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## IC - 38 **CORPORATE AGENTS** **LIFE****ACKNOWLEDGEMENT****This course is based on revised syllabus prescribed by Insurance Regulatory and**
**Development Authority of India (IRDAI) and prepared by Insurance Institute of**
**India, Mumbai.****AUTHORS/ REVIEWERS (in Alphabetical order)**Dr. R. K. Duggal
Dr. Shashidhar... | Final IC 38 - CA_Life - English.md | C-46 | CORPORATE AGENTS | Final IC 38 - CA_Life - English_000 | {
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|L-05|Applications of Life Insurance|38|
|L-06|Pricing and Valuation in Life Insurance|43|
|L-07|Life Insurance Documentation|52|
|L-08|Life Insurance Underwriting|65|
|L-09|Life Insurance Claims <br>|78|iv## SECTION## LIFE INSURANCE1## CHAPTER L-01## WHAT LIFE INSURANCE INVOLVES**Chapter Introduction**We have seen som... | Final IC 38 - CA_Life - English.md | L-05 | Chapter Introduction | Final IC 38 - CA_Life - English_001 | {
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income. Thus one should grow suspicious if Mr. Rajan was to ask insurance of Rs. 2
crores, while earning only Rs. 1.2 lakhs a year. The actual amount of insurance
purchased would depend on factors like how much insurance one can afford and
would like to buy.**B.** **Risk and Life Insurance**As we have seen above, life ... | Final IC 38 - CA_Life - English.md | null | B. | Final IC 38 - CA_Life - English_002 | {
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claims of those dying at higher ages. The level premium is an average of both. The
excess premiums of earlier ages compensate for the deficit of premiums in later
ages. The level premium feature is illustrated below.**Diagram 2:** **Level Premium**Level premiums are required because life insurance contracts are long te... | Final IC 38 - CA_Life - English.md | t2 | Diagram 2: | Final IC 38 - CA_Life - English_003 | {
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expected net future earnings.c) The level premium is a premium fixed such that it does not increase with agebut remains constant throughout the contract period.d) Mutuality is one of the important ways to reduce risk in financial markets, theother being diversification.e) The element of guarantee in a life insurance co... | Final IC 38 - CA_Life - English.md | t2 | Key Terms | Final IC 38 - CA_Life - English_004 | {
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concerned about the high cost of education to make the child qualified
to face the challenges of life.For instance, consider the amount that
needs to be set up to finance a medical course that runs for five years.In
many Indian homes, making provision for marriage and settlement of
girl children is a critical area of c... | Final IC 38 - CA_Life - English.md | e11 | Empty Nester(age 55 to 65): | Final IC 38 - CA_Life - English_005 | {
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There are two types of such needs:**i.** **Specific transaction needs** : that are linked to specific life events whichrequire a commitment of resources. For instance making a provision for
higher education/ marriage of dependents; or purchase of a house or
consumer durables**ii.** **General transaction needs:** Amount... | Final IC 38 - CA_Life - English.md | e11 | Specific transaction needs | Final IC 38 - CA_Life - English_006 | {
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needs along with his or her risk profile and income, to chart out a road map for
meeting various anticipated/ unforeseen needs through recommending appropriate
financial products.Elements of financial planning include: Investing - allocating assets based on one’s risk taking appetite, Risk management, Retirement pla... | Final IC 38 - CA_Life - English.md | c14 | Diagram 4: | Final IC 38 - CA_Life - English_007 | {
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An unplanned, impulsive approach to financial planning is one of the prime causes
of financial distress of individuals.**Test Yourself 2**When is the best time to start financial planning?I. Post retirement
II. As soon as one gets his first salary
III. After marriage
IV. Only after one gets rich**C.** **Financial plann... | Final IC 38 - CA_Life - English.md | null | Test Yourself 2 | Final IC 38 - CA_Life - English_008 | {
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For instance, if an amount of Rs 1000 is invested today at 8% rate of interest,
at the end of five years, it would accumulate to Rs 1469 and at the end of
10 years it would more than double to reach Rs 2159. This expectation of
returns which helps to accumulate wealth is one of the prime motives of
investment. At the s... | Final IC 38 - CA_Life - English.md | null | Risk tolerance | Final IC 38 - CA_Life - English_009 | {
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or utilised according to one’s wishes after one is no more.**6.** **Tax planning**Tax planning is done to determine how to gain maximum tax benefit from existing
tax laws and also for planning of income, expenses and investments taking full
advantage of the tax breaks. As per the tax laws in India, life insurance premi... | Final IC 38 - CA_Life - English.md | s19 | Tax planning | Final IC 38 - CA_Life - English_010 | {
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agent’s role is to understand and pitch on these features and benefits to make the
products of their companies unique and attractive compared to others.**Example**Colgate, Close up and Promise are all different brands of toothpastes. But the
features of each brand is different from the other.Products may be:**i.** **Ta... | Final IC 38 - CA_Life - English.md | p24 | Example | Final IC 38 - CA_Life - English_011 | {
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of the contract. Riders are commonly used to provide supplementary benefits like
increasing the amount of death benefit provided by a policy, say, because of
accidents. Life insurance companies offer a number of riders through which the
value of their offerings get enhanced Riders help to customise different
requiremen... | Final IC 38 - CA_Life - English.md | p24 | Test Yourself 1 | Final IC 38 - CA_Life - English_012 | {
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one to buy relatively large amounts of life insurance on a limited budget.**f)** **Variants**A number of variants of term assurance are possible.**Diagram 3:** **Variants of Term Assurance****i.** **Decreasing Term Assurance**
These plans typically consist of decreasing term insurance which provides an
amount of death ... | Final IC 38 - CA_Life - English.md | e26 | Variants | Final IC 38 - CA_Life - English_013 | {
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compulsory method of savings accumulation.People buy endowment plans as a sure method of providing against old age or for
meeting specific purposes like having a fund for (a) educational purposes, (b)
meeting children’s marriage expenses or(c) paying a mortgage (housing) loan.**Government usually offers tax benefits on... | Final IC 38 - CA_Life - English.md | a28 | Government usually offers tax benefits on the premiums paid, which make it | Final IC 38 - CA_Life - English_014 | {
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be disclosed at the time of taking the policy.**Important**Death benefits are subject to regulations of IRDAI issued from time to time. At
present, as per the new Regulation 9 of IRDAI (Non-linked) Products Regulation,
2019 pertaining to traditional products, the minimum death cover is as follows:For all non-linked ind... | Final IC 38 - CA_Life - English.md | null | Important | Final IC 38 - CA_Life - English_015 | {
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annuity options.**Saral Pension:** To provide uniformity across Insurers, to reduce confusion in the
market about annuity schemes, and to make available a product that will broadly
meet the needs of an average customer, in January 2021, IRDAI mandated all Life
Insurers to introduce a standard, immediate annuity product... | Final IC 38 - CA_Life - English.md | o4353 | Saral Pension: | Final IC 38 - CA_Life - English_016 | {
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products which have insurance as well as a savings element in them.People have been questioning the ability of traditional life insurance policies to
provide a rate of return comparable to other assets in the financial market. Issues
have also been raised about the way they are structured into a single package of
benef... | Final IC 38 - CA_Life - English.md | e2019 | Limitations of traditional products | Final IC 38 - CA_Life - English_017 | {
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displacing traditional plans in many markets.Unit linked policies help to overcome the limitations of traditional products.
The premium paid by the policyholder gets divided into two major portionsthe first portion which is utilised for providing insurance cover, andthe second portion that gets invested into the fund o... | Final IC 38 - CA_Life - English.md | null | Diagram 1: | Final IC 38 - CA_Life - English_018 | {
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the benefits, vis-à-vis the premiums paid, would be very low and even less than the
premiums paid in the early years of the contract.**iv.** **Death Benefit**Unlike in traditional policies, the amount of death benefit in ULIP policies is a
multiple of the premiums paid. In case of death during the term of the policy, t... | Final IC 38 - CA_Life - English.md | e2 | Death Benefit | Final IC 38 - CA_Life - English_019 | {
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becomes payable to the Official Trustee of the State in which the office at
which the insurance was effected is situated.39**Benefits**The Trust is set up under a deed that cannot be revoked or amended. It can contain
one or more insurance policies. It is important to appoint a trustee who would be
responsible for admi... | Final IC 38 - CA_Life - English.md | t40 | Benefits | Final IC 38 - CA_Life - English_020 | {
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IV. Evade eviction in case of default**Summary**Section 6 of the Married Women’s Property Act, 1874 provides for security of
benefits under a life insurance policy to the wife and children.The policy effected under MWP Act shall be beyond the control of court
attachments, creditors and even the life assured.Keyman insu... | Final IC 38 - CA_Life - English.md | L-06 | Summary | Final IC 38 - CA_Life - English_021 | {
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would hence encourage payment via yearly and half yearly modes by allowing a
rebate on these. They may also charge a little extra for monthly mode of
payments, to cover additional administrative expenses involved.**3.** **Extra charges**The tabular premium is charged for those individuals who are not subject to any
sig... | Final IC 38 - CA_Life - English.md | g45 | Extra charges | Final IC 38 - CA_Life - English_022 | {
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derive Higher the mortality rate in the mortality table, higher the premiumswould be
Higher the interest rate assumed, lower the premium**Net premium**
The estimates of mortality and interest give the “Net Premium”**Gross premium**
Gross premium is the net premium plus an amount called loading. There are
three consi... | Final IC 38 - CA_Life - English.md | null | Net premium | Final IC 38 - CA_Life - English_023 | {
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receive premiums in future for these policies.Liabilities are thus the present value of all payments that have to be made less the
present value of premiums expected to be received on these policies. The present
value is arrived at by applying a suitable rate of discount [the interest rate]
Surplus arises as a result o... | Final IC 38 - CA_Life - English.md | m2 | Example | Final IC 38 - CA_Life - English_024 | {
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insured for purchasing an insurance policy.The process of setting the premium for life insurance policies involves
consideration of mortality, interests, expense management and reserves.Gross premium is the net premium plus an amount called loading.A lapse means that the policyholder discontinues payment of premiums. I... | Final IC 38 - CA_Life - English.md | m2 | Key Terms | Final IC 38 - CA_Life - English_025 | {
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facility of Nomination is available to the proposer, the Agent shall inform him/ her
of the provisions of Section 39 of the Act and encourage the proposer to avail the
facility.Aspects related to the personal financial planning of the life proposed including his/
her work span, projected income and expenses, as well as... | Final IC 38 - CA_Life - English.md | null | Age Proof: | Final IC 38 - CA_Life - English_026 | {
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receipts when it receives further premiums from the proposer. These receipts are
known as renewal premium receipts (RPR). The RPRs act as proof of payment in the
event of any disputes related to premium payment.**2.** **Policy Document**The policy document is the most important document associated with insurance. **It*... | Final IC 38 - CA_Life - English.md | null | Policy Document | Final IC 38 - CA_Life - English_027 | {
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otherwise have lapsed for non-payment of premium, to continue in force during the
grace period. Every life insurance contract undertakes to pay the death benefit on
the condition that the premiums have been paid up to date and the policy is in
force. The “Grace Period” clause grants the policyholder an additional perio... | Final IC 38 - CA_Life - English.md | e58 | Important | Final IC 38 - CA_Life - English_028 | {
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surrender value), from lapsation, by keeping them alive to the extent of paid-up
sum assured even without payment of further premiums. This is because the
policyholder has a claim to the cash value accumulated under the policy.**a)** **Surrender values**Surrender value is the amount you stand to get when you decide to ... | Final IC 38 - CA_Life - English.md | e58 | Surrender values | Final IC 38 - CA_Life - English_029 | {
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iv. Nomination can be done either **at the time the policy is bought or later** atany time before the maturity of the Policy.59v. Nomination may be incorporated in the text of the Policy itself or by anendorsement on the Policy. Nominations need be communicated to the
insurer and registered by the insurer in the record... | Final IC 38 - CA_Life - English.md | null | Important | Final IC 38 - CA_Life - English_030 | {
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The person who transfers the rights is called **assignor** and the person to whom
property is transferred is called **assignee** . On assignment, the ownership of the
policy changes and hence nomination is cancelled, except when assignment is
made to the insurance company for a policy loan.There are two types of assign... | Final IC 38 - CA_Life - English.md | f62 | Diagram 3: | Final IC 38 - CA_Life - English_031 | {
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no objection from anyone else.b) **Alteration**Policyholders may seek to effect alterations in policy terms and conditions.
There is provision to make such changes subject to consent of both the insurer
and assured. Normally alterations may not be permitted during the first year of62the policy, except for change in the... | Final IC 38 - CA_Life - English.md | f62 | Alteration | Final IC 38 - CA_Life - English_032 | {
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death.The assignment of a life insurance policy implies the act of transferring the
rights right, title and interest in the policy (as property) from one person to
another. The person who transfers the rights is called assignor and the person
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These are the ones whose anticipated mortality is higher than the average or
standard lives, but are still considered to be insurable. They may be accepted
for insurance with higher (or extra) premiums or subjected to certain
restrictions.**iv.** **Declined lives**
These are the ones whose impairments and anticipated e... | Final IC 38 - CA_Life - English.md | null | Declined lives | Final IC 38 - CA_Life - English_034 | {
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regard to a life proposed for underwriting.**a)** **Acceptance at ordinary rates (OR)** is the most common decision. This ratingindicates that the risk is accepted at the same rate of premium as would
apply to an ordinary or standard life.68**Diagram 3:** **Underwriting decisions****b)** **Acceptance with an extra:** T... | Final IC 38 - CA_Life - English.md | null | Acceptance at ordinary rates (OR) | Final IC 38 - CA_Life - English_035 | {
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companies often divide their underwriting into categories accordingly. Factors like
income, occupation, lifestyle and habits, which contribute to moral hazard, are
assessed as part of **financial underwriting**, while medical aspects of health fall
under **medical underwriting** .**a)** **Female insurance**Women genera... | Final IC 38 - CA_Life - English.md | null | Female insurance | Final IC 38 - CA_Life - English_036 | {
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These tests may reveal deeper insights about the health of the proposed life
than the answers given in the proposal or an ordinary medical examination can
provide.**Examples**
When a proposal is submitted at a branch located far away from the place of
residence of the proposed insuredA medical examination is done elsew... | Final IC 38 - CA_Life - English.md | null | Examples | Final IC 38 - CA_Life - English_037 | {
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accidents, violence, family abuse, depression and suicides.**Substance abuse** : Substance abuse refers to the use of various kinds of
substances like drugs or narcotics, sedatives and other similar stimulants. Some
of these are even illegal and their use indicates criminal disposition and moral
hazard.73**Test Yoursel... | Final IC 38 - CA_Life - English.md | null | Substance abuse | Final IC 38 - CA_Life - English_038 | {
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the system.**d)** **Backdating:**Backdating means changing the start date of the policy to an earlier one. For
example, you bought a Life insurance policy on 1st June, 2013 but later you
think that the policy would have generated better returns if you had bought it
in April 2013. You and your insurance company agree to... | Final IC 38 - CA_Life - English.md | L-09 | Backdating: | Final IC 38 - CA_Life - English_039 | {
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3. Non-medical underwriting
4. Rating factor
5. Medical underwriting
6. Anti-selection**Answers to Test Yourself****Answer 1** - The correct option is III.**Answer 2** - The correct option is II.**Answer 3** - The correct option is II.77## CHAPTER L-09## LIFE INSURANCE CLAIMS**Chapter Introduction**This chapter explain... | Final IC 38 - CA_Life - English.md | L-09 | Answers to Test Yourself | Final IC 38 - CA_Life - English_040 | {
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contract itself. For instance, the date of maturity and the dates when the
instalments of survival benefits may be paid under a money back policy are
clearly laid out at the time of preparing the contract.**iii.** **Surrender value payments** are different from other claim payments. Here,unlike other claims, the event ... | Final IC 38 - CA_Life - English.md | s81 | Surrender value payments | Final IC 38 - CA_Life - English_041 | {
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**iii.** **Unit Linked Insurance Plan (ULIP):** In case of ULIPs, the insurer pays thefund value as the maturity claim.**iv.** **Money-back Plan:** In case of money-back policy, the insurer pays thematurity claim minus the survival benefits already paid during the term of
the policy.The insurance contact terminates aft... | Final IC 38 - CA_Life - English.md | s81 | Unit Linked Insurance Plan (ULIP): | Final IC 38 - CA_Life - English_042 | {
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repudiated giving all the relevant reasons, within 30 days from the date of
receipt of all relevant papers and required clarifications. However, if the
insurer needs the claim to be investigated, it shall initiate and complete the
investigation at the earliest, in any case not later than 90 days from the date
of receip... | Final IC 38 - CA_Life - English.md | null | Role of an agent | Final IC 38 - CA_Life - English_043 | {
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## IC - 38 **INSURANCE AGENTS** **SECTION - COMMON****ACKNOWLEDGEMENT****This course is based on revised syllabus prescribed by Insurance Regulatory and**
**Development Authority of India (IRDAI) and prepared by Insurance Institute of**
**India, Mumbai.****AUTHORS/ REVIEWERS (in Alphabetical order)**Dr. R. K. Duggal
Dr... | Final IC 38 - IA_English Common.md | C-46 | INSURANCE AGENTS | Final IC 38 - IA_English Common_000 | {
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wishes all interested in studying the material a successful career in insurance
marketing.iii## CONTENTS|Chapter no.|Title|Page no.|
|---|---|---|
|**SECTION **|**COMMON CHAPTERS **|**COMMON CHAPTERS **|
|C-01|Introduction to Insurance|2|
|C-02|Core Elements of Insurance|18|
|C-03|Principles of Insurance|27|
|C-04|Feat... | Final IC 38 - IA_English Common.md | C-01 | CONTENTS|Chapter no.|Title|Page no.| | Final IC 38 - IA_English Common_001 | {
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Losses arising from the demise of a member were shared by various family
members so that each member of the family continued to feel secure.The break-up of the joint family system and emergence of the nuclear family in
the modern era, coupled with the stress of daily life has made it necessary to
evolve alternative sys... | Final IC 38 - IA_English Common.md | null | Lloyds | Final IC 38 - IA_English Common_002 | {
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insurance. 6General Insurers deal only in Health insurance. 2 are specialised
insurers - Agricultural Insurance Company [AIC] and Export Credit and
Guarantees Corporation [ECGC], both set up as Public sector entities.c) There is one Reinsurance Company – The General Insurance Corporation ofIndia [GIC Re] and 11 foreign... | Final IC 38 - IA_English Common.md | null | Test Yourself 1 | Final IC 38 - IA_English Common_003 | {
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result of being exposed to a given loss situation/ event.**Diagram 3:** **Risk burdens that one carries**There are two types of risk burdens that one carries – **primary and secondary** .7**a)** **Primary burden of risk**The **primary burden of risk** consists of losses that are actually suffered by
households (and bus... | Final IC 38 - IA_English Common.md | t8 | Diagram 3: | Final IC 38 - IA_English Common_004 | {
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|Funds flow from one source to many<br>destinations.|Funds flow from many sources to one.|**Diagram 4:** **Mutuality -** Mutuality (Funds flow from many sources to one)The Principle of Mutuality is what gives insurance contracts their power and
uniqueness. By paying a small contribution (the premium), an insured immedi... | Final IC 38 - IA_English Common.md | null | Diagram 4: | Final IC 38 - IA_English Common_005 | {
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locations; (ii) fixing fire proof doors in hazardous areas of factories.**4.** **Risk financing**This refers to the provision of funds to meet losses that may occur.**a)** **Risk retention through self-financing** involves bearing losses oneself as theyoccur. The firm assumes and finances its own risk, either through i... | Final IC 38 - IA_English Common.md | null | Risk financing | Final IC 38 - IA_English Common_006 | {
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transferring the risk [the insurance premium] against the cost of bearing it oneself.
Insurance would be most required where the loss impact could be very high, but the
probability (and hence the premium), is very low. E.g. (i) the chance of an
earthquake; (ii) the chance of a ship sinking.**a)** **Do not risk a lot fo... | Final IC 38 - IA_English Common.md | null | Do not risk a lot for a little | Final IC 38 - IA_English Common_007 | {
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their contributions are given below.a) Insurance is founded on the principle of Mutuality, in which the collectivepower of the community is brought together to support its unfortunate fewmembers who suffer an economic loss. There are no substitutes forinsurance.b) Insurance companies collect small amounts of premium an... | Final IC 38 - IA_English Common.md | s1 | Information | Final IC 38 - IA_English Common_008 | {
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common pool of funds it is known as pooling.Apart from insurance, other risk management techniques include: Risk avoidance,16 Risk control,
Risk retention,
Risk financing and
Risk transfer- The thumb rules of insurance are: Do not risk more than one can afford to lose,
Consider the likely outcomes of the ris... | Final IC 38 - IA_English Common.md | k2 | Key Terms | Final IC 38 - IA_English Common_009 | {
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accept the goods or defaulted on payments. **Life insurance**What about our lives? There is indeed nothing as valuable to us as our own lives and
those of our loved ones. Our lives can be seriously affected when subjected to anaccident or an illness.This can impact in two ways: Firstly there are costs of treatment of... | Final IC 38 - IA_English Common.md | null | Life insurance | Final IC 38 - IA_English Common_010 | {
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may be reversible to some extent. Critical losses would include those resulting
in serious financial losses, compelling a firm to borrow to continue operations.**Example: Critical** A fire in the plant of a large multinational company at Gurgaon destroysinventory worth Rs 1 crore. The loss is heavy but not so high as ... | Final IC 38 - IA_English Common.md | null | Example: Critical | Final IC 38 - IA_English Common_011 | {
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onset of a major ailment.**c)** **Legal hazard** is more prevalent in cases involving a liability to pay for damages.It arises when certain features of the legal system or regulatory environment
can increase the incidence or severity of losses.**Example**The enactment of law governing workmen’s compensation in the case... | Final IC 38 - IA_English Common.md | null | Legal hazard | Final IC 38 - IA_English Common_012 | {
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size of the pool of risks, the actual average of losses would be closer to the
estimated or expected average loss.24**c)** **Insurance Companies to remain Solvent:**If the pools of risks and the premium pools created are not sufficient to meet
the liabilities towards paying claims (in case they occur), the system of ri... | Final IC 38 - IA_English Common.md | C-03 | Insurance Companies to remain Solvent: | Final IC 38 - IA_English Common_013 | {
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b) Risk
c) Hazard
d) Risk pooling
e) Offer and acceptance
f) Lawful consideration**Answers to Test Yourself****Answer 1** - The correct option is II.26## CHAPTER C-03## PRINCIPLES OF INSURANCE**Chapter Introduction**In this chapter, we discuss the principles, based on which the mechanism ofinsurance works.a) Utmost Goo... | Final IC 38 - IA_English Common.md | C-03 | Answers to Test Yourself | Final IC 38 - IA_English Common_014 | {
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of premium and the terms and conditions. The insured has an obligation to fully
and accurately disclose all facts that are material to an insurance contract.Whether an undisclosed fact was material or not would depend on the
circumstances of the individual case and could be decided ultimately only in a
court of law. Th... | Final IC 38 - IA_English Common.md | l28 | Example | Final IC 38 - IA_English Common_015 | {
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answers were incomplete.**b.** **Duty to Disclose:** In the case of insurance contracts, the duty to disclose ispresent throughout the entire period of negotiation until the proposal is accepted
and a Life Insurance policy is issued.Once the Life Insurance policy is accepted, there is no further need to disclose any
ma... | Final IC 38 - IA_English Common.md | null | Duty to Disclose: | Final IC 38 - IA_English Common_016 | {
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of revival of the policy or (d) the date of the rider to the policy, whichever islater.The insurer needs to communicate the reasons on which the policy is questioned
in writing to the insured or his/ her legal representatives, nominees or assignees.The expression "fraud" means any act committed by the insured, with the... | Final IC 38 - IA_English Common.md | null | B. | Final IC 38 - IA_English Common_017 | {
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insurable interest should be present both at the time of taking the policy and at
the time of claim with some exceptions like marine policies in which case itmust exist at the time of claim.In case of fire and accident insurance, insurable interest should be present both
at the time of taking the policy and at the time... | Final IC 38 - IA_English Common.md | e34 | C. | Final IC 38 - IA_English Common_018 | {
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was due to the ‘normal wear and tear’ of the car and the air-conditioning system,
which was an excluded peril in the insurance policy. Mr Ajay approached the Court
and after examining the survey report which said that the car was 12 years old and
neither the car nor the air-conditioning had been serviced/ repaired duri... | Final IC 38 - IA_English Common.md | e34 | Scenario 2: | Final IC 38 - IA_English Common_019 | {
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insurer and insured agree on the value of the property to be insured, at the
beginning of the insurance contract. In the event of total loss, the insurer agrees
to pay the agreed amount of the policy. This type of policy is known as “ **Agreed**
**Value Policy** ”.**b)** **Underinsurance:** Consider a situation now whe... | Final IC 38 - IA_English Common.md | e37 | Agreed | Final IC 38 - IA_English Common_020 | {
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Hence, it is also called a ‘corollary’ of Indemnity. Contribution is a principle that
arises in general insurance contracts. It tells us how the liability is to be met when
the insured has taken insurance from more than one insurer. Contribution implies
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the Indian Contract Act, 1872 govern all contracts in India, including insurancecontracts.An insurance policy is a contract entered into between two parties, viz., the
company, called the **insurer**, and the policy holder, called the **insured** and fulfils
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in advance in the prescribed manner. This is an important feature of the insurance
industry in India.The Insurance Rules, 1939, provide certain exceptions to this condition of advance
payment of premium, in respect of particular categories of insurances. Section 59
of the Insurance Rules allows accepting premiums in in... | Final IC 38 - IA_English Common.md | d43 | Solicitation | Final IC 38 - IA_English Common_023 | {
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before the due date. Grace period for paying the premium do not apply. In case
a comprehensive policy lapses for more than 90 days, the accrued No Claim
Bonus (NCB) benefit would also be lost.In the interest of smooth operation of affairs during the Covid-19 pandemic,
IRDAI permitted the following relaxations:i. In cas... | Final IC 38 - IA_English Common.md | d-19 | Free-Look Period introduced by “IRDAI” | Final IC 38 - IA_English Common_024 | {
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known as the premium.
ii. A contract is an agreement between parties, enforceable at law.iii. The elements of a valid contract include:Offer and acceptanceConsideration,Consensus ad-idem,- Free consentCapacity of the parties and46Legality of the object**Key Terms**1. Offer and Acceptance2. Lawful consideration3. Consen... | Final IC 38 - IA_English Common.md | d46 | Key Terms | Final IC 38 - IA_English Common_025 | {
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medical aspects, fitness levels and family history and measure the effect of each
factor affecting the risk.**Sources of information for underwriting**The first stage in any numerical (or statistical) analysis is the collection of data.
When pricing a risk, an underwriter should gather as much information as possibleto... | Final IC 38 - IA_English Common.md | null | Sources of information for underwriting | Final IC 38 - IA_English Common_026 | {
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made on each component of the risk. Factors like age, race, occupation, habits etc.
are examined and scored numerically based on predetermined criteria.The amount of premium to be paid by each depends on a rate, which is determined
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5,00,00,000] x 100 = 0.5%Therefore the rate of premium that a motor cycle owner pays is half a percent of
Rs. 50,000/ - i.e. Rs. 250/ - per year. This is called the **‘Pure’ premium,** also known
as ‘Burning Cost’.At the rate of Rs. 250 per motor cycle, Rs. 2.5 lakhs is collected which is paid outin claims on total los... | Final IC 38 - IA_English Common.md | d53 | Therefore, the ‘pure premium’ is suitably loaded or increased by adding | Final IC 38 - IA_English Common_028 | {
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ensure that he/ she takes due care. For instance, health insurers may insist on a
deductible so that insured would not overspend on costly hospital rooms just
because insurance is there. Some Insurers also may not prefer spending time on
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following: The extent of the insured’s insurable interest in the property affected
The value of salvage
Application of underinsurance
Application of contribution and subrogation conditionsIn the matter of claims relating to life insurance, the insurer checks whether1) Conditions of policy have not been breached
... | Final IC 38 - IA_English Common.md | r1 | B. | Final IC 38 - IA_English Common_030 | {
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arising directly or indirectly in respect of the said claim.Date (Signature)vi. **Post settlement action**The action taken after settlement of the non-life claim in relation to underwritingvaries from one class of business to another.**Example**Sum insured under a fire policy stands reduced to the extent of the amount ... | Final IC 38 - IA_English Common.md | o59 | Post settlement action | Final IC 38 - IA_English Common_031 | {
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parties to the dispute themselves. In the event of a single arbitrator, the parties
have to agree about that person. Many commercial insurance policies contain an
**arbitration clause** stating that disputes will be subject to arbitration. Fire and most
miscellaneous policies also contain an arbitration clause which pr... | Final IC 38 - IA_English Common.md | o60 | Example | Final IC 38 - IA_English Common_032 | {
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and the important documents, commonly applicable for practically all
policiesImportance of Age Proof and acceptable documents.63**A.** **Prospectus**Prospectus is a proposal stage document. The prospectus is a formal legal document
used by insurance companies that provides details about the product. It can mean
a docum... | Final IC 38 - IA_English Common.md | s5 | A. | Final IC 38 - IA_English Common_033 | {
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conditions of the cover to be granted.The Principle of Utmost Good Faith and the Duty of Disclosure of material
information begin with the Proposal Form for insurance. The proposer must provide
all information correctly and completely as this document becomes the basis of
granting insurance and any wrong or concealed i... | Final IC 38 - IA_English Common.md | null | Proposal Form - Details | Final IC 38 - IA_English Common_034 | {
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including his/ her work span, projected income and expenses, as well as needs for
savings and investment, health, retirement and insurance may also be enquiredabout.The Agents recommendations including the reasons for such recommendation may
also be part of the proposal form. In compliance to the IRDAI regulations ment... | Final IC 38 - IA_English Common.md | e68 | Declaration in the Proposal Form | Final IC 38 - IA_English Common_035 | {
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of cases involving or suspected of involving money laundering. It is necessary to be68vigilant and ensure, right at the beginning of the contract that it is not intended to
be a tool for money laundering of any sort.The Prevention of Money Laundering Act, 2002 (PMLA) was been brought into force
by the Government of Ind... | Final IC 38 - IA_English Common.md | e68 | Age Proof – for Personal Lines | Final IC 38 - IA_English Common_036 | {
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**Answer 2** - The correct option is II.
**Answer 3** – The correct option is II.**Summary**Prospectus is a formal legal document used by insurance companies that
provides details about the product.The application document used for making the proposal is commonly known as
the ‘proposal form’.70Some documents considered... | Final IC 38 - IA_English Common.md | d71 | Answer 2 | Final IC 38 - IA_English Common_037 | {
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when contacting a service provider. First impressions last long.73**3.** **Customer service and insurance**Leading sales producers in the insurance industry state that the secret of reaching
the top and staying there is in getting the patronage and support of a large number
of existing clients with whose help the busin... | Final IC 38 - IA_English Common.md | r74 | Customer service and insurance | Final IC 38 - IA_English Common_038 | {
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of experience that we shall call the ‘ **Customer Journey’** . The agent needs to
partner with the customer through the entire duration of the contract, hand holding75him/ her in each step of the journey to create memorable experiences at everystep.Let us look at some milestones in the journey and the role played at ea... | Final IC 38 - IA_English Common.md | g75 | Customer Journey’ | Final IC 38 - IA_English Common_039 | {
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home at a place where the risk of floods is negligible it may not be necessary toobtain such cover.Many customers may not be much concerned about getting maximum insurance per
rupee spent, but would be interested in **reducing the cost of handling risk** . The
concern would be thus on identifying those risks which a cu... | Final IC 38 - IA_English Common.md | null | Handling Objections and Closing the Sale: | Final IC 38 - IA_English Common_040 | {
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and motor classes of business, cover note is discussed in detail under the GeneralInsurance Section.It is the agent’s responsibility to ensure that the cover note is issued by the
company, where applicable, to the insured. Promptness in this regardcommunicates to the client that his/ her interests are safe in the hands... | Final IC 38 - IA_English Common.md | null | Policy Document | Final IC 38 - IA_English Common_041 | {
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the premium at regular intervals based on premium payment term. This does
not apply to one-time payments.General Insurers usually send a Renewal Notice, well in advance of the date of
expiry of the premium paying period, inviting renewal of the policy.The customer’s choice to renew or continue with the policy may often... | Final IC 38 - IA_English Common.md | e80 | The claim stage | Final IC 38 - IA_English Common_042 | {
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The dress must be appropriate for the meeting or occasion
The look must be clean and tidy – with good haircut and shave, clean andtidy clothes, neat and tidy make up**iii.** **A warm, confident and winning smile** puts a person and his/ her audienceimmediately at ease with one another.**iv.** **Being open, confiden... | Final IC 38 - IA_English Common.md | l83 | A warm, confident and winning smile | Final IC 38 - IA_English Common_043 | {
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assumptions, judgments, and beliefs one carries.**Not being judgemental: If the listener is judgemental,** even if he hears what
the speaker is saying, he will understand only according to his biased
interpretation.**d)** **Empathetic listening:****Empathy implies hearing and listening patiently, and with full attentio... | Final IC 38 - IA_English Common.md | y84 | Not being judgemental: If the listener is judgemental, | Final IC 38 - IA_English Common_044 | {
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II. Maintaining confidentiality of client’s business and personal information
III. Placing self-interest ahead of client’s interests
IV. Placing client’s interest ahead of self interest85**Summary**a) The role of customer service and relationships is far more critical in the case ofinsurance than in other products.b) F... | Final IC 38 - IA_English Common.md | t85 | Summary | Final IC 38 - IA_English Common_045 | {
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Cell. If it is not satisfactorily resolved, the complainant may approach the Regulator
through the Integrated Grievance Management System.**B.** **Integrated Grievance Management System (IGMS)**Each Insurer has its own grievance redressal mechanism. All operating/ controlling/
corporate offices of Insurance companies h... | Final IC 38 - IA_English Common.md | s88 | B. | Final IC 38 - IA_English Common_046 | {
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price charged is in excess of that fixed by law or displayed on package
goods which will be hazardous to life and safety when used are being offeredfor sale to the public in contravention of the provisions of any law requiring
trader to display information in regard to the contents, manner and effect of
use of such... | Final IC 38 - IA_English Common.md | l2 | Consumer dispute | Final IC 38 - IA_English Common_047 | {
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|**Established by the**<br>**Central Government**|**Established by the**<br>**State Government**|**a)** **Procedure for filing a complaint**The procedure for filing a complaint is very simple in all the above three
agencies. There is no fee for filing a complaint or filing an appeal whether before
the State Commission ... | Final IC 38 - IA_English Common.md | null | Established by the | Final IC 38 - IA_English Common_048 | {
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The objective of these rules is to resolve all types of complaints mentioned above,
in a cost effective, and impartial manner.**The Ombudsman, by mutual agreement of the insured and the insurer can act as**
**a mediator and counsellor within the terms of reference.****The decision of the Ombudsman, whether to accept or... | Final IC 38 - IA_English Common.md | null | The Ombudsman, by mutual agreement of the insured and the insurer can act as | Final IC 38 - IA_English Common_049 | {
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goods or services and the compensation claimed is up to Rs.20 lakhs.I. District CommissionII. State CommissionIII. Zilla ParishadIV. National Commission**Summary**IRDAI has launched an Integrated Grievance Management System (IGMS) which
acts as a central repository of insurance grievance data and as a tool for
monitori... | Final IC 38 - IA_English Common.md | n4 | Summary | Final IC 38 - IA_English Common_050 | {
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applicant holds agency appointment with more than one life insurer, one general
insurer, one health insurer and one of each of the mono-line insurers. He will also
verify the centralised list of agents maintained by the Authority and verify whether
the applicant is black listed. If satisfied, the designated official ma... | Final IC 38 - IA_English Common.md | null | Appeal Provision | Final IC 38 - IA_English Common_051 | {
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Matters like identifying oneself and one’s Insurer properly by showing the agency
identity card and the duty to disclose the agency appointment letter to the prospecton demand are discussed.The code of conduct specifies the duties of Agents in detail. Some of the important
duties that Agent Applicants need to know are ... | Final IC 38 - IA_English Common.md | r98 | Insurance agents are prohibited from | Final IC 38 - IA_English Common_052 | {
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Authority of India (Appointment of Insurance Agents) Regulations, 2016. There is a
provision for black listing agents whose appointment is cancelled/ suspended by a
designated official of the insurer on grounds of violation of the Code of Conduct
and/ or fraud. If the agency of the insurance agent is cancelled, he/ she... | Final IC 38 - IA_English Common.md | s2 | Key Terms | Final IC 38 - IA_English Common_053 | {
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## IC - 38 **WEB AGGREGATORS** **COMPOSITE****ACKNOWLEDGEMENT****This course is based on revised syllabus prescribed by Insurance Regulatory**
**and Development Authority of India (IRDAI) and prepared by Insurance**
**Institute of India, Mumbai.****AUTHORS/ REVIEWERS (in Alphabetical order)**Dr. R. K. Duggal
Dr. Shashi... | Final IC 38 - WA_Composite - English.md | C-46 | WEB AGGREGATORS | Final IC 38 - WA_Composite - English_000 | {
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|C-06|Claims Processing|60|
|C-07|Documentation|67|
|C-08|Customer Service|76|
|C-09|Grievance Redressal Mechanism|93|
|C-10|Regulatory Aspects for Web Aggregators|101|
|**SECTION **|**LIFE INSURANCE **|**LIFE INSURANCE **|
|L-01|What Life Insurance Involves|116|
|L-02|Financial Planning|123|
|L-03|Life Insurance Produ... | Final IC 38 - WA_Composite - English.md | C-06 | SECTION | Final IC 38 - WA_Composite - English_001 | {
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