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European Insurance and Occupational Pensions Authority

Mass accident risk sub-module

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TITLE I > CHAPTER V > SECTION 4

Article number:  161

1. The capital requirement for the mass accident risk sub-module shall be equal to the following:

SCR ma= sqrt(sum s (SCR^2 (ma,s))

where:

(a) the sum includes all countries set out in Annex XVI;

(b) SCR (ma,s) denotes the capital requirement for mass accident risk of country s.

2. For all countries set out in Annex XVI, the capital requirement for mass accident risk of a particular country s shall be equal to the loss in basic own funds of insurance and reinsurance undertakings that would result from an instantaneous loss of an amount that, without deduction of the amounts recoverable from reinsurance contracts and special purpose vehicles is calculated as follows:

L (ma,s) = r s * sum e (x e * E (e,s))

where:

(a) r s denotes the ratio of persons affected by the mass accident in country s as set out in Annex XVI;

(b) the sum includes the event types e set out in Annex XVI;

(c) x e denotes the ratio of persons who will receive benefits of event type e as a result of the accident as set out in Annex XVI;

(d) E (e,s) denotes the total value of benefits payable by insurance and reinsurance undertakings for event type e in country s.

3. For all event types set out in Annex XVI and all countries set out in Annex XVI, the sum insured of an insurance or reinsurance undertaking for a particular event type e in a particular country s shall be equal to the following:

E (e,s) = sum i (SI (e,i))

where:

(a) the sum includes all insured persons i of the insurance or reinsurance undertaking who are insured against event type e and are inhabitants of country s;

(b) (b) SI (e,i) denotes the value of the benefits payable by the insurance or reinsurance undertaking for the insured person i in case of event type e.

The value of the benefits shall be the sum insured or where the insurance contract provides for recurring benefit payments the best estimate of the benefit payments in case of event type e. Where the benefits of an insurance contract depend on the nature or extent of any injury resulting from event e, the calculation of the value of the benefits shall be based on the maximum benefits obtainable under the contract which are consistent with the event. For medical expense insurance and reinsurance obligations the value of the benefits shall be based on an estimate of the average amounts paid in case of event e, assuming the insured person is disabled for the duration specified and taking into account the specific guarantees the obligations include.

4. Where Article 88 is complied with, insurance or reinsurance undertakings may calculate the value of benefits payable to insured person referred to in paragraph 3 based on homogenous risk groups, provided that the grouping of policies complies with Article 35.

 

 

Metadata

RULEBOOK TOPIC:  SECTION 4 - Health underwriting risk module

RULEBOOK CATEGORY:  DELEGATED REGULATION (EU) 2015/35

Last update on:  27 Mar 2024