Presentation is loading. Please wait.

Presentation is loading. Please wait.

GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA.

Similar presentations


Presentation on theme: "GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA."— Presentation transcript:

1 GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 AIA confidential and proprietary information. Not for distribution. AIA.COM GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 PCE – Part B General Insurance Revision 01 (25/11/2011)

2 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 14 General Insurance How much do you understand about General Insurance ? Share only 1 point about GI that comes across to your mind… CHARACTERISTICS OF GENERAL INSURANCE PRODUCTS (OVERVIEW)

3 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B Introduction 9.2Characteristics of General Insurance Products CHAPTER 14 : CHARACTERISTICS OF GENERAL INSURANCE PRODUCTS (OVERVIEW)

4 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 General insurance provides cover against risks usually not covered by life insurance. In general, not every policy will eventually become a claim : Introduction

5 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 General insurance contracts are short-term contracts with varying premiums at renewals. General insurance contracts are contracts of indemnity. Payment of a claim does not terminate a general insurance contract The risk to be insured does not necessarily increase with time 14.2 : Characteristics of General Insurance Products

6 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CLASSES OF GENERAL INSURANCE BUSINESS & GENERAL TAKAFUL BUSINESS CHAPTER 15

7 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 15 CLASSES OF GENERAL INSURANCE BUSINESS & GENERAL TAKAFUL BUSINESS General Insurance available in the market How many classes of General Insurance available in the market? Please name me 1…

8 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B Marine Insurance 15.2Fire Insurance 15.3Motor Insurance 15.4Miscellaneous Accident Insurance 15.5Types of Takaful Business CHAPTER 15 CLASSES OF GENERAL INSURANCE BUSINESS & GENERAL TAKAFUL BUSINESS

9 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Marine Insurance Type of policy - Hull - Cargo - Freight - Building Risk Subject matter of insurance - Vessel, machinery & limited collision liability - Cargo (goods carried on the vessel) - Freight (money/fee charged for carriage of goods by the vessel) - Vessel under construction

10 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Marine Insurance Institute Cargo Clauses A Institute Cargo Clauses C Institute Cargo Clauses B

11 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Marine Insurance Perils ABC Clauses Striking, stranding, capsizing   Fire, explosion, collision           Earthquake, volcanic eruption, lightning Jettison, general average & salvage Discharge of cargo at port of distress      

12 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Marine Insurance Perils ABC Clauses Washing overboard    Entry of sea water into vessel      Total loss of package(loading/discharge) Pirates and thieves Deliberate damage or destruction     

13 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Fire Insurance Fire Insurance Consequential Loss Houseowner Householder

14 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Fire Insurance Type of policy - Fire - Houseowner - Householder - Consequential Loss Subject matter of insurance - Buildings and contents - Private dwellings - Household content - Insured’s profit

15 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Fire Insurance CHAPTER 15 Perils ABC War, nuclear Earthquake, volcanic eruption Subterranean fire, flood A: Standard Fire B: Standard Houseowner C: Standard Householder Burning of property by authority Fire, lightning, explosion (domestic gas)      #: Extension is available    #  #

16 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Fire Insurance Perils ABC Overflowing of water tanks Typhoon, hurricane, windstorm Burning of forest & bush lallang A: Standard Fire B: Standard Houseowner C: Standard Householder Removal of debris, architect fee, rental Aircraft damage, impact damage #  #: Extension is available,  : Extension with condition #  # #   # # #

17 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Fire Insurance Perils ABC Spontaneous combustion Subsidence or landslip Plate glass A: Standard Fire B: Standard Houseowner C: Standard Householder Riot, strike and malicious damage Fermentation, natural heating #: Extension is available,  : Extension with condition # # #

18 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Fire Insurance (Consequential Loss) Basic Cover (i) Loss of gross profit due to reduction of turnover (total amount of goods or services sold) (ii) Additional expense to minimize loss of turnover Exclusio n Similar to fire policy Extensio n (i) Similar to fire policy (ii) Loss of gross profit arising from business interruption in other’s premises

19 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Motor Insurance (Types of Vehicles) Private CarMotorcycle Commercial Vehicle

20 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Motor Insurance (Types of Cover) Act Only Third Party Only Third Party, Fire & Theft Comprehensive

21 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Motor Insurance (Types of Cover) Act Only Death/Bodily injury to 3rd party 3rd Party CoverAct only + 3rd party property 3rd Party, Fire & Theft 3rd Party + Loss/Damage to insured vehicle by fire or theft Comprehensive3rd Party, Fire & Theft + Accidental Damage + medical Expense + Personal Accident

22 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Miscellaneous Accident Insurance Theft InsuranceLiability Insurance Personal Accident Fidelity Guarantee Engineering Insurance Aviation Insurance

23 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Theft Insurance Burglary Insurance All Risks Insurance Goods in Transit Money Insurance

24 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Liability Insurance Products Liability Employers’ Liability Professional Indemnity Public Liability Workmen’s Compensation

25 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Personal Accident (Types of Benefit) Death Permanent Disablement Temporary Disablement Medical Expenses

26 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Fidelity Guarantee (Types of Policies) Individual Policy Blanket Policy Collective Policy

27 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Bonds (The 3 Parties) EmployerSurety (Insurer) Contractor

28 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Engineering Insurance Erection All Risks Machinery Breakdown Contractors’ All Risks Electronic Equipment Boiler Explosion

29 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Aviation Insurance Freight Liability Loss of Licence Personal Accident

30 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B Medical And Health Insurance (MHI) -A policy of insurance on disease, sickness or medical expense that provides specified benefits against risks of persons becoming totally or partially incapacitated as a result of sickness or accident. -Policy benefits are usually paid out in the manner according to the policy type or cover purchased as follows: reimbursement of medical expenses lump sum payment of the sum insured, or an allowance for the period the policyowner is hospitalized.

31 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 Basic Cover 1) Hospitalization and Surgical Insurance. - Common Policy Extensions/ Benefits: a) Outpatient Clinical Insurance b) Maternity Benefit 2) Major Medical Insurance 3) Dread Disease/ Critical Illness Insurance 4) Disability Income Insurance 5) Hospital Income Insurance CHAPTER 15 CLASSES OF GENERAL INSURANCE BUSINESS & GENERAL TAKAFUL BUSINESS

32 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 Policy Benefit Limitations a. General Waiting Period Shall not exceed 30 days from policy effective date b. Specified Illnesses Shall not exceed 120 days from policy effective date c. Co-payments CHAPTER 15

33 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 Exclusions 1)Pre-existing conditions 2)Congenital abnormalities or deformities including hereditary conditions 3)Plastic/ Cosmetic surgery, circumcision and eye examination 4)Pregnancy, childbirth, miscarriage and abortion 5)Disabilities arising out of duties of employment that are covered under workmen’s compensation insurance CHAPTER 15

34 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 Exclusions 6) Psychotic, mental or nervous disorders 7) Sickness or injury arising from racing of any kind (except foot racing) 8) Expenses incurred for sex changes 9) Investigation and treatment of sleep and snoring disorders, hormone replacement therapy and alternative therapy 10)Costs of services of a non-medical nature such as television,telephones etc 11) Private flying other than as a fare paying passenger CHAPTER 15

35 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 Golfers Insurance Basic Cover 1) Liability to the public 2) Personal Accident 3)Golfing Equipment/ Golf Clubs 4)Hole in one expenses CHAPTER 15

36 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 Exclusions -War risks, riot strike and civil commotion -Wear & Tear, depreciation, gradual deterioration or any process of repairing -Loss destruction/ Damage directly caused by or contributed to by or arising from radioactive or nuclear risks -Terrorism risk CHAPTER 15 CLASSES OF GENERAL INSURANCE BUSINESS & GENERAL TAKAFUL BUSINESS

37 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Takaful Business General Takaful business is all takaful business which is not Family Takaful Business General Takaful scheme is short-term Tabaruk Contract Participants in the scheme agree to pay entire contributions to create General Takaful Fund After deducting operational costs, the surplus shall be shared between participants and Takaful company according to Principle of Mudharabah CHAPTER 15 CLASSES OF GENERAL INSURANCE BUSINESS & GENERAL TAKAFUL BUSINESS

38 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 PRACTICE OF GENERAL INSURANCE- RISK ASSESSMENT, UNDERWRITING & RATING CHAPTER 16

39 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 Who are involving in the process of Underwriting ? CHAPTER 16 PRACTICE OF GENERAL INSURANCE- RISK ASSESSMENT, UNDERWRITING& RATING

40 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 16 PRACTICE OF GENERAL INSURANCE- RISK ASSESSMENT, UNDERWRITING& RATING 16.1 Underwriting 16.2 The Underwriting Process 16.3 Determination of Premiums, Terms & Conditions 16.4 Confirmation of Acceptance 16.5 Reinsurance & Coinsurance 16.6 Rating 16.7 Minimum Premium 16.8 Minimum Sum Insured 16.9 Refund of Premium 16.10/12 How to Use Tariff

41 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Underwriting CHAPTER 16 The purpose of underwriting is to - Guard against anti-selection - Charge a premium that is commensurate with the risk transferred When anti-selection exists within a class of risks, the actual loss will be greater than the expected loss because the class of risks does not represent a randomly selected group (Law of Large Number)

42 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : The Underwriting Process CHAPTER 16 Underwriting can be defined as: - A process of assessment and selection of risks - Determination of premium, terms and conditions

43 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : The Underwriting Process - Physical Hazards CHAPTER 16 Fire - Type of construction, Height of Building - Nature of Flooring, Type of Occupancy etc Motor - Type of vehicle, Cubic capacity, Use of Vehicle - Age & condition of vehicle, Modification on Vehicle Burglary - Nature of Stock, Situation - Type of Construction, Security Precaution Personal Accident - Age of Person, Type of Occupation - Health & Physical Condition, Hobbies

44 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : The Underwriting Process- Moral Hazards CHAPTER 16 CarelessnessFraud Unreasonableness

45 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Determination of Premiums, Terms & Conditions CHAPTER 16 Risk Improvement Warranties ExclusionRestricted Cover ExcessFranchise

46 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Confirmation of Acceptance CHAPTER 16 If the terms and conditions are acceptable to proposer, the insurer will usually issue cover note as evidence of temporary cover.

47 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Reinsurance & Coinsurance CHAPTER 16 Reinsurance is an arrangement where the insurer reinsures/cedes the part of risk assumed which is in excess of his retention to reinsurer Coinsurance is an arrangement between two or more insurers to share original risk

48 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Rating CHAPTER 16 ClassMerit Individual

49 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B /8 : Minimum Premium /Minimum Sum Insured CHAPTER 16 Minimum Premium Fire RM 50 Private Car RM 50 Workmen Compensation RM 35 MotorcycleRM 20

50 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B /12 : How to Use Tariff CHAPTER 16 FireMotor Workmen Compensation

51 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Refund of Premium CHAPTER 16 Premium is refundable due to - Failure of consideration - Provision in the policy

52 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 INSURANCE DOCUMENTS CHAPTER 17

53 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 Why do we need to fill up a Proposal Form ? CHAPTER 17

54 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 17 Part A : Overview The Proposal Form The Cover Note The Certificate of Insurance The Policy Form Endorsement Renewal Notice Renewal Certificate Claims Form Discharge Form

55 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 17 Part B : Proposal Form 1.An insurance contract is effected when the offer made by one party (the proposer) is accepted by the other party (the insurer). 2.It is a document drafted by insurer in the form of questionnaires to gather information required to access a risk being proposed. 3.Proposal Forms are not used in Marine Cargo Insurance and For Large Risks

56 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 17 Part B : Proposal Form : The Structure of A Proposal Form It is divided into 5 sections:- (a)Requirements of Insurance Act, 1996 (b)Questions of a General Nature (c)Insurance related Questions (d)Declaration (e)Signature

57 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER : The Structure of A Proposal Form (a) Requirements of Insurance Act, 1996 Subsection 149(4) You are to disclose in the proposal from, fully and faithfully all the facts which you know or ought to know, otherwise the policy issued hereunder may be invalidated.

58 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER : The Structure of A Proposal Form (b) Questions of a General Nature Proposer’s Name Proposer’s Address Risk Address Proposer’s Occupation Previous and Present Insurance Loss Experience Sum Assured Subject Matter

59 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER : The Structure of A Proposal Form (c) Insurance Related Questions Some examples:- Fire Insurance Motor Insurance  Type of construction and  Cubic capacity use of the building  Whether building is detached  Year of manufacture or adjoined to another  Type of power used  Driving offences  Occupation of adjoining  Cover required building (left & right)

60 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 17 Part C : The Cover Note A Cover Note is issued:-  in advance of a policy when negotiation is completed  during the course of negotiation  when a survey has to be carried out

61 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 17 A Cover Note :-  a temporary policy  evidence of the insurance contract  provides the usual coverage found in a standard policy  provides that the insurance is subject to Tariff warranties if the risk proposed is governed by a Tariff

62 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 17 Part D : The Certificate of Insurance  A certificate of Insurance is issued when insurance is made compulsory by law  The marine certificates (not compulsory by law) are issued by mutual agreement between Insured and Insurer  The marine certificate provides evidence of insurance to interested parties including banks and consignees

63 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 17 Part E : The Policy Form  A policy is a document drafted by the insurer  A policy has to be stamped  Use the wording provided by the Tariff if the insurance is governed by Tariff  Types of policy form :- * Scheduled * Narrative

64 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER : The structure of a Scheduled Policy Form  Heading  The Preamble or Recital Clause  The Operative or Insurance Clause  Exclusion  The Schedule  Attestation or Signature Clause  Conditions

65 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER : The Schedule The information in the schedule:-  Insured name and address  Premium  Policy number  Date of issue  Agency  Risk covered  Period of Insurance  Property Insured  Sum Insured  Warranties applicable

66 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER : Conditions Classification of conditions:- (i)Express (ii) Implied (iii)the time that conditions need to be fulfilled * Conditions Precedent to Contract * Conditions Subsequent to Contract * Conditions Precedent to Liability

67 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER : Policy Register Section 47 of Insurance Act every insurer shall maintain an up-to-date register of all policies and none of them shall be removed as long as the insurer is still liable for these policies.

68 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 17 Part F : Endorsement (a) Endorsements are used to modify The Terms & The Standard Policy Document  The endorsement form part of the policy  In certain classes of business, the attachment of endorsement to the policy is compulsory. Eg. Workmen’s Compensation Insurance and Motor Insurance

69 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 17 (b) Endorsements May Incorporate Alterations to an Existing Policy  Variation in Sum Insured  Change of Insurable Interest  Extension of insurance  Change of risk  Transfer of property to another location  Cancellation of insurance  Change in name and address

70 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 17 Part G : Renewal Notice  Insurers usually issue a renewal notice one month in advance of the date of expiry  Important notes in renewal notice:- * A note advising the insured to disclose any materials alterations in the risk since the inception of policy (or last renewal date) * “No risk can be assumed unless the premium is paid in advance”

71 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 17 Part H : Renewal Certificate  Renewal Certificate will be issued if the renewal is on similar terms as the original contract  If the renewal is on different terms, a fresh policy is usually issued

72 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 17 Part I : Claim Form  Claim forms are documents drafted by the insurers to gather information relevant to assessing claims  The issue of a claim form does not constitute an admission of liability on the part of the insurance  Claim forms are not used in marine insurance except in respect of inland transit claims

73 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 17 Part J : Discharge (i) Claims Settlement Methods  settlement with an insured in respect of an insured loss(own loss); or  settlement with 3rd party on behalf of an insured in respect of the insured’s liability for loss caused to the 3rd party(Liability to 3rd party) (ii) The Purpose of a Discharge  To avoid the possibility of any further claims being made in relation to the loss

74 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 17 Part J : Discharge (iii) The Declaration Section of The Discharge Form [a]“Own loss” declaration stating that the insured claimant:-  has received a sum of money from the insurer  the money received is in full satisfaction of his claim under the policy in relation to that loss

75 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 17 Part J : Discharge (iii) The Declaration Section of The Discharge Form [b]“Liability to 3rd party” declaration stating that the 3rd party claimant:-  has received a sum of money from the insurer  the money received is paid by the insurer on behalf of the insured, and  the money received is in full satisfaction of the 3rd party’s right to claim from the insured person in respect of the loss

76 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 17 Part J : Discharge (iv) If Settlements is Not by CASH... The insurers would issue a discharge form known as completion / satisfaction note which usually incorporates a declaration stating that:-  The repair, reinstatement and/or replacement has been effected by a person (on behalf of the insurer), and  They are carried out to the satisfaction of the claimant

77 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 17 Part J : Discharge (v) Other information Provided by a Discharge Form  Name and identity of the claimant  Details of the loss:- * date and time of loss * place of loss * parties affected * subjected matter of loss * Signature of attesting witness, if required

78 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 PRACTICE OF GENERAL INSURANCE: CLAIMS CHAPTER 18

79 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 What are our roles in facilitating a Claim? CHAPTER 18 : CLAIMS

80 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 18 Part A : Overview  Claims Procedure  Claims Documentation  Settlement of Claims  Recoveries from Reinsurers, Co-insurers, Subrogation and Contribution  Repudiation of Liability by insurers  Average  Claims Settlement Agreement  Disputes  Post-Settlement Action

81 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 18 Part B : Claims Procedure : Notification of Loss  Immediate notification of loss is expected  The Duty of Good Faith requires the Insured to minimize the loss

82 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER : Checking Coverage Notice of loss received Preliminary check valid claim exists Claim Form/ Accident Report Form

83 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER : Checking Coverage Conditions for a Valid Claim  Is the policy in force?  Has premium been paid?  Is the loss caused by an insured peril?  Is the subject matter affected by the loss the same as that insured under the policy?  Has notice of loss been given without undue delay?

84 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER : Investigation of The Claim  A small claim will usually be paid on the basis of documents submitted by the claimant  Advice is sought from loss adjustors in setting large and complicated claims  Claim investigation involves ascertaining:- * The validity of a claim * The amount of loss

85 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER :Ascertaining the Amount of Loss  Property damage or loss claims: Proof of the value of lost items or estimates of repair, replacement or reinstatement.  Liability claims: Subjection of negotiation between the insurer and the person who has suffered injury or property damage

86 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 18 Part B : Claims Procedure :Ascertain Subrogation rights & Contribution Duties Notice of loss received Preliminary check valid claim exists Claim Form/ Accident Report Form Investigation of the Claim Ascertaining the amount of loss Ascertain Subrogation rights & Contribution Duties

87 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 18 : CLAIMS Part C : Claim Document The documents required vary with the type and nature of the claim. Fire Insurance  Photographs  Technician report (where applicable)  Purchase invoices, repair bills, sales record and other related documents  Police report (where damage is extensive)  Fire brigade report (where damage is extensive)

88 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 18 : CLAIMS Part D : Settlement of Claims Methods of Settling a Claim  Cash-payment of claim by cheque, or  Repair  Replacement  Reinstatement

89 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 18 : CLAIMS Part F :Repudiation of Liability by Insurers Repudiation of liability is based on several grounds:-  There was no loss or damage as reported;  The loss or damage for which a claim has been made was not caused by a peril or was excluded by the policy; or  The policy has been rendered void as a result of a breach in condition (implied / express) or warranty

90 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 18 : CLAIMS Part G :Average  When under-insurance exists, the policy is subject to average Amount = Sum Insured x Amount of Payable Value of property Loss  The principle of average is therefore applied to penalise the insured who has underinsured his property

91 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 18 : CLAIMS Part H :Claims Settlement Agreement  Most motor insurers subscribe to a claim settlement agreement known as the “Knock-For-Knock” Agreement  The participating insurers agree to pay the cost of repairing their own comprehensively insured cars regardless of who is to blame

92 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 18  Advantages of the “Knock-For-Knock” Agreement  Enable motor insurers to speed up settlement of claims and reduce legal and administration expenses  Disadvantage of the “Knock-For-Knock” Agreement  Withdrawal of policyholder’s NCD upon settlement of any claim  Normally, the policyholder will claim against the negligent motorist’s insurer and thereby retain his NCD

93 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 18 : CLAIMS Part I :Disputes Disputes may involve one of the two issues:-  the question of whether the insurer is liable; or  the quantum of loss, if the insurer is liable Dispute is resolved through the following channels:-  Negotiation  Litigation  Arbitration  Insurance Mediation Bureau

94 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 18 : CLAIMS Part J :Post-Settlement Action  Terminate the policy; or  Reduce the sum insured, and reinstate if requested by insured, in which event new terms and conditions may be imposed

95 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 18 Part J :Post-Settlement Action : Terminate Policy  a total loss arising under the policy; or  the full sum insured under the policy; or  a capital sum benefit under a personal accident policy; or  any claim under a fidelity guarantee policy

96 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 18 Part J :Post-Settlement Action : Reduce Sum Insured and Reinstate, if requested : Impose New Terms and Conditions

97 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 PRACTICE OF GENERAL INSURANCE : POLICY FORMS CHAPTER 19

98 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 CHAPTER 19 : POLICY FORMS What information can we obtain from Policy Forms ?

99 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 PART A : OVERVIEW CHAPTER 19 : POLICY FORMS Fire Policy Private Motor Car Policy

100 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B FIRE POLICY Heading Recital Clause Operative Clause Conditions Exclusion Schedule Attestation CHAPTER 19 : POLICY FORMS

101 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B FIRE POLICY Heading Consists of the Company’s name and address Recital Clause Insured has proposed to the company Proposal and declaration is basis of contract Insured has paid or agreed to pay premium CHAPTER 19 : POLICY FORMS

102 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B FIRE POLICY Operative Clause Coverage Payment of loss Compliance of condition Option to pay cash, repair, reinstate or replace Maximum liability of the company CHAPTER 19 : POLICY FORMS

103 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B FIRE POLICY Condition Misrepresentation Premium Payment Other insurance Fall or displacement of building Unoccupancy Refund of premium CHAPTER 19 : POLICY FORMS

104 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B FIRE POLICY Condition Notification of loss Fire Brigade charges etc Subrogation Fraudulent Claim Average clause Reinstatement of sum insured Arbitration CHAPTER 19 : POLICY FORMS

105 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B FIRE POLICY Exclusion Theft during or after fire, War, Pollution Burning of property by public authority Subterranean fire, Convulsion of nature Bush fire, Explosion (except domestic use) Precious stone, work of art, drawing, stamps Spontaneous fermentation, combustion CHAPTER 19 : POLICY FORMS

106 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B FIRE POLICY Reasons for Exclusion Cover by other appropriate policy Further inquiry on the risk Additional premium is necessary The risk is uninsurable CHAPTER 19 : POLICY FORMS

107 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B FIRE POLICY Schedule Name of insurer Name and address of insured Business/Occupation Location of property insured Period of insurance, premium & sum insured Endorsement and warranties Attestation This has the effect of binding insurer CHAPTER 19 : POLICY FORMS

108 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B PRIVATE MOTOR CAR POLICY Heading Recital Clause/Preamble Operative Clause General Exclusion Conditions Schedule Attestation CHAPTER 19 : POLICY FORMS

109 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B PRIVATE MOTOR CAR POLICY Operative Clause Section I: Loss or damage Section II:Liability to 3rd Party Section III:Medical Insurance Section IV: Accidents to Insured CHAPTER 19 : POLICY FORMS

110 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B PRIVATE MOTOR CAR POLICY Operative Clause Section I: Loss or damage Accidental collision or overturning Fire or lightning, house breaking or theft Malicious act Direct sea route or whilst in transit CHAPTER 19 : POLICY FORMS

111 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B PRIVATE MOTOR CAR POLICY Operative Clause Section I: Exclusion Consequential loss, depreciation Mechanical breakdown Act of cheating Criminal breach of trust CHAPTER 19 : POLICY FORMS

112 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B PRIVATE MOTOR CAR POLICY Operative Clause Section II: Liability to 3rd Party Death or bodily injury to 3rd party Damage to property belonging to 3rd party CHAPTER 19 : POLICY FORMS

113 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B PRIVATE MOTOR CAR POLICY Operative Clause Section III: Medical Insurance Bodily injury sustained by insured or driver Section IV: Accidents to Insured Bodily injury sustained by insured CHAPTER 19 : POLICY FORMS

114 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 PRACTICE OF GENERAL INSURANCE: ETHICS AND CODE OF CONDUCT CHAPTER 20

115 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 What are the good Ethics and Code of Conduct ? CHAPTER 20 : ETHICS AND CODE OF CONDUCT

116 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B174 OVERVIEW The Essential of Inter-Company Agreement on General Insurance Business Commission Cash-Before-Cover Guidelines on Claim Settlement Practices CHAPTER 20 : ETHICS AND CODE OF CONDUCT

117 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : ICAGIB (Objectives) Promote and protect the interests of the general insurance industry Regulate and control the conduct of every person transacting general insurance business Monitor tariffs, commissions & remuneration CHAPTER 20 : ETHICS AND CODE OF CONDUCT

118 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Dealings with Agents Authorized agents Restriction on payment Compliance with regulations Scope of agency Suspension and Cancellation Information CHAPTER 20 : ETHICS AND CODE OF CONDUCT

119 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : General Insurance Business for All Intermediaries (Exclude Insurance Broker) General sales principles Factors to be observed when explaining contract Disclosure of underwriting information Accounts and financial aspect Documentation, existing policyholder and claim CHAPTER 20 : ETHICS AND CODE OF CONDUCT

120 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B (a): General Sales Principles Make prior appointment Identify own self Recommend policy suitable to needs Recommend other specialist when necessary Treat all information by prospect confidential CHAPTER 20 : ETHICS AND CODE OF CONDUCT

121 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B (b): Explaining A Contract Identify insurance company Explain all essential provision Draw attention to exclusion/restriction (c): Disclosure of Underwriting Information Proposal forms are fully & accurately completed All answers are prospect’s own responsibility CHAPTER 20 : ETHICS AND CODE OF CONDUCT

122 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B (d): Accounts and Financial Aspect Keep proper account Distinguish premium from other payment Remit money collected (e-g): Documentation, Policyholder & Claim Provide all documentation to policyholder Render appropriate after sales service Inform insurer immediately should claim arise CHAPTER 20 : ETHICS AND CODE OF CONDUCT

123 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : Commission No discount or rebate is allowed 20.3: Cash Before Cover Part XV Regulation 65 of the Insurance Regulation 1996 provides that an insurer or its insurance agent shall not assume motor policy unless the premium has been paid CHAPTER 20 : ETHICS AND CODE OF CONDUCT

124 AIA confidential and proprietary information. Not for distribution. GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA BLUE R0 G115 B : GUIDELINES ON CLAIMS SETTLEMENT Part I: Deal with claims other than motor - Claim procedure - Disclosure of material fact Part II: Deal with motor insurance claims - Own damage - Total loss - Theft- Subrogation - 3rd Party CHAPTER 20 : ETHICS AND CODE OF CONDUCT

125 AIA confidential and proprietary information. Not for distribution. Thank You


Download ppt "GREY R209 G211 B212 RED R211 G17 B69 WEALTH MANAGEMENT R139 G155 B147 TAKAFUL R109 G179 B63 PLUM R156 G0 B88 CITRUS R248 G152 B32 LIME R178 G187 B30 SEA."

Similar presentations


Ads by Google