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效率与协作 · SKILL.md

property-casualty-insurance

property-casualty-insurance

【效率与协作】Guides property and casualty (P&C) insurance—commercial and personal lines, major LOBs (property, GL, workers comp, commercial auto, umbrella, specialty), underwriting and risk selection, policy triggers (occurrence vs claims-made), limits and exclusions, claims (FNOL, reserving, litigation), reinsurance and catastrophe, distribution (agents, brokers…

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name: property-casualty-insurance description: | Guides property and casualty (P&C) insurance—commercial and personal lines, major LOBs (property, GL, workers comp, commercial auto, umbrella, specialty), underwriting and risk selection, policy triggers (occurrence vs claims-made), limits and exclusions, claims (FNOL, reserving, litigation), reinsurance and catastrophe, distribution (agents, brokers, MGAs), metrics (loss ratio, combined ratio, cat load), and state DOI/rate filing overview—not legal advice. Use for P&C insurance, property and casualty, commercial lines, workers comp, general liability, combined ratio, loss ratio, underwriting, claims-made, occurrence policy, reinsurance, catastrophe, MGA, rate filing, or FNOL—not actuarial modeling (actuary), life/health depth, legal interpretation (commercial-counsel), or GRC controls without insurance context (compliance-engineer).

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

NeedSkill
Pricing, reserving, triangles, IBNR, assumption governanceactuary
Contract review, policy wording disputes, regulatory interpretationcommercial-counsel
Business case, operating model, transformationbusiness-consultant
Technical control evidence, audit packagescompliance-engineer
GRC program charter and gap plans (non-insurance-specific)compliance-specialist
IFRS 17 / insurance contract measurement (accounting)ifrs
Financial statements and close packsfinancial-statements (if installed)
Vendor and cyber third-party riskvendor-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

DeliverableMinimum content
Underwriting summaryRisk description, appetite fit, terms, pricing rationale, open items
Coverage memoForm edition, triggers, limits/deductibles, key exclusions, gaps
Claims statusFNOL facts, coverage position (preliminary), reserves, next steps
Reinsurance briefStructure, layer, retention, reinstatement, cat aggregation note
Metrics commentaryPeriod 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
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