Sure! KOSTER International Insurance Digest

January 2012

Sure! is a compilation of press reports as well as market research conducted by KOSTER verzekeringen b.v. and Europe House, Inc., in order to gain more insight into the developments concerning the insurance industry as it relates to the overall global economic climate, social structure and the political environment. The information published in Sure! does not necessarily reflect the viewpoint or the opinion of KOSTER or Europe House, Inc.

Part 1: 2012: Global Economic, Social and Political Outlook

  • Summary of issues
  • Main developments
  • Europe Forecast — EMU
  • Conclusions

    Part 2: Global Insurance Industry Highlights
    Europe
    European Union

  • European Commission adopts guidelines
  • Europe-wide solvency standards for insurers delayed until 2014
    France
  • French citizens putting their money in banks while Insurance Industry suffers
    Greece
  • Hellenic Association of Insurance Companies report net written life premiums decreased by 8,5%
    Netherlands
  • ING bank reorganizes its bad EURO debt
  • KPMG LLP indicates a “dramatic reversal” of the Insurance sector’s outlook is underway
  • Netherlands Insurance Industry Intermediary Agent Sector (NIIIAS) concerned about discriminatory approach Dutch Government towards the sector
    Poland
  • Pharma sector joins doctors in attack on proposed Government reimbursement law

    Asia
    China

  • China Life Insurance Company Limited posts 586.728 million euro profit third quarter 2011
  • Chinese Insurance Industry faces major challenges in 2012
    Indonesia
  • Social Health Insurance for the Poor
    Japan and New Zealand
  • Reinsurer says earthquakes in Japan, New Zealand make 2011 industry’s costliest yet
    Thailand
  • Major losses in 2011 as a result of floods

    The American Continent
    Brazil
    - Brazilian personal accident, health insurance market to grow
    Canada

  • Social media a tool to focus protests against the insurance industry
    USA
  • Major health insurers doing very well
  • Employment figures US Insurance Industry
  • Linking US Medicare reimbursements to the quality of a hospital's care

    Part 1: 2012: Global Economic, Social and Political Outlook
    Looking at the possible Global scenarios for 2012, the Conference Board, a US based non-advocacy, not-for-profit organization provided the following outlook.

    Summary of Issues:
    Until at least the middle of the next decade, global growth is likely to slow to approximately 3% per year on average – a rate somewhat below the average of the last two decades. A recovery in advanced economies will be more than offset by a gradual slowdown in emerging ones as they mature, with the net result that global growth will slow. But the biggest risk ahead for the global economy is not this slower overall growth in output but a slowdown in average output per capita, which will determine how fast living standards can be supported and raised.

    Main developments:

    • Global growth is projected to grow at 3,2% in 2012, then accelerate somewhat to 3,5% from 2013-2016, and then show a further slowdown to 2,7% from 2017-2025. At 3 %, on average, global growth will still be somewhat higher than the period 1980-1995 but between half and a full percentage point below the growth rate from 1995-2008.
    • Advanced economy growth is expected to slow down from an already meager 1,6% in 2011 to 1,3% in 2012. For 2013-2016, the outlook suggests some recovery in advanced economies, bringing these countries back to the pre-recession growth trend of a little more than 2%.
    • In 2012 emerging economies will slow in growth by 1,3 percentage points on average, going from 6,4% growth in 2011 to 5,1% in 2012, partly as a result of slower export growth and partly because several of them have been growing above trend. From 2017-2025 emerging and developing countries are projected to grow at 3.4%. Many economies will begin to show signs of maturing, at which point the rapid catch-up growth abates.
    • The greatest challenge for the global economy in this slow growth environment is to raise productivity without losing job opportunities for the millions who are looking for reasonably paid jobs to support their living standards. The growth rate of per capita income globally has been around 2,4% since the beginning of the century. But sometime between 2017 and 2025, this rate will fall below 2%. In contrast to the past half century, that slowdown will also be accompanied by slower growth in population.
    Europe Forecast 2012
    Looking at the European developments for 2012, the Stratfor Group, a subscription-based provider of geopolitical analysis founded in 1996 by bestselling author George Friedman, noted “the European Union and eurozone will survive 2012, and Europe's financial crisis will stabilise, at least temporarily.” However, Stratfor expects Europe to continue its long, painful slide into deepening recession.

    We expect accelerating capital flight out of peripheral European countries as investors in Europe and farther afield lose confidence in the European system. We expect financial support measures to be withdrawn on occasion to maintain pressure on governments to implement austerity, which will lead to financial scares and extreme volatility.”

    However, the driving force behind developments in Europe in 2012 will be political, not economic. Germany, seeing an opportunity in the ongoing financial crisis, is using its superior financial and economic position to attempt to alter the eurozone's structure to its advantage. The core of this "reform" effort is to hardwire tight financial controls into as many European states as possible, both in a new intergovernmental treaty and in each state's national constitution. Normally, we would predict failure for such an effort: Sacrificing budgetary authority to an outside power would be the most dramatic sacrifice of state sovereignty yet in the European experiment – a sacrifice that most European governments would strongly resist. However, the Germans have six key advantages in 2012.

    First, there are very few scheduled electoral contests, so the general populace of most European states will not be consulted on the exercise. Of the eurozone states, only France, Slovakia and Slovenia face scheduled national elections. Out of these three, France is by far the most critical: The Franco-German partnership is the core of the European system, and any serious breach between the two would herald the end of the European Union. If Germany is to compromise on its efforts for anyone, it will be for France, and if France needs another country in order to secure its own position in Europe, it needs Germany. Consequently, the two have chosen to collaborate rather than compete thus far, and we expect their partnership to survive the year. Luckily for the German effort, French elections will be at the very beginning of the ratification process, so any possible modifications to the German plan will come early.

    Second, Germany only needs the approval of the 17 eurozone states - rather than the 27 members of the full European Union - to forward its plan with credibility. That the United Kingdom has already opted out is inconvenient for those seeking a pan-European process, but it does not derail the German effort.

    Third, the process of approving a treaty such as this will take significant time, and some aspects of the reform process can be pushed back. European leaders are expected to sign the new treaty in March, and the rest of the year and some of 2013 will be used to seek ratification by individual countries. Amending national constitutions to satisfy Germany will be the bitterest part of the process, but much of that can be put off until 2013, and judgment by European institutions over how the revision process was handled comes still later. Such delays allow political leaders the option of pushing back the most politically risky portions of the process for months or years.

    Fourth, the Germans are willing to apply significant pressure. Nearly all EU states count Germany as the largest destination for their exports, and such exports are critical for local employment. In 2011, Germany used its superior economic and financial position as leverage to help ease the elected leaderships of Greece and Italy out of office, replacing them with unelected former EU bureaucrats who are now working to implement aspects of the German program. Similar pressures could be brought to bear against additional states in 2012.

    Those most likely to clash with Germany are Ireland, Finland, the Netherlands and Spain. Ireland wants the terms of its bailout program to be softened and is threatening a national referendum that could derail the ratification process. Finland's laws require parliamentary approval by a two-thirds majority for some aspects of ratification. The normally pro-European government of the Netherlands is a weak coalition that can only rule with the support of other parties, one of which is strongly eurosceptic. Spain must attempt the most painful austerity efforts of any non-bailout state if the reform process is to have credibility - and it must do so amid record-high unemployment and a shrinking economy. Also, if Greece decides to hold new elections in 2012, European stakeholders will attempt to ensure that the new government in Athens does not end its collaboration with the European Central Bank, European Commission and International Monetary Fund. None of these issues will force an automatic confrontation, but all will have to be managed to ensure successful ratification, and the Germans have demonstrated that they have many tools with which to compel other governments.

    Fifth, the Europeans are scared, which makes them willing to do things they would not normally do - such as implementing austerity and ratifying treaties they dislike. Agreeing to sacrifice sovereignty in principle to maintain the European economic system in practice will seem a reasonable trade. The real political crisis will not come until the sacrifice of sovereignty moves from the realm of theory to application, but that will not occur in 2012. In many ways, the political pliability of European governments now is all about staving off unbearable economic catastrophe for another day.

    The economic deferment of that pain is the sixth German advantage. Here, the primary player is the ECB. The financial crisis has two aspects: Over-indebted European governments are lurching toward defaults that would collapse the European system, and European banks (the largest purchasers of European government debt) are broadly insolvent - their collapse would similarly break apart the European system. In December, the ECB indicated that it was willing to put up €20 billion ($28 billion) a week for sovereign bond purchases on secondary markets to support struggling eurozone governments, while extending low-interest, long-term liquidity loans to European banks in unlimited volumes. The bond program is large enough to potentially purchase three-fourths of all expected eurozone government debt issuances for 2012, while the first day of the loan program extended 490 billion euros in fresh credit to ailing banks.

    Together these two measures make a eurozone financial meltdown highly unlikely in 2012, but they will greatly degrade European competitiveness and efficiency. That will be a problem for another time, though. For now, ECB actions are buying economic and political breathing room: economic in that austerity efforts can be somewhat softer than they would otherwise need to be, and political in that there is a feeling that Germany is willing to compromise somewhat on the issues of budgetary discipline today in order to achieve its broader goals of budgetary control tomorrow. Therefore, while the financial support is not exactly buying goodwill from other European states, it is certainly buying time. As the ratification process proceeds, European hostility toward Germany and Brussels will increase. Internationally, the key theme will be states attempting to protect themselves from what they see as a growing - and unwelcome - German intrusion into their internal affairs. At the national level, deepening austerity will generate anger toward governments. The relative dearth of elections will deny that anger its normal release valve of centrist opposition parties, emboldening nationalist and extremist movements and leading to social unrest.

    Conclusions: EU will not collapse in 2012
    Political and financial turbulence will persist within this framework as Germany negotiates the new treaty with other eurozone countries. Though the core of these negotiations is a highly contentious abdication of national fiscal sovereignty, Europe is highly likely to adopt the new treaty since a perceived failure would dramatically accelerate the collapse of EU political structures and implementation will not happen in 2012.

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    Part 2: Global Insurance Industry Highlights
    Europe
    European Union
    Europe-wide solvency standards for insurers delayed until 2014
    The introduction of new Europe-wide solvency standards for insurers will not be fully implemented until at least January 2014. This has been confirmed by local Insurance regulators. Rather than coming into force this year as originally planned the Directive will be transposed into law by 1 January 2013 when the responsibilities of the European Insurance and Occupational Pensions Authority (EIOPA) take effect.

    European Commission adopts guidelines
    The European Commission has recently adopted guidelines to help the insurance industry implement unisex pricing, after the Court of Justice of the European Union ruled that different premiums for men and women constitute sex discrimination. In its ruling on the Test-Achats case on 1 March 2011, the Court of Justice gave insurers until 21 December 2012 to treat individual male and female customers equally in terms of insurance premiums and benefits.

    Vice-President Viviane Reding, the EU's Justice Commissioner, met with leading EU insurers in September 2011 to discuss how the industry should adapt to the Court's ruling. Following consultations with national governments, insurers and consumers, the new Commission guidelines respond to the need for practical guidance on the implications of the ruling. They aim to benefit both consumers and insurance companies.

    France
    French citizens putting their money in banks while Insurance Industry suffers
    Reuters reported that with unemployment claims at a 12-year high, French households are preparing for a rainy day despite a generous social safety system to provide for them when they retire or lose their jobs.

    French savers have been piling into French banks just as professional investors have been pulling money out of their stocks on concerns about their exposure to troubled euro sovereign debtors and their reliance on wholesale funding In case of bankruptcy, bank deposits are guaranteed in France up to EUR 100.000,- by an industry body while life insurance policies are guaranteed up to EUR 70.000,-.

    Germany
    Generali Deutschland Group signs license agreement with Conning
    Conning, a leading US global provider of asset management services, risk and capital management solutions and research to the insurance industry, recently announced that Generali Deutschland Group, the second-largest primary insurance group in the German market, has signed a multi-year license agreement to use Conning's GEMS(R) Portfolio Analyzer to support the development and control of its investment strategy.

    Greece
    Hellenic Association of Insurance Companies report net written life premiums decreased by 8,5%
    According to a recent survey by the Hellenic Association of Insurance Companies, the total net written life premiums for the first 9 months of 2011 decreased by 8,5% from the same period in 2010. All life sectors reported a loss, besides those linked to investments which reported a net premium increase of 45,6% and the Health sector which experienced a net premium increase of 55,1%. Life sector, however, dropped substantially by 19,5%.

    Netherlands
    ING bank reorganizes its bad EURO debt
    The ING Groep NV, the bailed-out Dutch bank and insurer, announced it sold a further EUR 1,2 billion worth of bonds issued by southern European nations, as it continues efforts to reduce risks to its balance sheet. The firm, which is due to split into two by next year, is seeking to alter its business model after running into deep trouble during the financial crisis that started in 2008 following the collapse of U.S. investment bank Lehman Brothers. The company's banking arm plans to return to a more traditional approach, relying more on funding from retail depositors and less on financial markets, and investing more in business loans rather than in financial products developed by other banks.

    A dramatic reversal of the insurance sector’s outlook is underway
    A new survey of insurance providers by global consulting firm KPMG LLP indicates a “dramatic reversal” of this sector’s economic outlook is underway — a reversal that may result in higher insurance rates. According to the 350 insurance executives polled by KPMG, more than a third (36%) said that business conditions for the insurance sector have worsened compared to a year ago — a significant turnaround in executive perception compared to last year’s survey, the firm noted, when more than half (51%) said conditions had improved from 2009 to 2010.

    In addition, many do not anticipate much brighter prospects in the next 18 to 24 months, as 28% predict another downturn/double dip before the economy begins to significantly recover, and 58% believe the recovery will not occur until 2013 or later. Facing this economic environment, only 31% of insurance execs surveyed expect their company to perform above expectations next year — a decline of 10% compared last year’s poll — while 24% expect to perform below expectations; up from 19% in 2010.

    Netherlands Insurance Industry Intermediary Agent Sector (NIIIAS) concerned about discriminatory approach Government towards the sector
    In a recent press release KOSTER verzekeringen b.v. commented on Dutch Government requirements, whereby Intermediary Agent Insurance Companies by law have to adhere to the requirements of the Authority of Financial Markets ( AFM) and are also required to become a member of the Complaints Institute Financial Intermediaries ( KiFiD). This means in the case of the KiFiD that the Insurance Intermediary Agent Company has to provide information to the KiFiD on the quality, reliability, and integrity of the company and its employees, in addition to complete corporate disclosure, including information on the relationship with insurance companies and commission details. The question which arises with NIIIAS companies like KOSTER is: "are these same rules also applied by the Government to the established cartel of insurance companies, banks, their subsidiaries and employees?"

    Poland
    Pharma sector joins doctors in attack on proposed Government reimbursement law
    “The government may have reached some kind of uneasy compromise with the country's doctors, but industry players say the flaws in the legislation the doctors are protesting against remain”, says Paulina Kieszkowska-Knapik, a lawyer at Baker & McKenzie specializing in pharmaceutical law.

    The doctors are up in arms about a clause in the new law that obliges doctors to monitor their patients' health insurance histories and sets fines for doctors for prescription errors. Some doctors have refused to state refund levels on prescriptions, instead marking them with a "refund upon NFZ decision" stamp.

    PM Donald Tusk has said the legislation will be amended after the doctors' protest ends, although
    the “basic elements of the new medical refund law are immovable.”

    The main cost cutting involves setting fixed prices and margins for reimbursed drugs, which will disallow discounts at all levels of the distribution chain and make prices of reimbursed drugs uniform across all pharmacies in Poland. It also caps reimbursement levels — reimbursement constituting 17% of the health budget - with a payback scheme for companies that cause excess spending. By 2014, wholesale margins will be reduced to 5% from the current 8.91% The Ministry of Health submitted the reimbursement bill in October 2010, including a fixed wholesale mark-up of 7% on prescription drugs reimbursed, with the method for establishing reference drugs for reimbursement calculations also being changed. The law means that 17% of the total annual budget of the Polish National Health Fund (NFZ) will be spent on the reimbursement of medicines.

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    Asia
    China
    China Life Insurance Company Limited posts 586.728 million euro profit third quarter 2011
    China Life Insurance Company Limited, the country's largest life insurer, posted a net profit of nearly 6 billion Yuan (586.728 million euro's) in the third quarter of 2011, up 155% year on year. The company attributed the profit surge to the improvement in the country's equity market, which led to higher investment returns. China's key Shanghai stock index has gained more than 70% this year, boosted by a recovery of the country's economic growth. China Life said its net profit totalled almost 20 billion Yuan in the first three quarters, up 52% year on year.

    Chinese Insurance Industry faces major challenges in 2012
    China’s insurance industry faces greater challenges in 2012 and insurers should seek ways to boost their capital, said the chairman of the country’s Insurance Regulatory Commission. Insurance companies faced difficult conditions last year when the annualized return on investment dropped to 3,6%. The commission is encouraging companies to find ways to boost their capital with a focus on issuance of subordinated, convertible and hybrid bonds, Xiang said in a separate statement.

    Indonesia
    Social Health Insurance for the Poor
    Indonesia's Health Minister Endang Rahayu Sedyaningsih said in January 2012 that her ministry has allocated some 6.5 trillion rupiah (about $700 million) as a first step towards Universal Health care in Indonesia.

    For 2010, the health ministry has been allocated $2,2 billion, which is a slight increase over last year but still half of what is generally spent by the defence department. Overall, spending on health comes in at less than 2% of the year's total fiscal expenditures estimated around $110 billion. Health Minister Endang Rahayu Sedyaningsih admits “it is not right yet, but a national health system is there."

    Japan and New Zealand
    Reinsurer says earthquakes in Japan, New Zealand make 2011 industry’s costliest yet
    The devastating earthquakes in Japan and New Zealand made 2011 the costliest year yet for the insurance industry in terms of natural disaster losses, a leading reinsurance company said. Munich Re AG said in an annual report that insured losses last year totalled $105 billion – exceeding the previous record of $101 billion set in 2005, when losses were swollen by claims from Hurricane Katrina in New Orleans.

    Japan’s earthquake and tsunami in March caused overall losses of $210 billion and insured losses of between $35 billion and $40 billion, Munich Re said. That didn’t include the consequences of the subsequent meltdowns at the Fukushima Dai-ichi nuclear plant, which resulted in the evacuation of a wide swath of land. The second most costly disaster for insurers, at $13 billion, was the February quake that devastated much of the New Zealand city of Christchurch. Overall losses came to $16 billion.

    Thailand
    Major losses in 2011 as a result of floods
    In Thailand claims from natural catastrophes alone reached $103 billion in 2011, compared to only $43 billion the year before. Everest Re Group, Ltd. announced that it expects to incur net losses of between $100 million and $125 million, after reinstatement premiums and taxes, for claims arising from floods in Thailand. This range of estimates is predicated on an industry loss estimate of between $10 billion and $15 billion.

    The Company’s view of its estimate of losses from this event remains preliminary and is subject to considerable uncertainty. Significant rainfall during monsoon season coupled with the aftermath of three typhoons resulted in widespread flooding across many provinces in Thailand. The event spanned several months between the periods of July and December 2011 and has had a significant impact on the Thai economy.

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    The American Continent
    Brazil
    Brazilian personal accident, health insurance market to grow
    Brazil’s personal accident and health insurance market is expected to grow in 2015 after recording the third-largest share in terms of total retained premiums of the Brazilian insurance industry in 2010.The factors of this growth will be increased penetration of health insurance products, rising disposable income and enhanced awareness for health insurance need in the country.

    The other key driver of growth is the increasing number of companies that offer health insurance as an employee benefit in the country. Group health insurance policies are also expected to increase their market share in 2015.

    Canada
    Social media a tool to focus protests against the insurance industry
    Social media could be used to harm the Canada's property and casualty industry as much as help it, according to Philip Cook, president and CEO of Omega Insurance Holdings. Specifically, Cook referred to the power of social media to mobilize public protests against insurers when economic times are tough and the affordability of insurance takes centre stage in the political spotlight.

    Cook pointed out that consumers are carrying higher debt loads and have access to less disposable income as a result of recent financial crises. Insurance pricing could therefore become a credible target of discontent for these groups. Conceivably, they could take advantage of social media to mobilize against individual insurance companies or insurance regulators.

    USA
    Major health insurers doing very well
    The president of WellNet Healthcare Group, a US based national healthcare management company, recently revealed that US top health insurers were doing very well – even as the rest of the US economy struggled. UnitedHealth, for instance, posted more than $25 billion in revenue between July and September – and profits of more than $1 billion.

    Americans now wonder if their increasing premiums are simply lining insurers' pockets, and insurers do nothing to dissuade them of that notion by refusing to make public the data underpinning their rate hikes. That's unacceptable. Consumers have a right to know how insurers set premiums. Armed with such data, employers and individuals could resist unreasonable premium increases and make more cost-effective healthcare decisions.

    Premiums were up 9% in 2011, after increases of 3% in 2010 and 5% in 2009. Insurers insist the high cost of care is to blame for the high cost of insurance. That's plausible. But why won't they open up their books to prove it?

    Insurers argue that their data is a "trade secret" and that publicizing it would benefit rivals, reduce competition, and produce higher prices. But if consumers had access to insurers' data, they'd be able to determine where their healthcare dollars were going – and take steps to cut costs. For example, if employers learned that doctors' visits were driving up the cost of the coverage they provided workers, they could establish on-site medical clinics to save money.

    Or if companies discovered that prescription drugs were responsible for rate hikes, they could encourage employees to use cheaper generic alternatives. Employers and employees would benefit. Health costs would plummet even as beneficiaries received equally good or better care.

    Employment figures US Insurance Industry
    Employment in the U.S. insurance industry added 3,300 jobs in December -- a 3.3% increase from the previous month. The insurance-industry employment figures for December put the industry about on par with where it stood in April. On a year-to-year basis, the industry, which currently sits at roughly 2.2 million jobs, is up just 0.39% since December 2010.

    Linking US Medicare reimbursements to the quality of a hospital's care
    Hospitals across the USA have spent more than a year preparing for Oct. 1, 2012. That is the expected launch date for two health care reform measures that will link Medicare reimbursements to the quality of a hospital's care. Readmission rates, patient satisfaction and a plethora of other measures will be used to calculate reimbursement rates, with lower-performing hospitals receiving less money than higher-performing ones.

    The health care reform bill signed into law by President Barack Obama in March 2010 contains a number of measures scheduled to be rolled out this year. The coming year might also bring a decision on one of the portions of health care reform legislation requiring every American to buy health insurance by 2014 or risk financial penalties.

    One of this year's measures is called value-based purchasing, which means Medicare reimbursements to hospitals will be based on the quality of care performed. There are a number of measures that will be considered when assessing a hospital's quality of care, and more will be added as time goes on.

    How satisfied a patient is with the care he or she received is one of the quality measures being linked to Medicare reimbursements. Patients will be asked about how well doctors and nurses communicated with them, whether their pain was controlled and even if the hospital was quiet and the patients' rooms were clean.

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