Insurance Loans: GROUP INSURANCE

WHAT IS RISK?

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Risk mean something that cannot
be certain an elements  of uncertainty
attached with it. It also means that the probability possibility of a certain
loss. This probability is estimated depending 
upon a large number of factors such as a person’s age, gender education,
habits etc.,  PHYSICAL HAZARD:  This risk is increased a by a few physical
factors known as physical hazards  and a
few nonphysical factors known as moral hazards. The physical hazards are in
view of the physical conditions  which
increase the possibility of risk like the physical impairment, onset of a  disease etc.,   </div>
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MORAL HAZARDS:  This occurs when the life proposer wants to
obtain an undue pecuniary benefits from a 
policy. This takes place when one person plans a suicide  after taking the policy, so that the benefits
of the policy go it his or her family members or by hiding certain facts of his
or her illness account  in the proposal
form, which may lead to his or her death the and the insurer may have to pay the
claim. The insurer controls  this moral
hazard by the careful underwriting, calling for special examinations.,  by imposing restrictive clauses waiting
periods, lien clauses etc.,  Legal hazard
too can be there due to the legal systems in the country or due to the
regulatory provisions.  It can be case of
the over insurance where in the insurer has to investigation the character and
the financial standing of the applicant. For example has the applicant already
been adequately insured or can be he afford so much of insurance from the point
of view of his income? There are all to be verified. Wherever  the life assured and the applicant are two
different persons, the insured has to be cautions about the insurable interest,
I ,e the extent of the economics loss due to the death of the assured. </div>
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Female  lives are a  having more hazard with regard to childbirth
and also a place of their residence as to whether all modern medical facilities
are available  . The risks include: 1.
Personal risk, 2. property risks,. 3,. Liability risks,. 4,. Natural
catastrophes like hurricane, earthquake, flood etc.,  affecting the society as a whole.,  Let us deal with personal risks only in this
unit.  1. PERSONAL RISKS:  These affect the individual  personally like death, disability illness,
etc.,  Untimely death  of an individual leads to certain unfulfilled
financial obligations such as a mortgage loan of the house, educational needs
to the children, social commitments like marriage of children, start-up funds
etc., If adequate risk cover is not there the death can lead to the family
coming to the street sooner  or later.
There are other exp0enses too such as a medical and funeral expenses,
settlements cost, cost of probate of the will , etc.,  The non economic   costs causes such as loss of guidance,
support loss of the apparent etc., which are called the emotional costs, can
never be compensated by the insurance company money./ That way insurance is not
a substitute for the human life . It can be only mitigate the  economic suffering of the people who are left
behind. There is also a risk of insufficient of retirement. This is a called
the risk of living  long as a against the
risk of dying early. Both can be covered through life insurance. There is a
risk  of poor  health of 
a person like losing the capacity to earn on account of an accident  or onset of a diseases etc., These lead to
the concept of health insurance. In this unit 
we have restrict  to the life
insurance angle only. </div>
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  FACTORS AFFECTING
MORTALITY:  The rate of the mortality
means that the probability of a person dying in a particular year,  i, e,. 
out of the 100 people how many may die within one year. The factors  affecting mortality are:  1. Age, 2. sex,  3. race, 
4. occupation,  5.  residence, 6. the hygienic conditions of
living,  7. personal habits,  8. longevity as revealed in the family
history I ,e hereditary factors,  9.
personal health,  10. any physical
disability,  11. body built,  12. any other details revealed in the medical
report.  NON MEDICAL  UNDERWRITING: 
An insurer can choose to underwrite a risk purely on the basis of
information declared personally in a personal statements in the personal forms.
This is a called non medical underwriting . This comes  under the umbrella  of “Uberima fides” the principle of utmost
good faith. This does not mean any 
lowering of standard of selections. Coupled  with the field representative’s like agent
field officer’s  report the personal can
be accepted. The claim experience under non medical is generally not </div>
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unfavorable . We have a lot of saving in cost due to medical
fees, hassles avoided for the proposer , simplicity in forms etc.,  </div>
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WHAT IS RISK?

Risk mean something that cannot be certain an elements of uncertainty attached with it. It also means that the probability possibility o...

THE PRINCIPLE OF OUTMOST GOOD FAITH

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We have
seen in   Unit I that for an insurance
contract to be valid and enforceable there has to be a  proposal by a the insured, its acceptance  by the insurer and the payment of the a  consideration 
to the insurer, Many commercial 
contracts  go by  the caveat emptor  principle 
(meaning  let the buyer
beware)  , which presupposes  that the parties  to the contact should not mislead the other  party, but does not make up it imperative to
disclose more than what is asked for . </div>
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However for the insurance contract , the
buyer is buying a promise based on certain information declared by him, and the
seller sells that promise and charges 
the considerations  based on and
believing  the information  furnished by the proposer. Non-discolour  of some facts can make the value  of the promise much  costlier 
than the considerations charged 
and even change the fundamentals 
based on the which the insurer gave the promise. At this point  the situations  is one-sided and heavily  prejudiced against the insurer because the
proposer has full knowledge about the risk offered for insurance while the
insurer does not have any knowledge  of
it. An argument that the insurer could have 
a good study of the risk before accepting  it is only technical and does not really
match with the overall philosophy  of
insurance</div>
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 The fact remains that with any amount  of investigation , it many may not be
practically  possible for an insurer
to  develop a reasonable  understanding 
of every risk, before accepting 
it. Further , the cost and time involved in the process would
heavily  add to the insurer’s  expenditure. 
These practicalities  make it
imperative  for the insurer to have
utmost  good faith on the insured.
Overall  insurance has to be understood
as an honest deal for a noble cause between two gentlemen.  Further the humanitarian  idea of the community contributing  to alleviate the  financial loss an unfortunate member, which
forms the bedrock of the insurance system, 
envelops  the insurance contract in
an atmosphere of trust. Though trust or good faith is cardinal to all financial
transactions , the above positions emphasizes, the importance of trust in
insurance. Hence the insurer  expects a
higher degree of good faith, termed as utmost good faith from the proposer of
insurance. Lord  justice, Scrutton,
defined the principle  of utmost faith
(or uberrima fides) in the case of Rozanes V 
Bowen (1928) as follows:.  As the
underwriter knows nothing and then man who comes to him to insure knows
everything  it is duty the assured, the
man who desires to have a policy. to make a full disclosure    to the underwriters  without being asked of all the material
circumstances, because  the underwriter
knows nothing  and the assured knows
everything. That is expressed by saying that it is a contract of utmost  good faith. 
Any circumstance  which is within
knowledge  of the insuring person and is
likely ti influence  the insurer in
deciding  whether he will  accept of refuse the risk,  or influence 
to the insurer before the contract is concluded . Sections 19 to 23 of
the Marine insurance Act, 1963,  provide
that every contract of insurance requires 
an insured  to make all a full
disclosure  of all material facts to the
insurer. For instance, when a ship is proposed for insurance, the proposer
states the details such as a age, tonnage, vessel class, sea worthiness
certifications  etc., to the
insurers </div>
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The insurer would insure  it with terms and rates applicable  to any other vessel of the same class,
tonnage age, etc., However the proposer would have an intimate knowledge  of the actual physical condition  of the ship, details of the repairs that it
underwent details of worn out machinery 
, or details of repair that are a due but postponed for some reason or
other which the insurer cannot be the reasonably  expected to know. It is possible that the
proposer has intentionally not disclosed 
some negative details  about the
ship to the insurer.  If the insurer had
come to know of these details about the he might have insured it only with
some  additional conditions, or with an
additional premium or even he might not have insured the ship at all. In such a
case, the action of the proposer  in
within with holding  these vital details
from the insurer is not in keeping  with
the principle  of utmost good faith.   In the context  of insurance covering Consequential Loss,
which protects against loss of profits and loss of expenses  such as a rent etc., emanating put of the
insured event (The concepts of Consequential 
Loss or Loss of profits insurance are described  in detail in Unit 5, ), the doctrine of
utmost good faith gives a clear understanding 
that in the event of damage the insured will follow sound
accounting  procedures and take all
reasonable  steps to minimize the
resulting loss. In other words, if and when a loss or occurs, the insured are
expected to perform  all the actions
normally expected of them, as though they were not insured.</div>
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THE PRINCIPLE OF OUTMOST GOOD FAITH

We have seen in Unit I that for an insurance contract to be valid and enforceable there has to be a proposal by a the insured, its acc...

CHANGES IN THE INDIAN INSURANCE MARKET IN RECENT TIMES

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The history
and evolution  of the Indian  general insurance market have been
discussed  in detail  in Unit 
1. It is  generally regarded  that the market  evolved into a fairly  modern from by the middle  of the 1930s . During  this period the Indian  market 
came out of  its adolescence  and started 
addressing  problems similar  to those faced by the more markets . We have
seen that the combined offers of the market and the Government lead to the
enactment  of the insurance act,
1938.,  In the early  1990s 
the need for further changes in the insurance market was  voiced by a various  segment in both the national  and international market. The consequent  changes and the succession of events  that has 
formed  the market the way  it is today are discussed  here. The insurance companies  were 
widely criticized  for
inefficiencies  arising  out 
overstaffing , governmental 
interferences  in management ,
lack of the freedom in decision  making,
waning  company, loyalty  as well as 
deficiencies in the system, which could 
neither provide  enough
motivation  for  meritorious 
employees,  nor effectively  penalize  
employees  for non-performances or
lethargy. Professionalism  in the
industry started  declining  and the industry’s  growth 
rate got largely limited  to the
rates  of inflation and the returns  the companies 
could earn by the investing  their
surplus  funds.  With market 
penetration  becoming  static, 
the insurers  were criticized  as indifferent to the country’s  needs 
and the  Government  was criticized  for  it
is this a being  over-protective of the
nationalized  industry  by not 
allowing  competition   from private players.<br />
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THE MALHOTRA
COMMITTEE  REPORT ON INSURANCE REFORMS
1994, : The central Government  responded  to the situation  by setting up a high-power  committee  on re forms 
in insurance sector on April  7,
1993, headed  by R. N. Malhotra,  former 
Governor  Reserve Bank of
India.,  To examine  the reforms required  in the insurance sector,  This committee  is popularly 
referred  to as the Malhotra
committee.  The committee  interacted 
with the insurance companies their staff unions, various  chambers 
of commerce  trade bodies  and a cross sections  of the country’s  public, and a made a  detailed 
analysis  of the present  Indian insurance industry . It also visualized  the shape of things to come in the future
.and put forward its recommendations  for
the insurance industry  on January 7,
1994, . The Malhotra committee’s report recommended  that both life  and non life insurance sectors  should be a 
gradually  opened for the  private 
participation  and
recommended  entry to foreign  companies 
through joint  ventures  established 
in India with Indian partners. The Committee  prescribed 
a minimum  paid-up capital  for new insurers  as not less than Rs. 100 crores . Which would
be backed by the well-defined solvency standards., This Committee
recommended  that the regulatory  apparatus should be activated  even in the present  set up of the nationalized  insurance sector and amongst  others 
things recommended  the
established  of a strong  and effective 
Insurance Regulatory Authority, (IRA) 
in the form of  a statutory   autonomous 
board on the lines of Securities 
and Exchange  Board of India
(SEBI) . By way of detail  the Committee
recommended  retention  of all major tariff for some  period 
of time, and progressive, liberalization.,<br />
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The recommended  of the Malhotra committee were discussed  across the country  at different 
forums ,  including  the management  of the life insurance corporation  the General insurance corporations, it's
a  subsidiary  companies 
trade unions, chambers  of
commerce and  various consumer
interest  groups . The Consultative  committee 
of the Parliament and  the
ministry  of finance also held  discussions of the Report the committee  on Reforms 
in sector with the various 
stakeholders  in the market .
After prolonged  deliberations , the
government  accepted  the Committee’s recommended  to set up an autonomous  interim insurance Regulatory Authority
(IRA).  THE (INTERIM) INSURANCE
REGULATORY AUTHORITY , 1996: In his 
1995, Budget speech  the Finance
Minister  announced  the Governments  views on the subject  as follows an intern  insurance regulatory Authority (IRA)  was 
formed  accordingly  on January 23. 1996, by  a Government resolution , pending the
enactment  of comprehensive  legislation, which would take  time. The IRA 
came into the  existence  with Mr. N. Rangachari as  its full time Chairman,  two part time member  and a 
skeletal secretariat,  The
IRA  through seminars, discussions  and press 
releases  made an attempt to
create  awareness   about the modern  trends in insurance among various
segments  of the insured,<br />
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However it did
not have sufficient  legislative  power to brings about any significant  change to the insurance industry .
Though  the Government had vested  the powers 
of the Controller  of insurance  with the Chairman  of the IRA, no serious  change could be  made in the 
working of the government  owned
public sector  insurer’s  Then the Finance Minister in his  budget 
speech of July ,1996, announced 
that in keeping  with the trend of
liberalization  the non-statutory  insurance Regulatory Authority  would be a made statutory  and suitably 
empowered  so that it would have
been sufficient  teeth to play an
effective  regulatory role. In the
Statement  of object  and Reasons, 
necessitating  the submission  of the insurance Regulatory Authority  Bill to the 
parliament   in December , 1996,
in the Finance Minister observed  that
the insurance industry required a high degree or regulations . He pointed  out that the insurance Act 1938,
provides  for the institution  of the Controller  of insurance to act as a strong  and powerful 
supervisory  and regulatory  authority 
with powers to direct advise  cautions  prohibit , investigation  inspect, prosecute , search, seize  fine, amalgamate , register and regulate  insurance companies  . It was 
also conceded that the Government 
was seized of the fact  that
after  the nationalizations  of the Life Insurance industry in 1956, and
the General insurance Industry  in 1972.
The role  of the  controller 
of insurance had gradually 
diminished  in it's a  significance.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgbym-8YgpS716sbamL9ctNAIVv9au_cfOz1Rzgu1efs_3hfrnzzvNsCzmCelnBpgRxZ1rc_YDB-jtp4j0kCSk8kmCHYL_VXHMDeAQxWPTrhDlVPIx8Uwn7qbUyFbEJn8dbz_HgZ0TuljY/s1600/girls.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="250" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgbym-8YgpS716sbamL9ctNAIVv9au_cfOz1Rzgu1efs_3hfrnzzvNsCzmCelnBpgRxZ1rc_YDB-jtp4j0kCSk8kmCHYL_VXHMDeAQxWPTrhDlVPIx8Uwn7qbUyFbEJn8dbz_HgZ0TuljY/s400/girls.jpg" width="400" /></a></div>
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The insurance regulatory
Authority Bill was a  submitted  to the Parliament in by the December 1996,
but had  to be withdrawn  to incorporate certain  changes 
suggested  by the member  of parliament In 1997, when it was shelved
once against  due to opposition  from some quarters . In 1997, the Bill was
presented  a third  time by the new Government. The house felt
that Bill needed  to be studied  by multi party  parliament 
Committee under Mr. Murli Deora., Then 
M. P. This committee  made fresh
changes to the bill and the same was a 
subsequently  cleared  by the Council  of Ministers . The revised  bill termed as the Insurance Regulatory  and Development Authority Bill was
accordingly submitted  to the
parliament  for it's a consideration.</div>
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