IC01 English Notes and Terminology for III Licentiate Exam
IC01- Licentiate Practice Paper
- Peril is an Event or Incident, that may cause a Loss. Examples of Perils can be, Fire, Flood, Earth-Quake, Lightning, Land-Slide, etc.
- Insurance cannot prevent the Occurrence of the Peril or the Resultant Loss due to a Peril. Insurance only tries to reduce the Financial Loss to the Owner or Beneficiary of the Asset.
- Risk is Un-Certainty of Outcome. If there is a Chance that the Outcome will be Different from Expectations, there is a Risk.
- Risks can be classified as Catastrophic Risks and Important Risks, Financial Risks and Non-Financial Risks, Dynamic Risks and Static Risks, Pure Risks and Speculative Risks, Fundamental Risks and Particular Risks.
- Catastrophic risks - Single event leads to higher than usual number/amount of claims on the insurer
- Financial risks - Loss from risk can be quantified in monetary terms
- Non-financial risks - Loss from risk cannot be measured in monetary terms
- Dynamic risks - Risks resulting from changes in the economy
- Static risks - Loss from risks due to perils of nature and dishonesty of other individuals
- Pure risks - These risks are not under the control of the person
IC01- Licentiate Practice Paper
- Speculative risks - In these risks there is a chance of gain or loss. Examples - Stock Market Trading
- Fundamental risks - These risks affect a lot of people together
- Particular risks - These risks affect only specific persons
- Hazard is a Condition, that increases the Chances of Loss. It is something that accelerates the Peril.
- Hazard can be classified as Physical Hazards and Moral Hazards.
- Physical Hazard refers to the Characteristics, and qualities of the subject matter, which is proposed to the insured.
- A moral Hazard refers to the Character of the Person, who is approaching the Insurance Company for Insurance.
- The Actual Loss, arising out of a Peril-Striking, includes the Costs of (a) Repair, Replacement, or Reinstatement; and (b) Consequential Losses, until Repair, Replacement, or Reinstatement.
- Consequential losses - Expenses for cleaning up and removal of debris, Loss of rent, production, revenue, and profits until normalcy is restored, Possible liability losses for third party injuries
- Ways of managing the Risks include; Prevention of Risk, Reduction of Risk, Retaining the Risk, Transferring the Risk.
- Loss-Reduction Techniques, including Separation, Duplication, Diversification, Indemnity-Agreements, Hedging, etc.
- An individual can manage the Risk, associated with His or Her Life, by transferring it, to a Life Assurance Company, by buying a Life Assurance Plan.
- Organizations meet costs of retained risks: - From current revenue, and, By creating special funds.
- Separation - Isolating subjects exposed to the same risk
- Duplication - Keeping 'back up' copies
- Diversification - Spreading risks across different areas
- Indemnity agreements - One party agrees to compensate for losses the other party may incur
- Hedging - Financial transaction is made to offset the loss in another transaction
- Concept of insurance - An insurance company (referred to usually as the insurer) promises to pay to the owner (insured) or beneficiary of the asset, a certain sum of money (sum assured), if a loss occurs, to ensure the continuance of the financial benefits. The insured pays a certain amount (consideration) to the insurance company for bearing the risk, which is known as a premium.
IC01- Licentiate Practice Paper
- The business of insurance is related to the protection of the economic value of assets, An asset is valuable for the owners because they get benefits from it in the form of comfort and convenience.
- Evolution of insurance - Insurance evolved in India in the 18th century, In 1818, The Oriental Life Insurance Company was the first life insurance company to start insurance operations in Kolkata.
- Insurance industry - Concept of pooling - People exposed to similar risk are brought together, the Insurance company acts as an intermediary, Mutual consent among group members to share the loss and compensate the person who suffered the loss, Compensation is expected to put the person in the same place, financially, as before suffering the loss.
- Importance of Insurance - Provides steadiness and stability to trade and industry, Increases risk-taking ability for trade and industry, Provides protection against losses due to vagaries of nature
- Export Credit and Guarantee Corporation (ECGC) provides protection to exporters against risks related to international trade like - Importer payment default, Currency appreciation risk, Changes in economic policy, etc.
- Liability insurance can protect professionals like Doctors, Lawyers, Accountants, and Engineers who run the risk of being charged with negligence and subsequent liability for damages. The amounts claimed in damages can be fairly large and beyond the capacity of the individual to bear
- An accountant can be sued by the client if he faces a loss because of wrong advice, An engineering company can be sued if a bridge built by it collapses claiming some lives, A doctor can be sued if a patient dies because of his negligence.
- Insurance is needed to protect One, from the Risks associated with an Asset, and to continue earning the Benefits from it.
- Insurance transfers the Risk from the Asset-Owner to the Insurance Company, in Return for a Fee (Premium).
- The First Written Insurance Policy was on a Babylonian Obelisk Monument, with the Code of Kind Hammurabi. In India, the First Life Assurance Company was Oriental Life Insurance Company, which was started in Kolkata, in Year: 1818.
- In India, in the Year: 2000, the Insurance Sector was opened-up, up to Private Players.
- Risk management by individuals - There are four ways to manage risk: - Avoidance or prevention of risk, Reduction of Risk, Retention of risk, Transfer of risk
- Avoidance or prevention of risk - cannot be completely avoided as these are often caused by natural perils or actions of others
- Reduction of risk - possible to reduce risk before or after an incident has occurred
- Retention of risk - assess the seriousness of the risk (how often it may occur, the extent of damage, possibility of damage to the environment, potential damage to the safety of people)
- Transfer of risk - it can be transferred to an insurance company
- Insurance spreads the Losses of Individuals, over a Group of Individuals, who are exposed to Similar Risk, thereby, making the Process, Fair and Equitable, for All.
- Reinsurance - Transfer of risk from one insurance company to another is called reinsurance, To ensure that they can fulfill their promise to pay claims even during catastrophic events, insurers transfer a part of their risk to another insurer.
- Reinsurance - In India, insurers are to compulsorily cede 10% of their premium to the national reinsurer; the General Insurance Corporation (Reinsurance). General Insurance Corporation of India is the National Re-Insurer.
IC01- Licentiate Practice Paper
- The purpose of insurance is to: - Bring people who are exposed to similar risks together (sharing the same risk), Collect premiums from the individuals, Pay compensation, called claims, in the event of loss
- Revenue comes from - Premium collected, Income from interest, and dividends on investments
- Expenses include:- Payment of claims, Salaries, commission, rent, and other expenses associated with managing business
- Managing Funds - An insurer is effectively a trustee as it is managing a common fund on behalf of its policyholders.
- The Difference in an Insurer's Revenue and Expenses is Not treated as Profit, it is held in Reserve, to cover Claims-Costs. After maintaining a Reserve, the Balance can be distributed as Profit to Share-Holders, and Bonus to Policy-Holders.
- Insurance Premiums are based on the Expectation, of Loss, and Insurers use Statistical Principles, such as the 'Law of Large Numbers', to determine these.
- Underwriting is the process, used to determine Entry to the Group. Underwriting includes Assessing the Risk, determining the Exposure of the Group, and determining the Premium-Charged.
- Economic development - Economic growth depends on business and business depends on insurance. The non-life insurance business grows parallel to economic growth, The industry depends on insurers to manage their manufacturing and commercial risks.
- Economic development - General insurance contributes to the continuation of a trade by fulfilling obligations at claim time which in turn can prevent businesses from going broke, Insurers collect premiums, a substantial part of which is invested in various infrastructure projects which leads to economic growth.
- The Insurance Market can be broadly divided into 5 Categories: Insurance Companies, Intermediaries, Specialists, Regulatory Bodies, and Educational Institutions.
- The Insurance Companies, transacting Insurance businesses, can be broadly classified into Life Assurance Companies, Non-Life Insurance Companies, Standalone Health Insurance companies, and Re-Insurance Companies.
- Agents and Brokers are intermediaries and procure Insurance Business, on behalf of the Insurers. Specialists - Surveyors, Medical examiners, TPA
- A Surveyor, also known as Loss-Assessor, is an Individual, whose Job is to assess the Loss, in the General, Insurance Business.
IC01- Licentiate Practice Paper
- Medical Examiners - Examine and certify the health and insurability of the proposer, May be involved in underwriting as medical referees, Cases of doubt are referred to them for an opinion, In case of health insurance; advice may be sought to check if the claim being made is reasonable or not.
- Third-Party Administrator (TPA) - A TPA is a specialized service provider rendering various services related to health insurance, especially those relating to claims processing and settlement, Both the insured as well as the insurer benefit from the services of the TPA, TPA should meet eligibility in terms of share capital (Rs. 1 Crore), director qualification, officer training and passing the prescribed examination.
- Insurance Regulatory and Development Authority of India (I.R.D.A.I.) is the Regulatory Authority, to Administer The Insurance Act, and to Regulate, Promote and Ensure the Orderly Growth of the Insurance Industry.
- The Insurance Ombudsman is appointed to handle the Complaints of Aggrieved Insured Persons, and to ensure Quick Disposal of Grievances and mitigate their Problems, involved in Redressed of those Grievances. This Institution is of Great Importance and Relevance, for the Protection of Interests of Policy-Holders, and also in building their Confidence in the System. Currently, there are Ombudsmen Offices in 17 Cities, across India.
- Insurance Ombudsman - The government body has appointed twelve ombudsmen across the country and allotted them different geographical areas as their areas of jurisdiction, A person can lodge a complaint with the ombudsman if the complaint has been rejected or not addressed satisfactorily or not replied to by the insurer.
- Nature of complaint to Ombudsman - Any partial or total repudiation of claims by insurance companies, Any dispute with regard to the premium paid or payable in terms of the policy, Delay in settlement of claims, Any dispute on the legal construction of the policy wordings in case such dispute relates to claims, Non-issuance of any insurance document to customers after receipt of premium
- Under the Insurance Regulatory and Development Authority of India (I.R.D.A.I.) Grievance Redressed Mechanism, Customers can dial 155255, which is, a Toll-Free Number, or email complaints@irda.gov.in, and register their Complaint, against Insurance Companies.
- Institutes, like, the Insurance Institute of India, the Institute of Actuaries of India, the Indian Institute of Surveyors and Adjusters, and Many Other Institutes provide Insurance-Training and Services, such as Associateship Diplomas and Fellowship Diplomas, and Various Other Programmes.
- Agents - Agents have to obtain a license from IRDA which is valid for three years after which it needs to be renewed, Should meet the eligibility criteria, Individuals as well as corporate bodies like banks, firms, companies, etc. can be allowed to become agents.
- Agents - Remuneration is by way of commission which is regulated by IRDA, It is the duty of the agent to keep the interests of the customer before everything else, analyze the customer's requirement, and accordingly recommend only those products that fulfill the customer's requirement.
- Brokers - Brokers are independent professionals and have to obtain a license from IRDA, License may authorize the broker to place direct business with any insurer/insurers, or arrange reinsurance or both
- Brokers - Should meet the minimum capital requirement ranging from Rs.50 lakhs for a direct broker to 250 lakhs for a reinsurance broker or composite broker, Remuneration is by way of brokerage by the insurers or reinsurers and is regulated by IRDA.
- An insurance broker is an individual, a company, a society, or a firm, wholly engaged in the sourcing insurance business for various companies.
- Surveyor - A surveyor is an individual whose job is to assess the loss in the general insurance business, Surveyors are technically competent people who are specialists in various fields and are impaneled by insurers.
- Surveyor - For all claims exceeding Rs.50,000 in value, a report has to be obtained from a licensed surveyor, Surveyor has to obtain a license from IRDA after clearing the prescribed examination and undergoing practical training. Surveyors are categorized as A, B, or C.
- Third-Party Administrator (TPA) - A TPA is a specialized service provider rendering various services related to health insurance, especially those relating to claims processing and settlement, Both the insured as well as the insurer benefit from the services of the TPA, TPA should meet eligibility in terms of share capital (Rs. 1 Crore), director qualification, officer training and passing the prescribed examination.
- Medical Examiners - Examine and certify the health and insurability of the proposer, May be involved in underwriting as medical referees, Cases of doubt are referred to them for an opinion, In case of health insurance; advice may be sought to check if the claim being made is reasonable or not.
- A Customer is a Person, who buys Goods or Services, that a Business has to offer. Types of Customers - Outside Customer, Internal Customer
- Outside Customer - A person who buys goods or services that a business has to offer. These are people who are not a part of the business.
- Internal Customer - Refers to the interrelationship of the departments, i.e. the work output of one department being an input for another department in the same organization.
- The Code of Ethics, Spelt out by the Insurance Regulatory and Development Authority of India (I.R.D.A.I.), in Various Regulations, is directed towards Ethical Behavior.
- Un-Ethical Behavior is, when, the Benefits of Self are considered More Important than the Benefits to the Policy-Holder.
- Being Ethical in Business is, about doing the Right Thing, such as Not Lying or Stealing, but Being Honest.
- Importance of ethical behavior - Being ethical is about doing the right thing, Ethics in business include increased accountability and corporate governance.
- Importance of ethical behavior - The Right to Information Act, 2005 and the development of Public Interest Litigation (PIL) have assumed considerable importance as ways of achieving better accountability and governance.
- Possibility for ethics to be compromised in the following situations - Choosing between two plans, one of which has considerably less premium or commission than the other, Selling two plans, one of which has considerably less commission than the other.
- Possibility for ethics to be compromised in the following situations - Temptation to recommend discontinuing an existing policy and taking a new one, Becoming aware of circumstances that, if known to the insurer, could adversely affect the interests of the customer or the beneficiaries of a claim.
- Happy customers - They are recognized and respected, Their feelings and views are not ignored, They are not taken advantage of, They feel cared for and helped
- How insurance customers are different? - While making purchases of tangible goods there is a sense of gratification or satisfaction from that purchase. When making purchases of services there is a sense of pleasure from the purchase, Purchase of insurance does not give any immediate sense of pleasure, nor does it give anything tangible from the purchase.
- How insurance customers are different? - The purchase of insurance is based on the likelihood of tragedy, and not on the expectation of immediate pleasure, The customer has to visualize the possibility of a tragedy before they seek insurance, The benefits of insurance often come in a period of distress for a customer.
- In respect of life insurance, customers will be having 3 different mindsets at different stages of the contractual relationship - The person who buys the policy, the Person who collects maturity proceeds, the person who receives the claim
- In general insurance, the customer will have two different mindsets at different stages of the contractual relationship - At the time of buying insurance, At the time of claim
- The insurance policy would specify the following: - The risk which is the subject matter of the contract, The event upon which the liability of the insurer would arise, The nature of liability of the insurer, the amount and the manner of payment
- The insurance policy would specify the following: - The amount and manner of payment of premium by the policyholder, Other obligations, if any, of the policyholder, Consequences of any default in obligations by the policyholder
- Principle of insurable interest - A person is said to have an 'insurable interest' when they stand to gain or benefit from the continued existence (safety) and well-being of the person or property insured and would suffer a financial loss if there is damage to the person or property.
- Insurable interest - Legal basis for deciding whether insurance can be taken or not
- Insurable interest has to be proved at the following three stages: - In some cases only at the time of taking the policy - e.g. life insurance, In some cases at the time of taking the policy and also at the time of making the claim - e.g. property insurance, Only at the time of making the claim e.g. marine cargo insurance
- Insurance is meant to indemnify (i.e. compensate for losses). According to the principle of indemnity, insurance should place the insured in the same financial position after the loss, as they enjoyed before it; not better.
- The principle of indemnity makes sure that the insurance company compensates the insured only to the extent of the loss so that the insured does not profit from insurance
- How does indemnity work? - Individual has taken insurance, Individual suffers a loss, Individual makes a claim, Insurance company indemnifies individual
- Indemnity in life insurance - The principle of indemnity does not apply to life insurance, Life insurance contracts are Value Contracts, There is no need to assess the extent of loss, In case of death, the full sum assured is paid in life insurance policies.
- Agreed value policies - On special types of properties such as artwork, paintings, obsolete machinery, vintage cars, etc., arriving at a valuation is difficult. In such cases, the insured and the insurance company agree on a fair value for the property and an agreed value policy is issued.
- Ways of indemnifying in general insurance - Cash Payment, Reinstatement, Repair, Replacement
- In general insurance, the manner in which the principle of indemnity is applied depends on the following: - class of insurance, subject matter such as property, liability, etc., type of policy
- Factors that affect indemnity - Deduction for Under-Insurance or the Condition of Average, Deductibles or Excess, Maximum amount recoverable in a Property Insurance Policy
- Deduction for Under-Insurance or the Condition of Average: - If the insured insures his property for lesser than its actual value, it is unfair to the other contributors of premium to pay him the full loss.
- The Principle of Insurable Interest gives the Person, the Right to insure a Subject-Matter, with which, they have a Relationship, recognised by Law. Insurable Interest can be on the basis of Common Law, Contract, or Statute.
- The Principle of Indemnity ensures that Insurance places the Insured, in the Same Financial Position, after the Loss, as they enjoyed before it, Not Better.
- In General Insurance, the Insured can be indemnified in 4 Ways: Cash, Repair, Replacement, Reinstatement.
- As per the Principle of Subrogation, the Rights of the Insured are passed on to the Insurance Company, to recover the Claim-Amount, from the Third-Party, Responsible for the Loss.
- If there are Two Policies on the Same Subject-Matter, the Principle of Contribution requires that Both Insurance Companies pay their Proportionate Share of the Claim, and the Insured does not make a Profit by making a Claim to Both the Companies.
- The Principles of Indemnity, Subrogation, and Contribution, do not apply to Life Assurance.
- The Principle of Utmost Good Faith imposes a Duty of Disclosure on Both, the Insurer and the Insure, to disclose All Material Facts, Relevant to the Insurance Contract.
- Principle of subrogation - The substitution of one person in the place of another with reference to a lawful claim, demand, or right, so that he or she who is substituted succeeds to the rights of the other in relation to the debt or claim, and its rights, remedies, or securities.
- Subrogation ensures - Having paid the claim, the insurance company gets the right to make good the damages from the party who caused the loss, Having been indemnified by the insurer, the insured does not retain the right to get compensated by the party who caused the loss and thus make profit from insurance.
- The insurer cannot profit - Subrogation ensures the insurance company is entitled to recover money from the third party, but only to the extent it has paid as compensation to the insured person.
- Principle of Contribution - The principle of contribution ensures that if there is more than one insurance policy drawn upon the same subject matter, the insured cannot recover their loss from all the insurers, in which case they will recover more than their loss, or even make a profit.
- Contribution - The insured does not profit by making separate claims from multiple companies for the same event, Each insurer pays only their proportionate share of the loss, The principles of subrogation and contribution apply only to contracts of indemnity. So the two principles do not apply to life insurance contracts and similar contracts with fixed benefits.
- Principle of utmost good faith - As per the principle of utmost good faith, the proposer is obliged to declare all relevant facts that are material to the assessment of the risk, at the time of making the proposal. This information is important for the insurer in deciding whether to accept the proposal and the appropriate premium to be charged.
- Material Facts - A fact is said to be material if it affects the decision of the underwriter to accept or reject the risk or to determine rates, terms and conditions if the risk is accepted. That is if the 'fact' is relevant to the assessment of the risk and determination of the premium.
- Ways in which principle of Utmost Good Faith may be breached - Non-disclosure, Misrepresentation
- Non-disclosure - Not disclosing material facts
- Misrepresentation - Giving wrong information
- Duty of disclosure in life insurance - In life insurance, the duty of disclosure ends with the completion of the contract.
- Duty of disclosure in non-life insurance - In non-life insurance, the contract will stipulate whether changes are to be intimated or not.
- Duty of disclosure on insurance companies - The insurance company should declare all the relevant information and benefits of the product to the customer.
- Proximate cause - Proximate cause is defined as the active and efficient cause that sets in motion a chain of events that brings about a result, without the intervention of any force started and working actively from a new and independent source.
- The dominant, effective, or operative cause of an event is known as the proximate cause.
- Insurance - A contractual process wherein a person protects his physical assets (such as a car or home) as well as life from certain events or perils by transferring the risk to an insurer.
- Insurer - A company that provides protection by entering into a contract with the person seeking protection for his assets.
- Insured - The person who applies for insurance protection is called the insured.
- Proposal - The insurance process starts with an application in writing, called a proposal, made by the person who wants to take insurance and includes details of what they want to insure and the type of cover they require.
- Underwriter - The person representing the insurance company whose job is to assess the proposal for insurance.
- Premium / Consideration - It is the amount of money or consideration that has to be paid in exchange for the insurance.
- The underwriter decides - Whether insurance can be given or not, If given, what will be the terms of the policy, What will be the amount of premium to be charged
- Insurance policy contains - Endorsements, Subject matter of insurance, Exclusions, Sum assured, Tenure of the policy
- Conditions for an insurance policy - Conditions precedent, Conditions subsequent, Conditions precedent to liability
- Conditions precedent - require the insured to disclose any material facts
- Conditions subsequent - require notification of changes while the policy is valid
- Conditions precedent to liability - require the insured to give notice of an event happening within a specified period of time
- Representation - A statement (which has a bearing on the risk), regardless of whether made in writing or verbal, by the person requesting insurance is called a representation.
- Warranty - A promise, assurance, or guarantee made by the policyholder.
- Expense ratio - The ratio of expenses to premium.
- Loss ratio - The ratio of claims paid to the amount of premium.
- It is important to monitor insurance ratios because - insurers should be aware of how much of the premium is spent by way of claims, the laws prescribe limits on expenses, a part of all premiums is used for expenses and it is important to ensure that actual expenses do not exceed estimated expenses
- Incurred Claims Ratio (ICR) in general insurance - ICR = Claims paid during the year + Outstanding claims at end of the year - Outstanding claims at beginning of year/Premium income
- Mode of payment - Frequency of premium payments like Monthly, Quarterly, Half-Yearly, and Annually
- Limited Payment Policy - premiums are paid for a period shorter than the term of the policy.
- Single-Premium Policy - the entire premium is paid in the first year itself, at the start of the policy.
- With a profit' or participating policy - bonuses are payable based on the insurer's profits.
- Without profit' or non-participating policy - do not receive any bonus, and premiums for such policies are lesser than 'with profit' policies.
- Terms that are specific to non-life insurance - Non-life policies are for the short term, They require renewal every year, With each renewal, there is a new contract.
- Certificates of Insurance are issued for motor policies which provides evidence that the Motor Vehicles Act has been complied with.
- If a policyholder has not made a claim and renews the policy, he may be given an NCB (No Claim Bonus.)
- If the policyholder has had a claim and it exceeds a specified limit, the premium is increased. This increase or loading on the premium is called Malus or Loading.
- Valued Policies - The insurer agrees to pay a certain amount in the event of a total loss without taking into account allowances for depreciation or appreciation.
- Full Value Policies - The policyholder states that the sum assured is the true and full value of the subject matter of insurance.
- First Loss Policies - These policies fix the sum assured as less than the full value as it is unlikely that the loss would be total.
- Floater Policies - These policies are issued to cover fire risks on stock at different locations under one sum assured. The locations have to be clearly specified. In respect of health insurance, 'floater' indicates the common sum insured that floats over a family or group.
- Declaration Policies - In cases where can be substantial fluctuations in stock or goods at a location, a declaration policy with a provisional premium may be issued.
- Types of marine policies - Specific policy, Open policy, Increased value, Duty insurance, Time and voyage policies
- Specific policy - Issued to cover a single consignment for a single transit.
- Open policy - A contract for a specific period of time, usually twelve months, and covers shipments as they are made when the consignments are reported to the insurer within a specified period of time by declarations.
- Increased value - Policies provide for an increase in the value of goods due to the increase in the market value of the goods, at the destination.
- Duty insurance - Covers the custom duty paid in case of loss to goods imported.
- Time and voyage policies - Issued for hull insurance and are for a fixed term, generally twelve months, or a specific voyage.
- Institute Cargo Clauses are drafted by the Institute of London Underwriters and used internationally
- Total losses - Actual total loss, a constructive total loss. Actual total loss - when there is a clear material loss of the subject matter of insurance. Constructive total loss - when total loss appears unavoidable as the subject matter of insurance is destroyed beyond repair and repair cost would be uneconomical
- Average Clause - used when the value of the property is deliberately understated by the insured
- General Average - loss caused by extraordinary sacrifice or expenditure voluntarily and reasonably made or incurred at the time of peril for the purpose of preserving property imperiled in the common adventure.
- Particular Average - partial loss caused by a peril insured against and is not a general average loss.
- Except for Marine Cargo Insurance, All Insurance Transactions begin with a Proposal.
- Insurance Documentation given to an Insured, will include Information, detailing the Subject-Matter of Insurance, the Sum-Assured, Any Endorsements, the Term of the Contract, Exclusions, and Any Other Conditions attached to the Policy
- Life Assurance Policies have Options of Limited Payment, where, Premium is paid for a Short Period of Time; or Single Payment, where, the Entire Premium is paid at the start of the Policy.
- Each Renewal of a General Insurance Policy is a New Contract, and the Terms and Conditions may be changed at that time.
- Premium, set aside to cover the Cost of Claims, is called Premium Reserve.
- Life insurance plans have either or both of the two basic elements: - Death benefit, the Survival benefit
- Death benefits - It is payable on the death of the insured during the tenure of the policy. It is also known as death cover.
- Survival benefit - It is payable on the maturity of the policy if the insured person survives the entire tenure of the policy. It is also known as maturity benefit.
- The two Most Basic plans, offered by Life Assurance Companies, are Term Assurance Plan, which pays, only if the Life-Assured dies during the Tenure of the Policy, and Pure Endowment Assurance Plan, which pays, only if the Life-Assured does not die during the Tenure of the Policy. Most of the Traditional Plans, offered by Life Assurance Companies, are a combination of these 2 Basic Plans.
- Term assurance plan - Provides only death cover. Pure endowment plan - Provides only survival benefits.
- Endowment assurance plan - Combination of Term Assurance and Pure Endowment Plan. Provides sum assured (SA) on survival of a specified period (Pure Endowment) or on death (term assurance), if it happens earlier i.e. during the tenure of the policy.
- Whole life plan - A term assurance plan with an unspecified period. Sum Assured is paid whenever Death happens.
- Money-back plan - Combination of a term assurance plan and multiple pure endowment plans.
- Unit Linked Insurance Plan (ULIP) - A ULIP is an insurance plan which is a combination of insurance protection and investment.
- Choice of funds in ULIP - Equity fund, Debt fund, Balanced fund, Money market fund
- Equity fund - Invests major portion of money in equity and equity-related instruments
- Debt fund - Invests major portion of money in fixed income securities
- Balanced fund - Invests a major portion of money in a mix of equity and debt
- Money market fund - Invests a major portion of money in instruments such as Treasury Bills, Certificates of Deposit, etc.
- Claim settlement in ULIP - On maturity of the plan the fund value is paid, On the death of the life insured during the tenure of the policy either the sum assured or the fund value is paid, whichever is higher.
- Switching in ULIP - Allows the transfer of existing investments from one fund to another during the tenure of the policy.
- Redirection in ULIP - Allows investment of new premium money (after deductions) in a fund other than the fund which has existing investments.
- An Annuity is an Insurance Plan, which makes Periodic Payments (Annuities) to the Annuitant.
- Immediate annuity - The annuitant makes a lump sum payment to the insurance company and the insurance company starts paying annuities (periodic payments) soon after the policy commences.
- Deferred annuity - The annuity payments start after a specified period known as the deferment period.
- Frequency - Annuitants can receive annuity payments monthly, quarterly, half-yearly, or annually.
- Tenure - The annuity payments may continue till - the annuitant lives or, for a minimum specified period and thereafter till the annuitant live or, till the last person among the joint annuitant dies
- Group policies - Master policy is issued covering multiple lives, Policy is issued in favor of the person representing the group of beneficiaries, Can be issued to a group of people brought together for a common objective.
- Group Insurance Policies offer Insurance Cover, to a Group of People, who are brought together for a Common Goat or Common Objective.
- Non-life insurance - Marine Cargo insurance, Marine Hull Insurance, Fire insurance, Miscellaneous
- Miscellaneous - Fidelity guarantee, Personal accident insurance, Workmen compensation, Engineering insurance, Aviation insurance, Motor insurance, Health insurance, Other miscellaneous
- Fire insurance - Provides cover for financial losses due to damage to property arising out of the fire, explosions, etc., Fire policies may also cover damage through the impact of vehicles, riots, typhoons, cyclones, strikes or other malicious acts, etc., Fire insurance policies may have a provision for 'loss of profits' or 'consequential losses'.
- Marine cargo insurance - Cover for goods in transit by sea, air, rail, road, or by post, War, strikes, riots, and civil commotions can be added at an extra premium, Export/import shipments are covered under the terms of Institute Cargo Clauses of Institutes of London Underwriters, according to international practice.
- Marine hull insurance - Covers loss or damage to ocean-going ships and other vessels such as fishing vessels etc., War and strikes are covered under the Government of India War Risks Scheme, Cover provided is under the terms of the Institute Time Clauses (Hull) or Institute Voyage, Clauses (Hulls) framed by Institute of London Underwriters, which are used internationally.
- Motor insurance - It deals with insurance of motorized vehicles on road, whether used for private comfort or public service, whether carrying passengers or goods. As per Motor Vehicles Act, every vehicle plying on Indian roads should be insured for Liability to Third Parties including property damage.
- Motor insurance may cover: - damage to vehicles, injury or death of persons, and, damage to property belonging to third parties
- Personal accident insurance - Personal accident policies cover death or disablement arising out of accidents of any kind (caused by external, violent, and visible means).
- In the case of personal accident policies, there is a need for assessment of risk on the factor of occupation, The conditions are standard, The policy can also cover consequential costs of medical care and loss of income due to disability leading to absence from the workplace.
- Health insurance - Health insurance cover treatment costs that require hospitalization (including domiciliary treatment). Health insurance can indemnify hospital costs or provide fixed benefits.
- Types of health insurance - Individual policy, Family floater policy, Group health insurance policy
- Liability insurance - Liability insurance provides indemnity (protection against financial loss payable under law) for injuries to third parties or their property, The policy covers indemnity for professionals providing services such as doctors lawyers, accountants, engineers, etc.
- Liability insurance - Professionals run the risk of being charged with negligence and subsequent liability for damages, Liability insurance can be broadly categorized into Public Liability. (Industrial and Non-Industrial), Product Liability, Professional Indemnity, and Errors & Omissions Policy.
- Miscellaneous - Fidelity guarantee, Overseas medical insurance, Workmen's compensation insurance, Engineering insurance, Boiler, and pressure plant, Aviation insurance, Industrial All Risks, Other miscellaneous insurance
- Fidelity guarantee - covers risks related to dishonesty, fraud, and embezzlement by employees and protects employers from loss of cash and securities.
- Overseas medical insurance - Covers medical expenses incurred while traveling abroad
- Workmen's compensation insurance - Covers compensation that is to be paid by the employer to the employee for death or disablement or injuries, as per the Workmen's Compensation Act 1926, for accidents while at work
- Engineering insurance - This includes risk covers like risk cover for contractors in civil engineering projects, erection of electrical plants, breakdown of machinery and its consequential loss of profits, etc.
- Boiler and pressure plant - Cover damage (other than by fire) caused by explosions (boilers or pressure plants) to the plant, and to surrounding property of the insured and to third parties.
- Aviation insurance - Covers damage to aircraft and liabilities to freight, passengers, and third parties.
- Industrial All Risks - Industrial All Risks is a package policy that covers fire, burglary, machinery breakdown, business interruption, or a combination of these.
- Other miscellaneous insurance - These include burglary, loss of baggage during travel, householder effects, shopkeeper's business, banker's indemnity, horses, bees, cattle, poultry, plantations, etc.