ChecklistGuro Loss Ratio Analysis Process
Optimize your underwriting profitability with our comprehensive Loss Ratio Analysis Process. Streamline insurance claims evaluation, identify high-risk patterns, and uncover actionable insights to reduce claims leakage and boost your bottom line through data-driven loss forecasting and risk assessment.
Start
Start of the Workflow/Process.
1. Fetch Total Premiums
Retrieve all premium entries for the specified period from the Premium Data Model.
2. Fetch Total Claims Paid
Retrieve all claims paid entries for the specified period from the Claims Data Model.
3. Fetch Total Claims Outstanding
Retrieve all unpaid/reserved claim amounts from the Claims Data Model.
4. Aggregate Total Premium
Sum all premium entries to calculate the total earned premium.
5. Aggregate Total Claims Cost
Sum both paid and outstanding claims to determine the total incurred loss.
6. Calculate Loss Ratio
Execute formula: (Total Incurred Loss / Total Earned Premium) * 100.
7. Identify Variance
Calculate the difference between the current loss ratio and the target threshold (e.g., 60%).
8. Determine Threshold Breach
Logic check: If Loss Ratio > Target Threshold, return 'Breach'; else return 'Healthy'.
9. Create Analysis Record
Create a new entry in the 'Loss Ratio Reports' data model containing the calculated metrics.
10. Assign Investigation Task
If a breach is detected, create a task for the Underwriting Manager to investigate the spike in claims.
11. Notify Actuary
Create a task for the Actuarial team to review the data accuracy.
12. Send Executive Summary
Send an automated email to the CFO with the summary of the Loss Ratio results.
13. Generate Visual Trend Report
Generate a visual report comparing this month's ratio against historical monthly trends.
14. Update Risk Status
Update the 'Risk Profile' data model to reflect 'High Risk' if the loss ratio exceeds a critical limit.
End
End of the Workflow/Process.
Start of the Workflow/Process.
Retrieve all premium entries for the specified period from the Premium Data Model.
Retrieve all claims paid entries for the specified period from the Claims Data Model.
Retrieve all unpaid/reserved claim amounts from the Claims Data Model.
Sum all premium entries to calculate the total earned premium.
Sum both paid and outstanding claims to determine the total incurred loss.
Execute formula: (Total Incurred Loss / Total Earned Premium) * 100.
Calculate the difference between the current loss ratio and the target threshold (e.g., 60%).
Logic check: If Loss Ratio > Target Threshold, return 'Breach'; else return 'Healthy'.
Create a new entry in the 'Loss Ratio Reports' data model containing the calculated metrics.
If a breach is detected, create a task for the Underwriting Manager to investigate the spike in claims.
Create a task for the Actuarial team to review the data accuracy.
Send an automated email to the CFO with the summary of the Loss Ratio results.
Generate a visual report comparing this month's ratio against historical monthly trends.
Update the 'Risk Profile' data model to reflect 'High Risk' if the loss ratio exceeds a critical limit.
End of the Workflow/Process.
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