PDF_Answers (1)Ic33.xls
Content
SR
Option --1
Option--2
Option--3
1 "ee$l pre#iu#s are (enerall collecte% or 'hich tpe?ran(e tpe?ran(e o plans
QUESTION
Banca assurance
Health plans
Micro Insurance
2 I insurer 'ant to coer the ris$ 'hich is 0eon% their li#its the 'ill approach
Bancassurance
Reinsurance
Lie insurance !ouncil
3 "hich #ar$et areas %o Micro Insurance pro%uct concentrate
&eople 'ith lar(e a#ilies
people 'ith lo' inco#e
people e#ploe% 'ith the (oern#ent
) Insurance co#pan sellin( pro%ucts throu(h ne'spaper a%ertise#ents is calle%
In%irect Sellin(
*'areness
+irect Sellin(
, I a client 'ants to co#pare 0et'een all inancial pro%ucts In%ii%ual a(ent then the 0est person he can approach is . In lie insurance 0usiness i a person is 'or$in( in calculatin( institutes o actuaries o In%ia pre#iu# rates o insurance pro%ucts; then he is #ostl li$el a #e#0er o
!orporate a(ent
Ban$
insurance institute o In%ia
!harte% institute o insurance
/ In ter# insurance i !ritical illness ri%er clai# happens then 'hat 'ill happen to eistin( polic
!I 0eneit 'ill cease
!I 0eneit re%uce% ro# eistin( su# assure%
!I 0eneit continues
I insure% (ets the t'o a%ance pa#ent in the ,rs @ 16th r an% in the #aturit he (ets rest o su# a ssure%5 "hat tpe o polic it is
Mone 0ac$ polic
!onerti0le plan
Ter# plan
4 The concept o in%e#nit is 0ase% on the $e principle that polichol%ers shoul% 0e preente% ro#
Insurin( eistin( losses5
Ma$in( alse insurance clai#s5
&ain( ecessiel or insurance coer5
E#ploees
*(e o the (roup
16 9or assessin( the ris$ o a (roup health insurance polic; 7roup liestle 'hich o the ollo'in( inor#ation is the #ost critical 11 I ,A 0onus is (ien eer ear then or a S* o 1 la$h; 'hat 'ill 0e the paout ater 1, ears in a si#ple reisionar 0onus sste#
.6666
/,666
166666
12 !urrent re(ulation allo's the 0an$ to act as Insurance a(ent or 13 &art C*D #a$es oer to CBD @ CBD con%itionall accepts the oer than the action is consi%ere% as
7iin( insurance policies to Ban$s5
Sellin( insurance policies throu(h Ban$s5
7iin( (uarantee to policies 0 Ban$s5
!ounter oer
Response oer
&artial acceptance
1) *n * n insurance a(ent is inter#e%iar 0et'een85
!lient an% Insurance !o#pan
Insurance !o#pan an% IR+*
!lient an% IR+*
1, "hich o the ollo'in( %o not inclu%e the channel o in%irect #ar$etin(
in%ii%ual a(ents
0ancassurance
insurance 0ro$ers
1. Hu Hu#an 0ein(s nee% lie insurance 0ecause555555555555555555
%eath is certain
%eath is uncertain
the ti#in( o %eath is uncertain
1/ Lie insurance the ris$ is %eter#ine% on the 0asis o 5555555555
uture %ata
past %ata
statistical %ata
1 Li Lie insurance co#pan %eter#ine the leel o ris$ 0ase% on
9uture epenses5
!lai# eperiences5
&resent epenses5
14 Insurance 0usiness is classiie% into three #ain tpes:
Lie; Non <lie; Micro Insurance5
Lie; Non Lie; Miscellaneous
Lie; Non lie; Re-insurance5
26 *#it is loo$in( or ter# insurance plan or protection o his a#il; he is a%ise% to approach to:
&ropert Insurance
Lie Insurance
Health Insurance
insuranceco#plaints=ir%a5(o5in
ir%aco#plaints=(o5in
21 Insure% can contact to see$ the resolution o (rieances the !o#plaint=(o5ir%15in hae a(ainst insurer to IR+* throu(h: 22 La La' o Lar(e nu#0er helps the insures to
!alculate the pre#iu#
Increase the proita0ilit
*scertain the %eath ratio
23 Micro insurance is transacte% 0
Lie Insurers onl
Non-Lie Insurers onl
non-lie an% lie insurers
2) EE-sales reers to sales o insurance pro%ucts throu(h
Insurance 0ro$ers5
Bancassurance5
In%ii%ual a(ents5
*t an earl a(e
*nti#e in lie
2, The ti#in( o %eath is uncertain; so 'hen one shoul% ta$e lie *t the ti#e o uncertaint insurance 2. "hat is the #ai#u# coer that can 0e proi%e% in #icro insurance 2/ No N on 7oern#ent or(ani>ation operate in insurance #ar$et to to #a$e re(ulations
,666
16666
,6666
to help IR+*
to connect the 0uer an% seller
2 "hen insurers sell throu(h a%ertise#ents it is
in%irect sellin(
%irect sellin(
throu(h inter#e%iaries
24 "hat #ain epense is eli#inate% i insurer #oes to sellin( online 36 I insurer 'ant to coer the ris$ 'hich is 0eon% their li#its the 'ill approach 31 Sahil 'as recentl appointe% as a %irector o a lie insurance co#pan5 In accor%ance o IR+* co%e o con%uct; this 'ill preent hi# ro# carrin( out the role o
!o##ission
Inco#e Ta
Mar$etin( !ost
Bancaassurance
reinsurance
Lie Insurance council
!hie *ctuar
Insurance *(ent
No%al Oicer
QB-ENG-Page 1 of 54
Option--)
*NS
Ter# Insurance
3
IR+*
2
people 'ith hi(h inco#e
2
"ron( Sellin(
3
Bro$er
4
Insurance institute o ris$ #ana(e#ent
1 No chan(e in polic5
1
En%o'#ent polic
1 &roitin( ro# insurance5
4
Me%ical histor o (roup
3 ,666
2 None o the a0oe5
2
Mo%iie% acceptance
1 Insurance an% Re-insurance co#pan5
1
throu(h internet
4 +eath is the solution5
3
#athe#atical %ata
2 2 3
Tar(ete% 0onus rates5 Lie; Health; Micro Insurance Lia0ilt Insurance
2 !o#plaints=ir%a5(o5in
+eclare the 0onus Sel help (roup Internet5 *t the ti#e 'hen *%isor ta$es the %ecision 166666 to #a$e pre#iu#s throu(h 0ro$ers Reinsurance IR+*
4 1 3 4 2 3 3 2 1 2
Un%er'ritin( Un%er'ritin( #ana(er
2 QB-ENG-Page 2 of 54
32 "hat #ain epense is eli#inate% i insurer #oes to sellin( online 33 " "h ho is the custo#er o a Re insurer
!o##ission
Inco#e Ta
Mar$etin( !ost
Hi(h Net 'orth In%ii%ual
Insurance !o#panies
License% Insurance *(ents
3) La' o lar(e nu#0er helps Insurer to analse 'hich $e area *%#inistratie epenses
in iin( the correct pre#iu#
to re#oe a%erse selection
3, cate(orisin( 0et'een Lun( cancer an% s#o$in(
lun( cancer is peril an% s#o$in( is a ha>ar%
s#o$in( is peril an% lun( cancer is ha>ar%
Both the state#ent is correct
3. "hat is the %eath 0eneit i the person has #ultiple su#s assure% un%er %ierent policies 3/ "hich o the ollo'in( ris$s are insura0le
Su# *ssure% 'ill 0e pai% as total o all insurance plans 9inancial Ris$
Su# *ssure% 'ill 0e pai% or onl one plan 'ith hi(hest S* Non-inancial Ris$
No S* 'ill 0e &ai%5
3 Sahil @ ia ; 0oth health status sa#e; ho'eer ia 'as tri((ere% 'ith #e%icals5 #e%icals5 "hat are the reasons
+ierence in a(e
+ierence in a#il health status
+ierence in ho00ies
34 The tpe o ris$ that can 0e insure% a(ainst is %isa0ilit is 0est )6 In insurance ter#s; the ris$ o suerin( a %isa0ilit %escri0e% as 'hat tpe o ris$ )1 Ho' are perils an% ha>ar%s nor#all %istin(uishe% un%er ter# insurance policies
Speculatie Ris$ 9inancial5
&ure Ris$ 9un%a#ental5
&ure @ Speculatie ris$ Ho#o(enous5
&erils are #e%ical actors 'hich inluence the ris$ o &erils are ris$s that polichol%ers 'ill %ie 0eore a %in( an% ha>ar%s are liestle actiities 'hich speciie% %ate an% ha>ar%s are actors 'hich coul% inluence the ris$ o %in(5 inluence that ris$5
&erils are actors 'hich aect the ris$ 0ein( insure% an% ha>ar%s are the si>e o the ris$ 0ein( insure%5
)2 The Institute o insurance an% ris$ #ana(e#ent alon( 'ith insurance e%ucation %oes 'hat #ore )3 Mr5 unal use% to participate in !ar race5 "hile ta$in( up the Insurance polic he %isclose% this inor#ation5 "hat $in% o ha>ar% %oes it reers to )) La' o lar(e nu#0ers is 'or$e% out 0 'hich o the
Re(ulation
Re%ressal
Research
&hsical ha>ar%
9rau%ulent representation
Moral ha>ar%
&oolin( o ris$
Both are correct
Maintainin( insura0le interest
"ith ut#ost (oo% aith
), "ith poolin( o ris$s an insurance co#pan pools the Un%er no circu#stances pre#iu# collecte% ro# seeral in%ii%uals to insure the# a(ainst si#ilar ris$s5 *t 'hat circu#stances 'ill the insurance co#panies pool the ris$ o a lie insurance an% health
Un%er con%itions o the reinsurer
*s %irecte% 0 actuar
). "hat is the #ain o0ectie o ta$in( the lie insurance polic Ta Ta 0eneit
Sain(s
Inest#ent
)/ ia receie% his polic 0on% on 11th June; 261 +ue to so#e No; as 1, %as perio% is oer personal pro0le#s he has %eci%e% to cancel the polic on th Jul; 261 !an he cancel or return the polic
Fes; as it is 'ithin 1 ear
No; as 26 %as perio% is oer
) The CRis$D contains85
certaint o eent
Uncertaint @ leel
certaint an% reGuenc
)4 7roupin( the si#ilar ris$s 0 Insurance !o#pan is calle%
7roupin( o Ris$
Ris$ 7ra%in(
Ris$ *ssess#ent
,6 The unction o Insurance 'or$s on855
Ris$ Transer
Ris$ aoi%
Ris$ retention5
,1 Mr5 Mahesh is a sot'are en(ineer5 He has ta$en a ter# insurance or Rs5 36;666;66?- or 36 ears5 This is an ea#ple or----------------,2 "hich o the ollo'in( can 0e an ea#ple o #oral ha>ar%
Ris$ retention
Ris$ transer
Ris$ aoi%ance
a a#il histor o heart %isease
a person 'or$in( in a che#ical actor
a person consu#in( alcohol
,3 On .th *u(ust there 'as a tphoon5 Mr5*u(ustin 'ho ha% insurance %ie% in tphoon5 No' ho' 'ill the insurance co#pan 'ill cate(ories this particular ris$
Un%er the cate(or o &ure ris$
Un%er the cate(or o peril ris$
Un%er the cate(or o particular ris$
,) Ra# 'or$s in a 9ire crac$er actor5 He stoc$s the crac$er in Speculatie5 his house5 He runs 'hich tpe o ris$5 ,, *n Insurance co#pan pools the pre#iu# collecte% ro# &ure Ris$ seeral In%ii%ual to insure the# a(ainst si#ilar ris$ is calle%: ,. "hich o the ollo'in( Ris$ is associate% 'ith those eents 'hich are not in control o an in%ii%ual an% also no possi0ilit o #a$in( proit: ,/ 'hich o the ollo'in( reers to speciic eent 'hich #i(ht cause a loss 555 , The conseGuences o these ris$s 'hich 'ill aect speciic in%ii%uals or local ,4 &ure ris$ is classiie% un%er .6 * person suerin( ro# lun( cancer is a s#o$er5 Here s#o$in( can 0e ter#e% as .1 Mo M oral ha>ar% relects the 5555 .2 Mr K has &ancreatic cancer %ue to %rin$in( 5"hat is *lcohol or hi#
&articular5
9inancial5
&oolin( o Ris$
Insuraa0le Ris$
&ure Ris$5
&articular Ris$5
9inancial Ris$5
&eril
Ha>ar%
&hsical ha>ar%s
&ure ris$
9inancial ris$
&articular ris$
Econo#ic ris$ &eril
Speculatie ris$ Ha>ar%
9inancial ris$ social nee%
intention an% attitu%e o proposer
ha0it an% ho00ies o proposer
occupation an% resi%ence o proposer
a ha>ar% @ peril
a ris$
a ha>ar%
QB-ENG-Page 3 of 54
Reinsurance Non 7oern#ent Or(ani>ation Non o the a0oe Both the state#ent is incorrect None o the a0oe None o the#
1 2 2 1 1 1
*ll o the a0oe
Non 9inancial Ris$ Speculatie5 &erils are actors 'hich coul% inluence an insure% eent occurrin( an% ha>ar%s are the actual eents 'hich 'ill tri((er a paout Repositor
4 2 1
2 3
&eril
Ran%o#ness
3 4
*s per co#pan polic
1 &rotection
4
Fes; as it is 'ithin 3 #onths
e#otional loss &oolin( o Ris$ *ll o the a0oe5 Ris$ tolerance
1 2 4 1
2 * teacher 'or$in( in a pri#ar school5
3
Un%er the cate(or o Ris$ Transer
1 9un%a#ental5
4
Sharin( o Ris$
2 Insura0le Ris$
1 Uncertaint &hsical ha>ar% Insura0le ris$ Uncertaint #e%ical an% personal histor o proposer a peril
1 3 4 1 1 1 QB-ENG-Page 4 of 54
.3 * client has ta$en an en%o'#ent polic 'ith S*- 66666 an% este% 0onuses- .66665 He pai% annual pre#iu#s in the 36 ear plan5 !alculate pai%-up S* .) The coolin( perio% allo's the polichol%er to 'ith%ra' the polic 'itin 1, %as o ., Un%er 'hat tpe o insurance polic %ose insura0le interest nee% onl eist onl at the ti#e o clai# .. * polic has t'o no#inations5 "hat a#ount shoul% 0e (ien to the t'o no#inees ./ Mr5 K is illiterate an% is 0uin( insurance5 Mr5 F ill up the proposal or# on 0ehal o Mr5 K an% also en%orses an% si(ns an attestation in the proposal or#5 In a%%ition to all %ocu#ent 'hat else shoul% 0e ta$en
4333
24333
ris$ co##ence
proposal or# illin( sta(e
ater polic receie%
Lia0ilit Insurance
Marine insurance
Motor insurance
16A to each no#inee
2,A to each no#inee
Mr5 K photo(raph
Mr5 F photo(raph
No#inee one shoul% not 0e pai% #ore than no#inee t'o Mr5 K thu#0 i#pression
It is a #one 0ac$ polic
It is pai% up
&re#iu# 'ith Interest
&re#iu# less char(es
. On Maturit o an insurance polic onl 2,A o the a#ount It is assi(ne% can is pai%5 This is %ue to .4 * person pain( 1 la$h earl pre#iu# %iscontinue the polic &re#iu# Return ater the irst ear pre#iu# an% surren%er the sa#e on the secon% ear 'hat 'ill 0e the surren%er alue /6 Ja 0us a polic on the lie o Na>ia5 "ho is Ja /1 * !lient can 'ith%ra' the polic on receiin( un%er ree loo$ perio% 'ithin nu#0er o %as /2 9or Lo((in( a polic ; 'hich o these is a stan%ar% a(e proo Baptis# !ertiicate or Ration !ar%
2/3333
Lie *ssure%
No#inee 36
&roposer 1,
,6
Ration !ar%
Baptis# !ertiicate
Ration car% an% 0aptis# certiicate are Stan%ar% a(e proo
/3 The ris$ co##ence#ent %ate o polic is /) &rinciple o In%e#nit applica0le to /, &art C*D #a$es oer to CBD @ CBD con%itionall accepts the oer than the action is consi%ere% as /. The con%ition that the polic hol%er shoul% pa the pre#iu#s re(ularl is #entione% in // Ecept Surren%er; ho' one polic hol%er can transer #one to a thir% part ; 0arrin( No#inee / Insurance !ontract 'ithout an Insura0le Interest 'ill result as /4 a &olic hol%er ta$es a insurance contract or 36 ears an% the S* re%uces ater 2, ears 'hat coul% 0e the li$el reason
*ter the U?" process Lie Insurance !ounter oer
&re#iu# receipte% 7eneral Insurance Response oer
&olic is %ispatche% Both a @ 0 &artial acceptance
&olic %ocu#ent
&rospectus
&roposal or#
B "ill
B %oin( *ssi(n#ent
!lai#
"a(erin( !ontract
Le(al !ontract
oi% !ontract
No 0onus accu#ulate%
*(e proo 'as su0stantiall 'ron(
&olic has 0eco#e pai% up
6 *#it is illiterate5 He 'ants to ta$e polic @ his rien% Sura helps hi# in $no'in( the Guestion an% illin( the proposal or#5 *part ro# *#its let thu#0 i#pression ; 'hat shoul% Sur a shou shoul% l% %o 1 * lie insurance polic can onl 0e #a%e pai% up i 'hat particular polic eature eists 2 Harish ta$es a lie insurance polic or Ra#esh5 "hich o the ollo'in( state#ent 0est %escri0es the principle o Insura0le Interest5 3 Li#it o no#inees can 0e attache% to a ter# insurance polic
Suras &hoto(raph
Sura also has to put his let thu#0 i#pression alon( Sura has to (ie his a(e proo alon( 'ith a#its thu#0 i#pression 'ith a#its a(e proo
In%ein( contri0ution5
No#ination acilit5
Ri%er 0eneits5
Ra#esh %eclares all his lia0ilities
Ra#esh is el%er than Harish
Ra#esh o'es #one or# Harish
on one
) In a 'hole lie plan - The polichol%ers responsi0ilit to (ie at the 0e(innin( o the contract %isclosure , Mr5 *B! 0uin( Ter# insurance polic; insurer shoul% #ention operatie clause O#0u%s#an a%%ress in 'hich part o polic %ocu#ent
t'o
three
throu(h out the contract
Reial sta(e
&rea#0le
Inor#ation state#ent
. One o the (enuine Reason or surren%er o the polic coul% 0e / To 0e a ali% contract ;the %eclaration is necessar in 'hich %ocu#ent Tpes o assi(n#ent
ne' pro%uct ro# co#petition
a%isor entices the polichol%er to surren%er
"ants to 0u a car
&olic +ocu#ent
proposal or#
9&R
*0solute
Ter# assi(n#ent
!on%itional
4 The insurer reGuires the a(e proo or calculatin( the
S*
Ris$ assess#ent
I%entit eriication
QB-ENG-Page 5 of 54
214333
3 on pre#iu# 0ein( pai%
3
Trael insurance
2
There is no speciie% li#it li$e that
4
Mr5 F thu#0 i#pression
3 *n one o the a0oe
2
Nothin( as surren%er is not allo'e% 0eore , polic ears
4 3
*ppointee 26 Ration car% an% 0aptis# certiicate are 0oth Non stan%ar% a(e proo polic is receie% Neither a nor 0 Mo%iie% acceptance 9irst pre#iu# Receipt not possi0le to transer non oi%a0le contract
2
2 2 2 1 1 2 1
Its a ULI& &lan
3 Onl a %eceleration has to 0e (ien 0 Sura
4 Sain(s ele#ent5 Harish suers inancial loss incase o %eath o Ra#esh not speciic Be(innin( an% also at reial sta(e
4
3 4 1
sche%ule
3 Has 9inancial &ro0le#s R&R *0solute @ !on%itional 9inancial assess#ent
4 2 4 2
QB-ENG-Page 6 of 54
46 * polic %ocu#ent or a #one-0ac$ polic inclu%es the state#ent the proposal an% %eclaration si(ne% 0 the proposer or# the 0asis o the contract‟5 In 'hich #ain section o the polic %ocu#ent 'ill this nor#all appear
*ttestation5
Operatie clause5
&rea#0le5
41 &olic * an% &olic B 'ere surren%ere% on the sa#e %a ater pain( the 22n% instal#ent o the pre#iu#5 But the Surren%er alue in polic * 'as hi(her as co#pare% to polic B 0ecause 42 I so#eone o a(e (roup 1, ?1. hain( a contract 'ith insurance co#panies that contract 'oul% all un%er 'hich cate(or 43 The o0li(ation o the insurer or the 'hole lie polic is #entione% in 4) In 'hich $in% o polic the insura0le interest shoul% eist at the ti#e o clai# onl 4, The clause o in%isputa0le is applica0le ro# inception o polic to 4. Insura0le interest on ones o'n lie li#ite% upto
&olic * has a hi(her ter# than &olic B
&olic B has a hi(her ter# than &olic *
&olic * has 0een assi(ne%
ali%
Inali%
oi%
operatie clause
&rea#0le
&roiso
Motor insurance
Marine insurance
Lia0ilit insurance
) ears
2 ears
3 ears
26 ti#es o 7ross *nnual inco#e
li#it %epen%s upon the insurance co#pan
16 ti#es the a#ilies annual inco#e
4/ The concept o in%e#nit is 0ase% on the $e principle that polichol%ers shoul% 0e preente% ro#
Insurin( eistin( losses5
Ma$in( alse insurance clai#s5
&ain( ecessiel or insurance coer5
4 Sachin 'ho is 1/ ears 'ants to 0u an en%o'#ent 'ith proit polic 5 The insurance co#pan reects the proposal or# on 'hat (roun%
the resi%ence proo is not ro# the In%ia
sachin is not attaine% le(al a(e to enter a contract
En%o'#ent polic %o not hae 'ith proit eature
Throu(hout the polic contract
0eore pre#iu# %eposit
0eore receiin( polic %ocu#ent
&roposal or#
Me%ical reports
!lient coni%ential reports
*ter , ears
'ithin one ear o surren%erin(
can neer 0u another polic
*t the inception o the contract
*t ti#e o %eath clai#s
%urin( the surial 0eneit paouts
163 I the su# assure% re#ains the sa#e; 'hat 'ill 0e i#pact o net pre#iu# i the a(e o the polichol%er increases
It rises
It alls
It re#ains constant
16) In case the custo#er has stoppe% #a$in( pa#ent or the pre#iu# o the polic5 The reial proce%ure 'oul% reGuire the 'hich o the ollo'in( 16, In a lie insurance polic it is later oun% that the person %oesn‟t hae insura0le interest then the contract is
pa#ent o outstan%in( pre#iu# 'ith interest ; Onl reinstate#ent ees has to 0e pai% proo o (oo% health @ in so#e cases reinstate#ent ees epire% reie'e%
44 "hen 'ill the &rinciple o Ut#ost 7oo% aith appl in Ter# insurance plan 166 Insurance co#pan co#es to $no' that Mr * ha% 0een issue% a polic earlier 'ith etra pre#iu# char(e% 5 "hich %ocu#ent 'as reerre% 0 the insurer to co#e to this conclusion 161 *n a(ent surren%ere% the polic o a client on 16 9e05 2611; 'hen can this client 0u ne' plan 162 "hen %oes insura0le interest eist in lie insurance contract
Upto t'o ears the pre#iu# 'ith penalt can 0e 'aie% o 5 oi%
16. Net pre#iu# is eGual to
&re#iu# plus interest earnin(
Ris$ pre#iu# plus interest earnin(
&re#iu# #inus interest earnin(
16/ &rinciple o ut#ost (oo% aith 'ill operate in eistin( polic
Eer ti#e pre#iu# is pai%
I the polic has lapse% an% it has to 0e reie%5
16 Both the parties to a contract #ust a(ree an% un%erstan% the !onsi%eration5 sa#e thin( an% in the sa#e sense 'hich is calle%
Le(alit o an o0ect5
I the insure% person alls sic$ an% is a%#itte% to hospital5 !onsensus a% i%e#5
164 *#ita0h is #arrie% an% he has as his %epen%ants ; his 'ie Neli#a an% no chil%; 'hich shoul% 0e his priorit in
Inheritance plannin(
Inest#ent eicienc
&rinciple a#ount
+iscounte% alue 'ith persistenc 0onus
+iscount
#ortalit char(es
Inco#e protection
116 *#it has ta$en a 7-Sec an% has parte% 'ith it #i% 'a as he +iscounte% alue reGuire% the #one 'ith the intention o not (ettin( the interest5 "hat 'ill he (et 111 "hen net pre#iu# is a%uste% in or%er to calculate the (ross Loa%in( pre#iu# ; this process 'oul% 0e $no'n as 'hat 112 * lie insurance polic is issue% 'ith a Lien ; this 'oul% 0e #entione% in 'hich part o the polic %ocu#ent
&roiso
Sche%ule
Ter#s @ con%itions
113 In a pension plan illustration 'hat are the parts 'hich sho's the 0eneit or an annuitant5
Open #ar$et option part
*nnuit part
7uarantee% an% non (uarantee% part
QB-ENG-Page 7 of 54
Ter#s an% con%itions5
3 &olic B has 0een assi(ne%
2 Ille(al
3 En%orse#ent
1
Trael insurance
2
,ear
2
No li#it to sel lie
)
&roitin( ro# insurance5 ) Su0#itte% F! %ocu#ents are not ali% or Sachin
*ter receiin( the polic %ocu#ent
2
1
Me%ical reerees report 1 'hereer he 'ants to 0u
)
Throu(h out the Ter# o the plan
1
7ross pre#iu#s increases 3 No reial is possi0le 'hen the polic iis lapse%
1
ali% 3 Ris$ pre#iu# #inus interest earnin(
3
I the insure% person chan(es his o05
2
*cceptance5 3 Lon( ter# sain(s
1
&rinciple 'ith persistenc 0onus 1 Interest a%% ups 1 En%orse#ent 2 co##utation part
3 QB-ENG-Page 8 of 54
!onertin( the polic to 'hole Lie 2
*n insurer has #a%e another proposal5
1
Rollin( contract5
1
Sche%ule o polic %ocu#ent5
3
&olic +ocu#ent is receie% 0 polichol%er5 "hen cheGue is poste%?couriere% 0 the insure5 *cGuires pai% up alue5
2 3
) No#ination nee% not 0e inor#e% 0ut assi(n#ent nee%s to 0e inor#e% to insurer5 "hen the client is enoin( (oo% There is no insura0le interest attache% to the polic5 *0solute *ssi(n#ent
1 3 )
2
*nnuit &lan 1
oreite% the &re#iu# 2 Sche%ule o &olic 2 'ill 0e &aa0le to Saani No#ineeP at the a(e o 1th 2
&rinciple o Ut#ost (oo% aith 1
&roo o Inco#e ta paer 2 26th ear
) QB-ENG-Page 12 of 54
1,2 i$as su0#itte% an *(e proo ro# illa(e &anchaat 'hile Stan%ar% an% accept the proposal ta$in( a Ter# plan or Rs , La$h S* 5 The insurance co#pan 'oul% consi%er this as 'hich o the ollo'in(
Not stan%ar% @ 'ill accept the proposal
"ill reect the proposal
1,3 I a custo#er has #entione% he is a %rin$er in the proposal or#; the insurance co#pan can eclu%e this ha>ar% an% #ention it in 'hich part o the polic %ocu#ent
&roisio
En%orse#ents
Operatie clause
1,) "hat to 0e consi%ere% 'hile ta$in( irst polic 1,, "hich o the ollo'in( is a Non Stan%ar% *(e &roo
&ersonal +etails &*N !ar%
9a#il +etails !ertiicate o Baptis#
E#plo#ent %etails !ertiicate ro# illa(e &anchaat
1,. In the insurance contract the ris$ coer is (ien in return o the 1,/ I a lie insurance contract is esta0lishe% 'ithout an insura0le interest in eistence ; the contract 'ill 0e
!onsi%eration
!onsensus a% i%e#
!apa0ilit to peror#
Inali%
uncon%itional
ali%
1, Mr > accepte% the contract or#e% 0 Mr F 5Is this
a consi%eration
an oer @ acceptance
oi%a0le contract
1,4 Mr5 * @ B starte% an en%o'#ent polic on the sa#e %ate pain( sa#e pre#iu# on Guarterl #o%e5 *ter pa#ent o 22n% pre#iu# 0oth surren%er the polic Mr5 *s surren%er alue is hi(her than B; 'hat coul% 0e the reason
*s ter# is #ore than B
Bs ter# is #ore than *
* is health @ 0 is not
1.6 &a#ent o S* on happenin( o an eent o %ates pre#iu# pa#ent ;no#inees ;lien all or# part o 1.1 "hen is *n appointee is reGuire% in the Lie Insurance plan ; the reason coul% 0e 1.2 "hile un%er'ritin( Mr5 K proposal or# it is oun% out that there is a cri#inal case a(ainst hi# or rau%ulent actiities5 "hat tpe o ris$ 'oul% this all in
sche%ule
&rea#0le
Ter#s @ con%itions
No#inee is spouse
No#inee is Minor
L* is #inor
9un%a#ental ris$
&hsical ha>ar%
Moral Ha>ar%
1.3 Ho' #uch insurance can 0e (ien to a 'or$in( person
*s per Hu#an lie alue
16L
,6L
1.) "hile calculatin( Hu#an lie alue HLP in si#ple #etho% t'o co#ponents nee% to 0e $ept in #in% ; the irst one is net #onitor contri0ution to the a#il per annu# an% the secon% 'oul% 0e 1., T"O 9RIEN+S H*E T*EN S*ME &OLI!F BUT THEIR &REMIUMS *RE +I99ERENT "HF 1.. Till 'hat perio% is the interi# 0onus ali% 1./ *nnual pre#iu# o insurance pro%uct is Rs5 32;666; )A loa%in( on Quarterl #o%e o pa#ent "hat is the Guarterl pre#iu# 1. *s per the nor#s o ris$ assess#ent 0 un%er'ritin(; 0oth the parents o a polic hol%er %ie% in their earl 36s %ue to Heart %isease; 'hat is the ris$ a ssesse%
Ban$ 9ie% %eposit rate
%iscount rate
Esti#ate% lie epectanc
*7E
ME+I!*L
S*
as lon( as the polic is inorce
Till the net %eclaration o 0onus /.6
Moral Ha>ar%
Till the net ali%ation %ate 666
326
Me%ical Ha>ar%
Occupational Ha>ar%
1.4 In accor%ance to #one laun%r re(ulation; the NRI shoul% No Ris$ 0e cate(ori>e% to 'hat tpe o custo#er 1/6 Mr5Sunil is %oin( pre#iu# calculation or his co#pan; as per !ouncil o *ctuaries 'hich authorit is his proession relate% to
Lo' Ris$
#e%iu# Ris$
Insurance council o In%ia
Insurance institute o In%ia
1/1 'hat is the special report that is as$e% 0 the un%er'riter HL report ro# the oicer o the insurer 1/2 The insurer reGuires a(ent coni%entialit report in or%er to To calculate &re#iu#
*(ents coni%ential report
#oral ha>ar% report
To !alculate the co##ission %ue or the a(ent
To eri the &lan propose%
1/3 * hu#an 0ein( is *n econo#ic asset 1/) Sura ha% ta$en an en%o'#ent plan or Rs 16 La$h S* 5 He The &olic 'as issue% 'ith a Lien %ie% in ei(ht #onths ro# the inception %ate 5 The Insurance co#pan %i% not pa the 9ull S* ; Instea% pai% out Rs ,La$h 5 "hat coul% 0e the reason 5
Has a capacit to (enerate the inco#e The 0onus or the polic ha% not et %eclare%
Has a inite lie span The polic ha% onl #aturit clai# proision
1/, Mr5 * 'ants insurance coer 5 But he is %rin$s alcohol reGuentl 5 "hat $in% o ha>ar% ou #a cate(ori>e
Moral Ha>ar%
inancial ris$
&hsical ha>ar%
QB-ENG-Page 13 of 54
"ill accept 'ith a lo'er S* 2 Ter#s an% !on%itions ) *ll o the a0oe !ertiicate ro# School or !olle(e
)
Uncon%itional acceptance
1
3
oi%a0le 1 consensus a% i%e#
2
* inancial con%ition is 0etter than B 2
En%orse#ents
1
*ll cases
2
No Ris$ 3 1 !rore
1
Esti#ate% a#ount at retire#ent 2 *LL THE *BOE
) 2
none o the a0oe ,66
3 &hsical Ha>ar% ) Hi(h Ris$
)
IR+* 1 #e%ical report
3
To help the un%er'riter to asses the Ris$ *ll o the a0oe The %eath 'as %ue to acci%ent
) )
1
&ure ris$ 2
QB-ENG-Page 14 of 54
1/. Insurer appoints a can%i%ate o this proessional Gualiication ;'ho %eci%es the a#ount o pre#iu# in insurance pro%ucts 1// as per IR+* re(ulation ; the %ecision on the proposal has to 0e co##unicate% to the &roposer 'ithin ho' #an %as o receiin( the proposal 0 the insurance co#pan
*ctuar
Un%er'riters
Sales Oicer
/ %as
16 %as
1, %as
1/ "hen an interi# 0onus is pai% un%er 'ith proit polic; This nor#all represents a 0onus coerin( 'hat perio%
&olic start %ate to the 1st *nniersar
&olic start %ate to the en% o the 1st calen%ar ear
&reious aluation %ate to clai# %ate
1/4 "hile calculatin( HL in the incre#ental #etho% ; alon( 'ith uture inco#e; nu#0er o ears o 'or$ @ uture alue o earnin( potential 'hich is the other #ost i#portant actor ta$en into consi%eration
Inlation5
Interest5
+iscount rate
16 ishal an% san%eep applie% or a health plan in KF Lie Insurance !o#pan5 ishal is as$e% to un%er(o a #e%ical chec$ up 0ut San%eep is not as$e% to %o so5 "hat 'ill 0e #ost possi0le reason 11 9or 'hich o the ollo'in( reasons; the un%er'riter shoul% as$ 0eon% a(ent‟s coni%ential report5 12 "ith reerence to the principle o in%e#nit a lie insurance polic is a5 13 Micro insurance is #a%e speciicall or people ro#5 1) I Insura0le interest %oes not eists at the ti#e o inception o the lie insurance polic then; lie insurance contract is
San%eep has ta$en another polic ro# KF Lie Insurance !o#pan
ishal is ol%er than San%eep
San%eep is earnin( #ore then ishal
&hsical Ha>ar%
Moral Ha>ar%
S* is too hi(h
Insurance contract5
In%e#nit contract5
alue contract5
Hi(h inco#e5 Non oi%a0le
Mi%%le class5 Inali%
Lo' inco#e5 ali%
1, I a contract is si(ne% 0 a 1, ears ol% 0o; this contract 'ill 0e 1. Shailesh an% an$it 'ant to retire in the a(e o .,rs5 But shailesh pas #ore #onthl pa#ent than an$it or sa#e a#ount o polic5 "h 1/ In a case; the un%er'riter elt that the ris$ associate% 'ith the person 'oul% %ecrease 'ith ti#e; then he 'oul% accept the case 'ith 1 Mr5 u#ar‟s 'ie is suerin( ro# 0loo% cancer5 +octors lost their hope on her lie5 Mr5 u#ar 'oul% li$e to ta$e Lie Insurance polic on 'ie‟s na#e in or%er to (et #onitor 0eneit5 Insurance co#pan reects this proposal on the (roun%s o885
Null an% oi%
Inali%
oi%a0le
Shailesh is ol%er than *n$it5
Shailesh‟s inco#e is #ore than *n$it‟ s inco#e
Shailesh a#il is lar(er than an$its a#il
* clause
* Lien
* Loa%in(
*nti Mone Laun%r
Moral Ha>ar%
!apacit o pain( uture pre#iu#s5
14 "hat is the #ain source or insurance co#pan to (et inor#ation o proposer 146 Moral Ha>ar% relects the 885
*%ertise#ents5
&roposal or#5
!on%uctin( interie's5
Intentions an% attitu%e o &roposer5
Ha0its an% Ho00ies o &roposer5
141 Inco#e replace#ent #etho%s eGuates Hu#an Lie alue HLP to 142 The un%er'riter can (et the reGuire% inor#ation a0out the proposer in55555 143 Mr5 Ra#esh 'or$s in a #inin( co#pan5 So he is epose% to55555555555555 14) Lien is i#pose% on a polic 'hen un%er'riter eels that555555
9uture alue o &resent earnin(s5
&resent alue o uture earnin(s5
Occupation an% Resi%ence o &roposer5 &resent alue o preious earnin(s5
&roposal or#5
rene'al receipt
0rochure
#oral ha>ar%
phsical ha>ar%
#ental ha>ar%
the ris$ associate% #i(h t increase
the ris$ associate% #i(h t %ecrease
14, "hat %oes the #ortalit ta0les contains
Ta0les o %eath occurrin( in arious circu#stances
Ta0les o %etails o arious pro0a0ilities o %eath
the ris$ associate% #i(ht not 0e har#ul Ta0les o %etails o un%er'riter‟s calculation on %eath
14. Mr5 7uptha is recentl %etecte% 'ith lun( cancer5 He 'oul% li$e to ta$e an insurance5 "hat is our su((estion
Ti#e o %eath is uncertain; so insurance can 0e (ien
Onl lun( is aecte% so h ealth insurance can 0e (ien5
14/ "hich o the ollo'in( inor#ation %oes not appear in the #etho% an% reGuenc o pre#iu# pa#ent 9irst &re#iu# Receipt 14 Mr5Santhosh 'or$in( as a hea% #aster 'ho is aroun% ,2 * 5 &hsical ha>ar%; as he is ol% ears ha% reGueste% or an Insurance coer or Rs51 crore5 He insiste% that his 0rother‟s son shoul% 0e the no#inee not his 'ie5 Un%er'riter 'ill eri this case or 'hich one o the ollo'in(:
He can ta$e insurance ater su0#ittin( health certiicate
+ate o co##ence#ent o last pre#iu#
+ate the polic #atures
B5 Moral ha>ar%; as he is ,2 ears ol% an% 'ie is not the no#inee
!5 Moral ha>ar%; as coera(e is hi(h an% 0rother‟s son is the no#inee
QB-ENG-Page 15 of 54
*%isor 1 36 %as 3 clai# %ate to net aluation %ate 3 !o#poun%in(5 3
ishal is 'or$in( in a MN! 2 &ure Ris$
3
Maor lie contract5
3
*luent class5 Null
3 2
ali%
1
Shailesh is a Business#an an% an$it is a (oern#ent e#ploee
1
Leel &re#iu# 2 &hsical Ha>ar% 2
Telephonic conersations5
2
Me%ical an% &ersonal Histor o &roposer5 9uture alue o preious earnin(s5
1
annual report
1
Ethical ha>ar%5
2
the ris$ associate% #i(ht 0e (eneral
2
Ta0les o %etails o actuarial calculation on %eath
)
2
!annot (ie insurance or health reason ) +ate the last pre#iu# 'ill 0e pai%
2
+5 Moral ha>ar%; as he is a hea% #aster an% ,2 ears ol% 3
QB-ENG-Page 16 of 54
144 Mr59ero> has applie% or an insurance coer o Rs5) !r5 The !o#pan 'ill accept or reect the proposal onl ater conir#in( ro# one o the ollo'in( a(encies
9inancial Inspection a(encies
Speciali>e% inspection a(encies
!re%it 'orth inspection a(encies
266 The responsi0ilit or classiication an% analsis o the proposal or# lies 'ith 'ho# 261 In un%er'ritin( the econo#ic alue o the person is %eter#ine% 0 'hat 262 Ra$esh purchase% a lie insurance polic5 "hile 'ritin( a proposal or# he hi%e that he practices #ountaineerin(5 Sa%l he %ie% in an acci%ent 'hile cli#0in( Mount Eerest5 The insurers reecte% the clai#5 "hat is the reason or reection
Ris$ *nalsis +epart#ent
!lassiication o Ris$ +epart#ent
Un%er'riter
The occupation o the person
The inancial histor o his a#il
The inco#e that he earns
Innocent #isrepresentation5
9rau%ulent #isrepresentation5
!onceal#ent5
263 Ra# Lal is an insurance polichol%er5 He has recentl shite% his ho#e ro# Ne' +elhi to Noi%a5 He 'ants the a%%ress to 0e chan(e%5 This chan(e in polic %ocu#ent 'ill 0e eectie throu(h 26) "hen an un%er'riter #a consi%er Moral Ha>ar%
Ter#s @ !on%ition5
&rea#0le5
En%orse#ent5
*n in%ii%ual is proposin( S* 1, ti#es his annual inco#e5 Ris$ &re#iu#5 Mini#u# &ossi0le Loss5 Si#ple Reisionar 0onus
Insurance is ta$en out 0 an in%ii%ual 'ith %epen%ent Net &re#iu#5 Maor &ossi0le Loss5 !o#poun% Reisionar 0onus
* no#inee is not a %epen%ent5 Loa%in( o &re#iu#5 Minor &ossi0le Loss5 &ersistenc Bonus
Leel &re#iu#
Ris$ &re#iu#
Insurance a(ent coni%entialit report
Na#es an% a%%ress o the proposers rien%s an% collea(ues
&hsical Ha>ar%
Moral Ha>ar%
Occupational ha>ar%
Insurers %octor "ill 0e consi%ere% as stan%ar% a(e proo It is hi(her
Un%er'riter "ill 0e consi%ere% as non stan%ar% a(e proo +ecrease
*(ent "ill not 0e accepte% Sli(htl hi(her
Stan%ar% *(e &roo
Non Stan%ar% *(e &roo
&repare a #ore %etaile% report
&repare a Moral Ha>>ar% report
Stan%ar%; i acco#panie% 0 a(ents si(nature &repare a %etaile% inesti(ation Report
26, Leel &re#iu# is calculate% 0ase% on 26. M&L a00reiates 26/ "hich one o the ollo'in( 0onuses is (ien 0 insurer as an incentie to the insure% to or lon( ter#:
26 Ra#esh 0ou(ht an en%o'#ent plan or ten ear5 He pas the 7ross &re#iu# sa#e *#ount in eer ear throu(h out the polic ter# 5 This a#ount is calle%: 264 "hich one o the ollo'in( is not source o inor#ation a0out &roposal 9or# the proposer reGuire% 0 the Un%er'riter 5 216 Manish 0ein( a sole earnin( #e#0er o his a#il ; has not insure% hi#sel 5 But he is loo$in( or insurance or his son 'ho is stu%ent 5 This coul% all un%er 'hich cate(or os Ha>ar% in insurance 211 "ho is the pri#ar un%er'riter o the clients 212 !ertiicate ro# the illa(e panchaat 213 "hat 'ill 0e lien a#ount in 3r% ear as co#pare% to the )th ear o lien5 21) * person su0#its as a(e proo; a certiicate ro# the illa(e &anchaat5 Is it a 21, *!R is prepare% 0 Insurance a(ent5 I Mr K 'ants a hi(her S* then the un%er'riter 'oul% as$ or a%%itional report apart ro# *!R ; the 0ranch hea% 'ill hae to %o 'hat
21. *ter receiin( the proposal or#; un%er ho' #uch ti#e the / %as insurance co#pan has to reert to the proposer 'ith its %ecision 21/ *nil is (oin( to ta$e lie insurance polic in 'hich total annual &re#iu# is Rs 32666?- an% there is )A reGuenc loa%in( or Guarterl #o%e5 "hat 'ill 0e the Guarterl pre#iu#
16 %as
/26
1, %as
666
326
21 The process o a%ustin( the a#ount o Lie Insurance pre#iu#; so as to relect 0onuses is calle%
In%e#niin(
In%ein(
Loa%in(
214 Un%er'riter is assessin( the ris$ or the in%ii%ual 'ho alrea% is alrea% a polichol%er an% preious polic 'as accepte% at non stan%ar% rates; 'hich o the ollo'in( %ocu#ents 'ill 0e helpul to assess the ris$
pre#iu# Quotation 5
clai# or#
&roposal 9or# 5
226 "hat ta rate; i an; 'ill 0e applica0le to a lie insurance Nil polic hol%er or the #aturit procee%s o a Rs ,6;666 lie insurance polic 221 "hat is #ai#u# leel o Insurance pre#iu# or 'hich Inco#e Ta 0eneit is aaila0le 222 Mr5 K 'ants a lie coer or the ter# o 26 Frs5 *lso he 'ants Ter# &lan a #o%est a#ount i he suries throu(h the ter#5 "hich plan 'oul% ou su((est to Mr K
2,666 En%o'#ent plan
QB-ENG-Page 17 of 54
651
652
,6666
166666 !onerti0le plan
361 Ra$esh 'ants to 0u a polic pri#aril or Ris$ !oer 0ut at the en% o the ter# he 'ants to (et at least so#e return5 Un%er 'hich polic he 'ill (et these 0eneits
En%o'#ent plan
Ter# insurance 'ith Return o purchase price
"hole lie plan
362 In 'hat proportion is the coer in a 9a#il 9loater &lan
2,A each
1,A each
,6A each
363 "ho 'ill #aintain Mutual 9un% Sche#es
Mutual 9un% Mana(e#ent Societies
Mutual 9un% Mana(e#ent Sste#s5
*sset Mana(e#ent !o#panies5
36) "hich is the pri#ar sain( nee% a#on( all sain( nee%s
Insurance
&urchasin( House
Inest#ent5
36, Mr5 Rao has Rs5 16; 66;666 cash 'ith hi#5 He 'oul% li$e to Insurance use this a#ount or his %au(hter‟ s #arria(e 'hich is (oin( to happen 'ith in Nine #onths5 He 'oul% li$e to (et so#e returns ro# this #one in these 4 #onths perio%5 "hat is the 0est option to par$ h is #one
Shares
9ie% +eposit in Ban$
36. "hich o the ollo'in( aenues #a$es it easier or a person to ta$e a sain( pro%uct 36/ Mr5 Ra(opal has ineste% so#e #one5 He has 0een inor#e% clearl a0out the tenure; interest rate an% #etho% o pa#ent o interest at the inception o the inest#ent itsel5 His inest#ent #a 0e in55555
throu(h in%ii%ual a(ents
throu(h internet
corporate a(ents
Lie Insurance
Mutual un%
Shares
36 "hich o the ollo'in( can‟t 0e %e%ucte% un%er section 6 c ro# taa0le inco#e 364 "ho act as an inter#e%iar 0 oerin( a tra%in( plator# or 0uin( an% sellin( o shares 316 The !entral Ban$ has recentl announce% the %ecrease in interest rates5 The prices o 0on%s are 311 Ti#e %eposit account is issue% 0: 312 &an$a 'ants to sae ta oer an% a0oe the %e%uction allo'e% un%er section 6! o the inco#e ta act 14.1; 'hich allo's %e%uction ro# taa0le inco#e
&ension 9un%s
&u0lic &roi%ent 9un%
E#ploee 7ratuit 9un%
313 In 'hich o the ollo'in( Ban$ pas the Interest on the %eposit‟s un% on #onthl ?Guarterl ?hal earl? earl 0asis as chosen 0 %epositor un%: 31) ino% 0ein( an insurance a(ent can oer assistance to his client Ra#esh 0: 31, The concept o Ris$ %iersiication is applica0le in 'hich o the ollo'in( instru#ent 31. *a 0ou(ht a share or Rs5116 an% he sol% 'hen it 'as Rs5.365"hat ha% happene% to his share 31/ * client 'ants to sae up to 0u an epensie car; 0ut his %isposa0le inco#e an% uture epecte% inco#e esti#ates #a$e this %esire unreasona0le5 *n a(ent shoul% clari the %ierence 0et'een 31 *ter pain( pre#iu# o ,$ the custo#er receie% a #aturit a#t5 at 'hat rate 'ill it 0e tae% 5 314 *s per ne' (ui%elines or a Su# *ssure% o Rs 1 La$h 'hat is the #ini#u# *nnual &re#iu# 'hich one #ust ta$e
Bo#0a Share echan(e
Bo#0a Stoc$ echan(e
Stoc$ 0ro$ers
Li$el to increase5
Li$el to %ecrease5
"ill luctuate5
&ost oice !orporate Bon%
Ban$ Inrastructure Bon%
Mutual 9un% Health Insurance
Sain( +eposit
!u#ulatie %eposit
Tra%itional +eposit
&roi%in( hi# e#er(enc un%5
Matchin( the pro%uct 'ith Ra#eshs inancial nee%5
Mutual 9un%
Ris$ +iersiie% Insurance
Reco##en%ation o pro%uct 'ith hi(hest return5 Shares
!apital *ppreciation
!apital &roit
!apital Beneit
!urrent @ 9uture Nee%s
9inancial @ Non-9inancial Nee%s
I%enti an% Quanti nee%s
nil
326 *s per the inco#e ta act ho' #uch total pre#iu# is %e%ucte% ro# the taa0le inco#e un%er sec 6 c 'oul% 0e
651
652
26666
16666
,6666
2,666
,6666 1lac
321 I the 0an$ pai% a cu#ulatie interest in ie% %eposit sche#e Monthl then 'hat is a #o%e o interest pai%
Quarterl
Hal Fearl
322 In a act in%; it 'as oun% that a custo#er ha% proi%e% or . Hi(h #onths o epenses as e#er(enc un%s5 Is it
a%eGuate
Lo'
323 In a Unit Lin$e% Insurance &lan; 'here the annual pre#iu# is 2 La$hs Rs5.6;666; un%er the ne' (ui%elines; 'hat is the #ini#u# lie coer that a custo#er 'ill hae to ta$e
3 La$hs
) La$hs
32) & is an i%eal inest#ent or 'hat $in% o custo#er
Monthl Inest#ent
*nnual Inest#ent
Sin(le Inest#ent
QB-ENG-Page 25 of 54
Ulip 2 No &roportion
)
*sset Maintenance !o#pan Li#ite)5
3
!ontin(enc? E#er(enc 9un%5
)
Mutual 9un%s5 3
call centers
2
Ban$ %eposits )
Inrastructure Bon%s
3
Share 0ro$ers
3
No chan(e is li$el5
2
Lie Insurance co5 Interest pai% on e%ucation loan
1 2
9ie% +eposit 3 +iscourse sain( in a purposeul an% nee% 0ase% #anner5 Ris$ Sharin( insurance
2
!apital ariation
1
1
Real @ &erceie% Nee%s ) 653
1
166666 2 2lac 3 Fearl 2 Ina%eGuate 2 , La$hs 2 Monthl inest#ent at re(ular interal
1 QB-ENG-Page 26 of 54
32, Suresh has transerre% his phsical (ol% to (ol% ET95 This 'ill increase the liGui%it
%ecrease the liGui%it
attract ta at #aturit
32. The inest#ent peror#ance o a custo#ers sin(e lu#p-su# !orporate Bon%s pa#ent 'ill relect the peror#ance o a 'i%e ran(e o %ierent securities un%er 'hat tpe o pro%uct
isan i$as &atra
Mutual 9un%
32/ "hat perio% o ti#e a client has to 0e ineste% to (et ta 16 Fears 0eneit un%er postal sche#e 32 "hat is the a#ount o #one a client can ta$e out as a lu#p- One-tenth su# ro# a pension polic 324 O#$ar Starte% a pension polic 'ith proi%er * 0ut en%e% up !o##utation Option in ta$in( the annuit pa#ent ro# proi%er B5The result %irectl relects 'hich o the eature aaila0le in this polic
ears
. ears
one-thir%
one-ith
+iere% *nnuit Option
7uarantee% perio% option
336 +enn is #arrie% an% has 2 chil%ren a(e . an% 165 His parents are alie an% are /6 an% .5 "ho all can 0e inclu%e% un%er the a#il loater health plan 331 !ritical illness ri%er 'as ta$en an% the ri%er 0eneit has 0een clai#e% ; the ri%er 0eneit no' (ets 332 In a 7uarantee% annuit option o , ears ; the polic hol%er 'ill (et annuit till 333 "hat reGuencies can one ta$e in annuit
+enn onl
+enn an% his 'ie
+enn; His 'ie an% chil%ren
Re%uce% the 0ase S*
ter#inate%
continues as it is
entire lie ter#
till , ears an% continue till annuitant lies
annuit onl or , ears
#onthl;Guarterl;hal earl; earl
ortni(htl;Guarterl;#onthl;earl
33) "h is there a 'aitin( perio% in health insurance policies
&re-eistin( illnesses
!han(e in pre#iu# ter#s
ortni(htl; #onthl ;hal earl; earl Nature o ris$
33, Ho' is No !lai# Bonus is (ien in a Health Insurance &olic
B 'a o !ash +iscount
+iscount in Rene'al &re#iu#
9ree Rene'a0le
33. "hat is i#portance o Health insurance
#eet an #e%ical e#er(encies
Maor hospitalisation an% treat#ent epenses
#eet epenses post hospitalisation %ue to loss o inco#e
33/ * person retirin( 'ithin 3 #onths nee%s return as pension5 "hat $in% o inest#ent plan he nee%s to choose 5
I##e%iate *nnuit
+eerre% *nnuit
*nticipate% En%o'#ent
33 *n in%ii%ual nee% a lu#p su# at the a(e o retire#ent; the the %eer#ent perio% a#ount he nee% to inest annuall or the (oal 'ill %epen% on
a#ount 'hich reGuire%
inest#ent tools use% or inest#ent
334 "hat are the Special eatures o Health plan 3)6 "hat 'ill 0e #aturit 0eneit un%er health insurance plan
!oers %isease epenses 9un% alue
Helps in Ta Beneits &ai% pre#iu#
coers hospitali>ation cost &ai% pre#iu# 'ith interest
3)1 "hich is the suita0le sain(s plan or a senior citi>en
Ter# insurance plan
Mone 0ac$
ULI& &lan
3)2 !lai# *#ount receie% un%er !IBR Ri%er ;can 0e spen% or
Health Epenses Onl
3)3 "hat coul% 0e the percenta(e o (uarantee% return in all ULI& pension plan5 3)) * person has ta$en a ter# insurance o ) Lac5 "hat is the #ai#u# !ritical Illness Ri%er he can ta$e
Househol% epenses Onl 656.
1 Lac
3), co##utation is a eature o 'hich tpe o polic 3). Mr5 Shar#a 0us a ter# insurance polic alon( 'ith *cci%ent an% +isa0ilit 0eneits ri%er5 The ri%er cost 'oul% 0e restricte% up to 'hat percenta(e o the 0ase pre#iu# o the polic 3)/ Mr5Ra#esh ineste% Rs:,6666 in pension polic; 'hat is the percenta(e he can aail as ee#ption in Inco#e ta5
annuit
3) Mr5Su#esh ta$es a polic an% pas pre#iu# o 26666 'ith a su# assure% o 366666; 'hat 'ill 0e the ta i#plication on his #aturit a#ount 3)4 Fash 'ants to ta$e open #ar$et option in &ension plan5 "hat is the 0eneit 3,6 In risin( lie epectanc the nee% or pension polic is increasin( as retire#ent plannin( is 3,1 Ra#esh 'ants to 0u 1, ears pension plan or retire#ent 'hile calculatin( (aps reGuire% at the en% the (ratuit a#ount 'as co#pletel i(nore% 0ecause he is
9ull taa0le
Unspeciie% reason 656,
2 Lac
3 Lac
oint lie polic 652
656),
pure en%o'#ent polic 653
65)
653333 &ension plan is not eli(i0le or ta ee#ption
1
651
652
sae #ore ta
s'itch the un%erlin( un%
i#proe% annuit rate
Less epensie
Less Transparent
More necessar
sel e#ploe%
"i%o'er
Sain(s are si(niicantl hi(her
QB-ENG-Page 27 of 54
.21 Mr5 * is not satisie% 'ith solutions proi%e 0 Insurer so he approaches O#0u%s#an5 "ithin ho' #uch ti#e the O#0u%s#an has to (ie his reco##en%ation ro# the %ate o receipt o co#plaint
1, +as
.22 On su0#ission o co#plaint a(ainst an insurer to the 16 %as o#0u%s#an; %ecision is #a%e in aour o the polichol%er5 Mai#u# no5 o %as the insurer #ust honour the o#0u%s#ans er%ict: .23 * polic has 0een reecte% 0 the co#pan un%er %irect he has to inor# the custo#er that the co has inti#ation to the custo#er an% cop to the *(ent; 'hat is the 0ro$en relationship 'ith the custo#er net action o the *(ent .2) *n a%isor 'hile eplainin( the polic an% to sell he accepts to (ie a part o his *(ents co##ission; 'hat is the li#its
one #onth
2 Months
1, %as
26 %as
he plans to chan(e the plan
He has to eplain the reasons or reection to the custo#er
651
652 He cannot oer an co##ission
.2, Rau is a certiie% license hol%er un%er 'hat circu#stances he 'hen he sells ter# insurance nee%s to hol% his certiie% license 'ith hi# that is issue% 0 Ir+*
'hen he represents hi#sel as another insurer
'hen he sells pension policies
.2. has lai% %o'n the !o%e o !on%uct or all Insurance Institute o In%ia a(ents .2/ *ter %oin( the nee% a nalsis o the client; the a(ent a%ise% EnGuire a0out the reusal ro# the client the client to opt or TRO& pro%uct5 But the client reuse%5 *ccor%in( to ethical 0usiness practices 'hat 'ill the a(ent %o .2 Un%er the hospital care ri%er 'hat is the paout #a%e 16A o the su# assure%
Insurance Re(ulator @ +eelop#ent *uthorit
In%ian penal co%e
Su((est an alternatie plan
&ass on to the superior
Speciie% a#ount #ultiplie% 0 the nu#0er o %as the polichol%er is hospitali>e%
epenses incurre% per %a #ultiplie% 0 no5 o %as sta in the hospital
.24 Ethics can 0e %eine% as8
Behaior that is 0ase% upon the #oral u%(#ents o an in%ii%ual Un%er sellin( o Insurance policies5
.31 9or an insurance a%isor churnin( is5555555555555practice
(oo%
0a%
* stu% o 'hat #a$es one‟ s o'n actions ri(ht or 'ron(5 Eplainin( all %etails o the polic to custo#er5 co#pulsor
.32 Mr5 Shar#a is a ne'l recruite% insurance a%isor5 To #eet his #onth tar(et he eplains onl the (oo% points o ne'l launche% plan to his custo#er5 Here Mr5 Shar#as 0ehaior
ethical
unethical
proessional
.33 Rahul is a license% insurance a(ent5 *s a(ent he #ust carr out his role in accor%ance 'ith .3) Shan$ar; an a%iser; sol% a ter# insurance polic an% unitlin$e% insurance polic ULI&P to *#ar; the client; 'ho is un#arrie% an% has no %epen%ent5 !onseGuentl; Shan$ar‟ s action can 0e ter#e% as .3, &an$a 0ein( a license insurance a%isor has to ollo' co%e o !on%uct proi%e% 0: .3. I the sales tar(et or an insurance a(ent is si(niicantl re%uce% ; this shoul% nor#all hae 'hat i#pact on the actiit o churnin( .3/ i there is a si(niicant re%uction in the proportion o an Insurers &olicies 'hich are returne% %urin( ree loo$ perio%; this ten%s to in%icate that ethical practices 0 the co#pan
!o#pan‟s co%e o con%uct5
IR+* *cts co%e o con%uct5
IR+* Re(ulations co%e o con%uct5
Un%ersellin( o insurance policies5
!hurnin(5
Oersellin( o insurance policies5
Insurance Re(ulator +eelop#ent *uthorit
Lie Insurance !o#pan
Resere Ban$ o In%ia
Less li$el
More li$el
Less Transparent
hae 'orsene%
hae i#proe%
ocus #ostl on internal actiities
*era(e pre#iu# si>e
Epense ratio
.36 "hich is not unethical 0ehaiour in 0elo' state#ents
Those alues 'e co##onl hol% to 0e C(oo%D a n% Cri(htD5 Oer sellin( o Insurance policies5
.3 "hen insuicient e#phasis is place% on the lon( ter# n ature *era(e polic ter# o Lie Insurance policies %urin( sellin( process; this 'ill oten 0e apparent 0 notin( the i#pact o 'hich $e static .34 "h %oes an Insurer insists on a(e proo %ocu#ents
To calculate S*
9or ris$ *ssess#ent
9or I%entiication &roo
.)6 Mr * su0#itte% the proposal or# ; 'hen 'ill the ris$ 0e(ins or the co#pan .)1 To 0e ali% !ontract ; the %eclaration is necessar in 'hich %ocu#ent .)2 Mr *B! 0uin( is TERM insurance polic ; the insurer shoul% #entione% o#0u%s#an a%%ress in 'hich part o polic
On su0#ission o proposal or#
"hen 9&R is issue%
&olic issue%
&olic %ocu#ent
proposal or#
9&R
Operatie clause
prea#0le
Inor#ation state#ent
.)3 aina0 ta$es Insurance in the lie o as#eet ; aina0 'ill 0e calle% as
&roposer
No#inee
appointee
QB-ENG-Page 51 of 54
3 Months 2
2, %as 2 He ta$es up 'ith the hi(her authorities 3 He can oer up to ,6A 3 un%er all circu#stances ) Resere 0an$ o In%ia
2
&ass on to the other a(ent 1 166A o Su# *ssure% 2 *ll o the a0oe5
)
!hurnin(5
3
apprecia0le
2
&erect5 2 Insurance *cts co%e o con%uct5
3
Ethical practice 0 an a%iser5 3 SEBI5
1
More Transparent 1 ocus #ostl on eternal actiities 1 &ersistenc ratio ) or inancial assess#ent
2
'hen a(ent accepts the #one
2
R&R
2
Sche%ule Trust
3 1
QB-ENG-Page 52 of 54
.)) Loan is aaila0le or a polic in 'hich there is a eature o
9un% s'itch
sain( ele#ent
partial 'ith%ra'al
.), The appointees role 'oul% 0e 'hen
Me%ical chec$ up or polichol%er is there
'hen no#inee is #inor
'hen loan has to 0e ta$en 0
.). I polic has to 0e #a%e &ai% Up ; 'hat particular eature shoul% eist .)/ "h is *!R i#portant
In%eation contri0ution
No#ination acilit
Ri%er Beneits
To calculate co##ission or the a(ent
to eri the plan propose%
.) "hile Un%er'ritin( MR K proposal ; its oun% that there has 0een cri#inal char(es a(ainst hi# in rau%ulent act 5 "hat tpe o Ha>ar% this 'ill 0e cate(orise% into
Occupational
&hsical
to help the un%er'riter to asses the ris$ Moral
.)4 "ho is the pri#ar un%er'riter .,6 Lien can 0e consi%ere% as an alternatie to 'hich o the ollo'in( .,1 *t the ti#e o #aturit o the polic ; the &olichol%er receie% ust Guarter o S* an% 0onus ; 'hat coul% 0e the
Branch un%er'riter !lause
Sales Mana(er Reection
*ctuar acceptance
&artial 'ith%ra'al %one earlier
Lien ha% 0een i#pose%
its a #one 0ac$ polic
.,2 * polichol%er can pa the pre#iu# o Rs ,;66;666 5 "hat coul% 0e the #ai#u# Ta 0eneit he can aail un%er sec 6
,66666
366666
266666
.,3 Ra# has ineste% Rs ,666 in &&9 an% Rs 1 L$ in lie Lie Insurance pre#iu# Insurance pre#iu# 5 In 'hich he (ets #ai#u# ta 0eneit
&&9
,6A IN BOTH
.,) The 0est 'a to oerco#e the pro0le# o inest#ent %ecision %epen%s #ainl on peer inluence is
B canassin( 'i%e peer (roup
see$in( proessional a%ise
(o or lo' inest#ent tranche
.,, *s an inest#ent %iersiication Mr B ; Ineste% in ET9 5 "hats the 'ei(ht o 7ol% or 166 units .,. Insurer transers the ris$ 'hich it cannot 0ear to 'ho#
,?16 (#s
,6?166 (#s
1,?26 (#s
Reinsurance co#pan
Bancassurance
Thir% part a%#iration
.,/ "hat oerri%in( criteria an insurance a(ent consi%er 'hile proposin( a solution ., ie$ ta$es insurance polic @ %ies ater #onths 5 I the clai# nee%s to 0e eclu%e% ; then the 0asis o the eclusion 'oul% 0e 'hich .,4 *ccor%in( to IR+* 1444 ; central (oern#ent inole#ent in insurance sector 'oul% 0e ..6 !o#plaint council 0o%ies other than IR+* (rieance re%ressal oru# @ !O&* 'oul% 0e 'hich one ..1 "hich other 'a IR+* can 0e contacte% apart ro# toll ree nu#0er ..2 Rau is certiie% license hol%er un%er 'hat circu#stances he nee%s to hol% his license 'ith hi# that is issue% 0 IR+*
Ris$
Suita0ilit
9lei0ilit
Mur%er
Bo% not oun%
*cci%ent %eath
In a%ertise#ent
In le(al han%lin( o IR+* pro0le#s
Licensin( o Insurance co#panies
O#0u%s#an
Insurance institute o in%ia
Lie insurance council
Branch oice o insurer
E#ail
Insurance O#0u%s#an
Un%er all circu#stances
"hen he sells ter# Insurance
"hen he is sellin( in %ierent cit
..3 Harish ta$es a lie insurance polic on lie o R*MESH 'ho is his rien% 5 "hich o the ollo'in( state#ents 0est %escri0es the insura0le interest ..) Inestin( In ULI& can (et ee#ption up to 'hat li#it in Sec 6 c .., Suresh 'ants to transer his phsical (ol% into 7ol% ET9 5 In relation to echan(e this 'oul% help hi# in 'hich 'a
Harish is el%er than ra#esh
R*MESH is 'or$in( in oil co#pan an% is rich
Ra#esh o'es #one to Harish
+ecrease his liGui%it
Re%uce his encash#ents
'ill (ie insurance a(ainst certaint
... I#plication o +ail hospitali>ation 0eneit plan 'ill 0e 'hich o theses ../ Ra# has ta$en an En%o'#ent plan or Rs )L S* ; 'hat coul% 0e the #ai#u# S* he can ta$e or a critical Illness ri%er .. "h 'oul% sel e#ploe% in%ii%uals hae the nee% to 0u #e%ical insurance rather than in%ii%uals 'or$in( in &u0lic sector ..4 In 'hich sta(e o lie an in%ii%ual %oes not reGuire an protection coer ./6 Mr has 0een approache% 0 an a(ent an% on act in%in( the score o 3 'oul% in%icate 'hat ris$ appetite or Mr
9ie% @ %ail
onl on selecte% hospitali>ation or sur(eries
Onl in case o critical illness
Rs 2 L
Rs ,6666
Rs ) L$
&u0lic sector in%ii%uals %on ‟t all sic$
Sel e#ploe% in%ii%uals %o not hae sic$ leaes
&u0lic sector in%ii%uals eno #e%ical insurance coers relate% to o0
./1 Both parties to a contract a(ree an% un%erstan% the sa#e thin( an% in the sa#e sense 5 This 'oul% 0e
,6666
166666
266666
!hil%hoo%
Retire#ent
&re Retire#ent
Hi(h Ris$
Lo' ris$
Mo%erate ris$
!onsi%eration
!onsensus a% i%e#
!apa0ilit
QB-ENG-Page 53 of 54
surren%er
2
or si(nin( %eclaration 'hile ta$in( the
2
Sain( Ele#ent
)
to calculate the pre#iu#
3
9inancial 3 )
*(ent Ti#e 0arre%
2
It is a Ter# plan 'ith return o purchase price 166666 4,A IN Lie insurance pre#iu# an% ,A in &&9
3 ) )
&ostpone o inest#ent %ecision 2 16?26 (#s
2
actuaries
1
!ost
2
Suici%e ) issuin( (rants
)
9ER*
1
Hea% oice o Insurer
2
'hen he is sellin( ULI& plans 1 Harish O'es Mone to Ra#esh 3 Nil
2
He%(e a(ainst Inlation 3 S*
1
Rs 1 L$ 3 Sel e#ploe% in%ii%ual 'ants to ta$e 0est o the hospital 0eneits
3
Foun( #arrie%
1
No ris$ 3 !apacit 2 QB-ENG-Page 54 of 54
Option --1
Option--2
Option--3
1 "ee$l pre#iu#s are (enerall collecte% or 'hich tpe?ran(e tpe?ran(e o plans
QUESTION
Banca assurance
Health plans
Micro Insurance
2 I insurer 'ant to coer the ris$ 'hich is 0eon% their li#its the 'ill approach
Bancassurance
Reinsurance
Lie insurance !ouncil
3 "hich #ar$et areas %o Micro Insurance pro%uct concentrate
&eople 'ith lar(e a#ilies
people 'ith lo' inco#e
people e#ploe% 'ith the (oern#ent
) Insurance co#pan sellin( pro%ucts throu(h ne'spaper a%ertise#ents is calle%
In%irect Sellin(
*'areness
+irect Sellin(
, I a client 'ants to co#pare 0et'een all inancial pro%ucts In%ii%ual a(ent then the 0est person he can approach is . In lie insurance 0usiness i a person is 'or$in( in calculatin( institutes o actuaries o In%ia pre#iu# rates o insurance pro%ucts; then he is #ostl li$el a #e#0er o
!orporate a(ent
Ban$
insurance institute o In%ia
!harte% institute o insurance
/ In ter# insurance i !ritical illness ri%er clai# happens then 'hat 'ill happen to eistin( polic
!I 0eneit 'ill cease
!I 0eneit re%uce% ro# eistin( su# assure%
!I 0eneit continues
I insure% (ets the t'o a%ance pa#ent in the ,rs @ 16th r an% in the #aturit he (ets rest o su# a ssure%5 "hat tpe o polic it is
Mone 0ac$ polic
!onerti0le plan
Ter# plan
4 The concept o in%e#nit is 0ase% on the $e principle that polichol%ers shoul% 0e preente% ro#
Insurin( eistin( losses5
Ma$in( alse insurance clai#s5
&ain( ecessiel or insurance coer5
E#ploees
*(e o the (roup
16 9or assessin( the ris$ o a (roup health insurance polic; 7roup liestle 'hich o the ollo'in( inor#ation is the #ost critical 11 I ,A 0onus is (ien eer ear then or a S* o 1 la$h; 'hat 'ill 0e the paout ater 1, ears in a si#ple reisionar 0onus sste#
.6666
/,666
166666
12 !urrent re(ulation allo's the 0an$ to act as Insurance a(ent or 13 &art C*D #a$es oer to CBD @ CBD con%itionall accepts the oer than the action is consi%ere% as
7iin( insurance policies to Ban$s5
Sellin( insurance policies throu(h Ban$s5
7iin( (uarantee to policies 0 Ban$s5
!ounter oer
Response oer
&artial acceptance
1) *n * n insurance a(ent is inter#e%iar 0et'een85
!lient an% Insurance !o#pan
Insurance !o#pan an% IR+*
!lient an% IR+*
1, "hich o the ollo'in( %o not inclu%e the channel o in%irect #ar$etin(
in%ii%ual a(ents
0ancassurance
insurance 0ro$ers
1. Hu Hu#an 0ein(s nee% lie insurance 0ecause555555555555555555
%eath is certain
%eath is uncertain
the ti#in( o %eath is uncertain
1/ Lie insurance the ris$ is %eter#ine% on the 0asis o 5555555555
uture %ata
past %ata
statistical %ata
1 Li Lie insurance co#pan %eter#ine the leel o ris$ 0ase% on
9uture epenses5
!lai# eperiences5
&resent epenses5
14 Insurance 0usiness is classiie% into three #ain tpes:
Lie; Non <lie; Micro Insurance5
Lie; Non Lie; Miscellaneous
Lie; Non lie; Re-insurance5
26 *#it is loo$in( or ter# insurance plan or protection o his a#il; he is a%ise% to approach to:
&ropert Insurance
Lie Insurance
Health Insurance
insuranceco#plaints=ir%a5(o5in
ir%aco#plaints=(o5in
21 Insure% can contact to see$ the resolution o (rieances the !o#plaint=(o5ir%15in hae a(ainst insurer to IR+* throu(h: 22 La La' o Lar(e nu#0er helps the insures to
!alculate the pre#iu#
Increase the proita0ilit
*scertain the %eath ratio
23 Micro insurance is transacte% 0
Lie Insurers onl
Non-Lie Insurers onl
non-lie an% lie insurers
2) EE-sales reers to sales o insurance pro%ucts throu(h
Insurance 0ro$ers5
Bancassurance5
In%ii%ual a(ents5
*t an earl a(e
*nti#e in lie
2, The ti#in( o %eath is uncertain; so 'hen one shoul% ta$e lie *t the ti#e o uncertaint insurance 2. "hat is the #ai#u# coer that can 0e proi%e% in #icro insurance 2/ No N on 7oern#ent or(ani>ation operate in insurance #ar$et to to #a$e re(ulations
,666
16666
,6666
to help IR+*
to connect the 0uer an% seller
2 "hen insurers sell throu(h a%ertise#ents it is
in%irect sellin(
%irect sellin(
throu(h inter#e%iaries
24 "hat #ain epense is eli#inate% i insurer #oes to sellin( online 36 I insurer 'ant to coer the ris$ 'hich is 0eon% their li#its the 'ill approach 31 Sahil 'as recentl appointe% as a %irector o a lie insurance co#pan5 In accor%ance o IR+* co%e o con%uct; this 'ill preent hi# ro# carrin( out the role o
!o##ission
Inco#e Ta
Mar$etin( !ost
Bancaassurance
reinsurance
Lie Insurance council
!hie *ctuar
Insurance *(ent
No%al Oicer
QB-ENG-Page 1 of 54
Option--)
*NS
Ter# Insurance
3
IR+*
2
people 'ith hi(h inco#e
2
"ron( Sellin(
3
Bro$er
4
Insurance institute o ris$ #ana(e#ent
1 No chan(e in polic5
1
En%o'#ent polic
1 &roitin( ro# insurance5
4
Me%ical histor o (roup
3 ,666
2 None o the a0oe5
2
Mo%iie% acceptance
1 Insurance an% Re-insurance co#pan5
1
throu(h internet
4 +eath is the solution5
3
#athe#atical %ata
2 2 3
Tar(ete% 0onus rates5 Lie; Health; Micro Insurance Lia0ilt Insurance
2 !o#plaints=ir%a5(o5in
+eclare the 0onus Sel help (roup Internet5 *t the ti#e 'hen *%isor ta$es the %ecision 166666 to #a$e pre#iu#s throu(h 0ro$ers Reinsurance IR+*
4 1 3 4 2 3 3 2 1 2
Un%er'ritin( Un%er'ritin( #ana(er
2 QB-ENG-Page 2 of 54
32 "hat #ain epense is eli#inate% i insurer #oes to sellin( online 33 " "h ho is the custo#er o a Re insurer
!o##ission
Inco#e Ta
Mar$etin( !ost
Hi(h Net 'orth In%ii%ual
Insurance !o#panies
License% Insurance *(ents
3) La' o lar(e nu#0er helps Insurer to analse 'hich $e area *%#inistratie epenses
in iin( the correct pre#iu#
to re#oe a%erse selection
3, cate(orisin( 0et'een Lun( cancer an% s#o$in(
lun( cancer is peril an% s#o$in( is a ha>ar%
s#o$in( is peril an% lun( cancer is ha>ar%
Both the state#ent is correct
3. "hat is the %eath 0eneit i the person has #ultiple su#s assure% un%er %ierent policies 3/ "hich o the ollo'in( ris$s are insura0le
Su# *ssure% 'ill 0e pai% as total o all insurance plans 9inancial Ris$
Su# *ssure% 'ill 0e pai% or onl one plan 'ith hi(hest S* Non-inancial Ris$
No S* 'ill 0e &ai%5
3 Sahil @ ia ; 0oth health status sa#e; ho'eer ia 'as tri((ere% 'ith #e%icals5 #e%icals5 "hat are the reasons
+ierence in a(e
+ierence in a#il health status
+ierence in ho00ies
34 The tpe o ris$ that can 0e insure% a(ainst is %isa0ilit is 0est )6 In insurance ter#s; the ris$ o suerin( a %isa0ilit %escri0e% as 'hat tpe o ris$ )1 Ho' are perils an% ha>ar%s nor#all %istin(uishe% un%er ter# insurance policies
Speculatie Ris$ 9inancial5
&ure Ris$ 9un%a#ental5
&ure @ Speculatie ris$ Ho#o(enous5
&erils are #e%ical actors 'hich inluence the ris$ o &erils are ris$s that polichol%ers 'ill %ie 0eore a %in( an% ha>ar%s are liestle actiities 'hich speciie% %ate an% ha>ar%s are actors 'hich coul% inluence the ris$ o %in(5 inluence that ris$5
&erils are actors 'hich aect the ris$ 0ein( insure% an% ha>ar%s are the si>e o the ris$ 0ein( insure%5
)2 The Institute o insurance an% ris$ #ana(e#ent alon( 'ith insurance e%ucation %oes 'hat #ore )3 Mr5 unal use% to participate in !ar race5 "hile ta$in( up the Insurance polic he %isclose% this inor#ation5 "hat $in% o ha>ar% %oes it reers to )) La' o lar(e nu#0ers is 'or$e% out 0 'hich o the
Re(ulation
Re%ressal
Research
&hsical ha>ar%
9rau%ulent representation
Moral ha>ar%
&oolin( o ris$
Both are correct
Maintainin( insura0le interest
"ith ut#ost (oo% aith
), "ith poolin( o ris$s an insurance co#pan pools the Un%er no circu#stances pre#iu# collecte% ro# seeral in%ii%uals to insure the# a(ainst si#ilar ris$s5 *t 'hat circu#stances 'ill the insurance co#panies pool the ris$ o a lie insurance an% health
Un%er con%itions o the reinsurer
*s %irecte% 0 actuar
). "hat is the #ain o0ectie o ta$in( the lie insurance polic Ta Ta 0eneit
Sain(s
Inest#ent
)/ ia receie% his polic 0on% on 11th June; 261 +ue to so#e No; as 1, %as perio% is oer personal pro0le#s he has %eci%e% to cancel the polic on th Jul; 261 !an he cancel or return the polic
Fes; as it is 'ithin 1 ear
No; as 26 %as perio% is oer
) The CRis$D contains85
certaint o eent
Uncertaint @ leel
certaint an% reGuenc
)4 7roupin( the si#ilar ris$s 0 Insurance !o#pan is calle%
7roupin( o Ris$
Ris$ 7ra%in(
Ris$ *ssess#ent
,6 The unction o Insurance 'or$s on855
Ris$ Transer
Ris$ aoi%
Ris$ retention5
,1 Mr5 Mahesh is a sot'are en(ineer5 He has ta$en a ter# insurance or Rs5 36;666;66?- or 36 ears5 This is an ea#ple or----------------,2 "hich o the ollo'in( can 0e an ea#ple o #oral ha>ar%
Ris$ retention
Ris$ transer
Ris$ aoi%ance
a a#il histor o heart %isease
a person 'or$in( in a che#ical actor
a person consu#in( alcohol
,3 On .th *u(ust there 'as a tphoon5 Mr5*u(ustin 'ho ha% insurance %ie% in tphoon5 No' ho' 'ill the insurance co#pan 'ill cate(ories this particular ris$
Un%er the cate(or o &ure ris$
Un%er the cate(or o peril ris$
Un%er the cate(or o particular ris$
,) Ra# 'or$s in a 9ire crac$er actor5 He stoc$s the crac$er in Speculatie5 his house5 He runs 'hich tpe o ris$5 ,, *n Insurance co#pan pools the pre#iu# collecte% ro# &ure Ris$ seeral In%ii%ual to insure the# a(ainst si#ilar ris$ is calle%: ,. "hich o the ollo'in( Ris$ is associate% 'ith those eents 'hich are not in control o an in%ii%ual an% also no possi0ilit o #a$in( proit: ,/ 'hich o the ollo'in( reers to speciic eent 'hich #i(ht cause a loss 555 , The conseGuences o these ris$s 'hich 'ill aect speciic in%ii%uals or local ,4 &ure ris$ is classiie% un%er .6 * person suerin( ro# lun( cancer is a s#o$er5 Here s#o$in( can 0e ter#e% as .1 Mo M oral ha>ar% relects the 5555 .2 Mr K has &ancreatic cancer %ue to %rin$in( 5"hat is *lcohol or hi#
&articular5
9inancial5
&oolin( o Ris$
Insuraa0le Ris$
&ure Ris$5
&articular Ris$5
9inancial Ris$5
&eril
Ha>ar%
&hsical ha>ar%s
&ure ris$
9inancial ris$
&articular ris$
Econo#ic ris$ &eril
Speculatie ris$ Ha>ar%
9inancial ris$ social nee%
intention an% attitu%e o proposer
ha0it an% ho00ies o proposer
occupation an% resi%ence o proposer
a ha>ar% @ peril
a ris$
a ha>ar%
QB-ENG-Page 3 of 54
Reinsurance Non 7oern#ent Or(ani>ation Non o the a0oe Both the state#ent is incorrect None o the a0oe None o the#
1 2 2 1 1 1
*ll o the a0oe
Non 9inancial Ris$ Speculatie5 &erils are actors 'hich coul% inluence an insure% eent occurrin( an% ha>ar%s are the actual eents 'hich 'ill tri((er a paout Repositor
4 2 1
2 3
&eril
Ran%o#ness
3 4
*s per co#pan polic
1 &rotection
4
Fes; as it is 'ithin 3 #onths
e#otional loss &oolin( o Ris$ *ll o the a0oe5 Ris$ tolerance
1 2 4 1
2 * teacher 'or$in( in a pri#ar school5
3
Un%er the cate(or o Ris$ Transer
1 9un%a#ental5
4
Sharin( o Ris$
2 Insura0le Ris$
1 Uncertaint &hsical ha>ar% Insura0le ris$ Uncertaint #e%ical an% personal histor o proposer a peril
1 3 4 1 1 1 QB-ENG-Page 4 of 54
.3 * client has ta$en an en%o'#ent polic 'ith S*- 66666 an% este% 0onuses- .66665 He pai% annual pre#iu#s in the 36 ear plan5 !alculate pai%-up S* .) The coolin( perio% allo's the polichol%er to 'ith%ra' the polic 'itin 1, %as o ., Un%er 'hat tpe o insurance polic %ose insura0le interest nee% onl eist onl at the ti#e o clai# .. * polic has t'o no#inations5 "hat a#ount shoul% 0e (ien to the t'o no#inees ./ Mr5 K is illiterate an% is 0uin( insurance5 Mr5 F ill up the proposal or# on 0ehal o Mr5 K an% also en%orses an% si(ns an attestation in the proposal or#5 In a%%ition to all %ocu#ent 'hat else shoul% 0e ta$en
4333
24333
ris$ co##ence
proposal or# illin( sta(e
ater polic receie%
Lia0ilit Insurance
Marine insurance
Motor insurance
16A to each no#inee
2,A to each no#inee
Mr5 K photo(raph
Mr5 F photo(raph
No#inee one shoul% not 0e pai% #ore than no#inee t'o Mr5 K thu#0 i#pression
It is a #one 0ac$ polic
It is pai% up
&re#iu# 'ith Interest
&re#iu# less char(es
. On Maturit o an insurance polic onl 2,A o the a#ount It is assi(ne% can is pai%5 This is %ue to .4 * person pain( 1 la$h earl pre#iu# %iscontinue the polic &re#iu# Return ater the irst ear pre#iu# an% surren%er the sa#e on the secon% ear 'hat 'ill 0e the surren%er alue /6 Ja 0us a polic on the lie o Na>ia5 "ho is Ja /1 * !lient can 'ith%ra' the polic on receiin( un%er ree loo$ perio% 'ithin nu#0er o %as /2 9or Lo((in( a polic ; 'hich o these is a stan%ar% a(e proo Baptis# !ertiicate or Ration !ar%
2/3333
Lie *ssure%
No#inee 36
&roposer 1,
,6
Ration !ar%
Baptis# !ertiicate
Ration car% an% 0aptis# certiicate are Stan%ar% a(e proo
/3 The ris$ co##ence#ent %ate o polic is /) &rinciple o In%e#nit applica0le to /, &art C*D #a$es oer to CBD @ CBD con%itionall accepts the oer than the action is consi%ere% as /. The con%ition that the polic hol%er shoul% pa the pre#iu#s re(ularl is #entione% in // Ecept Surren%er; ho' one polic hol%er can transer #one to a thir% part ; 0arrin( No#inee / Insurance !ontract 'ithout an Insura0le Interest 'ill result as /4 a &olic hol%er ta$es a insurance contract or 36 ears an% the S* re%uces ater 2, ears 'hat coul% 0e the li$el reason
*ter the U?" process Lie Insurance !ounter oer
&re#iu# receipte% 7eneral Insurance Response oer
&olic is %ispatche% Both a @ 0 &artial acceptance
&olic %ocu#ent
&rospectus
&roposal or#
B "ill
B %oin( *ssi(n#ent
!lai#
"a(erin( !ontract
Le(al !ontract
oi% !ontract
No 0onus accu#ulate%
*(e proo 'as su0stantiall 'ron(
&olic has 0eco#e pai% up
6 *#it is illiterate5 He 'ants to ta$e polic @ his rien% Sura helps hi# in $no'in( the Guestion an% illin( the proposal or#5 *part ro# *#its let thu#0 i#pression ; 'hat shoul% Sur a shou shoul% l% %o 1 * lie insurance polic can onl 0e #a%e pai% up i 'hat particular polic eature eists 2 Harish ta$es a lie insurance polic or Ra#esh5 "hich o the ollo'in( state#ent 0est %escri0es the principle o Insura0le Interest5 3 Li#it o no#inees can 0e attache% to a ter# insurance polic
Suras &hoto(raph
Sura also has to put his let thu#0 i#pression alon( Sura has to (ie his a(e proo alon( 'ith a#its thu#0 i#pression 'ith a#its a(e proo
In%ein( contri0ution5
No#ination acilit5
Ri%er 0eneits5
Ra#esh %eclares all his lia0ilities
Ra#esh is el%er than Harish
Ra#esh o'es #one or# Harish
on one
) In a 'hole lie plan - The polichol%ers responsi0ilit to (ie at the 0e(innin( o the contract %isclosure , Mr5 *B! 0uin( Ter# insurance polic; insurer shoul% #ention operatie clause O#0u%s#an a%%ress in 'hich part o polic %ocu#ent
t'o
three
throu(h out the contract
Reial sta(e
&rea#0le
Inor#ation state#ent
. One o the (enuine Reason or surren%er o the polic coul% 0e / To 0e a ali% contract ;the %eclaration is necessar in 'hich %ocu#ent Tpes o assi(n#ent
ne' pro%uct ro# co#petition
a%isor entices the polichol%er to surren%er
"ants to 0u a car
&olic +ocu#ent
proposal or#
9&R
*0solute
Ter# assi(n#ent
!on%itional
4 The insurer reGuires the a(e proo or calculatin( the
S*
Ris$ assess#ent
I%entit eriication
QB-ENG-Page 5 of 54
214333
3 on pre#iu# 0ein( pai%
3
Trael insurance
2
There is no speciie% li#it li$e that
4
Mr5 F thu#0 i#pression
3 *n one o the a0oe
2
Nothin( as surren%er is not allo'e% 0eore , polic ears
4 3
*ppointee 26 Ration car% an% 0aptis# certiicate are 0oth Non stan%ar% a(e proo polic is receie% Neither a nor 0 Mo%iie% acceptance 9irst pre#iu# Receipt not possi0le to transer non oi%a0le contract
2
2 2 2 1 1 2 1
Its a ULI& &lan
3 Onl a %eceleration has to 0e (ien 0 Sura
4 Sain(s ele#ent5 Harish suers inancial loss incase o %eath o Ra#esh not speciic Be(innin( an% also at reial sta(e
4
3 4 1
sche%ule
3 Has 9inancial &ro0le#s R&R *0solute @ !on%itional 9inancial assess#ent
4 2 4 2
QB-ENG-Page 6 of 54
46 * polic %ocu#ent or a #one-0ac$ polic inclu%es the state#ent the proposal an% %eclaration si(ne% 0 the proposer or# the 0asis o the contract‟5 In 'hich #ain section o the polic %ocu#ent 'ill this nor#all appear
*ttestation5
Operatie clause5
&rea#0le5
41 &olic * an% &olic B 'ere surren%ere% on the sa#e %a ater pain( the 22n% instal#ent o the pre#iu#5 But the Surren%er alue in polic * 'as hi(her as co#pare% to polic B 0ecause 42 I so#eone o a(e (roup 1, ?1. hain( a contract 'ith insurance co#panies that contract 'oul% all un%er 'hich cate(or 43 The o0li(ation o the insurer or the 'hole lie polic is #entione% in 4) In 'hich $in% o polic the insura0le interest shoul% eist at the ti#e o clai# onl 4, The clause o in%isputa0le is applica0le ro# inception o polic to 4. Insura0le interest on ones o'n lie li#ite% upto
&olic * has a hi(her ter# than &olic B
&olic B has a hi(her ter# than &olic *
&olic * has 0een assi(ne%
ali%
Inali%
oi%
operatie clause
&rea#0le
&roiso
Motor insurance
Marine insurance
Lia0ilit insurance
) ears
2 ears
3 ears
26 ti#es o 7ross *nnual inco#e
li#it %epen%s upon the insurance co#pan
16 ti#es the a#ilies annual inco#e
4/ The concept o in%e#nit is 0ase% on the $e principle that polichol%ers shoul% 0e preente% ro#
Insurin( eistin( losses5
Ma$in( alse insurance clai#s5
&ain( ecessiel or insurance coer5
4 Sachin 'ho is 1/ ears 'ants to 0u an en%o'#ent 'ith proit polic 5 The insurance co#pan reects the proposal or# on 'hat (roun%
the resi%ence proo is not ro# the In%ia
sachin is not attaine% le(al a(e to enter a contract
En%o'#ent polic %o not hae 'ith proit eature
Throu(hout the polic contract
0eore pre#iu# %eposit
0eore receiin( polic %ocu#ent
&roposal or#
Me%ical reports
!lient coni%ential reports
*ter , ears
'ithin one ear o surren%erin(
can neer 0u another polic
*t the inception o the contract
*t ti#e o %eath clai#s
%urin( the surial 0eneit paouts
163 I the su# assure% re#ains the sa#e; 'hat 'ill 0e i#pact o net pre#iu# i the a(e o the polichol%er increases
It rises
It alls
It re#ains constant
16) In case the custo#er has stoppe% #a$in( pa#ent or the pre#iu# o the polic5 The reial proce%ure 'oul% reGuire the 'hich o the ollo'in( 16, In a lie insurance polic it is later oun% that the person %oesn‟t hae insura0le interest then the contract is
pa#ent o outstan%in( pre#iu# 'ith interest ; Onl reinstate#ent ees has to 0e pai% proo o (oo% health @ in so#e cases reinstate#ent ees epire% reie'e%
44 "hen 'ill the &rinciple o Ut#ost 7oo% aith appl in Ter# insurance plan 166 Insurance co#pan co#es to $no' that Mr * ha% 0een issue% a polic earlier 'ith etra pre#iu# char(e% 5 "hich %ocu#ent 'as reerre% 0 the insurer to co#e to this conclusion 161 *n a(ent surren%ere% the polic o a client on 16 9e05 2611; 'hen can this client 0u ne' plan 162 "hen %oes insura0le interest eist in lie insurance contract
Upto t'o ears the pre#iu# 'ith penalt can 0e 'aie% o 5 oi%
16. Net pre#iu# is eGual to
&re#iu# plus interest earnin(
Ris$ pre#iu# plus interest earnin(
&re#iu# #inus interest earnin(
16/ &rinciple o ut#ost (oo% aith 'ill operate in eistin( polic
Eer ti#e pre#iu# is pai%
I the polic has lapse% an% it has to 0e reie%5
16 Both the parties to a contract #ust a(ree an% un%erstan% the !onsi%eration5 sa#e thin( an% in the sa#e sense 'hich is calle%
Le(alit o an o0ect5
I the insure% person alls sic$ an% is a%#itte% to hospital5 !onsensus a% i%e#5
164 *#ita0h is #arrie% an% he has as his %epen%ants ; his 'ie Neli#a an% no chil%; 'hich shoul% 0e his priorit in
Inheritance plannin(
Inest#ent eicienc
&rinciple a#ount
+iscounte% alue 'ith persistenc 0onus
+iscount
#ortalit char(es
Inco#e protection
116 *#it has ta$en a 7-Sec an% has parte% 'ith it #i% 'a as he +iscounte% alue reGuire% the #one 'ith the intention o not (ettin( the interest5 "hat 'ill he (et 111 "hen net pre#iu# is a%uste% in or%er to calculate the (ross Loa%in( pre#iu# ; this process 'oul% 0e $no'n as 'hat 112 * lie insurance polic is issue% 'ith a Lien ; this 'oul% 0e #entione% in 'hich part o the polic %ocu#ent
&roiso
Sche%ule
Ter#s @ con%itions
113 In a pension plan illustration 'hat are the parts 'hich sho's the 0eneit or an annuitant5
Open #ar$et option part
*nnuit part
7uarantee% an% non (uarantee% part
QB-ENG-Page 7 of 54
Ter#s an% con%itions5
3 &olic B has 0een assi(ne%
2 Ille(al
3 En%orse#ent
1
Trael insurance
2
,ear
2
No li#it to sel lie
)
&roitin( ro# insurance5 ) Su0#itte% F! %ocu#ents are not ali% or Sachin
*ter receiin( the polic %ocu#ent
2
1
Me%ical reerees report 1 'hereer he 'ants to 0u
)
Throu(h out the Ter# o the plan
1
7ross pre#iu#s increases 3 No reial is possi0le 'hen the polic iis lapse%
1
ali% 3 Ris$ pre#iu# #inus interest earnin(
3
I the insure% person chan(es his o05
2
*cceptance5 3 Lon( ter# sain(s
1
&rinciple 'ith persistenc 0onus 1 Interest a%% ups 1 En%orse#ent 2 co##utation part
3 QB-ENG-Page 8 of 54
!onertin( the polic to 'hole Lie 2
*n insurer has #a%e another proposal5
1
Rollin( contract5
1
Sche%ule o polic %ocu#ent5
3
&olic +ocu#ent is receie% 0 polichol%er5 "hen cheGue is poste%?couriere% 0 the insure5 *cGuires pai% up alue5
2 3
) No#ination nee% not 0e inor#e% 0ut assi(n#ent nee%s to 0e inor#e% to insurer5 "hen the client is enoin( (oo% There is no insura0le interest attache% to the polic5 *0solute *ssi(n#ent
1 3 )
2
*nnuit &lan 1
oreite% the &re#iu# 2 Sche%ule o &olic 2 'ill 0e &aa0le to Saani No#ineeP at the a(e o 1th 2
&rinciple o Ut#ost (oo% aith 1
&roo o Inco#e ta paer 2 26th ear
) QB-ENG-Page 12 of 54
1,2 i$as su0#itte% an *(e proo ro# illa(e &anchaat 'hile Stan%ar% an% accept the proposal ta$in( a Ter# plan or Rs , La$h S* 5 The insurance co#pan 'oul% consi%er this as 'hich o the ollo'in(
Not stan%ar% @ 'ill accept the proposal
"ill reect the proposal
1,3 I a custo#er has #entione% he is a %rin$er in the proposal or#; the insurance co#pan can eclu%e this ha>ar% an% #ention it in 'hich part o the polic %ocu#ent
&roisio
En%orse#ents
Operatie clause
1,) "hat to 0e consi%ere% 'hile ta$in( irst polic 1,, "hich o the ollo'in( is a Non Stan%ar% *(e &roo
&ersonal +etails &*N !ar%
9a#il +etails !ertiicate o Baptis#
E#plo#ent %etails !ertiicate ro# illa(e &anchaat
1,. In the insurance contract the ris$ coer is (ien in return o the 1,/ I a lie insurance contract is esta0lishe% 'ithout an insura0le interest in eistence ; the contract 'ill 0e
!onsi%eration
!onsensus a% i%e#
!apa0ilit to peror#
Inali%
uncon%itional
ali%
1, Mr > accepte% the contract or#e% 0 Mr F 5Is this
a consi%eration
an oer @ acceptance
oi%a0le contract
1,4 Mr5 * @ B starte% an en%o'#ent polic on the sa#e %ate pain( sa#e pre#iu# on Guarterl #o%e5 *ter pa#ent o 22n% pre#iu# 0oth surren%er the polic Mr5 *s surren%er alue is hi(her than B; 'hat coul% 0e the reason
*s ter# is #ore than B
Bs ter# is #ore than *
* is health @ 0 is not
1.6 &a#ent o S* on happenin( o an eent o %ates pre#iu# pa#ent ;no#inees ;lien all or# part o 1.1 "hen is *n appointee is reGuire% in the Lie Insurance plan ; the reason coul% 0e 1.2 "hile un%er'ritin( Mr5 K proposal or# it is oun% out that there is a cri#inal case a(ainst hi# or rau%ulent actiities5 "hat tpe o ris$ 'oul% this all in
sche%ule
&rea#0le
Ter#s @ con%itions
No#inee is spouse
No#inee is Minor
L* is #inor
9un%a#ental ris$
&hsical ha>ar%
Moral Ha>ar%
1.3 Ho' #uch insurance can 0e (ien to a 'or$in( person
*s per Hu#an lie alue
16L
,6L
1.) "hile calculatin( Hu#an lie alue HLP in si#ple #etho% t'o co#ponents nee% to 0e $ept in #in% ; the irst one is net #onitor contri0ution to the a#il per annu# an% the secon% 'oul% 0e 1., T"O 9RIEN+S H*E T*EN S*ME &OLI!F BUT THEIR &REMIUMS *RE +I99ERENT "HF 1.. Till 'hat perio% is the interi# 0onus ali% 1./ *nnual pre#iu# o insurance pro%uct is Rs5 32;666; )A loa%in( on Quarterl #o%e o pa#ent "hat is the Guarterl pre#iu# 1. *s per the nor#s o ris$ assess#ent 0 un%er'ritin(; 0oth the parents o a polic hol%er %ie% in their earl 36s %ue to Heart %isease; 'hat is the ris$ a ssesse%
Ban$ 9ie% %eposit rate
%iscount rate
Esti#ate% lie epectanc
*7E
ME+I!*L
S*
as lon( as the polic is inorce
Till the net %eclaration o 0onus /.6
Moral Ha>ar%
Till the net ali%ation %ate 666
326
Me%ical Ha>ar%
Occupational Ha>ar%
1.4 In accor%ance to #one laun%r re(ulation; the NRI shoul% No Ris$ 0e cate(ori>e% to 'hat tpe o custo#er 1/6 Mr5Sunil is %oin( pre#iu# calculation or his co#pan; as per !ouncil o *ctuaries 'hich authorit is his proession relate% to
Lo' Ris$
#e%iu# Ris$
Insurance council o In%ia
Insurance institute o In%ia
1/1 'hat is the special report that is as$e% 0 the un%er'riter HL report ro# the oicer o the insurer 1/2 The insurer reGuires a(ent coni%entialit report in or%er to To calculate &re#iu#
*(ents coni%ential report
#oral ha>ar% report
To !alculate the co##ission %ue or the a(ent
To eri the &lan propose%
1/3 * hu#an 0ein( is *n econo#ic asset 1/) Sura ha% ta$en an en%o'#ent plan or Rs 16 La$h S* 5 He The &olic 'as issue% 'ith a Lien %ie% in ei(ht #onths ro# the inception %ate 5 The Insurance co#pan %i% not pa the 9ull S* ; Instea% pai% out Rs ,La$h 5 "hat coul% 0e the reason 5
Has a capacit to (enerate the inco#e The 0onus or the polic ha% not et %eclare%
Has a inite lie span The polic ha% onl #aturit clai# proision
1/, Mr5 * 'ants insurance coer 5 But he is %rin$s alcohol reGuentl 5 "hat $in% o ha>ar% ou #a cate(ori>e
Moral Ha>ar%
inancial ris$
&hsical ha>ar%
QB-ENG-Page 13 of 54
"ill accept 'ith a lo'er S* 2 Ter#s an% !on%itions ) *ll o the a0oe !ertiicate ro# School or !olle(e
)
Uncon%itional acceptance
1
3
oi%a0le 1 consensus a% i%e#
2
* inancial con%ition is 0etter than B 2
En%orse#ents
1
*ll cases
2
No Ris$ 3 1 !rore
1
Esti#ate% a#ount at retire#ent 2 *LL THE *BOE
) 2
none o the a0oe ,66
3 &hsical Ha>ar% ) Hi(h Ris$
)
IR+* 1 #e%ical report
3
To help the un%er'riter to asses the Ris$ *ll o the a0oe The %eath 'as %ue to acci%ent
) )
1
&ure ris$ 2
QB-ENG-Page 14 of 54
1/. Insurer appoints a can%i%ate o this proessional Gualiication ;'ho %eci%es the a#ount o pre#iu# in insurance pro%ucts 1// as per IR+* re(ulation ; the %ecision on the proposal has to 0e co##unicate% to the &roposer 'ithin ho' #an %as o receiin( the proposal 0 the insurance co#pan
*ctuar
Un%er'riters
Sales Oicer
/ %as
16 %as
1, %as
1/ "hen an interi# 0onus is pai% un%er 'ith proit polic; This nor#all represents a 0onus coerin( 'hat perio%
&olic start %ate to the 1st *nniersar
&olic start %ate to the en% o the 1st calen%ar ear
&reious aluation %ate to clai# %ate
1/4 "hile calculatin( HL in the incre#ental #etho% ; alon( 'ith uture inco#e; nu#0er o ears o 'or$ @ uture alue o earnin( potential 'hich is the other #ost i#portant actor ta$en into consi%eration
Inlation5
Interest5
+iscount rate
16 ishal an% san%eep applie% or a health plan in KF Lie Insurance !o#pan5 ishal is as$e% to un%er(o a #e%ical chec$ up 0ut San%eep is not as$e% to %o so5 "hat 'ill 0e #ost possi0le reason 11 9or 'hich o the ollo'in( reasons; the un%er'riter shoul% as$ 0eon% a(ent‟s coni%ential report5 12 "ith reerence to the principle o in%e#nit a lie insurance polic is a5 13 Micro insurance is #a%e speciicall or people ro#5 1) I Insura0le interest %oes not eists at the ti#e o inception o the lie insurance polic then; lie insurance contract is
San%eep has ta$en another polic ro# KF Lie Insurance !o#pan
ishal is ol%er than San%eep
San%eep is earnin( #ore then ishal
&hsical Ha>ar%
Moral Ha>ar%
S* is too hi(h
Insurance contract5
In%e#nit contract5
alue contract5
Hi(h inco#e5 Non oi%a0le
Mi%%le class5 Inali%
Lo' inco#e5 ali%
1, I a contract is si(ne% 0 a 1, ears ol% 0o; this contract 'ill 0e 1. Shailesh an% an$it 'ant to retire in the a(e o .,rs5 But shailesh pas #ore #onthl pa#ent than an$it or sa#e a#ount o polic5 "h 1/ In a case; the un%er'riter elt that the ris$ associate% 'ith the person 'oul% %ecrease 'ith ti#e; then he 'oul% accept the case 'ith 1 Mr5 u#ar‟s 'ie is suerin( ro# 0loo% cancer5 +octors lost their hope on her lie5 Mr5 u#ar 'oul% li$e to ta$e Lie Insurance polic on 'ie‟s na#e in or%er to (et #onitor 0eneit5 Insurance co#pan reects this proposal on the (roun%s o885
Null an% oi%
Inali%
oi%a0le
Shailesh is ol%er than *n$it5
Shailesh‟s inco#e is #ore than *n$it‟ s inco#e
Shailesh a#il is lar(er than an$its a#il
* clause
* Lien
* Loa%in(
*nti Mone Laun%r
Moral Ha>ar%
!apacit o pain( uture pre#iu#s5
14 "hat is the #ain source or insurance co#pan to (et inor#ation o proposer 146 Moral Ha>ar% relects the 885
*%ertise#ents5
&roposal or#5
!on%uctin( interie's5
Intentions an% attitu%e o &roposer5
Ha0its an% Ho00ies o &roposer5
141 Inco#e replace#ent #etho%s eGuates Hu#an Lie alue HLP to 142 The un%er'riter can (et the reGuire% inor#ation a0out the proposer in55555 143 Mr5 Ra#esh 'or$s in a #inin( co#pan5 So he is epose% to55555555555555 14) Lien is i#pose% on a polic 'hen un%er'riter eels that555555
9uture alue o &resent earnin(s5
&resent alue o uture earnin(s5
Occupation an% Resi%ence o &roposer5 &resent alue o preious earnin(s5
&roposal or#5
rene'al receipt
0rochure
#oral ha>ar%
phsical ha>ar%
#ental ha>ar%
the ris$ associate% #i(h t increase
the ris$ associate% #i(h t %ecrease
14, "hat %oes the #ortalit ta0les contains
Ta0les o %eath occurrin( in arious circu#stances
Ta0les o %etails o arious pro0a0ilities o %eath
the ris$ associate% #i(ht not 0e har#ul Ta0les o %etails o un%er'riter‟s calculation on %eath
14. Mr5 7uptha is recentl %etecte% 'ith lun( cancer5 He 'oul% li$e to ta$e an insurance5 "hat is our su((estion
Ti#e o %eath is uncertain; so insurance can 0e (ien
Onl lun( is aecte% so h ealth insurance can 0e (ien5
14/ "hich o the ollo'in( inor#ation %oes not appear in the #etho% an% reGuenc o pre#iu# pa#ent 9irst &re#iu# Receipt 14 Mr5Santhosh 'or$in( as a hea% #aster 'ho is aroun% ,2 * 5 &hsical ha>ar%; as he is ol% ears ha% reGueste% or an Insurance coer or Rs51 crore5 He insiste% that his 0rother‟s son shoul% 0e the no#inee not his 'ie5 Un%er'riter 'ill eri this case or 'hich one o the ollo'in(:
He can ta$e insurance ater su0#ittin( health certiicate
+ate o co##ence#ent o last pre#iu#
+ate the polic #atures
B5 Moral ha>ar%; as he is ,2 ears ol% an% 'ie is not the no#inee
!5 Moral ha>ar%; as coera(e is hi(h an% 0rother‟s son is the no#inee
QB-ENG-Page 15 of 54
*%isor 1 36 %as 3 clai# %ate to net aluation %ate 3 !o#poun%in(5 3
ishal is 'or$in( in a MN! 2 &ure Ris$
3
Maor lie contract5
3
*luent class5 Null
3 2
ali%
1
Shailesh is a Business#an an% an$it is a (oern#ent e#ploee
1
Leel &re#iu# 2 &hsical Ha>ar% 2
Telephonic conersations5
2
Me%ical an% &ersonal Histor o &roposer5 9uture alue o preious earnin(s5
1
annual report
1
Ethical ha>ar%5
2
the ris$ associate% #i(ht 0e (eneral
2
Ta0les o %etails o actuarial calculation on %eath
)
2
!annot (ie insurance or health reason ) +ate the last pre#iu# 'ill 0e pai%
2
+5 Moral ha>ar%; as he is a hea% #aster an% ,2 ears ol% 3
QB-ENG-Page 16 of 54
144 Mr59ero> has applie% or an insurance coer o Rs5) !r5 The !o#pan 'ill accept or reect the proposal onl ater conir#in( ro# one o the ollo'in( a(encies
9inancial Inspection a(encies
Speciali>e% inspection a(encies
!re%it 'orth inspection a(encies
266 The responsi0ilit or classiication an% analsis o the proposal or# lies 'ith 'ho# 261 In un%er'ritin( the econo#ic alue o the person is %eter#ine% 0 'hat 262 Ra$esh purchase% a lie insurance polic5 "hile 'ritin( a proposal or# he hi%e that he practices #ountaineerin(5 Sa%l he %ie% in an acci%ent 'hile cli#0in( Mount Eerest5 The insurers reecte% the clai#5 "hat is the reason or reection
Ris$ *nalsis +epart#ent
!lassiication o Ris$ +epart#ent
Un%er'riter
The occupation o the person
The inancial histor o his a#il
The inco#e that he earns
Innocent #isrepresentation5
9rau%ulent #isrepresentation5
!onceal#ent5
263 Ra# Lal is an insurance polichol%er5 He has recentl shite% his ho#e ro# Ne' +elhi to Noi%a5 He 'ants the a%%ress to 0e chan(e%5 This chan(e in polic %ocu#ent 'ill 0e eectie throu(h 26) "hen an un%er'riter #a consi%er Moral Ha>ar%
Ter#s @ !on%ition5
&rea#0le5
En%orse#ent5
*n in%ii%ual is proposin( S* 1, ti#es his annual inco#e5 Ris$ &re#iu#5 Mini#u# &ossi0le Loss5 Si#ple Reisionar 0onus
Insurance is ta$en out 0 an in%ii%ual 'ith %epen%ent Net &re#iu#5 Maor &ossi0le Loss5 !o#poun% Reisionar 0onus
* no#inee is not a %epen%ent5 Loa%in( o &re#iu#5 Minor &ossi0le Loss5 &ersistenc Bonus
Leel &re#iu#
Ris$ &re#iu#
Insurance a(ent coni%entialit report
Na#es an% a%%ress o the proposers rien%s an% collea(ues
&hsical Ha>ar%
Moral Ha>ar%
Occupational ha>ar%
Insurers %octor "ill 0e consi%ere% as stan%ar% a(e proo It is hi(her
Un%er'riter "ill 0e consi%ere% as non stan%ar% a(e proo +ecrease
*(ent "ill not 0e accepte% Sli(htl hi(her
Stan%ar% *(e &roo
Non Stan%ar% *(e &roo
&repare a #ore %etaile% report
&repare a Moral Ha>>ar% report
Stan%ar%; i acco#panie% 0 a(ents si(nature &repare a %etaile% inesti(ation Report
26, Leel &re#iu# is calculate% 0ase% on 26. M&L a00reiates 26/ "hich one o the ollo'in( 0onuses is (ien 0 insurer as an incentie to the insure% to or lon( ter#:
26 Ra#esh 0ou(ht an en%o'#ent plan or ten ear5 He pas the 7ross &re#iu# sa#e *#ount in eer ear throu(h out the polic ter# 5 This a#ount is calle%: 264 "hich one o the ollo'in( is not source o inor#ation a0out &roposal 9or# the proposer reGuire% 0 the Un%er'riter 5 216 Manish 0ein( a sole earnin( #e#0er o his a#il ; has not insure% hi#sel 5 But he is loo$in( or insurance or his son 'ho is stu%ent 5 This coul% all un%er 'hich cate(or os Ha>ar% in insurance 211 "ho is the pri#ar un%er'riter o the clients 212 !ertiicate ro# the illa(e panchaat 213 "hat 'ill 0e lien a#ount in 3r% ear as co#pare% to the )th ear o lien5 21) * person su0#its as a(e proo; a certiicate ro# the illa(e &anchaat5 Is it a 21, *!R is prepare% 0 Insurance a(ent5 I Mr K 'ants a hi(her S* then the un%er'riter 'oul% as$ or a%%itional report apart ro# *!R ; the 0ranch hea% 'ill hae to %o 'hat
21. *ter receiin( the proposal or#; un%er ho' #uch ti#e the / %as insurance co#pan has to reert to the proposer 'ith its %ecision 21/ *nil is (oin( to ta$e lie insurance polic in 'hich total annual &re#iu# is Rs 32666?- an% there is )A reGuenc loa%in( or Guarterl #o%e5 "hat 'ill 0e the Guarterl pre#iu#
16 %as
/26
1, %as
666
326
21 The process o a%ustin( the a#ount o Lie Insurance pre#iu#; so as to relect 0onuses is calle%
In%e#niin(
In%ein(
Loa%in(
214 Un%er'riter is assessin( the ris$ or the in%ii%ual 'ho alrea% is alrea% a polichol%er an% preious polic 'as accepte% at non stan%ar% rates; 'hich o the ollo'in( %ocu#ents 'ill 0e helpul to assess the ris$
pre#iu# Quotation 5
clai# or#
&roposal 9or# 5
226 "hat ta rate; i an; 'ill 0e applica0le to a lie insurance Nil polic hol%er or the #aturit procee%s o a Rs ,6;666 lie insurance polic 221 "hat is #ai#u# leel o Insurance pre#iu# or 'hich Inco#e Ta 0eneit is aaila0le 222 Mr5 K 'ants a lie coer or the ter# o 26 Frs5 *lso he 'ants Ter# &lan a #o%est a#ount i he suries throu(h the ter#5 "hich plan 'oul% ou su((est to Mr K
2,666 En%o'#ent plan
QB-ENG-Page 17 of 54
651
652
,6666
166666 !onerti0le plan
361 Ra$esh 'ants to 0u a polic pri#aril or Ris$ !oer 0ut at the en% o the ter# he 'ants to (et at least so#e return5 Un%er 'hich polic he 'ill (et these 0eneits
En%o'#ent plan
Ter# insurance 'ith Return o purchase price
"hole lie plan
362 In 'hat proportion is the coer in a 9a#il 9loater &lan
2,A each
1,A each
,6A each
363 "ho 'ill #aintain Mutual 9un% Sche#es
Mutual 9un% Mana(e#ent Societies
Mutual 9un% Mana(e#ent Sste#s5
*sset Mana(e#ent !o#panies5
36) "hich is the pri#ar sain( nee% a#on( all sain( nee%s
Insurance
&urchasin( House
Inest#ent5
36, Mr5 Rao has Rs5 16; 66;666 cash 'ith hi#5 He 'oul% li$e to Insurance use this a#ount or his %au(hter‟ s #arria(e 'hich is (oin( to happen 'ith in Nine #onths5 He 'oul% li$e to (et so#e returns ro# this #one in these 4 #onths perio%5 "hat is the 0est option to par$ h is #one
Shares
9ie% +eposit in Ban$
36. "hich o the ollo'in( aenues #a$es it easier or a person to ta$e a sain( pro%uct 36/ Mr5 Ra(opal has ineste% so#e #one5 He has 0een inor#e% clearl a0out the tenure; interest rate an% #etho% o pa#ent o interest at the inception o the inest#ent itsel5 His inest#ent #a 0e in55555
throu(h in%ii%ual a(ents
throu(h internet
corporate a(ents
Lie Insurance
Mutual un%
Shares
36 "hich o the ollo'in( can‟t 0e %e%ucte% un%er section 6 c ro# taa0le inco#e 364 "ho act as an inter#e%iar 0 oerin( a tra%in( plator# or 0uin( an% sellin( o shares 316 The !entral Ban$ has recentl announce% the %ecrease in interest rates5 The prices o 0on%s are 311 Ti#e %eposit account is issue% 0: 312 &an$a 'ants to sae ta oer an% a0oe the %e%uction allo'e% un%er section 6! o the inco#e ta act 14.1; 'hich allo's %e%uction ro# taa0le inco#e
&ension 9un%s
&u0lic &roi%ent 9un%
E#ploee 7ratuit 9un%
313 In 'hich o the ollo'in( Ban$ pas the Interest on the %eposit‟s un% on #onthl ?Guarterl ?hal earl? earl 0asis as chosen 0 %epositor un%: 31) ino% 0ein( an insurance a(ent can oer assistance to his client Ra#esh 0: 31, The concept o Ris$ %iersiication is applica0le in 'hich o the ollo'in( instru#ent 31. *a 0ou(ht a share or Rs5116 an% he sol% 'hen it 'as Rs5.365"hat ha% happene% to his share 31/ * client 'ants to sae up to 0u an epensie car; 0ut his %isposa0le inco#e an% uture epecte% inco#e esti#ates #a$e this %esire unreasona0le5 *n a(ent shoul% clari the %ierence 0et'een 31 *ter pain( pre#iu# o ,$ the custo#er receie% a #aturit a#t5 at 'hat rate 'ill it 0e tae% 5 314 *s per ne' (ui%elines or a Su# *ssure% o Rs 1 La$h 'hat is the #ini#u# *nnual &re#iu# 'hich one #ust ta$e
Bo#0a Share echan(e
Bo#0a Stoc$ echan(e
Stoc$ 0ro$ers
Li$el to increase5
Li$el to %ecrease5
"ill luctuate5
&ost oice !orporate Bon%
Ban$ Inrastructure Bon%
Mutual 9un% Health Insurance
Sain( +eposit
!u#ulatie %eposit
Tra%itional +eposit
&roi%in( hi# e#er(enc un%5
Matchin( the pro%uct 'ith Ra#eshs inancial nee%5
Mutual 9un%
Ris$ +iersiie% Insurance
Reco##en%ation o pro%uct 'ith hi(hest return5 Shares
!apital *ppreciation
!apital &roit
!apital Beneit
!urrent @ 9uture Nee%s
9inancial @ Non-9inancial Nee%s
I%enti an% Quanti nee%s
nil
326 *s per the inco#e ta act ho' #uch total pre#iu# is %e%ucte% ro# the taa0le inco#e un%er sec 6 c 'oul% 0e
651
652
26666
16666
,6666
2,666
,6666 1lac
321 I the 0an$ pai% a cu#ulatie interest in ie% %eposit sche#e Monthl then 'hat is a #o%e o interest pai%
Quarterl
Hal Fearl
322 In a act in%; it 'as oun% that a custo#er ha% proi%e% or . Hi(h #onths o epenses as e#er(enc un%s5 Is it
a%eGuate
Lo'
323 In a Unit Lin$e% Insurance &lan; 'here the annual pre#iu# is 2 La$hs Rs5.6;666; un%er the ne' (ui%elines; 'hat is the #ini#u# lie coer that a custo#er 'ill hae to ta$e
3 La$hs
) La$hs
32) & is an i%eal inest#ent or 'hat $in% o custo#er
Monthl Inest#ent
*nnual Inest#ent
Sin(le Inest#ent
QB-ENG-Page 25 of 54
Ulip 2 No &roportion
)
*sset Maintenance !o#pan Li#ite)5
3
!ontin(enc? E#er(enc 9un%5
)
Mutual 9un%s5 3
call centers
2
Ban$ %eposits )
Inrastructure Bon%s
3
Share 0ro$ers
3
No chan(e is li$el5
2
Lie Insurance co5 Interest pai% on e%ucation loan
1 2
9ie% +eposit 3 +iscourse sain( in a purposeul an% nee% 0ase% #anner5 Ris$ Sharin( insurance
2
!apital ariation
1
1
Real @ &erceie% Nee%s ) 653
1
166666 2 2lac 3 Fearl 2 Ina%eGuate 2 , La$hs 2 Monthl inest#ent at re(ular interal
1 QB-ENG-Page 26 of 54
32, Suresh has transerre% his phsical (ol% to (ol% ET95 This 'ill increase the liGui%it
%ecrease the liGui%it
attract ta at #aturit
32. The inest#ent peror#ance o a custo#ers sin(e lu#p-su# !orporate Bon%s pa#ent 'ill relect the peror#ance o a 'i%e ran(e o %ierent securities un%er 'hat tpe o pro%uct
isan i$as &atra
Mutual 9un%
32/ "hat perio% o ti#e a client has to 0e ineste% to (et ta 16 Fears 0eneit un%er postal sche#e 32 "hat is the a#ount o #one a client can ta$e out as a lu#p- One-tenth su# ro# a pension polic 324 O#$ar Starte% a pension polic 'ith proi%er * 0ut en%e% up !o##utation Option in ta$in( the annuit pa#ent ro# proi%er B5The result %irectl relects 'hich o the eature aaila0le in this polic
ears
. ears
one-thir%
one-ith
+iere% *nnuit Option
7uarantee% perio% option
336 +enn is #arrie% an% has 2 chil%ren a(e . an% 165 His parents are alie an% are /6 an% .5 "ho all can 0e inclu%e% un%er the a#il loater health plan 331 !ritical illness ri%er 'as ta$en an% the ri%er 0eneit has 0een clai#e% ; the ri%er 0eneit no' (ets 332 In a 7uarantee% annuit option o , ears ; the polic hol%er 'ill (et annuit till 333 "hat reGuencies can one ta$e in annuit
+enn onl
+enn an% his 'ie
+enn; His 'ie an% chil%ren
Re%uce% the 0ase S*
ter#inate%
continues as it is
entire lie ter#
till , ears an% continue till annuitant lies
annuit onl or , ears
#onthl;Guarterl;hal earl; earl
ortni(htl;Guarterl;#onthl;earl
33) "h is there a 'aitin( perio% in health insurance policies
&re-eistin( illnesses
!han(e in pre#iu# ter#s
ortni(htl; #onthl ;hal earl; earl Nature o ris$
33, Ho' is No !lai# Bonus is (ien in a Health Insurance &olic
B 'a o !ash +iscount
+iscount in Rene'al &re#iu#
9ree Rene'a0le
33. "hat is i#portance o Health insurance
#eet an #e%ical e#er(encies
Maor hospitalisation an% treat#ent epenses
#eet epenses post hospitalisation %ue to loss o inco#e
33/ * person retirin( 'ithin 3 #onths nee%s return as pension5 "hat $in% o inest#ent plan he nee%s to choose 5
I##e%iate *nnuit
+eerre% *nnuit
*nticipate% En%o'#ent
33 *n in%ii%ual nee% a lu#p su# at the a(e o retire#ent; the the %eer#ent perio% a#ount he nee% to inest annuall or the (oal 'ill %epen% on
a#ount 'hich reGuire%
inest#ent tools use% or inest#ent
334 "hat are the Special eatures o Health plan 3)6 "hat 'ill 0e #aturit 0eneit un%er health insurance plan
!oers %isease epenses 9un% alue
Helps in Ta Beneits &ai% pre#iu#
coers hospitali>ation cost &ai% pre#iu# 'ith interest
3)1 "hich is the suita0le sain(s plan or a senior citi>en
Ter# insurance plan
Mone 0ac$
ULI& &lan
3)2 !lai# *#ount receie% un%er !IBR Ri%er ;can 0e spen% or
Health Epenses Onl
3)3 "hat coul% 0e the percenta(e o (uarantee% return in all ULI& pension plan5 3)) * person has ta$en a ter# insurance o ) Lac5 "hat is the #ai#u# !ritical Illness Ri%er he can ta$e
Househol% epenses Onl 656.
1 Lac
3), co##utation is a eature o 'hich tpe o polic 3). Mr5 Shar#a 0us a ter# insurance polic alon( 'ith *cci%ent an% +isa0ilit 0eneits ri%er5 The ri%er cost 'oul% 0e restricte% up to 'hat percenta(e o the 0ase pre#iu# o the polic 3)/ Mr5Ra#esh ineste% Rs:,6666 in pension polic; 'hat is the percenta(e he can aail as ee#ption in Inco#e ta5
annuit
3) Mr5Su#esh ta$es a polic an% pas pre#iu# o 26666 'ith a su# assure% o 366666; 'hat 'ill 0e the ta i#plication on his #aturit a#ount 3)4 Fash 'ants to ta$e open #ar$et option in &ension plan5 "hat is the 0eneit 3,6 In risin( lie epectanc the nee% or pension polic is increasin( as retire#ent plannin( is 3,1 Ra#esh 'ants to 0u 1, ears pension plan or retire#ent 'hile calculatin( (aps reGuire% at the en% the (ratuit a#ount 'as co#pletel i(nore% 0ecause he is
9ull taa0le
Unspeciie% reason 656,
2 Lac
3 Lac
oint lie polic 652
656),
pure en%o'#ent polic 653
65)
653333 &ension plan is not eli(i0le or ta ee#ption
1
651
652
sae #ore ta
s'itch the un%erlin( un%
i#proe% annuit rate
Less epensie
Less Transparent
More necessar
sel e#ploe%
"i%o'er
Sain(s are si(niicantl hi(her
QB-ENG-Page 27 of 54
.21 Mr5 * is not satisie% 'ith solutions proi%e 0 Insurer so he approaches O#0u%s#an5 "ithin ho' #uch ti#e the O#0u%s#an has to (ie his reco##en%ation ro# the %ate o receipt o co#plaint
1, +as
.22 On su0#ission o co#plaint a(ainst an insurer to the 16 %as o#0u%s#an; %ecision is #a%e in aour o the polichol%er5 Mai#u# no5 o %as the insurer #ust honour the o#0u%s#ans er%ict: .23 * polic has 0een reecte% 0 the co#pan un%er %irect he has to inor# the custo#er that the co has inti#ation to the custo#er an% cop to the *(ent; 'hat is the 0ro$en relationship 'ith the custo#er net action o the *(ent .2) *n a%isor 'hile eplainin( the polic an% to sell he accepts to (ie a part o his *(ents co##ission; 'hat is the li#its
one #onth
2 Months
1, %as
26 %as
he plans to chan(e the plan
He has to eplain the reasons or reection to the custo#er
651
652 He cannot oer an co##ission
.2, Rau is a certiie% license hol%er un%er 'hat circu#stances he 'hen he sells ter# insurance nee%s to hol% his certiie% license 'ith hi# that is issue% 0 Ir+*
'hen he represents hi#sel as another insurer
'hen he sells pension policies
.2. has lai% %o'n the !o%e o !on%uct or all Insurance Institute o In%ia a(ents .2/ *ter %oin( the nee% a nalsis o the client; the a(ent a%ise% EnGuire a0out the reusal ro# the client the client to opt or TRO& pro%uct5 But the client reuse%5 *ccor%in( to ethical 0usiness practices 'hat 'ill the a(ent %o .2 Un%er the hospital care ri%er 'hat is the paout #a%e 16A o the su# assure%
Insurance Re(ulator @ +eelop#ent *uthorit
In%ian penal co%e
Su((est an alternatie plan
&ass on to the superior
Speciie% a#ount #ultiplie% 0 the nu#0er o %as the polichol%er is hospitali>e%
epenses incurre% per %a #ultiplie% 0 no5 o %as sta in the hospital
.24 Ethics can 0e %eine% as8
Behaior that is 0ase% upon the #oral u%(#ents o an in%ii%ual Un%er sellin( o Insurance policies5
.31 9or an insurance a%isor churnin( is5555555555555practice
(oo%
0a%
* stu% o 'hat #a$es one‟ s o'n actions ri(ht or 'ron(5 Eplainin( all %etails o the polic to custo#er5 co#pulsor
.32 Mr5 Shar#a is a ne'l recruite% insurance a%isor5 To #eet his #onth tar(et he eplains onl the (oo% points o ne'l launche% plan to his custo#er5 Here Mr5 Shar#as 0ehaior
ethical
unethical
proessional
.33 Rahul is a license% insurance a(ent5 *s a(ent he #ust carr out his role in accor%ance 'ith .3) Shan$ar; an a%iser; sol% a ter# insurance polic an% unitlin$e% insurance polic ULI&P to *#ar; the client; 'ho is un#arrie% an% has no %epen%ent5 !onseGuentl; Shan$ar‟ s action can 0e ter#e% as .3, &an$a 0ein( a license insurance a%isor has to ollo' co%e o !on%uct proi%e% 0: .3. I the sales tar(et or an insurance a(ent is si(niicantl re%uce% ; this shoul% nor#all hae 'hat i#pact on the actiit o churnin( .3/ i there is a si(niicant re%uction in the proportion o an Insurers &olicies 'hich are returne% %urin( ree loo$ perio%; this ten%s to in%icate that ethical practices 0 the co#pan
!o#pan‟s co%e o con%uct5
IR+* *cts co%e o con%uct5
IR+* Re(ulations co%e o con%uct5
Un%ersellin( o insurance policies5
!hurnin(5
Oersellin( o insurance policies5
Insurance Re(ulator +eelop#ent *uthorit
Lie Insurance !o#pan
Resere Ban$ o In%ia
Less li$el
More li$el
Less Transparent
hae 'orsene%
hae i#proe%
ocus #ostl on internal actiities
*era(e pre#iu# si>e
Epense ratio
.36 "hich is not unethical 0ehaiour in 0elo' state#ents
Those alues 'e co##onl hol% to 0e C(oo%D a n% Cri(htD5 Oer sellin( o Insurance policies5
.3 "hen insuicient e#phasis is place% on the lon( ter# n ature *era(e polic ter# o Lie Insurance policies %urin( sellin( process; this 'ill oten 0e apparent 0 notin( the i#pact o 'hich $e static .34 "h %oes an Insurer insists on a(e proo %ocu#ents
To calculate S*
9or ris$ *ssess#ent
9or I%entiication &roo
.)6 Mr * su0#itte% the proposal or# ; 'hen 'ill the ris$ 0e(ins or the co#pan .)1 To 0e ali% !ontract ; the %eclaration is necessar in 'hich %ocu#ent .)2 Mr *B! 0uin( is TERM insurance polic ; the insurer shoul% #entione% o#0u%s#an a%%ress in 'hich part o polic
On su0#ission o proposal or#
"hen 9&R is issue%
&olic issue%
&olic %ocu#ent
proposal or#
9&R
Operatie clause
prea#0le
Inor#ation state#ent
.)3 aina0 ta$es Insurance in the lie o as#eet ; aina0 'ill 0e calle% as
&roposer
No#inee
appointee
QB-ENG-Page 51 of 54
3 Months 2
2, %as 2 He ta$es up 'ith the hi(her authorities 3 He can oer up to ,6A 3 un%er all circu#stances ) Resere 0an$ o In%ia
2
&ass on to the other a(ent 1 166A o Su# *ssure% 2 *ll o the a0oe5
)
!hurnin(5
3
apprecia0le
2
&erect5 2 Insurance *cts co%e o con%uct5
3
Ethical practice 0 an a%iser5 3 SEBI5
1
More Transparent 1 ocus #ostl on eternal actiities 1 &ersistenc ratio ) or inancial assess#ent
2
'hen a(ent accepts the #one
2
R&R
2
Sche%ule Trust
3 1
QB-ENG-Page 52 of 54
.)) Loan is aaila0le or a polic in 'hich there is a eature o
9un% s'itch
sain( ele#ent
partial 'ith%ra'al
.), The appointees role 'oul% 0e 'hen
Me%ical chec$ up or polichol%er is there
'hen no#inee is #inor
'hen loan has to 0e ta$en 0
.). I polic has to 0e #a%e &ai% Up ; 'hat particular eature shoul% eist .)/ "h is *!R i#portant
In%eation contri0ution
No#ination acilit
Ri%er Beneits
To calculate co##ission or the a(ent
to eri the plan propose%
.) "hile Un%er'ritin( MR K proposal ; its oun% that there has 0een cri#inal char(es a(ainst hi# in rau%ulent act 5 "hat tpe o Ha>ar% this 'ill 0e cate(orise% into
Occupational
&hsical
to help the un%er'riter to asses the ris$ Moral
.)4 "ho is the pri#ar un%er'riter .,6 Lien can 0e consi%ere% as an alternatie to 'hich o the ollo'in( .,1 *t the ti#e o #aturit o the polic ; the &olichol%er receie% ust Guarter o S* an% 0onus ; 'hat coul% 0e the
Branch un%er'riter !lause
Sales Mana(er Reection
*ctuar acceptance
&artial 'ith%ra'al %one earlier
Lien ha% 0een i#pose%
its a #one 0ac$ polic
.,2 * polichol%er can pa the pre#iu# o Rs ,;66;666 5 "hat coul% 0e the #ai#u# Ta 0eneit he can aail un%er sec 6
,66666
366666
266666
.,3 Ra# has ineste% Rs ,666 in &&9 an% Rs 1 L$ in lie Lie Insurance pre#iu# Insurance pre#iu# 5 In 'hich he (ets #ai#u# ta 0eneit
&&9
,6A IN BOTH
.,) The 0est 'a to oerco#e the pro0le# o inest#ent %ecision %epen%s #ainl on peer inluence is
B canassin( 'i%e peer (roup
see$in( proessional a%ise
(o or lo' inest#ent tranche
.,, *s an inest#ent %iersiication Mr B ; Ineste% in ET9 5 "hats the 'ei(ht o 7ol% or 166 units .,. Insurer transers the ris$ 'hich it cannot 0ear to 'ho#
,?16 (#s
,6?166 (#s
1,?26 (#s
Reinsurance co#pan
Bancassurance
Thir% part a%#iration
.,/ "hat oerri%in( criteria an insurance a(ent consi%er 'hile proposin( a solution ., ie$ ta$es insurance polic @ %ies ater #onths 5 I the clai# nee%s to 0e eclu%e% ; then the 0asis o the eclusion 'oul% 0e 'hich .,4 *ccor%in( to IR+* 1444 ; central (oern#ent inole#ent in insurance sector 'oul% 0e ..6 !o#plaint council 0o%ies other than IR+* (rieance re%ressal oru# @ !O&* 'oul% 0e 'hich one ..1 "hich other 'a IR+* can 0e contacte% apart ro# toll ree nu#0er ..2 Rau is certiie% license hol%er un%er 'hat circu#stances he nee%s to hol% his license 'ith hi# that is issue% 0 IR+*
Ris$
Suita0ilit
9lei0ilit
Mur%er
Bo% not oun%
*cci%ent %eath
In a%ertise#ent
In le(al han%lin( o IR+* pro0le#s
Licensin( o Insurance co#panies
O#0u%s#an
Insurance institute o in%ia
Lie insurance council
Branch oice o insurer
E#ail
Insurance O#0u%s#an
Un%er all circu#stances
"hen he sells ter# Insurance
"hen he is sellin( in %ierent cit
..3 Harish ta$es a lie insurance polic on lie o R*MESH 'ho is his rien% 5 "hich o the ollo'in( state#ents 0est %escri0es the insura0le interest ..) Inestin( In ULI& can (et ee#ption up to 'hat li#it in Sec 6 c .., Suresh 'ants to transer his phsical (ol% into 7ol% ET9 5 In relation to echan(e this 'oul% help hi# in 'hich 'a
Harish is el%er than ra#esh
R*MESH is 'or$in( in oil co#pan an% is rich
Ra#esh o'es #one to Harish
+ecrease his liGui%it
Re%uce his encash#ents
'ill (ie insurance a(ainst certaint
... I#plication o +ail hospitali>ation 0eneit plan 'ill 0e 'hich o theses ../ Ra# has ta$en an En%o'#ent plan or Rs )L S* ; 'hat coul% 0e the #ai#u# S* he can ta$e or a critical Illness ri%er .. "h 'oul% sel e#ploe% in%ii%uals hae the nee% to 0u #e%ical insurance rather than in%ii%uals 'or$in( in &u0lic sector ..4 In 'hich sta(e o lie an in%ii%ual %oes not reGuire an protection coer ./6 Mr has 0een approache% 0 an a(ent an% on act in%in( the score o 3 'oul% in%icate 'hat ris$ appetite or Mr
9ie% @ %ail
onl on selecte% hospitali>ation or sur(eries
Onl in case o critical illness
Rs 2 L
Rs ,6666
Rs ) L$
&u0lic sector in%ii%uals %on ‟t all sic$
Sel e#ploe% in%ii%uals %o not hae sic$ leaes
&u0lic sector in%ii%uals eno #e%ical insurance coers relate% to o0
./1 Both parties to a contract a(ree an% un%erstan% the sa#e thin( an% in the sa#e sense 5 This 'oul% 0e
,6666
166666
266666
!hil%hoo%
Retire#ent
&re Retire#ent
Hi(h Ris$
Lo' ris$
Mo%erate ris$
!onsi%eration
!onsensus a% i%e#
!apa0ilit
QB-ENG-Page 53 of 54
surren%er
2
or si(nin( %eclaration 'hile ta$in( the
2
Sain( Ele#ent
)
to calculate the pre#iu#
3
9inancial 3 )
*(ent Ti#e 0arre%
2
It is a Ter# plan 'ith return o purchase price 166666 4,A IN Lie insurance pre#iu# an% ,A in &&9
3 ) )
&ostpone o inest#ent %ecision 2 16?26 (#s
2
actuaries
1
!ost
2
Suici%e ) issuin( (rants
)
9ER*
1
Hea% oice o Insurer
2
'hen he is sellin( ULI& plans 1 Harish O'es Mone to Ra#esh 3 Nil
2
He%(e a(ainst Inlation 3 S*
1
Rs 1 L$ 3 Sel e#ploe% in%ii%ual 'ants to ta$e 0est o the hospital 0eneits
3
Foun( #arrie%
1
No ris$ 3 !apacit 2 QB-ENG-Page 54 of 54
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