Captive Insurance Policies & Guidelines
Comprehensive policies governing underwriting standards, claims procedures, risk management protocols, and operational guidelines for the Integral Mass Captive.
Policy Framework
Our policies are designed to ensure actuarial soundness, regulatory compliance, and operational excellence across all aspects of the captive insurance program.
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Underwriting Standards
Rigorous criteria for evaluating and accepting risk from General Contractors across all three market segments.
Claims Management
Structured procedures for claims submission, evaluation, and resolution to ensure fair and timely outcomes.
Risk Management
Proactive protocols for identifying, assessing, and mitigating risks across the captive's operations.
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Standards and criteria for evaluating General Contractors and accepting risk into the captive.
Contractor Eligibility
- Licensing: Valid Arizona ROC in good standing
- Experience: Minimum 3 years prefab installation
- Financial: $500K+ annual revenue
- Safety: OSHA compliant, no major violations
- History: ≤2 claims in past 3 years
Risk Assessment
- Complexity: Installation difficulty & site conditions
- Market: Student, multi-gen, or rural profile
- Location: Weather, soil, utility access
- Subcontractors: Credentials & performance
- Quality Control: QC procedures & inspections
Premium Calculation
- Base Rate: $50K per contractor
- Experience Mod: ±20% claims adjustment
- Market Factor: Student 1.0x, Multi-Gen 0.9x, Rural 1.1x
- Volume Discount: 5% for 50+ units/year
- Safety Credit: Up to 10% discount
Coverage Limits
- Per Occurrence: $250K max per claim
- Aggregate: $1M annual per contractor
- Deductible: $5K per occurrence
- Tail Coverage: 10-year construction defects
- Exclusions: Intentional acts, pollution, asbestos
Claims Management Policies
Structured procedures ensuring fair, efficient, and transparent claims handling.
Claims Reporting
Notification Requirements:
- Initial notice within 48 hours
- Written claim within 10 business days
- Documentation within 30 days
Required Information:
- Incident date, time, location
- Description of damage/defect
- Estimated repair cost
- Photos and inspection reports
- Witness statements (if applicable)
Investigation Process
Investigation Steps:
- Adjuster assigned within 24 hours
- Site inspection within 5 business days
- Expert review for claims over $50K
- Contractor interview & documentation
Evaluation Criteria:
- Coverage verification
- Causation analysis
- Liability determination
- Damage quantification
Resolution Timeline
Decision Timeline:
- Simple claims (<$25K): 15 days
- Complex claims ($25K-$100K): 30 days
- Major claims (>$100K): 45 days
Payment Terms:
- Payment within 10 business days
- Partial payments available
- Direct payment to contractors/homeowners
- Subrogation rights reserved
Appeals Process
First Level Appeal:
- Submit written appeal within 30 days of denial
- Review by senior claims manager
- Decision within 15 business days
Second Level Appeal:
- Submit to independent arbitration panel
- Binding arbitration under Arizona law
- Final decision within 60 days
Risk Management Protocols
Proactive measures to identify, assess, and mitigate risks across all captive operations.
Loss Prevention Programs
- Quarterly safety training for all contractors
- Annual site inspections and audits
- Best practices documentation and sharing
- Pre-installation risk assessments
- Quality control checklists and protocols
Monitoring & Reporting
- Monthly loss ratio analysis by market segment
- Quarterly reserve adequacy reviews
- Annual actuarial evaluation
- Real-time claims tracking dashboard
- Trend analysis and early warning indicators
Reinsurance Strategy
- Excess of loss coverage above $250K per occurrence
- Aggregate stop-loss at 150% of expected losses
- Catastrophic coverage for multiple simultaneous claims
- Annual reinsurance treaty renewal
- A-rated reinsurer requirement
Operational Guidelines
Financial Management
- Capital Requirements: Maintain minimum $1M surplus at all times
- Investment Policy: Conservative portfolio (60% bonds, 30% equities, 10% cash)
- Reserve Methodology: Case reserves plus 15% IBNR (Incurred But Not Reported)
- Dividend Policy: Maximum 25% of surplus distributable annually
- Audit Requirements: Annual independent audit by certified actuary
Regulatory Compliance
- Arizona DOI Reporting: Quarterly financial statements and annual reports
- Tax Compliance: IRC Section 831(b) election for micro-captive status
- Record Retention: 10-year retention for all policy and claims documents
- Privacy Protection: HIPAA and GLBA compliance for personal information
- Anti-Fraud Measures: SIU (Special Investigations Unit) for suspected fraud
Governance Structure
- Board of Directors: 5 members including 2 independent directors
- Audit Committee: Quarterly meetings to review financial performance
- Risk Committee: Monthly review of loss trends and reserve adequacy
- Investment Committee: Quarterly portfolio review and rebalancing
- Conflicts of Interest: Annual disclosure and recusal requirements
Policy Review & Updates
- Annual Review: Comprehensive policy review by management and board
- Regulatory Updates: Immediate incorporation of new legal requirements
- Market Changes: Quarterly assessment of market conditions and adjustments
- Stakeholder Input: Annual survey of contractors for policy feedback
- Version Control: All policy changes documented with effective dates
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