property-casualty-insurance

Property and Casualty Insurance

When to Use

• Explain P&C lines, coverages, and how commercial vs personal programs differ
• Walk through underwriting workflow: appetite, submission, quote, bind, endorsements
• Clarify policy mechanics: occurrence vs claims-made, limits, deductibles, exclusions, triggers
• Describe claims lifecycle from FNOL through investigation, reserving, settlement, litigation
• Frame reinsurance structures and catastrophe risk transfer at overview level
• Compare distribution models (agent, broker, MGA, direct) and typical economics
• Interpret underwriting and profitability metrics (loss ratio, expense ratio, combined ratio)
• Outline state insurance regulation concepts (DOI oversight, rate/form filing)—not legal advice
• Support business cases, operating reviews, or due diligence with P&C domain context

When NOT to Use

• Life, health, annuity, or long-term care product design and pricing depth → dedicated life/health skills if available; otherwise note limitation
• Loss development triangles, IBNR methods, credibility studies, or appointed-actuary sign-off → actuary
• Legal interpretation of policy wording, coverage disputes, or regulatory enforcement → commercial-counsel
• Corporate FP&A, investor metrics, or non-insurance financial modeling → financial-analyst (if installed)
• SOC 2 / ISO control mapping without insurance operations context → compliance-engineer
• Executive strategy without insurance domain detail → business-consultant
• Enterprise risk registers unrelated to underwriting/claims → security-risk-analyst (if installed)
• AML/financial crime or sanctions programs → aml-compliance, financial-intelligence-unit

Related skills

Need	Skill
Pricing, reserving, triangles, IBNR, assumption governance	actuary
Contract review, policy wording disputes, regulatory interpretation	commercial-counsel
Business case, operating model, transformation	business-consultant
Technical control evidence, audit packages	compliance-engineer
GRC program charter and gap plans (non-insurance-specific)	compliance-specialist
IFRS 17 / insurance contract measurement (accounting)	ifrs
Financial statements and close packs	financial-statements (if installed)
Vendor and cyber third-party risk	vendor-cyber-risk-analyst
Anti-false-positive alert triage (fraud/claims analytics)	anti-false-positive-decision-making

Core Workflows

1. Engagement scoping

Before analysis:

1. Segment — Personal vs commercial; admitted vs surplus; program vs single policy
2. Line of business — Property, GL, WC, auto, umbrella, specialty, package
3. Decision — Quote, renewal, claims handling, reinsurance placement, regulatory filing context
4. Jurisdiction — State(s), filing status, experience mod (WC), territory
5. Materiality — Limits, deductibles, cat exposure, class codes, prior loss history

See references/pc_insurance_scope_and_lines.md.

2. Underwriting and risk selection

1. Define appetite and declination triggers (class, geography, limit profile)
2. Ingest submission: application, loss runs, SOV, financials, inspections
3. Apply rating variables and manual vs filed factors; document debits/credits
4. Set terms: limits, deductibles/SIR, endorsements, subjectivities
5. Price to target loss ratio and combined ratio; note reinsurance and cat load
6. Bind with clear conditions; track endorsements and mid-term changes

See references/underwriting_and_risk_selection.md.

3. Policy coverage and forms

1. Identify coverage part (CG, CP, CA, WC, etc.) and edition date
2. Map insuring agreement, exclusions, conditions, and endorsements
3. Confirm trigger (occurrence vs claims-made) and retro dates where applicable
4. Reconcile limits (per occurrence, aggregate, sublimits) and deductibles/SIR
5. Flag common gaps (ordinance/law, BI waiting period, employee injury exclusions)
6. Escalate wording disputes to commercial-counsel

See references/policy_coverage_and_forms.md.

4. Claims lifecycle

1. FNOL — capture facts, policy verification, coverage preliminary
2. Assign adjuster; establish reserves (case, IBNR directionally—detail with actuary)
3. Investigate liability and damages; manage vendors and counsel
4. Negotiate settlement; subrogation and salvage where applicable
5. Close with file documentation; feed experience to underwriting

See references/claims_lifecycle_and_handling.md.

5. Reinsurance and catastrophe

1. Classify peril and geographic cat accumulation
2. Select structure: quota share, surplus, per-risk XOL, cat XOL, cat bonds (overview)
3. Align retentions and reinstatements to capital and rating agency context
4. Coordinate with pricing cat load and aggregate monitoring

See references/reinsurance_and_catastrophe.md.

6. Metrics, regulation, and operations

1. Compute and interpret loss, expense, and combined ratios
2. Separate attritional vs cat and large-loss development in narrative
3. Outline DOI filing, market conduct, and financial examination concepts
4. Map distribution economics (commission, MGA overrides, profit sharing)

See references/metrics_regulatory_and_operations.md.

Deliverable standards

Deliverable	Minimum content
Underwriting summary	Risk description, appetite fit, terms, pricing rationale, open items
Coverage memo	Form edition, triggers, limits/deductibles, key exclusions, gaps
Claims status	FNOL facts, coverage position (preliminary), reserves, next steps
Reinsurance brief	Structure, layer, retention, reinstatement, cat aggregation note
Metrics commentary	Period ratios, drivers, cat/large loss callouts, actions

Always label preliminary coverage positions and regulatory comments as not legal or actuarial advice; escalate to qualified professionals for filings, sign-off, and disputes.

When to load references

• Scope and LOBs → references/pc_insurance_scope_and_lines.md
• Underwriting → references/underwriting_and_risk_selection.md
• Policy and coverage → references/policy_coverage_and_forms.md
• Claims → references/claims_lifecycle_and_handling.md
• Reinsurance and cat → references/reinsurance_and_catastrophe.md
• Metrics and regulation → references/metrics_regulatory_and_operations.md