\capitalcaron{H}

021F ȟ \v{h}
0220 Ƞ \M{N}
0221 ȡ \textctd

International Journal of
0224 Ȥ \textcommabelow{Z}

Environmental Research 0225 ȥ \textcommabelow{z}

\textcommatailz
and Public Health
0226 Ȧ \.{A}
\capitaldotaccent{A}
Article 0227 ȧ \.{a}
\c{E} 0228 Ȩ
The Impact of COVID-19 on the Insurance Industry
\capitalcedilla{E}
ȩ \c{e}0229
022A Ȫ \={\"O} 3,5
Pius Babuna 1,2,3 , Xiaohua Yang 1, * , Amatus Gyilbag 3,4 , Doris Abra Awudi ,
\textdieresisoverline{O}
3
David Ngmenbelle and Dehui Bian 1
022B ȫ \={\"o}
1
\textdieresisoverline{o}
School of Environment, Beijing Normal University, Beijing 100875, China;
022C Ȭ \={\~O}
201939180009@mail.bnu.edu.cn (P.B.); 201931180020@mail.bnu.edu.cn (D.B.) \texttildeoverline{O}
2 Department of Geography and Environmental Science, The University
022D ȭof Reading, Whiteknights,
\={\~o}
P.O. Box 227, Reading RG6 6AB, UK \texttildeoverline{o}
3 College of Agriculture and Natural Resources, Kwame Nkrumah Ȯ
022E University of\.{O}
Science and Technology,
\capitaldotaccent{O}
Kumasi PMB KNUST, Ghana; amatusmike@yahoo.com (A.G.); dorisawudi@outlook.com (D.A.A.);
022F ȯ \.{o}
yngmen2018@gmail.com (D.N.)
4 0230 Ȱ \={\.O}
Chinese Academy of Agricultural Sciences (CAAS), Institute of Environment and Sustainable Development
\textdotoverline{O}
in Agriculture (GSCAAS), Haidian District, Beijing 100875, China
0231 ȱ \={\.o}
5 Department of Nutrition and Food Hygiene, School of Public Health, Nanjing \textdotoverline{o}
Medical University,
Longmian Avenue 101, Nanjing 211166, China 0232 Ȳ \={Y}
* Correspondence: xiaohuayang@bnu.edu.cn; Tel./Fax: +86-10-5880-6050 \capitalmacron{Y}
0233 ȳ \={y}
0234 ȴ \textctl



Received: 22 June 2020; Accepted: 5 August 2020; Published: 10 August 2020

0235 ȵ \textctn
0236 ȶ \textctt
Abstract: This study investigated the impact of COVID-19 on the insurance industry by studying
0237 ȷ \textdotlessj
the case of Ghana from March to June 2020. With a parallel comparison to \j previous pandemics such
as SARS-CoV, H1N1 and MERS, we developed outlines for 0238 ȸ the
simulating impact of the pandemic
\textdblig
\textPUdblig
on the insurance industry. The study used qualitative and quantitative interviews to estimate
0239 ȹ \textqplig
the impact of the pandemic. Presently, the trend is an economic recession with decreasing profits but
\textPUqplig
increasing claims. Due to the cancellation of travels, events023A
and otherȺ economic losses, the Ghanaian
\textstrokea
insurance industry witnessed a loss currently estimated023B at GH Ȼ 112 million.
\textstrokecapitalc
Our comparison
and forecast predicts a normalization of economic indicators 023C fromȼJanuary \textstrokec
2021. In the meantime,
\textslashc
while the pandemic persists, insurers should adapt to working023D
from Ƚ
remote\textbarcapitall
locations, train and equip
staff to work under social distancing regulations, enhance 023Ecybersecurity
Ⱦ protocols and simplify
\textstrokecapitalt
claims/premium processing using e-payment channels. It will 023F require
ȿ the collaboration
\textrts of the Ghana
Ministry of Health, Banking Sector, Police Department, 0240 CustomsɀExcise\textrtz
and Preventive Service,
other relevant Ministries and the international community to bring the pandemic to a stop.

Keywords: coronavirus; COVID-19; insurance industry; infection rate; National Insurance 12

Commission; pandemic; World Health Organization

1. Introduction
Coronavirus disease, scientifically reclassified as COVID-19, has assumed global pandemic
proportions [1]. It attained a pandemic status declared by the World Health Organization (WHO) on
11 March 2019 [1]. The current spread of the virus at a fast rate compared to previous pandemics has
resulted in a total lockdown of nations, ban on travels, public gatherings and closure of offices. There has
been global closure of businesses as well as the loss of jobs and lives. The general economic situation is
a global recession. In most instances, the insurance industry and governments all over the world have
become the beacons of hope to which people look for rescue from total annihilation. However, due
to the fast increase in infection cases greater than the recovery of infected people, the pandemic has
overwhelmed many governments and financially weakened some insurance companies. The impact

Int. J. Environ. Res. Public Health 2020, 17, 5766; doi:10.3390/ijerph17165766 www.mdpi.com/journal/ijerph
 \textcommatailz \textcommatailz \capitalcedilla{E}
0228 Ȩ0225 \c{E} ȥ 0228 Ȩ0224 \c{E}
\textcommabelow{z} Ȥ \textcommabelow{Z} Ȩ \textcommabelow{z}
0225 0228 ȥLATIN CAPITAL \c{E}
LETTER
LATINE SMALL
WITH CEDILLA
LETTER Z WITH LATIN
HOOK CAPIT
0226 Ȧ \capitalcedilla{E}
\.{A} \textcommatailz \capitalcedilla{E}
0226 Ȧ 0229\.{A} ȩLATIN\textcommatailz \c{e}
\capitalcedilla{E}
CAPITAL LETTER A WITH DOT ABOVE
\capitaldotaccent{A} 0225 ȥ \textcommabelow{z}
\capitaldotaccent{A}
0229 ȩ0226 \c{e} Ȧ 0229
\.{A} ȩ \c{e} 0226022A
0229
\textcommatailz ȦLATINȪSMALL
ȩ \.{A} \={\"O}
\c{e}
LETTER E WITH
LATIN CEDILLA
CAPITAL LATIN
LETTER A WITH DOTSMAL
ABO
0227
Ȫ ȧ \.{a} \capitaldotaccent{A}0227
Ȫ0226 \={\"O} ȧ \.{a} LATIN\capitaldotaccent{A}
Ȫ SMALL\textdieresisoverline{O}
LETTER A WITH DOT ABOVE
022A \={\"O} 022A Ȧ \.{A} 022A LATIN CAPITAL \={\"O}
LETTER O WITH DIAERESIS AND LATIN
MACRON CAPIT
0228 Ȩ \textdieresisoverline{O}
0227 ȧ
\c{E} \.{a} 0228 Ȩ 022B\c{E}
0227
\textdieresisoverline{O} ȧ ȫLATIN\.{a}
\capitaldotaccent{A}
\={\"o}
\textdieresisoverline{O
CAPITAL LETTER
LATIN E WITH
SMALL CEDILLA
LETTER A WITH DOT ABOV
\capitalcedilla{E} \capitalcedilla{E} \textdieresisoverline{o}
022B 2020, 17,
Int. J. Environ. Res. Public Health ȫ0228 Ȩ
5766 \={\"o} 022B
\c{E} ȫ0227 \={\"o} ȧ 0228 022B ȨLATIN SMALL
\.{a} ȫ \c{E} \={\"o}
LETTER
ofO 14
2LATINWITH DIAERESIS
CAPITAL LETTERAND MACRON
LATIN
E WITH SMAL
CEDILLA
0229 ȩ \textdieresisoverline{o}
\c{e} \capitalcedilla{E} 0229 ȩ 022C\c{e} Ȭ
\textdieresisoverline{o} \={\~O}
\textdieresisoverline{o
LATIN\capitalcedilla{E}
SMALL LETTER E WITH CEDILLA
0228 Ȩ \c{E} \texttildeoverline{O}
022C022A Ȭ0229 Ȫ \={\~O} ȩ
\={\"O} \c{e}
022C Ȭ 022A
\={\~O} Ȫ 022C\={\"O}
0229
\capitalcedilla{E}ȩLATINLATIN
Ȭ \c{e}
CAPITAL \={\~O}
CAPITAL LETTER
LATIN
LETTER WITHO WITH
O SMALL TILDE DIAERESIS
LETTER E WITH
AND AND
MACRON
LATIN MACR
CEDILLA
CAPIT
\textdieresisoverline{O}\texttildeoverline{O}
\texttildeoverline{O}
Ȫ Ȫ ȭ
022D\textdieresisoverline{O}\={\~o}
\texttildeoverline{O}
of the pandemic on the 022A
Ghanaian insurance \={\"O}
industry is yet 0229 ȩ
to be\={\~o}
estimated 022A
\c{e}
and \={\"O}LATIN CAPITAL LETTER O WITH DIAERES
022D022B ȭ ȫ \={\~o} \={\"o} 022D ȭ022A
\textdieresisoverline{O} 022B ȫ projected
022D\={\"o} to
ȭ provide
LATINLATIN
SMALL SMALL
a O WITH
\texttildeoverline{o}
\={\~o}
LETTER TILDEDIAERESIS
\textdieresisoverline{O}
LETTER O WITH AND
AND MACRONLATINMACRO
SMAL
guide for government and insurers for \textdieresisoverline{o}
the simulation
\texttildeoverline{o} of future Ȫ
events. \={\"O}
\texttildeoverline{o} Ȯ
022E\textdieresisoverline{o}\.{O}
\texttildeoverline{o}
022B ȫ \={\"o} 022B ȫ
\textdieresisoverline{O} \={\"o}LATIN SMALL LETTER
\capitaldotaccent{O}
O WITH DIAERESIS

As of 22 June 2020, 022C Ȯ

022E14,007 Ȭ \.{O}
confirmed \={\~O}
cases022E beenȮ022B
reported 022C
\.{O}
\textdieresisoverline{o}
have in Ghana, Ȭ and 022E\={\~O}
the Ȯ
numbers
LATINLATIN
CAPITAL \.{O}
\textdieresisoverline{o}
keep
CAPITAL LETTER
LETTER O WITHO WITH TILDE AND
DOT ABOVE MACRON
LATIN CAPIT
\texttildeoverline{O}
\capitaldotaccent{O}
ȫ \={\"o}
\capitaldotaccent{O} 022F ȯ
\texttildeoverline{O} \.{o}
\capitaldotaccent{O}
increasing by day [1]. On022D 30 March,022C Ȭ
the president \={\~O}
of Ghana announced 022C
partial Ȭ
a \textdieresisoverline{o}
lockdown \={\~O}
in Accra,
LATIN CAPITAL LETTER O WITH TILDE AN
022F ȯ ȭ \.{o} \={\~o}022F ȯ
\texttildeoverline{O} 022D
\.{o} ȭ 0230022F LATINȰ
\={\~o} ȯ \texttildeoverline{O}
LATIN
SMALL SMALL\={\.O}
\.{o}
LETTERLETTER
O WITHO WITH TILDE AND LATIN
DOT ABOVE MACRON SMAL
Tema and Kumasi. The lockdown, 022Cthree Ȭ weeks \={\~O}
0230 Ȱ022D however, lasted for only
\texttildeoverline{o}
ȭ
\={\.O} \={\~o} Ȱ
0230 \={\.O}
and was \texttildeoverline{o}
lifted on
022D 0230 ȭLATIN Ȱ
\texttildeoverline{O}
19LETTER
April
\textdotoverline{O}
\={\~o}
CAPITAL \={\.O}
LATINO SMALL
WITH DOT ABOVE
LETTER AND
O WITHLATIN
MACRON
TILDECAPIT
AND
022E
following the overweight of economic meltdown Ȯ \.{O} on the nation.
\textdotoverline{O}
\texttildeoverline{o} 022E
Though the Ȯ
country
\textdotoverline{O} 0231 \.{O}
received ȱ a
LATIN \={\.o}
financial
\textdotoverline{O}
CAPITAL LETTER O WITH DOT ABOVE
\texttildeoverline{o}
\capitaldotaccent{O} 022D ȭ \={\~o} \capitaldotaccent{O} \textdotoverline{o}
support of USA $1 billion 0231 andȱdonations
022E \={\.o} Ȯfrom 0231 ȱ
\.{O} organizations,
other \={\.o} 022E 0231 Ȯ
philanthropists and ȱpartners
LATIN SMALL
\texttildeoverline{o} \.{O} \={\.o}
LETTER Oto
LATINWITH DOT ABOVE
CAPITAL LETTERAND LATIN
MACRON
O WITH DOTSMAL
ABO
022F ȯ \textdotoverline{o}
\.{o} \capitaldotaccent{O} 022F ȯ 0232\.{o} Ȳ
\textdotoverline{o} \={Y}
\textdotoverline{o}
LATIN\capitaldotaccent{O}
SMALL LETTER O WITH DOT ABOVE
cushion the impact of the0230 pandemic, 022E Ȯ \.{O}
0232 Ȱ the
Ȳ022F
economic effects of the partial
\={Y}ȯ
\={\.O} 0232
\.{o} Ȳ 0230
\={Y}
lockdown
Ȱ 0232
022F
were
\={\.O}
\capitaldotaccent{O}
muchCAPITAL
Ȳ
ȯLATINLATIN
greater
\.{o}
CAPITAL
\capitalmacron{Y}
\={Y}
LETTER
LETTER
LATIN O WITH
Y SMALL
WITH MACRONDOTOABOVE
LETTER WITH ANDCAPIT
LATIN
DOT MAC
ABOV
than can be contained by the nation. Increased pressure
\textdotoverline{O}
\capitalmacron{Y} on health workers
\capitalmacron{Y}and 0233
hospital ȳfacilities
\textdotoverline{O} \={y} at
\capitalmacron{Y}
0230 Ȱ \={\.O} 022F ȯ 0230
\.{o} Ȱ \={\.O}LATIN CAPITAL LETTER O WITH DOT ABO
present is overbearing, 0233
and ȳ ȱ a\={y}
0231it seems \={\.o}0233
catastrophic situationȳ is imminent.
\textdotoverline{O} 0231
\={y} ȱ 02340233\={\.o} ȴSMALL
ȳ \textdotoverline{O}
LATINLATIN SMALL\textctl
\={y}
LETTERLETTER
Y WITHO WITH
MACRONDOT ABOVELATIN
AND MACR
SMAL
0230 Ȱ \={\.O} \textdotoverline{o}
LATINȵ
ȴ \textdotoverline{o} ȴ 0235 ȴ \textctn
0234 0231 ȱ
\textctl 0234
\={\.o} \textctl
The insurance industry in Ghana plays a very important role in \textdotoverline{O} 0231 0234 ȱ
the national economy [2]. SMALL\={\.o}\textctl
LETTER L WITH
LATIN CURL
SMALL LETTER O WITHLATIN
DOT SMAL
ABOV

0235
0232
ȵ Ȳ \textctn\={Y} \textdotoverline{o} 0232
0235 ȵ \textctn
Ȳ 0236 0235
\={Y} LATINȶȵ CAPITAL LETTER Y WITH MACRON
\textdotoverline{o}
\textctt
\textctn
Ghana presently has a huge infrastructural deficit that requires
\capitalmacron{Y} ȱ
0231 the establishment
\={\.o}of efficient LATIN SMALL LETTER
insurance
\capitalmacron{Y}
N WITH CURL LATIN SMAL

0236 ȶ 0232 Ȳ \={Y} ȶ 0236 Ȳ

02320237
\textctt \textdotoverline{o} LATINȷSMALL
ȶ \={Y} \textdotlessj
LATIN CAPITAL LETTER Y WITH MACRON
policies to pursue economic 0233 ȳ \textctt
development \={y} The
[3,4].
0236
industry
\capitalmacron{Y}provides 0233
safety andȳ \={y}
stability to individuals,
LATIN
\textctt
LETTER T WITH CURL
SMALL LETTER Y WITH MACRON
\capitalmacron{Y}
\j
LATIN SMAL

0237 ȷ \textdotlessj0237 ȷ Ȳ
0232 \textdotlessj \={Y} 0237 LATIN SMALL ȷ \textdotlessj
LETTER DOTLESS J LATIN SMAL
groups, institutions and0234 businesses ȴ [5].
0233 \j A ȳ healthy
\textctl \={y}and developed 0234
\j insurance
ȴ industry
0233
\capitalmacron{Y} ȳ will
0238\textctl ȸ
LATIN\={y}
improve
SMALLLATIN
LETTER L WITH CURL
\textdblig
\j SMALL LETTER Y WITH MACRON
the stability of financial 0238
0235
markets. ȵ \textdblig
ȸ0234
Over ȴ period,
\textctn
a long \textctl
0238 theȸGhanaian 0235
ȳinsurance
0233 \textdblig ȵindustry
0234
\={y} 0238 ȴLATIN
\textctn
has ȸ \textPUdblig
LATIN\textctl
SMALL
witnessed
SMALL
LETTER
LATIN N WITH
SMALL
\textdblig
LETTER DB DIGRAPH
CURLL WITH CURL
LETTER
LATIN SMAL
0236 ȶ ȵ
\textctt
0235 \textPUdblig \textctn 0234 \textPUdblig0236
ȴ ȶ
0235
\textctl 0239 ȵ
\textctt ȹ
LATIN \textqplig
\textctn
SMALL \textPUdblig
LETTER
LATIN T WITH CURL
SMALL LETTER N WITH CURL
stability and economic growth due to the stable growth of the economy boosted by increased cocoa,\textPUqplig gold
02390237 ȹ0236 ȷ \textqplig
ȶ \textctt ȹ0235 \textqplig
\textdotlessj
0239 0237
ȵ ȷ 0239\textdotlessj
0236
\textctn ȹ
ȶLATINLATIN
SMALL \textqplig
\textctt
SMALL
LETTERLETTER DOTLESS
QP DIGRAPH
LATIN SMALL J T WITH
LETTER LATIN
CURLSMAL
and agricultural production. The recent boom
\j in
\textPUqplig the oil business has particularly
\textPUqplig catapulted
023A \j Ⱥ insurance
\textstrokea
\textPUqplig
0237 ȷ \textdotlessj 0236 ȶ 0237
\textctt ȷ \textdotlessj
LATIN SMALL LETTER DOTLESS J
premiums [2]. Currently, 023A0238 theȺtotalȸ assets of the
\textdblig
\textstrokea \j Ghanaian
023A Ⱥ insurance
\textstrokea ȸ 023B
0238 industry 023A LATINȻ
is\textdblig
GH Ⱥ 6.2
LATIN SMALL
\j
CAPITAL \textstrokecapitalc
billion.
\textstrokea
LETTER
LETTER DB DIGRAPH
A WITH STROKE LATIN CAPIT
\textPUdblig 0237 ȷ \textdotlessj
ȼ
\textPUdblig
The Life sector contributes 023B GH Ȼ0238 ȸ Non-Life
\textstrokecapitalc
3.1 billion, 023B GH Ȼ 2.4 billion
\textdblig and Reinsurance 023C
\j 0238 023B ȸ
\textstrokecapitalc GHLATIN Ȼ 0.7
CAPITAL \textstrokec
\textstrokecapitalc
billion.
\textdblig
LETTER
LATINC SMALL
WITH STROKE LATIN CAPIT
LETTER DB DIGRAPH

Thirty percent (30%) 023C

0239
of Ghanaians ȼ ȹ (i.e., \textqplig
\textstrokec
9,311,985 \textPUdblig
023C of 31,039,949)
0239
ȼ0238 \textstrokec
ȸ
are currently
ȹ 023C\textqplig
insured
\textdblig ȼ SMALL
while
LATIN SMALL
\textslashc
LATIN\textPUdblig
LETTER QP DIGRAPH
\textstrokec
twelve
LETTER C WITH STROKE LATIN SMAL
0239023D ȹ Ƚ \textqplig
\textPUqplig \textPUqplig \textbarcapitall
ȹ
0239 \textslashc \textqplig \textslashc\textPUdblig \textslashc
LATIN SMALL LETTER QP DIGRAPH
thousand (12,000) Ghanaians 023D Ƚ Ⱥ \textbarcapitall
023A are employed in the023D
insurance
\textstrokea
\textPUqplig industry
Ƚ0239 \textbarcapitall
ȹ
Ⱥ 023E
[2]. In 2018,
023A the
\textqplig
total annual
\textstrokea
023D LATINȾCAPITAL
profit
LATIN\textPUqplig
Ƚ CAPITAL LETTER A WITH STROKE
\textstrokecapitalt
\textbarcapitall
LETTER L WITH BAR LATIN CAPIT
of the insurance industry 023E
023B
was GHȾ Ȼ
023A 202 Ⱥ
\textstrokecapitalc
million while
\textstrokecapitalt
023E total
\textstrokeaȾ premium 023B
was GH Ȼ 2.9
023A 023F
\textPUqplig
\textstrokecapitalt Ⱥ
\textstrokecapitalc
billion. The
ȿ average
LATIN\textstrokea
Ⱦ
023E LATIN CAPITAL
CAPITAL LETTER
\textrts
LATIN C WITH
CAPITAL STROKE
LETTER
\textstrokecapitalt
LETTER
A WITH STROKE
T WITH DIAGONAL STROKE LATIN CAPIT

daily benefit paid by 023F Life023C ȼis GH

ȿ 023B
insurers Ȼ 1.9 million
\textstrokec
\textrts \textstrokecapitalc
023F andȿ023A
average 023C claim
Ⱥ
daily
\textrts
ȼ is0240
023B GH
\textstrokea
023F ȻLATIN
\textstrokec
1.1ɀLATIN \textstrokecapitalc
ȿmillion
SMALL [2].
SMALLLATIN
LETTER
\textrtz C WITHLETTER
CAPITAL
\textrts
LETTER
STROKEC WITH STROKE
S WITH SWASH TAIL LATIN SMAL
\textslashc \textslashc
Currently, the insurance 0240industry ɀ 023C
pays a ȼ
total
\textrtz \textstrokec
cooperate
0240 ɀ023B
tax of GH
\textrtz 023C 0240 ȼLATIN SMALL
Ȼ 36 million.
\textstrokecapitalc ɀ \textstrokec
LATIN SMALL LETTER C WITH STROKE
\textrtz
LETTER Z WITH SWASH TAIL LATIN SMAL
023D Ƚ \textbarcapitall
\textslashc 023D Ƚ \textbarcapitall
LATIN\textslashc
CAPITAL LETTER L WITH BAR
Historically, zoonosis (i.e., the transmission of diseases 023C
from ȼ to humans)
animals \textstrokec has been identified
023E Ⱦ
023D Ƚ
\textstrokecapitalt
\textbarcapitall 023E Ⱦ
023D
\textslashc Ƚ LATIN\textbarcapitall
\textstrokecapitalt
CAPITAL LETTER
LATIN T WITH
CAPITAL DIAGONAL
LETTER STROKE
L WITH BAR
as the major cause of global 023Fpandemics ȿ
023E [6].
Ⱦ Antonine
\textrts plague,
\textstrokecapitalt
023D
believed
023F
Ƚ to be Smallpox,
ȿ
023E Ⱦ
\textrts
\textbarcapitall
is the
LATIN earliest
\textstrokecapitalt
SMALL LETTER
LATIN S WITHLETTER
CAPITAL SWASH TAIL
T WITH DIAGONA

record of a global pandemic 0240that023F ɀ

occurred ȿbetween
\textrtz 165–180
\textrts AD, killing
023E Ⱦ ɀ people,
0240 5 million
12023F ȿ and
\textrtz
\textstrokecapitalt causing
LATIN\textrts
SMALL LETTER
LATIN 12
Z WITH
SMALL SWASH
LETTER TAIL SWASH TAI
S WITH

USA $11–25 million financial loss [7]. TheɀBlack \textrtz

0240 Death (1347–1351)
023F caused
ȿ by Yersinia
0240
\textrts ɀ pestis, bacteria
\textrtz
LATIN SMALL LETTER Z WITH SWASH TAI

found in rats, was a devastating pandemic that killed 200 million 0240 ɀ
people all\textrtz
over the world and caused
USA $70–120 million financial loss [8,9]. The Spanish flu occurred from 1918 to 121919 and was caused
by an H1N1 virus that lives in pigs [10–12]. The flu killed between 40–50 million people 12 and caused
an economic loss of USA $70–90 million [13,14]. HIV AIDS has been in existence since 1981 until 12
now [15–17]. It is caused by the Human Immunodeficiency Virus that lives on chimpanzees [18].
AIDS has killed between 25–35 million people so far and caused USA $100–200 million in financial
loss to the world [19,20]. More recently, the swine flu started in 2009 to 2010 [20–23]. It is caused by
an H1N1 virus in pigs and has killed 200,000 people as well as caused USA $10–20 million global
financial loss [24,25]. SARS-CoV started in 2002 and ended in 2003 [26]. It is caused by a coronavirus
in bats and civet cats and has killed 770 people while causing USA $1–3 million financial loss to
the global economy [27,28]. Ebola occurred in the West African sub-region from 2014 to 2016 [29–32].
It is caused by the ebolavirus in wild animals [33–42] and has killed 11,000 people while causing USA
$16–30 million financial loss to the global economy. Five years ago, MERS started and is still present.
It is caused by a coronavirus from bats and camels and killed 850 people so far [43]. Its total economic
loss is USA $2–9 million and still counting [43]. The origin of the novel COVID-19 at present is still
unknown, and its total economic loss is still counting.
While there is limited literature on the impact of pandemics on the insurance industry, a parallel
comparison can be made to the impact of other natural disasters on the global financial system.
Dimitri [44] studied how available economic resources could be shared by health authorities to stop
the spread of epidemic diseases. His analysis suggests that to be able to effectively distribute economic
resources optimally depends on the cost functions namely: the available technology for controlling
the relevant parameters underlying the epidemic and the available financial resources. Lagoarde-Segot
Int. J. Environ. Res. Public Health 2020, 17, 5766 3 of 14

and Leoni [45] used a theoretical model to study the stability of the banking sector in the joint prevalence
of Malaria and AIDS. Their studies suggest that the likelihood of collapse of the banking sector increases
as the prevalence of pandemics increases. Fan et al. [46] estimated national losses in national incomes
in the US economy that might occur in the event of a major influenza-related pandemic. Their study
also covered the number of lives lost as a result of the pandemic. They further estimated the expected
number of influenza-pandemic related deaths to reach 720,000 per year and calculated annual losses as
a result of pandemic impacts to reach USA $500 million. Bongini et al. [47] studied the profitability or
losses of banks in crises such as a global pandemic. Using a sample of 109 European bank holding
companies from 2006 to 2016, they studied the main drivers of profitability shocks and factors that
help banks bounced back avoiding a more severe situation. Their findings showed that the crisis
has its stocks in the lending activity and in the deterioration loan portfolio caused by a risk that
is not counterbalanced by adequate loan loss provisions and capitalizations. They also discovered
that banks that recovered after the shock adopted a more conservative lending policy, reduced their
rates and performed better afterward. Sigala [48] reviewed literature to understand the impacts of
COVID-19 on the tourism industry. Her study revealed that COVID-19 has different impacts on
the tourism industry, which are based on the characteristic nature of the particular tourism sector,
its size, location, management and ownership style. She further noted that the highly heterogeneous
nature of tourism demand also determines COVID-19 impacts and implications. They concluded that
COVID-19 tourism research should not only discuss the different impacts of COVID-19 on tourism
but also provide an explanation of the roots of such differences and the scope to test any suggestions
on how to address possible inequalities that may arise from impacts of COVID-19. Barro et al. [49]
studied the potential effect of the coronavirus on mortality and economic activity by comparing lessons
from the 1918–1920 Great Influenza Pandemic. With a parallel evaluation of economic declines in
GDP, increased consumption, deaths, decreased realized real returns on stocks and especially on
short-term government bills caused by the 1918–1920 Great Influenza Pandemic, the study compared
these economic impacts to that caused by the Coronavirus in our current dispensation to draw lessons
from previous experiences. The study concluded that the current situation decline in stock prices,
increases in stock-price volatility, decreases in nominal interest rates and contractions of real economic
activity are familiar outcomes that require quick responses. Cerra and Sexena [50] investigated
the behavior of output following financial and political crises in 190 countries. They particularly
examined the economic impact of deterioration in a country’s political governance. Alfaro et al. [51]
investigated aggregate and firm level stock returns during pandemics in real time. Their study showed
that unexpected changes in the trajectory of COVID-19 infections predict US stock returns in real time.
Their study further revealed that unanticipated doubling of projected infections forecast a next-day
decrease in aggregate US market value of 4 to 11 percent, indicating equity markets will rebound even
in the persistence of the pandemic. Haacker [52] investigated the economic cost of the HIV/AIDS
pandemic. His study revealed that HIV has caused financial losses to affected families and torn
families apart. Studies by Bloom et al. [53] warned the world about the possible emergence of a
pandemic. They stressed that the world was not ready now to accommodate a pandemic and suggested
buffering our economic indicators to survive in the event of a pandemic. The present occurrence of
COVID-19 pandemic suggests that the world has not paid heed to this warning. Dreyer et al. [54]
investigated the frequency of influenza (flu) [2] pandemics on the South African insurance industry
and studied the effects it had on the industry. Their study concluded that a mild pandemic will cost
the South African Economy R 1.1 billion claims excluding annuity, while a severe pandemic could cost
R 55 billion claims.
At present, insurers in Ghana are counting their losses as a result of COVID-19, but the pandemic
could also present an opportunity for a stronger bounce back. The most obvious effect of COVID-19 on
the insurance industry in Ghana is the upsurge in health, travel and business claims. Though insurance
policies do not directly cover pandemics, the impact of COVID-19 on the global economy has had a
toll on the insurance industry. There are reports of insurers already paying millions of cedis through
 USV Symbol Macro(s) Description
0216 Ȗ \textroundcap{U} LATIN CAPITAL LETTER U WITH INVERTED BREVE
\textinvbreve{U}
0217 ȗ \textroundcap{u}
Int. J. Environ. Res. Public Health 2020, 17, 5766
LATIN SMALL LETTER U WITH INVERTED BREVE
4 of 14
\textinvbreve{u}
0218 Ș \textcommabelow{S} LATIN CAPITAL LETTER S WITH COMMA BELOW

0219 ș \textcommabelow{s} LATIN SMALL LETTER S WITH COMMA BELOW

e-payment
021A
channels
Ț even during the lockdown period. There is obvious
\textcommabelow{T}
pressure on sales from
LATIN CAPITAL LETTER T WITH COMMA BELOW
reduced
021Bbusiness
ț activity and less use
\textcommabelow{t} of face-to-face channels in transactions. Though the lockdown
LATIN SMALL LETTER T WITH COMMA BELOW

in Ghana
021C was brief,
Ȝ it \YOGH
further exacerbated the impact of the pandemicLATIN resulting in YOGH
CAPITAL LETTER lowering interest
rates and ȝ
021D increasing credit
\yogh risk. The National Insurance CommissionLATIN of Ghana (NIC)
SMALL LETTER YOGH reported that

many 021E Ȟ now

more clients call in to complain about their insurers, and theLATIN
\v{H} number of people
CAPITAL LETTER calling in to
H WITH CARON
\capitalcaron{H}
enquire about claims has quadrupled within the pandemic period as compared to the same period
021F ȟ \v{h} LATIN SMALL LETTER H WITH CARON
last year.
0220
Most Ƞaviation passengers insist that insurers should refund LATIN
\M{N}
the CAPITAL
premiums they paid since
LETTER N WITH LONG RIGHT LEG
there is a ban onȡ travel.\textctd
0221 Business owners all over the country have alsoLATINcalled in to demand claims for
SMALL LETTER D WITH CURL

interruption
0224 of Ȥ
businesses. The NIC indicates that it is currently studying
\textcommabelow{Z} LATINthe impact
CAPITAL of the
LETTER Z WITH HOOKpandemic

and will ȥ
0225soon come out with guidelines and new policies on how to survive.
\textcommabelow{z} At present,
LATIN SMALL LETTER Z WITH HOOK there is no

study to investigate the\textcommatailz

impact of COVID-19 on the insurance industry in Ghana. Insurers either cannot
0226 Ȧ \.{A} LATIN CAPITAL LETTER A WITH DOT ABOVE
simulate impacts of the pandemic on their companies or are currently overwhelmed by mounting
\capitaldotaccent{A}
operational
0227 pressures
ȧ to be able to study the impacts of the pandemic. LATIN
\.{a} This study
SMALL LETTERaims to ABOVE
A WITH DOT investigate
the impact Ȩ
0228 of COVID-19 on the insurance industry in Ghana and discuss
\c{E} LATIN solutions
CAPITAL LETTER Eas well
WITH as project
CEDILLA
\capitalcedilla{E}
future expectations. We are covering the impact of the pandemic from the month of the first reported
0229 ȩ \c{e} LATIN SMALL LETTER E WITH CEDILLA
case count until the present moment of this study (i.e., March to June 2020). The specific objectives of
022A Ȫ \={\"O} LATIN CAPITAL LETTER O WITH DIAERESIS AND MACRON
the study are: \textdieresisoverline{O}
022B ȫ \={\"o} LATIN SMALL LETTER O WITH DIAERESIS AND MACRON
(i) to estimate the impact of COVID-19 on the insurance industry in Ghana.
\textdieresisoverline{o}
(ii) to discussȬinsurer\={\~O}
022C expectations and present solutions. LATIN CAPITAL LETTER O WITH TILDE AND MACRON
\texttildeoverline{O}
022D ȭ Methods
2. Materials and \={\~o} LATIN SMALL LETTER O WITH TILDE AND MACRON
\texttildeoverline{o}
022E Ȯ \.{O} LATIN CAPITAL LETTER O WITH DOT ABOVE
2.1. Sources of Data \capitaldotaccent{O}
022F ȯ \.{o} LATIN SMALL LETTER O WITH DOT ABOVE
Data for this study include operations data and documents from insurance companies,
0230 Ȱ \={\.O} LATIN CAPITAL LETTER O WITH DOT ABOVE AND MACRON
Ghana Health Service (GHS), World Health Organization (WHO), Ghana Statistical Service Department
\textdotoverline{O}
(GSS),0231 ȱ
Ghana National Insurance Commission (NIC), Ghana Labour Commission
\={\.o} (LC)
LATIN SMALL LETTER O WITHand theAND
DOT ABOVE Ghana
MACRON
\textdotoverline{o}
National Health Insurance Authority (NHIA). The Data includes population data which comprises,
0232 Ȳ \={Y} LATIN CAPITAL LETTER Y WITH MACRON
gender specification, job, insurance status, type of insurance, income and other social or economic
\capitalmacron{Y}
indices.
0233Data from
ȳ Ghana
\={y} Health Service and WHO consist of updates of COVID-19
LATIN SMALL case counts,
LETTER Y WITH MACRON

0234rates, ȴdeaths\textctl
infection and total recoveries, as well as information about
LATINresponses to the
SMALL LETTER L WITH CURL pandemic.

From the ȵ companies,

0235insurance \textctn the data consist of total premiums, claims,
LATINprofits, assets
SMALL LETTER and liabilities,
N WITH CURL

0236 ȶ \textctt LATIN SMALL LETTER T WITH CURL

market share and business investments. Insurance data was collected as far back as 2013 to compare
0237 ȷ \textdotlessj LATIN SMALL LETTER DOTLESS J
trends of operations. \j
0238 ȸ \textdblig LATIN SMALL LETTER DB DIGRAPH
2.2. Data Collection \textPUdblig
0239 ȹ \textqplig LATIN SMALL LETTER QP DIGRAPH
There are presently 141 regulated insurance companies in Ghana comprising 24 life insurance
\textPUqplig
companies, Ⱥ
023A 29 non-life insurance companies, 3 reinsurance companies LATIN
\textstrokea andCAPITAL
85 insurance brokers with
LETTER A WITH STROKE

023B GH Ȼ 6 billion
more than \textstrokecapitalc
total assets. LATIN CAPITAL LETTER C WITH STROKE

To023C
measure ȼ the impact
\textstrokec
of COVID-19 on the insurance industry, we designed and administered
LATIN SMALL LETTER C WITH STROKE
\textslashc
three different
023D
types
Ƚ of questionnaires
\textbarcapitall
to three types of responders. The first category of responders
LATIN CAPITAL LETTER L WITH BAR
includes
023Estatutory
Ⱦ actuaries. The questionnaire
\textstrokecapitalt was designed to capture the level of risk the pandemic
LATIN CAPITAL LETTER T WITH DIAGONAL STROKE

posed023F
on insurance
ȿ companies;
\textrts responses of insurers; actions and possible solutions;
LATIN SMALL expectations
LETTER S WITH SWASH TAIL of
insurers ɀ preparation.
0240and their \textrtz Category 2 responders include insurance officers
LATIN SMALL LETTER Zin the
WITH SWASHcategory
TAIL of
general manager, operations manager, supervisors, public relations officers, human resources officers,
logistic officers, accountants and Liaison officers. Questions for this category investigate the financial
losses to insurance companies and current relations with clients.
12 The last category of people were
clients, policyholders, stakeholders and partners of insurance companies as well as the general public
who are stakeholders of the insurance industry. This category of questions investigates customer’s
trust in the insurance company as well as how they were treated by the insurance companies before
and during the pandemic. Details of the questionnaire are presented in Supplementary Material as
Int. J. Environ. Res. Public Health 2020, 17, 5766 5 of 14

document Q1. Category 1 and 2 questionnaires were sent as official letters to the responders while
category 3 was
Int. J. Environ. administered
Res. Public Health 2020,via
17, xsocial media
FOR PEER platforms including Ghanaweb.com, Facebook.com,
REVIEW 5 of 14
Twitter, Jobsinghana.com and on WhatsApp messenger. In category 1, 5 actuaries were contacted
1, 5of
out actuaries
a total ofwere contacted
7 qualified out of a total
professional of 7 qualified
actuaries professional
in Ghana. actuaries
In category inletters
2, 200 Ghana.were
In category
sent via
2, 200and
email letters
WhatsAppwere sent via email The
to responders. and number
WhatsApp to responders.
of responders The number
interviewed of responders
in category 3 consists
interviewed
of 50 people on in face-to-face
category 3 consists of 50
interviews, 400people on face-to-face
via WhatsApp interviews,
messenger, 656 via400 via WhatsApp
Facebook and 468
on Ghanaweb.com. In total, 1779 responders from the 16 administrative regions in from
messenger, 656 via Facebook and 468 on Ghanaweb.com. In total, 1779 responders Ghana thewere
16
administrative regions in Ghana were interviewed.
interviewed.

3.3.Results
Results

3.1.
3.1.General
General Outlook
Outlook of
of the
the Ghanaian
Ghanaian Insurance Industry
Theoutlook
The outlookofofthe
theGhanaian
Ghanaian insurance
insurance industry
industry since
since thethe pandemic
pandemic started
started fromfrom March
March untiluntil
June
June shows
shows an economic
an economic recession.
recession. ThereThere are indications
are indications of reducing
of reducing profitsprofits and premiums,
and premiums, stablestable
assets
assets
and and market
market share
share but but increasing
increasing claims.claims.
FigureFigure 1 compares
1 compares the of
the trend trend
totalofprofits,
total profits, premiums,
premiums, claims
claims
and andfor
assets assets for the quarterly
the quarterly period period
MarchMarch
to Junetofrom
June2013
fromto2013 to 2020.
2020. Insurance
Insurance accounting
accounting on
on excel
excel spreadsheet can be found in supplementary material as table
spreadsheet can be found in Supplementary Material as Tables S1 and S2. S1 and S2.

Figure1.1. General quarterly

Figure quarterly(March
(MarchtotoJune)
June)outlook
outlook ofof the
the insurance
insurance industry:
industry: (A) trend
(a) trend of profits,
of profits, (b)
(B) trend
trend of premiums,
of premiums, (c) (C) trend
trend of claims
of claims andand (D) trend
(d) trend of assets.
of assets.

3.2.
3.2.Customer
Customer Complaints
Complaints
The
Theresults
resultspresent
present customer
customer complaints
complaints inin the insurance industry
the insurance industry with
withcompanies
companiescategorized
categorized
into
intolife
lifeand
andnon-life. TheThe
non-life. trend of customer
trend complaints
of customer in thein
complaints industry from March
the industry from to June istocompared
March June is
from
compared from 2014 to 2020. For life insurance companies, the trend indicates an increase in theof
2014 to 2020. For life insurance companies, the trend indicates an increase in the number
complaints until 2016. until
number of complaints The number
2016. Theofnumber
complaints then decreased
of complaints down todown
then decreased 2017. to
There
2017.was
Therea sharp
was
increase
a sharp in complaints
increase from 2017from
in complaints to 2018
2017and then and
to 2018 a decline.
then aCustomer complaints
decline. Customer in non-life
complaints ininsurance
non-life
companies were similar
insurance companies wereto life insurance
similar to life companies. Figure 2 presents
insurance companies. Figure 2 apresents
comparison of customer
a comparison of
complaints on life and non-life insurance companies.
customer complaints on life and non-life insurance companies.
Int. J. Environ. Res. Public Health 2020, 17, x FOR PEER REVIEW 6 of 14
Int. J. Environ. Res. Public Health 2020, 17, 5766 6 of 14
Int. J. Environ. Res. Public Health 2020, 17, x FOR PEER REVIEW 6 of 14

Figure 2. Comparison of customer complaints in the insurance industry within the period under
review.
Figure 2.
2. Comparison
Comparisonofofcustomer
customer complaints
complaints in insurance
in the the insurance industry
industry withinwithin the period
the period under
under review.
review.
3.3. Impact on Life and Non-Life Insurance Policies
3.3. Impact
We on Life
We have,
have, in and
in thisNon-Life
this section, Insurance
section,compared
compared Policies
life
lifeand
andnon-life
non-lifeinsurance
insurance companies
companies to to
seesee
thetheimpact on
impact
human
on humanlifelife
and andhealth. The
health. Theresults show
results show that
thatpremiums
premiums ofofall
all 28
28 non-life insurance companies
non-life insurance companies
We have, in this section, compared life and non-life insurance companies to see the impact on
dropped
droppedlifein 2020
in 2020 and the same for life insurance companies. Claims, however, increased for both life
life
human and and the The
health. sameresults
for lifeshow
insurance
that companies.
premiums of Claims,
all 28however,
non-life increased
insurance for both
companies
and non-life
and non-life insurance
insurance companies
companies within the period. Figure 3 compares performance of life and non-
dropped in 2020 and the same forwithin the period.
life insurance Figure 3 compares
companies. performance
Claims, however, of life and
increased non-life
for both life
life insurance
insurance companies.
companies.
and non-life insurance companies within the period. Figure 3 compares performance of life and non-
life insurance companies.

Figure 3. Life and non-life insurance companies’ performance compared.

3.4. The Impact

3.4. The onFigure
Impact on Health3.Insurance
Health
Life and non-life
Insurance Policy:
insurance
Policy: The
The ofcompanies’
Role of
Role Ghanaperformance
the Ghana
the
compared.
National Health
National Health Insurance Scheme
Insurance Scheme
Broadly,
3.4. The Impacthealth
Broadly, health insurance
on Health
insurance has
Insurance experienced
hasPolicy: some
The Role
experienced of
of the
some the
the operational
ofGhana challenges
National Health
operational general
Insurance
challenges Scheme
general insurance
insurance
and
and life insurance faced. Ghana has a National Health Insurance Scheme (NHIS), one of the few
life insurance faced. Ghana has a National Health Insurance Scheme (NHIS), one of the few in
in
Broadly,
Sub-Saharan health
Africa. insurance
The has
National experienced
Health some
Insurance of the operational
Authority (NHIA) challenges
superintends general
the insurance
operation of
Sub-Saharan Africa. The National Health Insurance Authority (NHIA) superintends the operation of
and
the life insurance
national health faced. Ghana
insurance hasthat
policy a National Health
works to
to ensureInsurance
access to Scheme
to basic (NHIS),
basic health
health one
care for of Ghanaians.
for all
all the few in
the national health insurance policy that works ensure access care Ghanaians.
Sub-Saharan Africa. The National Health Insurance Authority (NHIA) superintends the operation of
The NHIA also licenses and regulates District-level Mutual Health Insurance Schemes (DMHISs) and
the national health insurance policy that works to ensure access to basic health care for all Ghanaians.
The NHIA also licenses and regulates District-level Mutual Health Insurance Schemes (DMHISs) and
 022F ȯ \.{o}
0230 Ȱ \={\.O}
\textdotoverline{O}
0231 ȱ \={\.o}
\textdotoverline{o}
Int. J. Environ. Res. Public Health 2020, 17, 5766 0232 Ȳ \={Y} 7 of 14
\capitalmacron{Y}
0233 ȳ \={y}
The NHIA also licenses and regulates District-level Mutual 0234
Health ȴ
Insurance \textctl (DMHISs)
Schemes
0235 ȵ \textctn
and accredits others. Currently, there are 145 district health insurance schemes including 10 in Greater
0236 ȶ \textctt
Accra, the capital of Ghana. The national health insurance does not provide coverage for COVID-19,
0237 ȷ \textdotlessj
however, as a government institution, the NHIS partnered with the government \j to provide logistics
and PPEs to fight the pandemic. Under the National Health Insurance 0238 ACT,ȸ 2012 (ACT 852), Section 40
\textdblig
\textPUdblig
sets aside a National Health Insurance Fund (NHIF) that qualifies to support the nation in pandemic
0239 ȹ \textqplig
situations. Section 40 (2 c and d) states that the purpose of the NHIF is to facilitate \textPUqplig
provisions of health
facilities or invest in programs that promote the good health of Ghanaians.
023A Ⱥ In this regard, the NHIA
\textstrokea
supported the government efforts in fighting COVID-19 by donating 023B GH Ȼ 250,000 \textstrokecapitalc
to the COVID-19
relief fund set-up by the government. The NHIA also donated several ȼ
023C Personal \textstrokec
Protective Equipment
\textslashc
(PPEs), food and other items to communities, churches, schools 023D and mosquesȽ at\textbarcapitall
various municipal
and district levels. Private Health Insurance providers have also witnessed
023E increased
Ⱦ spending on their
\textstrokecapitalt
Corporate Social Responsibility (CSR) budgets to support communities 023F with
ȿ food and PPEs and to
\textrts
rebate clients who were facing financial challenges during the partial ɀ
0240 lockdown. \textrtz

3.5. Impact on Travel Insurance

COVID-19 has brought the travel industry especially aviation to a standstill. As the pandemic
intensified, there was a ban on travel and closure of airports in Ghana. Ghana presently has the second
busiest airport in West Africa with an average of 56 flights a day. Based on developments so far
(quarantine measures, border closures, travel bans) and compared with patterns of similar pandemics
(2003 SARS and 2009 global economic crisis), we estimate the impact of the pandemic on the growth of
the Ghanaian travel industry to −32% on Revenue Passenger Kilometres (RPK) and growth of −4% on
passenger revenue. During the partial lockdown, travel insurers stopped sales since there were no
travelers. There were also more refunds due to cancellation of travel policy as a result of unutilized
travel days as the insured cannot use their annual travel plans. Some insurers have started laying off
workers and switching full-time employees to part-time work. Insurers must consider the purpose for
which travel insurance was bought and therefore protect the interest of the customer. They must also
protect their commercial interest as loss cannot guarantee quality service or keep customers happy.
As a result of a reduction in travel, the auto insurance industry is subscribing partial premium credits
for customers to reduce claims.

3.6. Virtual Workforce

We discovered that some companies had to perform most of their operations virtually due to
social distancing guidelines and other government restrictions. This has created business continuity
challenges for companies, employers and employees. It has particularly affected actuaries who handle
large data sets models that require significant computing power and capacity. Having to remotely
manage these operations adds additional complexity and difficulty in systems access and processing
times. The abrupt and unplanned transition to a remote working environment has forced increased
collaboration between actuarial departments, finance and IT to meet targets.

3.7. Level of Preparedness, Expectations and Hopes of Ghanaian Insurers

Ghanaian insurers and reinsurers including actuaries were asked about their level of preparedness
for a pandemic. They were particularly asked to assess the level of threat the pandemic poses to
insurance companies, the measures insurers have in place to protect their companies, whether insurers
have attempted to quantify the risk and the extent to which profit and solvency are threatened by
COVID-19. Their responses are presented below:

• In general, insurers were optimistic that their assets cover regulatory minimums sufficient to
allow for a pandemic such as COVID-19, but 25% were doubtful whether if COVD-19 should
persist beyond 12 months, they will survive insolvency.
Int. J. Environ. Res. Public Health 2020, 17, 5766 8 of 14

• Most insurers have attempted to model the risk of the pandemic closely while others tried
modeling their results under stress testing, but the majority have done nothing. This raises a big
concern and needs to be considered by the National Health Insurance Commission. Elsewhere
in the world, it is beneficial for National Health Insurance Authorities to implement readiness
audits of all insurance companies to assess their finances and assets and model the impact future
pandemic will have on them.
• All companies agreed that COVID-19 has had an operational economic impact on them, and they
also agreed that they were not 100% prepared for the pandemic. They were however optimistic of
surviving the pandemic and hopeful of a successful bounce back.
• Companies fear that existing products with guarantee rates are likely going to be unable to recoup
losses as a result of COVID-19. They believe that even where rates are annually reviewable, it will
probably not be feasible to recover those losses in future premiums.
• Regarding new products, little has been done to anticipate the impact COVID-19 will cause.
• All the insurers were of the view that annuity savings will protect some of their assets, but many
insurance companies had little or no annuity businesses.

Summary of insurer responses to questionnaires are presented in Supplementary Material

in Table S3.

4. Discussion

4.1. The General Outlook

Due to reduced economic activity, premiums have reduced and are expected to reduce further
until the end of the year. Profits have been significantly reduced because more claims are being paid
out than premiums collected over the period. Some companies had to lay off employees thus reducing
productivity. Budgets of companies have also increased due to more spending on social responsibility
to help the government fight the pandemic. For instance, some insurers had to buy hand sanitizers,
gloves, nose masks and other PPEs for their workers. Food and other provisions were also bought
for communities during the three-week lockdown. Due to the volatility in the financial markets,
investment income has significantly dropped low with reduced interest rates. Insurers may also
experience an increase in policy lapses in certain segments of their business if individuals are unable or
choose not to pay premiums to keep their policies active. This trend will continue until the end of 2020.
Companies that cannot keep track of failed policyholders who may want to repurchase insurance are
likely to have an advantage over competitors in regenerating business. Insurers and actuaries are
advised to monitor the trends carefully to inform changes in the processes.
Claims have drastically increased along many lines. As companies transition to virtual working
environments, most companies have not seen the impact on claim processing. Companies are advised
to carefully evaluate the volume of claims received both during the pandemic and as it subsides, as well
as their efficiency to process claims virtually. Loss of lives and unproductivity have resulted in some
insurers having to rebate their clients to survive during the lockdown period. This may likely extend
till the end of 2020. Event cancellation has caused a huge loss to the insurance industry. The Ghana
premier league is currently on a standstill. Major music and comedy concerts are postponed, and other
sporting events have been put on hold. During the lockdown, all large public gatherings for music,
worship and celebration were canceled and will surely struggle to get insurance coverage in the future.
Travel insurance has become more expensive since the WHO declared the disease a pandemic.
Agriculture and oil insurance is expected to receive more payment of claims as Ghana is an
agricultural country. Dropping cocoa, forest products, oil and gold prices have further increased claims.
Oil insurance is a major contributor to the Ghanaian insurance industry since 2017.
Claims are also increasing in the short term due to supply-chain disruption and loss of revenues.
Liability insurance claims can be demanded where contraction of COVID-19 or death as a result of it is
attributed to negligence. For example, clients can litigate hotel owners for not taking precautionary
Int. J. Environ. Res. Public Health 2020, 17, 5766 9 of 14

measures to prevent the virus or for not operating an effective quarantine within their premises.
There could also be lawsuits where the virus is brought into hospitals and nursing homes and causes
fatalities. Presently, private schools in Ghana are afraid to operate for fear of litigation should a pupil
be infected. Churches and other prayer centers are afraid to open even though the lockdown has
been lifted by the president. Workers could demand compensation pay-outs where employees have
been infected at work especially commercial taxi and bus drivers driving cars of commercial transport
operators, aircraft flight crew workers, hospital workers and general company workers.
Customer complaints have increased because liquidity is beginning to hit some insurance
companies, and as a result, payment of claims has become challenging. Secondly, some clients do
not understand that insurance policies do not cover pandemics. Insurers of life and health policies
might not have properly explained to their clients how insurances do not cover pandemics, and since
COVID-19 is a novel virus, customers and insurers will disagree as to where to accurately place
the pandemic within the insured and non-insured diseases category of health insurance. This has
caused lots of arguments between insurers and their clients thereby increasing customer complaints
to the NIC. On business interruption claims, some insurers are arguing that the interruption on
business was brief and does not qualify for claims. On travel insurance, some customers complained
that recovering losses especially from airlines and travel agencies has been difficult as insurers have
challenged validating claims.

4.2. How Insurers Should Respond to the Crises

The Ghanaian insurance industry is responding to the COVID-19 on multiple fronts as capital
managers, employers, and claim payers. Each insurance company has its distinct challenges; however,
the most pressing concern for all insurers is protecting the health and safety of their employees
and partners including brokers and agents in the insurance community. The focus of insurers should
be to review and update their crisis management plans and take steps to continue operations with
little disruption to clients. Insurers should consider establishing temporal multi-purpose emergency
decision-making units purposely for this pandemic to coordinate responses and set new safety protocols
to contain shocks. They should also set up a comprehensive communications system to keep employees,
clients, distributors and other partners fully informed about the status of business continuity plans
and information on how to remain safe.
Insurers should also adapt to working from remote locations. They should enable and equip
company staff from actuaries, underwriters and claim managers to work offsite, most probably from
homes. They should particularly make it possible for employees to access necessary files from homes.
Furthermore, chief information security officers should be equipped to establish new cybersecurity
protocols to ensure the safe exchange of highly classified information among employees connecting
from homes. Insurers should particularly make sure that chief technology officers, chief information
officers, and chief information security officers have the following technological capabilities: (a) a
virtual private network to privately connect remotely for critical business operations, (b) a personal
laptop or desktop computer issued by the company, (c) video conferencing tools like Zoom and Tencent
meeting with training on how to use them, and (d) a competent, well-equipped IT support team to
answer employees questions and help employees from offsite.
Insurers should plan training and equipping staff to work under social distancing regulations
since there is potentially a long time to go for the pandemic. With good digital tools, this should not be
a problem for insurers. This could potentially be a period of productive planning, training and outreach
to stakeholder groups at remote distances. Lastly, insurers should establish a risk management
team to assess how quickly and effectively they were able to respond to crises in the pandemic
period. They should also determine any additional steps that may need to be taken to adapt to their
organizations and make them more resilient if faced with future pandemics like the type of COVID-19.
Int. J. Environ. Res. Public Health 2020, 17, 5766 10 of 14

4.3. Managing and Quantifying Loss During a Pandemic

Quantifying and managing loss are very critical to insurers during a pandemic. If a claim is
presented, it will be complex to measure the loss. Insurers can adopt the following procedures to
measure loss:

• By acting promptly: Early engagement with the client is very important to win the trust
and understand the potential impacts of the pandemic.
• Understand the drivers of business specific to the insured’s business model. The insured must
not be in say Accra, Kumasi or Tema (high COVID-19 case count cities in Ghana) to suffer a
potential business interruption loss. Businesses operate within a long supply chain, and therefore,
contingent business interruption tends to occur in the weaker part of the supply chain, which
could originate from any part of the country and can lead to large losses in business.
• Keep an accurate trace of cause and effect. As losses accrue, the ability to keep an accurately
documented trail to prove the direct causal link between the insured peril and financial losses is
very critical.
• Keep track of worldwide activities and business trends: It is very prudent to consider the financial
impact of the pandemic on other areas of the world.
• Seek early advice from professionals. Pandemics such as SARS and H1N1 have impacted insurance
industries in other parts of the world, and insurance professionals have experience operating in
pandemic situations. The early seeking of advice may save losses.

4.4. Other Solutions and Actions for Insurers

COVID-19 occurrence has exposed the weaknesses in the Ghanaian economy and insurance
industry. We have now seen how the country’s economy buckles under a major threat like a pandemic.
The questions that need to be asked are the following: how can insurers prepare for a pandemic? What
issues need to be considered to reduce the impact of a pandemic in its next occurrence, and what
questions need to be addressed during the recovery process? The following points address issues
that need to be considered to reduce the impact of a pandemic on mortality, morbidity and social
disruption:

• Giving up-to-date and truthful information to parties: Most often, due to politics, governments
and agencies try to hide the true scale of a pandemic by under-reporting on infection rates,
case counts and deaths.
• Getting prepared ahead of time: There are more worries about the likelihood of a pandemic
occurring today than there were 40 years ago. WHO and other partners have consistently warned
the general public of the likely occurrence of a pandemic. This should, therefore, give insurers
and hospitals enough reason to prepare adequately for a pandemic. The more time and resources
spend preparing, the more effective a global response shall be. Vaccine development is a very
important part of preparation. The government should maintain and support infectious disease
control and prevention units such as the University of Ghana medical school, the Kwame Nkrumah
University of Science and Technology School of Medical Sciences, the University for Development
Studies School of Medical Sciences, the Noguchi Medical Research Institute, the Kumasi Centre for
Collaborative Research In Tropical Medicine and some nursing training colleges such as the Jirapa
Nursing and Midwifery Training College to be able to do research into virology and build
the capacity of health workers. The aim is to promote research into developing vaccines that
will be stocked in readiness for a pandemic. Antivirals should also be prepared in waiting for a
pandemic situation.
0224 Ȥ \textcommabelow{Z} LATIN CAPITAL LETTER Z WITH HOOK

0225 ȥ \textcommabelow{z} LATIN SMALL LETTER Z WITH HOOK

\textcommatailz
0226 Ȧ \.{A} LATIN CAPITAL LETTER A WITH DOT ABOVE
\capitaldotaccent{A}
0227 ȧ \.{a}
Int. J. Environ. Res. Public Health 2020, 17, 5766
LATIN SMALL LETTER A WITH DOT ABOVE
11 of 14
0228 Ȩ \c{E} LATIN CAPITAL LETTER E WITH CEDILLA
\capitalcedilla{E}
0229 ȩ \c{e} LATIN SMALL LETTER E WITH CEDILLA
4.5. Recovering from the Pandemic
022A Ȫ \={\"O} LATIN CAPITAL LETTER O WITH DIAERESIS AND MACRON
\textdieresisoverline{O}
To recover from a pandemic will take the unified collaboration of several stakeholders including
022B ȫ \={\"o} LATIN SMALL LETTER O WITH DIAERESIS AND MACRON
the Ministry of Health, Insurance Industry, Banking Sector, Police Department and Customs Excise
\textdieresisoverline{o}
and Preventive
022C Ȭ Service. Global recovery depends on the preparedness
\={\~O} LATIN CAPITALof theO WITH
LETTER international
TILDE AND MACRONcommunity
as a whole and\texttildeoverline{O}
the severity of the pandemic. More important is the preparedness of the insurance
022D ȭ which
industry, \={\~o}
must work extra hard during the pandemicLATIN SMALL LETTER O WITH TILDE AND MACRON
period. Total recovery will only take
\texttildeoverline{o}
place in
022E Ȯ a post-pandemic
\.{O} environment, and companies who were not well prepared will suffer
LATIN CAPITAL LETTER O WITH DOT ABOVE
\capitaldotaccent{O}
the consequences of their unpreparedness.
022F ȯ \.{o} LATIN SMALL LETTER O WITH DOT ABOVE

0230 Ȱ the World

4.6. What \={\.O}Bank Must Do to Help Client Countries LATIN CAPITAL LETTER O WITH DOT ABOVE AND MACRON
\textdotoverline{O}
0231 Theȱ World Bank should assist insurance supervisory agencies
\={\.o} toLETTER
LATIN SMALL helpO WITH
them DOT survive and recover.
ABOVE AND MACRON

The insurance \textdotoverline{o}

industry will need assistance in crisis response strategies, training and facilitation
0232 Ȳ \={Y} LATIN CAPITAL LETTER Y WITH MACRON
to act decisively and help in upgrading their communication capacity. The World Bank can also
\capitalmacron{Y}
provideȳ support
0233 by providing solvency and capital and asset-liability
\={y} LATIN SMALLmanagement,
LETTER Y WITH MACRON mentoring training
0234 ȴ
and assisting supervisors to act in a more complex environment.
\textctl LATIN SMALL LETTER L WITH CURL

0235 ȵ \textctn LATIN SMALL LETTER N WITH CURL

0236 ȶ
5. Conclusions \textctt LATIN SMALL LETTER T WITH CURL

0237 ȷ \textdotlessj LATIN SMALL LETTER DOTLESS J

The COVID-19
\j pandemic has posed a sudden and unexpected shock to the insurance industry.
0238 ȸ
The financial impact is huge with profits dropping by 16.6% within
\textdblig the
LATIN SMALL period
LETTER under review—March
DB DIGRAPH
\textPUdblig
to June 2020. Total premiums have dropped by 17.01% while claims have increased by 38.4%.
0239 ȹ \textqplig LATIN SMALL LETTER QP DIGRAPH
Most companies have reduced market share with only a few maintaining their market share.
\textPUqplig
023A Ⱥ
The estimated financial loss to the Ghanaian insurance industry
\textstrokea within
LATIN CAPITAL LETTER Athe period under review
WITH STROKE

is GH Ȼ 112 million.
023B \textstrokecapitalc LATIN CAPITAL LETTER C WITH STROKE

023C ȼ
Insurance \textstrokec
companies were affected differently depending on different factors such as liquidity,
LATIN SMALL LETTER C WITH STROKE
\textslashc
their portfolio
023D Ƚ at risk, reliance on reinsurance, level of free assets
\textbarcapitall
and protection that reinsurers have
LATIN CAPITAL LETTER L WITH BAR
in
023E place.
Ⱦ \textstrokecapitalt LATIN CAPITAL LETTER T WITH DIAGONAL STROKE

023F Theȿ initial response of insurers was poor as the Ghanaian

\textrts insurance
LATIN SMALL industry
LETTER S WITH SWASH TAIL does not have

0240 ɀ experience
sufficient \textrtz in managing a pandemic situation, but LATINrecovery was
SMALL LETTER quick
Z WITH as most insurance
SWASH TAIL

companies have now adapted to working from remote locations and enhanced their IT as well as
security protocols. Insurance managers have also responded by issuing statements and taken specific
actions to calm down panic reactions among policyholders.
12 They have particularly simplified the claim
process to make policyholders access claims easily and set new rules to regulate the sector. Insurers
have also increased measures for underwriting claims service. The government has set up a COVID-19
fund to fight the pandemic. There is also a fund for frontline health workers to be compensated for
risking their lives.
Though the loss in finance is expected to continue until the end of the year, the forecast shows a
bounce back in operations that will resume normal accounting on claims, premiums and profits in
early 2021. This growth is expected to be sustained for five years, but insurers must adapt to the new
mode of business transaction and be able to quantify and manage their losses.
The World Bank can step in to assist insurers with training on crisis response strategies, training
and facilitation to act decisively and offer financial bail-out to insurers who are unable to recover.
While the pandemic persists, insurers must learn to give up-to-date and truthful information to
their clients; they must be proactive rather than reactive in their response and be prepared at all times
for worst-case scenarios. They must continue to relate with clients in a positive working environment
to maintain their trust.

Supplementary Materials: The following are available online at http://www.mdpi.com/1660-4601/17/16/5766/s1.

Table S1: Excel template of forecasting. Table S2: Excel template of insurance accounting. Table S3: Summary of
questionnaire results. Document Q1: Questionnaires for testing insurer response and responses of insurers.
Int. J. Environ. Res. Public Health 2020, 17, 5766 12 of 14

Author Contributions: Conceptualization, P.B., A.G. and D.A.A.; methodology, P.B. and D.N.; software, P.B.,
D.N., D.B. and A.G.; validation, P.B., X.Y. and D.A.A.; formal analysis, P.B. and X.Y.; investigation, P.B. and X.Y.;
resources, P.B. and X.Y.; data curation, P.B.; writing—original draft preparation, P.B.; writing—review and editing,
P.B., A.G, D.A.A. and D.N.; visualization, D.A.A. and D.B.; supervision, X.Y.; project administration, X.Y.; funding
acquisition, X.Y. All authors have read and agreed to the published version of the manuscript.
Funding: This research was funded by the National Key Research Program of China (grant numbers. 2017YFC0506603,
2016YFC0401305), the State Key Program of National Natural Science of China (grant number. 41530635) and the Project
of National Natural Foundation of China (grant number. 51679007).
Acknowledgments: Thanks to all authors for their efforts in conducting this research.
Conflicts of Interest: The authors declare no conflict of interest.

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