difficult that Juventus can find a single insurance company that is willing to provide this kind of coverage: therefore, what happens is that more (!) insurance companies insure this risk and each of them takes a part of the risk and consequently encash a part of the premium.

The relationship between the insured and each of the insurers is classified as direct business (“lavoro diretto”, in italiano. Si trova l’espressione “premi da lavoro diretto”).

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Cioè, si sta facendo riferimento ad un rapporto contrattuale di assicurazione che è stato stipulato dalla compagnia con un suo cliente che non (!) è, a sua volta, un’impresa di assicurazioni.

Il lavoro indiretto consiste, invece, nell’attività assicurativa che una compagnia svolge avendo come controparte un’altra impresa di assicurazione. E questo avviene nel caso della riassicurazione.

So, let’s imagine that a company has insured a certain risk: therefore, the insurer has provided coverage against a certain risk to the insured. This is (again) direct business.

Then, imagine that, for some reasons, the insurer believes that it would be better to transfer (at least, a part of) this risk to another insurer: therefore, what happens is that the insurer insures itself against (part of) the risk taken by transferring this risk to a so-called reinsurer.

The relationship between the insurer and the reinsurer is classified as indirect business.

Si dice anche che la riassicurazione è l’assicurazione degli assicuratori.

In this case, the insured doesn’t meant to be informed about the re-insurance transfer. Cioè, l’assicurato non è affatto tenuto a sapere che poi il suo assicuratore ha trasferito ad un’altra compagnia una parte del rischio.

Anche perché, se si verifica l’evento assicurato, l’assicurato si rivolge all’assicuratore con cui ha stipulato il contratto.

E quest’ultimo non può dirgli che lui ha fatto il trasferimento del rischio, ma deve pagare l’assicurato. Solo in un secondo momento (!), infatti, l’assicuratore si rivarrà nei confronti del riassicuratore.

Quindi, l’assicuratore ha un rischio di credito (!) nei confronti del riassicuratore.

Ne parleremo, comunque, meglio in seguito.

L’unica cosa da notare era che le normative europee in ambito assicurativo molto spesso trattano congiuntamente il caso della assicurazione e della riassicurazione.

Mutual recognition ed EU passport

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So, this paragraph simply states the principle of mutual recognition, which is applying to EU banks and EU investment companies and to insurance companies too.

That is to say, an Italian undertaking [impresa (di assicurazione)] has been authorized by IVASS to pursue insurance [ad esercitare l'assicurazione] in the class of accidence and sickness (infortuni e malattie)…

… In force of this authorization given by IVASS, that Italian undertaking is implicitly authorized to carry out the same business in whichever (!) State that is member of the EU.

So, mutual recognition. Or EU passport.

(IVASS è l’Istituto per la Vigilanza sulle Assicurazioni, che è l’organo di vigilanza delle imprese di assicurazione in Italia e che ha sostituito l’ISVAP.

Quest’ultima era la precedente autorità di vigilanza per il settore assicurativo ed è stata commissariata affidando l’ISVAP (cambiando il nome in IVASS) alla Banca d’Italia. Perciò, il presidente dell’IVASS è il direttore generale della Banca d’Italia.)

Impresa assicurativa italiana e CAP

What about the Italian insurance undertaking?...

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Italian Code of Private Insurance = Codice Italiano delle Assicurazioni [punto 2]… “Insurance”… Private (CAP).

Questo codice ha riunito in maniera organica e sistematica tutta la normativa italiana riguardante le assicurazioni.

Quindi, il testo di legge fondamentale per l’accesso all’attività assicurativa nel nostro Paese è il CAP.

Ovviamente, quanto è contenuto nel CAP ricalca in massima parte il contenuto delle direttive dell’UE in materia assicurativa. therefore, a bank (!) can’t (!) pursue the insurance business… [punto 1 del punto 2]… “undertakings”… :

… So, what about bank insurers? Banks are simply distributing (!) insurance products.

Questi ultimi, infatti, sono realizzati da imprese che hanno ricevuto l’autorizzazione dall’IVASS.

Another phenomenon is the so-called captive insurance…

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