Insurance Terminologies – III


In this 3rd installment of Insurance Terminologies series, let’s look at couple of the jargons which comes across during health insurance purchase or claims.

  • Cumulative Bonus: Cumulative Bonus, as the name suggests, is an increase in the sum insured for the claim free year. This terminology is used in health insurance. This means if the customer has not made any claim for an year, there will be a percentage increase in sum insured which is generally 5% to 10% and can also range from 10% to 50% which varies from insurer to insurer. The maximum bonus given is 50%. One important thing to be noted is that the cumulative bonus is provided on the basic sum insured. For example, if the basic sum insured is INR 100000 and there is no claim made by the customer, the sum insured will be increased by 10% at the time of renewal and hence the new sum insured becomes INR 110000 for the next year. If no claim is reported again in the subsequent year, the cumulative bonus of 10% (10% of 100000=10000) will be provided and the total sum insured will become INR 120000 ( 110000+10000= 120000). As you can see cumulative bonus is calculated on basic sum insured which is INR 100000 in the given example and it is accumulated for every claim free year. The cumulative bonus is added to the sum insured of preceding year which becomes the new sum insured for subsequent year (110000+10000= 120000).
  • Waiting period: Waiting period is the duration for which the coverage is not provided. Health insurance policies have waiting period of 30-60 days. This means any claim made during this period is not payable even though if the loss occurred due to the risks covered in the policy. Any claim made post waiting period is payable provided the loss would have occurred due to the perils covered in the policy. One important point to be noted is that for pre-existing disease, waiting period is 48 months (4 years). Pre-existing diseases are covered after 4 years from the inception of the policy.

Ashish Kumar

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Insurance Terminologies – II


I started this series of posts related to the terminologies used in insurance. In this second installment, let us know few of them which is discussed below.

  • Premium: It is the consideration that one pays in monetary value for buying the insurance policy. The money paid by you to purchase the insurance policy is known as the premium. As per Section 64VB of Indian Insurance Act 1938, premium should be paid in advance before the risk coverage starts. Hence, no coverage will be provided before paying the premium.
  • Indemnity: Indemnity means bringing back to the same financial condition as if the loss didn’t occurred. This is one of the basic principles of insurance which states that there should be no benefit out of the coverage. Meaning that if the person suffers a loss of INR 10000 due to the peril covered in the policy, the insurance company will pay only the amount of loss i.e INR 10000 and not more than that even though the policy cover is of greater value say INR 100000. The amount paid by the insurance company is subject to the total amount covered in the policy. This principle is applicable in general insurance while in life insurance, principle of indemnity is not applicable.
  • Endorsement: This means any alterations or modifications in the insurance policy. Endorsement can be financial or non financial. Financial endorsement includes change in the sum insured, change in premium etc. Non-financial endorsement endorsement includes change in address, change of contact details, email id etc. A written application by the policyholder has to be given to the insurance company for any endorsement.

Ashish Kumar

Insurance Terminologies – I


I have decided to start a new series of post containing various terminologies related to insurance which one can come across in dealing with insurance related matters. This is the first installment of this series. I will keep things simple and straightforward so that any one reading the post can understand. I will not cover too much terminology in one post. Each post will contain three to five terminologies. This may also be helpful to those pursuing or willing to pursue their study in insurance. So let’s start.

  • Insured: Insured is the person who has taken the insurance policy. The other word which is synonymous to this is the policyholder. Both are synonymous to each other. Suppose, if you have taken a life insurance policy, then you are the insured or the policyholder.
  • Insurer: This is the insurance company which provides you the insurance. The company providing life insurance is known as life insurer and the company providing non-life insurance is known as non-life or general insurer. Some of the insurers in India are LIC of India, ICICI Lombard, SBI Life Insurance, SBI General Insurance, HDFC Ergo General Insurance, Bajaj Allianz General Insurance, PNB Metlife etc.
  • Beneficiary: This is the individual who will receive payment due to annuity, life insurance policy etc. Nominee is an example of beneficiary who receives the payment on the event of insured death.

Ashish Kumar

About IRDAI


The insurance industry in India is regulated by Insurance Regulatory and Development Authority of India (IRDAI), headquartered at Hyderabad. IRDAI was formed by an Act of Parliament in 1999. The IRDA Act, 1999 paved the way for the formation of IRDAI. The history goes back to the recommendations of Malhotra Committee where the need for a regulator for insurance sector was suggested. Being the regulator IRDAI carries various functions like:

  • Protecting policyholder’s interest.
  • Granting of license to insurers, brokers etc.
  • Renew, modify, suspend, and cancel the registration.
  • Promoting efficiency in the conduct of insurance business.
  • Regulating investment funds by insurance companies.
  • Regulating maintenance of margins of solvency etc.

Apart from Hyderabad where it is headquartered, the Authority also has office in New Delhi and Mumbai. The composition of Authority as defined in Section 4 of IRDA Act, 1999 consists of 10 members which comprise of the following:

  • A Chairman
  • Five whole time members
  • 4 part-time members.

All the members are appointed by Government of India.

IRDAI is the regulating all forms of insurance except pension funds and postal insurance. Pension fund is regulated by Pension Fund Regulatory and Development Authority (PFRDA). Postal insurance include Postal Life Insurance (PLI) and Rural Postal Life Insurance (RPLI).

One of the reform measures initiated by IRDAI for general insurance industry came in 2007 when general insurers were allowed to price the premium accordingly. Prior to that, premium pricing was decided by Tariff Advisory Committee (TAC). Hence this is also known detariffing where general insurers are now allowed to decide the price of the premium. General insurers are allowed to decide the premium price to all forms of insurance except motor third party liability where the premium price is decided by IRDAI.

IRDAI is also the promoter of the following organizations:

  • Institute of Insurance and Risk Management (IIRM), Hyderabad: IIRM Hyderabad was established jointly by IRDAI and Government of Telangana in 2002. The institute provides quality education in insurance, risk management, Financial services, Acturial Science etc. The institute provides 1 year International Post Graduate Diploma (IPGD) and two year full time masters i.e Post Graduate Diploma in Management (PGDM). It is one of the rare institutes in the country providing MBA in insurance and related fields. The insurance course is accredited by Chartered Insurance Institute (CII), London and Insurance Institute of India (III), Mumbai. This is a good platform for those who wish to build their carrier in insurance.
  • Insurance Information Bureau of India (IIB): IIB was promoted by IRDAI in 2009 with the participation of stakeholders from insurance sector, with the objective of supporting the insurance industry with sector-level data to enable data based and scientific decision making including pricing and framing of business strategies.

This was a brief introduction about IRDAI and I hope it will be informative. I will be coming up with various other topics related to insurance from time to time. Stay tuned.

– Ashish Kumar

Insurance industry in India


 

Insurance is a part of financial services apart from banking, capital market, money market etc. Insurance is considered as a protection from events which results into financial loss. The insurance industry in India comprises of life insurance, general insurance, stand alone health insurance and reinsurance. The Indian insurance industry is guided by Insurance Act, 1938 which was amended from time to time, the latest amendment happened in 2015.

This post briefly gives an overview of insurance sector in India particularly discussing about the regulator, life insurance, general insurance, stand alone health insurance and reinsurance. The life insurance comprises of around 79% of the market, the rest 21% is occupied by general insurance. Of the general insurance, motor insurance has the highest market share of 44% followed by health insurance having market share of 29%, as per IRDAI Annual Report 2015-16. It is worth to mention that the insurance industry in India has showed a significant growth after it got opened for private sector in the year 2000. Since then, the industry is growing rapidly. In 2015, the reinsurance sector was allowed for foreign players which were solely dominated by General Insurance Corporation of India (GIC Re).  A small discussion about regulator, life insurance, stand alone health insurance and reinsurance is mentioned below.

Regulator:  Indian insurance industry is regulated by Insurance Regulatory and Development Authority of India (IRDAI) which was formed by an Act of Parliament in 1999. The Insurance Regulatory and Development Authority (IRDA) Act was passed in 1999 leading to the formation of IRDAI. IRDAI is headquartered in Hyderabad and has offices in New Delhi and Mumbai. The regulator is responsible for carrying various activities like granting license to insurance companies, framing regulations which the insurers need to follow, protecting policyholder’s interest etc. Breach of IRDAI regulations can have serious implications resulting from penalty to cancellation of license of the insurance company.

Life Insurance: At present, there are 24 life insurers in India, of which, Life Insurance Corporation of India (LIC) is wholly owned by the Government of India. LIC was formed in September 1956 by an Act of Parliament known as LIC Act, 1956.  Some of the private life insurers include ICICI Prudential Life Insurance, HDFC Standard Life Insurance, SBI Life Insurance etc.

General Insurance: Non-life or general insurance comprises of all kinds of insurance except life. It has various segments comprising of motor insurance, health insurance, fire insurance, marine insurance, engineering insurance, aviation insurance, satellite insurance etc. There are 33 non-life insurers operating in India consisting of public and private insurers. The public insurers include the following:

  • The New India Assurance Co Ltd. (NIACL), headquartered at Mumbai.
  • National Insurance Co Ltd. (NICL), headquartered at Kolkata.
  • Oriental Insurance Co Ltd (OIICL), headquartered at New Delhi.
  • United India Insurance Co Ltd (UIICL), headquartered at Chennai.
  • Export Credit Guarantee Corporation of India (ECGC)
  • Agriculture Insurance Company of India (AIC)

ECGC and AIC are known as specialized insurers. Apart from above mentioned public sector companies, some of the private non-life insurers include ICICI Lombard, HDFC Ergo General Insurance, SBI General Insurance, IFFCO Tokio General Insurance, Tata AIG General Insurance etc.

Standalone Health Insurance: These are those companies which are solely carrying their business on health insurance. There are six stand alone health insurers like Apollo Munich Health Insurance, Star and Allied Health Insurance, Max Bupa Health Insurance, Cigna TTK Health Insurance, Religare Health Insurance and Aditya Birla Health Insurance. One of the ways to recognize the stand alone health insurers is that the stand alone health insurers will have the word “health insurance” in the name of the company as in the above mentioned six stand alone health insurers.

Reinsurance: General Insurance Corporation of India (GIC Re) is owned by the Government of India and is the national reinsurer which is headquartered at Mumbai. The reinsurance industry in India is now opened for foreign players to open their branch offices in after the Insurance Act, 1938 was amended in 2015. At present there are 9 foreign reinsurers who have opened their branch offices in India. They are mentioned below:

  • Swiss Re
  • Munich Re
  • Llyod’s India
  • Reinsurance Group f America (RGA)
  • Hannover Re
  • SCOR
  • XL Insurance Company
  • Axa France Vie
  • General Reinsurance AG

It is important to note that apart from GIC Re and the above mentioned foreign reinsurers, ITI Re is the first private Indian reinsurance company which got licensed by IRDAI. Hence the Indian reinsurers include GIC Re and ITI Re.

 

Apart from the above players, the insurance industry also comprises of various intermediaries and distribution channels like agents, brokers, Insurance Marketing Firms (IMF), Web Aggregators etc. which I will discuss in separate post.

One thing to be noted is that the insurers in India can take part in either life insurance or general insurance business and not both. This means that a life insurer cannot start their business of motor insurance, fire insurance etc and vice versa. Health insurance is the only insurance product which can be offered by both non-life and life insurers. Non-life insurers can sell separate health insurance policy while life insurers offer health insurance in the form of riders. Riders are the extra benefits which are covered by paying some extra premium. Example of riders include Accidental Death Benefit (ADB) rider, critical illness rider etc. Life  insurers cannot offer separate health insurance products.

– Ashish Kumar