Академический Документы
Профессиональный Документы
Культура Документы
Submitted To PUNE UNIVERSITY BY TAUSIF AHMED SHAIKH In Partial Fulfillment of Master of Business Administration (MBA) Guided by Prof Kavita Shendker Unique Institute of Management S.No. 36/3C, Gokul Nagar , Katraj Kondhwa Road, Katraj, Pune 411046 2012-2013
CERTIFICATE
This is to be certified that project report titled Study of the process of Underwriting is a benefice work carried out by Mr Tausif A Shaikh Student of M.B.A II of our institute for fulfillment of M.B.A degree of University of Pune. He has worked under our guidance and supervision.
DECLARATION
I Tausif Ahmed Shaikh student of Unique Institute of Management MBA (2011-2013) solemnly declares that the project work on Study of the process of Underwriting at Future Generali India Life Insurance Company Private Limited was carried out by the partial fulfillment of the Master of Business Administration Degree, to the University of Pune. It is a bonafied piece of research work carried out by me and no part of this have been submitted earlier, either to this University or any other institution for fulfillment of the requirement of any Degree or Diploma. This project was undertaken as a part of the academic curriculum according to the University Rules and by no commercial interest or motives.
Date:
Place: Pune
Signature of Candidate
ACKNOWLEDGEMENT
This project is a product of encouragement and motivation from various sources. I am sincerely thankful to everyone who has contributed to the successful completion of this project. I would like to thank all who have helped me in the implementation of this project at all stages. I offer my profound gratitude to the management for giving me an immense opportunity of exposure to use my theoretical knowledge with my practical experience, in a professional environment. I would like to express my honest and sincere gratitude to my mentor Mr Rajiv Sudan (Regional Manager) and my reporting officer Mr Shakeel Ahmed (Branch Manager) for the confidence shown in me and guiding & motivating me throughout the project. With their helpful attitude, they added to my thoughts, provided some timely suggestions and cleared my doubts to perfection. This project could not have been completed without the guidance of Mr Irfan Shaikh (learning & development Manager). I express my sincere thanks and gratitude to the above stated persons and also to my colleagues in operation department who have helped me directly and also to those who have indirectly helped me. I am thankful to Prof Kavita Shendkar (internal guide) for her support in completion of project work and I am also thankful to Dr P.B Kumbhar (Director, UIM) for his support and opportunity given to express my knowledge. Under their valuable guidance & suggestion I am able to bring my project to a successful completion.
Sincerely
EXECUTIVE SUMMARY
INDEX
Sr No.
Chapter Name
Page No
1.
2.
Company profile
3.
4.
Review of literature
5.
Research Methodology
6.
7.
8.
9.
Bibliography
10.
Annexure
By Ningthoujam Sandhyarani
Life insurance underwriting is the assessment of the information that has been provided through an application for life insurance and the recognition of any need to obtain further information. This is in order to make a fair and accurate underwriting decision on the applicant so as to determine the exact terms the insurer is willing to offer them. In short is risk evaluation.
COMPANY PROFILE FUTURE GENERALI INDIA LIFE INSURANCE CO BLOCK A HERITAGE HOUSE, 6 RAMABAI AMBEDKAR ROAD NEAR PUNE RAILWAY STATION, PUNE- 411001 IRDA REGISTRATION NO 133
Future Generali is a joint venture between the India-based Future Group and the Italy-based Generali Group.
Future Generali is present in India in both the life and Non-life businesses as Future Generali India Life Insurance Co. Ltd and Future Generali India Insurance Co. Ltd.
FUTURE GROUP
Future Group, led by its founder and Group CEO Mr Kishore Biyani, is one of Indias leading business houses with multiple businesses spanning across the consumption space. While retail forms the core business activity of Future group, group subsidiaries are present in consumer finance, capital, insurance, leisure and entertainment, brand development, retail estate development, retail media and logistics. Led by its flagship enterprise, Pantaloon Retail, the group operates over 12 million square feet of retail space in 71 cities and town and 65 rural locations across India. Headquartered in Mumbai (Bombay), Pantaloon Retail employs around 30000 people and is listed on the Indian stock exchanges. The company follow a multi-format retail strategy that captures almost the entire consumption basket of Indian customers. In the lifestyle segment, 6
the group operates Pantaloons, a fashion retail chain and central, a chain of seamless malls. In the value segment, its marquee brand, Big Bazaar is a hypermarket format that combines the look, touch and feel of Indian bazaars with the choice and convenience of modern retail. The groups specialty retail formats include sportswear retailer, planet sports, electronics retailer, eZone, home improvement chain, Home town and retail chain, Aadhaar, among others. It also operates popular shopping portal, www.futurebazaar.com. Future Capital Holdings, the groups financial arm, provides investment advisory to assets worth over$ 1 billion that are being invested in consumer brands and companies, real estate, hotels and logistics. It also operates a consumer finance arm with branches in 150 locations. Other group companies include, Future Generali, the groups insurance venture in partnership with Italys Generali Group, Future Brands, a brand development and IPR Company, Future logistics, providing logistics and distribution solution to group companies and business partners and Future Media, a retail media initiative The groups presence in leisure & Entertainment segment is led through, Mumbai-based listed company Galaxy Entertainment Limited. Galaxy leading leisure chains, sports bar and bowling o. and family entertainment centre, F123. Through its partner company, Blue Foods the group operates around 100 restaurants and food courts through brands like Bombay Blues, Spaghetti Kitchen, Noodle Bar, The Spoon, Copper Chimney and Gelato. Future Groups joint venture partners include US-based stationery products retailers, staples and Middle East-based Axiom Communications. Future Group believes in developing strong insights on Indian consumers and building businesses based on the Indian ideas, as espoused in the groups core value of Indianness. The groups corporate credo is Rewrite rules, Retain values.
IDENTITY CARD
Since its establishment, the Generali group has always held a reputation for its capital and financial strength. Its solidity derives from prudent investment management and a focus on achieving a correct match between risk and medium/ long-term profitability. Generali Group is one of the leading insurance groups in Europe, with a 2009 total premium income of more than 70 billion It is present in 68 countries It has 85,322 employees(15,956 in Italy) It has over 400 billion of assets under management High rating assigned by the international rating agencies:
A.M. BEST: A+ STABLE Standard & Poors: AA- STABLE Fitch Ibca: AA- NEGATIVE Moodys: Aa3 STABLE
VISION STATEMENT
Pledged to provide financial security to all people & enterprises through total insurance solution 8
VALUES
Respect: For all stakeholders-employees, customers, for all rules and regulations both internal and external
Indianess: We understand India in all its diversity and different facets and will use for our local understanding to respond to our specific markets, design our products and craft our processes.
Nimbleness : A combination of speed and quality, and ability to overcome all obstacles which come in the way of the achievement of our vision
Can Do : An attitude which demonstrate our passion, entrepreneurship, and positive thinking
POSITIONING
Knowledge organisation with Leadership Approach One Stop Total Insurance Solution & Service Provider Customer Centric Model embracing Passion, Convenience and Service Excellence
OBJECTIVES
To provide superior customer service through our knowledge-based business partners and employees supported by the innovative products and services.
10
11
12
REVIEW OF LITERATURE
Meaning of Underwriting
The process of verifying the level of risk in each new entrant [ life to be insured ] and determining the terms of admission [policy issuance] is called Selection or Underwriting. Underwriting is the Process by which applicants for insurance are selected and are classified according to the level of risk that each one represents. 13
Risk is the possibility of adverse consequences that might result in a claim [Death, sickness or disability].
Underwriting involves evaluation of risk exposure and determining the premium that needs to be charged to insure that risk.
Life insurance underwriting is a crucial process for determining the risk profile and estimating the premium amount of a policyholder. The underwriting guidelines for insurance companies may differ from one another. When you purchase any type of insurance quote, be life, health, or motor insurance, you might have come across the underwriting process. Underwriting can be considered as a process to scrutinize an applicant, whether he/she is eligible for issuing a life insurance policy underwriting ( underwriters ) consider a series of factors to determine the risk of the applicant for death ( especially premature death). Based on the risks involved, the pricing of the insurance quote or premium amount is decided
Importance of Underwriting
A decision to charge premium higher than necessary would not be fair to the proposer. Also, the cost of additional risk [if any], not recovered from the proposer would have to be borne by the rest of the policyholders. That is not fair to them. Thus, if the risk is wrongly assessed, the premium charged would not be appropriate.
Hence underwriting helps to Ensure that appropriate premium is charged for the particular risk involved. Maintain equity between policy holders Protect the company from wrong selection [antiselection] Remain competitive Offer cover to as wide a group of lives as Possible 14
Underwriting
Financial Underwriting
Occupational Underwriting
Medical Underwriting
Non-Medical Underwriting
15
Standard
Accept as proposed at OR [ Ordinary Rates ]
16
UNDERWRITING TOOLS
Application Form Medical Reports Agents Confidential Report Moral hazard Report Age proof Documents Photo Identity proof Residential proof Income proof Additional questionnaires[ if required]
Once the application form is submitted with necessary documents, proofs, reports and questionnaires; the as Non-Medical case Medical case
Important Of Application Form Is a part of the legal contract between the company and policyholder 17
MEDICAL REPORTS
Non-Medical Underwriting
It is underwriting a life without a medical examination on the basis of the Application Form and the Agents report. Non-medical cases are being processed subject to limit on the: Sum Assured Age at entry However if needed, medical reports can be called for .e.g. if the to be insured is Diabetic we can call for relevant medical tests.
Medical Underwriting
It is underwriting a life with a medical examination conducted by TPAs at the approved diagnostic centre. The type of medical test that the Life to be insured needs to undergo can be identified from the grid based on the Sum Assured and age of LA. However, if needed, underwriter may call for additional medical test depending on the information provided in the application form and the medical test already conducted.
MEDICAL GRID
For medical underwriting the following medical grid is use
18
MSA/AGE In yrs.
Up 13
to 14-17
18-35
36-45
46-50
51-55
>55yrs
UPTO 1 Lac
1 Lac-2 Lacs
2 Lacs-5 Lacs
5 Lacs-10 Lacs
10 lacs 15 lacs
15 lacs 20 lacs
20 lacs 30 lacs
30 lacs 50 lacs
50 lacs-10 lacs
The above medical grid is to be used for all of Future Generali except the Term Plan.
19
[MSA] Medical Sum Assured = [1* Basic sum assured] + [1.5* CI Rider sum assured] + [1* Term rider sum assured] + Previous [Basic Sum assured + 1.5* CI + ta] and / or
A B C D E F G N
MRF MRF, FBS, RUA, ECG-R, LIPID PROFILE MRF, HIV, FBS, FGI-15, RUA MRF, HIV, FBS, FGI-15, RUA, ECG-R MRF, HIV, FBS, FGI-15, RUA, TMT MRF, HIV, FBS, FGI-15, RUA, TMT+(CXR) JME Non-Medical
FGI-15 - Combination of various biochemical blood tests RUA ECG HIV TMT JME CXR - Routine Urine analysis - Electro cardiogram - Human Immunodeficiency Virus - Tread Mill Test - Juvenile medical Examination - Chest X-Ray
20
Medical Requirement for Future Care Plus AGE MSA 10 lacs-15 lacs 15 lacs -25 lacs 50 lacs 1 Cr > = 1 Cr 18 35 A A 36 45 A C D E E 46 - 50 B D E E F 51 - 55 B D E E F 55 60 D E E E F
25 lacs 50 lacs C D D
Type of Test
A B C D E F
Medical Tests
MRF, FBS MRF, FBS, RUA, ECG-R, LIPID PROFILE MRF, FBS, RUA, HIV, FGI-15 MRF, FBS, RUA, HIV, FGI-15, ECG-R MRF, FBS, RUA, HIV, FGI-15, TMT MRF, FBS, RUA, HIV, FGI-15, TMT +(CXR)
21
MEDICAL DISCRIPTION
Sr. No. Name of Medical test Physical examination of the client which includes Height, 1 MRF Weight Blood pressure reading etc.. Check the glucose level in blood after fasting period of 12 2 FBS hours Description
RUA
A microscopic examination of urine Electro cardio gram cardiac evaluation of the heart
ECG(R)
Chest X- Ray A combination of different test ( listed as below) which require blood sample Lipids Liver Functions Test Detects any Liver related abnormality Detects Fats concentration
FGI-15
Proteins
Detects
the
normal
or
abnormal
concentration of proteins in the blood Rental Function test HbA1c Give the idea about the blood sugar control in last 3 months CBS Complete Blood Count Detects any kidney related abnormality
22
For cases sourced from Blacklisted area, need MHR from ZBH for agency cases For Alternate/ Alliances Channel we issue the case & send it for Address Verification check. Meanwhile the Dispatch of policy bond will be kept on hold. For all case above 30 lakhs MHR will be called from Relationship Manager for that Alliance partner. 23
For Housewife / Major Student cases need the MHR to be given by AM for all the cases For employee cases MHR [wherever required] needs to be provided by his / he superior
AGE PROOFS
As age increases, the probability of death increases. These probabilities are taken into consideration while deciding the premium rate. Certain risks increase with age. Certain other risks decrease with age. For example, being little overweight is a positive or favourable factor among young children, while it may not be so among older persons. Younger persons who are underweight need closer scrutiny than elders who are underweight. Hence, knowing the exact age of the life to be insured is very important.
Therefore, it is very important to have a valid document that reveals the date of birth of life to be insured. Hence, documents having DOB or age are classified into two categories:
Nonstandard age proofs are those where DOB / age is not verified while issuing the same. Hence, it is an additional risk to the company when exact DOB is not known. Therefore, in such cases extra premium is charged to the customer for the additional risk the company is undertaking.
24
Restriction under non proposal [traditional plans only] received with Non Standard Age proof Restrictions Maximum age at entry Maximum age at maturity Traditional Plans 55 years 65 years Up to age 50 Rs 2 per thousand of sum NSAP charges assured 50-55 Rs 3 per thousand of sum assured Maximum Term 25 years Up to age 45 Rs 10 lakh Maximum Sum Assured Product not offered NSAP not allowed Age 46 to 55 Rs 5 lakh Term insurance, whole life insurance Minors Only ADB, ATPD and WOP on disability Riders will be allowed. CI Term & LG riders will not be allowed
RIDERS : Only Accidental Death Rider [ ADB], Accidental Total and Permanent disability Rider[ATPD] and waiver of premium [ WOP] on disability Rider will be allowed. Critical Illness [CI], Term & Life Guardian Rider [ LG] will not be allowed. 25
Multiples will not go above the maximum multiplier or the product specifications, whichever is lower
Age Proof
Description
PAN card
A pan card is used for Income Name of LA with the name Tax filing which has the name written on the PF & DOB mentioned DOB mentioned is matching with the DOB mentioned on
the application form Birth certificate A birth certificate is document Check the registration num which has the record of birth Check for registration date Check for seal and stamp and sign of the issuing authority Voter ID Voters ID enables the The age calculated as per the
individual to use his voting voter id should match with the rights which has the name & age mentioned in the PF the age mentioned Name of LA matches with the name written on the PF Ration card A ration card is used to Check for date of issue. The acquire rationed goods which calculated age as per ration mentions the name and age of card should match with the the individual Pension order for self age mentioned on the PF
Pension order is the document Check for name & DOB which enales a retired written on the pension order
individual to get pensions Any age proof Should not be and half half
document which is issued in Gram panchayat Register with villages Seal, Serial no, otherwise will be considered as NSAP School certificate A school certificate is given to Any correction needs to be the individual on completion countersigned by the issuing of the study tenure in school authority with the seal which has the individuals name Please note if age proof is vernacular then translation for the same needs to be provided with BM/SM /AM/City Head signature and employee code 27
Documents
Documents as per AML guidelines are required to be collected based on amount of Annualized Premium AML is applicable for all Life Insurance policies taken including term plans [excluding health & group insurance] by Individual for AML adherence In case the premium or the receipted amount exceeds Rs 1 lakh, Income proof needs to be obtained on account of AML. For Example A. Annualized Premium is Rs.99,999 and receipted amount is Rs. 1 lac B. Annualized Premium is Rs.1 lac and receipted amount is Rs.99,999 Restriction on Cash Transaction and requirement of PAN: To comply with AML regulation, if a case is logged for a premium of Rs.50000/- and receipting in cash has been done of Rs.49999/- then requirement will be raised in this case for PAN
AML Grid
Up to Rs 10000
Rs 10001 to 99999
1 Recent Photograph
2 Photo Id Poof
3 Address Proof 1 Recent Photograph 4 Proof of Source of Income 1. Photo Id Proof 2 Photo Id Proof 5 PAN card 3 Address Proof [If annualized premium is greater than 1 lakh on a per policy basis] Note: If PAN copy is
49A along with declaration stating that the PAN card copy will be submitted post receipt of the same.
Bank Pass book is issued by Latest transaction [ within six the bank which gives the months required] individual
Check
within six months ] DL and Passport if expired Driving license is used by an cannot be consider as ID or individual to ride/drive a address proof vehicle
Factor
20 X average annual income 15 X average annual income 12 X average annual income 05 X average annual income
For Financial underwriting policies lapsed for more than 2 years from last unpaid premium, will not be counted. All riders as per underwriting norms can be given to this category. 30
Income proof
Detailed report by sales representative (BM/ADM) For FSA beyond 10 lakhs [This report needs to be lakhs given by the employee i.e. BM / ADM / SM who is sourcing the
Less than Rs 25 lakhs [ All plans except Term Plan] Up to Rs 15 lakhs for Term products
policy. It is similar to the ACR which has questions like have you seen the life assured personally? , is the health conditions of the life assured good? etc. that need to be provided by the employee] If the SA<25L but if the annualized premium exceeds 1L income proof will be
SALARIED
>Rs 25 lakhs [ All plans except Term Plan] > Rs 15 lakhs for Term products - FQ to be sudmitted
Form No 16 issued by employer or Income tax returns for last 3 years or Salary slips for last 3 months or Bank statement showing salary
credited for last 6months or Salary Certificate issued by the employer [duly signed / stamped with issuing authority seal] in case
Companies] and Branch Managers profile letter [ providing details of the client s profile] detailing assets & liabilities with the credentials of the LA in the social market
32
BUSINESS
Form No.16 A or Income tax returns for last 3 years or Audited Profit and Loss Account and Balance Sheet of the firm for the last 3 financial years; or
>Rs 25 lakhs [ All plans except Term Plan] > Rs 15 lakhs for Term products - FQ to be submitted
Chartered
Accountants
certificate
with PAN, GIR No; stating the Annual Income from all sources forthe last financial years [duly attested by CA with his membership number]. CA to mention the list of documents verified and source from where the Documents are verified. Branch Managers profile letter
[providing details of the client s profile] detailing assets & liabilities with the credentials of the LA in the social market
Occupational Underwriting
Occupation is a critical part for underwriting as it helps in assessing the exact nature of duties [% admin & % manual] & helps in understanding the profile of the customer. Basis the occupation the underwriter to take a call as to whether a case can be considered standard or needs to be rated up / loaded / extra premium charged or if the need be give a counter offer.
33
Incomplete / incorrect disclosure of occupation will have a significant bearing on claims & may even lead to a claim repudiation hence it is important to disclose the correct occupation with the exact nature of duties.
Occupation List
All products will be allowed up to 5 lacs with loading 2 / mille for certain occupational categories ATPD, CI ,WOP & Term Rider will be excluded as per guidelines Fishing & Mining will be excluded as per the given occupational list
Guidelines:
Points to be remembered while filling proposal form [PF] of Major student:
PF must be signed by Major student & Proposer [if relevant] Proof of Annual income of parent / guardian [if required] Previous insurance details of life assured, Parents & other sibling must be filled Family history & Personal history of life assured should be filled in the respective personal medical & family history columns of proposal form Latest Photo ID of Proposer [premium payer]. In case photo ID is not available annexure as per AML guidelines, must be enclosed.
Please note in case of students more than 23 years of age ,then proof of study needs to be provided [e.g. fee receipt, examination admit card]
Latest photo of Proposer [Premium Payer] duly signed by him must be enclosed in the Declaration column of PF. Residence proof of Proposer must be enclosed Annual Income of Parents shall be stated on the PF; 34
FQ must accompany all such cases Income proof of the parent who is paying the premium would be necessary if the total amount of insurance applied or existing on students s life and on the life of any other person financed through the same source, exceeds 25 lakhs
Max Cover after linking to parents / other siblings insurance 50 lakhs (basic cover only) 50 lakhs allowed only if educational loan is taken [including FGI & non FGI policies]
Riders
Allowed Critical Illness Rider & Accident Rider Not allowed Term Rider
35
In case of minor life assured, total insurance cover on the life of parents will be clubbed together to determine the life cover to be given to the child. For financial underwriting purpose, only proposer's insurance cover (existing and current) & cover proposed by him on the family members will be considered
Enclosures MINOR
In case of a minor child who is an NRI, a copy of the passport, duly attested by the parent is mandatory, irrespective of them Sum-Assured. Medicals of minor life assured ( if required) A std. age-proof is a must. School going proof where age of the child is above 6 years. Previous insurance details of Minor Life assured, Proposer & other siblings Minor life addendum must be filled by Proposer. Latest Photo I.D of Proposer, Latest photo of Proposer duly signed by him must be enclosed in the declaration column of proposal form.
Proof of residence of Proposer must be enclosed with proposal form Previous insurance details of Minor Life assured, Proposer & other siblings Income proof of Proposer along with the financial questionnaire In case Proposer is an NRI a copy of passport and NRI Q must be enclosed
Maximum Cover:
Total cover (Total SA of all policies including CI rider) of 5 lakhs will be granted without linkage to Husbands insurance. 37
Riders / Plans
Term Products not allowed. Term Riders TPD WOP not Riders, TPD, allowed Critical Illness rider is allowed [Note: Housewives whose premiums are financed from Husbands income can be given CI rider only]
Signature Mismatch:
For signature mismatch Self Declaration ( addendum) will be sufficient Minimum Premium: The minimum premium for any mode / any product must be Rs.2500 for New business log-in with immediate effect. 38
In case of only SIP product, the premium for minimum 2 months @ Rs.3000 or Rs.4000/- is acceptable. Any exception to above must be approved by ZBH & Channel head
Underwriting Summary
The process of verifying the level of risk in each new entrant [life to be insured] and Determining the terms of admission [policy issuance] is called Underwriting.. The factors affecting risk on the life on individual are called Hazards. Hazards may be Physical Hazards, Occupational hazards, and Moral hazards. The underwriter makes decision on the basis of information sourced through various tools - Application form, Medical reports, agents confidential report, moral hazard report, age proof, AML / KYC documents and additional questionnaires.
The various underwriting decisions are Standard, Substandard / Counter offer, Postpone for specific period, Decline. The various underwriting categories are: Medical / Non medical, Financial underwriting, Occupational underwriting, Major Students lives underwriting, Minor lives underwriting and Female lives underwriting
39
Risks and uncertainties are not avoidable in life. They threaten the assets and their earning capacities. The assets may be by human or material. The risks have to be managed. Management of risk has developed as a subject of specialised study. The objectives of managing risk are to eliminate, or at least reduce, the effects of, the risks. To do so, the risks have to be first identified and then analysed, in the same ways problems are identified and analysed, before attempting solutions. There are ways of doing these. After identifying and analysing the risks, The ways of managing risks are Avoidance or Prevention Reduction Retention Transfer
Risks are not totally preventable, because they are often caused by forces and situations outside ones control. Natural perils like cyclones and earthquakes are not preventable. Even a very careful person will be involved in a motor accident because someone else makes a mistakes. Buildings collapse because some occupants add more weight than permitted through alteration and storage. Other suffer In retrospect, it may be felt that the damage was avoidable. Yet, what is practical does not always happen. There are limits to prevention.
Reduction of risk may be possible. Segregation of hazardous material and processes, proper periodical maintenance of electrical and other installations, good housekeeping, proper packing, regular training for personal handling materials and safety functions, regular drills creating mock situation, installing sprinklers and heat detector systems that detect danger signals, easy access for fire engines and availability of water, fire extinguishers, waterproof or pilfer proof packing, wearing car seat belts or helmets etc. are some methods to reduce risk.
40
Steps towards reduction may aim at situation before a peril has struck as well as situation after the peril has struck, as reflected by the steps mentioned earlier. However, reduction of risk is not an alternative to reduction or transfer. The efforts to find ways of reducing risks should never end. Useful ideas may emerge at any time. Reduction must continue despite retention or transfer.
Strategies for reduction of risks have to be thought of beforehand, to be put into operation after the perils has struck. Regular drills simulating likely disaster situations are essential as preparation to reduce losses. Otherwise, someone would be reading the instructions on the fire extinguisher after the fire has broken out or searching for the telephone numbers of emergency services. The extent of loss of lives and property after a rail crash or a fire, is affected by the speed and quality of reaction and responses are known to cause more deaths and casualties than the events themselves.
Risk Management
Risk Management begins with identifying the risks and then analysing the risks. MPL and PML are two factors that helps to identify and analyse the risks. A third factor to look at is the credibility of the data that have been used in the analysis. Occasional comparisons of forecasts of losses made in the past with actual losses would establish credibility as well as the steps necessary to improve credibility.
Risk Management attempts to identify and eliminate, or at least reduce the effects of, various risks. There are financial risks related to ones financial resource, arising out of fluctuations in the stock market or because od exchange rate fluctuations or because of political disturbances or any other reason.
In practise, risk management will be done through a mix of all the alternatives. They are not mutually exclusive. Attempts at prevention and reduction will continue even after transfer is arranged, because the loss will invariably be more than what the insurer will compensate. Even retention and transfer, which seem to be mutually exclusive are not. Some risks can be transferred to insurers, retention are possible through systems of excess. The relevant considerations are costs as well as feasibility.
HAZARDS
PHYSICAL
OCCUPATIONAL
MORAL
Physical hazards Age Sex Build Physical condition Physical impairments Personal history Education, Lifestyle, risky hobbies like adventurous sports, habits, consumption of alcohol / tobacco / narcotics or drugs, financial status, insurable interest. Family history
Occupational hazards Nature of job E.g. cashier in shop, pilot, banker, circus artist, driver, etc.( exact nature of duties)
Place in which the job is done E.g. working in chemical factories, working with high voltage electricity, working
at heights, working with high speed machines, adventure sports, working in bank, post office and so on.
42
Moral hazards If the intention is to seek undue advantage through the insurance policy, there is some moral hazard. The undue advantage may be to get a lower premium or to make some quick monetary gains. Moral hazard is not measurable. It is a matter of opinion. In the following situation, moral hazard can be suspected: The proposal is for an amount much larger than what the income would justify
Premium
Meaning of Premium In a contract of insurance, the insurer promises to pay to the policyholder a specified sum of money, in the event of a certain specified happening. The policyholder has to pay a specified amount to the insurer, in consideration of this promise. Premium is the name given to this consideration that the policyholder has to pay in order to secure the benefits offered by the insurance contract. It can be looked upon as the price of the insurance contract. It may be one-time payment. It is then called a single premium policy. That is not common. Often, it has to be paid regularly over a period of time. A default in premium can endanger the continuance of the policy. If that happens, the policy will be treated as lapsed and the expected benefits may not be available. The consequences of default are specified in the policy condition, which will be discussed in a later chapter. Thus, premium has an important role in the business of insurance. It does not have the meaning of being higher quality or more expensive which it has in different contexts. The calculation of premium is a complex technical process, involving actuarial and statistical principles. Only trained professional, called actuaries, do it. Tables of premium rates for each plan of insurance are made available by insurance companies for use in quoting premiums for a particular policy. This chapter is meant to make students aware of the rationale behind the premium calculations. The premium is calculated on the basis of assumption relating to the future experience on mortality, interest rates and expenses. These assumptions are based on the insurers own experience in the past and therefore not arbitrary.
43
Yet, they are assumptions as far as the likely future experience is concerned. The margin for contingencies is provided because of the uncertainty that these assumptions will turn out to be valid, as the future unfolds.
Types of Premiums
Premium
Risk
Net
Level
Office
Extra
Risk Premium
The business of insurance is based on the probabilities of risk. The premium to be paid by each person is determined on the basis of assumptions made relating to the probability of the risk for which cover is sought. With regards to each kind of perils and the associated risks, probabilities are worked out based on past experience. The probability of 37 risk will depend partly on how frequently the peril may occur and how severe can its impact be. Both frequency of occurrence of the perils and extent of damage depend on a number of factors. Some of these factors may be controllable and some may not be controllable. The studies on probabilities of risks will not help an insurer to say which one of its insured persons will suffer from the peril in question. It may however, be possible to say how many persons, on an average, are likely to be affected by peril insured. Premiums are determined on that basis. The following example explains the above concept in a very simplified manner. Example There are 1000 persons who are all aged 50 and are healthy. If the probability of death at age 50 within one year is assumed to be 1% or 10 persons in this case, and if each person wants to insure for Rs 20,000/- the total loss is expected to be Rs 2,00,00 in one year.
If the person who insured group contribute Rs 200, the common fund would be Rs 2,00,000. This would be enough to pay Rs 20,000 to the family of each of the persons who die. Thus, the risks are shared by 1000 persons, although 990 of them did not suffer any loss. The risk premium is calculated on the basis of an expectation as to how many persons are likely to die within a year in an age group. This expectation, regarding the number of persons likely to die within a year, at each age, is calculated by actuaries on the basis of past experiences and made available as Mortality. Tables Mortality tables prepared for use of insurance offices, contain data relating to such probabilities. If the mortality tables shows that X% is the probability of death within one year for any age, (100-X)% persons are likely to be living at the end of one year, when they would all be one year older. This is a probability and not a certainly. It does not mean that X% will die. It means that over a long period of time, if large numbers of people at that age are observed, nearly X% may be dying within a year. Mortality studies, reflecting the experience of Indians, are made by the mortality and morbidity investigation bureau (mmib) set up jointly by the Life Insurance Council and the Actuarial Society of India, to help insurers.
Net Premium or Pure Premium The premium collected by insurers every year are not utilised for payment of claims. This is so for many reasons. One is that the real experience may be different from the probabilities indicated by the mortality tables. Secondly, the portion of the premium is meant to meet survival benefits and must be kept aside. The balance premium kept aside, after outgoes of various kinds, will be invested and will earn some interest. To the extent of these interest earnings, the premium charged can be reduced. The premium worked out after taking into account the interest likely to be earned, is called the Net premium or Pure premium. The premium is calculated on the basis of assumptions relating to the future experience on mortality, interest rates and expenses. These assumptions are based on the insurers own past experience in the past and therefore not arbitrary. Yet, they are assumptions as, far as the likely future experience is concerned. The margin for contingencies is provided because of the uncertainty that these assumption will turn out to be valid, as the future unfolds.
45
Level Premium If it is expected that out of 10,000 persons at a specified age, the probability is that one may die within one year, the mortality rate at that age is said to be 0.01%. The risk premium chargeable for person at that age would be Rs 0.10 per Rs 1,000 SA. If a policy has a term of 20 years, the risk premium and therefore, the premium charged would vary for each
of the 20 years. It would be difficult to administer annual changes in a continuing contract. Apart from that, the premium at later ages, towards the end of the policy term, would be very high and people may find it beyond their ability to pay. They will then be without the protection of insurance at times when they need it most. To offset this problem, insurers spread the risk premium on a uniform basis, throughout the term of the policy. The premium will remain constant for 20 years. Such uniform premium is called level premium. This implies that the premium collected would be more than necessary for the risk in the early ages, and less than necessary towards the latter part of the policy.
Office Premium
The level premium figures arrived at after loading the net premium or pure premium is called the office premium. They are now ready for use. The premium figures printed in the promotional literature and brochures are office premiums. They are also reffered to as the Tabular Premium. Obviously, the chances, or probability, of a person dying within the next 10 years is more than the chances of his dying in the next year, whatever be the age of the person. In the other words, the risk (of death) is more in a term. Therefore, at any age, the premium for a longer term plan like Whole Life would be more than for an endowment plan. But because of the practise of level premiums, the tabular premium charged (per annum), would be less for a longer term policy than for a shorter term policy. On the aggregate, the total premium over the entire term would be higher in the longer term plan than in the shorter term plan. The tabular premium for an Anticipated Endowment plan would be higher than for an Endowment plan for the same term, because the insurer may have to pay a higher SA in the Anticipated Endowment Plan.
46
Extra Premium
Extra premium may be charged on any particular policy. This may happen because of the grant of some benefits in addition to the basic benefits under this plan, like accidental benefit or premium waiver benefit. Riders (discussed in a subsequent chapter) provide additional or supplementary benefits. Extra premium may become chargeable because of decisions relating to the extent of risk in any particular case. If the risk of the person to be insured is assessed as more than normal, because of health or because of occupation or habits, insurers may charge extra premiums. These are usually stated as say, Rs 2 per thousand, and will be added to the tabular premium otherwise chargeable.
Calculation of Age
The premium to be charged will vary according to the age of the life assured. Premium rates for each plan of assurance are calculated for each age. If, after the policy is issued, the age is found to be different from the age stated in the proposal, the premium mentioned in the policy will be changed from inception. Either the shortfall will be collected as arrears or the excess will be refunded. Insurers prefer to admit the age to the commencement of the policy, in order to avoid such problems later. Age has to be determined as on the date of commencement of the policy. As the date of commencement of the policy would not be the date of birth of the life insured, and age has to be reckoned only in complete years, not months and days, three different methods are followed by insurers. These are age next birthday (birthday coming after the date of commencement of policy), age last birthday (birthday prior to the date of commencement) or age nearest birthday (birthday within six months of the date of commencement, whether before or after). If a person is born on 20th August 1980 and the policy has commenced on 10th July 2007, the age next birthday would be 27, the age last birthday would be 26 and the age nearest birthday would be 27. If the date of birth is 17/06/1985, the age next birthday on 25/06/2007 would be 23, the age next birthday on 25/06/2007 would be 23, the age last birthday would be 22 and the age nearer birthday would be 22.
47
Premium Calculation
The following illustrations are based on certain assumptions with regards to practices of insurers. These assumptions are specified at the appropriate places. While making calculations for any policy, the practices of that insurer must be conformed to. Step 1 Find out tabular premium i.e. premium quoted in published premium rates, for given age (nearer, next or last birthday as the case may be) for the relevant plan and term. This premium is usally stated as Rs per thousand SA. Assume that the tabular premium is Rs 45.60
Step 2 Deduct adjustment for large SA, if applicable. Assuming that the insurer allows rebates as follows Sum assured Rs 25,000- Rs 49,999 Rs 50,000- Rs 99,999 Rs 1,00,000 and over Rebate per thousand SA Re.1/Re.1.50/Re. 2/-
In this policy for Rs 75000 SA, the premium would be Rs 44.10 (45.60 less 1.50)
Step 3 Make adjustment for mode of payment of premium. Assuming that the insurer provides rebates of 1% for yearly mode and that the mode proposed in this case is yearly, the premium Would decrease by 1% of 44.10 or Rs 0.44 making the premium Rs 43.66 40 Step 4 Add extras, assuming that the extras in this case are Rs. 1.50 per thousand for occupational hazard and Rs. 2 per thousand for supplementary benefits the total addition is Rs 3.50, making the total premium Rs 47.16
48
Note If the adjustment of 1% for mode (step 3) is made before the adjustment for SA, the deduction would have been 0.46, instead of 0.44. The difference can be significant, if the insurance is for a large SA. Insurers would clarify how they want it to be done.
The above calculation was made for yearly mode of premium. Therefore, the figure of 3537 is the premium to be charged. If however, the mode was quarterly, then the annual premium worked out by the above method, without the rebate of 1% for yearly mode, will have to be divided by 4 to determine the quarterly instalment premium.
In the calculation shown in the earlier paragraph, the final figure arrived at has no paise. If there are paise in the final figure, they may be (i) ignored or (ii) rounded off to the next higher integer, or (iii) rounded off to the nearest integer or (iv) rounded off to the nearest 50 paise or any other adjustment, as the insurer may practice.
Age 35 30 30
Note
DAB stands for Double accidental benefit and EPDB stands for extended permanent disability benefit. Most insurers combine these two benefits together.
49
50
RESEARCH METHODOLOGY
Meaning of Research:
Research as a means for gaining knowledge can be carried out either at random or in a systematic fashion. Research is a way of finding new way of looking at familiar things in order to explore ways of changing it. Research in common manner of speaking refers to a research of knowledge. One can also define research as a scientific and systematic search for relevant information on a specific topic. In fact, research is an act of scientific investigation. Research concerns itself with obtaining information through observation that can be used to systematically develop logically related proposition so as to attempt to established casual relationships among variables -: Black and Champion. A] Selection of study area:Future Generali India Life Insurance Co Primary Data Discussion with Mrs the Underwriter of the company. Collecting the information relating to the Underwriting from other members of the Underwriting Dept. of the organisation. Discussion with the Branch Manager, Mr Shakeel Ahmed. Discussion with the learning & Development Manager Mr Irfan Shaikh.
B] The secondary data as is provided by the organisation The needed information is collected from: Human Resource Methodology by Nirali Prakashan.
The present study is aimed at analysing the Life Insurance Underwriting Method of the Future Generali India Life Insurance Co. Pvt. Ltd. 51
Research Design
A research design is a blue point prepared depending on various types of blue point available for the collection, measurement & analysis of data. Every research design must have a scientific base to achieve the desire objective. A research design is a marter plan or model for the conduct of formal investigation & survey. It decides the sources of information & methods of gathering data. A questionnaire or other forms are rested to use for the collection of data. Sample design is to be selected. Good research design insure that the information obtained is relevant to the research question & that the collection by objective since research design is simply framework or plan for a blue print is followed in completing for research study. Research design decision should be in the following order: What is study about? Why should is being carried out? What type of plan is required? Where can be the required data found? What period of time shall the study include? How shall be the sample design? What method/technique of data collection will be used? How will the data be analysed? In what style shall the report prepared?
Research Design is classified for the purpose of survey/ investigation is as follows Research Design
Exploratory
Descriptive
Casual Experiment
Here for this research study descriptive method/ design has been used. Survey & interview were used to collect primary data where in secondary data was collected from internet, manuals, magazines etc. this research aims at describing the various sales promotion techniques being used & its effectiveness
52