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, Important Risks, Financial Risks, Non-Financial Risks, Dynamic Risks, Static Risks, Pure Risks, Speculative Risks, Fundamental Risks &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

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 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.

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 fulfil 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.

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.

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, 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, analyse the customer’s requirement, and accordingly recommend only those products that fulfil 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 impanelled 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 Behaviour.

Un-Ethical Behaviour 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 behaviour – Being ethical is about doing the right thing, Ethics in business include increased accountability and corporate governance.

Importance of ethical behaviour – 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 mind-sets 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 mind-sets 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 and 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 imperilled 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.

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.

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.

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

1Fidelity 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 and 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 doctor’s 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.

हेल्थ इंश्योरेंस अब जरूरी क्यों है? – All about health insurance

हम जानते हैं की इंडिया मे हेल्थ इनश्योरेंस कोई जबरदस्त एक्साटिंग शानदार खरीदने की चीज नहीं है। कोई भी इसे अपने टॉप विशलिस्ट मे नहीं रखता। जब भी हेल्थ इनश्योरेंस खरीदने की बात होती है सब नायाब इनोवेटिव बहाने ढूंढ लेते हैं… मसलन “बाद में कर लेंगे अभी तो जवान हैं”, “देख लेंगे अभी दूसरा काम है” , “अभी थोड़ा हाथ टाइट है नेक्स्ट टाइम करेंगे ”. यहाँ सब अपने ही एक्सक्यूज से लड़ते रहते हैं.

मैं आपसे बस एक बात कहूँगा “हाँ ये सच है कि हेल्थ इन्सुरंस या कोई भी इन्श्योरेन्स जब आप खरीदते है तो वो कोई खाश खुशी नहीं देती क्योंकि ये कोई भोग विलाश की वस्तु नहीं होती है पर याद रहे संकटकाल में इनश्योरेंस की अनुपस्थिति आपकी सारी खुशियों को बर्बाद कर सकती है।

तो चलिए आज मैं कुछ और इम्पॉर्टन्ट कारण बताता हूँ जिससे शायद आपको हेल्थ इन्श्योरेन्स की प्रासंगिकता समझने में मदद मिल पायें….

1. सबसे पहले कि हम कोई फैंटम नहीं हैं…

यहाँ कोई फैंटम नहीं हैं – Shashi Kumar Aansoo

हम सब जानते हैं कि आज कोई सुरक्षित नहीं है। कोई भी बीमार हो सकता है, किसी को कहीं भी संक्रमण अपनी चपेट मे ले सकता है। एक्सीडेंट की तो पूछिए मत!

सो ये बात तो क्लेयर है की हम कोई फैंटम ना हीं सुपर मैन हैं ना सुपर वुमन ये गलतफहमी से दूर रहें कि “हमे कुछ नहीं होगा” आज की परिस्थिति हमारा सुपर सेंस तो यही कहता कि जल्द हेल्थ इन्श्योरेन्स कवर ले लें ताकि कम प्रीमियम पड़े।

अगर आप 40 साल की उम्र से पहले ये हेल्थ इनश्योरेंस कवर लेते हैं तो आपको बिना शर्त के मैक्सिमम फायदा मिल सकता है।

2. कोरोना जैसे वायरस का अकस्मिक आघात

अगर कोरोना जैसे खतरनाक परिवार का विषाणु अगर बेलगाम हो जाये तो हम परिणाम देख रहें हैं…

फिलहाल आप कोविड-19 की से तो परिचित हो चुके हैं। ऐसे बहुत सारे दुर्दांत वायरस जो हमारी देह की दहलीज लांघ कर हमे रोग ग्रसित करना चाहता है, बस एक असावधानी ही काफी है। 

वैसे दुनिया पहले से H2N2, एशियन फ्लू, रैबीज, इबोला, HIV, Smallpox,रोटा वायरस, सार्स, मर्स और न जाने कितने वायरस की भयावहता झेल रही है ।

ऐसे काल मे एक सम्पूर्ण हेल्थ इनश्योरेंस की सख्त जरुरत है जिससे हम बेफिक्र होकर बेस्ट मेडिकल सुविधा ले सकें बिना खर्चों की चिंता कीये।  

3. फ्री हेल्थ चेक-उप की सुविधा

हेल्थ चेक उप हमे अगाह करते रहता है

हर कोई युवराज सिंह जैसा लकी नहीं होता।  उनकी कैंसर जैसी जानलेवा बीमारी का पता शुरुआती दिनों में सिर्फ इसलिए लग पाया था क्योंकि उसकी नियमित हेल्थ चेक उप होती थी। वह एक खिलाड़ी था।  

हमारे यहाँ तो जब तक कि कोई बड़ी विपदा न आ जाए हम हम अपना हेल्थ चेक-उप टालते रहते हैं। फैन्टम जो ठहरे! हम यहाँ भी जुगाड़ कर लेते हैं ये जानते हुए कि रेगुलर हेल्थ चेक-उप हमें दुर्दांत रोगों की आहट पहले दे देती है पर हम इगनोर करते रहते है। 

हेल्थ इनश्योरेंस आपको फ्री हेल्थ चेक-उप की सुविधा देती है ताकि आप प्रीपेयर्ड रहें।

4 अव्यवस्थित 24/7 की जीवन-शैली

आज हम अपने आप को 24/7 वाले जनरेशन कहलाने में गौरवान्वित महसुस करते है पर ताज़ा सर्वेक्षण साफ-साफ इंगित करता है कि ये भागमभाग की जिंदगी हमें धीमे-धीमे बीमार और बीमार कर रही है। फिजिकल एक्टिविटी हमारी प्राइऑरटी में नीचे जा रही है।  

खान-पान की तो अलग दुविधा है। मिडल क्लास मे तो चाइनीज, कॉन्टिनेंटल और इटैलियन फूड खाना स्टैटस सिंबल बनता जा रहा है।

इंस्टाग्राम पर पोस्ट जो करना हैं #हैविंग_इटैलियन_फूड पेट अपना दुखड़ा भी नहीं कह पा रहा दिन ब दिन हमारी रोग प्रतिरोधक क्षमता कमजोर पड़ती जा रही हैं। नए नए रोग पनप रहे हैं।  आए दिन हमे अस्पताल के चक्कर लगाने पड़ते हैं।

ये सब आकस्मिक खर्चे का जंजाल है, इसके लिए जरूरी है कि हमारे पास स्वास्थ्य बीमा हो जो बुरे वक्त मे काम आ सके।   

5. आस-पास का बढ़ता प्रदूषण

WHO के हाल के रिपोर्ट के अनुसार वायु प्रदूषण हमारे फेफड़े, हृदय और हमारे सारे नाज़ुक अंगों पर अपना खतरनाक कुप्रभाव डाल रही है। जाने अनजाने कितने तरह के प्रदूषण के संपर्क मे हम आते रहते हैं।

भारत मे हर साल 18 लाख लोगों की मौत का जिम्मेदार ये वायु प्रदूषण है। विशेषज्ञ तो यहाँ तक मानते हैं की दिल्ली मे अकेले 30 हजार प्रीमेच्योर मौतों के लिए ये प्रदूषण हीं जिम्मेदार हैं। आकड़े पुराने है पर डरावने हैं।

हम दिन व दिन नये रोगों के प्रति इक्स्पोज़ होते जा रहें हैं ऐसे में प्रीपेयर्ड रहना हमारी मज़बूरी और जरूरत दोनो बन गई है।

6. हृदय व कैंसर रोगियों की बढ़ती तदात

आंकड़ों की मानें तो पिछले 25 बरस में हृदय रोगियों की तादाद में 50 प्रतिशत का इजाफा हुआ है. एक स्टडी के अनुसार 75 वर्ष की उम्र से पहले कैंसर से मौत का जोखिम (मोर्टेलिटी रेट) पुरुषों में 7.34 फ़ीसदी और महिलाओं में 6.28 फ़ीसदी तक होता है। आज भारत में होने वाली 61% मौतों के लिए असंक्रामक बीमारियाँ (NCD – Non-Communicable Disease), जैसे कैंसर, डायबिटीज और हृदय रोग जिम्मेवार है।

लोगों की निष्क्रिय जीवनशैली और खानपान की खराब आदतों के चलते हृदय रोग से पीड़ित लोगों की संख्या में तेजी से वृद्धि हो रही है। कुछ वर्ष पहले तक, 50 से 60 वर्ष के बीच की उम्र वाले लोगों के लिए हृदय रोग चिंता का विषय हुआ करता था, लेकिन अभी 20 से 40 वर्ष की आयु वर्ग वाले लोगों में भी यह दिखना शुरू होने लगा है।

भारत में निजी अस्पतालों में सामान्य हृदय रोग के उपचार पर 1,50,000 रुपए से 6,00,000 रुपए का खर्च आता है और दवाइयों पर आने वाला मासिक खर्च अलग है।

हृदय रोग के बढ़ते खतरों के मद्देनजर कार्डियक प्लान वाली बीमा पॉलिसी है जरूरी हो गई है।

7. फाइनेंशियल ब्रेक डाउन से सुरक्षा

याद रहे हॉस्पिटल किसी तरह का मोल भाव या नेगोशिएशन नहीं करती है। जिस तरह से हेल्थ सर्विस में सुधार आ रहा है सुविधाएं भी बहुत महंगी होती जा रही है। हम सबने अपने आसपास खेत-जेवर बिकते देखे हैं। ख़ुशहाल परिवार को  अचानक आये मेडिकल विपदाओं के कारण पैसे के लिए बिलखते देखे हैं।
हेल्थ इन्सुरंस उन्ही अप्रत्याशित खर्चों का ख्याल रखती है जो अचानक अस्पताल में भर्ती होने से उत्पन्न होता है। फाइनेंसियल एक्सपर्ट की एक हीं सलाह होती है की आप आपने सालाना आय का 2% हेल्थ इनश्योरेंस के लिए व्यय करें।  

इंश्योरेंस कंपनियों का हर बड़े-छोटे हॉस्पिटलों से टाई-अप होता है, अगर आपके पास हेल्थ इंश्योरेंस है तो आप अपना उपचार कहीं भी करा सकते है वो भी कैशलेस सुविधा के साथ। आपको इलाज के लिए पैसों की चिंता करने की जरूरत नहीं होती। आपके हॉस्पिटल बिल के लिए नेगोशिएशन करने की जरूरत नहीं होती ये काम आपकी इन्श्योरेन्स कंपनी करती है.  आप बेफिक्र होकर अपना इलाज करा सकते हैं।

हेल्थ इंश्योरेंस में मरीज को हॉस्पिटल लाने ले जाने में एंबुलेंस का जो  खर्च भी कवर होता है। 

हाँ इन सब के साथ हेल्थ इनश्योरेंस के लिए जो प्रीमियम का भुगतान किया जाता है, उस पर आयकर भुगतान अधिनियम की धारा 80डी के तहत टैक्स में छूट मिलती है।

त्रुटियों के लिए अग्रीम माफी –
इसमें बहुत सारी त्रुटियां हो सकती है पर मैंने अपनी कपैसिटी मे ईमानदार कोशिश की है और आशा करता हूं कि आप अपने कमेंट से मुझे और सुझाव देंगे। आप से आग्रह है की इसे समझे और इस बात से अपने आसपास के लोगों को अवेयर करें। मेरी यह कोशिश है कि समाज में इनश्योरेंस के बारे में अवरेनेस बढ़े इसलिए मैं बोलचाल की भाषा उपयोग करता हूँ . मैं कोई लल्लनटॉप नहीं हूँ और न इनश्योरेंस का ज्ञाता। बस जितना जानता हूँ वो आप तक बढ़ा दिया। अच्छा लगे तो आप दुसरो को बढ़ा दे बस यही मेरी चाहत है. मैं चाहता हूँ की इस लॉक डाउन में हम और स्टीरिओ टाइप के ज्ञान से थोड़े आगे बढ़े कुछ नया सीखे कुछ नया जाने


#Disclaimer – Opinions expressed are solely my own or drawn from innumerable centers of culture & lore. It do not express the views or opinions of my employer.

मोटर इंश्योरेंस के पक्ष : What Are Parties In General Insurance – Shashi Kumar Aansoo

मोटर इंश्योरेंस के संबंध में तीन पक्ष (Parties) होते हैं —

A. First Party (प्रथम पक्ष):
वह पक्ष (व्यक्ति या संस्था) जो कि जो बीमा खरीदता है वह First Party (प्रथम पक्ष) होता है। बीमा के संबंध में बीमा ग्राहक को प्रथम पक्ष माना गया है।

B. Second Party (द्वितीय पक्ष):
वह पक्ष, जो कि बीमा पॉलिसी बेचता है वह Second Party (द्वितीय पक्ष) होती है। बीमा के संबंध में बीमा कंपनी को द्वितीय पक्ष माना गया है।

C. Third Party (तृतीय पक्ष):
बीमा ग्राहक और बीमा कंपनी के अलावा कोई अन्य व्यक्ति या संपत्ति जो कभी भी किसी वाहन दुर्घटना के चपेट में आ सकता है उसे इन्श्योरेन्स के संबंध में थर्ड पार्टी कहा जाता है अर्थात Third Party (तृतीय पक्ष) वह है जिसे कभी आपके वाहन की टक्कर से नुकसान पहुंच

थर्ड पार्टी इंश्योरेंस ऐसी बीमा पॉलिसी होती है, जिसका फायदा न तो बीमा करवाने वाले कस्टमर (प्रथम पक्ष = First Party) को होता है और न ही बीमा करने वाली कंपनी (द्वितीय पक्ष = Second Party) को होता है बल्कि इस बीमा का फायदा, अलग किसी अन्य क्षतिग्रस्त होने वाले व्यक्ति Third Party या सम्पत्ति को होता है। इसमे उस अन्य व्यक्ति या संपत्ति को हर्जाना मिलेगा, जिसे आपके वाहन से नुकसान पहुंचा है। इसमें आपको या आपके वाहन को हुए नुकसान का कोई क्लेम नहीं मिलेगा।

हेल्थ और लाइफ इंश्योरेंस पॉलिसी से ऐसे बचाएं टैक्स

मौजूदा वित्त वर्ष के लिए अगर आपने अब तक टैक्स सेवर नहीं खरीदे हैं तो इन इंश्योरेंस प्रॉडक्ट्स पर विचार करें। अगले वित्त वर्ष से अगर आप नई टैक्‍स व्‍यवस्‍था चुनते हैं तो टैक्स बचाने को लेकर इंश्‍योरेंस की प्रासंगिकता खत्म हो सकती है।

आप भी उन लोगों में हैं जो अपनी टैक्‍स देनदारी घटाने के लिए इंश्‍योरेंस पॉलिसी खरीदते हैं? मौजूदा वित्त वर्ष के लिए अगर आपने अब तक टैक्स सेवर नहीं खरीदे हैं तो इन इंश्योरेंस प्रॉडक्ट्स पर विचार करें। अगले वित्त वर्ष से अगर आप नई टैक्‍स व्‍यवस्‍था चुनते हैं तो टैक्स बचाने को लेकर इंश्‍योरेंस की प्रासंगिकता खत्म हो सकती है, क्योंकि नी व्यवस्था में आपको डिडक्‍शन और एग्‍जेम्‍पशन नहीं मिलेंगे।

बहरहाल जानकार कहते हैं कि इंश्‍योरेंस केवल टैक्‍स बचाने के मकसद से नहीं खरीदना चाहिए। मौजूदा टैक्‍स सिस्टम में लाइफ इंश्योरेंस और मेडिक्‍लेम खरीदने पर कई तरह की टैक्‍स छूट मिलती है। इनकम टैक्स कानून, 1961 में कई प्रावधान हैं जिनके तहत आप टैक्‍स डिडक्शन क्‍लेम कर सकते हैं। आइए जानें इनके बारे में।

सेक्‍शन 80C
मौजूदा टैक्स सिस्टम में आप एन्डाउमेंट, होल लाइफ, मनी बैक, टर्म इंश्‍योरेंस और यूलिप (यूनिट लिंक्‍ड इंश्‍योरेंस पॉलिसी) जैसी इंश्‍योरेंस पॉलिसी के प्रीमियम के भुगतान पर सेक्‍शन 80सी के तहत आप डिडक्‍शन क्‍लेम कर सकते हैं। हालांकि, इस सेक्‍शन के तहत अधिकतम 1.5 लाख रुपये तक के निवेश पर ही टैक्‍स छूट मिलती है।

सेक्‍शन 80CCC
सेक्‍शन 80सीसीसी के तहत लाइफ इंश्योरेंस कंपनी के ऐन्‍युइटी प्‍लान के लिए पे की जाने वाली रकम पर छूट मिलती है। इस सेक्शन के तहत टैक्‍स डिडक्‍शन की सीमा 1.5 लाख रुपये है। यह सेक्‍शन 80सी और 80सीसीडी के तहत छूट में शामिल है। यानी इन तीनों सेक्‍शन को मिलाकर इनके तहत 1.5 लाख रुपये की टैक्स छूट का दावा किया जा सकता है।

पेंशन प्‍लान्स के अमूमन दो हिस्‍से होते हैं। ऐक्‍युमुलेशन फेज और विदड्रॉल या पेआउट फेज। पॉलिसी मैच्‍योरिटी डेट तक आप जो प्रीमियम देते हैं, उसमें से कुल रकम का 60% आप एकमुश्‍त ले सकते हैं। बाकी की रकम नियमित पेंशन के तौर पर आपको मिलती है।

आप सेक्‍शन 80CCC के तहत डिडक्‍शन क्‍लेम कर सकते हैं। डिडक्‍शन की सीमा 1.5 लाख रुपये तक है। वहीं विदड्रॉल फेज में एकमुश्‍त राशि का एक तिहाई टैक्‍स-फ्री होता है। बची हुई रकम को या तो एकमुश्‍त या रेगुलर पेंशन के तौर पर दिया जाता है। इसे उस साल की इनकम माना जाता है. इस पर करदाता को टैक्‍स देना पड़ता है.

सेक्‍शन 10 (10D )
इनकम टैक्स के इस सेक्‍शन के तहत लाइफ इंश्योरेंस पॉलिसी की मैच्‍योरिटी या इसे सरेंडर करने या इंश्योर्ड व्‍यक्ति की मौत हो जाने पर मिलने वाली रकम (सम अश्‍योर्ड) और बोनस पूरी तरह टैक्‍स फ्री हैं। यह एग्‍जेम्‍पशन सेक्‍शन 10 (10D) के तहत मिलता है।

हेल्‍थ इंश्‍योरेंस पर टैक्‍स में फायदे
हेल्‍थ इंश्‍योरेंस पॉलिसी के मामले में आप सेक्‍शन 80D के तहत टैक्‍स छूट ले सकते हैं।

सेक्शन 80D
1- इस सेक्‍शन में लाइफ पार्टनर, बच्चों और अपने लिए प्रिवेंटिव हेल्थकेयर चेकअप की कॉस्ट के साथ हेल्थ इंश्योरेंस प्रीमियम के लिए आप 25,000 रुपये तक डिडक्शन क्लेम कर सकते हैं।
2-अगर माता-पिता के लिए हेल्थ इंश्योरेंस खरीदते हैं तो 50,000 रुपये तक एक्स्ट्रा डिडक्शन पा सकते हैं बशर्ते माता-पिता सीनियर सिटिजन हों।

अगर टैक्सपेयर और उसके माता-पिता दोनों की उम्र 60 साल से ज्‍यादा है तो मेडिक्‍लेम पॉलिसी पर 1 लाख रुपये तक डिडक्‍शन क्लेम किया जा सकता है।

Sachin Bansal buys DHFL General Insurance

Flipkart co-founder Sachin Bansal’s bet on the insurance firm is part of his broader ambition in financial services industry.

The deal has been routed through Navi Technologies, formerly BAC Acquisitions which Bansal had founded along with IIT-Delhi batchmate Ankit Agarwal after selling stake in Flipkart in 2018.
Sources said Bansal has bought out the entire stake in the insurer, held by Kapil
Wadhawan-owned WGC. “Navi is actively scouting for opportunities in BFSI space,” a spokesperson for the company said when contacted . “Specifically, it is interested in the intersection of technology and financial services, where we believe technology can be harnessed to improve access and availability of financial services,” the spokesperson said.

DHFL General Insurance has about Rs 400 crore assets under management.
“Bansal wants to get a footing into the banking and financial services sector. There has been a lot of talk about him being keen on obtaining a banking licence and has been looking at opportunities in the asset management space,” a source said. Bansal’s move to step into the insurance sector comes on the back of Navi Technologies acquiring a majority stake in Chaitanya Rural Intermediation Development Services, which runs a microfinance platform. Having picked up more than 90% stake in Chaitanya, he took over as its chief executive last year.

How To Renew Your Car Insurance – Know the Basic Facts of General Insurance : (आपकी गाड़ी का इंश्योरेंस रिनूअल)

आपकी गाड़ी का इन्सुरंस सही समय पर रिनूअल हो ये मोटर व्हीकल एक्ट के तहत आपकी कानूनी व अहम् जिम्मेदारी है ख्याल रहे मोटर इंश्योरेंस एक्ट के अनुसार भारत में थर्ड पार्टी मोटर इंश्योरेंस अनिवार्य है।
कभी-कभी हम जानकारी के अभाव में या गलत जानकारी के वज़ह से अपनी गाड़ियों की बीमा में टालमटोली कर बैठते है और बड़े जोखिम को वेवज़ह न्योता दे बैठते हैं । लोग इन्श्योरेन्स न होने की भयावहता से शायद परिचित नहीं होते है याद रहे इन्श्योरेन्स हमे कोई खुशी प्रदान तो नहीं करती पर पर पर इसकी अनुपस्थिति हमारी खुशियों पर ग्रहण जरूर लगा जाती है। हम कुछ पैसे बचाने के चक्कर मे अपनी खूद की गाड़ियों का इंश्योरेंस नहीं करके अपना हीं नुकसान कर बैठते हैं।

आज सभी प्रमुख इंश्योरेंस कंपनी हर जगह प्रमुखता से से उपलब्ध है। आप आपकी कार के इन्श्योरेन्स का तुलनात्मक अध्ययन व उसके सभी उपलब्ध सुविधाओं के बारे मे रिनूअल के पहले सटीक जानकारी ले सकते हैं। आज ज्यादातर जनरल इन्श्योरेन्स कंपनी अपने रिनूअल के लिए सारे ऑनलाइन पेमेंट का विकल्प देती है और साथ मे आपका एजेंट भी आपंकों एस काम मे मदद करते है।

आजकल के डिजिटल वर्ल्ड मे जानकारी प्राप्त करना बेहद आसान है बस जरूरत है की आप सब्जेक्ट मैटर को बेहतर ढंग से समझे इसलिए यदि आपके कार इन्श्योरेन्स का रिनूअल नजदीक है, तो चलिए कुछ ध्यान रखने वाली कुछ बेहद इम्पोर्टेन्ट टर्म्स को जान लेते हैं ….

. सही इंश्योरेंस कंपनी का चुनाव (Select the Correct Insurance Company) : अगर आपकी वर्तमान इन्सुरंस कंपनी आपको सही सुविधा नहीं दे रही तो रिन्यूअल के वक्त आप नए इंश्योरेंस कंपनी में अपनी कार का इन्सुरंस रिन्यूअल करवा सकते हैं पर ख्याल रहे कम प्रीमियम के चक्कर में आप गलत सिलेक्शन न कर बैठे। आप सही कंपनी के चुनाव करते वक्त यह सुनिश्चित कर ले की उक्त कंपनी की सर्विस आपके शहर में या उसके आस पास के शहरों में उपलब्ध है या नहीं ! ऐसा न हो की जरुरत पड़ने परआपको मदद हीं न कर सकें. आप उसकी लोकल ब्रांच की उपलब्धता जरूर देख लें ।

२. इंश्योरेंस के प्रकार की सही जानकारी (Find The Correct Insurance Coverage Type): आप एक बार सही इन्श्योरेन्स कंपनी की तलाश अगर पूरी कर लेते हैं तो अप अपनी कार के लिए सही कवरेज के बारे में जानकारी का पता लगायें. आपके कौन-कौन सी कवरेज की आवश्यकता है और उनकी बेस्ट कीमत कितनी है, इसका पता लगाएं।  आप आपने एजेंट से अपनी रिन्यूअल नोटिस की मांग करें और दिए गए कवरेज को समझे या आपने एजेंट की सहायता लें। आप कंपनी के कस्टमर केयर को कॉल करके भी आपकी रिनूअल में दिए गए कवरेज की जानकारी ले सकते हैं। ऐसे प्रचलित रूप से हमारे इंडिया मे मोटर इंश्योरेंस मुख्यतः तीन प्रकार के होते हैं…

  • कंप्रिहेंसिव इंश्योरेंस पॉलिसी(Comprehensive Insurance ):

    यह एक प्रकार की नियमित मोटर पॉलिसी होती है। इसका दायरा भी बड़ा होता है। इसके तहत इंश्योरेंस कंपनी फर्स्ट पार्टी यानी आपका एवं थर्ड पार्टी अर्थात आपके अलावा अन्य किसी का दुर्घटना में हुए जान माल का नुकसान का खर्च की भरपाई करती है। बोलचाल की भाषा में इसे फुल पार्टी इन्सुरंस भी कहते  हैं।
  • थर्ड पार्टी इन्श्योरेन्स पॉलिसी (Third Party Insurance):

    थर्ड पार्टी इन्श्योरेन्स कानूनन अनिवार्य होता है। थर्ड पार्टी इंश्योरेंस को समझने के पहले हमें यह जान लेना चाहिए कि “थर्ड पार्टी” क्या होता है…

दरअसल मोटर इंश्योरेंस के संबंध में तीन पक्ष (Parties) होते हैं —  

  1.  First Party (प्रथम पक्ष): वह पक्ष (व्यक्ति या संस्था) जो कि जो बीमा खरीदता है वह First Party (प्रथम पक्ष) होता है। बीमा के संबंध में बीमा ग्राहक को प्रथम पक्ष माना गया है।
  2. Second Party (द्वितीय पक्ष): वह पक्ष, जो कि बीमा पॉलिसी बेचता है वह Second Party (द्वितीय पक्ष) होती है। बीमा के संबंध में बीमा कंपनी को द्वितीय पक्ष माना गया है।
  3. Third Party (तृतीय पक्ष): बीमा ग्राहक और बीमा कंपनी के अलावा कोई अन्य व्यक्ति या संपत्ति जो कभी भी किसी वाहन दुर्घटना के चपेट में आ सकता है उसे इन्श्योरेन्स के संबंध में थर्ड पार्टी कहा जाता है अर्थात Third Party (तृतीय पक्ष) वह है जिसे कभी आपके वाहन की टक्कर से नुकसान पहुंच सकता है।  

    थर्ड पार्टी इंश्योरेंस ऐसी बीमा पॉलिसी होती है, जिसका फायदा न तो बीमा करवाने वाले इन्शुर्ड (प्रथम पक्ष=First Party) को होता है और न ही बीमा करने वाली कंपनी (द्वितीय पक्ष=Second Party) को होता है बल्कि इस बीमा का फायदा, अलग किसी अन्य क्षतिग्रस्त होने वाले व्यक्ति Third Party या सामान को होता है। सिर्फ उस अन्य व्यक्ति या संपत्ति को हर्जाना मिलेगा, जिसे आपके वाहन से नुकसान पहुंचा है। इसमें आपको या आपके वाहन को हुए नुकसान का कोई क्लेम नहीं मिलेगा।
  • Standalone OD/ SAOD Insurance (स्टैंड अलोन ओ डी रिन्यूअल ): सुप्रीम कोर्ट के आदेशानुसार अगर आप नये दोपहिया वाहन खरीदते है तो पाँच साल का और प्राइवेट कार खरदते हैं तो तीन साल का थर्ड पार्टी इन्श्योरेन्स अनिवार्य रूप से करना पड़ेगा । इसी लिए IRDAI ने 1 सितंबर 2018 से नई व पुरानी कारों और दोपहिया वाहनों के लिए नई इन्श्योरेन्स पॉलिसी स्टैंडअलोन ओडी कवर की की व्यवस्था की है। अगर आप दोपहिया गाड़ी खरीदते है तो अक्सर आपकी इन्श्योरेन्स 1+5 टर्म (1 Year OD + 5 Years TP Cover) की मिलती है जहाँ एक साल कंप्रिहेंसिव कवर और बाकी अगला चार साल थर्ड पार्टी कवर हीं होता है, वही अगर आप कार खरीदते हैं तो वह १+३ टर्म (1 Year OD + 3 Years TP Cover) की होती है इसका सीधा मतलब एक साल कंप्रिहेंसिव कवर और बाकी अगला दो साल सिर्फ थर्ड पार्टी कवर हीं होता है । जब आपकी गाड़ी का एक साल पुरानी होती है तो आपके गाड़ी के OD कवर का रिनूअल इसी स्टैंड अलोन ओडी रिन्यूअल के तहत होता है ताकि आपकी गाड़ी का कंप्रिहेंसिव रिस्क चालू रहे .
    आजकल सभी इन्श्योरेन्स कंपनी प्रमुखता से स्टैंडअलोन ओडी इंश्योरेंस कवरेज प्रदान करती है।

3 .सही ऐड ऑन प्लान का चुनाव (Select The Correct Add-On Plan): आपकी कार का बेसिक कंप्रिहेंसिव इन्श्योरेन्स कवरेज मे बहुत सारे कन्डिशन होते हैं जिसके कारण दुर्घटना के बाद पूरा हर्जाना या क्लेम नहीं मिल पता पता है अतः सही ऐड-ऑन कवर का चुनाव अतिअवाश्यक है. जैसा कि नाम बताता है, यह आपके  नियमित मोटर पॉलिसी के दायित्व के अतिरिक्त, कुछ ऐड ऑन रिस्क कवर करती है जिसे कुछ अतिरिक्त राशि का भुगतान करके प्राप्त किया जा सकता है। आज हरएक इंश्योरेंस कंपनी आपके मूल मोटर बीमा पॉलिसी के साथ कई वैकल्पिक एड-आँन कवर दे रही है। यदि सही कवर चुना जाता है तो ये मनीसेवर्स हैं। ऐड-ऑन एक बेसिक कार इंश्योरेंस पॉलिसी का दायरा भी बढ़ाते हैं।

कुछ प्रचलित ऐड-ऑन कवर इस प्रकार हैं….(Following are Some Popular Add-on Coverage Options…

  • ज़ीरो डेप्रीसियेशन कवर (Zero/Nil Depreciation Reimbursement Cover):  आपकी गाड़ी में एक्सीडेंट के वज़ह से या अन्य किसी कारन से  किसी भी तरह का नुकसान पहुचता है तो इन्श्योरेन्स कंपनी क्लेम के बाद बदले गए पार्ट्स की कीमत का पूरा भुगतान नहीं करती बल्कि एक निश्चित प्रतिशत की राशि काट कर क्लेम का भुगतान करती है।  उसी काटे गए रकम को क्लेम डेप्रीसियेशन (मूल्यह्रास) कहते हैं जैसे सभी प्रकार के रबर/नायलॉन/प्लास्टिक पार्ट्स, टायर और ट्यूब, बैटरी और एयर बैग के लिए-50% और फाइबर ग्लास के लिए – 30% डेप्रीसियेशन होता है.  मेटल और लकड़ी के पार्ट के लिए उसके उम्र के अनुसार क्लेम अमाउन्ट मे से डेप्रीसियेशन किया जाता है जो की पहले 5% से 50% तक जाता है. यदि आप ज़ीरो डेप्रीसियेशन कवर / निल डेप्रीसियेशन का विकल्प चुनते हैं, तो नुकसान के मामले में इन्श्योरेन्स कंपनी आपके क्लेम के वक्त किसी भी तरह की कटौती/डेप्रीसियेशन नहीं करती है।
  • इंजन सिक्योर (Engine Secure Cover): इंजन में पानी के प्रवेश के कारन या इंजन से लुब्रिकेंट के रिसाव के कारन आपकी गाड़ी के इंजन, गियर बॉक्स या ट्रांसमिशन असेंबली में किसी भी प्रकार की क्षति पहुचती है तो इंजन सिक्योर कवर हीं इंजन और गियर बॉक्स के आंतरिक भागों के नुकसान की मरम्मत या रिप्लेसमेंट के खर्चों को कवर करती है।
  • रिटर्न टू इन्वाइस (Return to Invoice Cover): अगर आपकी गाड़ी चोरी हो जाती है या एक्सीडेंट के बाद टोटल लॉस केटेगरी मे आती है तो इन्श्योरेन्स कंपनी सिर्फ आपको आपकी गाड़ी के  IDV (सम इन्शुर्ड वैल्यू) या करंट रिप्लेसमेंट वैल्यू का क्लेम पेमेंट करती है पर अगर आप रिटर्न टू इन्वाइस ऐड ऑन कवर का विकल्प चुनते है तो ऐसी परिस्थिति आपको आपकी गाड़ी के IDV (सम इन्शुर्ड वैल्यू) के जगह गाड़ी की इन्वाइस वैल्यू (खरीदने व्यक्त की कीमत) का भुगतान करती है. इसके साथ-साथ  फर्स्ट टाइम रजिस्ट्रेशन चार्ज और रोड टैक्स का भी का भुगतान करती है. आप चंद और पैसे लगाकर नयी गाड़ी ख़रीद सकते है।
  • कंज़्यूमेबल्स कवर (Consumables Expenses Cover) : आपकी गाड़ी मे क्लेम के बाद नुकसान की मरम्मत या रिप्लेसमेंट के दौराननट बोल्ट, कूलेंट, इंजन ऑइल, ब्रेक ऑइल, बेयरिंग, ग्रीस, कन्डिशनर गैस आदि जैसी कंज्यूमेबल्स आइटम की कीमत कार इंश्योरेंस में कवर नहीं होती है हाँ अगर आप ‘कंज्यूमेबल्स कवर ऐड-ऑन’ का विकल्प लेते हैं, तो आपको कंज्यूमेबल्स आइटम मे किए गए खर्च का मुआवजा मिल सकता है।
  • की रिप्लेसमेंट कवर (Key Replacement Cover) : अगर आपकी गाड़ी की चाभीखो जाती है या चोरी हो जाती है या चाभी आपकी गाड़ी में ही टूट जाती है तो यह की (चाबी) रिप्लेसमेंट कवर हीं उसे मरम्मत या बदले जाने की खर्च को कवर करती है. अमूमन यह बेसिक इन्श्योरेन्स पॉलिसी मे कवर नहीं होता है। इस कवर को प्राप्त करने के लिए पुलिस शिकायत अनिवार्य है।
  • टायर सिक्योर कवर (Tyre Secure Cover) : आपकी नॉर्मल इन्श्योरेन्स पॉलिसी सिर्फ टायर या ट्यूब मे हुए नुकसान को कवर नहीं करती है।  जब एक्सीडेंट के वजह से आपकी गाड़ी को तो कोई नुकसान नहीं होता पर टायरों और ट्यूबों को नुकसान पहुँचता है जैसे बबल, पंचर, बर्स्ट या कट जाना या क्षति होना तब टायर सिक्योर कवर उसे रिप्लेसमेंट करने या उसे मरम्मत किए जाने वाले खर्चों को कुछ शर्तों के साथ कवर करती है।

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ISRO likely to purchase first insurance policy for satellite

According to the information from sources, the Indian Space Research Organisation (ISRO) is eying to buy its first insurance policy for a domestically launched space satellite, the first since it began launching satellites in 1975.
There can be two factors which are expected to have been influencing ISRO to begin buying satellite insurance.

Firstly, there is an unexpected setback in Project Chandrayaan-2, which cost nearly INR10 billion (US$139.4 million). Secondly, there is the success of ISRO’s Mars mission, which brought down reinsurance rates for Indian space exploration activities.

While ISRO has not insured launches conducted on Indian soil, it has typically insured launches done in partnership with other countries, such as Russia and the US. New India Assurance and other state-owned insurers were typically those tapped to provide cover for these projects, with reinsurance from the international market.

IRDAI sets up working group to review title insurance structure

A working group has been constituted by IRDAI ( Insurance Regulatory and Development Authority of India) to revisit the product structure of title insurance, develop a standard product and recommend measures to spur demand for the product. The decision comes in the backdrop of a less-than-desired response to title insurance products. “The number of title insurance policies sold is minimal despite availability for the last one and half years and the obligation cast under the Real Estate (Regulation and Development) Act, 2016 upon promoter/developers to obtain the said policy,” said the IRDAI order, while constituting a 12-member working group.

There are very few general insurers that offer title insurances and their product features vary in policy terms and conditions and scope of coverage depending on the support received from their reinsurers. While stating this, IRDAI said the feedback received from the Government of India revealed that stakeholders, especially developers associations, had flagged the need for standardisation in title insurance products.

The working group has been formed with a deadline of three months to submit the report. Apart from developing a standard product and coming out with recommendations to spur demand, the group will examine the legal and regulatory framework in place and its impact on the marketability of title insurance; study the structure of such products available and analyse reasons for sluggish demand; and suggest augmentation of reinsurance capacity in the domestic market.

Premium Rates for Motor Insurance Cover for FY 2019-20

Premium Rates for Motor Insurance Cover for FY 2019-20 (WEF. 16/06/2019)

Disclaimer: Its Ready Reckoner Indian Motor tariff Rates as per IRDIANL/NL/NTFN/MOTP/91/06/2018

For Details Refer IRDA Website –

or Call Toll Free No. 155255 (or) 1800 4254 732

What is Insurance Underwriting? (General Insurance) – Shashi Kumar Aansoo

What is Insurance Underwriting?

Let’s take a look at the concept of underwriting.

“Underwriting is a core insurance function. It is a methodological approach to ensure that the insurance business is conducted on sound lines and that risks are evaluated for loss potential on both frequency and severity over a period of time.”

Underwriting is the process of:

  • Determining the level of risk presented by a proposer
  • Deciding whether to accept the proposal
  • Deciding the terms and price of the accepted proposal

Each underwriting decision involves balancing the insurer’s desire to earn premium often in competitive conditions with margins required to pay claims and expenses and also to ensure compliance with regulatory requirements. Underwriting is essential in all forms of insurance. For example, an automobile insurer will charge higher rates to young drivers, old models of vehicles, or may refuse coverage to drivers with a history of accidents. The underwriter may offer discounts for vehicles fitted with anti-theft devices. Fire insurers may inspect properties, offer reduced premiums for safety features such as sprinkler systems, and so on.

Understanding Risk Sharing

Understanding the concept of risk sharing or pooling will make it easier for you to understand the role of underwriting and risk classification in insurance.

All risks are not equal. For example, in the field of property and casualty insurance, wooden structures are at a greater risk of burning than stone structures. Therefore, a higher premium is required to insure a wooden structure. The same concept applies to life insurance. An individual with a serious illness such as cancer or diabetes is at a greater risk of premature death than an individual without the illness.

Since all risks are not equal, it would be inequitable to make all insured contribute the same amount. Thus, underwriting attempts to classify risks based upon their characteristics so that each insured in a specific class pays a premium in proportion to the risk involved.

The issue of fairness to the other participants is at the core of this risk classification (underwriting) process. When viewed from a perspective of fairness, proper risk classification becomes a central obligation of insurers to the policyholders who participate in their risk pools. This applies for all risks – life, assets or earnings.

Definition of Combined Ratio for Insurance Business

“Combined Ratio’

A measure of profitability used by an insurance company to indicate how well it is performing in its daily operations.

The combined ratio is defined as

The sum of incurred losses and operating expenses measured as a percentage of earned premium.

The combined ratio is comprised of the claims ratio and the expense ratio.

The claims ratio is claims owed as a percentage of revenue earned from premiums.

The expense ratio is operating costs as a percentage of revenue earned from premiums.

The combined ratio is calculated by taking the sum of incurred losses and expenses and then dividing them by earned premium.

It is a measure of the profitability of the insurer. (The ratio is typically expressed as a percentage.)

The combined ratio shows the underwriting profitability of the insurer. A ratio below 100% indicates that the company is making underwriting profit while a ratio above 100% means that it is paying out more money in claims that it is receiving from premiums.

‘Combined Ratio Calculated as:

“Combined Ratio”= “Incurred Loses + Expanses” /”Earned Premium”


Combined Ratio
Combined Ratio

Continue reading “Definition of Combined Ratio for Insurance Business”

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