What do underwriters actually want to see in a senior care submission?

Senior care exposures are broadly similar across facilities of similar acuity. Residents fall, wounds develop, medications are administered, staff turn over. What differs enormously between operators is how those realities are managed, and management is what predicts loss.

So an underwriter reading two accounts with identical bed counts and similar loss totals is looking for the thing that distinguishes them. If your submission does not contain it, they price you on the class, which is by definition the average of everyone including the operators you are better than.

The single most informative item in a senior care submission is how claim reserves moved between first report and today. Sustained upward development says your reported numbers understate ultimate cost, and an underwriter will load for it whether or not you explain it.

If you have adverse development, explain it. Reserving practice changed, a claims administrator changed, a particular file was atypical. An explained pattern is priced differently from an unexplained one, and the explanation only lands if you offer it before they find it.

Staffing: hours per resident day by unit, agency usage as a share of hours, and turnover by role. Agency share and turnover are read as leading indicators of claim frequency, and they are.

Clinical: fall risk assessment and intervention protocol, skin integrity and wound program, medication administration policy written per state, and for memory care the elopement risk assessment, secured egress testing record and missing resident drill log.

Governance: abuse prevention training records, background check policy including contractors, incident reporting protocol, and quality assurance meeting minutes showing findings actually being tracked to closure.

Senior care is served by a limited number of specialty markets. The first broker to reach a market blocks the others from approaching it, so sending the same account out through several brokers does not create competition. It creates duplicate submissions that markets decline on sight and burns your market list for the year.

Pick one broker who works in this class, give them the whole account, and let them control the market approach. This is one of the few situations where limiting your options improves your outcome.

Ask every market to quote the same structure: same defense treatment, same abuse sublimit and aggregate basis, same retention with the same erosion treatment, same retroactive date. Otherwise you are comparing prices for different products.

And ask for the declination reasons on anything that comes back no. A market that declines for a reason you can fix is more useful information than three that quote.