Understanding Insurance Services Basics
Understanding Insurance Services Basics
Introduction
Uncertainty, risk and insecurity are incidental. This makes insurance indispensable for an individual or
business. Insurance is a form of risk management primarily used to hedge against the risk of loss. It is
the equitable transfer of risk of potential loss from one entity to another in exchange for a premium.
Definition of Insurance
Insurance is defined as a contract in writing under which one party agrees to indemnify the other party
against a loss or damage suffered by it on account of an uncertain future, in return for a consideration
called ‘premium’.
The person/business who gets its life/property insured is called ‘Insured/Assured’. The agency which
helps in entering into an insurance arrangement is called ‘Insurer/Insurance Company’. The agreement
or contract which is put in writing is called a ‘Policy’.
Nature of Insurance
1. Contract
It is a contract between two parties in which one party agrees to provide protection to other party
from losses in exchange for premium. The parties are insurer and insured. Insurer guarantees
compensation in occurrence of any contingency to insured and insured pays premium to insurer
for protection. Insurance companies accept the offer made by the insurance policy holder and
enter into contract. Contract for insurance is always in written.
2. Lawful Consideration
Existence of lawful consideration is a must for insurance contract like any other lawful contract.
Insurance policy holder is required to pay premium regularly to the insurance company. This
premium is paid in exchange for protection against losses and damages guaranteed by insurance
companies.
3. Payment on Contingency
Insurer has to compensate the insured only on happening of contingency for the damages and
losses done. Insured cannot make profit from insurance policy but can only claim compensation
from insurer in case of contingency. If no contingency occurs, insurer is not required to pay any
compensation to insured.
4. Risk Evaluation
Insurer evaluates risk associated with the subject matter of insurance contract. Proper risk
evaluation enables insurer to calculate the right amount of premium to be paid by insured. Insurer
uses different techniques for risk evaluation. If insurance object is subject to heavy losses, heavy
premium will be charged. On the other hand, if there is less expectation of losses then low
premium will be charged.
6. Cooperative device
It’s a cooperative device to pool risk among large number of persons. It is a platform where
different persons come together to share risk by taking insurance policy from insurer. All pay
premium regularly to insurance companies. If any of the person incurs losses or damages due to
occurrence of any contingency, insurance company will compensate him out of premiums paid
by different persons.
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7. Not Charity or gambling
Insurance is a legal contract and cannot be termed as a charity or gambling. Compensation paid
to insured by insurer is not in charity but is paid in exchange of premium. Insured cannot make
profit out of insurance policy and is meant for recovering him from losses only. The insured is
paid compensation only when losses are incurred due to contingency.
Principles of Insurance
1. Utmost Good Faith
An insurance contract is known as a contract of ‘Uberrimate Fidel’ or a contract based on ‘utmost
good faith’. It means both the parties must disclose all material facts. Any fact is material which
goes to the root of the contract of insurance and has a bearing on the risk involved. It is only
when the insurer knows the whole truth that he is in a position to judge:
a) Whether he should accept the risk
b) What premium he should charge.
Concealment of any fact will entitle the insurer to deprive the assured of benefits of the contract.
Also, as insurance shifts risk from one party to another, it is essential that there must be utmost
good faith and mutual confidence between the insured and the insurer.
2. Indemnity
A contract of insurance is a contract of indemnity. It means that the insured, in case of loss
against which the policy has been issued, shall be paid the actual amount of loss not exceeding
the amount of the policy, i.e. he shall be fully indemnified. The object of every contract of
insurance is to place the insured in the same financial position, as nearly as possible, after the
loss, as if the loss has not taken place at all. This is applicable to all types of insurance except
life, personal accident and sickness insurance. A contract of insurance does not remain a contract
of indemnity if a fixed amount is paid by the insurer to the insured on the happening of the event
against, whether he suffers a loss or not. Like, in case of life insurance, the insurer is liable to pay
the sum mentioned in the policy on the death, or expiry of a certain period.
3. Insurable Interest
It means that the insured must have an actual interest in the subject matter of insurance. A
contract of insurance affected without insurable interest is void. A person is said to have an
insurable interest in the subject matter if he is benefited by its existence and is prejudiced by its
destruction. For example, a person has insurable interest in the building he owns; employer can
insure the lives of his employees because of his pecuniary interest in them; a businessman has
insurable interest in his stock, plant and machinery, building, etc. So, all these people have
something at stake and all of them have insurable interest. It is the existence of insurable interest
in a contract of insurance which distinguishes it from a mere wagering agreement. In case of life
insurance, insurable interest must be present at the time when the insurance is affected. It is not
necessary that the assured should have insurable interest at the time of maturity also. In case of
fire insurance, insurable interest must be present both at the time of insurance and at the time of
loss. In case of marine insurance, interest must be present at the time of loss. It may or may not
be present at the time of insurance.
4. Causa Proxima
Causa proxima means that cause of loss must be proximate or immediate and not remote. If the
proximate cause of the loss is a peril insured against, this insured can recover the loss. When a
loss has been brought about by two or more causes, the real or the nearest cause shall be the
causa proxima, although the result could not have happened without the remote cause. But, if the
loss is brought about by any cause attributable to the misconduct of the insured, the insurer is
liable. In a contract of insurance the insurer undertakes to protect the insured from a specified
loss and the insurer receives a premium for running the risk of such loss. Thus, risk must attach
to a policy.
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5. Mitigation of Loss
In the event of some mishap to the property of the insured, the insured must take all necessary
steps to mitigate or minimise the losses, just as any person would do in case of loss attributable to
his negligence. Insured is bound to do his best for his insurer, but he is not bound to do so at the
risk of his life.
6. Subrogation
Subrogation means something that is natural and is result of something else. According to it,
when an insured has received full indemnity in respect of his loss, all rights and remedies which
he has against third person, will pass on to the insurer and will be exercised for his benefit until
he (the insurer) recoups the amount he has paid under the policy. The insurer’s right of
subrogation arises only when he has paid for the loss for which he is liable under the policy and
this right extends only to the rights and remedies available to the insured in respect of the thing to
which the contract of insurance applies.
7. Contribution
When there are two or more insurances on one risk, principle of contribution comes into play.
Aim of contribution is to distribute the actual amount of loss among the different insurers who
are liable for the same risk under different policies in respect of the same subject matter. Any one
insurer may pay to the insured the full amount of the loss covered by the policy and then become
entitled to contribution from his co-insurers in proportion to the amount which each has
undertaken to pay in case of the loss of the same subject matter.
Types of Insurance
I. Life Insurance
II. Non-Life Insurance
1. Marine Insurance
2. Fire Insurance
3. Motor insurance
4. Heath/Medical Insurance
5. Burglary Insurance
6. Crop Insurance
I. Life Insurance
It is a contract between the insurer and the person who is insured against the risk to his life. The insured
person pays premium regularly to the insurance company once the policy is taken and in lieu of this, the
insurer promises to pay a fixed sum of money at the time of the death of insured or on the expiry of a
specified period of time, whichever is earlier. Payment for life insurance is certain but the event for
which insurance is taken is not certain. If the insured dies during the policy period his family/nominee
gets the sum assured along with the bonus accrued. If the insured survives the policy period he gets the
maturity amount accrued under the policy.
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Step 9: Commencement of Risk
As soon as the first installment is paid by the insured, the risk is automatically transferred to the
insurance company or the insurer.
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2. Survival Benefit Claim
It is not payable under all types of plans. It is payable in case of endowment or money back plans
after a lapse of a fixed period say 4 or 5 years, provided the policy is in force and the
policyholder is alive. The insurer sends premium notices to the policyholder for payment of
premium due and also sends intimation to the policyholder when a survival benefit falls due.
Letter of intimation of survival benefit carries with it a discharge voucher mentioning amount
payable. The policyholder has to return the discharge voucher duly signed along with the policy
document. The policy document is necessary for endorsement to the effect that the survival
benefit which was due has been paid. The survival benefit can take different forms under
different types of policies.
3. Maturity Claim
It is final payment under the policy as per the terms of the contract. The insurer is under
obligation to pay amount on due date. The intimation of maturity claim and discharge voucher
are sent in advance with instruction to return it soon. If the life assured dies after the maturity
date, but before receiving the claim, there arises a typical problem as to who is entitled to receive
the money. As the policyholder was surviving till the date of maturity, the nominee is not entitled
to receive the claim. The policy under such conditions is treated as death claim where the policy
does not have nomination. The insurer in such a case shall ask for a will or succession certificate,
before it can get a valid discharge for payment of this maturity claim. If maturity claim is
demanded within one year, before the maturity it is called a discounted maturity claim. This
amount is much less than the maturity claim. The following documents are to be submitted:
(a) Age proof, if age is not admitted.
(b) Original policy document for cancellation.
(c) In case assignment is executed on a separate paper, that document has to be surrendered.
(d) Discharge form duly executed.
(e) Indemnity bond in case policy document is lost or destroyed, duly executed by the
policyholder and a surety of sound financial standing.
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(d) Valued Policy
It is a policy in which the subject matter is agreed upon between the insurer and the insured and it
is specified in the policy itself.
2. Fire Insurance
Contract by which the insurer in return for a consideration (premium) agrees to indemnify the
insured for the financial loss which the latter may suffer due to destruction of or damage to
property or goods, caused by fire, during a specified period. The contract specifies the maximum
amount agreed to by the parties at the time of contract, which the insured can claim in case of
loss. The loss can be ascertained only when the fire has been occurred. Insurer is liable to make
good the actual amount of loss not exceeding the maximum amount fixed under the policy. Fire
insurance policy cannot be assigned without permission of insurer because the insured must have
insurable interest in the property at the time of contract as well as at the time of loss. Insurable
interest in goods may arise out on account of
(a) Ownership
(b) Possession
(c) Contract
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(e) Replacement Policy
It is also known as re-instatement policy. In this a insurer inserts a re-instatement clause,
whereby he undertakes to pay the cost of replacement of the property damaged or destroyed by
fire. Thus he may re-instate or replace the property instead of paying cash. In this, the insurer has
to select one of the two options. Once chosen he cannot change to other option.
3. Health Insurance
It is type of insurance that covers medical expenses that arise due to an illness. These expenses
could be related to hospitalization costs, cost of medicines or doctor consultation fees. Health
insurance has become a necessity today because it plays an important role in health care. One
never knows when illnesses may strike. Health insurance can be a source of support by taking
over the financial burden the family may have to go through. Health insurance policies cover the
following:
(a) Medical expenses incurred prior to hospitalization
(b) Cashless hospitalization for all the expenses incurred in the hospital
(c) Post-hospitalization expenses
(d) Expenses incurred on ambulance services
(e) Expenses incurred for general health examination
(f) Daily hospital allowance
Family cover:
(a) Whole family covered under one policy
(b) Each member is eligible
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(c) Pre-existing diseases covered
The cost of health insurance premium is deductible to the payer and the benefits received are tax
free.
4. Motor Insurance
Under this, a personal or commercial vehicle is subjected to combined insurance against the risk
of:
(a) Loss or damage to the vehicle
(b) Death of or injury to the owner or passenger
(c) Damages possible to the third party by the owner of vehicle
(d) Insurance against the first two cases is optional but every owner has to take the insurance under
the third case as it is compulsory under Motor Vehicle Act of 1956.
A motor insurance policy is a mandatory policy issued by the insurance company as a part of
prevention of public liability to protect the general public from any accident that might take place
on the road.
5. Crop Insurance
It is a means of protecting the agriculturist against financial losses due to uncertainties that may
arise from crop failures/losses arising from all unforeseen perils beyond their control. It is
purchased by agricultural producers, and subsidized by the government, to protect against either
the loss of their crops due to natural disasters, or the loss of revenue due to declines in the prices
of agricultural commodities. A number of crops are covered with includes:
(a) Food crops (Cereals, Millets and Pulses), Oilseeds, Annual Commercial/Annual
horticultural crops
(b) Covers damages due to local calamities, landslides, etc. and risk relating to sowing,
germination, etc.
(c) Crop insurance is categorized into 3 types:
(i) Multiple Peril Crop Insurance
It provides financial coverage to manage risks arising from weather-related losses, such
as a flood, drought, etc.
6. Burglary Insurance
It is insurance against loss or damage resulting from or following the unlawful breaking and
entering of designated premises or places of safekeeping. It is a type of insurance that protects
you against the financial loss you might sustain in the event of a break-in or an attempted break-
in at your home or place of business. A forced entry into a home or company to steal something
is referred to as a burglary. Insurance companies require policyholders to notify the authorities of
the burglary as one of the first steps before they make the claim. Before paying any claims, the
insurance company requires documented proof of ownership of the existence of the goods prior
to the burglary. This enables them to avoid losses arising from individuals fabricating the
ownership of goods for monetary gains.
Landmark Developments
1. Pre-Independence Developments
The history of life insurance in India dates back to 1818 when it was conceived as a means to
provide for English Widows. Interestingly in those days a higher premium was charged for
Indian lives than the non-Indian lives as Indian lives were considered more risky for coverage.
The Bombay Mutual Life Insurance Society started its business in 1870. It was the first company
to charge same premium for both Indian and non-Indian lives. The Oriental Assurance Company
was established in 1880. The General insurance business in India, on the hand, can trace its roots
to the Triton (Tital) Insurance Company Limited, the first general insurance company established
in the year 1850 in Calcutta by the British. Till the end nineteenth century insurance business was
almost entirely in the hands of overseas companies. Insurance regulation formally began in India
with the passing of the Life Insurance Companies Act of 1912 and the provident fund Act of
1912. Several frauds during 20’s and 30’s sullied insurance business in India. By 1938 there were
176 insurance companies. The first comprehensive legislation was introduced with the Insurance
Act of 1938 that provided strict State Control over insurance business.
2. Post-Independence Developments
The insurance business grew at a faster pace after independence. Indian companies strengthened
their hold on this business but despite the growth that was witnessed, insurance remained an
urban phenomenon. The Government of India in 1956, brought together over 240 private life
insurers provident societies under one nationalised monopoly corporation and Life Insurance
Corporation (LIC) was born. Nationalisation was justified on the grounds that it would create
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much needed funds for rapid industrialization. This was in conformity with the Government’s
chosen path of State lead planning and development. The (non-life) insurance business continued
to thrive with the private sector till 1972. Their operations were restricted to organised trade and
industry in large cities. The general insurance industry was nationalised in 1972. With this,
nearly 107 insurers were amalgamated and grouped into four companies - National Insurance
Company, New India Assurance Company, Oriental Insurance Company and United India
Insurance Company. These were subsidiaries of the General Insurance Company (GIC).
Cross Selling
Meaning of Cross Selling
It is a method that companies, businesses and agencies use/employ to generate more sales. It is done by
recommending items to customers related to, in addition to, or complementary to the item the buyer is
already committed to purchase. It is a sales strategy pointed at producing more deals by proposing extra.
In insurance industry, cross-selling is when one sells additional insurance products to an established
client. Cross-selling insurance allows a company to earn additional profit without the cost of searching
for new leads. Firm can build client relationship by staying up to date on events and changes in clients’
lives-which might require new or greater coverage. It leads to improved client retention. However, cross-
selling must be done in the right way because if clients are aggressively pushed to purchase products
they don’t want or need, a firm might risk losing their business.
4. Greater convenience
Convenience is important to today's consumers. Nobody wants to drive from store to store
looking for every product they need. Even moving from one website to another can be difficult.
As a result, when you cross-sell them a product they adore, customers will be delighted to return
time and time again. Firms should strive to become a one-stop-shop, and thus they will have an
easier time competing.
3. Bad practices may compel customers to buy items they don’t need
When customers are offered items unrelated to what they are purchasing, they may feel pressured
to buy things they don’t need. This may increase initial purchases, but it can have a detrimental
effect on long-term customer retention. Agencies can avoid this by being aware of who their
target audience is and what they need so that they can offer items that will suit the clients they
have.
Bancassurance
Meaning of Bancassurance
It is an arrangement between a bank and an insurance company, allowing the insurance company to sell
its products to the bank's client base. This partnership arrangement can be profitable for both companies.
Banks earn additional revenue by selling insurance products and insurance companies expand their
customer base without increasing their sales force. Banks can easily earn profits without doing any risky
work. Banks need to sell insurance company products, and in return, the bank will get a commission.
Banks will get more benefits by offering life insurance products because they will get a chance to build
good relationships with customers. Life Insurance companies will organize specialized training for bank
employees, which is an added benefit for the bank.
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Merits of Bancassurance – Customers
1. One-stop shop for all financial needs
It provides the end users a customized insurance solution by giving a right product at a right time
i.e. at a location; they already are for their financial needs – their bank. This improves the overall
experience of the customers. They are more likely to opt for a complete financial solution from
their banks, thus making bancassurance a success.
3. Ease of Renewals
Banks being in the forefront in dealing with customers, handle renewals as well. This makes the
transaction hassle-free. With new technology and data access for the bancassurance channel,
tracking renewals is very easy.
4. Trust
Customers trust their banks to sell them the right product. The trust they would place on
insurance carriers and independent agents is comparatively lesser. Therefore, the propensity to
buy insurance products from their banks is higher.
5. Expert Advice
Banks have mounds of customer data. This, along with insurance carriers’ expertise in packaging
insurance products helps the alliance suggest the right products. Customers also recognize this
expertise, majorly because of their trust in their banks.
Demerits of Bancassurance
1. Data management of an individual customer’s identity and contact details may result in the
insurance company utilizing the details to market products, thus compromising on data security.
2. There is a possibility of the conflict of interest between the other products of bank and insurance
policies (like money back policy). This could confuse the customer regarding where he has to
invest.
3. Better approach and services provided by banks to customer is a hope rather. This is because
many banks in India are known for their bad customer service and this fact turns worse when
they are responsible to sell insurance products.
4. Work nature to market insurance products requires submissive attitude, which is a point that has
to be worked on by many banks in India.
5. Need for training for those who will handle this because of a lack of vision and awareness.
Reinsurance
Meaning of Reinsurance
Reinsurance is insurance of insurance, where one or more insurance companies agree to indemnify the
risk, partially or altogether, for the policy issued by another one or more insurance companies.
Reinsurance indicates the process where the original insurer accepted the risk from the original insured
gets the risk covered by another insurer or reinsurer for the same reason the original insured got
protection. Reinsurance is a deal wherein the insurer shares a part of the risk portfolio with another
insurance firm. It helps spread the risk to avoid an enormous unmanageable financial strain on a single
entity. The insured entity is called a ceding insurer, while the organization reinsuring it in return for a
portion of the insurance premium is labeled a reinsurer. Moreover, the ceding insurer can promptly buy
it from the reinsurer or by a mediator or liaison.
Importance of Reinsurance
1. Reinsurance helps decrease risk
When an insurance company singularly insures a large number of clients and their property, they
take on a huge amount of risk. Reinsurance is a great strategy to reduce that risk, placing some of
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the burden on a reinsurance company instead of shouldering the burden completely alone.
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