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Introduction to Financial Services: Insurance


This In Focus provides a summary of the insurance market
and regulatory system in the United States.

Market Structure
Insurance companies constitute a major segment of the U.S.
financial services industry. The insurance industry is often
separated into two parts: life and health insurance
(life/health), which also includes annuity products, and
property and casualty insurance (property/casualty), which
includes most other lines of insurance, such as homeowners
insurance, automobile insurance, and various commercial
lines of insurance purchased by businesses. According to
the insurance rating agency A.M. Best, 2017 net premiums
for the more than 300 life/health companies (with over 800
subsidiaries) in the United States totaled $592.2 billion,
with admitted assets totaling $7.07 trillion. The 2017 net
premiums  for the more than 1,000 property/casualty
insurance companies (with over 2,800 subsidiaries) totaled
$556.1 billion, with admitted assets totaling $1.98 trillion.
Despite the large numbers of insurance companies, both
life/health and property/casualty insurance are also
reasonably concentrated industries, with the top 25
life/health company groups writing 61% of overall
premiums  and the top 25 property/casualty company groups
writing 69% of overall premiums. Figure 1 displays the
market share of the top 25 insurers versus the rest of the
market in 2017.

Figure  I. Insurance Market  Concentration
                 (Net Premiums; $ billions)

                          flop 25     Rest of Industry

   Property/Casualty                        $173.1
   $5561 billion

   Life/Health
   $592.2 billion

Source: CRS using data for 2017 from AM. Best.

Different lines of insurance present very different
characteristics and risks. Life insurance typically is a
longer-term proposition with contracts stretching over
decades and insurance risks that are relatively well defined
in actuarial tables. Annuity products, which are also usually
offered by life insurers, present similar long-term insurance
risks. Particular life insurance and annuity products,
however, may  be based on securities like stocks or bonds,
and thus may present shorter-term risks more similar to
investment products for both the consumer and the insurer.
Property/casualty insurance typically is a shorter-term
proposition with six-month H.R. 6292 or one-year contracts
and greater exposure to catastrophic risks.


Updated January 8, 2019


Health insurance has evolved in a very different direction
than life and property/casualty insurance. Many health
insurance companies are heavily involved with healthcare
delivery, including negotiating contracts with physicians
and hospitals, rather than purely insurance operations. The
health insurance regulatory system is much more influenced
by the federal government through Medicare, Medicaid, the
Employee  Retirement Income  Security Act of 1974
(ERISA;  P.L. 93-406), and the Patient Protection and
Affordable Care Act (ACA;  P.L. 111-148). The following
discussion addresses primarily property/casualty and life
insurance.

Role   of  Federal and State Governments
The role of the federal government in regulating private
insurance is relatively limited compared with its role in
banking and securities. Insurance companies, unlike banks
and securities firms, have been chartered and regulated
solely by the states for the past 150 years. There are no
federal regulators of insurance akin to those for securities or
banks, such as the Securities and Exchange Commission
(SEC)  or the Office of the Comptroller of the Currency
(OCC),  respectively.

Each state government has a department or other entity
charged with licensing and regulating insurance companies
and those individuals and companies selling insurance
products. States regulate the solvency of the companies and
the content of insurance products as well as the market
conduct of companies. Although each state sets its own
laws and regulations for insurance, the National Association
of Insurance Commissioners (NAIC)  acts as a coordinating
body that sets national standards through model laws and
regulations. Models adopted by the NAIC, however, must
be enacted by the states before having legal effect, which
can be a lengthy and uncertain process. The states have also
developed a coordinated system of guaranty funds,
designed to protect policyholders in the event of insurer
insolvency.

The limited federal role stems from both Supreme Court
decisions and congressional action. In the 1868 case Paul v.
Virginia, the Court found that insurance was not considered
interstate commerce, and thus not subject to federal
regulation. This decision was effectively reversed in the
Court's 1944 decision, U.S. v. South-Eastern Underwriters
Association. In 1945, Congress passed the McCarran-
Ferguson Act (15 U.S.C. §§1011 et seq.) specifically
preserving the states' authority to regulate and tax insurance
and also granting a federal antitrust exemption to the
insurance industry for the business of insurance.

The Dodd-Frank  Wall Street Reform and Consumer
Protection Act (Dodd-Frank, P.L. 111-203) in 2010
significantly altered the overall financial regulatory


>s://crsreports.congress.gos

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