General Insurance
General Insurance
General Insurance
Defining Insurance
Insurance in broad terms may be described as a method of
sharing financial losses of few from a common fund who are
equally exposed to the same loss.
Insurance is defined as the equitable transfer of the risk of a loss,
from one entity to another, in exchange for a premium, and can
be thought of a guaranteed small loss to prevent a large, possibly
devastating loss.
An insurer is a company selling the insurance. The insurance rate
is a factor used to determine the amount, called the premium, to
be charged for a certain amount of insurance coverage.
Concept of risk
Massive risk with high magnitude
Mission
"to protect the interests of the policyholders, to regulate, promote
and ensure orderly growth of the insurance industry and for matters
connected therewith or incidental thereto."
Benefits of Insurance to an Individual
Peace of mind
Aversion of risk
Protects mortgaged properties
Provides self dependency
Tool of savings
Tool of investment
Satisfies various needs
Benefits of Insurance to Business
Reduced reserve requirements
Capital freed for investment
Indemnification
Reduction of uncertainty
Reduced cost of capital
Reduced credit risk
Loss control activities
Business and social stability
Benefits of Insurance to Society
Protects wealth of the country
Control inflation
Cost of Insurance
Operating Expense
Distribution cost
Underwriting cost
Policy Administration Cost
Reserve cost
Moral Hazard resulting in extra cost
Exaggerated Losses
Benefit-cost Tradeoff
Insurance Classification
Insurance
Insurable Interest
Principle of Indemnity
Principle of Contribution
Principle of Subrogation
The insurer must provide the insured complete ,correct and clear
information of subject matter.
The insurer must provide the insured complete ,correct and clear
information regarding terms and conditions of the contract.
Under this the insurer agrees to compensate the insured for the
actual loss suffered.
Principle of Contribution
The principle is a corollary of the principle of indemnity.
Under this principle the insured can claim the compensation only
to the extent of actual loss either from any one insurer or all the
insurers.
Principle of Subrogation
As per this principle after the insured is compensated for the loss
due to damage to property insured , then the right of ownership of
such property passes on to the insurer.
The property may be insured against some causes and not against
all causes.
Reasonable care
Fraud
Basic principles
Insurable interest
Utmost good faith
Subrogation
Contribution
Indemnity
Fire
Health
Marine
Motor Vehicle
Fire Insurance
Fire Insurance
Fire insurance is a form of property insurance which protects people
from the costs incurred by fires. When a structure is covered by fire
insurance, the insurance policy will pay out in the event that the
structure is damaged or destroyed by fire.
Types of Fire Insurance Policies
Specific policy: In this type of policy, the insurance company is
liable to pay a sum, which may be less than the property’s real
value. The insured is called to bear a part of the loss, as the actual
value of the property is not considered in deciding the amount of
indemnity.
Claim Form
Photographs
Tax benefit
Productivity of workforce
Answer
Insurer
Clients confidence - warrantable claim will be paid out in a reasonable
time frame
New clients have to be reached
Value for money
Design products as per clients needs
Product transparency
Cost efficiency
affordability
Wellness programmes
Initiatives of IRDA
Committee to formulate regulations
Renewability
Senior citizens
Impediments in Health Insurance
Lack of Data
Medical Inflation
New treatments
Unnecessary treatments
Difficulty in pricing
Mis-selling/fraud
Mitigation of Impediments
Insurer
Designing a less complex products
Transparency in the product features
Clarity in policy terms, conditions & exclusions
Efficient back-office support for underwriting and claims
processing
Higher Reinsurance
Need for quicker services. E.g. Toll free numbers, cashless,
quick response
Expense analysis on a regular basis
Product innovation
Efficient training of sales force
Mitigation of Impediments
Policyholder
Pay attention to policy conditions
Read the exclusions and limitations very carefully
Compare premium costs, deductibles, co-payments
Take an informed decision
TPA
Proper infrastructure
Speedy claim settlement process
Less paper work
Mitigation of Impediments
Regulator/Government
Come out with health insurance regulations
Centralized data base for health insurance experience statistics
Provider rating
Cap on renewal premiums
Ensure that a decent portfolio of health coverage represent
the rural sector
Guard against ill effects of privatization
Further tax incentives
Compulsory savings towards health care
Types of Health Insurance Plans
Individual health plan
These plans are indemnity policies, that is, they reimburse the
actual expenses incurred up to the amount of the cover that you
buy.
Some of the expenses that are covered are room rent, doctor’s
fees, anaesthetist’s fees, cost of blood and oxygen, and operation
theatre charges.
Family Floater Plans
This is a fairly new entrant in the health insurance firmament.
Under a family floater (FF) health plan, the entire sum insured can be
availed by any or all members and is not restricted to one individual only
as is the case in an individual health plan.
The purpose of a critical illness plan is to let you put aside a small
regular amount now, as an insurance against all this happening.
For example, a person buys a DHC plan with a limit of Rs 2,000 per
day. He gets hospitalised for 7 days and the total bill is Rs 35,000.
He would be reimbursed Rs 14,000 (2,000x7). If the bill is Rs 8,000,
he would still be reimbursed Rs 14,000.
Unit-linked health plan (ULHP)
All ULHPs offer one or more combination of the other benefits (for
which risk premium is deducted from fund value).
Also, charges such as premium allocation charge and policy
administration charge are deducted from the fund value.
LIC has launched Health Plus plan, a unique long term health
insurance plan that combines health insurance covers for the
entire family (husband, wife and the children) – Hospital Cash
Benefit (HCB) and Major Surgical Benefit (MSB) along with a ULIP
component (investment in the form of Units) that is specifically
designed to meet domiciliary treatment (DTB) related expenses for
the insured members.
Health Insurance in India
The health insurance market in India is very limited covering about
10% of the total population. The existing schemes can be categorized
as:
Voluntary health insurance schemes or private-for-profit schemes;
Employer-based schemes
Voluntary health insurance schemes
In private insurance, buyers are willing to pay premium to an
insurance company that pools similar risks and insures them for
health related expenses.
The main distinction is that the premiums are set at a level, which
are based on assessment of risk status of the consumer (or of the
group of employees) and the level of benefits provided, rather
than as a proportion of consumer’s income.
Cargo
Freight
The first type is the perils of the sea that include both natural
calamities and fortuitous accidents.
All risks
Further Cover
Pollution Hazard
Salvage loss
Follows forced sale of badly damaged cargo
Cargo Partial Loss
Where goods delivered damage measure of indemnity is
equal to the gross sound value less damaged value at place of delivery
Freight Insurance
Insures the profit made by a ship owners out of ships used to carry
cargo, both their own and others
Voyage policy
Mixed policy
Open policy
Time Policy
A time policy is one that runs for a period of time usually not
exceeding 12 months.
The policy will not apply if the actual voyage and/or ports are
different from those in the policy.
Mixed Policy
This is a policy that covers the subject matter for the voyage within
a time period.