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Medical Malpractice Insurance & TheInsurance Cycle
Medical Professional Liability & the P/C Insurance Industry
Robert P. Hartwig, Ph.D., CPCU, PresidentInsurance Information Institute ♦ 110 William Street ♦ New York, NY 10038
Tel: (212) 346-5520 ♦ Fax: (212) 732-1916 ♦ [email protected] ♦ www.iii.org
31st Annual Physician Insurance Association of America Meeting
Philadelphia, PAMay 15, 2008
Presentation Outline• P/C Operating Overview & Outlook
ProfitabilityUnderwriting TrendsPremium Growth & Price DriversCapacity & Surplus
• Medical Professional Liability Insurance OverviewMedical & Health Care Cost InflationMed Mal Operating ResultsMed Mal Investment Performance
• Med Mal Tort Environment• P/C Investment Overview & Outlook• Weakening Economy: Insurance Impacts & Implications
Implications of Treasury reform “Blueprint” for insurers• Catastrophic Loss: Spillover Effects? • Shifting Legal Liability & Tort Environment: P/C
P/C INSURANCE OPERATING OVERVIEW
The Cycle is Alive and Well
PROFITABILITYInsurer Profits in 2006/07
Reached Their Cyclical Peak
P/C Net Income After Taxes1991-2008F ($ Millions)*$1
4,17
8
$5,8
40
$19,
316
$10,
870
$20,
598
$24,
404 $3
6,81
9
$30,
773
$21,
865
$3,0
46
$30,
029
$61,
940
$49,
900
-$6,970
$65,
777
$44,
155
$20,
559
$38,
501
-$10,000
$0
$10,000
$20,000
$30,000
$40,000
$50,000
$60,000
$70,000
91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08F
*ROE figures are GAAP; 1Return on avg. surplus. **Return on Average Surplus; Sources: A.M. Best, ISO, Insurance Information Inst.
2001 ROE = -1.2%2002 ROE = 2.2%2003 ROE = 8.9%2004 ROE = 9.4%2005 ROE= 9.6%2006 ROE = 12.2%2007 ROAS1 = 12.3%**
Insurer profits peaked in 2006
-5%
0%
5%
10%
15%
20%
87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08F
US P/C Insurers All US Industries
ROE: P/C vs. All Industries 1987–2008E
2008 P/C insurer ROE is I.I.I. estimate.Source: Insurance Information Institute; Fortune
Andrew Northridge
Hugo Lowest CAT losses in 15 years
Sept. 11
4 Hurricanes
Katrina, Rita, Wilma
P/C profitability is cyclical, volatile and vulnerable
-5%
0%
5%
10%
15%
20%
25%
75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 0607
E08
F
Profitability Peaks & Troughs in the P/C Insurance Industry,1975 – 2008F*
1975: 2.4%
1977:19.0% 1987:17.3%
1997:11.6%
2006:12.2%
1984: 1.8% 1992: 4.5% 2001: -1.2%
10 Years
10 Years 9 Years
*GAAP ROE for all years except 2007 which is actual ROAS of 12.3%. 2008 P/C insurer ROE is I.I.I. estimate.Source: Insurance Information Institute, ISO; Fortune
-4%
-2%
0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07
ROE Cost of Capital
ROE vs. Equity Cost of Capital:US P/C Insurance:1991-2007
Source: The Geneva Association, Ins. Information Inst.
The p/c insurance industry achieved its cost of capital in 2005/6 for the first time in many years
-13.
2 pt
s
+0.2
pts
US P/C insurers missed their cost of capital by an average 6.7 points from 1991 to 2002, but on
target or better 2003-07
-0.1
pts
+1.7
pts
-9.0
pts
The cost of capitalis the rate of return
insurers need to attract and retain
capital to the business
+2.3
pts
P/C, L/H Stocks: Lagging the S&P 500 Index in 2008
-4.30%
-54.41%
-17.48%
-24.75%-8.22%
-7.89%
-17.47%
-5.41%
-60.0% -50.0% -40.0% -30.0% -20.0% -10.0% 0.0%
S&P 500
All Insurers
P/C
Life/Health
Multiline
Reinsurance
Mortgage*
Brokers
*Includes Financial Guarantee.Source: SNL Securities, Standard & Poor’s, Insurance Information Inst.
Total YTD Returns Through May 9, 2008
P/C, Life insurance stocks underperforming S&P—
concerns about soft market, credit/subprime exposure of
some companies
Mortgage & Financial Guarantee insurers were
down 69% in 2008
Factors that Will Influence theLength and Depth of the Cycle
• Capacity: Rapid surplus growth in recent years has left the industry with between $85 billion and $100 billion in excess capital, according to analysts
All else equal, rising capital leads to greater price competition and a liberalization of terms and conditions
• Reserves: Reserves are in the best shape (in terms of adequacy) in decades, which could extend the depth and length of the cycle
Looming reserve deficiencies are not hanging over insurers they way they did during the last soft market in the late 1990sMany companies have been releasing redundant reserves, which allows them to boost net income even as underwriting results deteriorateReserve releases will diminish in 2008; Even more so in 2009
• Investment Gains: 2007 was the 5th consecutive up year on Wall Street. With sharp declines in stock prices and falling interest rates, portfolio yields are certain to fall Contributes to discipline
Realized capital gains are already rising as underwriting profits shrink, but like redundant reserves, realized capital gains are a finite resourceA sustained equity market decline (and potentially a drop in bond prices at some point) could reduce policyholder surplus
Source: Insurance Information Institute.
Factors that Will Influence the Length and Depth of the Cycle (cont’d)
• Sarbanes-Oxley: Presumably SOX will lead to better and more conservative management of company finances, including rapid recognition of deficient or redundant reserves
With more “eyes” on the industry, the theory is that cyclical swings should shrink• Ratings Agencies: Focus on Cycle Management; Quicker to downgrade
Ratings agencies more concerned with successful cycle management strategyMany insurers have already had ratings “haircut” over the last several years they way they did during the last soft market in the late 1990s; Less of a margin today
• Finite Reinsurance: Had smoothing effect on earnings; Finite market is gone• Information Systems: Management has more and better tools that allow
faster adjustments to price, underwriting and changing market conditions than it had during previous soft markets
• Analysts/Investors: Less fixated on growth, more on ROE through soft mkt.Management has backing of investors of Wall Street to remain disciplined
• M&A Activity: More consolidation implies greater disciplineLiberty Mutual/Safeco deal creates 5th largest p/c insurer. More to come?
Source: Insurance Information Institute.
FINANCIAL STRENGTH &
RATINGSIndustry Has Weathered
the Storms Well, But Cycle May Takes Its Toll
P/C Insurer Impairment Frequency vs. Combined Ratio, 1969-2007E
90
95
100
105
110
115
120
69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07E
Com
bine
d R
ati o
00.20.40.60.811.21.41.61.82
Impa
irmen
t Rat
e
Combined Ratio after DivP/C Impairment Frequency
Impairment rates are highly correlated
underwriting performance and could reach near-record low in 2007
Source: A.M. Best; Insurance Information Institute
2006 impairment rate was 0.43%, or 1-in-233 companies, half the 0.86% average since 1969;
2007 will be lower; Record is 0.24% in 1972
Reasons for US P/C Insurer Impairments, 1969-2005
*Includes overstatement of assets.Source: A.M. Best: P/C Impairments Hit Near-Term Lows Despite Surging Hurricane Activity, Special Report, Nov. 2005;
Catastrophe Losses8.6%
Alleged Fraud11.4%
Deficient Loss
Reserves/In-adequate Pricing62.8%
Affiliate Problems
8.6%
Rapid Growth
8.6%
2003-2005 1969-2005
Deficient reserves,
CAT losses are more important factors in
recent years
Reinsurance Failure3.5%
Rapid Growth16.5%
Misc.9.2%
Affiliate Problems
5.6%
Sig. Change in Business
4.6%
Deficient Loss
Reserves/In-adequate Pricing38.2%
Investment Problems*
7.3%
Alleged Fraud8.6%
Catastrophe Losses6.5%
UNDERWRITINGTRENDS
Extremely Strong 2006/07;Relying on Momentum &
Discipline for 2008
90
95
100
105
110
115
120
70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08F
Combined Ratios1970s: 100.31980s: 109.21990s: 107.82000s: 102.0*
Sources: A.M. Best; ISO, III *Full year 2008 estimates from III.
P/C Insurance Combined Ratio, 1970-2008F*
115.8
107.4
100.198.3
100.7
92.4
98.6
95.6
90
100
110
120
01 02 03 04 05 06 07 08F
P/C Insurance Combined Ratio, 2001-2008F
Sources: A.M. Best; ISO, III. *III estimates for 2008.
2005 figure benefited from heavy use of reinsurance which lowered net losses
2006 produced the best underwriting result
since the 87.6 combined ratio in 1949
As recently as 2001, insurers were paying out nearly $1.16 for
every dollar they earned in premiums
2007/8 deterioration due primarily to falling rates, but results still strong assuming
normal CAT activity
87.6
91.292.1 92.3 92.4 92.4
93.1 93.1 93.3
95.6
93.0
85
87
89
91
93
95
97
1949 1948 1943 1937 2006 1935 1950 1939 1953 1936 2007
Ten Lowest P/C Insurance Combined Ratios Since 1920 vs. 2007
Sources: Insurance Information Institute research from A.M. Best data. *2007: III Earlybird survey.
2007 was the 20th
best since 1920
The industry’s best underwriting years are associated with
periods of low interest rates
The 2006 combined ratio of 92.2 was the best since the 87.6 combined in 1949
-55-50-45-40-35-30-25-20-15-10-505
101520253035
75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08
Source: A.M. Best, Insurance Information Institute
$ B
illio
ns
Insurers earned a record underwriting profit of $31.7 billion in 2006, the largest ever but only the
second since 1978. Cumulative underwriting deficit from 1975 through 2007 is $422 billion.
Underwriting Gain (Loss)1975-2008F*
110.
3
110.
2
107.
6
103.
9 109.
7
112.
3
111.
1
122.
3
110.
2
102.
5 105.
4
91.2 94
.7 97.5
102.
0
112.
5
85
90
95
100
105
110
115
120
125
93 94 95 96 97 98 99 00 01 02 03 04 05 06 07E 08F
Recent results benefited from favorable loss cost trends, improved tort environment, low CAT losses, WC reforms and reserve releases
Commercial coverages have exhibited significant
variability over time.
Commercial Lines Combined Ratio, 1993-2008F
Outside CAT-affected lines, commercial
insurance is doing fairly well. Caution is required in
underwriting long-tail commercial lines.
Sources: A.M. Best (historical and forecasts)
$10.
8 $22.
8 $33.
4
$36.
9
$18.
9
($5.0)($6.0)($5.3)
$0.4
($7.0)
8.9
-1.1-1.3-1.6
4.5
-1.20.1
3.5
8.6
6.5
($10)($5)$0$5
$10$15$20$25$30$35$40
00 01 02 03 04 05 06 07F 08F 09F
Res
erve
Dev
elop
men
t ($B
)
(3)(2)(1)012345678910
Com
bine
d R
atio
Poi
nts
PY Reserve DevelopmentCombined Ratio Points
Impact of Reserve Changes on Combined Ratio
Source: A.M. Best, Lehman Brothers estimates for years 2007-2009
Reserve adequacy has
improved substantially
PREMIUM GROWTH
At a Virtual Standstillin 2007/08
-10%
-5%
0%
5%
10%
15%
20%
25%
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
F20
08F
Note: Shaded areas denote hard market periods.Source: A.M. Best, Insurance Information Institute
Strength of Recent Hard Markets by NWP Growth*
1975-78 1984-87 2001-04
Post-Katrina period resembles
1993-97 (post-Andrew)
2007: -0.6% premium growth was the first decline since 1943
Growth in Net Written Premium, 2000-2008F
*2008 forecast from A.M. Best.Source: A.M. Best; Forecasts from the Insurance Information Institute.
5.0%
8.4%
15.3%
10.0%
3.9%
0.5%
4.3%
-0.6% -1.0%2000 2001 2002 2003 2004 2005 2006 2007 2008F
P/C insurers are experiencing their slowest growth rates since 1943… underwriting results are deteriorating
WEAK PRICING
Under Pressure in 2007/08, Especially Commercial Lines
Average Commercial Rate Change,All Lines, (1Q:2004 – 1Q:2008)
-3.2
%
-5.9
%
-7.0
%
-9.4
%
-9.7
% -8.2
%
-4.6
% -2.7
%
-3.0
%
-5.3
%
-9.6
%
-11.
3%
-11.
8%
-13.
3% -12.
0%
-13.
5%
-16%
-14%
-12%
-10%
-8%
-6%
-4%
-2%
0%1Q
04
2Q04
3Q04
4Q04
1Q05
2Q05
3Q05
4Q05
1Q06
2Q06
3Q06
4Q06
1Q07
2Q07
3Q07
4Q07
1Q08
Source: Council of Insurance Agents & Brokers; Insurance Information Institute
Magnitude of rate decreases diminished greatly after Katrina but have grown again
KRW Effect
-0.1
%
Cumulative Commercial Rate Change by Line: 4Q99 – 1Q08
Source: Council of Insurance Agents & Brokers
Commercial account pricing has been trending down for 3+ years and is now on par with prices in late 2001, early 2002
CAPACITY/SURPLUS
Accumulation of Capital/ Surplus Depresses ROEs
$0
$50
$100
$150
$200
$250
$300
$350
$400
$450
$500
$550
75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07
U.S. Policyholder Surplus: 1975-2007*
Source: A.M. Best, ISO, Insurance Information Institute. *As of December 31, 2007
$ B
illio
ns
“Surplus” is a measure of underwriting capacity. It is analogous to “Owners Equity” or “Net Worth” in non-insurance organizations
Capacity as of 12/31/07 was $517.9B, 6.5% above year-end
2006, 81% above its 2002 trough and 55% above its 1999 peak.
The premium-to-surplus fell to $0.85:$1 at year-end 2007, approaching
its record low of $0.84:$1 in 1998
Annual Catastrophe Bond Transactions Volume, 1997-2007
$1,729.8
$966.9
$7,329.6
$4,693.4
$1,991.1
$1,142.8$1,219.5$846.1$984.8$1,139.0
$633.0
$0
$1,000$2,000
$3,000
$4,000
$5,000$6,000
$7,000
$8,000
97 98 99 00 01 02 03 04 05 06 07
Ris
k C
apita
l Iss
ues
($ M
ill)
0
5
10
15
20
25
30
35
Num
ber o
f Iss
uanc
es
Risk Capital Issued Number of Issuances
Source: MMC Securities Guy Carpenter, A.M. Best; Insurance Information Institute.
Catastrophe bond issuance has soared in the wake of
Hurricanes Katrina and the hurricane seasons of 2004/2005,
despite two quiet CAT years
Lloyd’s Insurance Market Capacity, 1998-2008 (£ billions)*
*Beginning of the year.Source: Lloyd’s Members’ Services Unit.
The capacity of the Lloyd’s market rose significantly during the period 2001 to 2004. In 2005, capacity reduced but increased again in 2006 and 2007 due to the impact of the U.S. hurricane season. Capacity reduced to £15.95 billion ($32 billion) in 2008.
£15.95 £16.1 £14.8
£13.7 £14.9 £14.4
£12.2 £11.3
£10.1 £9.9 £10.2
0
2
4
6
8
10
12
14
16
18
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
£bi
llion
s
P/C Insurer Share Repurchases,1987- Through Q4 2007 ($ Millions)
$564
.0
$646
.9
$311
.0
$952
.4
$418
.1
$566
.8
$310
.1
$658
.8
$769
.2
$4,5
86.5
$5,2
66.0
$763
.7
$5,2
42.3
$4,3
70.0
$7,0
94.1
$22,322.6
$4,4
97.5
$1,5
39.9
$2,7
64.2
$2,3
85.6
$4,2
97.3
$0
$5,000
$10,000
$15,000
$20,000
$25,000
87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07
Sources: Credit Suisse, Company Reports; Insurance Information Inst.
2007 share buybacks shattered the 2006 record, up 214%
Reasons Behind Capital Build-Up & Repurchase Surge
•Strong underwriting results•Moderate catastrophe losses
•Reasonable investment performance
•Lack of strategic alternatives (M&A, large-scale expansion)
Returning capital owners (shareholders) is one of the
few options available
2007 repurchases to date equate to 3.9% of industry surplus, the highest in 20 years
MEDICAL PROFESSIONAL
LIABILITY OVERVIEW
Significant Improvements
MEDICAL & HEALTH CARE
COST INFLATION
National Problem & Insurer Cost Driver
Consumer Price Index for Medical Care vs. All Items, 1960-2007
207.3
351.1
0
100
200
300
400
60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07
All Items Medical Care
Source: Department of Labor (Bureau of Labor Statistics).
(Base: 1982-84=100)
Inflation for Medical Care has been surging ahead of general inflation (CPI) for
25 years. Since 1982-84, the cost of medical care has more than tripled.
National Health Expenditures and Health Expenditures as a Share of GDP,
1960-2017F ($ Billions)$2
8
$1,9
73$2
,106
$2,2
46$2
,394
$2,5
55$2
,726
$2,9
05$3
,098
$3,3
05$3
,524 $3,7
57 $4,0
08$4
,277
$1,6
03
$1,7
32
$253
$714
$1,3
54
$75
$1,1
91
$1,8
52
$1,4
70
$1,1
25$9
13 $1,2
66
5.2%
7.2%
9.1%
13.7
%
14.5
%15
.3%
15.9
%15
.9%
16.0
%16
.3%
16.6
% 19.1
%19
.5%
16.9
%
17.1
%17
.4%
17.7
%18
.0%
18.4
%18
.8%
12.3
% 13.6
%
13.8
% 15.8
%
13.6
%
13.7
%
$0
$500
$1,000
$1,500
$2,000
$2,500
$3,000
$3,500
$4,000
$4,500
60 70 80 90 93 97 98 99 00 01 02 03 04 05 06 07E
08E
09E
10E
11E
12E
13E
14E
15E
16E
17E
Nat
iona
l Hea
lth E
xps
0%
5%
10%
15%
20%
25%
Nat
iona
l Hea
lth E
xp. a
s % o
f GD
P
National Health Expenditures National Health Expenditures as % of GDP
Health care expenditures will consumed 16.6% of GDP in
2008 and are expected to rise to 19.5% by 2017
Source: Centers for Medicare & Medicaid Services, Office of the Actuary; Insurance Information Institute.
National Health Expenditures Per Capita, 1960-2017E ($Bill)
$4,5
23$4
,790
$5,1
48$5
,560
$5,9
52$6
,301
$6,6
49$7
,026
$7,4
39$7
,868
$8,3
29$8
,816
$9,3
22$9
,862
$10,
439
$11,
043
$11,
684
$12,
369
$13,
101
$356
$2,8
13$1
,100
$148
$3,4
69$4
,104
$4,2
97
$0$1,000$2,000$3,000$4,000$5,000$6,000$7,000$8,000$9,000
$10,000$11,000$12,000$13,000$14,000$15,000
60 70 80 90 93 97 98 99 00 01 02 03 04 05 06 07E
08E
09E
10E
11E
12E
13E
14E
15E
16E
17E
Source: Centers for Medicare & Medicaid Services, Office of the Actuary; Insurance Information Institute.
Health costs on a per capita basis continue to rise rapidly, as health expenditures rise faster
than population growth
Average Annual Growth in US Per Capital Health Care Costs, 1960-2017F
14.1%
20.9%
15.6%
7.0% 7.9% 7.6%
0%
5%
10%
15%
20%
25%
1960-1970 1970-1980 1980-1990 1990-2000 2000-2007 2007-2017
The 1970s were the most inflationary decade for medical costs at nearly
21% per year
Over the net decade health care expenditures will likely
increase well ahead of economic growth and the general pace of inflation
Source: Insurance Information Institute calculations based on data from the Centers for Medicare &Medicaid Services, Office of the Actuary.
4.5%3.6%
2.8% 3.2% 3.5%4.1% 4.6% 4.7%
4.0% 4.4% 4.2% 4.0%
5.1%
7.4%
10.1%
8.3%
10.6%
8.2%
14.0%
7.4%
9.0%
6.8%
11.7%
7.5%
0%
2%
4%
6%
8%
10%
12%
14%
16%
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Change in Medical CPIChange Med Cost per Lost Time Claim
WC Medical Severity Rising Far Faster than Medical CPI
Sources: Med CPI from US Bureau of Labor Statistics, WC med severity from NCCI based on NCCI states.
3.5
pts
WC medical severity rose more than twice as fast as the medical CPI (8.8% vs. 4.0%)
from 1995 through 2006
Med Costs Share of Total Costs is Increasing Steadily
Indemnity55%
Medical45%
Source: NCCI (based on states where NCCI provides ratemaking services).
Indemnity52%
Medical48%
Indemnity41%
Medical59%1986
1996
2006p
Auto Claim Costs Rise Faster than CPI or Health Care Costs
9%
4%
8%
6%
3%4%
0%1%2%3%4%5%6%7%8%9%
10%
Claimed BIEconomic
Loss
Total BIPayment
Claimed PIPEconomic
Loss
Total PIPPayment
CPI CPI-Medical
Sources: Insurance Research Council, Auto Insurance Claims: Countrywide Patterns in Treatment, Cost and Compensation, 2008 Edition; Insurance Information Institute.
Inflation in auto insurance claims is a significant and long-
term cost driver
Claimed BI economic
losses are 3 times the overall
inflation rate
MEDICAL MALPRACTICE
OPERATING ENVIRONMENT
Improved, But Still Vulnerable
103.
7
108.
0
96.4 99
.8
106.
6
107.
9 115.
7
129.
7
133.
7
154.
7
142.
5
137.
5
111.
0
101.
0
91.2
83.0
94.5
108.
8 115.
7
107.
0
108.
3
106.
7
106.
0
102.
0
105.
9
108.
0
110.
1 115.
8
107.
5
100.
1
98.4 10
0.8
92.5 95
.6 98.6
127.
9
80
90
100
110
120
130
140
150
160
170
91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07P 08E
Medical Malpractice All Lines Combined Ratio
Medical Malpractice Combined Ratio
Source: AM Best, Insurance Information Institute
Insurers in 2007 paid out an estimated $0.83 for every $1
they earned in premiums.As recently as 2002,
med mal insurers paid out $1.55 for
every dollar earned
The dramatic improvement has
restored med mal’s viability
Medical Malpractice: Losses & Expenses Paid vs. Premiums Earned
$ Billions
$4.0
$4.0
$4.1
$4.2 $4
.9 $5.2
$5.1 $5
.6 $6.1
$7.2
$8.5
$8.4
$9.5
$9.6
$4.2
$4.1
$5.2
$4.6
$4.5 $5
.1
$5.3 $6
.0 $6.6 $7
.5
$9.5 $1
0.3 $1
1.6
$9.3 $9.6
$8.8
$4.7
$4.8
$4.8
$4.8
$2$3$4$5$6$7$8$9
$10$11$12
90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06Earned Premiums Losses & Expenses Paid
Source: Computed from A.M. Best data by the Insurance Information Institute
Before reforms took hold in the mid-2000s, premium earned rose 54% while losses and expenses rose 125% over the
period from 1990 through 2003,
Medical Malpractice:Underwriting Loss/Profit, 1990-2007p
$ Millions
-$147.8
-$1,135.9
-$344.1-$808.6
-$3,077.0
-$922.9
-$94.7
$848.3
$1,488.0
-$3,172.5-$3,353.1
-$1,890.6-$1,517.7
-$387.1-$289.3
$111.6$14.4
-$230.8
-$4,000
-$3,000
-$2,000
-$1,000
$0
$1,000
$2,000
90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07
Source: Insurance Information Institute calculations based on data from A.M. Best.
Med Mal underwriting losses exploded by $3.1 billion or 1059%
between 1996 and 2001
Med Mal insurers
now operating
in the black
Medical Malpractice:Cumulative Underwriting Losses
$ Millions
-$23
1
-$37
9
-$1,
515
-$1,
859
-$1,
747
-$1,
733
-$2,
022
-$2,
409
-$3,
218
-$4,
735
-$6,
626
-$9,
979
-$13
,056
-$16
,229
-$17
,151
-$17
,246
-$16
,398
-$14
,910
-$20,000
-$18,000
-$16,000
-$14,000
-$12,000
-$10,000
-$8,000
-$6,000
-$4,000
-$2,000
$0
90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07
The cumulative underwriting loss in Med
Mal from 1990-2003 totaled more than $17 billion
Source: Insurance Information Institute calculations based on data from A.M. Best.
Outlook for MPLIOperating Environment
• Short-Term: Soft market persists, driven by relatively good underlying underwriting performance
• Intermediate Term: Cyclical deterioration in profitability as underwriting begins to deteriorate under soft market conditions
• Long-Run: Erosion of reforms of recent years begins to take toll, further damaging results
• Conclusion: Underwriting Cycle can’t be banished, but its depth and length can be moderated via disciplined underwriting and pricing
• Tort Cycle: Med Mal tends to experience a tort crisis every 10-15 years. If history is any guide, the next crisis will be evident around 2012-2015
Investment Componentof Medical Malpractice
Operating Results
Investment Gain: Med Mal vs.All Commercial Lines*
*As a % of net earned premium. Investment gains consists primarily of interest, dividends andrealized capital gains and losses.
Source: A.M. Best; Insurance Information Institute estimate
12.5
%
14.3
%
14.1
%
16.8
%
16.9
%
15.1
%
16.8
%
14.3
%
9.6%
8.9% 9.4% 10
.3%
10.2
%
27.4
%
29.3
%
30.2
%
30.0
%
28.0
%
23.7
% 27.9
%
19.1
%
12.8
%
15.5
%
15.1
%
14.0
% 18.9
%
0%
5%
10%
15%
20%
25%
30%
35%
94 95 96 97 98 99 00 01 02 03 04 05 06Commercial Lines Med Mal
Investment returns have generally shrunk since 2000, but are still important. “Heavy Lifting” must be done through underwriting & pricing
Medical Malpractice Investment Gain*
$ Billions
$1.5 $1.5
$2.1
$1.8
$1.5 $1.4$1.2
$1.6
$1.2
$0.9
$1.3 $1.3 $1.3
$1.8
$1.3$1.4 $1.5
$0.0
$0.5
$1.0
$1.5
$2.0
$2.5
90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06*Imputed from investment gain data as a % of net earned premium. Investment gains consistsprimarily of interest, dividends and realized capital gains and losses.
Source: A.M. Best; Insurance Information Institute estimate
Investment returns have risen, but poor investment environment today implies “Heavy Lifting” must be done through
underwriting & pricing
Medical Malpractice Tort
Environment
Harvesting the Fruitsof Reform
Medical Malpractice Tort Cost: Growth Continues, Though Modestly
$ Billions
$1.2
$1.4
$1.8
$2.2 $4
.8 $5.8 $6
.8$6
.7$6
.9$7
.3$7
.6 $8.5 $9.2 $1
0.1
$10.
6$1
1.5
$12.
5$1
3.3
$14.
1$1
5.5
$16.
4$1
7.9
$19.
6 $21.
7 $24.
2 $26.
5$2
8.2
$29.
4$3
0.3
$2.7
$3.4
$4.1
$0$2$4$6$8
$10$12$14$16$18$20$22$24$26$28$30$32
75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06
Sources: Tillinghast-Towers Perrin, US Bureau of Labor Statistics, Insurance Information Institute
•Over the period from 1990 through 2006, medical malpractice tort costs rose 229%, more than double the 90% increase in tort costs generally over the same period.
•Over the period from 1975 through 2006, medical malpractice tort costs have increased at an annual rate of 11.1 percent, versus 8.2 percent for all other tort costs.
ME
NH
MACT
PA
WVVA
NC
LATX
OK
NE
ND
MN
MI
IL
IA
ID
WA
OR
AZ
HI
NJ
RI
MDDE
AL
VT
NY
DC
SC
GA
TN
AL
FL
MS
ARNM
KYMOKS
SD WI
INOH
MT
CA
NVUT
WY
CO
Medical Crises across the U.S.*
Crisis states at height of 2000s
AMA: Crises reached in 22 states in the 2000s
PR
AK
*The AMA is no longer categorizing states as crisis states.
Source: American Medical Association, February 2008
2007 Top Ten Verdicts
Source: LawyersWeekly USA, January 22, 2008.
FloridaAuto Crash, Death$45 Million
New JerseyVioxx$47.5 Million
NevadaPrempro$47.6 Million
AlabamaProduct Liability, Death$50 Million
FloridaDUI Crash$50 Million
New MexicoNursing Home, Death$54 Million
FloridaPrivate Air Crash$54 Million
CaliforniaProduct Liability, Death$55.2 Million
FloridaPremises Liability, Death$102.7 Million
New YorkMedical Malpractice$109 Million
StateIssueValue
2002 Top Ten Verdicts
Source: LawyersWeekly USA, January 2003.
New YorkMed Mal (Birth Injury)$80 Million
MissouriProd. Liab/Personal Inj. (Auto)$80 Million
New YorkMedical Malpractice$91 MillionNew YorkMed Mal (Birth Injury)$95.2 Million
CaliforniaBusiness Fraud$97.2 Million
VirginiaProduct Liab. (Auto Accident)$122 Million
OregonTobacco (Product Liability)$150 Million
TexasProduct Liability (Rollover)$225 Million
KentuckyPersonal Injury (Burn)$270 Million
MissouriNegligence (Pharmacy Mal)$2.2 Billion
FloridaTobacco (Product Liability)$28 Billion
StateIssueValue
2001 Top Ten Verdicts
Source: LawyersWeekly USA, January 2002.
CaliforniaReal Estate$94.5 MillionNew YorkMedical Malpractice$107.8 MillionTexasInheritance Dispute$108.2 MillionNew YorkMedical Malpractice$114.9 MillionVirginiaIntellectual Property Theft$116 Million
ColoradoPolice Auto Crash$ 256 MillionTexasNursing Home$312.8 MillionFloridaPrivate Airplane Crash$480 MillionLouisianaLand Contamination$1 BillionCaliforniaTobacco$3 BillionStateIssueValue
Average Jury Award inMedical Malpractice Cases*
$ Millions
$1.14
$2.02 $1.88 $1.93
$3.29
$4.78
$3.74
$4.26$3.83
$2.92 $2.89$3.24
$0.0$0.5$1.0$1.5$2.0$2.5$3.0$3.5$4.0$4.5$5.0
94 95 96 97 98 99 00 01 02 03 04 05*Ultimate award may be reduced by judge or upon appeal.Source: Jury Verdict Research; Insurance Information Institute.
The average med mal jury award more than tripled
between 1994 and 2005, but has moderated since 2002
Trends in Million Dollar Verdicts*4%
10%
8%
23%
22%
36%
48%
4%
8%
12%
31% 37
%
49%
59%
13%
14%
29%
51%
62%
5%
17%
13%
32%
41%
55%
64%
4%
39%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
VehicularLiability
PersonalNegligence
PremisesLiability
BusinessNegligence
GovernmentNegligence
MedicalMalpractice
ProductsLiability
1996-1998 1999-2001 2002-2003 2004-2005
*Verdicts of $1 million or more.Source: Jury Verdict Research; Insurance Information Institute.
Sharp jumps in multi-million dollar awards in recent years across most types of defendants. In med mal, million dollar-plus awards rose from 36% of all awards from 1996-98 to 55% in 2004-05, well above most other categories.
MERGER & ACQUISITION
Catalysts for P/C Consolidation Growing
in 2008
P/C Insurance-Related M&A Activity, 1988-2006
$2,4
35
$5,1
00
$19,
118
$40,
032
$1,2
49$4
86$2
0,35
3$4
25$9
,264
$35,
221
$55,825
$30,
873
$8,0
59$1
1,53
4
$1,8
82
$3,4
50$2
,780
$5,1
37
$5,6
38
$0
$10,000
$20,000
$30,000
$40,000
$50,000
$60,000
88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06
Tran
sact
ion
Valu
e ($
Mill
)
0
20
40
60
80
100
120
140
Num
ber o
f Tra
nsac
tions
Transaction Values Number of Transactions
Source: Conning Research & Consulting.
M&A activity began to accelerate during the second
half of 2007
No model for successful
consolidation has emerged
Motivating Factors for Increased P/C Insurer Consolidation
Motivating Factors for P/C M&As• Slow Growth: Growth is at its lowest levels since the late 1990s
NWP growth was 0% in 2007; Appears similarly flat in 2008Prices are falling or flat in most non-coastal markets
• Accumulation of Capital: Excess capital depresses ROEsPolicyholder Surplus up 6-7%% in 2007 and up 80% since 2002Insurers hard pressed to maintain earnings momentum Options: Share Buybacks, Boost Dividends, Invest in Operation, AcquireOption B: Engage in destructive price war and destroy capital
• Reserve Adequacy: No longer a drag on earningsFavorable development in recent years offsets pre-2002 adverse develop.
• Favorable Fundamentals/Drop-Off in CAT ActivityUnderlying claims inflation (frequency and severity trends) are benign
Lower CAT activity took some pressure of capital baseSource: Insurance Information Institute.
P/C INVESTMENT OVERVIEW
More Pain, Little Gain
Property/Casualty Insurance Industry Investment Gain1
$ Billions
$35.4
$42.8$47.2
$52.3
$44.4
$36.0
$45.3$48.9
$59.4$55.8
$63.6$56.9
$51.9
$57.9
$0
$10
$20
$30
$40
$50
$60
94 95 96 97 98 99 00 01 02 03 04 05* 06 071Investment gains consist primarily of interest, stock dividends and realized capital gains and losses. 2006 figure consists of $52.3B net investment income and $3.4B realized investment gain.*2005 figure includes special one-time dividend of $3.2B.
Sources: ISO; Insurance Information Institute.
Investment rose in 2007 but are just 9.8% higher than what they were
nearly a decade earlier in 1998
Property/Casualty Industry Investment Results, 1994-2007
$33.
7
$36.
8
$38.
0
$41.
5
$37.
1
$36.
7
$38.
7
$39.
6 $49.
5
$52.
3
$54.
6
$1.7
$6.0 $9
.2 $10.
8
$18.
0
$13.
7 $16.
9
$6.9 $6
.9 $9.3
$9.7
$3.5
$9.0
$40.
8
$38.
6
$39.
9
$20
$30
$40
$50
$60
$70
94 95 96 97 98 99 00 01 02** 03 04 05 06 07E
Bill
ions
Capital Gains/LossesInvestment Income
*Primarily interest, stock dividends, and realized capital gains and losses.**Not shown: $1.1B capital loss in 2002.2005 figure includes special one-time dividend of $3.2B. Sources: ISO; Insurance Information Institute.
$52.3
$57.7
$44.0
$35.6
$45.6$48.9
$59.2$55.8
$63.6Realized capital gains rising as underwriting
results slip$57.9
US P/C Net Realized Capital Gains,1990-2007 ($ Millions)
$2,8
80 $4,8
06
$9,8
93
$1,6
64
$5,9
97
$9,2
44 $10,
808
$13,
016 $1
6,20
5
$6,6
31
-$1,
214
$6,6
10 $8,9
71
$18,019
$3,5
24
$9,7
01
$9,1
25
$9,8
18
-$5,000
$0
$5,000
$10,000
$15,000
$20,000
90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07Sources: A.M. Best, ISO, Insurance Information Institute.
Realized capital gains rebounded strongly in 2004/5
but fell sharply in 2006 despite strong stock market
as insurers “bank” their gains. Rising again in 2007 as underwriting results slip
-30%
-20%
-10%
0%
10%
20%
30%
40%
1970
1972
1974
1976
1978
1980
1982
1984
1986
1988
1990
1992
1994
1996
1998
2000
2002
2004
2006
2008
Source: Ibbotson Associates, Insurance Information Institute. *Through May 9, 2008.
Total Returns for Large Company Stocks: 1970-2008*
S&P 500 was up 3.5% in 2007, down 5.45% YTD 2008*
Markets were up in 2007 for the 5th consecutive year; 2008 could be first down
year since 2002
2%
3%
4%
5%
6%
7%
8%
9%
90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08*
P-C Inv Income/Inv Assets 10-Year Treasury Note
P/C Investment Income as a % of Invested Assets Follows 10-Year US T-Note
*As of January 2008 month-end.Sources: Board of Governors, Federal Reserve System; A.M.Best; Insurance Information Institute.
Investment yield historically tracks 10-year Treasury note quite closely
Investment Outlook• Short-Term: Low interest rates, poor equity market
performance will reduce investment gains and depress profitability
• Intermediate Term: Fed likely to begin raising rates as early as late 2008, if credit market conditions continue to improve
Stock markets could begin recovery from first quarter lows• Long-Run: Interest rates and stock market returns are
modest• Conclusion: Insurers (including long-tail carriers
offering MPLI) cannot count on investment gains to offset underwriting losses
• Implication: Insurers Must Remain Disciplined in Termsof Underwriting and Pricing
REINSURANCE MARKETS
Reinsurance Prices are Falling in Non-Coastal Zones, Casualty Lines
Share of Losses Paid by Reinsurers, by Disaster*
30%25%
60%
20%
45%
0%
10%
20%
30%
40%
50%
60%
70%
Hurricane Hugo(1989)
Hurricane Andrew(1992)
Sept. 11 TerrorAttack (2001)
2004 HurricaneLosses
2005 HurricaneLosses
*Excludes losses paid by the Florida Hurricane Catastrophe Fund, a FL-only windstorm reinsurer, which was established in 1994 after Hurricane Andrew. FHCF payments to insurers are estimated at $3.85 billion for 2004 and $4.5 billion for 2005.Sources: Wharton Risk Center, Disaster Insurance Project; Insurance Information Institute.
Reinsurance is playing an increasingly
important role in the financing of mega-CATs; Reins. Costs
are skyrocketing
US Reinsurer Net Income& ROE, 1985-2007*
$1.9
4
$2.0
3
$1.9
5 $3.7
1$4
.53
$5.4
3$1
.47
$1.9
9
$1.3
1 $3.1
7$3
.41
$2.5
1$9
.68
$7.9
6
($2.98)
$0.1
2
$1.9
5
$1.3
8$1
.22
$1.8
7
$1.1
7 $2.5
2$1
.79
($4)
($2)
$0
$2
$4
$6
$8
$10
$12
85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07*
Net
Inco
me
($ B
ill)
-10%
-5%
0%
5%
10%
15%
20%
RO
E
Net Income ROE
Source: Reinsurance Association of America. *2007 ROE figure is III estimate based return on average 2007 surplus.
Reinsurer profitability rebounded post-Katrina
but is now falling
Reinsurer Market Share Comparison: 1990 vs. 2006
U.S. Reinsurer
64.7%
Offshore Reinsurer
35.3%
1990 2006
Sources: Reinsurance Association of America; Insurance Information Institute.
U.S. Reinsurer
46.9%
Offshore Reinsurer
53.1%
U.S. Reinsurer market share fell precipitously between 1990 and 2006
Regional Distribution of Reinsurers by NWP, 2006
Other11%
U.K.6%
Switzerland12%
Ireland2%
Japan6%
Germany25%
France3%
Bermuda10%
U.S.25%
Source: Standard & Poor’s, Global Reinsurance Highlights, 2007 Edition
International reinsurers from
Germany, Switzerland and
France account for 40 percent of global reinsurance volume.
Bermuda is a growing market, with a 10 percent
share. Lloyd’s and London-based
reinsurers account for 6 percent of the
world market.
Eight countries account for 89 percent of global reinsurance volume.
A STORMY ECONOMIC FORECAST
What a Weakening Economy & Credit Crunch Mean for
the Insurance Industry
3.7%
0.8%
1.6%
2.5%
3.6%
3.1%
2.9%
0.6%
3.8%
4.9%
0.6%
2.1%
1.9% 2.0%
2.6% 2.
8% 2.9%
0.6%
0.1%
0%
1%
2%
3%
4%
5%
6%
20
00
20
01
20
02
20
03
20
04
20
05
20
06
07:1
Q
07:2
Q
07:3
Q
07:4
Q
08:1
Q
08:2
Q
08:3
Q
08:4
Q
09:1
Q
09:2
Q
09:3
Q
09:4
Q
Real GDP Growth*
*Yellow bars are Estimates/Forecasts.Source: US Department of Commerce, Blue Economic Indicators 4/08; Insurance Information Institute.
Economic growth has slowed dramatically
in 2007/2008
A Few Facts About the Relationship Between Insurance & Economy
• Vast Majority of Insurance Business is Tied to RenewalsApproximately 98+% of P/C business (units) is linked to renewalsA very large share of p/c insurance premiums are statutorily or de facto compulsory (e.g., WC, auto liability, surety, usually HO…)P/C insurers have marginal exposure impact due to economyMost life revenues and units are renewals, but some products (e.g., variable annuities are sensitive to market volatility)Life insurers who manage 401(k) assets seeing more loans and hardship withdrawals;
• Insurers are Sensitive to Interest RatesAbout 2/3 of P/C invested assets and 75% if Life assets are fixed incomeHistorically, yield on industry portfolios has tracked 10-year note closelyAll else equal, lower total investment gain implies greater emphasis on underwritingHistorically, industry’s best underwriting performances are rooted in periods when interests rates were low and/or equity market performance poor (1930s – 1950s, early 2000s gave rise to strong 2006/07)
Source: Insurance Information Institute.
5.2%
-0.9
%-7
.4%
-6.5
%-1
.5%
1.8%
4.3%
18.6
% 20.3
%5.
8%0.
3%-1
.6%
-1.0
%-1
.8%
-1.0
%3.
1%1.
1%0.
8%0.
4%0.
6%-0
.4%
-0.3
%1.
6%5.
6%13
.7%
7.7%
1.2%
-2.9
% -0.5
%-2
.9%
-2.7
%
-10%
-5%
0%
5%
10%
15%
20%
25%78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08F
Rea
l NW
P G
row
th
-4%
-2%
0%
2%
4%
6%
8%
Real
GDP
Gro
wth
Real NWP Growth Real GDP
Real GDP Growth vs. Real P/C Premium Growth: Modest Association
P/C insurance industry’s growth is influenced modestly by growth
in the overall economy
Sources: A.M. Best, US Bureau of Economic Analysis, Blue Chip Economic Indicators, 2/08; Insurance Information Inst.
Summary of Treasury “Blueprint”for
Financial Services Modernization
Impacts on Insurers
Treasury Regulatory Recommendations Affecting Insurers
Source: Department of Treasury Blueprint for a Modernized Financial Regulatory System, March 2008.
• Establishment of an Optional Federal Charter (OFC)Would provide system for federal chartering, licensing, regulation and supervision of insurers, reinsurer and producers (agents & brokers)OFC insurers would still be subject to state taxes, provisions for compulsory coverage, residual market and guarantee funds OFC would specify specific lines covered by charter; Separate charters needed for P/C and Life
• OFC Would Incorporate Several Regulatory ConceptsEnsure safety and soundnessEnhance competition in national and international marketsIncrease efficiency through elimination of price controls, promote more rapid technological change, encourage product innovation, reduce regulatory costs and provide consumer protection
• Establishment of Office of National Insurance (ONI)Department within Treasury to regulate insurance pursuant to OFCHeaded by Commissioner of National InsuranceCommissioner has regulatory, supervisory, enforcement and rehabilitative powers to oversee organization, incorporation, operation, regulation of national insurers and national agencies
• Establishment of Office of Insurance Oversight (OIO)Department within Treasury to handle issues needing immediate attention such “reinsurance collateral”; OIO could focus immediately on “key areas of federal interest in the insurance sector”OIO: lead regulatory voice on international regulatory policyWould have authority to ensure states achieved uniform implementation of declared US international insurance policy goalsOIO would also serve as advisor to Treasury Secretary on major domestic and international policy issues
• UPDATE: HR 5840 Introduced April 17 Would Establish Office of Insurance Information (OII)
Very similar to OIOSource: Department of Treasury Blueprint for a Modernized Financial Regulatory System, March 2008.
Treasury Regulatory Recommendations Affecting Insurers (cont’d)
CATASTROPHICLOSS
No Appreciable Spillover Effects
U.S. Insured Catastrophe Losses*$7
.5$2
.7$4
.7$2
2.9
$5.5 $1
6.9
$8.3
$7.4
$2.6 $1
0.1
$8.3
$4.6
$26.
5$5
.9 $12.
9 $27.
5
$6.7
$3.4
$100
.0
$61.
9
$9.2
$0
$20
$40
$60
$80
$100
$120
89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 0708
:Q1
20??
*Excludes $4B-$6b offshore energy losses from Hurricanes Katrina & Rita. Note: 2001 figure includes $20.3B for 9/11 losses reported through 12/31/01. Includes only business and personal property claims, business interruption and auto claims. Non-prop/BI losses = $12.2B.Source: Property Claims Service/ISO; Insurance Information Institute
$ Billions
2006/07 were welcome respites. 2005 was by far the worst year ever for insured catastrophe losses in the US. Few “spillover effects” into
non-property lines
$100 Billion CAT year is coming soon
Shifting Legal Liability & Tort
EnvironmentIs the Tort Pendulum
Swinging Against Insurers?
Bad Year for Tort Kingpins*“King of Class Actions” Bill Lerach
•Former partner in class action firm Milberg Weiss•Admitted felon. Guilty of paying 3 plaintiffs $11.4 million in 150+ cases over 25 years & lying about it repeatedly to courts•Will serves 1-2 years in prison and forfeit $7.75 million; $250,000 fine
“King of Torts” Dickie Scruggs•Won billions in tobacco, asbestos and Katrina litigation•Pleaded guilty for attempting to offer a judge $40,000 bribe to resolve attorney fee allocation from Katrina litigation in his firm’s favor. His son/others guilty on related charges•Could get 5 years in prison, $250,000 fine
Sour
ce: S
an D
iego
Uni
on T
ribun
e, 9
/19/
07So
urce
: Wal
l Stre
et Jo
urna
l, 3/
15/0
7
$17.0$49.6 $58.7
$85.6$17.1
$51.0$70.9
$85.6
$5.2
$20.4
$30.0
$45.5
$0
$50
$100
$150
$200
$250
1980 1990 2000 2006
Commercial Lines Personal Lines Self (Un)Insured
Bill
ions
Total = $39.3 Billion
*Excludes medical malpracticeSource: Tillinghast-Towers Perrin, 2007 Update on US Tort Cost Trends.
Total = $121.0 Billion
Total = $159.6 Billion
Total = $216.7 Billion
Personal, Commercial & Self (Un) Insured Tort Costs*
Tort System Costs, 1950-2009E
$1.8 $5.4 $7.9$13.9$20.0
$83.7
$130.2
$179.2
$246.0$265
$277
$158.5
$247.0
$42.7
$3.4
0.62%0.82%
1.03%
1.34%1.22%
1.98%2.14%
1.82% 1.83%1.83%1.87%
2.24%2.24%
1.53%
1.11%
$0
$50
$100
$150
$200
$250
$300
50 55 60 65 70 75 80 85 90 95 00 03 06 08E 09E
Tor
t Sys
tem
Cos
ts
0.0%
0.5%
1.0%
1.5%
2.0%
2.5%
Tor
t Cos
ts a
s % o
f GD
P
Tort Sytem Costs Tort Costs as % of GDP
Source: Tillinghast-Towers Perrin, 2007 Update on U.S. Tort Costs as % of GDP
After a period of rapid escalation,
tort system costs as a % of GDP are
now falling
The Nation’s Judicial Hellholes (2007)
Source: American Tort Reform Association; Insurance Information Institute
TEXASRio Grande Valley and Gulf Coast
South Florida
ILLINOISCook County West Virginia
Some improvement in “Judicial
Hellholes” in 2007
Watch ListMadison County, ILSt. Clair County, IL
Northern New Mexico
Hillsborough County, FLDelawareCalifornia
Dishonorable MentionsDistrict of Columbia
MO Supreme CourtMI Legislature
GA Supreme CourtOklahoma
NEVADAClark County (Las Vegas)
NEW JERSEYAtlantic County (Atlantic City)
Business Leaders Ranking of Liability Systems for 2007
Best States1. Delaware2. Minnesota3. Nebraska4. Iowa5. Maine6. New Hampshire7. Tennessee8. Indiana9. Utah10. Wisconsin
Worst States41. Arkansas42. Hawaii43. Alaska44. Texas45. California46. Illinois47. Alabama48. Louisiana49. Mississippi50. West Virginia
Source: US Chamber of Commerce 2007 State Liability Systems Ranking Study; Insurance Info. Institute.
New in 2007ME, NH, TN,
UT, WI
Drop-OffsND, VA, SD,
WY, ID
NewlyNotorious
AK
RisingAbove
FL
Midwest/West has mix of good and bad states
Insurance Information Institute On-Line
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