Professional Documents
Culture Documents
CHAPTER 1: INTRODUCTION TO RISK AND INSURANCE: Basic concept of risk Assets Risks and Perils Risk and Uncertainty Risk as Statistical Dispersion - Classification of Risks - Nature of Risk Environment - Static and dynamic risks Fundamental and Particular Risks Hazards - role of Insurance - Insurance and the burden of risk - mechanism of insurance. CHAPTER 2: RISK MANAGEMENT AND INSURANCE: Risk Management and Insurance Management - Steps in the Risk Management Process - Laying the objectives - Identification of risks - Evaluating and measuring the risk - Loss Frequency - Loss Severity - Classifying the Risk - Managing the Risk - Risk Control Retention - Insurance as a tool. CHAPTER 3: PRINCIPLES OF GENERAL INSURANCE: General insurance the legal definition - Heterogeneity of Risk Exposures - Heterogeneity and Risk Classification Solidarity - Claims Frequency and Size - Distribution of Claims - Credibility theory - Risk Theory and the concept of Ruin The Pure risk premium - The Office Premium - Class and Individual Rates Reserves. CHAPTER 4: LIFE INSURANCE AN INTRODUCTION: Life Insurance and its customers The Economic Life Cycle The Asset Defining and Measuring HLV The Risks Mortality verses other risks Age and mortality risk Level Premiums Types of Life Insurance - Pooling and financial risks The contract The Buy Term Debate. CHAPTER 5: PRINCIPLES OF LIFE INSURANCE: PREMIUMS: Determination of Premiums Premiums and Price Elements of Premium Mortality The Mortality Table Standard Mortality Table Calculation of Mortality Costs Interest - Future and Present Value of Annuity The Net Premium Net single
Premium Net Level Annual Premium Gross Premiums Reasons for Loading Loading for Expenses Loading for contingencies Bonus Loading. CHAPTER 6: PRINCIPLES OF LIFE INSURANCE: PROFIT AND RETURNS: The Actuarial Control Cycle Reserves Net and Gross Premium Reserves Assets Shares and Surrenders Valuation and Surplus Analysis of Surplus Sources of Surplus Determining the divisible surplus Factors influencing retention of surplus Free Assets Distribution of surplus The Bonus mechanism Reversionary Bonus Cardinal principles in bonus distribution Re valorisation The contribution method Investment and Unit Linked Insurance. CHAPTER 7: LEGAL FOUNDATION OF INSURANCE: Sources of Law Elements of Insurance Contract The Principle of Adhesion The Principle of Uberrims Fides Material Facts Breach of Utmost Good Faith MisRepresentation Proximate Cause. CHAPTER 8: PENSION HEALTH AND GROUP INSURANCE: Pensions and Old Age Income Security Public Pensions Occupational Pensions Personal Pension Pensionsthe value proposition Morbidity and Insurance Medical Expenses Insurance Managed Care and Medical Expenses Living Benefits Long Term Care Discuss the Group Insurance. CHAPTER 9: THE FINANCIAL MARKET PLACE AND INSURANCE: Representation and Warranty The principle of Insurable Interest The Principle of Subrogation The Principle of Contribution
Introduction of Finance and Financial Products Basic Categories of Financial Products Distinctive Features of Financial Products Attributes of Financial Assets Risk Liquidity Convenience Tax Benefit Fiduciary Responsibility Financial Market-A Taxonomy Primary and Secondary Market Money and Capital Markets. CHAPTER 10: INSURANCE: THE CHANGING CONTEXT: Demographics and other changes Life Cycle Changes Family Changes The Three Pillars Changing Profit of Non-Life Risks Financial Market Changes Implication and Industry Responses. I nsurance I nstitute of I ndia 2
returns on retirement plans Maintenance of Retirement Plan Pensions in US Types of IRAs. CHAPTER 6: RISK MANAGEMENT AND INSURANCE PLANNING: Risk Management and Insurance Risk, perils and Hazard Process of Risk Management Requirement of an Insurable Risk Understand Life InsuranceConcept, types, needs of Human Life Value Term Plan Tax Benefits What is HLV Calculation, Method, Need based Approach of HLV General Insurance General Insurance Products. CHAPTER 7: ESTATE PLANNING: Needs - Different methods to bequeath estate / wealth through Wills, Trust, Gifts, Power of Attorney, Partition, Life Insurance - Intestate Succession in India General Rules for Succession Inheritance Muslim Law in India. CHAPTER 8: TAX PLANNING: What is Tax Planning Income Tax Law in India Basic Concept Definitions Income Tax Rates Education Cess Incomes Exempt from Income Tax Classification of Heads of Income Income tax on Salary VRS guidelines Quantum Exemptions Tax Free perquisites Income from House Property Gross Annual Value Profits and Gains of Business or Professions Depreciation & its definition Capital Gains Income from other sources Deductions Clubbing of Income Aggregation of Income Deductions and Rebates Rebates and Reliefs Wealth Tax Gift Tax.
approaches for selling Life Insurance HLV Approach Need Analysis Approach Vogue Methods Positioning Life Insurance Principle Value Propositions of General Insurance General Insurance Products Approaching Prospects Risk Management Process Identify needs for Insurance. CHAPTER 5: EXPLORING THE MARKET: Definition of ones market Process of Market Research Companys Data Base Internal Report Marketing Intelligence Marketing Research Customer Market Segmentation How market is targeted. CHAPTER 6: PROSPECTING: Importance of Prospecting Hurdles of Prospecting Approaches Methods of Prospecting. CHAPTER 7: GETTING THE APPOINTMENT FOR A SALES INTERVIEW: Necessary to search for an appointment various contexts for which appointment may be sought - Fixing the appointment Language use - Plan, Do, Review. CHAPTER 8: THE SALES INTERVIEW: Confidence Risks Opening of the meeting - structure of the discussion - effective questioning techniques I nsurance I nstitute of I ndia 5
prospects needs - Financial Planning Tool - Fact Find Formats and their applications - Wealth Enhancement. CHAPTER 9: PRESENTING THE SOLUTIONS: Neuro Linguistic Programming Personality Types How to structure a solution High Net worth Individuals How to convince the prospects. CHAPTER 10: OBJECTIONS HANDLING: Welcoming Objections - Approaches to handling objections Meeting an objection Life Insurance the principal objections. CHAPTER 11: THE CLOSE: Significance of closing a sale Effective Closes Probability close Trial Close Summary Close Fear Close The Weightageassignment Close Implied Close. CHAPTER 12: CONTINUING THE RELATIONSHIP: Customer Lifetime Value Approaches to building Customer Relationships. CHAPTER 13: THE DISCIPLINES OF SELLING: Introduction of Disciplines Self Awareness Planning and goal setting Role of Persistence and averages Ethics Managing Frustration Work Life Balance. CHAPTER 14: THE KARMA AND THE DHARMA OF SELLING: Karma Probable approaches Perception Dharma. CHAPTER-15: INSIGHT: MAKING OF A SUCCESSFUL INSURANCE SALESPERSON
Employees Deposit Linked insurance Scheme Group Insurance Scheme in-lieu of EDLI Social Security Scheme. CHAPTER 6: LINKED LIFE INSURANCE POLICIES: Concept of Unit-linked policies ULIP premium and its break-up Types of funds in ULIPS Traditional plans Vs ULIPS How ULIPS work Top Up & NAV Features of ULIPS Revival of ULIPS IRDA guidelines on ULIPS. CHAPTER 7: APPLICATIONS AND ACCEPTANCE: Fundamentals of life insurance contracts Principles of utmost good faith Insurable interest Life insurance policy application and process Proposal form and related documents. CHAPTER 8: POLICY DOCUMENTS: Importance of a policy document Format of a policy document Policy schedule and its various components Conditions and privileges in a policy document Duplicate policies. CHAPTER 9: PREMIUM PAYMENT, POLICY LAPSE AND REVIVAL: Premium calculations Surrender value and non-forfeiture options Revival of lapsed policies and its types Revival of postal life insurance policies. CHAPTER 10: ASSIGNMENT, NOMINATION AND SURRENDER OF POLICY: Assignment of life insurance policies Conditional assignment Absolute assignment Process of Assignment Nomination Process of Nomination Features of Nomination Assignment Vs Nomination Surrender of policies Foreclosure of insurance policies. CHAPTER 11: POLICY CLAIMS: Different types of policy claims Survival Benefits Death Claims Maturity Claims Submission of Proof of title at claim processing stage Early Claims & Non early claims Documents required for processing early claims Death due to un-natural causes or accidents Nomination Assignment Waiver of evidence of title Claims Concession Clause and Extended Claims Concession Clause Presumption of I nsurance I nstitute of I ndia 8
Death Insurance Riders Accidental Death Benefit rider Permanent Death Benefit Rider IRDA regulations w.r.t Claim payments.
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CHAPTER 6: SPECIALISED INSURANCES: Industrial All Risks insurance Advance Loss of Profits insurance Oil & Energy Risks insurance Satellite insurance. CHAPTER 7: UNDERWRITING: Objectives and approach Underwriting policy Class Rated Products Individually Rated Products Filing of products Role of Actuary Compliance officer Underwriting Practice in different classes of insurance Moral hazard Underwriting of physical hazards Declined risks Risk inspections Reinsurance Risk Management Insurers role in risk management Documentation procedure Renewal procedure Customer service IRDA Regulation Protection of Policyholders Interest. CHAPTER 8: RATING & PREMIUM: Classification of risks Discrimination Bonus/Malus Claims cost Acquisition cost Management expenses Classification of products Premium Short period scales Failure of consideration Refund / return of premium Advance payment of premium. CHAPTER 9: CLAIMS: PRELIMINARY PROCEDURE Loss minimization Procedure Claims form Investigation & assessment Surveyors and loss assessors Claims documents Arbitration Discharge vouchers Post settlement actions Recoveries Salvage & loss minimization In house settlement Practices in U K & USA. CHAPTER 10: INVESTMENT & ACCOUNTING: IRDA Investment Regulations 2000 Accounting Reserves for outstanding claims Unexpired risk reserves Other reserves Final accounts Profit & Loss account Balance Sheet Returns Returns for Management control Claims, underwriting and general administration returns Database on computer.
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Economic Planning and Planning Models, Needs, Meaning, Price Mechanism, Elements of Plan, Planned model, Planning in India. CHAPTER 5: MACROECONOMIC INDICATORS AND BUSINESS
ENVIRONMENT: Economic Impact, relation between Demographics, income, savings, investment and insurance, Demography, National Income and related Indicators, concept and measurement of national income, Gross Domestic Product (GDP), Measuring National Income, Purchasing Power Parity [PPP], GDP and Welfare, Economic Development and Structural Change, Division of Sectors as Organised and Unorganised, Poverty - an Analysis, Inequality, Unemployment, Inflation, Reflect, Consumer Price Index (CPI), Recession and the Business cycle. CHAPTER 6: ECONOMIC REFORMS: LIBERALISATION, PRIVATISATION AND GLOBALISATION: Liberalization, Privatization and Globalisation, reforms in various sectors in India, needs of reforms, Reforms in Perspective, INDIAN ECONOMY THE WOW factor, Demographic Transition, Agriculture, Infrastructure, Industry, Rural Markets Government Spending in Rural India, Trade and Investments, Booming Capital Market. CHAPTER 7: FISCAL AND MONETARY POLICY: Public finance and taxation (fiscal policy), Objectives of Fiscal policy, Fiscal Policy certain concepts, Public Expenditure, Public Revenue, Specific and Ad-Valorem Taxes, Progressive, Proportional and Regressive Taxes, Indian budget, The economic Survey, The Budget, Capital Budget, Taxes, Value Added Tax [VAT], Tax burden, Tax reforms, TAX - GDP Ratio, Tax rebate, The fiscal challenge, Budget policy instruments, Monetary policy, Role of Reserve Bank of India, Relevance of monetary and credit policy, Open Market Operations (OMO), Monetary Policy and Inflation, The Budget. CHAPTER 8: EXTERNAL SECTOR - FOREIGN TRADE: Open economy macroeconomics, The Balance of Payments, BoP Surplus and Deficit, Autonomous I nsurance I nstitute of I ndia 13
and Accommodating Transactions, The need for foreign trade, Theory of Foreign Trade, Foreign Trade Policy, History of Foreign Trade Policy, objectives, Growth of Foreign Investment, FDI - Foreign Direct Investment, Purpose and need for FDI, FDI-related Institutions in India, Legal Framework, Mode of entry, Mergers and Acquisitions, Foreign Institutional Investors, Rising Domestic Investment Demand. CHAPTER 9: FINANCIAL MARKETS AND THE ECONOMIC ENVIRONMENT: Overview of the financial systems, Instruments of financial Market, Market Efficiency, Foreign Exchange Market, Money and Foreign Exchange Market, Bank and their Role, Financial Intermediaries, State Level Financial Corporations, Insurance Companies, Mutual Fund, Non-Banking Finance Corporations, Banks as Financial Intermediaries, Banking in new Millennium, The Indian Banking System, Deficiencies of Indian Banking System, Evolution of Banking, Success and competition, liberalization, Current Scenario, Indian Capital Market, Stocks and Scams, Liberalising Indias Financial Sector. CHAPTER 10: GOLBAL TRENDS IN THE INSURANCE INDUSTRY: Key Findings, Steep Driver and Factors.
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CHAPTER 6: MOTIVATION: Needs, Drives and Goals, Needs and their types, Needs Arousal, Maslows Hierarchy of Needs, Sheths Five Needs, Mc Clellands Three Needs Theory, Ernest Dichters Motives for Consumption, Motives and Motivation, Positive and Negative Motivation, Consumer Motivation, Consumer Moods, Hedonic Consumption, Consumer Involvement, Personality, Theories of Personalities, Freudian Theory, Trait Theory, Neo-Freudian Personality Theory, Personality and consumer Diversity, Consumer innovativeness, Social Character, Cognitive personality Factors, Consumer Materialism to Compulsive Consumption, Brand Personality, Personality and Colour, Psychographics, values and lifestyles, Social Class. CHAPTER 7: PERCEPTION: Perception a Background, Factors in perception, process of Learning, Learning and Memory, Classical conditioning, Negative Reinforcement, Operant Conditioning, Vicarious Learning, Memory. CHAPTER 8: CONSUMER DECISION MAKING PROCESS: Consumer Decision Making Process, Steps in Decision making process, Consumer Decision Rules, Level of Consumer Decision Making, Consumer Behaviour Model, Economic and Marshallian Models, Disposable Personal Income, Learning or Pavlovian model, The Psychoanalytical Model, Gestalt, Cognitive theory, Sociological Model, Howard Sheth Brand Buyer Behaviour Model, Nicosia Model. CHAPTER 9: ROLE OF RESEARCH IN UNDERSTANDING CONSUMER BEHAVIOUR: Consumer Research Methods, Primary vs Secondary Research Method, Focus Group, Personal Interviews, Projective Techniques, Observation, Online research Method, Scanner Data, Research Sequence, Caution. CHAPTER 10: EPILOGUE THE MEGA MORPHING OF THE INDIAN CONSUMER SINCE MARUTI 800: Emerging, The path breaking changes, The New, New Consumer, softer issues.
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CHAPTER
7:
AGENCY
DEVELOPMENT
AND
MANAGEMENT
CYCLE:
Developing an insurance agent, Agent Recruitment and Development Cycle, Suspecting, Prospective Activities, Steps for agent recruitment activities, Nominators, Agent Referrals, Name collection Activity, Screening, Business opportunity Preview, Selection and appointment, Post recruitment stage, Establishing Authority and Accountability, New Agent Development Process, Reward and recognition platform. CHAPTER 8: AGENCY MANAGEMENT TOOLS AND PROCESSES: Goal Setting Exercise, Types of goals, Developing Sales Team, Classroom intervention and Field orientation, Field Demonstration, Filed observation, Feedback, Mentoring, Coaching, Different types of coaching model, Coaching vs Mentoring, Performance Review Meeting, Counselling. CHAPTER 9: REGULATORY COMPLIANCE IN AGENCY BUSINESS OF LIFE INSURANCE: Introduction and Objective, Mission statements of IRDA, Compliance to regulation, Code of Conduct of agents, Regulations of Agents in Life Insurance, New/Modified Regulations.
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CHAPTER 6: REFORMS IN THE INSURANCE SECTOR: The Malhotra Committee, the IRDA, Initiatives of the IRDA. CHAPTER 7: PROGRESS SINCE 2000: Insurance Business, Life Insurance
Business Growth, Life Insurance Growth of Different Products, Life Insurance Growth in Distribution Channels, Issues in the Development of Insurance in India, Business and Organisation General Insurance, Marketing Channels in Insurance, Intermediaries for Claims Processing - General Insurance, T.P.A. in Health Insurance, Product Development in Insurance, Appointment of Actuary, Products in General Insurance, Health Insurance, Different Govt. Schemes, Hospitalisation Cover, General Insurance Emerging Products, Micro Insurance, Types, Issues in Life Insurance, Issues in Growth and Productivity, Product Diversity, Profitability, Profits After Tax Of Life Insurers, Retrospect. CHAPTER 8: OTHER INSTITUTIONS AND LAWS: Role of Institutions and Growth, National Insurance Academy, Institute of Actuaries of India (IAI), Ombudsmen, Integrated Grievance Management System [IGMS], Insurance Information Bureau, Indian Institute of Insurance Surveyors And Loss Assessors, Motor Vehicles Act, Lok Adalat, Jald Rahat Yojana, Hit and Run Cases, Various Acts Relating to Marine Insurance, Acts Relevant to Workmen / Employees Insurance.
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PRODUCTS: The life Insurance product, Value for Customers, The HLV Concept, Need Analysis Approach, Contact of indemnity and insurance, Long term relationship aspects, The Post-Sales service obligation, The safety of Investment Aspects, The immediate Estate Feature. CHAPTER-3: NECESSITY, WANTS AND NEEDS: Difference between Needs, wants and necessity, Hierarchy of needs, Limitation of Maslows Theory, FMCG, Durables, Financial Products & Life Insurance, its Fundamentals, Features, Typical Life Insurance needs, Death & Living Benefit products, Compounding and Discounting. CHAPTER 4: LIFE INSURANCE: A COMPLETE LIFE-STAGE FINANCIAL PLANNING TOOL: Life Cycle stages and roles, Insurance Products for life stages, Protection, Development in Term Assurance, Variants of Term Assurance, Appeals, Health Cover-Stand alone and Riders, Terminal illness, Medical Savings, Savings for needs or aspirations, Growth /Enhancement of Wealth, Retirement Planning, Other Contingencies, Estate Planning, Insurance Plans for Corporates, Key man insurance Restriction, Partnership Insurance, Group Insurance. CHAPTER 5: OTHER CONTINGENCIES AND PRODUCTS: Protection plans and Disability, Disabilities and its solutions, Disability Income Insurance, Long I nsurance I nstitute of I ndia 21
Term Care, Life Insurance Product Plans, Family Oriented Policies, Juvenile Insurance, Dynamic Life Insurance, Capital Accumulation and Traditional Plans, With Profit Plans, Bundled and unbundled plans, Universal Life, Variable life Insurance plans, Universal Variable Life Plans, Unit linked Insurance Policies, Unit Linked vs Traditional Life Insurance Plans, Difference between ULIP and Mutual Funds, Riders, Pensions, Types of pension annuities. CHAPTER 6: LIFE INSURANCE VS. OTHER FINANCIAL PRODUCTS:
Financial products attributes and attribute preferences, Attributes a closer look, Liquidity, Types of Financial Products, Bonds, Mutual Funds, Equity Shares, Fixed Deposit. CHAPTER 7: LIFE INSURANCE PRODUCT DEVELOPMENT: Concept and approaches to product Development, Steps of product development, Comprehensive Business Analysis, Product Life Cycle and its Stages. CHAPTER 8: TAKAFUL (ISLAMIC INSURANCE): Meaning and concept of Takaful, Takaful Development, Takaful Market, Principles of Islamic Insurance, Elements of Takaful, Takaful Operational Model, Segregated Funds, Participants Investment Funds, Operating Principles of Takaful Company, Administration of Takaful Company, Types of Life Insurance Products, Pricing, Claims under Family Takaful, Distribution of Profit.
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CHAPTER 7: REGULATION AND TAXATION OF ANNUITIES: Regulatory Authorities governing Financial Institutions in India; Insurance regulatory system in India; ombudsman, tribunals, appellate courts, etc. (regulatory influences - also include LIC council and advisory committees for tax rule changes), Licencing requirements, legalese, contract provisions, Scope of IRDA examinations, Policy holder protection act, Market conduct laws, Solvency laws, Reserve requirements, Investment regulations for pension business, Tax provisions-a) for premium payments, b) for investment earnings, c) during the payout phase, d) estate taxation. CHAPTER 8: MARKETING OF ANNUITIES: Role and uses of annuities in the Financial services market place, Annuities as asset protection products, Factors that impact the market for annuities as retirement savings and investment products, Marketing plan and segmentation for individual and group annuities, Distribution of Annuities, Promotion, Sales practices and customer behaviour, Challenges for annuity marketers, Future of Annuities. CHAPTER 9: ANNUITY ADMINISTRATION: Accumulation phase and payout phase, Recording transactions, Processing transactions, Furnishing contracts and information, Disbursing money, Customer service, IT and annuity administration.
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CHAPTER 4: FINANCIAL UNDERWRITING: Purpose of financial underwriting Objectives of financial underwriting Concept of Insurable interest & Insurable value Personal Insurance Cover Human Life Value Insurance on Housewives & Women with no earned income Insurance on Minors Key Person Insurance Partnership Insurance Employer-Employee Insurance Hindu Undivided Family ( HUF) Insurance under Married Womens Property Act Sources of financial data ( documentation) Standard Income Documents. CHAPTER 5: OCCUPATIONAL, AVOCATIONAL AND RESIDENTIAL RISKS: Sources of information to assess Occupational, Avocational & Residential risks Basic risk factors for occupation Armed Forces, Aviation & Merchant Navy Chemical Industry Mining Nuclear Power Industry Oil & Natural Gas Industry Basic Risk factors for Avocation Aviational risks Car racing Mountaineering Residential Risks. CHAPTER 6: REINSURANCE: Need for reinsurance Types of reinsurance Facultative reinsurance Automatic reinsurance Catastrophe reinsurance Advantages of reinsurance arrangements Reinsurance treaty Underwriting Audits by reinsurers. CHAPTER 7: BLOOD DISORDERS: Functions of blood Components of blood Functions of blood cells Key components of the CBC (Complete Blood Count) Peripheral blood smear Anaemia ,its causes and classification Iron Deficiency anaemia Thalassemia Risk assessment of anaemia Other important disorders of blood Polycythaemia Leukaemia Lymphomas Idiopathic Thrombocytopenic Purpura (ITP) Haemophilia. CHAPTER 8: NERVOUS SYSTEM: Components of the nervous system Main structures of CNS( Central Nervous System) Brain Stem Spinal Cord Main I nsurance I nstitute of I ndia 26
Component of the Peripheral Nervous system CSF (Cerebro Spinal Fluid & the meninges) Common disorders of the nervous system Common signs and symptoms of the Nervous System disorders Common investigations done for diagnosing Disorders of the Nervous system Common nervous system disorders Neurovascular disorders Stroke Aneurysmal Subarachnoid hammorrhage Underwriting considerations Underwriting epilepsy & underwriting considerations. CHAPTER 9: DIABETES MELLITUS: Diabetes Types of diabetes Type I Diabetes Type 2 Diabetes Gestational Diabetes Impaired fasting glucose(IFG) Impaired Glucose tolerance (IGT) Diabetes and insurance (OGT) Oral Glucose Tolerance Test Glycosylated Haemoglobin - Complications of Diabetes Diseases of the circulatory system Other complications of Diabetes Clinical assessment of Diabetic applicants Treatment of diabetes Underwriting diabetics. CHAPTER 10: THYROID DISEASES: Thyroid gland Common problems encountered with the thyroid gland Hypothyroidism and its main causes Hypothyroidism Diagnosis, treatment & underwriting implications Hyperthyroidism Graves Disease Goiter Diagnosis, treatment and Underwriting implications of hyperthyroidism. CHAPTER 11: URINARY SYSTEM: Components of the urinary system Proteinuria & Albuminuria Haematuria Causes of haematuria Kidney disease & its Diagnosis BUN & Serum Creatinine Disorders of the urinary system and their underwriting implications Kidney stones Renal (Kidney) failure Urinary tract infections Polycystic kidney disease Diabetic nephropathy Glomerulonephritis Renal Cell carcinoma. CHAPTER 12: THE RESPIRATORY SYSTEM: Introduction Components of the respiratory system Mechanics of Respiration Common respiratory I nsurance I nstitute of I ndia 27
conditions and underwriting implications Asthma & its classification Signs & symptoms of Asthma & Treatment Exams & tests for respiratory disorders Classification of severity of asthma Underwriting considerations Bronchitis (Acute & Chronic forms of bronchitis) Underwriting considerations Emphysema Chronic Obstructive Pulmonary Disease (COPD) Tuberculosis Underwriting Questionnaire. CHAPTER 13: GASTROINTESTINAL (DIGESTIVE) SYSTEM: Introduction Common terminology and investigations of the digestive tract Disorders of the digestive system Tumors of the gastro Intestinal tract Liver functions tests (LFTs). CHAPTER 14: CARDIOVASCULAR SYSTEM: Introduction Common
terminology used in the diseases of the cardio vascular system Blood circulation Common symptoms of disorders of the cardio vascular system Common investigations for diagnosing disorders of the cardiovascular system ECG-ECHO Cardiogram / ECHO Doppler Exercise Stress test ( Stress test/ Tread-meill test) Coronary angiography Nuclear cardiology Cardiac CT Blood pressure and Hypertension Types of hypertension Complications of hypertensions Underwriting implications Coronary Artery disease (CAD) , Coronary Heart Disease( CHD) Ischemic Heart disease (IHD) Risk factors Symptoms & signs of CAD Types of Coronary Artery Disease Treatment of Coronary artery disease Invasive and surgical procedures complications of heart diseases Underwriting information Risk assessment of CAD Valvular Heart disease, causes, treatment and underwriting considerations Types of Congenital Heart Diseases Underwriting considerations. CHAPTER 15: SPECIAL SENSES: DISORDERS OF THE EYES, EARS AND NOSE: EYE Anatomy of the eye disorders of the eye Cataract Glaucoma Retinopathies Retinal detachment Refractive errors Blindness Strabismus/ squint Underwriting considerations of each other eye disorders I nsurance I nstitute of I ndia 28
EARS Anatomy of the ears Disorders of the ear Otitis Acute otitis media Chronic Otitis media Deafness Presbyacusis. NOSE Anatomy Disorders of the nose Deviated Nasal Septum Sinusitis Nasal polyps. CH A P TER 16: G LOSSARY: Definition of commonly used terminology in underwriting.
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Underwriting of New Business Scrutiny of Proposals Limits of Acceptance Acceptance subject to controlling office Approval Acceptance of Extra Hazardous Risks Underwriting Safeguards New Business Procedure Underwriting of Renewal Business. CHAPTER 3: PRINCIPLES OF RATE MAKING: An introduction making the Rate Structure The Process of Rate Making Mathematical Equations Pure Premium and Loss Ratio Methods Trended, Projected Ultimate Losses Loading Factors Individual Risk Rating Experience Rating Composite Rating. CHAPTER 4: RATING APPROACHES IN PRICING: IRDA Guidelines on Classification of General Insurance Products Class Rated and Individual Rated Products Class Rating Individual or Merit Rating Schedule Rating Experience Rating Objectives, Basis, Applicability, Essentials & Disadvantages of Experience Rating Exposure Rating. CHAPTER 5: FILE & USE REGULATIONS: Goals of Regulatory Supervision of Insurance Business Filing of Rates & Policy Forms for Regulatory Review Prior Approval File & Use Use & File FLEX rating Regulation I nsurance I nstitute of I ndia 30
Components for Product Evaluation Indian Insurance Market IRDA Requirement for Consideration & Review of Products Classification of Products. CHAPTER 6: APPLICATIONS OF FILE & USE REGULATIONS: File & Use Requirement Role of Board Underwriting Policy Roles of Moderator / Compliance Officer / Appointed Actuary / Advocate - Internal Technical Audit Practical Applications of Guidelines detailed Discussion on Form A, B, C, & D. CHAPTER 7: TOOLS OF UNDERWRITING: Risk Management Framework Approaches as Tools Tools for Effective Policy Underwriting Document, Insurance Documentation Proposal Form, Endorsements,
Reinsurance Placement Slip, Insurance Certificates, Cover Notes, Renewal Notices Exclusions Deductibles Co-insurance Reinsurance and Retention levels Portfolio Management. CHAPTER 8: TYPES OF POLICIES: Classification of Insurance Covers by
Subject Matter Insurance of Property, Earnings/Profits, Liability and Persons Classification by Insurance Act Classification by Market Segments Classification by Perils (Named Perils and All Risks) Customised Policies Special Covers. CHAPTER 9: UNDERWRITING PROFITABILITY & REVIEW STRATEGIES: Planning for Underwriting Profits Importance of Underwriting Philosophy & Policy Important Factors in Underwriting policy and Practice Estimation of Underwriting Profit Factors that affect Underwriting Results Rating, Underwriting Guidelines, Policy wordings, Reserving, Claims Processing, High Exposures, High Expenses Reviewing the Underwriting Policy Analysis of Claims Corrective Steps Underwriting Audit Review of Claims and Special Events.
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CHAPTER 10: Protection of Policyholders Interest: IRDA Protection of Policyholders Interest Regulations 2002 Stipulations relating to Point of Sale Proposal Grievance Redressal Procedure Policy Contents Claims Procedures Servicing Mutual Obligations Policyholders Awareness Disclosure by Insurers/ CHAPTER 11: RESEARCH & DEVELOPMENT IN UNDERWRITING, RATING & PRODUCT INNOVATION CHALLENGES AHEAD: Need for Research & development Use of Emerging Technologies Four Distinct Areas of New Challenges New Potential Hazards, New Vulnerabilities, Untested Insurance Product, Growing Needs for International Coverages Innovative Rating Programmes Reasons for Underwriting Errors Product Innovation process. CHAPTER 12: IT. APPLICATIONS IN UNDERWRITING: Challenging Market Conditions Conceptual I.T. System Architecture I. T. System Services Need for Speed, Flexibility & Functionality Individualization of Services and Policies Important Business Concerns Customer Relationship Management Technology & Underwriting Consistency & Speed, Business Process Automation, Managing Underwriting Workflow Rules Engines Case Management Web based Technologies Benefits of Technology-based Underwriting A Different Perspective. CHAPTER 13: GLOSSARY OF TERMS.
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CHAPTER 6: UNDERWRITING: Definition of Underwriting Classification of Underwriting Factors - Large Volume of Business Selection of Business Fixing Retentions Reinsurance Objectives & Types Proportional Treaties Non Proportional Treaties Indian Fire Reinsurance Programme Guidelines on File & Use Procedures Reinventing the Principles of Underwriting Corporate Governance. CHAPTER 7: CLAIMS LEGAL ASPECTS: Essentials of Processing & Settlement of Claims Duties of the Insured Onus of Proof Doctrine of Proximate Cause Insured perils Excepted Perils Rights of Insurers Warranties Exgratia Payments Without Prejudice Rules of Interpretation Amount of Claim Payable Meaning of Value in Relation to Buildings / Machinery / Furniture, Fixtures, Fittings / Stocks / Household Goods & Personal Effects Salvage Contribution Subrogation Pro-rata Average. CHAPTER 8: CLAIMS PROCEDURAL ASPECTS: First Step on Receiving Intimation of a Claim Registration Issue of Claims Form Appointment of Surveyor Preliminary Survey Report Process of Surveying & Loss Assessment Examination of Policies Inspection of Scene of Loss Cause of Loss Assessment of Loss Final Survey Report and its Contents Final Assessment of Loss. CHAPTER 9: CONSEQUENTIAL LOSS INSURANCE 1: Object of Consequential Loss Insurance Basis of Profits Insurance Measure of Indemnity Indemnity Period Sum Insured Examples of Standing Charges The C. L. Policy Material Damage Proviso Particulars in the Policy Schedule The Specification Definitions of Net profits / Standing Charges / Gross Profit / Turnover / Indemnity Period / Rate of Gross Profit / Annual Turnover / Standard Turnover Adjustment Clause Variations & Special Circumstances Worked Examples / Departmental Clause Return of Premium Losses not Payable.
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CHAPTER 10: CONSEQUENTIAL LOSS INSURANCE 2: Components of Rate of Premium Basis Rate C L Rate Extensions of Cover Insured Property at Other Locations Damage at Suppliers Premises Insurance of Wages Auditors Fees Output Basis Specification Difference Basis Specification New Business Clause Revenue Policies Gross Fees Policy Claims Procedure. CHAPTER 11: SPECIALISED POLICIES & OVERSEAS PRACTICE: Oil & Petrochemical Plants Insurance System & Provisions of Erstwhile Special Tariff on Petrochemical Risks Industrial All Risks Insurance Policy Details Practice in U.K. relating to Standard Fire cover / All Risks Policy / Treatment of Other Perils / Fixation of Sum Insured / Combined Policies / Package Policies Practice in the U.S.A.
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CHAPTER 5: HEALTH INSURANCE POLICY FORMS AND CLAUSES: Health insurance contracts Insurance contracts VS other contracts Proposal forms used in health insurance Comparison of proposal forms & questionnaires of health insurance with Personal Accident insurance, Life insurance & Group InsuranceDisability benefit plans or Income Protection Long term care plan Health Savings / Investment Linked plans Group Health Insurance Schemes Commonly used clauses in health insurance Pre-existing diseases and exclusions Cancellation Clause Renewability clause Standardization of definitions, forms, non-medical expenses in health insurance, standardization w.r.t treatments (STG) . CHAPTER 6: HEALTH INSURANCE DATA, PRICING & RESERVING:
Importance and use of data in health insurance for insurers, regulators, government, TPAs and other stake-holders Data mandated from insurance companies by regulators data warehousing Collection and collation of data Data interpretation and advanced analysis of data Insurance Information Bureau Actuarial function in health insurance companies Actuarial techniques Fundamentals of pricing Claim reserving Data and data modelling. CHAPTER 7: REGULATORY AND LEGAL ASPECTS OF HEALTH INSURANCE: Principles and practice of health insurance regulations Need for regulations in health insurance Various kinds of risks in health insurance Regulatory structure Licensing and registration Types of regulations Enforcement of regulations Monitoring activity by regulators Prevention of mis-selling Health insurance regulations in India Policy holders regulation and Grievance re-dressal system health insurance for rural and informal sector workers Role of IRDA in initiatives for standardization Pre-existing diseases( PEDs) renewability of health insurance policies.
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CHAPTER 8: CUSTOMER SERVICE IN HEALTH INSURANCE: Consumer protection & policy holders protection Claim servicing types of cashless claims Grievance redressal survey on grievance redressal. CHAPTER 9: HEALTH INSURANCE FRAUD: Introduction Cause and effects of frauds Classification of frauds health insurance frauds Vs general insurance frauds types of frauds by the consumers stages of insurance frauds cash defalcation types of fraud during in the contractual period and claims stage methods to combat and mitigate insurance frauds technology and process interface Initiatives by IRDA and the industry. CHAPTER 10: REINSURANCE: Definition of reinsurance utility of
reinsurance health insurance and reinsurance models products supported by reinsurers white labelling social reinsurance annual reinsurance programme.
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CHAPTER 7: MUTUAL FUNDS: Meaning need classification of MF schemes operational, portfolio based classifications Asset management Companies functions Indian scenario. CHAPTER 8: EVALUATION OF PORTFOLIO PERFORMANCE: Need different methods of evaluation time horizon Treynors measure Sharpe measure Jensen Measure Fama Measure. CHAPTER 9: DERIVATIVES: Meaning futures Options hedging hedging using futures stock options. CHAPTER 10: FOREIGN EXCHANGE MANAGEMENT ACT (FEMA):
Background basic definitions provisions main functions of RBI under FEMA Securities and Exchange Board of India(SEBI) organization powers and functions Insurance Regulatory and Development Authority (IRDA) organization powers and functions other regulators RBI organization functions.
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Conditions, Underwriting Considerations, Rating Pattern, Claims Procedure, Types of policies Court and Government Bonds Commercial Guarantees. I nsurance I nstitute of I ndia 41
CHAPTER 7: BANKERS INDEMNITY AND JEWELERS BLOCK INSURANCE: Introduction Coverage, Exclusions Conditions Special features Underwriting Considerations Rating pattern Claims procedure. CHAPTER 8: OTHER MISCELLANEOUS INSURANCES: Pedal Cycle Insurance Plate glass insurance Missing Documents Indemnity Neon Sign Insurance Blood Stock (Horse) Insurance Pet Dog Insurance Sports Insurance etc. CHAPTER 9: PACKAGE COVERS: Shopkeepers Package (Evolution and basic details) Doctors Package Office Protection Package for Executives and Businessmen Package Policies for Credit Societies House Holders Package Complete Package for Families etc. CHAPTER 10: SPECIALIZED COVERS THE NEW TREND: Special
Contingency Policies Machinery and Equipment Event Insurances Matches Entertainment events; Latest requirement of covers Identity Theft Theft of Portable items ATM Withdrawals Kidnap and Ransom Intellectual Property Rights E-Commerce Web Business. CHAPTER 11: REINSURANCE: Concept of Reinsurance Types of Reinsurance Reinsurance Programs in India. CHAPTER 12: RURAL INSURANCES 1: Government Role, IRDA Regulations Market Agreements NGOs and Agents Role Coverage available Cattle Insurance Sheep Goat Poultry Duck Aquaculture. CHAPTER 13: RURAL INSURANCES 2: Different Policies Insurance of
Elephants Pigs Rabbits Zoo Circus Animals Sericulture Honeybee Horticulture Agricultural Pump set Failed Well Lift irrigation Salt Works Pedal Cycle Cycle Rickshaw Animal Drawn Vehicle Hut Farmers Package Tribal Package etc.
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Institute Commodity Trade Clauses Institute Coal clauses Institute Jute Clauses Institute Bulk Oil Clauses Package Policy For Coffee Package I nsurance I nstitute of I ndia 43
Policy for Cardamom Estates Package Policy for Rubber Estates Tea Crop Insurance Cargo in sailing vessels Inland transit Clauses 9Rail /Road)(A)/(B)/(C) Container Insurance Limits Clause. CHAPTER 6: TYPES OF COVERS: Specific Policy Open covers Declaration of Consignments Open Policies Annual Policy Duty and Increased Value Insurance Insurance on FOB terms Shut out Cargo Exports incentives Insurance Sellers Interest Contingency Special Storage risks Insurance Package Policy under Duty Exemption Scheme Scope of Cover Multi Transit policy Stock Throughput Insurance policy Sales turnover Insurance Marine (Advance) Loss of profits Insurance Buyers Contingency Insurance Important Conditions Difference in conditions cover Freight Contingency Insurance- Strikes expensive /war expenses. CHAPTER 7: HULL INSURANCE-PART 1: Classification of Vessels Indian register of Shipping Types of vessels Types of Policies Institute Time Clauses Hull Perils covered Pollution Hazard Duty of the Assured (Sue & Labour) Collision Liability Sistership Deductible Notice of claims Disbursements Warranty - Termination Perils Pollution Hazard Class ISM Optional covers Institute Voyage Clause Insurance of Freight Time and Voyage freight clauses Valued and unvalued Policies Loss of freight Loss of Time clause Claim documents Port risk insurance Institute Fishing Vessels Clause Protection & indemnity Associations. CHAPTER 8: HULL INSURANCE-PART 2: Hull proposal form details of the vessel trade details documents Valuation of ship Classification of vessels Rating factors Hull initial rating Renewal rating Risks with adverse underwriting features Warranties Insurance of Fishing vessels conditions of Insurance insurance of sailing vessels Insurance of Inland Vessels Damage Cargo Salvage Loss Insurance of dredgers.
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CHAPTER 9: MARINE CLAIMS: Actual Total Loss Constructive Total loss Particular Average Damage Cargo Salvage Loss General Average Loss Sue and labour charge Particular Charges Salvage charges Forwarding Charges Extra Charges Cargo Claims Procedures Intimation of Claim Insurance Surveys Claims Payable Abroad Recoveries from third parties Hull Insurance Claims Total Loss Partial loss Particular Average General Average Salvage charges Sue and labour Charges Collision Liability Claims of Ocean going vessels fishing vessels sailing vessels inland vessels General Average Application of insurance to G.A Contribution and G.A Sacrifice- Adjustment of General Average Salvage liability. CHAPTER 10: MARINE RECOVERIES: Marine recoveries from third parties Indian Carriage of Goods by Sea Act Shipowners responsibility, liabilities/rights and immunities Notice of loss or damage Time limit for legal action Carriage of goods by Rail Rights /Liabilities of Railway Authorities Notice of Claim for Compensation Carriage of goods by Road Act Carriage by goods by Air Multimodal transportation/ responsibilities/ liabilities/ limits Liabilities of Port Authorities major and other ports Postal Authority Customs Salvage Disposal. CHAPTER 11: ROLE OF BANKERS IN MARINE INSURANCE: Methods for payment in International trade Consignment purchase Down payment Open account Documentary Collections Letter of Credit detailed working procedure Uniform customs and practices for Documentary Credits Signatories Cover note Insurance Documents and Coverage Currency of coverage amount of coverage port to port cover excess/franchise. CHAPTER 12: LOSS PREVENTION, REINSURANCE, MARITIME FRAUDS: Cargo Loss control and prevention Theft, Pilferage and Non Delivery Handling and Stowage damage Water damage Multi Modal containerization its inspection and packing and stowing of cargo Reinsurance of Marine I nsurance I nstitute of I ndia 45
cargo and hull risks Methods of Reinsurance Proportional Facultative Quota share Treaty Surplus Treaty Non proportional Excess of loss Stop loss Pooling arrangements Alternative risk transfer Common Reinsurance Programme Maritime frauds Scuttling frauds Documentary frauds Cargo thefts Charter Party Fraud Piracy Maritime fraud Scuttling Frauds Documentary Frauds prevention in cargo and hull insurance.
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CHAPTER 7: DOCUMENTS: Importance of documentation - Proposal Form Certificate of Insurance - Cover Note- Policy forms Endorsements and Renewal Notice. CHAPTER 8: UNDERWRITING: Underwriting and Rating considerations the Vehicle the Usage the Area of Operation the Driver past experience the Cover; Insurance and road safety Importance of Statistical data. CHAPTER 9: CLAIMS 1: Own Damage Claims Survey Assessment Settlement Claim Documentation and Procedures Types of losses Fraudulent OD Claims. CHAPTER 10: CLAIMS 1: Third Party Liability Claims Procedural Aspects Legal Aspects Negligence Types of Claims Death Disability Property; Legal System Tribunals Courts Knock for Knock Agreements Fraudulent TP Claims. CHAPTER 11: MOTOR THIRD PARTY POOL: The Pooling Concept Objectives Pooling Procedure Pool Administration. CHAPTER 12: IT APPLICATIONS IN MOTOR INSURANCE: Importance of
Statistical data in motor insurance Tariff Advisory Committee as statutory data repository Data Inputs Underwriting Data Claims Data Reports.
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