UNDERSTAND YOU COVERAGE BEFORE YOU NEED IT

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UNDERSTAND YOU COVERAGE BEFORE YOU NEED IT

What does self-insured retention mean?

Self-insured retention (SIR) is a risk management strategy used in insurance policies where the policyholder agrees to pay a specified amount for losses before the insurance policy takes effect. This guide explains the concept, its benefits, and how it differs from deductibles.

Definition of Self-Insured Retention

The self-insured retention is a dollar amount specified in a liability insurance policy that the insured must pay before the insurance policy will respond to a claim. It is a form of self-insurance where the insured assumes responsibility for a portion of the risk.

Understanding the Dollar Amount

The dollar amount of the self-insured retention can vary significantly depending on the policy and the level of risk the insured is willing to retain. It’s crucial for the insured to carefully consider this amount to ensure they have the financial resources to cover potential losses.

 

Responsibility for Claims

With self-insured retention, the insured is responsible for handling claims up to the specified dollar amount. This means they must have processes in place to manage claims efficiently and effectively to minimize financial impact.

How Self-Insured Retention Works

Under an insurance policy with a self-insured retention provision, the insured pays defense and/or indemnity costs associated with a claim until the self-insured retention limit is reached. After that point, the insurer makes any additional payments for defense and indemnity covered by the policy.

Managing Costs Until Limit is Reached

Until the self-insured retention limit is reached, the insured must cover all costs associated with the claim, including legal fees, settlements, and judgments. This can require careful financial planning and management to ensure sufficient funds are available.

Involvement of the Insurance Company

Once the self-insured retention limit is reached, the insurance company takes over responsibility for handling the claim. This can provide relief to the insured, as they no longer have to bear the full financial burden of the claim.

Self-Insured Retention vs. Deductibles

While both self-insured retention and deductibles require the insured to pay a portion of the claim, they differ in how claims are handled. Under a policy with a self-insured retention provision, the insured company is responsible for paying for claims or handling claims however they see fit. In contrast, under a policy with a deductible provision, the insurance company handles all claims and then seeks reimbursement from the insured company for the deductible after the claim is concluded.

Claims Handling Process

With a deductible, the insurance company typically manages the entire claims process, including investigation, settlement negotiations, and payment. The insured only becomes involved after the deductible amount has been exceeded.

Control Over Claims

Self-insured retention gives the insured more control over the claims process, allowing them to make decisions regarding settlement, litigation, and other aspects of claims management. This can be advantageous for companies that have the resources and expertise to handle claims internally.

Benefits of Self-Insured Retention

Self-insured retention offers several benefits, including:

●      Cost Savings: By assuming a portion of the risk, the insured can often negotiate lower premiums with their insurance company.

●      Customization: Self-insured retention policies can be tailored to the policyholder’s specific needs, allowing for more control over the insurance program.

●      Risk Management: Self-insured retention encourages the insured to manage risks more actively, potentially reducing the likelihood of losses.

Negotiating Lower Premiums

Insurance companies may offer lower premiums to companies that choose higher self-insured retention limits, as they are assuming more of the risk themselves. This can result in significant cost savings over time.

Tailoring Coverage

With self-insured retention, the insured has the flexibility to customize their coverage to meet their unique needs. They can adjust the self-insured retention amount and other policy parameters to align with their risk tolerance and financial capabilities.

Proactive Risk Management

By retaining a portion of the risk, companies are incentivized to implement risk management strategies to mitigate potential losses. This can lead to improved safety practices, loss prevention measures, and other initiatives aimed at reducing risk.

Disadvantages of Self-Insured Retention

However, self-insured retention also has some disadvantages, including:

●      Financial Risk: The insured must have the financial resources to cover losses up to the self-insured retention limit.

●      Complexity: Self-insured retention policies can be more complex than traditional insurance policies, requiring more resources and expertise to manage.

Financial Planning Challenges

Determining the appropriate self-insured retention limit requires careful consideration of the company’s financial position, risk exposure, and cash flow projections. Companies must ensure they have sufficient reserves to cover potential losses without jeopardizing their financial stability.

Administrative Burden

Managing self-insured retention programs can be administratively burdensome, requiring dedicated resources to handle claims, legal matters, and other aspects of risk management. This can strain internal resources and require additional expertise to navigate complex insurance issues.

Self-Insured Retention on an Umbrella Policy

Self-insured retention on an umbrella policy is used when the umbrella policy kicks in to cover gaps in the underlying policy. In this case, the self-insured retention acts as an underlying policy, with the insured paying the specified amount before the insurance company gets involved.

Filling Coverage Gaps

Umbrella policies provide additional liability coverage beyond the limits of underlying policies. By incorporating self-insured retention into an umbrella policy, companies can ensure seamless coverage for claims that exceed the underlying policy limits.

Coordination with Underlying Policies

Companies must carefully coordinate self-insured retention amounts with their underlying policies to avoid gaps or overlaps in coverage. This requires close collaboration with insurance brokers and carriers to ensure all aspects of the insurance program are aligned.

 

Becoming Self-Insured

To become self-insured, the insured must create a fund that covers the self-insured limit and have someone to handle those claims. This option is best suited for mid-size and large employers who have the financial muscle to cover the costs of significant losses using cash at hand.

Establishing a Risk Management Fund

Creating a self-insured retention fund requires careful financial planning and risk assessment. Companies must set aside sufficient reserves to cover potential losses while maintaining liquidity and financial stability.

Claims Management Infrastructure

Implementing a self-insured retention program requires establishing robust claims management processes and systems. This may involve hiring claims administrators, legal counsel, and other professionals with expertise in insurance and risk management.

Conclusion

The self-insured retention is a risk management strategy that allows the insured to assume a portion of the risk, potentially leading to cost savings and more control over the insurance program. However, it requires the insured to have the financial resources to cover losses up to the self-insured retention limit and can be more complex than traditional insurance policies. Understanding the benefits and disadvantages of self-insured retention is essential for businesses considering this risk management strategy.

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