Cms 200 Insurance Risk Management Module

CMS 200: INSURANCE AND RISK MANAGEMENT
CMS 200: INSURANCE AND RISK

MANAGEMENT
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About this STUDY MANUAL

CMS 200, Insurance and Risk Management has been produced by
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Study skills.
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Course assignments and assessments.
Activity icons.
CHAPTERs.
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before starting your study.
The course content
The course is broken down into CHAPTERs. Each CHAPTER
comprises:
An introduction to the CHAPTER content.

CHAPTER outcomes.
New terminology.
Core content of the CHAPTER with a variety of learning
activities.
A CHAPTER summary.
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COURSE OVERVIEW
Introduction
This course introduce the learners to the concepts of risk, risk management and
insurances, and attempts to delve into various aspects of insurance and risk management,
with a view to help the learner(s) have a greater understanding of the risk surrounding an
entity and several ways to manage such risks with more emphasis on risk transfer
strategy, specifically insurance as the core strategy.
Learning Outcomes
By the end of this unit the learner should be able to:
i) Explain the concept of risk, risk management and Insurance and their application
in business.
ii) Critically appraise the factors risk managers need to take into account in order to
prevent or restrict the extent of loss
iii) Analyze and evaluate the insurance concepts and frameworks available to the risk
manager in dealing with various risks.
TABLE OF CONTENTS
Lecture 1: the concept of Risk
1.1 Introduction
1.2 Lecture Outline
1.2.1 Introduction
1.2.2 Meaning of risk
1.2.3 Perils and Hazards
1.2.4 Classification of risk
1.3 Lecture Objectives
Reflection questions, activity, exercises/quizzes
1.4 End of lecture activities (self tests)
1.5 Summary
1.6 Suggestion for further reading
Lecture 2: Response to risk

2.0 Introduction
2.1 Lecture Outline
2.1.2 It wont happen to me syndrome
2.1.3 The risk schooling
2.1.4 Sector response; Personal, Organizational, National response to risk
2.1.5 The cost and Burden of risk.
2.4 Summary
Lecture 3: Risk Management
3.0 Introduction
3.1 Lecture Outline
3.1.2 Definition of risk management.
3.1.3 Nature of risk management
3.1.4 Principles of risk management
3.1.5 Risk management policy
3.4 Summary
Lecture 4: Risk management strategies
4.0 Introduction
4.1 Lecture Outline
4.1.2 Risk Control
4.1.3 Risk Financing
4.1.4 Risk Transfer
4.1.5 Rules in Risk management
Lecture 5: Risk Management process

5.0 Introduction
5.1 Lecture Outline
5.1.2 Determination of Objectives
5.1.3 Identifying risks
5.1.4 Evaluating risks and considering alternatives
5.1.5 Implementation, evaluation and review
5.1.6 Risk management Problems
Lecture 6: Insurance development
6.0 Introduction
6.1 Lecture Outline
6.1.2 Historical development of insurance
6.1.3 Insurance Mechanism
6.1.4 Requisite of Insurability
6.1.5 Factors Limiting insurability of risks.
6.1.6 Functions and Benefits of insurance
Lecture 7: Classes of Insurance
7.0 Introduction
Lecture Outline
7.1.2 Life and Health
7.1.3 Liability Insurance
7.1.4 Property insurance
7.1.5 Transport insurance
7.1.6 Pensions and annuities
Lecture 8: Principles of Insurance
8.0 Introduction
8.1. Lecture Outline
8.1.2 Special Insurance contracts.
8.1.3 Principle of Insurable Interest

8.1.4 Principle of Utmost good faith
8.1.5 Principle of Proximate cause
8.1.6 Principle of Indemnity
8.1.7 Principle of Subrogation and contribution.
Lecture 9: Insurance documentation and Regulation

9.0 Introduction
9.1 Lecture Outline
9.1.2 Proposal Forms
9.1.3 Policy Document
9.1.4 Premiums, claims and disputes
9.1.5 Underwriting and Policy writing.
9.1.6 Pre and Post Independence regulation
9.1.7 Objectives of regulating Insurance services
Lecture 10: Reinsurance and Insurance marketing
10. Introduction
10.1 Lecture Outline
10.1.2 Definition of Reinsurance
10.1.3 Forms of Reinsurance
10.1.4 Reasons and Functions of reinsurance
10.1.5 Buyers and sellers of Insurance
10.1.6 Competitive challenges associated with marketing insurance
LECTURE 1: THE CONCEPT OF RISK

1.1 Introduction
Welcome to the first lecture on the definition of risk and related terms. We shall begin the
lecture by highlighting meaning of risk. We will further explain the other related terms;
perils and hazard, and classification of risk.
1.2 Specific objectives:
At the end of the lecture you should be able:

i) Define risk and enumerate its various meaning.
ii) Discuss the different types of risks that organizations face.
iii) Distinguish between Hazard and Perils.
iv) Classify the risks in its various forms.
1.3 Lecture Outline

to
1.2.1 1)
Introduction
2) to
1.2.2 3)
Meaning
to of risk
1.2.3 Perils and Hazards
1.2.4 Classification of risk.
Introduction
The word risk is certainly used frequently in everyday conversation and seems to be well
understood. Risk implies some form of uncertainty about an outcome in a given situation.
An event might occur and if it does, the outcome is not favourable to us. Risk can be
contrasted with the word chance which implies some doubt about the outcome in a given
situation; the difference is that the outcome may also be favourable e.g. risk of an
accident, chance of winning a bet etc.
However in common business conversations the word risk is used to mean different
things:
i.
Risk as cause e.g. fire as a risk, Personal injury as a risk etc.
ii.
Risk as likelihood e.g. the risk of something happening, leaving keys in a car results
in high risk etc.
Risk as the object e.g. factory, plane, machine or ship might be referred to as the
iii.
risk.
Risk as verb It is not only used as a noun but also as a verb e.g. risk of crossing the
iv.
road.
All the above illustrate how the use of the word goes far beyond its technical meaning.
Meaning of risk
Various scholars have advanced different definitions of risk as follows:i.
Risk is the possibility of an unfortunate occurrence.
ii.
Risk is a combination of hazards.
iii.
Risk is unpredictability the tendency that actual results may differ from
predicted results.
iv.
Risk is uncertainty of loss.
v.
Risk is the possibility of loss.
Rather than try to ascertain the best definition of risk, the underlying commonality in all
the definitions should be of interest and they include;
i) Uncertainty
Uncertainty implies doubt about the future based on a lack of knowledge or imperfection
in knowledge. If we always knew what was going to happen, there would be no risk.
ii) Levels of Risk
Risk is thus a combination of the likelihood of an event and the severity of damage
should the event occur. If an event occurs a great deal, then our knowledge about
the future begins to increase and an element of certainty begins to creep in e.g.
shoplifting, combining frequency and severity we find two relationships
iii) Peril and Hazard (Cause(s)
Peril is the prime cause, it is what will give rise to the loss e.g. storm, fire etc. Factors
which may influence the outcome are referred to as hazards. Hazards are not themselves
10
the cause of the loss but they can increase or decrease the effect should a peril operate.
Hazard can be physical or moral. Physical hazard relates to the physical characteristics of
risk e.g. grass thatched house while moral hazard concerns human aspects which may
influence the outcome. It usually relates to the attitude of the person e.g. conman.
Classification of Risk
Risks could be classified as follows:
i.
Financial and non-financial risks- a financial risk is one where the outcome can be
measured in monetary terms and where it is possible to place some value on the
outcome. Measurement in personal injury may be done by a court when damages are
awarded or negotiation among lawyers and insurers. There are cases where
measurement is not possible e.g. choice of a new car, selection from a restaurant
menu, selection of a career, choice of a marriage partner etc. all these are nonfinancial risks. Generally in business we are concerned with financial risks.
ii.
Pure and speculative risks- pure risks involve a loss or at best a break even situation.
The outcome can only be unfavourable to us or leave us in the same position as we
enjoyed before the event occurred e.g. motor accident, fire, theft etc. speculative risk
is where there is a chance of gain e.g. investing money in shares (the investment may
result in a loss or possibly a break-even but the reason it was made was the prospect
of gain), pricing of products, marketing decisions, decisions on diversification,
expansion or acquisition, providing credit to customers among others. Generally pure
risks are normally insurable while speculative risks are generally not insurable though
the trend is changing and hence dynamic.
iii.
Fundamental and particular risks- fundamental risks are those which arise from
causes outside the control of any one individual or even a group of individuals. In
addition the effect of fundamental risks is felt by large numbers of people e.g.
earthquakes, floods, famine, volcanoes, war etc. Particular risks are much more
personal both in their cause and effect e.g. fire, theft etc. Al these risks arise from
individual causes and affect individuals in their consequences. Risks however change
classification, mostly from particular to fundamental e.g. unemployment. In the main,
particular risks are insurable while fundamental risks are not.
11
1.5 Activities
1. Enumerate the various types of hazards that exist in the Kenyan business
environment.
2. Provide a theoretical definition of risk.
3. Distinguish between frequency and severity of risk in risk measurement?
1.6 Self Test Questions
To analyze the impact of risks on the social-economic development of a country

like Kenya.
1.6 Summary
In this lecture you have learnt that:

1.Risk implies some form of uncertainty about an outcome in a given situation.
2. In common business conversations the word risk is used to mean different
things; cause, likelihood, object and verb.
3. The underlying commonality in all the definitions should be of interest and
they include; Uncertainty, level of risk and perils and hazard.
4. Risk can be classified as financial and non-financial, pure and speculative,
fundamental and particular risks, personal and business, dynamic and static e.t.c

Dickson, G.C. (1997) Risk Management the Chartered Insurance Institute
Vaughan, E. and Vaughan, T. (2003) Fundamentals of Risk and Insurance 9th
Edition, Wiley
Dorfman, M.S. (2005) Introduction to Risk Management and Insurance, 9th
Edition, Prentice Hall
12
LECTURE 2: RESPONSE TO RISK

2.1 Introduction
Welcome to the second lecture on the response to risk. We shall begin the lecture by
highlighting the various sectorial responses to risks, the risk schooling and the cost and
burden of risk to a society.

i) Explain the syndrome it wont happen to me
ii) Discuss the different sector responses to risk, such as personal, organizational
and National.
iii) Critically review the cost and burden of risks.
2.3 Lecture Outline

4) to
2.3.2
It
wont happen to me syndrome
5) to
2.3.3
The
6) to
risk schooling
2.3.4 Sector response; Personal, Organizational, National response to risk
2.3.5 The cost and Burden of risk.
It wont happen to me syndrome
For a long time, general management suffered from it wont happen to me syndrome
and many would go through the school system without sensitization on risk. The trend
has been changing however with more positive attitude to risk developing and today we
have individuals designated as risk managers. At personal level individuals could be risk
takers-jumping on any bandwagon, risk neutral- fence seaters and risk averse-those
avoiding it at all costs.
The risk schooling
Organizations undergo tremendous changes within a very short span of time, in the
process a lot of things such as bankruptcy, job losses, and restructuring and hostile take-
13
over occur. In view of the rapidly changing business environment, managers must be
schooled in the perspectives of such changes which denote that the business environment
is very fluid and risky. The orientation of managers should be to expect the unimaginable
to happen. The most successful companies of yester years like unilever and Eveready
batteries are todays underdogs, while the yesterdays underdogs are todays most
successful companies to envy and reckon with.
Sector response; Personal, Organizational, National response to risk
At personal level, there are situation that require that we adequately respond, for instance
in this current times where effects of globalization may adversely affect a firm that is not
proactive in its risk management plans, an individual may find himself retrenched at a
very young age, due to economic pressures an individual may also not reach their
economic potential may be because they were unable to respond appropriately to their
situations and risks that if they had overcame they would be in a better position. For
example a young graduate joining the labor market in the current times, the mantra could
be exit the organization mentally the very day you join it. The implication of this is that
prepare for your smooth exit in the organization so as to have less acrimonious separation
with the employer in your retirement. Also have in mind that there are no permanent jobs
these days, even when they call it permanent, because your organization is not permanent
as well, it all depend on how it responds to its risks.
At the organizational level, response to risk is very critical to remain afloat, innovation,
creativity and proactiveness is the hallmark of surviving the dynamisms of current
business environment. It is not a guarantee that you will remain a giant in the business
environment, your position as a market leader can only be assured if you are innovative,
creative and proactive. Some of the dominant market players in the corporate scene today
like Equity Bank and Safaricom were not their say 10-15 years ago and may not be sure
if they will be there in the coming 10-15 years ahead if they do not innovate and manage
the risks facing them proactively. Hence managers of such organizations have a duty to
constantly respond to risks surrounding their business operations to be guaranteed of their
continued existence and performance.
14
National response to risk calls for a thorough scrutiny of the policies that drive the
national economy. Right from say education system and how that education system
guarantees the individuals a way of life or not, risks begin to emerge. For example there
is need to have a policy that guarantees all the primary students graduating from class
eight a place in a secondary school, a vocational training centre or a polytechnic and or at
worst be absorbed for a short course at the National youth service then be deployed in the
informal sector through a government framework such as youth enterprise fund. By
picking a few to join secondary school and leaving the others to sought out themselves
because they did not meet qualify grades or points, the country creates a security disaster
in the waiting. These young minds who still needs to be transformed find themselves
helpless and hapless at a critical time in their developmental stage, they resort to join any
gang that may give them hope and a listening hear, when all other doors closes at such an
early age, anything can do, even if joining a criminal gang they will gladly join it without
a second thought. Hence policy markers need to know that failure to adequately respond
to national risk, like in the example of education above creates a big burden to the tax
payers. The innocent children are at later stage branded very dangerous criminals, and
more resources to put up police stations, recruit police officers and infrastructure to fight
crime are expensed on innocent citizen who only needed right policy intervention at the
right time in their life and would have changed the course of their lives and relieved the
tax payers the wastages it has to incur to protect themselves from such innocent students
now turned rogue criminals who kill and maim at will, while the government continue to
waste the scarce resources to react to such situations, the best they could have done is to
proactively ensure a smooth transition of all the student across the various levels of
education and link them to the various sectors of the economy where there relevant
manpower is needed.
The cost and Burden of risk
The risk surrounding potential losses creates significant economic burdens for businesses,
governments and individuals. Millions of shillings are spent every year on strategies for
15
financing potential losses, especially when losses are not planned for in advance, items
may cost even more.
Businesses may be reluctant to engage in projects that are otherwise strategically
attractive if the potential losses appear to be unmanageable, thereby depriving the society
of services judged to be too important.
The following are the cost and burden of risk to a society;
1. The greatest burden of risk is that some losses will actually occur e.g. floods will
destroy houses hence loss to the house owner. That is why individuals attempt to
avoid risk or minimize its impact.
2. Risk also has additional detriment apart from causing loss. The uncertainty as to
whether loss will occur makes individuals establish risk minimization measures
such as taking insurance cover or accumulating funds to meet such losses should
they occur. The accumulated funds are reserved in highly liquid investments so
that they are readily available to set off the losses. Such investments yield very
low returns and hence investment waste due to low return investments.
3. Without insurance as a risk minimization measure, each property will be required
to accumulate their own individual funds so that the aggregate of individual funds
will exceed the insurance funds hence another wasteful investments.
4. Existence of risk may also have different effects on economic growth and capital
accumulation which determines economic progress. Investors incur risks of a
new venture only if the returns from the venture are high enough to compensate
both static and dynamic risks.
Such investors therefore make the cost of
borrowing capital expensive to new venture owners. The venture owners must in
turn charge higher prices to consumers; the economy will therefore have the cost
of living increased in order to bear the burden of risk.
5. The uncertainty caused by risks produces feelings of frustrations and unrest,
particularly in the case of pure risk more than others. Speculative risks are
attractive to many individuals because it offers a chance to make gains or profits.
16
2.3 Activities
1. Provide an outline of how you will respond to the risks you face as an
individual.
2.6.Analyze the Agricultural sector response to various risks facing them
7.
3.8.Pick an organization you are familiar with its operations and document how
they respond to risk facing them.
9.
2.5 Summary
In this10.lecture you have learnt that:
11.
1.12.The It wont happen to me syndrome is away in which people only believe

13.certain things happen to others and not them, it could be because they feel they
14.
15.are well endowed, well resourced and may not feel like taking precautions
16.
17.because whatever is being managed is far from them.E.g University graduates
18.who graduated in the 90s and or earlier 2000 given that they got jobs
19.
20.immediately after clearing their studies may not feel the risk of unemployment as
21.
22.something major.
2. Risk schooling is a very important aspect in risk management, in view of the

rapidly changing business environment; managers must be schooled in the
perspectives of such changes which denote that the business environment is very
fluid and risky.
3. The sector response to risk can be categorized into personal, organizational and
National. Personal is individual specific and details our responses on the personal
risk facing the individual.
1.723.
Suggestion for further reading
24.
Dickson,
G.C. (1997) Risk Management the Chartered Insurance Institute
25.
26.
Vaughan, E. and Vaughan, T. (2003) Fundamentals of Risk and Insurance 9th
27.
28. Wiley
Edition,
Dorfman, M.S. (2005) Introduction to Risk Management and Insurance, 9th Edition,
Prentice Hall
17
LECTURE 3: RISK MANAGEMENT

3.1 Introduction
We have throughout portrayed risk as having a negative effect e.g. great steps in medical
fields have been achieved at the personal risk of those researchers prepared to test drugs
and treatment; risk is also at the very heart of any free market economy i.e. it enables
wealth to be created. In summary therefore risk can be negative or positive and the
challenge to us is to manage the risk to which a business is exposed. This has led to the
evolution of the discipline of risk management which is the identification analysis and
economic control of those risks which threaten the assets or earning capacity of an
enterprise.

i)
Define risk management
ii)
Explain the main functions of a risk manager
iii)
Discuss the benefits of a risk policy framework to an organization.
3.3 Lecture Outline

3.3.1 Definition of risk management.
3.3.2 Nature of risk management
7) to
3.3.3 8)
Principles
of risk management
to
3.3.4 9)
Risktomanagement
policy

3.4 Summary
Definition of Risk management
It has also been defined as the logical development and carrying out of a plan to deal with
potential losses. It can also be defined as the human activity which integrates recognition
18
of risk, risk assessment, developing strategies to manage it, and mitigation of risk using
managerial resources. Risk Management involves:
i) Identifying and measuring potential risk.
ii) Develop and execute a plan to manage these potential losses.
iii) Continuous review of the plan after it has been put into operation.
Nature of Risk Management
Buying of insurance was the traditional role of risk management and was the key function
of risk managers. A part from purchasing insurance, other functions of a risk manager
are:
(i)
Assists the organization identify the risk
(ii)
Implement a loss prevention and control programmes
(iii)
Review contracts and documents for risk prevention and management purpose
(iv)
Provide training and education on safety related issues
(v)
To ensure compliance with laws and government regulation. This will involve
monitoring changes in the laws and implementation requirements from
various stake holders
(vi)
Claims management and working with legal representatives to manage

litigation risks.
(vii)
Designing and co-coordinating employee benefit programmes, including

retirement packages
(viii)
Currency hedging i.e. protects the organization from adverse effects arising
due to fluctuations of currency. The risk manager can recommend the
purchase of a stable currency or money equivalent in an effort to protect the
organization.
(ix)
Government lobbying Where the risk manager constantly interacts with

influential persons in an effort to ensure that government policies do not
adversely affect the company.
(x)
Advice on company restructuring including acquisition and mergers even

disposals. The purpose will be to avoid diverse effects of the restructuring
from affecting the company Public relation.
19
Principles of risk management

Risk Management should;
i) Create value
ii) Be tailored
iii) Take into account human factors.
iv) Be transparent and inclusive.
v) Be dynamic, iterative and responsive to change.
vi) Be capable of continual improvement and enhancement.
vii) Be transparent and inclusive.
viii)
Be an integral part of organization processes.
ix) Be part of decision making.

x) Explicitly address uncertainty.
xi) Be systematic and structured.
xii) Be based on the best available information
Risk Management Policy
Is an organizations written statement that sets out its approach to risk management. Its
objective is to safeguard the organizations property, interest and certain interest of
employees during the conduct of business.
Benefits of risk management policy statement
i.
It enables the organization to survive in case of emergency situation i.e. a policy

that document measures to be taken in case of fire out break may save the
organization from suffering severe losses when such occur.
ii.
Reassures staff, stakeholders and governing body in business of the organization

going concern capacity. This could give the insurance a hedge over its
competitors.
iii.
Support Strategic and Business Planning. A risk Management policy statement

would support an efficient development of business plan by the organization since
it avails information on how to cater for potential risks.
20
iv.
Enhances
communication
between
production,
sales,
marketing
and
Administration department.
v.
Improves the organizations ability to meet objectives and achieve opportunities.
vi.
It encourages organization to take activities that have a high level of risk because risk can
be identified and are well managed, so that the exposure to risk is both understood and
acceptable.
vii.
It ensures survival and growth of the business even after making losses.
viii.
It leads to minimization/prevention of losses which occurs due to unstructured

procedures.
ix.
Enables quick assessment and gasp of new technology.
x.
Supports the effective use of resources.
xi.
Promotes continuous improvement.
xii.
Well prepared risk management policy makes the company socially responsible towards
its environment, employees, suppliers, customers, and the communities in which it
Operates
xiii.
Well prepared risk management policy assures the firm of stability of earnings.
29.
3.4 Activities
30.
31.
32.
Arrange and visit a manufacturing firm in the industrial zone in your

neighborhood, while there
i) Identify the various functions that a risk manager executes in a
manufacturing firm like the one you have visited.
ii) Find out the risk management principles put in place by the manufacturing
firm.
iii) Find out if the firm has a risk management policy. Discuss the benefits of
such a policy to such a manufacturing firm.
executes in a manProvide an outline of how you will respond to the risks you
face as an individual.
2. Analyze the Agricultural sector response to various risks facing them
3. Pick an organization you are familiar with its operations and document how they respond
to risk facing them.
21
1. In some sense, a risk manager must be a jack of all trades, because of the breadth of
his or her activities. Identify several areas in which a risk manager should be
knowledgeable, and explain why this would be useful. Bring out the background that a
risk manager should have to undertake his roles effectively.
2. Global competition is a reality many businesses cannot ignore. In light of this, the
business leaders have a justification to develop plans and strategy to manage these
global as well as local risks. Discuss the benefit of such a move.
33.
3.5 Summary
34.
In this 35.
lecture you have learnt that:
i) That36.
apart from buying insurance, risk managers executes several other functions in
37.
38.
the organization.
39.
ii) The40.
principles of risk management are applicable to service, manufacturing, public or
private41.
sectors of the economy.
42.
iii) That an organization must have a risk management policy which has numerous
benefits to the organization.
43.
1.7 Suggestion
for further reading
44.
Dickson,
45.G.C. (1997) Risk Management the Chartered Insurance Institute
46.
Vaughan,
E. and Vaughan, T. (2003) Fundamentals of Risk and Insurance 9th Edition,
47.
Wiley 48.
Prentice Hall
22
LECTURE 4: RISK MANAGEMENT STRATEGIES

4.0 Introduction
Risk, at the general level, involves two major elements: the occurrence probability of an
adverse event and the consequences of the event. Risk estimation, consequently, is an
estimation process, starting from the occurrence probability and ending at the
consequence values. Risk evaluation is a complex process of developing acceptable
levels of risk to individuals, groups, or the society as a whole. Generally there are several
risk management strategies that can be employed to mitigate risk exposures. The
strategies can be broadly categorized into three; risk control, risk financing and risk
transfer.

i) Discuss the three categories of risk management strategies used in the risk
environment.
ii) Discuss the main strategies applied in controlling risks in the organizations.
iii) Discuss risk financing and risk transfer strategies that are mostly used in
organizations.
iv) Explain the rules that are applied in managing risks.
.
4.1 Lecture Outline

4.1.2 Risk Control
4.1.3 Risk Financing
4.1.4 Risk Transfer
10) to
11) to
Rules12)
in Risk
to Management Risk Control
This is a strategy that focuses on minimizing the risk of loss to which an organization is
exposed. Techniques used are avoidance and risk reduction.
23
i)Risk avoidance this occurs when decisions are made that prevent risks from coming
into existence in the first place, example an organization can avoid risks by deciding not
to engage in activities which it considers high risk e.g manufacture of explosives or
poisonous substances. Risk avoidance should only be used where exposure to risk is
catastrophic and the risk cannot be transferred or reduced. Risk avoidance is a negative
approach for managing risks because the advancement of personal and economic
progress requires risk taking and if risk avoidance is used extensively the organization is
unlikely to achieve its primary objectives.
ii)Risk reduction- Risk reduction consists of all techniques that are designed to reduce
the likelihood of loss or the potential severity (impact) of such losses should they occur.
Efforts to reduce the likelihood of loss are referred to as loss prevention, while efforts to
reduce the severity of loss are referred to as loss control.
Consideration of risk reduction
i.
Reduction of like hood of loss can be done through putting up signs such as no
smoking sign on a petrol station or installing protective devices around machinery to
reduce the number of injuries to employees. This will reduce frequency of loss or
their probability.
ii.
Reduction of severity of impact of loss. These can be done or demonstrated by

installing sprinkler or five extinguished or separation and dispersions of the company
assets to different location in an effort to salvage company assets in case of loss.
iii.
Engineering approach to loss prevention. This approach focuses on removal of

hazard. It focuses on system analysis and mechanical unavoidable e.g air bugs can
boost safety belts in vehicles.
iv.
Human behavior approach on loss prevention. This approach focuses on the

elimination of unsafe acts by the person. This approach is based on the fact that most
accidents are as a result of human failure e.g. alcohol and drug consumption fatigue
among others.
v.
Timing of risk reduction measures Such measures may be designed for prior to the
loss event, during the loss event and after the loss events. Measures prior to loss
include:
24
Training of personnel measures before

Measures during five; five:
Fastening seat belts
Measures after the event may be:
Rush victim to hospital
Offer first aid
RISK FINANCING
These concentrate on availing the funds to meet the losses arising from risks that remain after the
application of risk control technique of measure. Risk financing include:
Risk retention
Risk acceptance
RETENTION/ SELF INSURANCE

This is the most common method of dealing with risks whereby organization and
individual face unlimited number of risks most of which nothing can be done about.
Risk retention can either be conscious (intentional) or unconscious (unintentional). It can
also be voluntary or involuntary and even be funded or unfounded. When nothing can be
done about the particular exposure then the risk is retained. It is in last resort on risk
management strategy whereby the risk cannot be avoided, reduced or transferred. The
self-assumption of risk consists of waiting for the event to happen with no effort to any
financial provision in advance for the occurrence of risk. In some instances the individual
subjected to the risk may provide some amount in advance to cover for the anticipated
financial consequences of the risk normally referred to as self-insurance.
The major disadvantage of using insurance reserve is that:
(i)
The amount set aside may be more or less at the time when the risk occurs.
(ii)
A loss may occur before the fund is sufficient to meet the risk
(iii)
There are chances that this fund may be mismanaged or may be misused by the
firm
Self-assurance is normally possible where there is a large number of risks and more of
them have a large number of value. These objects are distributed such that the possibility
25
of the risk occurring to all of them at the same time is minimal. As a general rule, the
risks that are retained are those that need small losses.
Classes of Risk Retention
Unintentional risk It occurs when a risk is not recognized so that an individual
(i)
or organization may unknowingly or unwillingly retain the risk of loss.

Voluntary retention Results from a decision to retain risk rather than avoid or
(ii)
transfer that risk. Sometimes voluntary retention will occur when a risk manager
purchases insurance that does not cover fully the risk exposure.
(iii)
Involuntary retention occurs when its not possible to avoid or reduce or transfer
an exposure to an insurance company.
NB
Voluntary retention occurs when its not possible to transfer, refer or avoid
risks of loss e.g. death or earthquake.

(iv)
Funded Retention - This is where an organization sets side assets that are held in
liquid or semi-liquid. To cater for the risk of loss. Such risks are visually accepted
or retained by the entity.
(v)
Unfunded retention Is a case where there are no budgeted allocations to meet

uninsured losses.
Advantages of retention
Saves money-The firm can save money in the long run if its actual losses are less than
the loss allowance in the insurers premium.
Lower expenses- The services provided by the insurer can be provided by the firm at
a lower cost.
Encourage loss prevention-Since the exposure is retained; there may be greater

incentives for loss prevention.
Increase cash flow- Cash flow may be increased, since the firm can use funds that
normally would be held by the insurer.
Disadvantages of retention
Possible higher losses-The losses retained by the firm may be greater than the loss
allowance in the insurance premium.
26
Possible higher expense- Expenses may actually be higher
Possible higher taxes- Income taxes may also be higher as the premiums paid to the
insurer are income tax deductibles.
Risk Transfer
Is the shifting of the risk burden from one party to another. This can be done through
several ways;
a) Through risk allocation, where there is sharing of the risk burden with other parties.
This is usually based on a business decision when a client realizes that the cost of
doing a project is too large and needs to spread the economic risk with another firm.
Also, when a client lacks a specific competency that is a requirement of the contract,
e.g., design capability for a design-build project. A typical example of using a risk
allocation strategy is in the formation of a joint venture.
b) Through purchase of insurance. Whereby in consideration of a specific payment
(premium) by one party, the second party contracts to indemnity the first party against
specified loss that may or may not occur up to a certain limit
c) Subcontracting whereby if an employee accepts work which they are not fully
competent without the assistance of others, they can subcontract the extra work. Extra
work would involve specialist work which that employee lacks the knowledge to
handle; or which would involve excessive amount of work beyond the capability of
that employee.
d) Through the use of contract indemnification provisions
e) Leasing and renting
RULES IN RISK MANAGEMENT
The following are the guidelines:
(i)
Do not risk more than you can afford to risk. This does not tell us what needs to
be done about a given risk but informs the individual or the company not to risk
more than it can afford to retain.
For instance, if the risk can result in bankruptcy, then retention is not the most
appropriate method of managing the risk.
27
The ability of a company to retain a particular risk is complicated and varies from
one company to another and depends on company cash flow, liquidity position
gearing level.
The rule gives guideline as to which risks should never be retained that is those
that are catastrophic.
(ii)
Consider the odds. If the individual can determine or predict the probability that a
loss will occur then he/she is in a better position to deal with that risk than when
he did not have such information. High, medium and low probability of risk
enables the manager to determine which method of risk management to use.
(iii)
Do not risk a lot for a little. The risk should not be retained when possible risk is
large relative to the premium saved through retention and vise versa.
This rule requires that the risk manager analyses the cost benefit of the risk
when selecting the appropriate method of handing the risk.
4.3 Activities;
49.
50.
Take
time and visit any three professional management firms in your nearest town,
51.
52. there find out the various business ventures they do, secondly find out the
while
53.
strategies
they put in place to manage the various risks that faces them and if they
54.
employ different strategies to manage the same set of risks they encounter.

With many catastrophes such as drought, floods, hunger, insecurity affecting many parts of
Kenya. Discuss the various risk management strategies that can be used to manage such risk.
28
4.5 55.
Summary
56.
In this
57. lecture you have learnt that:
58. control is a strategy that focuses on minimizing the risk of loss to which an
i) Risk
59.
organization
is exposed; it can be done using risk reduction and risk avoidance.
60.
ii) Risk financing concentrate on availing the funds to meet the losses arising from risks
that remain after the application of risk control techniques. Risk financing include; Risk
retention and risk acceptance.
iii) Risk transfer is the shifting of the risk burden from one party to another. This can be
done through; risk allocation, purchase of insurance, Subcontracting, use of contract
indemnification provisions and Leasing and renting.
iv) Rules of risk management require that you do not risk more than you can afford to
61.secondly consider the odds and lastly do not risk a lot for a little.
risk,
62.
63.

Vaughan, E. and Vaughan, T. (2003) Fundamentals of Risk and Insurance 9th Edition, Wiley
Dorfman, M.S. (2005) Introduction to Risk Management and Insurance, 9th Edition, Prentice
Hall
29
LECTURE 5: RISK MANAGEMENT PROCESS AND RISK MANAGEMENT

PROBLEMS
5.0 Introduction
Risk management process refers to a series of steps that must be accomplished in
managing risks. They includes; Determination of objectives, Identification of risks,
Evaluation of risks, considering alternatives and selecting the risk treatment device,
implementing decisions, evaluation and Review
i) Discuss the risk management process that can be universally adopted by
organizations in Kenya.
ii) Enumerate the various tools that can be used to identify risks that affect
organizations.
iii) Enumerate the various risk management problems faced by companies today
5.1 Lecture. Outline

13) to
5.1.5 Implementation,
evaluation and review
14) to
15)management
to
5.1.6 Risk
Problems

The objectives of a risk management program must be determined initially i.e. deciding
precisely what the organization would like the risk management to do.
Risk management has a variety of objectives that can be classified into two;
30
i)
Pre-loss objectives
ii)
Post-loss objectives
Pre-loss objectives
This will include economy, reduction of anxiety, and meeting externally imposed
obligations and social responsibility
Post-loss objectives
This will include survival, continuity of operations, earning stability, continued growth
and social responsibility.
Other scholars have advocated that the objective of risk
management is similar to the ultimate goal of other functions of the business, which is to
maximize value of the organization.
The limitation to the value maximization objective is that it is only relevant to business
entities and not relevant to the organization such as the government and nongovernmental organization.
Some scholars have argued that the main objective of risk management is survival, in
order to guarantee the continued existence of the organization or preserve the operating
effectiveness of the organization.
This objective of survival will ensure that the organization is not prevented from
achieving its objectives by losses that may occur out of pure risk.
Because one cannot know those losses will occur or the amounts of such losses,
arrangements to guarantee fee survival must reflect the worst possible combination of
outputs.
Before risk management can be done, the risks that face the organization must be
identified. This is the most difficult step because it is a continuous process as well as it is
difficult to establish when risk identification has been done completely and exhaustively.
It is difficult to generalize about the risks that face the organization hence the need for a
systematic approach to risk identification.
In risk identification we ask the question, how can the assets or earning capacity of the
enterprise be threatened? The objective being to identify all risks facing the organization
31
not limited to insurable or those experienced in the past. For risk identification to be
successful there must be two essentials;
(i)
The task of risk identification must be someones job. This is because

everybodys responsibility is nobodys responsibility e.g. having a risk manager
or someones job description includes risk identification. Good management on
its own is not enough to identify risk, it must be someones job.
(ii)
The tools of risk identification must be available to the person to identify risk.
The techniques and tools of risk identification include;

a) Gaining thorough knowledge of the organization and its operations by way of
interviews and outside the organization as well as examining the internal records and
documents.
b) Analysis of documents
The purpose of this is to discover trends. The documents to be analyzed include;
financial statements, contracts, inventory records, valuation reports e.t.c.
c) The flow charts
The flow chart of an organizations internal operations will view the organization as a
process and therefore seek to discover all contingencies (Unexpected liabilities) that
could interrupt the processes involved e.g. damage to key assets of the organization,
loss of key staff through death, incapacitation or resignation.
d) Risk Analysis questionnaires
These are also referred to risk tact tenders and assist in identifying risks by pausing a
series of questions whose answers will indicate whether hazardous conditions exist
e.g. does KSPS have flammable substances within the premises, does the college
have fire extinguishers that are in operational order etc.
e) Exposure Check list
This refers to a list of common exposures where aim is to reduce chances of
commissions and oversight some of which can be serious.
f) Insurance Policy checklists
These are checklists available from insurance companies and publishers of insurance
material that indicate the variety of policies that exist to cover risks.
32
g) Export computer systems

Such systems incorporate the features of risks analyze questionnaires, exposure
checklists and insurance policy checklists in one system.
h) Other Internal Records:
In addition to the Financial Statements there are other internal documents that can be
used to identify loss. These include; corporate laws, annual reports, minutes of board
and directors meetings, organization chart, policy manual, contracts such as leases
and rental agreement, purchase orders etc.
i) On Site Inspection:
Involves visiting various locations and departments where assets are located. Just as
one picture is worth a thousand words, one inspection tour may be worth a thousand
checklists.
j) Contract analysis:
This specifies who bears the loss in case it happens e.g. in sales contract, you may be
given a warrant.
k) Statistical Analysis of Past Losses:
This is done by simulating the chance of occurring using data generated by a
computer based on past events. Example; In motor vehicle industry (Matatu)
accidents occurs mostly during holidays (Easter, Xmas etc.) due to either overloading
or over speeding.
l) Studying organizational chart: Studying organizational chart could help the company
identify exposure to pure loss through loss of key personnel. Example is the case of a
very expensive machine critical to a manufacturing process which can only be
operated by one employee. This unfortunate state of affair could be identified through
scrutiny of the organizational chart.
m) Forecasting :The organization can identify its pure loss exposure through forecasting
of expected income under normal circumstances and an estimation of post loss
income .The difference is the loss
33
n) Valuation of property: Knowledge of replacement values can help the risk manager to
estimate the exposure to pure loss. Risk managers should keep current price and
source list for their properties.

Once risks have been identified, the risk manager must evaluate them by ranking them in
terms of importance (prioritization).
There is need to consider the approaches that might be used to deal with risk and then
select the technique appropriate to deal with the identified risk. During this stage, the
risk manager is primarily concerned with deciding on which of the techniques available is
appropriate.
In deciding which of the available techniques should be used, the risk manager should
consider:
1. The size of potential loss.
2. The probability of potential loss
3. Resources available to meet the loss should it occur.
4. The cost and benefits of each of the techniques to be adopted.
5.1.5 Implementation, evaluation and review
At this stage of the risk management process, a decision is made and implemented in the
organization such that if the decision is loss prevention, then a loss prevention program
must be designed and executed. If the decision is risk transfer through insurance, then
the selection of the insurer negotiation and placement is made. If the decision is to retain
risk, reserve funds must be accumulated in order to meet losses should they occur.
5.1.6 Evaluations and Review
There is need to evaluate and review the whole process due to the new changes that may
occur and new risks that arise. Hence, the technique that was appropriate in previous
periods may no longer be applicable in the current year.
Evaluation and review is important as it enables the risk manager to review decisions
made and detect mistakes before they become costly. Review can be done by repeating
34
the steps of the risk management process to determine whether past decisions were
proper in the light of existing conditions.
5.1.7 Risk management Problems
Many of the challenges faced by risk managers are often similar to those faced by other
managers. However, a number of key characteristics will tend to distinguish risk
management problems and they include the following:
a)
Time horizon
b)
Measurement of costs and benefits
c)
Credibility of data
d)
Possible uncertainties
e)
Possible externalities
f)
Independent exposures
a)
Time horizon
The evaluation of risk control efforts usually require long term view even up to 20
years in order to evaluate companys risk management projects that require
capital investment. Also, risk financing consideration companies will require a
long-term horizon for example decisions regarding medical insurance schemes
will be adopted by a company as opposed to a company where a fixed medical
allowance is granted to all employees or where medical bills are refunded upon
production of genuine receipts.
b)
Measuring costs and benefits

A good feature of a successful RM is where theres absence of unpleasant surprises.
When a risk manager prevents or reduces losses and benefits accruing to the company,
they may not want to be faced with losses that they are not compensated. Some may
be difficult to measure, hence the need to install safety devices, to prevent such uncontemplated risks.
35
c)
Credibility of data
The justification of risk management efforts will often rely on the data developed from
past experience, hence environmental change and the nature of the organization can
make data obsolete for decision making purposes.
d)
Possible Uncertainties
The prediction of future outcomes in order to make current decisions is often a risky
task and can only be done by use of probabilities.
e)
Recognition of externalities
Externalities are economic costs that are not captured in the price of a product. They
represent market failure to the extent that the market pricing systems fail to capture or
predict production costs.
For example, when pricing and costing items in a factory, the pollution caused by
the factory may not be factored unless the factory is under duty to clean up such
pollution
f)
Identification of Inter-dependence:
Inter dependent exposures are present when a single peril can cause more than one
loss. Possible interdependence is of critical importance to a risk manager. For
example, a natural calamity can trigger more than one loss such as property
destruction; death etc yet such peril may not be insurable.
64.
5.2Activities;
65.
i) Plan a visit to the nearest service station in your locality, while there;
66.
a) Find out the risk management process that is followed by the entity in operating its fuel
67.
and gas business.
68.
b) Establish the tools that they use to identify the risks facing them.
ii) Determine some of the unique problems that risk manager in the energy sector face.
36

1. Risk management identification tools are at best assumed to be scientific in the
69.
organizational
risk management strategy. Point out the most commonly used tools in
organization today. Discuss how such tools can be practically applied with positive
impact to business organizations in Kenya.
2. Risk management process is a detailed plan that if well adhered to saves the
organizations many losses. Articulate in brief the risk management process that should be
in place for a manufacturing firm. What are the business consequences of not adhering to
the process?
3.Relate the unique problems of risk management as a discipline to the normal
operational management issues faced by business managers in todays organizations.
5.4 Summary

70.
i)The risk management process comprises of the following processes; Determination of
71.
Objectives, Identifying risks, Evaluating risks and considering alternatives,
72.
Implementation, evaluation and review.
73.
ii) The there are various techniques and tools that are used in risk identification, among
74.
them includes; Analysis of documents, the flow charts, Risk Analysis questionnaires,
75.
Exposure Check list and Valuation of property among other tools.
76.
iii) There are number of key characteristics that tend to distinguish risk management
77.
problems from the other operational managers problems and they include the following:
78.
time horizon, measurement of costs and benefits, credibility of data, possible
uncertainties, possible externalities, and independent exposures

Vaughan, E. and Vaughan, T. (2003) Fundamentals of Risk and Insurance 9th Edition,
Wiley
Prentice Hall
37
LECTURE 6: INSURANCE DEVELOPMENT

6.0 Introduction
In this lecture we are going to learn how insurance business came to evolve with the
Chinese merchants as early as 3000BC, the transfer of risk via Great Code of
Hammurabi, to the times of Edward Lloyd coffee house. The lecture will also delve
into the African traditional societys ways of managing risk to the modern times. We
shall explore on how the insurance mechanism works, requisites of insurability,
guiding principles in establishing risk classes and lastly look at the functions and
benefits of insurance to a society.

i) Document the historical development of insurance from the ancient times to its
present day developments.
sites
ii) Explain how the insurance mechanism operates in an economic system like
Kenya.
iii) Discuss the functions and benefits of insurance to a country like Kenya.
6.1 Lecture Outline

6.1.2 Historical development of insurance
6.1.6 The guiding principles in establishing risk classes
6.1.2 Historical development of insurance.

As early as 3000BC Chinese merchants utilized the techniques of sharing risks. About
500 years later, the famous Great Code of Hammurabi provided for the transfer of the
risk of loss from merchants to moneylenders. Under the provisions of the code, a trader
whose goods were lost to bandits was relieved off the debt to the moneylender who had
38
loaned the money to buy the goods. Babylonian moneylenders loaded their interest
charges to compensate for this transfer of risk. Loans were made to ship-owners and
merchants engaged in trade, with the ship or cargo pledged as collateral. The borrower
was offered an option, for somewhat higher interest charge, the lender agreed to cancel
the loan if the ship or cargo was lost at sea. The additional interest on such loans was
called a premium and the term is still used even today. The contracts were referred to as
bottomry contracts in cases where the ship was pledged and respondentia contracts
when cargo was the security. Although these were insurance of sorts, the modern
insurance business did not begin until the commercial revolution in Europe following the
crusades.
Marine insurance the oldest of the modern branches of insurance was started in Italy
during the 13th Century. This early marine insurance was issued by individuals rather
than insurance companies. A ship-owner or merchant prepared a sheet with information
describing the ship, its cargo, its destination among others. Those who agreed to accept a
portion of the risk wrote their names under the description of the risk and the terms of the
agreement. This practice of writing under the agreement gave rise to the term underwriter.
Ship-owners seeking insurance found the coffeehouses of London convenient meeting

places. One of the coffeehouses owned by Edward Lloyd, soon became the leading
meeting place. Lloyds is known to have been in existence early in 1688.
3.1.1 Traditional African society

The concept of insurance is not new to Africa. The African communities have had
traditional forms of managing risks facing them. It is still common for the old or sick to
expect material support from members of their families or clan. The family was a strong
compact unit and family meant more than just husband, wife and children. The cost
(premium) was that any good fortune was shared by all. Relics of this practice exist even
today and the famous Harambee is a spin off these traditional insurance practices.
These traditional forms of insurance are dying fast in most developing countries as a
result of economic and social developments.
39
3.1.2 Modern Insurance in Kenya

Following the scramble for Africa towards the end of the 19th Century, various European
powers established sovereignty on the African soil. This meant that trading operations
needed certain services among them insurance. The insurance industry in Kenya owes its
beginning to foreign nationals mainly of British and Asian origin. Although the exact
date of birth of the insurance industry in East Africa is not known, there is evidence that
the first marine agency was opened in the Island of Zanzibar in 1879. It took another
twelve years before an insurance office was opened in Kenya. One British company was
represented here in 1891. But the real birth of the industry was within the first two
decades of the 20th Century. The foreign companies in Kenya operated through agents
before establishing branches. Most of the agents were individuals or firms that transacted
other businesses and not specialized in insurance. One of the early companies to open
branches was Royal Exchange Assurance of London which opened a branch in Kenya in
1922. It was in 1930 that the first locally incorporated company was set up in the name of
Pioneer Assurance Society Limited. The others that followed are Jubilee Insurance in
1937 and Pan Africa Insurance in 1946. The insurance industry has grown since then to
the current position. There are about 200 registered insurance brokers, 193 loss assessors,
22 surveyors, 18 loss adjusters, 3 risk managers, about 3000 insurance agents, 43
insurance companies and 2 local reinsurance companies.

Individuals and companies (exposure units) reduce their risks by forming a pooling
arrangement. Risk averse individual and companies are persons who value lower risks
and therefore they have the incentive to participate in the risk pooling arrangement,
especially if such arrangements can be made at a lower cost.
Its not costly to operate a pooling arrangement and indeed, the cost of organizing and
operating this arrangement is the main reason for existence of insurance companies.
If for example there are 1000 vehicles in a given community, with a value of sh
1,000,000 each, the vehicle owners face the risk that they could be stolen or be involved
in serious accidents, five etc.
40
The financial loss that will therefore occur would be 1 billion. Some vehicles may
actually incur loss, but the probability that all of them will actually suffer or incur loss is
remote. If the vehicle owners enter into an agreement to share the cost of loss as they
occur, to the extent that no single vehicle owner will be forced to incur the entire
financial loss of sh 1M, it would mean that in case a vehicle incurs a loss, all the 1000
vehicle owners should contribute to that loss.
Under this arrangement, vehicle owners who suffer financial loss will be indemnified by
those who do not suffer the accident hence owner who escape loss will be willing to pay
those who suffer loss, because by doing so, they eliminate the possibility of themselves
suffering the sh 1M loss.
The potential difficulty of this arrangement is that some group members may refuse to
pay their assessment of sh 1M at the time of loss and this problem can only be solved by
requiring advance payment of cash by each person contributing to the arrangement. The
assessment that each individual is required to pay will be calculated on the basis of past
exposure and experience.
Insurance does not decrease uncertainty of financial losses or alter the probability of
occurrence, but reduces the probability of financial loss connected to the event.
Expectation gap in risk pooling arrangement

Some people believe that its a waste to purchase insurance especially if a loss
(i)
does not occur and they are indemnified.

(ii)
Other people believe that if they have not had a loss during the policy term, they
should be refunded their premium.
Both points constitute ignorance because:

i.
Insurance provides a valuable feature which is freedom from uncertainty and even
if a loss did not occur during the policy term the insured will have received the
benefits for the premium paid, which is the promise of indemnification if a loss
occurred.
41
ii.
The operation of the insurance principle is based on the contribution of many

paying for loses of the unfortunate few, who have suffered. Therefore, if
premiums were to be returned to the many who did not suffer loss, there will be
no funds to cater for the few who actually incurred losses.

It is important to note that the world of businesses is not static and what may be
uninsurable risk today could very well be insurable tomorrow. A good example is recent
moves to ensure political risks through the African Trade Insurance Agency (ATIA).
However, the following would be the requisites for insurability:1. Fortuitous the happenings of the event must be entirely fortuitous to the insured.
These rules out inevitable events such as wear, tear and depreciation. Any damage
inflicted on purpose by the insured would be ruled out. However, purposeful events
by other persons would be covered provided they were fortuitous as far as the insured
is concerned. In life assurance, although death is certain, the timing of death is what is
fortuitous and that is the concern of life assurance.
2. Financial Value Insurance does not remove the risk but it endeavours to provide
financial protection against the consequences. Therefore, the losses must be capable
of financial measurement.
In some cases the court will decide the level of
compensation due to an injured person while in property insurance it is possible to

place a value on the loss or damage.
In life assurance, the level of financial
compensation is agreed at the beginning of a contract.

3. Insurable Interest Refer to principles of insurance to be discussed later
.
4. Homogenous Exposure The law of large numbers entails that given a sufficient
number of exposure to similar risks, the insurance company can forecast the expected
extent of their loss and therefore move towards accuracy in setting premium levels.
There might be a few cases where heterogeneous exposures are insurable but on the
whole insurers prefer homogenous exposures in order to benefit from the law of large
numbers.
42
5)
Pure Risks Insurance is primarily concerned with pure risks. Speculative risks
are generally not covered because it may act as a disincentive to effort e.g.
insuring profit would mean no effort to achieve desired results. But the pure risks
consequences of speculative risks are insurable e.g. risks of a new line of business
selling or not though in itself a speculative, the risk of the factory being
damaged by fire is pure and therefore insurable.
6)
Particular risks Fundamental risks are generally not insurable e.g. war, inflation
etc. However fundamental risks arising out of physical cause e.g. earthquakes
may be insurable.
7)
Public Policy Contracts must no be contrary to what society would consider

right and moral e.g. contracts to kill a person, no insurance for criminal venture.

i)
Premium Loading
Risk averse people desire insurance cover but the extent to which they purchase
the insurance depends on the insurance premium loading. The premium and
insurance is equal to the total claim cost and a loading for administration and
capital costs.
If the loading is 0, the premium will be equal to the expected payments from the
insurer and therefore the risk averse will purchase full insurance cover
Unfortunately the premium loading is rarely zero because the insurer must be
compensated for their costs.
ii)
Moral Hazard
It refers to increased probability of loss that result from existence of insurance
fraud. This may result from reduced incentive of the policy holders to prevent
losses or engage in activities that cause loss for personal gain.
43
iii)
Adverse Selection
Arises when it is too costly for the insured to classify perfectly the insured on how
much they should be charged for the insurance purchased.
Different covers are charged different premiums yet due to the information given
to the insurance companies concerning the high and low risks, insurance
purchased may be charged for similar risks. Ideally, high-risk persons should be
charged a higher rate in order to generate funds compensating such persons.
However, since classification is costly, insurance companies will only classify if it
is cost effective.
iv) Subsidization
Occurs as a result of the insurers inability to classify perfectly the insured, some
insureds are wrongly classified and are made to pay more than their fair share of the risk
they face. For example classifying 20 year olds in the same class with 60 year olds. The
20 yr olds will subsidize for the 60 yr olds.
6.1.6 The guiding principles in establishing risk classes

i) Separation and class homogeneity
If the insurer constructed its risk classes carefully, each class will have a
significantly different expected loss (separation). Moreover, each member of a
given class will have approximately the same chance of loss (class
homogeneity). This rule prevents combining males ages 20 and 40 in the same
life insurance pool and causes a mathematically fair insurance exchange.
ii) Reliability
If insurers decide to use a particular factor for classifying insureds, information
about the factor should be easily obtained and not subject to manipulation by the
insured. The variables of age and sex would meet this standard, but asking an
applicant kilometers are driven each year or whether drugs or alcohol are used
would not do as well because insureds can provide false information.
44
iii) Incentive value

If risk classes are crafted in a way designed to promote using societys resources
carefully, insureds should be rewarded for maintaining clean driving records or
for applying loss prevention measures. Thus, factors used for risk classification
should reward good insureds (those with below-average loss potential) with
better insurance rates.
iv) Social acceptability
This is the underwriting criterion that is the most difficult to handle. Who is to define
social acceptability? Moreover, this measure has the possibility of being at odds with
the preceding risk classification criteria. How are such conflicting outcomes to be
resolved? What do we do when the desirability of a mathematically fair insurance
exchange conflict with a socially desired outcome?

1.
Risk Transfer The primary function of insurance is that it is a risk transfer

mechanism which exchanges uncertainty for certainty. It exchanges the uncertain
loss for a certain premium.
2.
Creation of Common Pool This enables the losses of a few to be met by the
contributions of many. An insurance company operates such a pool. It takes
contributions in form of premium and is able to pay the losses to a few. The
insurer benefits from the law of large number i.e. the actual number of events
occurring will tend towards the expected where there are large similar situations.
3.
Equitable Premiums - An insurance company maintains several pools for each

risk. This enables the insurer to tell the profitable from the unprofitable ones.
However, similar types of risks could be brought into a common pool although
they will represent different degrees of risk to the pool. This should be reflected
in the contributions to the pool. It wouldnt be equitable for private car owners to
subsidize commercial vehicle owners.
The insurer has to ensure that a fair
premium is charged, which reflects the hazard and value of risk brought to the
45
pool. The completive forces must also be taken into consideration in premium
rating.
Benefits of Insurance
1.
Peace of Mind The knowledge that insurance exists to indemnify provides

peace of mind for individuals, industry and commerce. Insurance encourages
entrepreneurship by way of transfer of risk. It also stimulates the business in
existence by releasing funds for investment. The recent spate of robberies to
banks in Kenya could have easily sent some closing, but because of insurance
these risks are catered for. The need of peace of mind has led the government
to make some forms of insurance compulsory e.g. third party liability cover,
workmens compensation and employers liability.
2.
Loss Control Insurers play a great role in reduction of the frequency and
severity of losses. The surveyor plays the role of risk control specialist.
Advice could be given on pre-loss control (e.g. wearing safety belts) and post
loss control (e.g. having fire extinguishers).
3.
Social Benefits The fact that insurance provides indemnity after loss means
jobs may not be lost and goods and services can still be sold.
4.
Investment of Funds Because of the time lapse between receipt of premium

and payment of claims, insurers are major investors of funds. By having a
spread of investments, insurance helps government in borrowing, offers loans
through mortgages, buying of shares on the stock exchange etc. They form a
part of institutional investors including banks, building societies and pension
funds. They also invest in property e.g. ICEA Building, Jubilee Insurance
House, etc. Most life funds are invested in longer term ventures as apposed to
general insurance. Insurance therefore assists in mobilizing savings.
5.
Invisible Earnings Insurance is one of the invisible earning forums including

such areas as tourism, banking etc. Risks outside the country can be insured in
Kenya and money earned on these transactions represents a substantial
volume of earnings. It contributes to a favorable balance of trade i.e. exports
exceed imports.
46
6.2 Activities;
i) Plan79.
a visit or make a call to Jubilee insurance head office in Nairobi with a sole purpose of
80. its historical development in the country.

knowing
ii) Try81.
to establish the requisites Jubilee insurance considers in order to accept a risk for
insurance.
82.
iii) The
83.benefits and or impact its insurance business has had in the country in the years it has
operated in the country.
84.
85.
1. Highlight
the major milestones in the development of insurance sector in Kenya up
to its present status.
2. Using local examples and illustration demonstrate how the insurance mechanism,
the law of large numbers and the principle of expectation gap operate.
3. Requisite for insurability are critical determinants in any insurance business. Discuss
the application of this concept in the present insurance business today.
6.4 Summary
86. lecture you have learnt that:
In this
87.
i)
88.
89.
ii)
90.
91.
92.
iii)
93.
94.
95.
96.
97.
98.
99.
iv)
Insurance has developed from the ancient times to its present day developments.
Insurance mechanism is a risk pooling arrangement where an individual transfer
his or her risk to the pool.
There are requisites of insurability that insurers considers vital before insuring
any risk brought to them and they includes, risk must be accidental, must
have financial value, must be a pure risk, homogenous exposure among
other requisites.
Insurance has several functions and benefits to a society key among the functions
include; risk transfer and creation of the insurance pool. The benefit includes;
the peace of mind and the social benefits it provides the members of the
society.
47

100.
101. G.C. (1997) Risk Management the Chartered Insurance Institute
Dickson,
102.
Vaughan,
E. and Vaughan, T. (2003) Fundamentals of Risk and Insurance 9th
103.
104. Wiley
Edition,
105.

48
LECTURE 7: CLASSES OF INSURANCE
7.0 Introduction
Insurance offices are split into departments or sections, which deal with types of risks
which have affiliation with each other. Generally insurance companies are categorized
into the following offering the specified products or policies:
At the end of the lecture you should be able to:

i) Distinguish between Life and Health insurance policies.
ii) Enumerate the various categorization of Life and Health class.
iii) Discuss the different liability insurance policies available in the market.
iv) Discuss the various property insurance policies sold in the Kenyan market.
v) Explain the difference between pensions and annuities.
Lecture Outline
16) to
17) to
to insurance
7.1.418)
Property

This is a contract between the policy owner and the insurer, where the insurer agrees to
pay a sum of money upon the occurrence of the insured individuals or individuals
death. It is the risk pooling plan and economic device through which the risk of
premature death is transferred from the individual to a group In return the policy owner
or policy payer agrees to pay a stipulated amount called a premium at regular intervals or
in lump sums (so-called paid up insurance).
49
A life insurance contract is intended to meet the needs of survivors or beneficiaries, when
the investor dies. From the life insurance contract, the beneficiaries receive a sum of
money that far exceeds the value of the premiums the investor had paid. The
beneficiaries, of course, receive this benefit if the person insured dies during the contract
period.
The contract of life insurance is different from other types of insurance in the following
respects.
i)
The event insurer against is an eventual certainty i.e nobody lives forever.
ii)
It is not the possibility of death that is insured against; rather, its the
untimely death. The risk is not whether the insured person is going to die
but when.
The risk increases as the individual ages or grows older because chances
of death are greater in later years than in initial years.
iii)
There is no possibility of partial loss in life as in the case of property and

liability insurance. Therefore, if a loss occurs under life assurance, the
insurer will have to pay the face value of the policy.
iv)
Life assurance is not a contract of indemnity, that is, the position after the
loss as before the loss. This is because it is not possible to place a value on
human life.
v)
Life assurance does not violet the principle of contribution i.e counts of
law have held that every individual has unlimited interests in their own
lives and individuals can assign insurable interests to any one therefore, if
the person taking insurance does so with many insurers all of them will
compensate the next of kin.
Ordinary life assurance, industrial life and group life would all fall under the wider
caption of life and health insurance. Under life and health, there are various types of
(assurance) as follows:
a) Term Assurance It provides for payment of the sum assured on death occurring
within a specified term. If the life assured survives to the end of the term, cover
ceases and nothing is payable by the life office.
50
b) Decreasing Term Assurance It is designed to cover the outstanding balance of a

debt. It is common with mortgage institutions like HFCK and Saccos.
c) Convertible Term Assurance - This is synonymous with term assurance but has a
clause which allows the life assured to convert the policy into an endowment or
whole life contract at normal rates, without medical evidence.
d) Family Income benefits The benefits on death within the term is paid out by
installments every month or quarter as opposed to lump sum.
e) Whole Life Assurance The sum assured is payable on the death of the assured
whenever it occurs. Premiums are payable throughout life or till retirement but
benefits are payable on death whenever it occurs.
f) Endowment Assurance The sum assured is payable in the event of death within a
specified period but if the life assured survives up to the end of the period, the sum
assured will also be paid. For a given level of cover, it has the highest premium
because payment will be at a given date or before if the assured dies, the end of the
period is called the maturity date. The shorter the term of an endowment, the more
expensive it becomes.
g) Group Life Assurance Employers sometimes arrange special terms for life
assurance for their employees, the sum assured is payable on death of an employee
during his term of service with the employer. The policy is issued to the employer as
sponsor.
h) Permanent Health Insurance It was designed to overcome the limitations of 104
weeks maximum benefit under personal accident and sickness cover.
Cover is
provided to assureds disabled for longer periods who due to accident or illness may
not engage in any occupation or change to a lower paid occupation. The cover usually
excludes say the first six or twelve months since many employees under such
circumstances may remain on payroll for such period before being struck off. The
maximum benefit is usually 75% of previous earnings less any other disability
benefits payable.
51

This cover is for loss suffered by the insured as to the amount he is liable to pay another
as compensation or some loss of his own money. There are types of liability insurance
namely:a) Employers Liability - This arises where an employee is injured by the fault of the
employer and the injured employee can claim compensation or damages from the
employer. In the past before introduction of this, an industrial injury was very much a
particular risk and not responsibility of the employer. The principle was volenti
non fit injuria i.e. the employee has concerted to run the risk of injury by being
employed. It was also extremely difficult for an ordinary employee to succeed in any
claim. When an employer is held legally liable to pay damages to an injured
employee he can claim against his employers liability policy which will provide him
with the amount paid out. The cover would include lawyers and doctors fees. The
policy is in respect of injury or death and not applicable where the property of an
employee is damaged. This insurance is compulsory at law.
b) Public Liability Is designed to provide compensation for those who have to pay
damages and legal costs for injury or property damage in respect of members of the
public.
c) Products Liability Where a person is injured by a product he has purchased and can
show that the seller or manufacturer was to blame he can claim for damages.
d) Professional Indemnity Insurance - This is liability to other parties arising out of
professional negligence e.g. A lawyer may give advice carelessly that results in a
client losing money. Therefore, professional indemnity insurance would be cover for
various professional e.g. Lawyers, Accountants, Doctors, Brokers etc.
e) Directors and Officers Liability Shareholders, creditors, customers and employees
can take action against directors as individual for negligence in operating a company.
This recent development has been aided by legislation to make individuals
accountable. The policy therefore will cover defense costs and compensation for
which a director may be liable to pay.
52
7.1.4 Property insurance

There are various covers for property depending with the cause or way in which it is
damaged:
a) Fire Insurance The basic fire policy provides compensation to the insured person
if the property is damaged as a result of fire, lighting or explosions, where the
explosion is brought about by gas or boilers not used for any industrial purpose.
b) Theft Insurance This covers theft which within the meaning of the policy is to
include force and violence either in breaking into or out of the premises of the
insured.
c) All Risks Insurance Uncertainly of loss may not only be due to fire or theft, this
led to the design of a wider cover known as all risks. The term all risks is a
misnomer
as there are a number of risks that are excluded but it is an
improvement on the traditional scope of cover that was available on the market.
The policy can cover expensive items like jewellery, cameras etc. The objective of
the cover being to cover a whole range of accidental loss or damage.
d) Goods in Transit It provides compensation, if goods are damaged or lost while in
transit, this would cover modes of transport like road, railway etc. The cover can
be affected by the owner of the goods or the carrier if he is responsible for them
while in his custody.
e) Contractors All Risks When new buildings or civil engineering projects are
being constructed, a great deal of money is invested before the work is finished.
There is a risk that the building or bridge may sustain severe damage prolonging
construction time and delaying eventual completion date. This may entail the
contractor to start building again or repair the damages. The extra cost cannot be
added to the eventual charge the contractor will make to the owner. The intention
of the policy is to provide compensation to the contractor for damage to
construction works from a wide range of perils.
f) Money Insurance The policy provides compensation to the insured in the event
of money being stolen either from the business, his home or while it is being
carried to or from bank.
53

The policies here cover marine, aviation and road risks. Marine policies relate to three
areas of risk i.e. hull, cargo and freight. Freight is the sum paid for transporting goods or
for hire of a ship. When goods are lost or destroyed by marine perils then freight or part
of it is lost thus need for cover. The risks covered in a marine policy are generally
referred to as perils of the sea and includes fire, theft, collision etc.
i)
The main types of marine policies are:a)
Time Policy Which is for a fixed period e.g. 12 months.
b)
Voyage Policy which is operative for the period of the voyage - for
cargo it is from ware house to warehouse.
c)
Mixed Policy Which covers the subject mater for the voyage and a
period of time thereafter e.g. while in port.
d)
Building Risk Policy It covers construction of marine vessels.
e)
Floating Policy - It provides the policy holder with a large reserve of for
cargo. A large initial sum is granted and each time shipments are sent, the
insured declares the value which is deducted from the outstanding sum
insured.
f)
Small Craft It covers the leisure use small boats. It is comprehensive in

style covering liability insurance.
ii)
Aviation Insurance Most policies are issued on an all risks basis, subject to
certain restrictions. In most cases a comprehensive policy is issued covering the
aircraft itself (the hull), the liabilities to passengers and the liabilities to others.
iii)
Motor Insurance The minimum requirement by law is to provide insurance in

respect of a legal liability to pay damages arising out of injury caused to any
person. Motor Insurance polices can either be:
a) Third party only It provides cover in respect of liability incurred through
death or injury to a third party or damage to the third party property. This
is according to the Road Traffic Act.
b) Third party, fire and theft - It provides cover as above but in addition
cover damage or loss to the vehicle from fire or theft.
c) Comprehensive policy It provides cover as above but in addition cover
accidental loss or damage to the vehicle itself.
54

Pensions
The prime objective is to ensure that pension is available on retirement. Most of the
pension schemes are arranged by employers for the benefit of their employees. In
association with pensions, policies are normally effected covering death in service for
those employees who do not live up to the retirement age. This is normally in the form of
group life assurance. It is also possible for individuals to purchase personal pension
plans. The occupational pension plan may be on:
(i) Final Salary or defined benefit basis or
(ii) Money purchase or defined contributions
Annuities
An annuity is a contract that provides periodic payments for specified time periods e.g. a
number of years of the life of an individual. The payment may begin at a stated date or
may be contingent (unknown date). A person whose life governs the duration of payment
is called an annuitant. Annuities are the reverse of life assurance contracts. Whereas life
assurance is a method of scientifically accumulating an estate of funds, annuities are
devices for scientifically liquidating that estate of funds. The basic function of life
annuities is that of liquidating a principal sum regardless of how it was accumulated. It is
intended to provide protection against the risk of outliving ones income from savings.
Types of Annuities
1)
Deferred
This refers to an annuity where benefits are deferred until some future date / time.
The particular time when benefits are to begin may or may not be specified ahead of
time.
2)
Temporary
This type is rarely used, it pays benefits until the expiration of a specified period of years
or until the annuitant dies, whichever comes first.
3)
55
Joint and Survivor
An annuity may be issued on more than one life. It provides that annuity payments will
continue as long as either annuitant is alive. The periodic payment may be constant
during the entire period or it may be arranged so that the amount of each payment is
reduced upon the death of the first annuitant.
The size of the survivors benefit (payable when only one of the two persons is still alive)
is often stated as a % of the joint benefit (payable while both annuitants are living) using
the terminology joint and x % survivor annuity.
Thus a joint and 100% survivor annuity would pay the same benefits regardless of
whether one or two annuitants were still alive. But a joint and 50 % survivor annuity will
pay the survivor only one half of the joint benefit. Age is an important factor as J & S
annuities are more expensive at younger ages.
4)
Fixed-Annuity that has a benefit expressed in terms of a stated dollar amount

based on a guaranteed rate of return.
Immediate It starts to make the periodic payments immediately after purchase.

Certain The periodic payments are made for a certain period irrespective of
5)
death.
6)
Guaranteed - The annuity is made for a guaranteed period or until death

whichever is later.
Major differences between life insurance and annuities;

i)
While an annuity contract is intended to support the investors future income

requirements, the life insurance meets the financial needs of the beneficiaries
immediately after the occurrence of an insured peril.
ii)
While the annuity pays back the total value of the investment made plus the
gains earned on it, the life insurance investment returns an amount that may be
multiple times larger than the premiums paid.
iii)
Life insurance is paid upon death or maturity and in lump sum while annuity
is paid in instalments.
iv)
Life insurance has terms and conditions to be met while annuity matures at
expiry of the stated period.
56
v)
Annuity can be deferred while life insurance is upon expiry of the stated
period.
vi)
In life insurance penalties are charged if funds are accessed before maturity
while in annuity no penalties are charged.
vii)
Life insurance are sold but not purchased.
7.2 Activities;
106.
107. to attend the annual Association of Kenya Insurers expo to be held in one of
Arrange
108.
the
47 counties in Kenya. While there;
109.
110.
i) Find out the various policies under Life and health sold by most insurance
companies.
ii) Establish which policies are sold under property and liability insurance.
iii) Find out how most insurance companies manage their annuity funds.
111.
7.3 Self
Test Questions
112.
1. Discuss how the contract of life insurance is different from other classes of insurance.
2. Discuss the various types of assurances offered by the Kenyan insurance companies
under the life and health class.
3. The classes of property insurance are not clearly demarcated. Give reasons why this
could be so. Discuss some of the classes for property insurance sold in Kenya.
4. Using suitable local illustrations explain the various types of liability insurance covers
available in the insurance market in Kenya.
5. Discuss the reasons for pension provisions in Kenya.
6. Distinguish the different kinds of annuities available in the market.
57
7.4 Summary
113.
114.There are various policies sold under Life and Health class.
i)
115.
ii)
116.There are different liability insurance policies available in the market.
117.The are various property insurance policies sold in the Kenyan market.
iii)
118.
iv) Whereas pensions is a method of scientifically accumulating an estate of funds,

annuities are devices for scientifically liquidating that estate of funds

Wiley
Prentice Hall
58
LECTURE 8: PRINCIPLES OF INSURANCE

8.0 Introduction
In this lecture we are going to learn the special contracts that are unique to insurance,
unlike commercial contracts, insurance contracts have special elements which includes;
insurance as a contract of adhesion, Insurance as a aleatory contract and Insurances as a
contract of good faith (fiduciary contract) among others. We are also going to learn more
about the principles of insurance that guide insurance business operations

i) Discuss the various special insurance contracts that are unique to insurance
business.
ii) Discuss the principles of insurable interest and its application in the insurance
business operations.
iii) Explain the principle of utmost good faith and how this principle is applied.
iv) Highlight the main case laws that support the principle of proximate cause.
v) Provide a distinction between indemnity, subrogation and contribution principles
as applied in insurance business.
8.1. Lecture Outline

8.1.3 Principle
of Insurable Interest
19) to
20) to
21) to


Insurance as a contract of adhesion
59
A contract of adhesion is one prepared by one party, the insurer to be accepted or rejected
by another party. If the insured does not like the contract terms, he may choose not to
purchase the insurance. Therefore, if he purchases the insurance, he must accept the
policy the way it is. Under this doctrine, the counts of law have ruled that a person is
bound by the terms of a written contract that he signs or accepts whether or not the
person reads the contractual terms
Assurance Aleaotory Contract
aleatory means that the outcome is affected by chance and the money given by the
contractual parties will be unequal. That is the insured pays the required premiums and if
no loss is suffered, the insurer pays nothing. However, if a loss occurs, the compensation
made to the insured will outweigh the insureds premium.
Insurances as a contract of good faith (fiduciary contract)
Applicants for insurance must make full disclosures for the risk to the insurance agent or
company. The risk that the insurer assumes must be equal to the risk that is being
transferred to them by the insured.
8.1.3 Principle of Insurable Interest
An insurable contract is one whereby the insurer agrees to indemnify the insured should a
particular event occur or pay him a specified amount on the happening of some event. In
return the insured pays a premium. The subject matter of insurance under a fire policy
can be buildings, under liability policy can be legal liability for injury or damage, under
life assurance policy the life assured, in marine is the ship etc. It is important however to
note that it is not the house, ship etc that is insured. It is the financial or pecuniary interest
of the insured in the subject matter that is insured. The subject matter of the contract is
the name given to the financial interest which a person has in the subject matter of the
insurance. This is the root of insurable interest as in the case of Castellain V Preston
(1883) What is it that is insured in a fire policy? Not the bricks and materials, but the
financial interest of the insured in the subject matter of insurance.
Essential Features of Insurable Interest
a) There must be some property rights, interest, life, limbs or potential liability
capable of being insured.
60
b) Such property, rights, interest etc must be the subject matter of insurance.
c) The insured must stand in a relationship with the subject matter of insurance
whereby he benefits from its safety and would be prejudiced by its damage.
d) The relationship must be recognized at law e.g. Macaura V. Northern Assurance
Company (1925). Mr. Macaura effected a fire policy on an amount of cut timber on
his estate. He later sold the timber to a one-man company of which he was the only
shareholder. A great deal of the timber was destroyed in a fire and the insurers
refused to pay the claim on the basis that Mr. Macaura had no insurable interest in
the assets of the company of which he was principal shareholder. A company is a
separate legal entity from its shareholders and the relationship between timber and
Mr. Macaura, whereby Macaura stood to loose by its destruction had to be one
recognized or enforceable at law. In this case such a relationship did not exist as
Macauras financial interest in the company as a shareholder was limited to value of
his shares and he had no insurable interest in any of the assets of the company.
Creation of Insurable Interest
Insurable interest may arise in the following circumstances:
i)
At common law e.g. ownership of property or potential liability a negligent

car driver may be faced with it.
ii)
By contract - Here a person agrees to be liable for something for which he

would not be liable in the absence of the contractual condition e.g. a landlord
passing damage responsibility to a tenant. Such contracts place the tenant in a
legally recognized relationship and hence insurable interest.
iii)
By Statute Some statutes place responsibilities on people similar to

contractual obligations e.g. married womens property Act (1882) and married
womens policies of assurance Act 1980. These Acts provided married
women with insurable interest in their own lives and those of their husbands
for their own benefit.
Statutes Modifying Insurable Interest

The liability of some people was too onerous and statues were passed modifying this
liability. In most cases insurable interest was correspondingly reduced.
61
i)
Carriers Act 1830 - A common carrier is exempted from liability for certain
valuable articles of greater value than a fixed amount, except where the value
is declared and an extra charge paid
ii)
Hotel proprietors Act 1956 Where people have booked sleeping

accommodation at a hotel, where a schedule of the Act is displayed
prominently, the liability for loss or damage to property of a guest is limited to
a fixed amount so long as he was not negligent.
iii)
Trustee Act 1925 - Trustees can effect fire insurance on trust property, paying
premiums from the trust income.
Application of Insurable Interest to Main Forms of Insurance

1.
Life Assurance
Everyone has un-limited insurable interest in their own life and is entitled to
effect a policy for any sum assured. Also a person has unlimited insurable interest
in the life of his or her spouse. However, a blood relationship does not imply an
automatic insurable interest. But some people can assure the life of another to
whom they bear a relationship recognized at law, to the extent of a possible
financial loss. Therefore, partners can insure each others lives up to the limit of
their financial involvement. Also a creditor has insurable interest in the life of his
debtor.
2.
Property Insurance
For Property, insurable interest mostly arises out of ownership. A person with a
partial interest in some property is entitled to insure the full value of that property
rather than his partial interest. But in the event of loss, he acts as a trustee passing
over other proceeds to the other partners. Mortgagees and mortgagors have
insurable interest; the purchaser as owner and seller as creditor. A bailee is a
person legally holding the goods of another either for payment or gratuitously and
is legally responsible for property under their care and hence have insurable
interest.
62
3.
Liability Insurance
A person has insurable interest to the extent of potential legal liability he may
incur by way of damages and other costs. A persons extent of interest in liability
insurance is without limit.
When Insurable Interests Must Exist;

1.
In Marine Insurance, insurable interest need only exist at the time of any loss.
This is because of customs of maritime trading where cargo may change
ownership while in transit and protects merchants who may assume interest in
cargo during a voyage.
2.
In Life assurance Insurable interest needs to exist when the policy is

effected and not necessarily at the time of claim.
3.
For all other Insurances - Insurable interest must be present both at the time of
affecting the policy and when any claim is made.

Most commercial contracts are subject to the doctrine of caveat emptor (let the buyer
beware). In most of these contracts each party can examine the item or service and as
long as one does not mislead the other party and answers questions truthfully, the other
party cannot avoid the contract. There is no need to disclose information not asked for.
However, when it comes to arranging insurance contracts, while the proposer can
examine a specimen of the policy document before accepting the terms, the insurer is at a
disadvantage as he cannot examine all aspects of the proposed risks which are material to
him. In order to make the situation more equitable, the law imposes a duty of uberrimae
fidei or utmost good faith on the parties to an insurance contract. The contract is deemed
to be one of the faith or trust. The duty of full disclosure rests on the underwriters also
and they must not withhold information from the proposer which leads him into a less
favorable contract e.g. not to accept an insurance which they know is un-enforceable at
law or they are not registered to underwrite.
Utmost good Faith is a positive duty to voluntarily disclose, accurately and fully all facts,
material to the risk being proposed, whether asked for or not.
63
A material fact is every circumstance which would influence the judgment of a prudent
insurer in fixing the premium or determining whether he will take the risk. However, a
fact which was immaterial when the contract was made, but later became material need
not be disclosed in the absence of a policy condition requiring continuous disclosure. The
facts that must be disclosed are:i)
Facts which show that the risk being proposed is greater because of
individual, internal factors than should be expected from its nature or class.
ii)
External factors that make the risk greater than that normally expected.
iii)
Facts that would make amount of loss greater than normally expected
iv)
Previous losses and claims under other policies.
v)
Previous declinature or adverse terms imposed on previous proposals by other

insurers.
vi)
Facts restricting subrogation rights due to the insured relieving third parties
off liabilities which they would otherwise have.
vii)
Existence of other non-indemnity policies like life and personal accident.
viii)
Full facts relating to and descriptions of the subject matter of insurance
The following facts need NOT to be disclosed:i)
Facts of law.
ii)
Facts which the insurer is deemed to know.
iii)
Facts which lessen the risk.
iv)
Facts about which the insurer has been put on enquiry
v)
Facts which the insurers survey should have noted.
vi)
Fact s covered by policy conditions.
vii)
Facts which the proposer does not know.
ix)
Facts (convictions) which are spent under the rehabilitation of offenders Act
1974.
Duration of the Duty of disclosure

At common law, it starts at commencement of negotiations and terminated when the
contract is formed. However, in most cases the conditions of a policy extend the common
64
law position by requiring full disclosure during the currency of the contract which the
insurer is not obligated to underwrite.
The position at renewal is that for life and permanent health insurance contracts
disclosure lasts only until completion of the contract. This is because they are long term
contracts. But in the other classes of insurance the original duty of disclosure is revived at
renewal. However, for all classes if the terms of the contract are altered e.g. increase of
sum insured, then the duty of disclosure arises.
Representations and Warranties
Representations are written or oral statements made during negotiations for a contract.
Some of the statements will be material and others not. Warranties on the other hand in
ordinary commercial contracts are promises, subsidiary to the main contract, a breach of
which would have the aggrieved party with the right to sue for damages only. However,
warranties in insurance contracts are fundamental conditions to the contract and a breach
allows the aggrieved party to repudiate the contract. Warranties are imposed to ensure
good housekeeping and also ensure certain features of higher risk are not introduced
without the insurers knowledge. Warranties can either be express or implied. Express
warranties are agreed on upfront e.g. I will not store inflammable liquids in my premises.
Implied warranties are assumed to be part of the contract even though not expressly
negotiated e.g. the vehicle is road worthy.
Breach of utmost good faith can either be innocent or accidental and deliberate or
fraudulent. There are several remedies for breach of utmost good faith and include:i)
Avoid the contract by either repudiating the contract abinitio or

avoiding liability for an individual clam.
ii)
The damages if it is by concealment or fraudulent
iii)
Waive these rights and allow the contract to carry on.
The aggrieved party must exercise the option within a reasonable time of discovery of the
breach. However, for some insurance that are compulsory like third party cover for motor
vehicles, the Road Traffic Act prohibits the insurer from avoiding liability on grounds of
65
breach of utmost good faith. But the insurer may claim the amount paid from the insured
though this situation is faced with practical differences.
In insurance contracts, there are two main types of perils that need consideration:i)
Insured Peril these are perils that covered by the policy.
ii)
Excluded Perils - these are the perils not covered by the policy.
It is because of the above that the principle of proximate cause is important. Every loss is
the effect of some cause. Sometimes there is a single cause of loss but frequently there is
a chain of causation or several causes may operate concurrently, and in these
circumstances it may require considerable thought to decide whether the loss is within the
scope of the policy or not. The doctrine covering such deliberations is proximate cause.
Proximate cause means the active, efficient cause that sets in motion a train of events
which brings about a result, without the intervention of any force started and working
actively from a new and independent source. It is not necessarily the first cause nor the
last one but the dominant, efficient or operative cause.
Rules for the Application of Proximate Cause
i)
The risk insured against must actually take place e.g. mere fear of insured
peril is not loss by that peril.
ii)
Further damage to the subject matter due to attempts to minimize a loss

already taking place is covered.
iii)
Intervention of a new act is without the doctrine e.g. if during a fire onlookers
cause damage to surrounding property then fire is not the cause of the loss.
iv)
Last Straw Cases where the original peril has meant that loss was more or
less inevitable, the original peril will be the proximate cause even though the
last straw comes from another source.
The following case law illustrates this:a)
Gaskarth V Law Union (1972) a fire left a wall standing but in a weakened
condition. Several days later, a gale caused the collapse of the wall onto
another property. It was held that fire was not the proximate cause but the
66
gale. The crucial factor was the delay of several days during which no steps
were taken to shore up the weakened wall. The chain had been broken.
b)
Roth V South Easthope Farmers Mutual (1918) Lightening damaged a

building and almost immediately afterwards a storm blew it down. It was held
that lightening was the proximate cause. There was no time to take remedial
action and the danger created by the fire was still operating.
c)
Leyland Shipping V Norwich Union (1916) Last Straw Cases- A marine

policy excluded war risks. In time of war a ship was badly damaged. It
managed to get to a port and repair work was started but had to be stopped
when a storm blew up. The harbor master ordered the ship out of port in case
she sank and blocked the harbor. Outside the harbor she met bad weather
which normally she would have survived, but in this case she sank. It as held
the proximate cause of loss was war risks, the ship was in danger of sinking
from the moment it was damaged and as repairs had not been completed that
danger was always present.

Is the controlling principle in insurance law. It responds to the question what is the
person to receive when the insured against event occurs? Indemnity is a mechanism by
which insurers provide financial compensation in an attempt to place the insured in a
pecuniary position he was in before the loss.
Indemnity is related to insurable interest as it is the insureds interest in the subject
matter of insurance that is in fact insured. In the event of a claim, the payment made to an
insured cannot therefore exceed the extent of his interest. In life assurance and personal
accident insurance, there is unlimited interest and thus indemnity is not possible.
Methods of Providing Indemnity
i)
Cash payment It is the most common method of settlement where a cash

payment representing indemnity to the insured is made. In liability insurance
the money is paid directly to the third party rather than the insured.
ii)
Repairs It is commonly used in motor insurance where garages are

authorized to carry out repair work on damaged vehicles.
67
iii)
Replacement - It is common in glass insurance where windows are replaced

on behalf of insurers by glazing firms. It is also used in motor vehicle
insurance where a nearly new car is destroyed and replaced by a similar
model.
iv)
Reinstatement Used in property insurance where an insurer undertakes to

restore or rebuild a building damaged by fire.
Measurement of Indemnity
In property insurance the measure of indemnity in respect of loss of any property is
determined not by its cost but its value at the date of the loss and at the place of the loss.
If the value of the property has increased, the insured is entitled to this subject to the sum
insured or average being applied. For buildings it is the cost of repair or reconstruction
less an allowance for betterment which includes improvements or non deductions of wear
and tear. In liability insurance the measure of indemnity is the amount of any court award
or negotiated out of court settlement plus costs and expenses thereon.
Factors Limiting the Payment of Indemnity
i)
Sum Insured The limit of an insurers liability is the sum insured. The
insured cannot receive more that the sum insured even where indemnity is a
higher figure.
ii)
Average clause Where there is under-insurance the insurers are receiving a

premium only for a proportion of the entire value at risk and any settlement
will take this into account using the formula.
Liability of Insurer = Sum Insured
x loss
Full value
When average operates to reduce the amount payable, the insured receives
less than indemnity.
iii)
Excess An excess is an amount of each and every claim which is not

covered by the policy. Where excess applies to reduce the amount paid, the
insured receives less than indemnity
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iv)
Franchise A franchise is a fixed amount which is to be paid by the insured in

the event of a claim. But once the amount of franchise is exceeded then
insurers pay the whole of the loss.
v)
Limits Many policies limit the amount to be paid for certain events.
vi)
Deductibles - Deductible is the name given to a very large excess particularly

in commercial insurance.
Extension in the Operations of Indemnity

There are cases where the insured may receive more than indemnity.
i)
Reinstatement An insured can request that his policy be subject to the

reinstatement memorandum where settlement is without deductions of wear,
tear and depreciation. The sum insured is normally high with consequent high
premium.
ii)
New for Old Insurer agrees to pay for reinstatement of contents if destroyed
within a specified period without deduction of wear and tear.
iii)
Agreed additional costs Insurers may pay including additional costs like
architects and surveyors fees if agreed. This may mean receipt of more than
indemnity.

Subrogation and contribution are corollaries of indemnity. A major effect of indemnity is
that a man cannot recover more than his loss, he cannot profit from the happening of an
insured event. Subrogation is the right of one person to stand in the place of another and
avail himself all the rights and remedies of that other, whether already enforced or not. In
the case of Burnand V Rodocanachi (1882) - It was held that the insurer having
indemnified a person was entitled to receive back from the insured anything he may
receive from any other source. Subrogation only applies where the contract is one of
indemnity. Therefore life and personal accident contracts are not subject to subrogation.
However, also an insurer is not entitled to recover more than he has paid out.
Extent of Subrogation Rights
69
i)
An insurer is not entitled to recover more than be has paid out. Insurers must
not make profit by exercising subrogation rights.
ii)
Where the insured retains part of the risks e.g. by an excess or application of
average, he is entitled to an amount equal to that share of the risk out of any
money recovered. Where the insurer makes ex-gratia payment to an insured
then the insurer is not entitled to subrogation rights. This is because ex-gratia
payment is not indemnity and subrogation rights arise only to support the
concept of indemnity.
Ways in which Subrogation May Arise

a)
Arising out of tort A tort is a civil wrong and incorporates negligence,

nuisance, trespass, defamations and other legal wrongs. Where an insured has
sustained some damage, lost rights or incurred liability due to the tortuous
actions of some other person, then his insurer, having indemnified him for
loss, is entitled to take action to recover the outlay from the tortfeasor or the
wrong doer.
b)
Right arising out of contract This can arise where a person has contractual
rights to compensation regardless of fault and where the custom of trade to
which the contract applies dictates that certain bailees are responsible e.g.
hotel proprietor. The insurer then assumes the benefits of these rights e.g.
tenants agree to make good any damage to the property they occupy. The
owner may also maintain an insurance policy and in the event of damage; if he
recovers from the insurance policy, he is not entitled to compensation from
the tenant and the insurers assume the rights to any money from the tenants.
c)
Right arising out of statute where a person sustain damage in a riot and is
indemnified, his insurers have a right to recover the outlay from the police
authority as per Rot Damage Act 1886.
d)
Rights arising out of subject Matter of insurance - where an insured has been
indemnified for a total loss, he cannot claim the salvage as it would be more
than indemnity.
70
At common law subrogation does not arise until the insurers have admitted the insured
claim and paid it. However, insurers place a condition in the policy giving themselves
subrogation rights before the claim is paid. Subrogation has the effect of ensuring
negligent persons are not let off the hook simply because there was insurance.
Modification to the Operation of Subrogation
The exercising of subrogation rights by one insurer my involve claiming money from
another insurer. For a motorist hitting property, the property insurer would exercise
subrogation against the driver who in turn passes it to motor insurer. This may mean
insurers getting involved against each other often. This is particularly true for motor
insurance and is handled in the following ways:i)
Motor insurance Some insurers waive their subrogation rights against each
other by executing knock for knock agreements.
ii)
Other insurers sign agreements whereby they contribute towards the losses by
pre-determined proportions.
iii)
In employers liability, subrogation is waived where one employee causes

injury to another.
Contribution
In a case where someone has a right to recover his loss from two or more insurers with
whom he has affected policies, the principle of indemnity prevents the insured from being
more than fully indemnified by each by way of contribution. Contribution ensures that
the insurers will share the loss as they have all received a premium for the risk.
Contribution applies only to contracts of indemnity. Contribution is the right of an insurer
to call upon others similarly but not necessarily equally liable to the sum insured to share
the cost of an indemnity payment.
At common law contribution will only apply where the following are met:-
71
i)
Two or more policies of indemnity exist.
ii)
The policies cover the same or common interest
iii)
The policies cover the same or common peril giving rise to loss.
iv)
The policies cover the same or common subject matter
v)
Each policy is liable for loss.
The policies do not require to cover identical interest, perils or subject matter so long as
there is an overlap shared by them.
The leading case in contribution is North British & Mercantile V Liverpool & London
Globe (1877). It is also known as the King and Queen Granaries case. Merchants had
deposited grain in the granary owned by Barnett. The latter had a strict liability for the
grain by custom of his trade and had insured it. The owner had insured it to cover his
interest as owner. When the grain was damaged by fire the bailees insurers paid and
sought to recover from the owners insurers. As interests were different, one as bailee and
the other as owner, the court held that contributions should not apply.
When Contributions Operates
i)
At common law When an insured has more than one insurer, he can confine
his claim to one of them if he so wishes and that insurer must meet the loss to
the limit of his liability and can only call for contribution from the others after
he has paid.
ii)
To avoid the common law position, there is a contractual condition where

most policies state that the insured is liable only for his rateable portion of
the loss and the insured is left to make a claim against the other insurers if he
wishes to be indemnified.
However, sometimes the equitable right to contributions is removed by non-contributory

clauses e.g. this policy shall not apply in respect of any claim where the insured is
entitled to indemnity under any other insurance. Where a policy is issued covering a
wider range of property, a more specific clause is usually inserted to prevent
contribution between the wide range policy and any which might be more specific in its
cover. Also there are market agreements in relation to injuries suffered by employees
being carried in the employers vehicle in the course of their employment. A claim could
arise under the motor policy and employers liability policy. The market agreement states
that such claims will be dealt with as employers liability claims and that there is no
contribution with the motor insurers.
72
8.2Activities;
1.
Organize
an insurance contest with two teams; allow each team to randomly pick any
2.
3.
three principles of insurance from the list of the six principles.
4.
5. team to debate on the merits and demerits of each of the principles to the
Let each
insurance business.

6.
7. The insurance and risk industry operates certain principles. Provide an outline of
1.
these principles in the Kenya business sector and analyze how these principles
have impacted on the insurance business and risk Management in general.
2. Using suitable illustrations and examples, discuss the special elements of an
insurance contract and their usage in insurance practice.
8.4 Summary
8.

i) There are various special insurance contracts that are unique to insurance business
and they include; Insurance as a contract of adhesion, Insurance as a aleatory
contract, Insurances as a contract of good faith (fiduciary contract).
ii) That insurance business is guided by a number of principles which includes; the
principles of insurable interest, the principle of utmost good faith, the principle
of proximate cause, the principle of indemnity, principle of subrogation and
principle of contribution.
8.5 Suggestion
for further reading
9.
10. G.C. (1997) Risk Management the Chartered Insurance Institute
Dickson,
11.
Vaughan,
12. E. and Vaughan, T. (2003) Fundamentals of Risk and Insurance 9th Edition,
13.
Wiley
14.
Prentice Hall
73
LECTURE 9: INSURANCE DOCUMENTATION AND REGULATION

9.0 Introduction
In this lecture we shall examine how the underwriting department goes about insuring the
risks. This is done by way of making the insured fill a proposal form which covers the
material information and facts of the risk the insured would wish the insurer to
underwrite, once satisfied the insure issues a policy document that is a contract that binds
the two. We shall further examine the regulations affecting insurance business in Kenya.

i) Explain the use of a proposal form and its content in aiding the insurance business.
ii) Discuss the main components of a policy document normally used by the insurers.
iii) Discuss factors that can determine the amount of premium one pays in an insurance
policy and document the claims procedure used by most insurance claims
departments.
iv) Discuss the pre and post independent regulations that were in place to govern
insurance business in the country.
9.1 Lecture Outline

9.1.5 Underwriting and Policy writing.
9.1.6 Pre and Post Independence regulation

A proposal form is the mechanism by which the insurer receives information about risks
to be insured. It is completed by the proposer and submitted to the insurer for most
classes of insurance. However, there are classes of insurance where the proposal form is
74
not necessary. This is particularly so for corporate fire or marine insurance. The details
for fire are so complex to be confined to a proposal form. In these cases, insurers use
their own risk surveyors to visit the premises to discuss the risk with the proposer.
Brokers play an important part, preparing full details for an insurer. For personal
insurance, the form carries both general and specific questions. The forms are simple to
understand and easy to complete. For business insurances the information required is
greater and is supplemented by additional information provided by the proposer or
broker. Every proposal has a declaration that the proposer confirms that the information
which has been supplied is true to the best of the proposers knowledge and belief.
Once a proposer has completed a proposal, submitted it to an insurer and is accepted,
then there is a contract of insurance. A contract of insurance is subject to all laws of
contract and it exists whether policy is issued or not. The policy is only evidence of the
contract. Components of the policy document are:
i)
Heading It includes the name of the insurer, address and logo.
ii)
Preamble This is the wording at the beginning of each of the policies. It covers
the following aspects:a)
The proposal is stated as being the basis of the contract and

incorporated in it.
b)
It also states that premium has been paid or agreement that the insured
will pay
c)
It states that the insurer will provide cover detailed in the policy
subject to the terms and conditions.
iii)
Signature Under the preamble or close to it is the signature of an authorized

official of the insurer.
iv)
Operative Clause It is the part that outlines the actual cover provided. It begins
with The company will. And then states what the company promises.
v)
Exceptions or Exclusions This is the inevitable consequence of having a

scheduled policy e.g. war and nuclear risks.
75
vi)
Conditions they include a condition that the insured will comply with all terms
of the policy and procedure in the event of a claim etc.
vii)
Policy Schedule - This is where the policy is made personal to the insured. The
details specified include; name of the insured, address, nature of business, period
of insurance, premiums, sum insured and policy number among others.

The premium which an insured pays represents his contribution to the common pool and
thus must reflect the value of risk and the degree of hazard brought to the pool. The
premium must be sufficient to:a)
Cover expected claims the law of large numbers does allow the
underwriter to make a reasonably accurate assessment of the likely loss
costs.
b)
Create an estimate for outstanding claims the premium must take into
account those claims still to be settled at the end of the year.
c)
Provide a reserve contingencies must be taken into account e.g.

provisions for IBNR reserve.
d)
Meet all expenses including salaries, office costs, advertising,

commission etc.
e)
Provide for profit underwriter must ensure provision for reasonable

profit.
In arriving at the premium figure a number of commercial considerations must be taken

into account.
a)
Inflation the cost of settling claims may rise due to the fall in the value
of money.
b)
Interest rate Since insurers are major investors, variability in interest

rates should be incorporated in premium calculation
c)
Exchange rates Because of movement of money across national borders,

theres a problem of exchange rate risk which must be taken into account
in premium computation.
76
d)
Competition Charging too high a premium may result in loss of business

but too little could result in a loss, so a balance is needed.
Life assurance premiums are made up of four components namely:i) Mortality is the risk of death, mortality tables are used.
ii) Expenses salaries, commission etc.
iii) Investment Investments earn substantial income & are taken into account
iv) Contingencies Unexpected level of loss.
The premium charged will mostly be a level premium though the risk increases each year
as person gets older but this is taken into consideration.
Claims and Disputes
i.
Claims notification is the responsibility of the insured- The insurer will want
speedy notification of the claim. This enables the insurer for instance to take
statements from witnesses immediately after the accident. A claim is normally
intimated by completing a claim form. In life assurance, the insurer needs proper
proof of death and wills or assignments is taken into consideration.
ii.
Claims handling Small brokers may have authority to handle claims although
limits will be imposed. A majority of claims are handled in the claims department
of the insurer. The insured has to prove the amount of loss e.g. purchase receipt,
repair account or valuation. In addition to claims staff of insurance companies,
experts could be retained like loss adjusters. The adjusters report covers basic facts
about the insured and the loss.
iii.
Claims Settlement The final stage in the claims procedure is the actual
settlement. In life assurance, what is payable is a fixed sum. However for general
insurance the eventual costs of the claim will depend on the extent of loss or
damage and nature of cover afforded by the policy.
iv.
Disputes - when a dispute does a rise it could revolve around a number of

factors. The liability of an insurer to pay a claim, amount to be paid or the speed
with which claims are handled. Claims where liability has been admitted must first
be referred to arbitration, otherwise to court.
77
9.1.5 Underwriting and Policy writing

Underwriting includes all the activities necessary to select risks offered to the insurer in
such a manner that general company objectives are fulfilled.
In life insurance, underwriting is performed by home or regional office personnel, who
scrutinize applications for coverage and make decisions as to whether they will be
accepted, and by agents, who produce the applications initially in the field.
In property and liability insurance area, agents can make binding decisions in the field,
but these decisions may be subject to post underwriting at higher level because the
contracts are cancelable on due notice to the insured.
In life insurance, agents seldom have authority to make binding underwriting decisions.
Objectives of Underwriting
The main objective of underwriting is
i) To see that the applicant will not have a loss experience that is very different from
that assumed when the rates were formulated.
ii) To set up the standards of selection relating to physical and moral hazards
especially to help when rates are calculated.
iii) To ensure that the set standards are observed when risks are accepted.
iv) To accept risk exposures that will not make the insurer to incur losses, and at the
same time not to reject exposures just for the sake of it. I.e. ensure profitable
business to the insurer.
Services that aid the Underwriter.

In life insurance, the underwriter is assisted by:
i)
Medical reports from the physician who examined the applicant.
ii)
By information from agents.
iii)
By an independent report (Inspection report) on the applicant prepared by an

outside agency created for that purpose.
iv)
Advise from the companys own medical advisor.
v)
Applicants credit history as an additional rating factor got from credit

reference bureaus.
78
Policy Writing
Part of the work of underwriting department may be most concisely described as policy
writing. In property-liability insurance, the agent
i)
frequently issues the policy to the customer,
ii)
Helps fill out forms provided by the company.
The underwriting department then checks the work of the agent to determine the accuracy
of the rates charged, whether a prohibited risk has been taken
In life insurance, the policy usually is written in a special department whose main task is
to issue written contracts in accordance with instructions from the underwriting
department.
The underwriting department also keeps a register of the policies underwritten.
9.1.6 Pre and Post-Independence regulation
Pre-independence legislation
Modern insurance came with colonial administration; the legislation was racist as it
demonstrated a deliberate move by the colonial government to keep Africans out of the
monetary economy. The first legislation instrument governing insurance was enacted in
1945 and was in the form of a statute. It restricted the sale of insurance to Europeans
only arguing that Africans did not appreciate the services of insurance. In 1947 a second
legislative instrument was enacted referred to as the African life control ordinance. It
stated that the Africans could only buy insurance with approval of the governor in
council.
In 1960, the first wide ranging legislation was enacted called insurance
company ordinance (Cap 487). The reasons that led to its enactment were:
(a)
There was a rapid increase in number of insurance company in Kenya.
(b)
There was also a reasonable economic growth in the country.
It was a reproduction of the British laws governing insurance. It lacked tight control on
insurance company as compared to the British situation, although it was the first
comprehensive legislation. It did not have the interest of African at heart.
79
Post Independence legislation

In the attainment of independence, the government decided to nationalize insurance and
allowed it to operate in the private sector, but there was need for legislation to regulate
activities of insurance company, because:
(a)
Discriminatory and unfair legislation enacted before
(b)
Economic and social development attained by Kenya.
c)
Insurance generated a lot of money that needed protection and control.
d)
There was a growing need for citizens to buy insurance.
In 1962, 1960 ordinance was amended, giving access to insurance facilities by all the
locals. In 1964, the Kenya Government formed the first local insurance company by the
name Kenya National Insurance Company officially closed on 13th July 1996 following a
budget proposal on June 1996. In 1970 the state re-insurance act was enacted that
brought into existence the Kenya Reinsurance Corporation. In 1973, it was revised and
called the Kenya Reinsurance Corporation Act.
Since insurance involves taking money from members public, who thereby become
policyholders in return for promise of payment, some unscrupulous persons collected
premiums and diverted them without bothering to honor their promises. This was the
situation in Kenya in the late 1970s and early 1980s as insurance companies could start
their operations after being registered by the Registrar of companies. This made the
public to loose faith in the insurance companies. In 1984, Kenya Government passed the
insurance Act (Cap.487) and came into force in 1987 with the following objectives.
1. Protecting the interest of the policyholders, the insurance company must maintain
sufficient reserves to meet their obligations.
2. Building up and developing the local insurance market by shielding the local insurer
from foreign insurance.
3. Ensuring that insurers in Kenya must be incorporated under the Companies Act and
that Kenyan citizens hold a third of the controlling interests in the company.
80
4. Developing local insurance expertise. This is being achieved through training, e.g.
teaching insurance courses in the institution of higher learning and the opening of
the College of Insurance in 1991.
5. Ensuring that funds generated by insurance operations are channeled into the local
market.
6. Develop a policy framework with regard to insurance economic and social
development of the country.
The Insurance Regulatory Authority Previously referred to as the office of Commissioner
of Insurance is in charge of regulating Insurance activities in the country> The following
are the duties of a Commissioner include:
1) Enforce the provision of the insurance Act.
2) Formulate and enforce standard for conduct of the insurance business.
3) Direct insurers and re-insurers on the standardization of contracts of insurance.
4) Approve tariffs and rates of insurance in respect of any class or classes of
insurance.
5) Licenses all members of the industry annually and can revoke their licenses.
6) Ensuring that the insurers deliver the promised benefits and that the company is
being properly managed to meet its future liabilities as they fall due.
7) Ensure that an insurer invests their assets prudently and adopt a positive attitude
towards its obligation to policy holders and claimants.
8) Ensure that Insurance companies maintain deposits in government securities with
Central Bank of Kenya for certain amounts and for specific line of business. This can be
used to offset an insurers debt to policyholders if the insurer goes into liquidation.
81
9.2Activities;
1.
Plan 2.
a visit to the offices of Insurance Regulatory Authority (IRA) with a view to hold
discussions
with the officials concerning;
3.
i)4. Regulatory challenges facing the insurance sector and how the Authority is trying
5.
to address such challenges.
ii)6. Find out the mandate that the authority has over the insurance business in Kenya
and their achievements so far, with regard to their outlined mandate
7. Test Questions
9.3 Self
1. Explain
using relevant examples the components of life assurance premium.
8.
2. Explain the concept of underwriting in the Kenyan context. What are the
objectives of underwriters in Kenya?
3. Discuss the regulatory framework that was in place during pre-independence era. How did
it impact on the insurance business in Kenya?
4. Discuss the post independence era regulatory framework citing the reasons for legislating
insurance during this period.
5. Insurance regulatory Authority is a recently established autonomous institution. Discuss
the functions of this authority in regulating insurance
9.4 Summary
9.i) A proposal form is the mechanism by which the insurer receives information
10.
about risks to be insured. It is completed by the proposer and submitted to the
11.
insurer for most classes of insurance.
12.
ii) A policy document a contract that is the only evidence of the contract. And has
several components.
iii) There exist several factors that determine the amount of premium one pays in an
insurance policy.
iv) The pre and post independent regulations have had a significant bearing on the
governance of insurance sector in Kenya.
82

13.
14.
15.
Wiley
16.
17.
Prentice Hall
18.
83
LECTURE 10: REINSURANCE AND INSURANCE MARKETING

10. Introduction
Having accepted a risk the insurer is in much the same position as the insured as pertains
to uncertainty. Insurers are not immune to the possibility of larger than expected losses or
loses that is more than anticipated. Thus insurers also seek insurance; the insurers insure
the risk again, which is called reinsurance
i) Explain the main forms of Reinsurance
ii) Discuss the reasons and need for reinsurance in Kenya.
iii) Discuss the various buyers and sellers of insurance products in Kenya.
iv) Highlight the competitive challenges associated with marketing insurance products in
Kenya.
10.1 Lecture Outline

22) to
23) to
24) to
10.1.5
Buyers
and sellers of Insurance

There are two main forms of reinsurance namely facultative and treaty. For facultative,
each risk is offered to the reinsurer by the direct office and the reinsurer assesses it and
decides whether to accept or not to accept. Treaty is where there is an agreement to the
effect that all risks within certain parameters will be offered (ceded) to the reinsures. The
reinsure cannot decline the risk and the direct office cannot select which risk to offer and
which ones to retain.
84
The methods of provision of treaty reinsurance can either be by proportional treaties or

non-proportional treaties. The arrangements under proportional treaties include:
a) Quota share treaty where a fixed proportion of every risk defined in the treaty is
reinsured e.g. reinsures 80% of each and every risk.
b) Surplus treaty - The direct office decides how much to retain on each risk (retention)
e.g. Ksh.20, 000. The direct office then arranges reinsurance measured in lines. A line
being equal to the retention. Reinsurance will be multiples of this line e.g. a risk of
Ksh.500, 000 is placed with an insurer whose retention is Ksh.20, 000. There are two
surplus treaties, a ten line first surplus and a ten line second surplus. The reinsurance
arrangement would be as follows:Retention
20,000
First surplus treaty (10 x 20,000)
200,000
Second surplus treaty (10 x 20,000)
200,000
TOTAL
420,000
Facultative reinsurance
80,000
TOTAL RISK VALUE
500,000
The arrangement under non-proportional treaties include; Excess of loss and stop loss
reinsurance.
The reasons why insurers buy reinsurance are:a)
Security the insurer seeks security and peace of mind.
b)
Stability to avoid fluctuation in claim costs from year to year.
c)
Capacity the insurer can increase capacity to accept business
d)
Catastrophes which could cause financial problems are transferred

to reinsures
e)
Macro benefits the cost of risk is spread at the market place and the
world, the impact of risk does not fall solely on one economy.
85
Functions of Reinsurance
i.
Spreading of Risks
Insurance companies are able to avoid catastrophic losses by passing on a portion
of any risk too large to handle. Through excess loss reinsurance arrangements, a
company may protect itself against a single occurrence of catastrophic scope.
Smaller insurance companies are also able to insure expenses they could not
otherwise handle within the line of safety.
ii.
Financial Function
When the premium volume of an insurance company is expanding, the net
result will be a drain on the surplus of the company. With a continued
expanding premium volume, a company faces a dilemma.
iii.
Reinsurance provides a solution to the dilemma. When the direct writing company
reinsures a portion of the business it has written under a quota share or surplus line
treaty, it pays a proportional share of the premium collected to the re-insurer. The
re-insurer then establishes the unearned premium reserves or policy reserves
required and the direct writer is relieved of the obligation to maintain such
reserves.
Since the direct writer has incurred expenses in acquiring the business, the re-insurer pays
the direct writing company a commission for having put the business on the books. The
payment of the ceding commission by the re-insurer to the direct writer means that the
unearned premium reserves is reduced resulting in an increase in surplus.
iv.
Enlarging Financial Capacity

In normal circumstances a primary insurer often assumes liability for loss in excess of
the amount that its financial capacity permits. Instead of accepting only a portion of
the risk and thus causing inconvenience to and even will on the part of its customer,
the company accepts all the risk, knowing that it can pass on the re-insurer the part that
it does not care to bear.
The policyholder is thus spared the necessity of negotiating with many companies and
can place insurance with little delay. Using a single policy is therefore more uniform,
easier to comprehend and there is an added guarantee of the re-insurer, which makes it
safer.
86
v.
Reinsurance allows the ceding company to have a stable level of profits and
underwriting losses than it is to have a higher but unstable level in the long run;
thus smoothing out fluctuations that may occur. The ceding company may procure
new business as it participates in mutual risk sharing.
vi.
For new, small companies, the requirement that a company sets aside premiums
received as unearned premium reserves for policyholders may hinder growth.
Because no allowance is made in these requirements, for expenses incurred, the
insurer must pay for producers commissions and for other expenses out of surplus.
As the premiums earned during the life of the policy, these amounts are restored to
surplus. In this case the firm may not be able to finance some of the business it is
offered. Through reinsurance the firm can accept all the business it can obtain and
then pass on to the re-insurer part of the liability for loss and with it the loss and
unearned premium reserve requirement.
10.1.5 Buyers and sellers of Insurance

The Buyers of Insurance
Most people tend to think of insurance in terms of personal insurances e.g. private car
insurance, household insurance, life assurance etc. However, for most insurance
companies, it is commercial and group insurances that form a big volume of their
business. One single company could be spending millions per year on insurance
premium. Thus buyers of insurance are individuals and enterprises.
The Intermediaries
It is possible to buy insurance direct from the insurance company. It is also possible for
an individual to use services of an intermediary. The commercial buyer however may be
faced with complex risks. He needs expert advice to enable him assess the risks he has
and match them to the best seller of the insurance in the market. In legal terms an
intermediary is an agent who is authorized by the principal to bring the principal into a
contractual relationship with another third party. There are different forms of
intermediaries in the market place:-
87
a)
Insurance Broker A broker is an individual or firm whose full time occupation is

the placing of insurance with insurance companies e.g. AON Minet Insurance
Brokers Ltd. The broker offers independent advice on a wide range of insurance
matters e.g. insurance needs, best type of cover, best market, claims procedure
etc. Most commercial insurance will be transacted through a registered broker
b)
Lloyds Brokers carries out the functions mentioned above but only for placing
business at Lloyds. The council of Lloyds registers broking firms to act as
Lloyds brokers.
c)
Insurance Consultants - Regulations exist for those who wish to call themselves
brokers. Many of the persons acting as intermediaries without registering under
the relevant legislation (The insurance Act) may refer to themselves as
consultants.
d)
Tied Agents tied agents can only advise on products offered by their host
company.
e)
Home service representatives industrial life offices employ representatives to

call at the homes of policy holders to collect premium and pay claims.
The Sellers or Suppliers of Insurance

1) Lloyds - The Corporation does not transact insurance but provides premises,
services and assistance for the individual or corporate underwriting members. The
capital behind underwriting at Lloyds is supplied by investors called Names.
Until 1994 Names had to be individuals investing in personal capacity but from
January 1994, corporate members have been admitted.
2) Insurance Companies - majority sellers are insurance companies which can either
be:
a) Proprietary companies created by royal charter, or Act of parliament
normally formed by registration under the companies Act. These companies
have an authorized and issued share capital. The shareholders liability is
limited to the normal value of their shares.
b) Mutual Companies They are owned by the policy holders, who share any
profits made. The shareholder in the proprietary company receives his shares
88
of profit by way of dividends but in the mutual company the policy holder
owner may enjoy lower premiums or higher life assurance bonuses than
would otherwise be the case.
3) Captive Insurance companies its an arrangement where the parent company
forms a subsidiary company to underwrite certain of its insurable risks. It benefits
by the groups risk control techniques thus paying premiums based on its own
experience, avoidance of direct insurers overheads and purchasing reinsurance at
lower costs.
4) Reinsurance Companies - Reinsurance furthers the principle of spreading risk and
offers the insurer stability and protection against catastrophe and offers technical
devises.
(i)
Lack of proper training of salesmen
(ii)
Ignorance on the part of the insured
(iii)
Economic level of individuals.
Other challenges;
Price By offering lower prices to products than rival companies, an insurer can reduce
premiums by cutting down on the following operation cost:
(i)
Payment of losses
(ii)
Loss adjustment expenses
(iii)
Cost of marketing
(iv)
Administrative expenses
Quality By offering all forms of policies, or offering policies with benefit to the insured
i.e. broadening of coverage. This offers more flexible underwriting conditions.
Services By offering superior claim segment procedures, better agency represents and
loss prevention services.
Others include:
89
Gifts
Location and hours of business and commission.
1.
10.2 Activities;
2.
Plan 3.
a visit or call the risk management department of Kenya Airways Ltd.
4.
In your visit find out;
5.
i)6. How they insure their aircrafts and other aviation related risks.
ii) How did their insurer handle the crash that occurred in Abidjan 3years
ago? Did there insurer rely on the reinsurer to meet their claim obligation?
Have they found it a challenge to place their risk with a single insurer in
Kenya due to capacity constraints? Has there insurer always risen to the
occasion whenever disaster strikes?

1. Analyze the reinsurance sector in Kenya outlining its significance to the
national economy.
2. Discuss the concept insurance intermediary. With help of relevant examples,
discuss the insurance intermediaries promoting insurance products in Kenya.
3. Discuss the competitive challenges associated with the marketing of insurance
services in Kenya.
10.4 Summary
i) There are two main forms of reinsurance namely facultative and treaty.
ii) There are several reasons why insurers buy reinsurance and which include:Security, Stability, Capacity, Catastrophes and Macro benefits.
7.
iii) The Buyers of Insurance for most insurance companies, emanates from
8.
commercial
and group insurances that form a big volume of their business.
9.
10.
iv) There exist competitive challenges associated with marketing insurance and they
include; Lack of proper training of salesmen, Ignorance on the part of the insured,
Economic level of individuals, innovation and creativity of the sector players among
other challenges.
90
11.Suggestion for further reading

10.5
12.
13.
14.
Vaughan,
E. and Vaughan, T. (2003) Fundamentals of Risk and Insurance 9th
15.
Edition, Wiley
16.
91

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CMS 200: INSURANCE AND RISK MANAGEMENT

CMS 200: INSURANCE AND RISK

CMS 200: INSURANCE AND RISK MANAGEMENT

CMS 200: INSURANCE AND RISK MANAGEMENT

About this STUDY MANUAL

How this STUDY MANUAL is structured

CMS 200: INSURANCE AND RISK MANAGEMENT

An introduction to the CHAPTER content.

CMS 200: INSURANCE AND RISK MANAGEMENT

CMS 200: INSURANCE AND RISK MANAGEMENT

Lecture 2: Response to risk

CMS 200: INSURANCE AND RISK MANAGEMENT

Lecture 5: Risk Management process

CMS 200: INSURANCE AND RISK MANAGEMENT

8.1.3 Principle of Insurable Interest

Lecture 9: Insurance documentation and Regulation

CMS 200: INSURANCE AND RISK MANAGEMENT

LECTURE 1: THE CONCEPT OF RISK

1.2 Specific objectives:

At the end of the lecture you should be able:

1.3 Lecture Outline

Risk as cause e.g. fire as a risk, Personal injury as a risk etc.

CMS 200: INSURANCE AND RISK MANAGEMENT

Risk is the possibility of an unfortunate occurrence.

Risk is a combination of hazards.

Risk is uncertainty of loss.

Risk is the possibility of loss.

CMS 200: INSURANCE AND RISK MANAGEMENT

CMS 200: INSURANCE AND RISK MANAGEMENT

To analyze the impact of risks on the social-economic development of a country

In this lecture you have learnt that:

1.7 Suggestion for further reading

CMS 200: INSURANCE AND RISK MANAGEMENT

LECTURE 2: RESPONSE TO RISK

At the end of the lecture you should be able:

2.3 Lecture Outline

CMS 200: INSURANCE AND RISK MANAGEMENT

CMS 200: INSURANCE AND RISK MANAGEMENT

CMS 200: INSURANCE AND RISK MANAGEMENT

Such investors therefore make the cost of

CMS 200: INSURANCE AND RISK MANAGEMENT

1.12.The It wont happen to me syndrome is away in which people only believe

2. Risk schooling is a very important aspect in risk management, in view of the

CMS 200: INSURANCE AND RISK MANAGEMENT

LECTURE 3: RISK MANAGEMENT

At the end of the lecture you should be able:

Define risk management

Explain the main functions of a risk manager

Discuss the benefits of a risk policy framework to an organization.

3.3 Lecture Outline

3.4 Lecture Objectives

CMS 200: INSURANCE AND RISK MANAGEMENT

Assists the organization identify the risk

Implement a loss prevention and control programmes

Provide training and education on safety related issues

Claims management and working with legal representatives to manage

Designing and co-coordinating employee benefit programmes, including

Government lobbying Where the risk manager constantly interacts with

Advice on company restructuring including acquisition and mergers even

CMS 200: INSURANCE AND RISK MANAGEMENT

Principles of risk management

Be an integral part of organization processes.

ix) Be part of decision making.

It enables the organization to survive in case of emergency situation i.e. a policy