Insurance Organizational Structure Outline & Definitions
Insurance Organization Chart Template
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Insurance is a means to manage a contingent loss through which responsibility for a risk is transferred to another party in exchange for payment before the loss. The cost of insurance is based upon the insurance company's pooling of similar risks, occurrences that can be estimated using statistical modeling (actuarial analysis). An insurance company earns revenue from premiums, as well as the investment of those premiums in various financial instruments/markets. Insurance can be purchased by individuals for life, health, property and liability losses. Corporations purchase insurance to cover liability, property, business and executive health and life risks. Insurance can be purchased directly from a company, through "captive" agents working for a single firm or through independent insurance agents who sell products from multiple insurance providers.
Common Insurance job titles: Chief Executive Officer (CEO), Chief Operating Officer (COO), Chief Financial Officer (CFO)
Lines of Busines
Lines of Business (LOB) refers to specific products and services offered by insurance companies to both individual and commercial clients. Major LOBs typically include Commercial Insurance, Health Insurance, Investment Management, Life Insurance, Property & Casualty Insurance, Reinsurance and Risk Management. The insurance agents and back office staff members are responsible for pricing these products/services, generating new business and managing policyholder relationships. LOBs are supported by back office staff members, who work to perform non-customer-facing tasks like claims processing, customer service support, payment collection, and policyholder onboarding.
Common Lines of Busines job titles: Business Unit Manager, Business Team Manager, Business Manager, Business Controller
Commercial/Institutional Lines
The Commercial/Institutional Lines Group offers property and casualty insurance products to businesses. Commercial/Institutional Lines insurance include products such as commercial auto insurance, workers compensation insurance, federal flood insurance and so on. Commercial/Institutional lines protect businesses against potential losses (caused by accidents, lawsuits, natural disasters, etc.) they could not cover on their own. Coverage availability and premium costs vary by business type, size and location.
Common Commercial/Institutional Lines job titles: Commercial Insurance Account Executive, Commercial Lines Insurance Account Manager, Commercial Insurance Agent, Commercial Insurance Broker
Health Insurance
The Health Insurance line of business offers health plan benefits to customers. While there are several insurers that focus exclusively on health insurance, many multi-line insurers also offer health coverage. Health insurance can be provided on an individual or group (company or family coverage) basis and provides coverage for medicine, visits to the doctor or emergency room, hospital stays and other medical expenses. Health insurance is often included in employer benefit packages as a means of attracting quality employees.
Common Health Insurance job titles: Insurance Agent, Insurance Broker
Investment Management
The Investment Management line of business offers traditional retail investment products to customers. Investment products and services typically offered by insurance firms include annuities, universal life insurance, retirement planning and investment and college savings plans. Some insurance companies may offer investment solutions for businesses.
Common Investment Management job titles: Investment Management Analyst, Investment Management Associate, Investment Strategist, Investment Consultant
Life
The Life Insurance Group provides policyholders protection against the loss of income that would result if the insured passed away. The named beneficiary or beneficiaries then receive the proceeds and are thereby safeguarded from the financial impact of the death of the insured. Depending on the contract, some events such as terminal illness can trigger payment to the beneficiaries, while other events such as claims relating to suicide, or fraud are written as exclusions so as to limit the liability of the insurer. Life-based insurance contracts tend to fall into two major categories: protection policies and investment policies.
Common Life job titles: Life Insurance Agent, Life Insurance Sales Agent, Insurance Cusomer Service Agent
Property & Casualty
The Property & Casualty (P&C) Group provides coverage that protects against property losses such as to a home, car or other property, while also providing liability coverage to help protect policyholders if found liable for an accident that causes injuries to another person or damage to another person's belongings. P&C insurance can also cover the medical expenses of individuals involved in accidents as well as restitution or repair of damaged property. P&C insurance policies can cover several property types - aviation insurance, boiler and machinery insurance, marine insurance, earthquake insurance, renters insurance, etc.
Common Property & Casualty job titles: Insurance Property & Casualty Sales Representative, Insurance Agent, Insurance Representative, Client Service Specialist, Property & Casualty Insurance Broker
Reinsurance
The Reinsurance Group (usually called a reinsurer) takes on all or part of the risk covered under a policy issued by another insurance company (usually called a cedent) in exchange for a percentage of the premium payment. This allows cedent companies to reduce the likelihood of having to pay a large amount of money should one or more policyholders file claims that would financially destabilize the company (this usually occurs after a major disaster such as a hurricane or earthquake). The reinsurer may be either a company specializing in reinsurance, or another insurance company.
Common Reinsurance job titles: Senior Enterprise Risk Management Analyst, Reinsurance Accounting Technician, Risk Analyst, Reinsurance Associate, Reinsurance Administration Specialist, Reinsurance Analyst
Risk Management
The Insurance Risk Management function researches and analyzes potential liabilities for insurance policies based on potential hazards and risks. Such risks can originate from the policyholders themselves (how likely the policyholder will pay the premium and/or cause a claim to be filed), the location of the policyholder (how likely a flood will occur in an area, for instance), how lucrative an investment is (how likely the investment will incur a financial loss for the company) and so on. Based on the information gathered, companies can either accept or attempt to mitigate the risk.
Common Risk Management job titles: Insurance Risk Management Specialist, Risk Management Consultant, Risk Management Analyst
Back Office Operations
Insurance Back Office Operations refers to a set of essential non-customer-facing administrative and support services. The Back Office is responsible for managing several activities such as claims processing, policyholder service/support, premium payment collection, internal investments, underwriting and insurance application processing. Back Office staff members support both the insurance company's agency operation and individual lines of business such as Commercial & Institutional Lines, Health Insurance, Investment Management, Life Insurance, Property & Casualty Insurance, Reinsurance and Risk Management.
Common Back Office Operations job titles: Operations Specialist/Analyst, Customer Service Representative, Insurance Service Representative, Insurance Agent
Claims Processing
The Claims Processing function is tasked with examining and processing insurance claims, paper and/or electronic. Processors determine whether to return, pend, deny or pay claims within the client's policy guidelines and determine steps necessary for adjudication. In addition, claims processing compares claim applications and/or provider statements with policy files and other records to evaluate completeness and validity of a claim.
Common Claims Processing job titles: Claims Processor, Claims Coordinator, Claims Adjuster, Claims Examiner, Claims Investigator
Investments
Insurance company investment functions are responsible for taking profits earned from policyholder premium payments and investing them in financial instruments such as bonds, stocks, mortgages and real estate. In some cases, insurance investment teams may also lead mergers and acquisitions. The management of the investment function is an important element of an insurance company's profitability. Insurance companies face less regulation, on the securities trading front, than banking, broker dealer and investment management companies.
Common Investments job titles: Investment Specialist, Investment Associate, Investment Analyst, Investment Consultant
New Business Processing
The New Business Processing function is responsible for 'onboarding' new insurance policyholders. They collect the requisite information, pass that information to the appropriate underwriting and application processing staff members (based on application type, language requirements and product knowledge) to assess the appropriate premium and coverage levels, then communicate options and premium/deductible structures to the prospective policyholder.
Common New Business Processing job titles: New Business Specialist, Insurance Agent, Insurance Broker, Application Processor
Policyholder Services
The Policyholder Services, or In-force Customer Service, function is tasked with serving as the customer's reference point for all questions and needs concerning the policyholder's insurance policy and its related products. This function provides personal service support to internal and external customers for all areas within and outside the company. Additional tasks involve payment collection, offering advice on various insurance products or services, policy renewals, and providing accurate responses to other policyholders, providers and employee representatives as needed for issue resolution. High quality customer service is a key differentiator in the hyper-competitive insurance industry.
Common Policyholder Services job titles: Member Care Representative, Policy Service Representative, Customer Service Representative, Customer Care Associate
Payments & Commissions
The Payments & Commissions function is responsible for collecting customer premiums, processing salaries and commissions and distributing any applicable benefits to insurance agents. Though commissions are the most common form of compensation for insurance agents (amounts depend on the type and amount of insurance sold as well as whether the transactions are new policies or renewals), salaries are also managed and distributed.
Common Payments & Commissions job titles: Insurance Compensation Analyst, Payroll & Commissions Administrator, Commissions Specialist, Payroll Analyst
Agency Operations
The Insurance Agency Operations function manages the firm's network of insurance agents and brick and mortar branch offices. Agency operations managers are responsible for recruiting staff members (sales and non-sales), ensuring that all agents have the proper licensing and training to sell products on the firm's behalf, distributing marketing collateral, attracting and educating potential policyholders and monitoring the performance of agency offices. As more potential customers move to the internet and other direct channels to receive quotes and complete insurance applications, the importance of superior customer service, policyholder retention, effecitve use of technology and marketing/advertising reach for physical agency branch locations has taken on increased importance.
Common Agency Operations job titles: Agency Business Consultant, Sales Manager Assistant, Insurance Servie Operations Analyst, Operations Agent
Agency Office Administration
The Agency Office Administration function manages insurance policies (whether for customers or for company employees), dealing with the paperwork and the details of insurance contracts. Insurance agency office administration staff act as liaisons between employees and insurance companies (i.e., "the home office"), conduct administrative tasks as needed, makes sure the company's insurance certificates are in full compliance and helps the company develop policies for risk management and loss control.
Common Agency Office Administration job titles: Insurance Administrative Assistant, Agency Office Assistant, Insurance Office Assistant, Insruance Office Receptionist
Agent Recruiting
The Agent Recruiting function attracts, screens and selects quality candidates for open insurance agent positions within the company. This group identifies vacancies, develops position descriptions, formulates a strategic recruitment plan (includes posting positions on social media and other platforms, performing guest lectures at universities, attending job fairs and networking events, etc.), reviews candidates and sends selected candidates to the HR Department for further review. Some recruiters review applicants themselves and select individuals to be hired. Recruiters fall into two categories: internal and external recruiters.
Common Agent Recruiting job titles: Insurance Sales Recruiter, Insurance Recruiter, Insurance Recruiting Specialist
Agent Revenue Production (Sales)
The Agent Revenue Production (Sales) group is the main force behind insurance companies and involves the agents themselves. Also known as the Insurance Sales Team, or "Sales Force," this group is responsible for generating sales (involves new business, renewals and so on) for one or more insurance companies by contacting and meeting with potential clients, providing information concerning one or more types of insurance policies and generating accurate and timely insurance premium quotes. Many agents spend a lot of their time marketing their services and creating their own base of clients. Insurance agents fall under two categories: captive agents (agents who work for one insurance company) and independent insurance agents (agents who work for insurance brokerages).
Common Agent Revenue Production (Sales) job titles: Insurance Sales Agent, Insurance Agent, Insurance Sales Associate, Insurance Service Representative, Insurance Sales Producer