A STUDY ON

INSURANCE SECTOR IN INDIA

With reference to

UNITED INDIA INSURANCE & CO.LTD

A project report submitted to

the Department of Commerce
P. B. SIDDHARTHA COLLEGE OF ARTS AND SCIENCE
In partial fulfilment of the requirement for the award of the degree
of
BACHELOR OF COMMERCE
Submitted by:
B.V.S.S. KRISHNA
Regd no:
212368P
Under the Guidance of
Ms. T. NAGA MALLESWARI
Assistant. Professor
Department of
Commerce

P. B. SIDDHARTHA COLLEGE OF ARTS AND SCIENCE

An Autonomous College Accredited To “A+” By NAAC
(Affiliated to KRISHNA UNIVERSITY, Machilipatnam)

VIJAYAWADA 2021-2024
 P. B. SIDDHARTHA COLLEGE OF ARTS AND SCIENCE
VIJAYAWADA - 10

CERTIFICATE

This is to certify that this project work titled “INSURANCE SECTOR IN INDIA” is
a Bonafide work done by B.V.S.S. KRISHNA (Regd. No:212368P) under my
guidance and supervision in partial fulfilment of the requirement for the award of
the Degree of Bachelor of Commerce in P. B. SIDDHARTHA COLLEGE OF ARTS
AND SCIENCE, Vijayawada, Affiliated to Krishna University, Machilipatnam,
during the academic year 2021 - 2024.

Ms. T. NAGA MALLESWARI Kona Narayana Rao

Asst. Prof & Project Guide Head of Department

External Examiner
 DECLARATION

I, hereby declare that this Project report titled “INSURANCE SECTOR IN

INDIA” is a Bonafede work done by me under the guidance of Ms. T. NAGA
MALLESWARI , Asst Prof. This project work is submitted to P. B.
SIDDHARTHA COLLEGE OF ARTS AND SCIENCE in partial fulfilment of
the requirement for the award of BACHELOR OF COMMERCE during the
academic year 2021-2024.
I also declare that this project is a result of my own effort and that it has not been
submitted to any other college or university for the award of my degree.

Place: Vijayawada B.V.S.S. KRISHNA

Regd.No:212368P
 ACKNOWLEDGEMENT

It is a great pleasure to take the opportunity and express my gratitude to all those who
helped me throughout my project work.

First and foremost, I express my profound thanks to Dr. M. Ramesh, Principal, P. B.

SIDDHARTHA COLLEGE OF ARTS AND SCIENCE, for giving me this opportunity to
take up the project work.

I would also like to thank Sri. K. Narayana Rao Garu, HOD, Department of Commerce for
his valuable guidance and support for the completion of my project work.

I express my profound thanks to Ms. T. NAGA MALLESWARI, Asst. Prof & Project
Mentor, Department of Commerce for his valuable insights and incessant encouragement to
complete this project successfully.

I would like to express my sincere thanks to all the faculty of the Department of Commerce
for their continuous cooperation and encouragement to complete my project.

My sincere thanks to UNITED INDIA INSURANCE &CO.LTD for giving me a golden

opportunity to do this project in the esteemed organization and I also thank My SENIOR
DIVISIONAL MANAGER Sri. D.RAM SUDHAKAR Garu who helped me to learn various
concepts.

Finally, I thank one and all who directly and indirectly helped me to complete my project
successfully.

B.V.S.S. KRISHNA
Regd.No:212368P
 INDEX
Sl.No Content Page no.

1
CHAPTER-1

2
CHAPTER-2

3 CHAPTER-3

4 CHAPTER-4

5 CHAPTER-5

6 Findings and Suggestions

7 Bibliography
CHAPTER – 1
 INSURANCE SECTOR IN INDIA

Introduction of insurance
Insurance is, thus, a financial tool specially created to reduce the financial impact of unforeseen events and to
create financial security. Indeed, everyone who wants to protect himself against financial hardship should
consider insurance. Traditionally, “the joint family” has been an informal social security in India. In modern
society, social security is available only to those who are employed in the organised sector. Insurance is
considered one of the tools of social security for formal and informal sectors and is largely carried out in two
ways. i. The first way is known as Social Insurance. Here, the State or government takes care of those who are
subjected to losses due to some risk event. Examples are, providing a pension when one grows old or
providing free medical treatment, meeting the cost of hospitalization etc. The fund for this purpose comes
from a pool made up from taxes or mandatory social security contributions required to be made by all those
who work and earn an income. The Employees’ State Insurance scheme (ESI) that provides medical care and
other benefits to employees and Employees’ Provident Fund Organization (EPFO) that provides pensions and
survivors’ benefits in the event of an employee’s death are the popular schemes under this head. ii. The second
way is through voluntary Private Insurance. Here, individuals and groups can buy insurance from an insurance
company by entering into a contract of insurance with the company. The insurance company enters into a
contract (an insurance policy) whereby it (insurer) undertakes, in exchange for a small amount of money
(premium), to provide financial protection by agreeing to pay the insuring person (insured) a fixed amount of
money (sum assured) on the happening of a certain event (insured peril). Insurance companies collect
premiums to provide for this protection and losses are paid out of the premiums so collected from the insuring
public. In other words, an insurance contract promises to make good to the insured a certain sum in
consideration for the premium received from the insured.

Evolution of insurance in INDIA

In India, insurance has a deep-rooted history. It finds mention in the writings of Manu (Manusmrithi), Yagnavalkya
(Dharmasastra) and Kautilya (Arthasastra).

The writings talk in terms of pooling of resources that could be re-distributed in times of calamities such as fire, floods,
epidemics and famine. This was probably a pre-cursor to modern day insurance. Ancient Indian history has preserved the
earliest traces of insurance in the form of marine trade loans and carriers’ contracts. Insurance in India has evolved over time
heavily drawing from other countries, England in particular.

The advent of life insurance business in India

1818
Advent of life insurance business in India
1818 saw the advent of life insurance business in India with the establishment of the Oriental Life Insurance Company in
Calcutta. This Company however failed in 1834. In 1829, the Madras Equitable had begun transacting life insurance business
in the Madras Presidency. 1870 saw the enactment of the British Insurance Act and in the last three decades of the nineteenth
century, the Bombay Mutual (1871), Oriental (1874) and Empire of India (1897) were started in the Bombay Residency. This
era, however, was dominated by foreign insurance offices which did good business in India, namely Albert Life Assurance,
Royal Insurance, Liverpool and London Globe Insurance and the Indian offices were up for hard competition from the foreign
companies..

—1—
 1914
Government of India started publishing returns
In 1914, the Government of India started publishing returns of Insurance Companies in India. The Indian Life Assurance
Companies Act, 1912 was the first statutory measure to regulate life business. In 1928, the Indian Insurance Companies Act
was enacted to enable the Government to collect statistical information about both life and non-life business transacted in
India by Indian and foreign insurers including provident insurance societies. In 1938, with a view to protecting the interest of
the Insurance public, the earlier legislation was consolidated and amended by the Insurance Act, 1938 with comprehensive
provisions for effective control over the activities of insurers.

1950
The Insurance Amendment Act of 1950 abolished Principal Agencies
The Insurance Amendment Act of 1950 abolished Principal Agencies. However, there were a large number of insurance
companies and the level of competition was high. There were also allegations of unfair trade practices. The Government of
India, therefore, decided to nationalize insurance business..

1956
Life Insurance Corporation came into existance
An Ordinance was issued on 19th January, 1956 nationalising the Life Insurance sector and Life Insurance Corporation came
into existence in the same year. The LIC absorbed 154 Indian, 16 non-Indian insurers as also 75 provident societies—245
Indian and foreign insurers in all. The LIC had monopoly till the late 90s when the Insurance sector was reopened to the
private sector.

The history of general insurance

The history of general insurance dates back to the Industrial Revolution in the west and the consequent growth of sea-faring
trade and commerce in the 17th century. It came to India as a legacy of British occupation.

1850
The British establish the Triton Insurance Company Ltd
General Insurance in India has its roots in the establishment of Triton Insurance Company Ltd., in the year 1850 in Calcutta by
the British.

1907
The Indian Mercantile Insurance Ltd, was set up
In 1907, the Indian Mercantile Insurance Ltd, was set up. This was the first company to transact all classes of general
insurance business.

1957
General Insurance Council is formed
—2—
1957 saw the formation of the General Insurance Council, a wing of the Insurance Association of India. The General
Insurance Council framed a code of conduct for ensuring fair conduct and sound business practices.

1968
Insurance Act was amended
In 1968, the Insurance Act was amended to regulate investments and set minimum solvency margins. The Tariff Advisory
Committee was also set up then.

1973
General insurance business was nationalized
In 1972 with the passing of the General Insurance Business (Nationalisation) Act, general insurance business was nationalized
with effect from 1st January, 1973. 107 insurers were amalgamated and grouped into four companies, namely National
Insurance Company Ltd., the New India Assurance Company Ltd., the Oriental Insurance Company Ltd and the United India
Insurance Company Ltd. The General Insurance Corporation of India was incorporated as a company in 1971 and it
commence business on January 1st 1973.

—3—
 IMPLEMENTATION OF INSURANCE ACT
August 2000 The Authority has the power to frame regulations under Section
114A of the Insurance Act, 1938 and has from 2000 onwards framed various
regulations ranging from registration of companies for carrying on insurance
business to protection of policyholders' interests.

PRODUCTS OF INSURANCE
Insurance products

Health insurance
Life insurance
Motor insurance
Home insurance
Travel insurance
Pension plans
Term life insurance
Endowment policy
Unit-linked insurance plan
Child insurance plans
Commercial insurance
Child Plan
Money-back policy
Senior citizen health insurance
Accident insurance

—4—
 EXPANSION OF INSURANCE SECTOR

Economic growth, an expanding middle class, innovation and regulatory support is driving insurance market
growth in India. Over the next five years (2024‒28), we forecast that total insurance premiums will grow by
7.1% in real terms, well above the global (2.4%), emerging (5.1%) and advanced (1.7%) market averages. At
this rate, India will have the fastest growing insurance sector of the G20 countries.

In 2023 alone, premium growth moderated slightly from the previous year, reflecting still-in-process
adjustments to the post COVID-19 era. We estimate that life premium growth slowed to an estimated 4.1%
from 5.9% in 2022 as memories (ie, risk awareness) of the pandemic faded, and a recent change in tax norms
for high-ticket policies weighed on new premium growth. We expect robust growth in life business (premiums
up 6.7% in 2024‒28), supported by rising demand for term life cover by the middle-class and the country’s
young population, and also increasing industry adoption of Insurtech.

Non-life premium growth moderated slightly from 9.0% in 2022 to an estimated 7.7% in 2023, as the market
continued to stabilise after the pandemic. Macro dynamics such as high interest rates, and elevated retail and
medical inflation also presented some headwinds to non-life sector growth. Non-life premiums are forecast to
grow by an annual average of 8.3% during 2024‒28, driven by economic growth, improvement in distribution
channels, government support and a favourable regulatory environment.

—5—
 USES OF INSURANVCE PRODUCTS

Critical illness cover: There are a number of lifestyle-related diseases that are on the rise. Health issues
such as cancer, stroke, kidney failure and cardiac diseases can be very expensive to deal with and manage long-term.
This is precisely why critical illness insurance policies have been created. They can either be purchased as a rider or add-
on with your regular health insurance plan or separately as their own plan. These policies offer cover for very specific
issues and often provide claim payouts as a single lump sum payment after the diagnosis of a critical illness.

Life insurance: Life Insurance is a contract between an insurance policy holder and an
insurer, where the insurer promises to pay a sum of money to the beneficiary when the insured
person dies or after a pre-determined period in exchange for the premiums paid by policyholder.

In life insurance policy you need to pay premiums for a specified policy term and life insurance
company provides you with a comprehensive life cover, in return. Life Insurance protects future of
your loved by paying a lump sum amount referred to as death benefit if an unfortunate event
occurs. Some life insurance policies provide you a Maturity Benefit after the end of the policy term.

Retirement planning: Retirement planning is crucial today, especially where individuals no longer
receive pensions, can depend on their children, and must deal with the inflationary effect on expenses. It essentially entails
building a corpus and a steady stream of money post-retirement. There are specific plans that will help create a corpus for
retirement, which is then used to purchase an annuity plan that helps to generate a fixed, regular income through a pension.

Achieve child goals safely: t’s a given that as a parent, you would want the best
for your child. You can align your life insurance policy so that you can help fulfil your child’s goals
of higher education or marriage. But these goals require a lot of money.

There are specific life insurance plans made to achieve these goals known as Child Insurance
Plans. These not only include life cover but allow you to invest and build your corpus.
Canara HSBC Life Insurance Child Plans such as Smart Junior Plan as well as Invest 4G has a lot of
strategies with which you can achieve your goal.

Also, these come with a Premium Funding Benefit option that waives off the remaining premiums
if you die during the policy. The policy is continued.

—6—
Financial protection: A major benefit of any life insurance plan is that it provides
financial security to your family members. Life insurance policies include a death benefit. If you die
during the term of the policy, then a pre-defined amount, known as the sum assured is given to
your family members.

This ensures that your family members are financially secured even after you are not present with
them.

 Life insurance can cover final expenses: Life insurance offers

benefits while you're still alive and when you pass away.
 When you die, life insurance pays out a lump sum death benefit, enabling your
heirs to use this money to cover your final expenses and replace your income.
 Life insurance payouts generally are income-tax free.
 Some permanent life insurance policies build cash value, which is money you can
take out while still alive.
 Life insurance could also pay if you develop a serious illness or go into a nursing
home.

Protection: Insurance coverage does reduce the impact of loss that one bears in perilous
situations. It provides monetary reimbursement during financial crises. It not only protects the
insured from financial woes but also helps in checking mental stress arising out of it.

Risk coverage: f you are the sole breadwinner of your family, one of your biggest worries is how your family
would manage financially if an unfortunate event occurred. This is where life insurance comes in as a risk mitigation option.
The premise of life insurance is to mitigate risk and provide financial help to your survivors so that they are taken care of,
even if you are not around.

—7—
 SCHEMES OF INSURANCE PRODUCTS

Aam Aadmi Bima Yojana

Ayushman Bharat Yojana
Government
Employment State Insurance scheme
Rashtriya Swasthya Bima Yojana
Yeshasvini Health Insurance Scheme
Home insurance
Janshree Bima Yojana
Pension plans
Universal health care
West Bengal Health Scheme
Whole life insurance
Child Plan
Dr YSR Aarogyasri trust
Endowment policy
Health insurance
Karunya Health Scheme
Mukhyamantri Amrutam Yojana
Travel insurance
Unit-linked insurance plan
Motor insurance
Money-back policy
Life Insurance Corporation Act, 1956
Public liability coverage

—8—
 . Ayushman Bharat Yojana:

Ayushman Bharat is a universal health insurance scheme of the Ministry of Health and Family
Welfare, Government of India. PMJAY was launched to provide free healthcare services to more
than 40% population of the country. The scheme offers a health cover of Rs 5 Lakh.

In this scheme, it covers medicines, diagnostic expenses, medical treatment, and pre-
hospitalization costs. The poorest families of India can benefit from this healthcare scheme.

2. Pradhan Mantri Suraksha Bima Yojana:

Pradhan Mantri Suraksha Bima Yojana aims to provide accident insurance cover to the people of
India. People in the age group of 18 years to 70 years who have an account in a bank can avail
benefit from this scheme.

This policy provides an annual cover of Rs 2 lakh for total disability and death cover and Rs 1
lakh for partial disability. The policy premium gets automatically debited from the policyholder’s
bank account.

3. Aam Aadmi Bima Yojana (AABY):

This is one of the latest National Health Insurance schemes having been established in the year
2007, October. It basically covers individuals from the age of 18 years-59 years. AABY insurance
scheme is tailored for all those citizens living in the upcountry and in the rural areas.

It also covers the landless citizens who are tenants living both in urban and rural areas. It also
includes giving scholarships to underprivileged children.

Basically, the head of the family or the earning member is the one protected by this scheme. The
premium of 200 rupees per annum is shared equally by the state and the central government.
Upon a natural death, the family is compensated at 30000 rupees. However, upon death caused
by a permanent disability, the family is compensated at 75,000 rupees.

4. Central Government Health Scheme (CGHS):

—9—
This scheme was started in the year 1954 and provides comprehensive health care facilities for
central government officials and pensioners residing in cities. Operations of this scheme take
place in cities such as Kolkata, Mumbai, Lucknow, Delhi, Nagpur, and Pune.

The people covered by this scheme are required to be residing in India. This is a National Health
Company Online Renewal program that includes the privilege of health education to the
beneficiaries.

This scheme has the following main components: All dispensary related services including
domiciliary care. In addition, the beneficiaries of this scheme have the privilege of being
hospitalized each and every time they fall ill.

On the other hand, whenever you have an X-ray or laboratory examination requirements, they
would be provided free under this particular scheme. The most important advantage of this
National Health Insurance scheme is that it provides free specialists consultations both at
hospital level and dispensaries.

5. Employment State Insurance Scheme:

This is a multidimensional National Health insurance scheme due to the fact that it provides
social security as well as socio-economic protection to all workers in India. In addition, it
provides the same privileges those who depend on workers protected under this scheme.

This insurance scheme commences upon the first day of insurable employment to each and every
worker. They are provided with full medical care insurance for themselves and their families as
well.

On the other hand, those covered under this scheme (which is basically workers) are also entitled
to a wide range of cash benefits. They include cash in times of physical distress such as sickness
or even when one might become disabled may it be temporal or permanent.

In addition, for any woman who would lose the capacity to earn or dependents of persons
injured during occupational accidents, they are entitled to a monthly pension commonly referred
to as dependents benefits.

— 10
—
This scheme is not applicable to each and every person or company. It is only applicable to all
permanent factories employing more than ten employees. Recently, the scheme has been
extended to various businesses including shops, restaurants, road and motor transports and
newspaper entities that employ more than 20 people.

6. Janshree Bima Yojana:

Janshree Bima Yojana is designed for individuals in the poor category who are within the age
group of 18-59 years. The scheme includes special features like Women SHG Groups and Shiksha
Sahyog Yojana. At present there are 45 occupational groups under this scheme.

7. Chief Minister’s Comprehensive Insurance Scheme:

Chief Minister’s Comprehensive Insurance Scheme is a Tamil Nadu state government scheme. It
was launched in association with the United India Insurance Company Ltd. It is a family floater
policy that was designed to provide quality health care services to people. This scheme covers
more than a thousand medical procedures.

In this policy, you can claim for hospitalization expenses up to Rs 5 lakh. The beneficiary can
select from both private and government hospitals under this scheme. Tamil Nadu residents with
an annual income of lesser than Rs 75000 per year are eligible to enroll under this scheme.

8. Universal Health Insurance Scheme (UHIS):

This type of scheme was implemented to help the families who live below the poverty line. It
covers the medical expenses of each and every member of the family. In case of death due to an
accident, there is a cover that is provided.

The main drivers of the Universal Health Insurance Scheme are basically the four public sector
general insurance companies who have been doing this with an aim of improving healthcare to
the underprivileged and especially the economically disabled citizen in India.

Once a family member is hospitalized, this scheme may facilitate the medical expenses of up to
30,000 rupees. However, when the earning head of the family is admitted to the hospital, the

— 11
—
Universal health insurance scheme compensates a total of 50 rupees daily for a maximum of 15
days.

We can therefore say that this insurance scheme is designed for families below the poverty line.

9. West Bengal Health Scheme:

The Government of West Bengal launched this scheme for its employees in the year 2008. It is
also available for the pensioners. This coverage is provided on both individual and family floater
basis up to a sum insured of Rs 1 lakh. The policy covers OPD treatment and medical surgeries as
per the policy terms and conditions.

10. Yeshasvini Health Insurance Scheme:

The Karnataka State Government promotes the Yeshasvini Health Insurance Scheme. This scheme
is useful for peasants and farmers and who are associated with a co-operative society. This health
insurance scheme covers more than 800 medical procedures such as Neurology, Orthopaedic,
Angioplasty, etc.

Co-operative societies help the farmers to get enrolled in the Yeshasvini Health Insurance
Scheme. The beneficiaries can avail of health care services through network hospitals, and
coverage benefits are extendible to the beneficiary’s family members.

11. Mahatma Jyotiba Phule Jan Arogya Yojana

The Government of Maharashtra introduced this health insurance policy for the benefit of people
in the state around. The scheme is going to be helpful for below the poverty line and was
targeted at the farmers in Maharashtra.

The policy offers a family health cover of up to Rs 1.5 lakh for specified illnesses. The best part
about this policy is that there is no waiting period, and it is claimable after the first day itself,
unless it is specifically mentioned in the policy terms.

12. Mukhyamantri Amrutam Yojana

— 12
—
Mukhyamantri Amrutam Yojana was initiated by the Gujarat government in the year 2012 for the
benefit of the poor people living in Gujarat. People who are in the lower middle-income group
and below the poverty line are eligible to enroll under the scheme.

It is family floater health insurance policy that provides coverage up to Rs 3 lakh per family. The
policyholder can avail of medical treatment from private and government hospitals, as well as
trust-run hospitals.

13. Karunya Health Scheme:

In 2012, the Kerala Government had launched this scheme to provide health cover for listed
chronic illnesses. It is a Critical Illness plan for the poor and covers major diseases such as Kidney,
Cancer, cardiovascular illnesses, etc.

People who are below the poverty line can enroll themselves in this scheme. The beneficiary
needs to provide a copy of the Income Certificate and Aadhaar Card for the same.

14. Telangana State Government Employees and Journalists Health Scheme:

Telangana Government launched this scheme for its journalists and employees. It is beneficial for
the employed, retired, and pensioners. In this scheme, the beneficiary can avail of cashless
treatment in the hospitals that are registered. The beneficiaries do not have to rush to arrange
funds for emergency medical expenses.

15. Dr YSR Aarogyasri Health Care Trust:

Four health welfare schemes were launched by the Andhra Pradesh Government along with the
Dr YSR Aarogyasri Trust. These schemes offer medical cover to different people and help them at
the time of a medical emergency. The schemes are given below:

 Dr YSR Aarogyasri scheme for the welfare of the poor

 Arogya Raksha scheme is for Above the Poverty Line (APL)

— 13
—
 Working Journalist Health Scheme that provides cashless treatment cover for specified

procedures

 Employee Health Scheme provides health cover to the state government employees

— 14
—
 OBSERVATION OF HEALTH INSURANCE IN INDIA

Health insurance covers cost of an insured individual's medical and surgical

expenses. Subject to the terms of insurance coverage, either the insured pays costs
out-of-pocket and is subsequently reimbursed or the insurance company
reimburses costs directly.

Nearly 400 million individuals in India have zero access to health insurance.
Around 70% of the population is estimated to be covered under public health
insurance or voluntarily private health insurance. The remaining 30% of the
population –over 40 crore individuals, devoid of health insurance.

% of families with at least 1 member covered

State
under a Health Insurance

Rajasthan 88%

Andhra Pradesh 80%

Goa 73%

Chhattisgarh 71%

Telangana 69%

Assam 67%

— 15
—
 % of families with at least 1 member covered
State
under a Health Insurance

Kerala 58%

Mizoram 50%

Gujarat 44%

Himachal
39%
Pradesh

Tripura 36%

West Bengal 34%

Karnataka 32%

Sikkim 28%

Delhi 25%

Nagaland 22%

— 16
—
 % of families with at least 1 member covered
State
under a Health Insurance

Maharashtra 22%

Bihar 17%

Jammu and
14%
Kashmir

— 17
—
INTDRODUCTION AND IMPLEMENATION OF HEALTH INSURANCE

Launched in 1986, the health insurance industry has grown significantly mainly due to liberalization of
economy and general awareness. According to the World Bank, by 2010, more than 25% of India's population
had access to some form of health insurance. There are standalone health insurers along with government
sponsored health insurance providers. Until recently, to improve the awareness and reduce the procrastination
for buying health insurance, the General Insurance Corporation of India and the Insurance Regulatory and
Development Authority (IRDAI) had launched[8] an awareness campaign for all segments of the population.

HEALTH INSURANCE PERSPECTIVE IN INDIA

Launched in 1986,[6] the health insurance industry has grown significantly mainly due to liberalization of economy
and general awareness. According to the World Bank, by 2010, more than 25%[7] of India's population had access
to some form of health insurance. There are standalone health insurers along with government sponsored health
insurance providers. Until recently, to improve the awareness and reduce the procrastination for buying health
insurance, the General Insurance Corporation of India and the Insurance Regulatory and Development
Authority (IRDAI) had launched[8] an awareness campaign for all segments of the population.

TYPES OF POLICIES IN HEALTH INSURANCE

Individual health insurance
Senior citizens health insurance
Critical illness insurance
Group health insurance
Family floater health insurance
Personal accident insurance
Maternity health insurance
Mediclaim
Hospital daily cash
Unit linked health plans
Indemnity
Comprehensive coverage
Fixed benefits
ULIPs
Aditya Birla Diamond Plan
Ayushman Bharat
CARE
Insurance
General insurance
HDFC ERGO health Insurance
Janshree Bima Yojana
Niva Bupa Health Insurance
West Bengal Health Scheme
— 18 —
A BREIF ON VARIOUS PRODUCTS OF HEALTH INSURACE

ndividual Health Insurance

An Individual Health Insurance plan is meant for a single person. As the name suggests, it can be
bought by a single individual. The individual who gets himself insured with this plan is
compensated for the expenses incurred for illness and medical expenses. Such types of medical
insurance plan cover all the hospitalisation, surgical, pre and post medication expenditures till the
insured limit is reached. The premium of the plan is decided on the basis of the buyer’s age and
medical history. Moreover, the insured individual can cover his spouse, his children, and parents,
too by paying an extra premium under the same plan. However, if you get insured for any existing
illness, there is a waiting period of 2-3 years for claiming the benefits.
Family Health Insurance
Popularly known as the Family Floater Plan, Family Health Insurance Policy secures your entire
family under a single cover. Health insurance plans for family covers all the members of your
family including your spouse, kids, and elders. Only one member of the family has to pay the
premium, and the entire family gets insured in a single premium. In case two family members are
getting simultaneous treatment, you can claim the insurance for both of them till the limit is
reached. The premium is decided on the basis of the age of the eldest member to be covered up in
the plan. So, try to avoid adding the members who are above 60 years in your family health
insurance plan as they are more prone to illness, and thus, the premium will get impacted.
Critical Illness Insurance
The Critical Illness Insurance plan insures the person by offering a lump sum amount of money
for life-threatening diseases. At the time of buying the insurance, the chosen health problems are
included, and if you get affected by any of the pre-selected conditions, you can claim your
insurance. Hospitalisation is not required to file a claim under this type of insurance policy. Only
the diagnosis of the disease can make you avail the benefits of the critical illness insurance. The
amount to be paid is pre-decided irrespective of pre and post-hospitalization expenses. Below is a
list of all the critical diseases that are covered up in the Critical Illness Insurance.
 Major organ transplant
 Cancer
 Aorta graft surgery
 Kidney failure
 Stroke
 Multiple sclerosis
 Paralysis
 First heart attack
 Coronary artery bypass surgery
 Primary pulmonary arterial hypertension
Senior Citizen Health Insurance
As indicated by the name, such types of Health Insurance in India provides coverage to people
who are 65 years and above. So if you are planning to buy an insurance policy for your parents or
grandparents, then this is the best insurance policy for you. The Senior Citizen Health Insurance
will offer you coverage for the cost of hospitalisation and medicines, whether it arises from a
health issue or any accident. It covers hospitalisation expenses and post-treatment costs too. On
top of this, some other benefits like Domiciliary Hospitalization and Psychiatric benefits are also
being covered. The upper age limit has been marked at 70 years of age. Also, the insurer can ask
— 19 —
for a complete body checkup before he sells the Senior Citizen Health Insurance. Moreover, the
premium for this plan is comparatively higher as the senior citizens are more prone to illness.
Top Up Health Insurance
An individual can buy the Top Up Health Insurance plan if he seeks coverage for higher amounts.
But there is a “Deductible Clause” added to this policy. Therefore, when the claim is made, the
payment done is over and above the pre-defined limit that is mentioned in the policy. Moreover,
there is also a Super Top-Up plan available for the individual. It provides additional coverage over
the regular policy to increase the amount of sum insured. The Super Top-up plan can only be used
once the insured sum of the regular policy gets exhausted.
Hospital Daily Cash
Another segment is the different types of health insurance policy providing an innovative solution
is the Hospital Daily Cash. If you feel insecure about buying an insurance policy, then you should
go further with this plan and learn about how these health insurance policies work. This plan can
help you to protect yourself from unexpected expenses during your hospitalisation. Once a person
gets hospitalised, the routine hospital expenses are not fixed, and they tend to change as per the
condition. In such a situation, the Hospital Daily Cash works the best for an individual. In this
plan, the individual gets a daily cash benefit of Rs. 500 to 10,000, as per the coverage amount
selected at the time of insurance. Convalescence benefits are also offered in some of the plans if
the individual gets hospitalised for more than seven days. Other add-ons include Parental
accommodation and wellness coach.
Personal Accident Insurance
The number of road accident cases have increased over the years, and that is why today, there are
dedicated types of health insurance in India to protect the citizens. Thus, people end up losing
their life or getting disabled, and bearing the treatment expenses can be a bit traumatising. So,
availing of the personal accident insurance policy is a wise idea. This policy provides a lump sum
amount to the victim or his/her family as support. Some of the plans also offer education benefits
and orphan benefits meant to cover the expenses of the children. Moreover, Bajaj Allianz also
provides add-on coverage like temporary total disablement, assistance service, worldwide
emergency, and accident in-patient hospitalisation with personal accident plans. Other than this, if
the insured suffers from an accident and has any loan obligations, it will also be taken care of by
the insurance provider.
Mediclaim
Illnesses and accidents do not come with a pre-notification. The same goes for the expenses that
one has to bear once the person gets hospitalised for any of these. Therefore, one should go for
buying a Mediclaim Policy. The Mediclaim Policy ensures compensation for your hospitalisation
expenses in case of any illness and accident. It provides coverage for the in-patient expenses that
include surgery expenses, doctor’s fees, nursing charges, oxygen, and anaesthesia. The Mediclaim
Policy is available in the market as group mediclaim, individual medical insurance, overseas
medical insurance, etc.
Group Health Insurance
Group Health is one of the up and coming types of health insurance plans trending these days.
Many medium and large-scale enterprises are offering this insurance policy to the employees. This
type of health insurance is bought by the employer of the company for its employees. The
premium of this policy is comparatively lower than the Individual Health Insurance Policy. It is
offered to the group of employees to meet the financial crisis and prudence in the company.
Disease-Specific (M-Care, Corona Kavach, etc.)
— 20 —
Nowadays, people are prone to get infected by an array of illnesses, and one of them is Covid-19.
Thus, treatment for such infections can be a bit heavy on your pocket. Therefore, to make it easy
for the people to avail treatment Bajaj Allianz has introduced some disease-specific insurance
policies. Therefore, you must think of buying a health insurance policy that helps you in such
severe health problems. Disease-Specific comes under the situation-oriented types of medical
insurance policy that provides you coverage for specific diseases. One of the insurance policies is
Corona Kavach that provides a fund of Rs. 50,000 to Rs. 5,00,000 to the person insured. The age
limit is set between 18 to 65 years. It is a type of Family Floater Policy. If we talk about M-Care
Health Insurance Policy, it provides insurance to the insured person against the diseases caused by
mosquitoes. There are different types of mosquito-borne diseases that include Dengue Fever,
Malaria, Chikungunya, Zika virus, etc. Thus, M-Care offers you coverage for these diseases.
ULIPs
ULIPs expands to Unit Linked Insurance Plans. In these plans, a part of your premium is invested,
and the other remaining part is used for buying health covers. Therefore, this plan helps you earn a
return besides providing you a safety net. Your savings can run short with the ever-rising cost of
health facilities. So, it is always better to have more money at your disposal. ULIPs don’t assure
you a fixed amount as it is subjected to market risks. And the returns that are earned from ULIPs
are paid to the buyer at the end of the policy term.
Indemnity & Fixed Benefit Plans
Indemnity
Indemnity plans are those types of health insurance plans where the policyholder can claim the
hospital expenses up to a fixed limit. The policyholder can make multiple claims only till the
maximum limit is reached. There are two different ways by which your insurance provider will
provide you with your medical expenses:
 Reimbursement Facility- The bills are first paid by you, and then the insurance provider
reimburses those bills.
 Cashless Facility- Where you do not have to pay any bills as the insurance provider pays
them directly to the hospitals.
The types of medical insurance policy that fall in the category of Indemnity plans are as under:
 Individual Health Insurance
 Family Floater Plan
 Group Health Insurance
 ULIPs

Fixed Benefits
Fixed Benefits offers you a definite amount of money for specific health issues caused due to
accidents or illness. It covers those health conditions that are listed at the time of buying the
policy. The popular Health Insurance Policies that are covered in the fixed benefits are listed
below;
 Personal Accident Plan
 Critical Illness Plan
 Hospital Cash Plan.

BENEFITS OF HEALTH INSURANCE

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 1. Insurance Coverage for Healthcare emergencies

One of the primary benefits of health insurance plan is that it provides coverage for
various healthcare facilities. It can include regular check-up visits to the hospital as well
as major surgeries. The policy terms lay down the particulars of the health insurance
benefits at the time of purchase.
One of the desirable benefits of health insurance is the cashless treatment facility. In
case of emergency hospitalization, you may not have the resources available for paying
the expenses immediately. The health insurance benefits ensure that you receive proper
healthcare without worrying since the hospital can settle the bills directly with the insurer.
2. Safety Against Rising Medical Costs

The rapidly increasing healthcare costs are a matter of grave concern among people.
Research suggests that paying for healthcare out of pocket is one of the critical causes
of impoverishment. Under such conditions, the benefits of health insurance have become
incredibly valuable.
When you include a health insurance policy in your financial plan, it can save you much
trouble later. The assurance of safety against continually rising healthcare charges is
among the remarkable advantages of health insurance.
3. Affordable Premium for Young Individuals

A common misconception says that you do not need health insurance if you are fit and
healthy. Contrary to that, the benefits of health insurance can be immensely helpful if you
have planned for it beforehand. By doing so, you give yourself enough time to spread the
premium amount over the years and reduce the financial strain.
As we grow older, health issues become more frequent. If you do not have a plan in
place, it may drain your savings. Hence, it is inadvisable to wait for a medical emergency
to purchase a health plan. You may not avail of the benefits of health insurance
efficiently, and it may also cost comparatively higher.

4. Rider Protection for Various Life-related Uncertainties

Riders can be considered as one of the most valuable benefits of health insurance. Apart
from the fundamental medical insurance benefits, you can enjoy multiple other coverage
options. Such health insurance benefits help in creating a more personalized financial
plan.
For example, a critical illness insurance rider can provide coverage against a list of life-
threatening diseases that incur high healthcare costs. Max Life Insurance offers the
option to add a critical illness rider to term plans to enhance the policy's scope.

5. Additional Cover Above Employer Health Insurance

Many companies offer employer health insurance benefits to their employees. While they
are useful, you may not want to rely on it solely for assistance in a time of need. Since
the benefits of health insurance provided by a company are under a master policy, there
are limitations to individual coverage.

— 22 —
When you buy an individual plan, you can attain additional benefits of health insurance,
which are more particular to your requirements. You do not want to face a medical
emergency where the employer's health insurance benefits may fall short.

6. Tax Benefits
While the benefits of health insurance are undeniably useful, they also help save on tax.
The Indian government allows the policyholder to reduce their tax liability when they
purchase a health plan. Under Section 80D, there are specific tax benefits of health
insurance applicable to some conditions. Tax benefit are as prevailing tax laws subject to
change.

PERSONAL ACCIDENT POLICY.

The purpose of personal accident insurance is to pay fixed compensation for death or
disablement resulting from accidental bodily injury. The personal accident insurance
policy provides that, if at any time during the currency of this policy, the insured
(person who has taken the policy) shall sustain any bodily injury resulting solely and
directly accident caused by external violent and visible means, then the insurance
company shall pay to the insured or his legal personal representative(s), as the case
may be, the sum or sums set, forth, in the policy, if resulting in specified contingencies
such as death, permanent disablement etc.

a) Bodily injury: Any disease due to accident is known as bodily injury but does not
include any disease due to natural cause. Mental shock or grief does not amount to
accident unless and until some physical injury is caused. In current scenario it is
noticed that due to grief some disablement i.e paralysis is taking place and the same is
covered under this policy.
b) Solely & Directly: The bodily injury shall have been caused solely and directly by
an accident and the bodily injury must directly and independent of any other cause
result in death or disablement. For eg:
1) A person is thrown from his horse while hunting and so injured that he cannot walk
and he lies on the wet ground until he is pick up. He thus catches chill which turns
pneumonia and dies. Though he dies because of pneumonia but the actual cause is an
accident and it covered under personal accident insurance policy.
2) If a person breaks a leg in an accident and taken to hospital where he contracts an
infectious disease from another patient which result in to death and the same is not
covered under the personal accident insurance policy.
c) Accident: An accident is an event which is wholly unexpected not intended or
designed. For eg: Snake biting, Drowning suicide and unprovoked murder are covered
under this policy.
d) External, violent and visible means: The cause of accident i.e. the means must be
within the definitions as a whole but the result may not be external. In other words the
means or cause of accident must be within the definitions but the result or effect need
not be external or visible so long as it is bodily injury e.g. injury may be internal i.e.
inside the body but the result must be death or disablement.
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 e) Disablement : When a person is prevented by an accidental bodily injury from
engaging in any occupation or business he is said to be disabled and his ability to
attend to any occupation or business is call disablement.
FEATURES OF PERSONAL ACCIDENT
1) Offer & Acceptance; It is a prerequisite of any contract. Similarly the person will be insured under
personal DIPLOMA IN INSURANCE SERVICES MODULE - 4 Notes Personal Accident Insurance Practice
of General Insurance 62 accident insurance policy after the offer is accepted by the insurance company.
Example: A proposal submitted to the insurance company along with premium on 1/1/ 2011 but the insurance
company accepted the proposal on 15/1/2011. The risk is covered from 15/1/2011 and any loss prior to this
date will not be covered under fire insurance.
2) Payment of premium: An owner must ensure that the premium is paid well in advance so that the risk can
be covered. If the payment is made through cheque and it is dishonored then the coverage of risk will not exist.
It is as per section 64VB of Insurance Act 1938.(Details under insurance legislation Module).
3) Contract of Indemnity: This principle is not applicable to personal accident policy. This is so because life
is invaluable and no amount of money can compensate the death or disablement of a human being. When
polices are issued to employer to reimburse under service conditions the amounts of compensation paid by
them to their employees or their dependents on the disablement or the death of their employees i:e the insured
are indemnified with the exact amount of compensation paid by them.
4) Utmost good faith: The person must disclose all the relevant information to the insurance than company
while insuring himself because none other him knows about his health and other relevant particulars. Any
change in profession or occupation during the policy should also be informed to the insurance company. e.g. A
person is working in the office in administrative job and took the personal accident policy but later on he
becomes pilot then he should inform o the insurance company otherwise the insurance company can refuse the
claim in case it arises.
5) Insurable Interest: A person is having an unlimited interest in his own life and as such this feature is valid
in this policy. Similarly the wife has unlimited interest in the life of husband and vice versa. The employer has
the insurable interest in the life his employees.
6) Contribution: As the principle of indemnity is not applicable to this policy therefore the principle of
MODULE - 4 Practice of General Insurance Notes 63 Personal Accident Insurance DIPLOMA IN
INSURANCE SERVICES contribution will also not apply. The person will get sum insured of all personal
insurance policies irrespective of number of polices.
7) Period of Insurance: The period of insurance is to be defined in the policy which varies form one year to
five years. Some times this policy is issued for specific rail/ road/sea journey.
8) The cover under this policy is for 24 hours and on a worldwide basis. Even if the insured person dies in
foreign country due to accident the compensation will be paid in India in Indian rupees up to the sum insured.
9) Claims: To get the compensation under personal accident insurance the legal heirs should inform to the
insurance company about the death of the insured and incase of disability the person himself can inform the
insurance.

COVERAGE’S /COMPENSATION
a) Death: If a person dies due to an accident the risk is covered under the personal accident
policy. His legal heirs are entitled to get the sum insured. e.g. If the sum insured is Rs 1.00
lakhs and in case of death his legal heirs will get Rs 1.00 lakhs as compensation.
b) Disability: Disability can be classified further as follows: z Permanent Total
Disability(PTD) z Permanent Partial Disability(PPD) z Temporary Total Disability (TTD)
Permanent Total Disability: As the name indicates the disablement is of permanent and
irrecoverable nature and is absolutely total and the insured is unable to engage in the gainful
employment. Under this disability the compensation is equal to the sum insured. Example of
PTD: z Loss of sight of both eyes z Loss by physical separation of two entire hands or entire
feet z Loss of one hand and one foot DIPLOMA IN INSURANCE SERVICES MODULE - 4
Notes Personal Accident Insurance Practice of General Insurance 64 z Person in comma for
— 24 —
 longer period will also be treated as PTD .
Paralysis Permanent Partial Disability: The disability is not total but partial. e.g. Loss of toe or
a finger. The compensation will be based on the percentage of the disability and it will defined
in the policy and if it not defined then as per doctor certificate the compensation is paid.
Temporary total disablement: As the name implies this is a disablement which is total but for a
temporary period only. The temporary may be days, weeks, months or even years. The payment
is on weekly basis.
c) Carriage of dead body: The expenses incurred for a carriage of dead body of insured due
to accident to place of residence are reimbursed. The reimbursement is some percentage of the
sum insured say 2% of sum insured but maximum Rs 2500/-. This amount will be over & above
the sum insured.
f) Education amount for children: Incase of death or permanent disablement of the
insured person the insurance company also pays the education for two children if the age is
below 25 years of those children.
g) Modification of the house: In case of the permanent disablement of a insured
person, he has to modify his house for his free movement the expenditure of such modification
will be reimbursed by the insurance company up to certain limit of the sum insured.

JANATA PERSONAL ACCIDENT

Brief Description :
Any person irrespective of sex, occupation and profession in the age group of 10 to 80 years may be covered
under JANATA PERSONAL ACCIDENT POLICY.

Scope Of Cover
This insurance will pay to the Insured (or in case of death, to the assignee) the amount shown against the table of
benefits, if the insured shall sustain any bodily injury resulting solely and directly from accident caused by outward
violent and visible means and such bodily injury within the twelve calendar months of its occurrence be the sole
and direct cause of:

— 25 —
 Table Of Benefits Sum Insured Payable
a Death 100% of S.I.
.
Total and irrecoverable loss of sight of both eyes or 100% of S.I.
b
loss of use of two hands or feet or loss of sight of one
.
eye and loss of use of hand or foot.
c Total and irrecoverable loss of sight of one eye or loss 50% of S.I.
. of use of one hand or foot.
d Permanent total disablement due to accident 100% of S.I.
.

SUM INSURED :

The policy may be issued for minimum sum insured of Rs.25,000/- per person per annum and the maximum sum
insured is to be limited to Rs.5,00,000/- person per annum. Income proof is required if sum insured is more than
Rs.3 lakhs.

PREMIUM :

The rate of premium is Rs.15/- for a sum insured of Rs.25,000/-. The sum insured shall be increased in multiples
of Rs.25,000/- and premium is charged accordingly

EXCLUSIONS :

1.Any existing disability.

2.Death injury or disablement due to intentional self injuries, suicide or attempted suicide.
3.Disablement or death under influence of liquor or drug.
4.Death or disablement during racing, shooting, big game hunting, mountaineering, ice hockey, winter sports.
5.Insanity.
6.Breach of law with criminal intention.
7.War group of perils.
8.Nuclear group of perils.

CLAIMS PROCEDURE:

1.Immediate notice to be given to the Policy issuing office.

2.Claim form to be submitted with medical certificate and bills.
3.For death claim, nominees should submit:

 Death Certificate
 Original Policy
 Claim Form
 Postmortem Report
 Police Report, if complaint is lodged
4.Claims of persons presumed to be dead due to drowning may be settled after two years of the submission of the
following documents :

 Police report and final investigation report

 Report of findings by Customs/Port Authorities
 Affidavit duly notarized
5.Subject to above, claims of persons of fishing vessels which is missing or a total loss will be presumed dead and
claim settled accordingly.
— 26 —
OVERSEAS MEDICLAIM POLICY
WHEREAS THE INSURED PERSON is designated in the Policy Schedule here to having by a proposal and
declaration (and Medical History and Physician’s Report and certificate, if any) which shall be the basis of the
contract and shall be deemed to be incorporated therein, applied to The Oriental Insurance Company Limited
(hereinafter called the insurers) for the insurance hereinafter set forth and having paid the premium for the
insurance specified hereinafter for the number of days stated in the Policy Schedule.

HERITAGE is Heritage Health Services Private Limited, who provides assistance to the insured person whilst in
India. Their address is – Unit 28, Ground Floor, T.V. Industrial Estate, Hind Cycle Road (Behind Glaxo) Worli
Mumbai. Email: heritagehealth@vsnl.net
MEDICAL ADVISORS are medical Practitioners appointed by American assist Travel Services / Heritage.
PHYSICIAN means a person legally qualified to practice in medicine or surgery including other legally qualified
medical practitioner duly licensed by their respective jurisdiction which person is not a member of the insured
person’s family.
MEDICAL RELATED EXPENSES REASONABLY AND NECESSARILY INCURRED means expenses that in the
opinion of the treating physician and American assist Travel Services are medically necessary in order to maintain
life and/ or relieve immediate pain or distress for illness/disease accident first manifested/occurring during the
period of insurance.
PERMANENT TOTAL DISABLEMENTmeans a condition wherein the insured person is permanently, totally and
absolutely disabled from engaging in any employment or occupation of whatsoever description.
LOSS OF EYEmeans the total and irrecoverable loss of sight from one or more eyes.
LOSS OF LIMB means the loss of a hand or foot by permanent physical severance at or above the wrist or ankle
including total and permanent loss of use of a hand or foot.
CHECKED BAGGAGEmeans the baggage handed over by the Insured Person and accepted by an International
Airlines / carrier outside India for transportation in the same mode of conveyance as the Insured Person travels
and for which the carrier has issued a baggage receipt.
VALUABLESmeans photographic, audio, computer, telecommunication and electrical equipment, telescopes,
binoculars, spectacles, sunglasses antiques, watches, jewellery, furs and articles made of precious stones and
metals.
PERIOD OF INSURANCE
This insurance is valid from the First Day of Insurance or date and time of departure from India, whichever is later,
subject to General Condition [1 (i) ] and expires on the last day of the number of days specified in the policy
schedule or on return to India whichever is earlier.
Extension of the period of insurance is automatic for the period not exceeding 7 days, and without extra charge if
necessitated by delay of public transport services beyond the control of the Insured Person.
When injury/illness/ accident covered under this policy is contracted during policyperiod and treatment for the
same commences during the period and continues beyond the expiry date of this policy, only emergency expenses
would be paid up to 45 days from the date of expiry of the policy provided the insured person is medically
incapable of travel. American assist Travel Services must be notified immediately as soon as it is known that
insured person is unfit to return to India. If any new illness/injury/accident is contracted beyond the expiry date of
the policy, treatment for the same would not be covered.
GENERAL CONDITIONS APPLICABLE TO ALL SECTIONS
The conditions below apply throughout this insurance. Failure to comply with them may be prejudicial to a claim.
1. (i) The policy will be valid only if the insured journey commences within 14 days of the first day of Insurance as
indicated in the policy schedule.
(ii)Cancellation of the policy may be done ONLY in cases where a journey is not undertaken and ONLY on
production of the Insured person’s PASSPORT as a proof that the journey has not been undertaken. Any request
for cancellation will be entertained not less than 14 days after the First Day of Insurance as indicated in the policy
schedule. Such cancellation will be subject to deduction of cancellation charges by the underwriters as applicable.
(iii)No refund of premium or part thereof will be allowed in case insured person returns to India before expiry of
policy.
— 27 —
2. It is a condition precedent to liability hereunder that in the event of any occurrence likely to give rise to a claim
under this Insurance, that the Insured Person, or his representative, must notify American assist Travel Services
immediately. The Insured person or his representative should quote American assist Travel Services as much
information concerning the illness, accident or occurrence as is available, including the name of the treating doctor,
name and telephone number of the hospital, the OMP policy number and its date of issue.
For minor claims exceeding deductible, American assist Travel Services/ Heritage should be contacted upon
return to the Republic of India, and a claim form completed.
This document, together with invoices, travel documents and any other relevant details must be sent to American
assist Travel Services / Heritage, clearly stating under which section of this policy a claim is being made. Please
note that if medical treatment has been received, medical certificates showing the nature of the injury or illness
together with all bills, and receipts if already paid, should be forwarded to American assist Travel Services /
Heritage.
In no event should a claim be notified to American assist Travel Services / Heritage later than 31 days after the
end of an insured trip.
3.Insurers shall be fully and completely subrogated to the rights of the Insured Person against parties who may be
liable to provide indemnity or make a contribution in respect of any matter which is the subject of a claim under this
insurance .The Insured Person further agrees to co- operate fully with insurers in seeking such indemnity or
contribution including where appropriate, insurers instituting proceedings at their own expense against such parties
in the name of the Insured Person.
4.The Insurers may require the Insured Person to furnish at his own expense all certificates, information, proofs or
other evidence of claims. The insurers may approach any physician who may have treated the Insured Person,
and the Insured Person must co- operate in this respect.
5.No person shall admit liability or make any offer or promise of payment without the express written consent of the
Insurers / American assist Travel Services.
6.The Insured Person shall take all reasonable and proper care to safeguard against accident or illness or loss of
or damage to his property, as if this insurance was not in force. Failure to do so will prejudice the Insured Person’s
claim under this insurance.
7.The Insured Person may not transfer his interest in this insurance. However, the legal representatives of the
Insured Person shall have the right to act for the Insured Person who is incapacitated or deceased.
8.This insurance does not operate beyond a period of 180 days continuous absence from the Republic of India
unless specifically agreed by Insurers.
9.This policy and the Overseas Mediclaim Policy Schedule shall be read together as one contract and any wording
or expression to which a specific meaning has been attached in any part of the Overseas Mediclaim Policy and
Schedule shall bear such specific meaning wherever it may appear.
10.Dispute resolution clause and procedure : This Contract of insurance includes the following dispute resolution
procedure which is exclusive and a material part of this Contract of Insurance.

NATURE OF COVERAGE

This policy is not a general health insurance policy. Coverage under the medical expense section of this insurance
is intended for use by the Insured person in the event of a sudden and unexpected sickness or accident arising
when the insured person is outside the Republic of India.
b).Pre-existing Exclusions : This policy is not designed to provide an indemnity in respect of medical services,
the need for which arises out of a pre-existing condition as defined below in General Condition 10 (c).
c).Pre-existing condition : Any sickness for which the Insured Person has sought medical advice or has taken
medical treatment in the preceding 12 months prior to the commencement of travel.
— 28 —
 d).Prior Consultation : Any medical services or series of services with a cost of greater than US$ 100 shall not be
covered by this policy unless the Insured Person consults with American assist Travel Services in the manner set
out in the General Condition number 2.
e).Choice of Law : The parties to this insurance policy expressly agree that the laws ofthe Republic Of India shall
govern the validity, construction, interpretation and effect of this policy.
11.Arbitration : Any claim, controversy or dispute of any kind or nature arising out of or relating to this Contract of
Insurance or breach thereof or to the construction, existence , interpretation , meaning or validity thereof or to the
operation or performance thereunder, involving any of the parties, or anyone claiming the rights of any party to this
contract shall be by arbitration in the Republic of India in accordance with the provisions of The Indian Arbitration
and Conciliation Act 1996 as amended from time to time and for the time being in force, and it is the intent and
purpose of the parties hereto, to make the submission to arbitration or any dispute or controversy arising out of this
condition precedent to any legal or equitable action or proceeding of any nature.
12.Any claim under this policy that is fraudulent, or if fraudulent means are used to secure payment of benefits
under this policy, then such action shall render this policy null and void and all claims hereunder shall be forfeited.
13.No sum payable under this policy shall carry interest.
14.In the event of the Insured Person's death, Insurers shall have the right to carry out a post mortem at their
expenses.
15.Any claim which has not been conclusively proven and the amount thereof substantiated shall not be payable.

— 29 —
CHAPTER - 2

PRINCIPLES OF ISNURANCE

Interest
Indemnity
Subrogation
— 30 —
Utmost good faith
Contribution
Proximate cause
Loss minimization
Mitigation
Benefit insurance
Formation of insurance contracts and disclosure
Accident
Contractual protections
Insured risks
Pooling of risk
Underinsurance
Consumer protection

— 31 —
 Insurance - Meaning and Definition

The literal meaning of insurance would be an assurance against unforeseen and unfortunate loss. This
means, that if you encounter a less than normal event in your normal course of life, and happen to incur
a financial loss because of it, you can be compensated.

For example, you met with an accident on your way to the office in your car and the car suffers damage.
Your insurer can reimburse the repair expenses in this case. However, the insurer will not reimburse
normal wear and tear like a headlamp stopped working.

Legally insurance has been defined as a contract where the insurer agrees to compensate the insured
against the losses incurred due to any unforeseen contingency. The contract also involves a
consideration which is called a premium. The maximum available benefit amount is called sum assured
or sum insured.

LEAGL CONCEPTS OF THE INSURACE CONYRACTS

 Offer & Acceptance

 Consideration
 Legal Purpose
 Competent Parties
 Aleatory - Adhesion
 Unilateral
 Conditional
 Utmost Good Faith - Warranty - Representation - Concealment - Insurable Interest - STOLI
 Express Authority
 Implied Authority - Apparent Authority
 Waiver
 Void/Voidable Contract

Offer and Acceptance

— 32 —
To be legally enforceable, a contract must be made with a definite, unqualified proposal (offer) by one party and
the acceptance of its exact terms by the other. In many cases, the offer of an insurance contract is made by the
applicant when the application is submitted with the initial premium. The insurance company accepts the offer when
it issues the policy as applied for. When an offer is answered by a counteroffer, the first offer is void.

Consideration
For a contract to be enforceable, the promise or promises it contains must be supported by consideration.
Consideration can be defined as the value given in exchange for the promises sought. In an insurance
contract, consideration is given by the applicant in exchange for the insurer’s promise to pay benefits. It also
consists of the application and the initial premium. This is why the offer and acceptance of an insurance contract are
not complete until the insurer receives the application and the first premium. The Consideration clause also contains
information such as the schedule and amount of premium payments.

Legal Purpose
To be legal, a contract must have a legal purpose. This means that the object of the contract and the reason the
parties enter into the agreement must be legal. A contract in which one party agrees to commit murder for money
would be unenforceable in court because the object or purpose of the contract is not legal. Insurance contracts are
always considered to possess a legal purpose.

Competent Parties
To be enforceable, a contract must be entered into by competent parties. With a contract of insurance, the parties to
the contract are the applicant and the insurer. The insurer is considered competent if it has been licensed or authorized
by the state(s) in which it conducts business. The applicant, unless proven otherwise, is presumed to be competent
with three possible exceptions:

► Minors

► The mentally infirm

► Those under the influence of alcohol or narcotics Each state has its own laws governing the legality of minors and
the mentally infirm entering into contracts of insurance. These laws are based on the principle that some parties are
not capable of understanding the contract they agree to.

Aleatory

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Insurance contracts are aleatory. This means there is an element of chance and potential for unequal exchange of
value or consideration for both parties. An aleatory contract is conditioned upon the occurrence of an event.
Consequently, the benefits provided by an insurance policy may or may not exceed the premiums paid. For example,
an individual who has a disability insurance policy will collect benefits if she becomes disabled. However, if no
disability strikes, benefits are not paid. Both insurance and gambling contracts are typically considered aleatory
contracts.

Adhesion
Insurance contracts are contracts of adhesion. This means that the contract has been prepared by one party
(the insurance company) with no negotiation between the applicant and insurer. In effect, the applicant
“adheres” to the terms of the contract on a “take it or leave it” basis when accepted. Any confusing language
in a contract of adhesion would be interpreted in favor of the insured. The purpose is to correct any advantage
that may result for the party who prepared the contract. A policy of adhesion can also be described as one which
the insurance company can modify.

Unilateral
Insurance contracts are unilateral. This means that only one party (the insurer) makes any kind of enforceable
promise. Insurers promise to pay benefits upon the occurrence of a specific event, such as death or disability. The
applicant makes no such promise. In fact, the applicant does not even promise to pay premiums. The insurer cannot
require the premiums to be paid. Of course, the insurer has the right to cancel the contract if premiums are not paid.

Conditional
An insurance contract is conditional. This means that the insurer’s promise to pay benefits depends on the occurrence
of an event covered by the contract. If the event does not materialize, no benefits are paid. Furthermore, the insurer’s
obligations under the contract are conditioned on the performance of certain acts by the insured or the beneficiary.
For example, the timely payment of premiums is a condition for keeping the contract in force. If premiums are not
paid, the company is relieved of its obligation to pay a death benefit.

Valued or Indemnity
An insurance contract is either a valued contract or an indemnity contract. A valued contract pays a stated sum
regardless of the actual loss incurred. Life insurance contracts are valued contracts. If an individual acquires a life
insurance policy insuring her life for $500,000, that is the amount payable at death. There is no attempt to value
actual financial loss upon a person’s death.

An indemnity contract, however, is one that pays an amount equal to the loss. Contracts of indemnity attempt to
return the insured to their original financial position. Fire and health insurance policies are examples of indemnity
contracts. An insured that owns a $50,000 fire insurance policy and suffers a $5,000 loss due to fire will be able to
collect up to $5,000, not $50,000.
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 Utmost Good Faith
Insurance is a contract of utmost good faith. This means both the policyowner and the insurer must know all material
facts and relevant information. There can be no attempt by either party to conceal, disguise, or deceive. A consumer
purchases a policy based largely on the insurer and agent’s explanation of the policy’s features, benefits, and
advantages. Insurance applicants are required to make a full, fair and honest disclosure of the risk to the agent
and insurer. Concepts related to utmost good faith include warranties, representations, and concealment. These
represent grounds through which an insurer might seek to avoid payment under a contract.

Warranty
A warranty in insurance is a statement made by the applicant that is guaranteed to be true in every respect. It
becomes part of the contract and, if found to be untrue, can be grounds for revoking the contract. Warranties are
presumed to be material because they affect the insurer’s decision to accept or reject an applicant.

Representation
A representation is a statement made by the applicant that they consider to be true and accurate to the best of the
applicant’s belief. It is used by the insurer to evaluate whether or not to issue a policy. Unlike warranties,
representations are not a part of the contract and need be true only to the extent that they are material and related to
the risk. Statements made by applicants for insurance are considered to be representations and not warranties.

Concealment The issue of concealment is also important to insurance contracts. Concealment is defined as
the failure by the applicant to disclose a known material fact when applying for insurance. If the purpose for
concealing information is to defraud the insurer (that is, to obtain a policy that might not otherwise be issued if the
information were revealed), the insurer may have grounds for voiding the policy. Again, the insurer must prove
concealment and materiality.

In most cases, life insurers have only a limited period of time to uncover false warranties, misrepresentations, or
concealment. After that time period passes (normally two years from policy issue), the contract cannot be voided or
revoked for these reasons.

Insurable Interest
Another element of a valid insurance contract is insurable interest. Insurable interest is a component of legal
purpose. This means that the person acquiring the contract (the applicant) must be subject to loss upon the
death, illness, or disability of the person being insured. To have “an insurable interest” in the life of another
person, an individual must have a reasonable expectation of benefiting from the other person’s continued life.
A policy obtained by a person not having an insurable interest in the insured is not valid and cannot be enforced.
Thus, insurable interest must exist between the applicant and the individual being insured. When the applicant is the
same as the person to be insured, there is no question that insurable interest exists. Individuals are presumed to have
insurable interest in themselves.
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It is important to note that insurable interest must only exist at the time of the application of a life or health
insurance contract. It doesn’t have to continue throughout the duration of the policy nor does it have to exist at the
time of claim.

Stranger-Originated Life Insurance (STOLl)

Stranger-Originated Life Insurance (STOLI) transactions are life insurance arrangements where investors persuade
individuals (typically seniors) to take out new life insurance, naming the investors as beneficiary. This is
sometimes called Investor-Originated Life Insurance (IOLI). These arrangements are used to circumvent state
insurable interest statutes.

Generally, the investors loan money to the insured to pay the premiums for a defined period (usually two years based
on the life insurance policy’s contestability period).

Eventually the insured assigns ownership to the investors, who receive the death benefit when the insured dies. In
return, the seniors receive financial incentives. This normally includes: an upfront payment, a loan, or a small
continuing interest in the policy’s death benefit. After the two year period, the investors make the premium payments
on behalf of the insured.

AGENTS AND BROKERS

Contracts of insurance are binding and enforceable. As such, all parties to the contract (the insurer and the applicant)
are subject to specific legal requirements. We discussed some of the more important regulations that states impose on
people who solicit and sell insurance. Next, we will focus on the legal aspects of negotiating and issuing contracts of
insurance.

The Law of Agency

As noted earlier, an agent is an individual who is authorized by an insurer to sell its goods and services on its behalf.
An agent’s role involves the following duties:

► Describing the company’s insurance policies to prospective buyers and explaining the conditions under which the
policies may be obtained

► Soliciting applications for insurance

► Collecting premiums from policyowners

► Rendering service to prospects and to those who have purchased policies from the company

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The authority of an agent to undertake these functions is clearly defined in a “contract of agency” (or agency
agreement) between the agent and the company. Within the authority granted, the agent is considered to be the
insurance company. The relationship between an agent and the company represented is governed by agency law.

Principles of Agency Law

By legal definition, an agent is a person who acts for another person or entity (known as the principal) with regard to
contractual arrangements with third parties. An authorized agent has the power to bind the principal to contracts (and
to the rights and responsibilities of those contracts). With this in mind, we can review the main principles of agency
law:

► The acts of the agent (within the scope of his authority) are the acts of the principal

► A contract completed by an agent on behalf of the principal is a contract of the principal

► Payments made to an agent on behalf of the principal are payments to the principal

► Knowledge of the agent regarding business of the principal is presumed to be knowledge of the principal

Agent Authority
Agent authority is another important concept of agency law. Authority is what’s given by an insurer to a licensee
to transact insurance on their behalf. Technically, only those actions for which an agent is actually authorized can
bind a principal. In reality, an agent’s authority can be quite broad. There are three types of agent authority: express,
implied, and apparent. Let’s take a look at each.

1. Express authority. Express authority is the authority a principal deliberately gives to its agent. Express
authority is granted by means of the agent’s contract, which is the principal’s appointment of the agent to act on its
behalf. For example, an agent has the express authority to solicit applications for insurance on behalf of the
company.
2. Implied authority. Implied authority is the unwritten authority that is not expressly granted, but which the
agent is assumed to have in order to transact the business of the principal. Implied authority is incidental to
express authority because not every single detail of an agent’s authority can be spelled out in the agent’s contract.
For example, an agent’s contract may not specifically state that he can print business cards that contain the
company’s name, but the authority to do so is implied.
3. Apparent authority. Apparent authority is the appearance or assumption of authority based on the actions,
words, or deeds of the principal. It can also exist because of circumstances the principal created. For example,
by providing an individual with a rate book, application forms, and sales literature, a company creates the
impression that an agency relationship exists between itself and the individual. The company will not later be
allowed to deny that such a relationship existed.

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► The significance of authority (whether express, implied, or apparent) is that it ties the company to the acts and
deeds of its agents. The law will view the agent and the company as one and the same when the agent acts within the
scope of his authority. ► An insurer may be liable to an insured for unauthorized acts of its agent when the
agency contract is unclear about the authority granted.

Agent as a Fiduciary
Fiduciary is another legal concept which governs the activity of an agent. A fiduciary is a person who holds a position
of financial trust and confidence. Agents act in a fiduciary capacity when they accept premiums on behalf of the
insurer or offer advice that affects a person’s financial security.

Brokers versus Agents

Unlike agents, brokers legally represent the insureds. A broker (or independent agent) may represent a number of
insurance companies under separate contractual agreements. A broker solicits and accepts applications for insurance
and then places the coverage with an insurer.

Professional Liability Insurance (E&O)

Just as doctors should have malpractice insurance to protect against legal liability arising from their professional
services, insurance agents need errors and omissions (E&O) professional liability insurance. Under this insurance,
the insurer agrees to pay sums that the agent legally is obligated to pay for injuries resulting from professional
services that he rendered or failed to render.

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 aiver
A waiver is the voluntary giving up of a legal, given right. If an insurer fails to enforce (waives) a provision of a
contract, it cannot later deny a claim based on a violation of that provision.

Estoppel
The concepts of waiver and estoppel are closely related. Estoppel is the legal impediment to one party denying the
consequences of its own actions or deeds if such actions or deeds result in another party acting in a specific manner or
if certain conclusions are drawn. In other words, it is the loss of defense.

Parol Evidence Rule

Parol evidence is oral or verbal evidence, or that which is given verbally in a court of law. The parol evidence rule
states that when parties put their agreement in writing, all previous verbal statements come together in that writing
and a written contract cannot be changed or modified by parol (oral) evidence.

Void versus Voidable Contracts

The terms void and voidable are often incorrectly used interchangeably. A void contract is simply an agreement
without legal effect. In essence, it is not a contract at all, for it lacks one of the elements specified by law for a valid
contract. A void contract cannot be enforced by either party. For example, a contract having an illegal purpose is
void, and neither party to the contract can enforce it. An insurer may also void an insurance policy if a
misrepresentation on e application is proven to be material. **voidable contract is an agreement which, for a
reason satisfactory to the court, may be set aside by one of the parties to the contract. It is binding unless the party
with the right to reject it wishes to do so. Say that a situation develops under which the policyholder has failed to
comply with a condition of the contract: the policyholder ceased paying the premium. The contract is then voidable,
and the insurance company has the right to cancel the contract and revoke the coverage.

Fraud
In the event of fraud, insurance contracts are unique in that they run counter to a basic rule of contract law. Under
most contracts, fraud can be a reason to void a contract. With life insurance contracts, an insurer has only a limited
period of time (usually two years from date of issue) to challenge the validity of a contract. After that period, the
insurer cannot contest the policy or deny benefits based on material misrepresentations, concealment, or fraud.

DOCUMENTATION

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The insurance industry depends on documents for most of their work. This creates a need to simplify the creation of
these insurance documents. Templates offer a quick way to create documents for insurance claim among others,
especially those that are needed often and may require repeated actions to produce.
By creating templates for the following different types of insurance documents, insurance firms can make their work
easier and reduce the amount of time spent preparing documents for clients.

Insurance Quote Templates

Before an organization or individual signs up for insurance, they will be interested in knowing how much it will cost
them. Marketers and sales agents in insurance companies constantly need to generate quotations for possible clients.
An insurance quote sheet template for this document makes it easier to generate several quotations and deliver them
to clients without errors.
A typical insurance quote template Word would include the following sections:
1. Introduction Statement: This could be a brief letter describing the insurance company and letting the prospect
know what you stand for and what you represent in the insurance quotation template.
2. Product List: This insurance estimate format section has the full list of insurance packages that the insurance
company provides. Some insurance companies choose to focus on the packages that would interest the prospect while
others will mention everything they offer.
3. Pricing: This section is what would interest the prospect the most. It shows the premiums paid for different
policies as well as what is covered under those premiums. The pricing is usually for only the policies that apply to the
prospect. For example, a medical practice would not need quotes related to a hotel.
4. Terms and Conditions: This section explains the conditions under which the policy will be issued. These need to
be error-free and that is why having them as part of the template is important.

Insurance Policy Template

Every new client will need an insurance policy document that spells out what the insurance covers. These documents
for insurance policy have five parts and most of the information contained here is the same for all policies. Having an
insurance policy form template instead of copying and pasting sections would make it faster and easier.
Whether it is a life insurance template or a home insurance policy template it needs to have the following parts:
1- Declaration: This has the details of the insured individual or company, the type of insurance being provided, the
limit of coverage as well as the premium. The declaration is the summary of the policy. This part may have some
variables that need to be filled.
2- Agreements: This part has information regarding what the insurance company is ready to pay for in case the
insured risk befalls the client. There may be many agreements listed within the policy. An insurance form template
makes the process of producing this section faster.
3- Definitions: Some words or phrases are unique to insurance documents and so may have a slightly different
meaning from ordinary use. This part of the policy clarifies the meaning of such words. This helps policyholders
understand what the insurance policy covers.
4- Exclusions: This helps to clarify what may not be covered under the policy. Exclusions also can specify what is
covered (and to what extent).
5- Conditions: This section determines under what conditions the insurance company will provide cover under the
policy. For example, it will pay for the theft of property from a client’s home on condition there is evidence of forced
entry.

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 Insurance Letters
Insurance companies communicate with their clients often and letters are a common medium for communication. To
save time that would be spent drafting letters, insurance companies can have templates for these letters.
Insurance letters that need templates are usually notifications. These notify clients about progress made in their
claims processing, expiry of their policy as well as adjustments made to the policy or claims. These insurance
documents or letters need to have a standard flow and must be free of error.
Most parts of notification letters remain the same, so it is possible to have templates for them. The sections of the
insurance letter sample can include:
1. Address: The address of the insurance company and includes the logo of the company clearly at the top. The
information on this part does not change.
2. Particulars of Recipient: This is a variable section that can be populated according to the intended recipient's
information. It will comprise the name of the correspondent, address, policy number (where applicable)
3. Date: The date the letter was authored must be included. Sometimes a letter may be urging the correspondent to
take action within a given period from the date the letter was issued.
4. Body: This part of the letter contains the important information that the insurance company wishes to convey to the
recipient. The greater part of the body of the letter is standard except for variable fields like dates and figures.
5. Sign off: This part has the signature of the author of the letter or authorizing officer and where necessary, it will be
copied to other stakeholders.

Certificates of Insurance
Every time an insurance policy is approved, the policyholder is issued a certificate of insurance. This insurance
document contains a summary of the insurance policy as well as details of the holder of that policy. It is important
that no mistakes are made on this document and having a template for the document can eliminate errors.
Although there is no particular format for a certificate of insurance form, there are certain fields that need to be
included in the template. These include:
1. Date: This shows when the certificate of insurance are issued in. There is also another field that will show the
duration of the policy. It will show the start date and the expiry date.
2. Disclaimer: This section summarizes the nature of the insurance with limitations included.
3. Insurer: The name and particulars of the insurance broker that is issuing the certificate.
4. Policy Holder: This field contains the name of the individual or organization that is being insured. It will include
other details that help to identify the policyholder including the policy number.
5. Insurance Cover: This field spells out what the insurance policy covers. It is the section that most people pay
attention to when they ask for the certificate as it gives proof that the certificate holder is insured for a particular
liability. It can contain more than a single cover if the insured has multiple covers.
6. Liability Limit: This field gives the exact amount of money that would be paid as compensation under the
premium paid.
7. Additional Information: An extra field can include information like a list of items covered under the policy for
example a list of vehicles insured by an organization. It can also inform the holder about the means of communication
that will be used to notify them when the policy has been canceled.
8. Declaration: Some certificates will include a section where the parties involved declare their commitment to honor
the policy details.
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9. Signatures: This field contains signatures of the insurance company and the insurance broker.

Insurance Claims Documents

Insurance claims documents are detailed reports that need to be organized in a manner that makes them easy to read.
Having a template that structures documents required for insurance claim in a particular way will help achieve that
aim. The documents required for the settlement and claims of insurance policy will need templates and these include:
1. Medical Reports: For medical insurance, the claims template would be structured in a way that all the necessary
medical information can be captured to ascertain the amount of money to be paid towards settling the medical bills.
2. Accident Reports: For auto insurance, accidents are a common claim. The report template has a structure to be
followed when compiling and creating this report.
3. Inventory: In the case of loss or damage to property, the claims document will list all the property that has been
lost or damaged. The items will also be valued so that compensation can be made.
4. Third-party Claims: In case the insured person has caused injury or loss to a third party, an assessment is made
and the results of that are entered into the claims document. Different insurance companies can choose how these
document templates can be structured.

Insurance Loss Adjustment Documents

When a claim notice is issued, the insurance company uses loss adjusters to determine the liability of the insurance
company. The number of loss adjustment documents that may need to be produced by a single insurance company is
just as many as the claims and that is why templates are needed for the claim adjustment process. The template will
help to quicken the process of loss adjustment so that the client can get a settlement as soon as possible.

Money Insurance Policy

Brief Description

Cash insurance is a cover which indemnifies the insured against loss of money. Money

includes current coin, Bank and currency notes, cheques, postal orders, and current

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 postage stamps. There are four situations where loss is covered. Cover is available for

money drawn for the payment of wages, salaries and other earnings or for petty cash in

direct transit from the bank to the insured premises. Money other than described in item

in the personal custody of the insured or the authorized employees of the insured whilst

in direct transit between the premises and the bank or Post Office Money other than

described in item collected by and in the personal custody of the Insured or the

authorized employees of the insured whilst in transit to the premises or bank within a

period not exceeding .

Covered Risks
 (i) Robbery, theft / fortuitous act in case of Money in transit.

 (ii) Burglary/ Housebreaking/ Robbery/ Holdup while Money is in safe/ premises/

strong room.

48 hours from the time of collection Cash other than described in item while on the
premises during business hours or whilst secured in locked safe or locked strong room
on the insured’s premises.

Major Exclusion
Shortage of money due to error or omission, loss of money entrusted to any
person other than the Insured or an authorized employee of the insured (for full
details refer to the policy), Consequential loss, Loss due to war and warlike
operation.

Industrial All Risk Policy

Industrial All Risk Policy (IAR)
Material Damage, Machinery Breakdown and Business Interruption can lead to heavy losses in a business. The
Industrial All Risk Policy is a protecting solution that protects your business from financial implications in the case of
material damage or breakdown of machinery causing a halt in operations. This is a wider cover than the Standard Fire
and Perils policy.

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Key Benefits of the IAR Policy
 Complete coverage for the risks that threaten the industrial unit
This is a wider range of risks in comparison to a Fire Insurance Policy. It gives the insurer the benefit of
securing their business from a wider gamut of risks and not just fire.
 Option of coverage for Machinery Loss of Profits
The Industrial All Risk Policy also gives insurers the option of securing better coverage against losses
occurring due to machinery damage.
 Loss through interruption and interference of business covered
The Policy will cover losses occurring to a business when their business operations come to a halt or are
interfered with.

IAR Policy Eligibility

All industrial risks (other than risks ratable under Petrochemical Tariff) having an overall Sum Insured
of Rs. 100 crores and above in one or more locations in India shall be eligible for an Industrial All Risk
Policy. This policy provides cover against all risks/ perils other than those which are excluded in the
Policy.

IAR Policy Coverage

The policy protects your business in the event of –
 Material Damage
This includes material damage that might occur to a property that might require replacement of
assets like buildings, fixtures, inventory, etc.
 Business Interruptions
This is designed to cover loss of income that may occur due to business or service interruptions in
the event of a disaster leading to material damage/machinery breakdown causing a halt in
operations.
The Industrial All Risk Policy is important and relevant to several industries, especially those that need
large spaces, have a heavy worker population, are most likely to have round the clock operations, are
heavily dependent on electricity etc. These industries include:
 Cement Industries
 Metal Industries
 Power Plants
 Paper Mills
 Sugar factories
 Heavy Engineering
 Transmission line and sub stations
 Hospitality (Large Hotels)

Exceptions under the Industrial All Risk Policy

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With wider coverage offered in comparison to the traditional Fire Insurance and Special Perils policy, an
IAR Policy will protect businesses from an exhaustive list of perils under Material Damage. It however,
does not cover certain events.
 Faulty or defective design of materials, inherent vice, and wear and tear
Damage caused to the business because of faulty or defective material that might lead to a
rejection of the final product is not covered under the Industrial All Risk Policy.
 Collapse or cracking of buildings
Structural cracks in the industrial building leading to condemnation of the building, building
collapse etc are not covered under this insurance policy.
 Corrosion rust, shrinkage, loss of weight, contamination, etc
Any form of contamination of the final products caused by corrosion, shrinkage, loss of weight
etc are not covered by this policy.
 Larceny
The policy does not secure the business from theft on industrial property or any kind of pilferage.
 Dishonesty and inventory shortage
A shortage of inventory that might lead to halting of operations can lead to loss. However, these
losses are not covered by the Industrial All Risk Policy.
 Wilful negligence, cessation of work, and loss of market
Losses in the market, negligence of staff leading to any kind of perils are not covered under this
policy.
 War and war group of perils
A state of armed conflict among states or countries can lead to disruption of operations. This
however is not secured under the insurance policy.
 Nuclear group of perils
Losses occurring due to a halt in operations because of damage to nuclear reactors in the vicinity
of the industrial building are not covered under the Industrial All Risk Insurance Policy.
 Destruction of the property by order of public authority
Losses occurring due to halt of operations because of orders by any government authority are not
covered under this policy.

Sum insured and premium

The Sum Insured for Section I (Material Damage) relating to buildings, machinery, furniture, fixtures,
fittings and electrical installations shall be on Reinstatement Value basis only, while stocks shall be
covered on Market Value basis. The Sum Insured for machinery breakdown risk should be the same as
the Sum Insured of plant and machinery declared under fire, less the value towards piping and cabling.
The Sum Insured for Section II (Business Interruption) based on Annual Gross Profit and Indemnity
Period selected.
Indemnity Period i.e. the maximum period during which the business may remain interrupted, can be
chosen by the insured depending on the activities involved.

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The premium for a property insurance policy is dependent upon the type of cover opted, risk and
liability exposure, maintenance of the property and deductible opted under the policy.

BANIKNG IDMENITY POLICY

Bankers Indemnity Insurance is meticulously designed to cover the risks that come with working in the banking
industry. There is no denying the fact that banks handle public funds and are therefore vulnerable to risk when
dealing with cash and securities.

The risks are primarily associated with the event of a calamity in the bank’s premises, such as a fire, strike, burglary,
theft, robbery, riot, or hold-up case. With a comprehensive combination of coverage sections, Bankers Indemnity
Insurance aims to provide multi-faceted protection against the loss of money and securities.

Why Do Banks Need the Bankers Indemnity Insurance?

Over the last few years, banking sectors have witnessed a significant number of fraudulent activities. In
most of the cases, the losses were so massive that they left a cavernous hole on the balance sheets.

According to RBI, around 5,152 cases out of 23,000 were incidents of fraud in the year 2017-18, which
amounted to at least INR 285.59 billion. One can imagine the loss to the banks as well as the employees
working in it. Whether or not these losses will ever be reversible is still a matter of dilemma. However, what
is certain is the fact that each bank requires adequate insurance cover. Hence, having a Bankers
Indemnity Insurance emerges as a dire need among the banking world.

What Are the Features of Banker’s Indemnity Policy?

Some of the most important features of Banker’s Indemnity Policy are enumerated below:

1. Mixture Is Always Better!

Bankers Indemnity Insurance is a comprehensive policy that caters to the multiple needs of the banking
world. The clients can choose from a range of insurance limits, both for the “in-transit” and “on-premises”
sections.

2. What’s The Limit of Indemnity?

Under the Bankers Indemnity Insurance, the limit of indemnity doesn’t exceed the ‘Total Sum Insured’
given in the insurance plan.

Usually, the maximum aggregate loss per location or compound is around INR 10,000,000,000. In case
the aggregate loss suffered is more than INR 10,000,000,000, the amount payable will be reduced as per
the sum insured of the policy.

3. What’s In the Cancellation Clause?

There will be no refund of the premium when cancellation is done by the insured. Only the allocated refund
of the canceled policy premium will be authorized if the policy is canceled and rewritten in the middle of the

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term solely to coincide with the insured’s accounting year. If the cancellation is for any other reason, the
premium will only be refunded after short-term scale rates have been applied.

4. How Much Is the Excess?

On a general basis, around 0.5% to 2% of the sum insured is considered as ‘Excess’.

 For Industrial Risks: A minimum amount of around INR 1,00,000 and a maximum amount of INR 1,00,000,000.
 For Non-Industrial Risks: A minimum amount of around INR 25,000 and a maximum amount of INR 1,000,000.
 For Shops & Residences: A minimum amount of around INR 10,000 and a maximum amount of INR 500,000.

5. Retroactive Period Cover – Doesn’t Cover Your Past!

The retroactive period in Bankers Indemnity Insurance refers to the time period before the effective date of
the policy. The plan doesn’t exceed two years from the date of discovery of any loss for which this policy
will provide coverage. In addition, the insurance will continuously operate during the retroactive period, but
in no circumstances shall the insurance company be responsible to pay any claim in respect of a loss or
damage received prior to such retroactive period.

6. ‘Money’ – The Real Meaning Under the Policy!

The term ‘Money’ in Bankers Indemnity Plan is used to describe signed or unsigned banknotes, coins,
bullion, jewelry, ornaments, revenue stamps, postage stamps, stamp papers, and foreign currencies.

How Banker’s Indemnity Insurance Is Beneficial for Banks?

Enjoy All-Round Protection

Bankers Indemnity Insurance provides multi-faceted protection to various banks in three prominent ways:

 It provides coverage to the losses caused by employees, such as fraudulent acts, criminal acts, unauthorized alterations,
etc.
 It provides coverage to the losses caused by bank’s clients, such as forged checks, illegal transactions, etc.
 It covers losses caused by any other third party, such as robbery, forgery, terrorist attacks, etc.

Saves Your Professional Reputation

Having a strong and reliable professional reputation is a must for a bank. Any loss or damage to the
customer shall put the bank into various liabilities and risks. Therefore, the Bankers Indemnity Insurance
assists several banks to avoid the tarnishing of their names. In case your client or customer loses the
money, your bank will have the insurance to convince him/her, and thus to save your reputation.

Loss Due to ATM? – Cover Them Too!

The coverage can be extended to cover loss caused by any money and/or securities in the Automatic
Teller Machines (ATM) on the insured’s premises. An additional premium amount is to be paid for the
extension and it can be added at any time during the period of insurance.

Cover Losses Caused by ‘Act of God’

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The coverage can also be extended to cover the ‘Act of God’ or natural calamities, such as earthquakes,
subterranean fire, flood, volcanic eruption, typhoon, storm, cyclone, etc. An additional premium will be
charged with respect to the terms, conditions, inclusions, and exclusions of the policy.

What’s Covered?
 In-Transit Losses: Money and/or securities are covered if they are lost, misplaced, stolen, or misappropriated while in
transit in the employees’ hands, whether due to the employees’ negligence or fraud.
 On-Premises Losses: Money and/or securities belonging to a bank are protected against loss or destruction by fire,
strike, malicious damage, riot, terrorist act, theft, burglary, robbery, etc. on the banks or banker’s premises.
 Dishonest Acts: Covers losses in money and/or securities caused by its workers’ dishonesty or illegal acts.
 Forgery OR Unauthorized Alterations: Covers losses caused by the payment of counterfeit or fake cheques or drafts.
Besides, it also covers forged endorsements on legitimate cheques, drafts, or FDRs.
 Criminal Acts of Appraisers: Covers losses caused by appraisers’ infidelity or criminal acts, as long as the appraisers
are on the bank’s approved list.
 Hypothecated Goods: Covers damages incurred as a result of an employee’s fraudulent or dishonest behavior in
relation to goods/commodities hypothecated to the insured bank.

What’s Not Covered?

 Losses due to war and nuclear perils
 Losses caused due to computer frauds/faulty computer programming/manipulation of the data processing system
 Trading losses
 Consequential losses
 Negligent act or omission caused by an employee
 The wrongful act of directors
 Money or security pertaining to the loss before the inception of the policy period.

What’s The Claim Process?

In case of occurrence of any event included under the policy, the insured can raise a claim by following the
below-mentioned steps:

 Filing A Complaint: Firstly, the insured person is required to file a complaint against the act or incident of money loss.
 Apprehending & Taking Actions: Besides apprehending the guilty person, suitable departmental action should be
taken against the person.
 Send Notice to The Insurance Company: Once you are done with the above steps, send immediate notice to the
insurance company as soon as possible.
 Sending Details & Evidence: The bank now needs to send the information about the insured’s own expenses, amount
of loss or damage, and various other particular details to proceed further. Along with details, valid proofs or evidence
must also be submitted to the insurance company.
 Investigation: An investigation officer of the insurance company will go through the case to give it either a red or green
signal.
 Settlement of Claim: Once the insurance company gives a green signal, a substantial amount of coverage will be
provided to the insured bank.

— 48 —
CHAPTER-3
— 49 —
INSURANCE RELATED TO GRAMINA ACCIDENT
BIKE,CAR,NRI,CLAIMS AND SETTLEMENT PROCEDURE
AND LIVE STOCK INSURANCE.

Gramin Accident Insurance

Brief Description
We all in our day to day life are exposed to the risks of accidents.
Despite all possible precautions accidents do occur. This may result
into disablement or loss of limbs or sight in eyes or sometimes even
death. To cater to this need this cover is devised for any person
between the age group of 10 to 70 years irrespective of his occupation,
income, etc.

Covered Risks
This policy provides compensation in the event of death or permanent
total disablement or loss of limbs or sight in eyes.

Major Exclusions
— 50 —
 Intentional self injury, suicide or attempted suicide, Accident
while the insured is under the influence of intoxicating liquor or
drugs, loss caused by insanity, loss due to breach of law worth
criminal intent, War and allied perils, nuclear radiation.

What Is Bike Insurance?

Bike insurance is a contract between the bike owner and the insurance company, where the latter covers
any damage caused to the bike due to an accident, theft, or collision. The bike insurance plays a pivotal role
in safeguarding financial and legal obligations, which might arise in case of any unfortunate accident,
natural disaster such as fire, landslide or man-made causes such as theft, riots, vandalism and so on.

Bike insurance policies cover all sorts of two-wheelers, such as motorcycles, scooters, moped bikes and
electric bikes as well. As per the Indian Motor Tariff, 2002, it is mandatory for every bike owner to have at
least a third-party bike insurance policy.

— 51 —
 Key Features And Benefits Of Bike Insurance

360-Degree Protection: A bike insurance policy provides 360-degree financial and legal protection to you,
your vehicle and third-party person or property, in case of the occurrence of any accident or mishap.
Having a bike insurance also covers you against loss and damage arising due to theft, strike or war. While
third-party insurance is mandatory, one can opt for comprehensive coverage policy to get coverage for own
damages caused to your bike also.

Cashless Claim: This is one of the main benefits of a bike insurance policy. An insured bike owner can
easily apply for a cashless claim, in case of any damage caused to their bike due to an accident or any
mishap. All they need to get their damaged vehicle at any of the network garages, where the bill will be
directly settled between the garage owner and the insurance company.

No Claim Bonus: No-claim bonus is a kind of discount which insurance companies provide for making no
claim in the preceding years. Bike insurance companies provide up to 50% NCB benefit on the insurance
premium which is indeed a great benefit for insured. The NCB discount can be even carried further at the
time of renewal of your policy.

Personal Accident Cover: Personal accidental coverage is one of the benefits which the insured receives
as soon as they insure themselves under a bike insurance policy. This cover provides coverage to the bike
rider against any bodily injuries or death arising due to an accident. It is crucial to have a personal accident
cover especially when you drive, but if you do not have a separate PA cover, you can definitely get it along
at the time of buying a bike insurance for you.

Coverage for Long-term: Bike insurance companies have launched several long-term insurance policies
which can cover your bike up to a maximum of three years. The benefit of being covered in a long-term
policy is that the premium is fixed for the next three years and there will be no hassle of yearly renewal of
policy. Many insurance companies also provide discounts on premium for option these long tenure bike
insurance policies.

Different Types Of Bike Insurance Policies?

While buying a bike insurance, you can select from the various kinds of insurance policies based on your
coverage requirement. The bike insurance in India is broadly categorized into three major kinds, which
are:

— 52 —
 Third-Party Insurance

In India, as per The Motor Vehicles Act, 1988, it is mandatory to own a third-party insurance to ride a bike
on Indian roads. Third-party insurance covers all injuries, disabilities or death caused to the third-party
due to an accident from the insured’s bike. However, the insured’s bike damages or theft is not covered
under this plan. The third-party premiums have been already decided by the insurance regulator of India,
IRDAI, which are as follows for FY 2022-2023::

Engine Cubic Capacity of Bike Third Party Insurance Premium

Less than 75 cc 538

75 – 150 cc 714

150 – 350 cc 1,366

Exceeding 350 cc 2,804

Comprehensive Insurance

This kind of insurance policy provides an all-rounder protection to the bike owner. It covers you, your bike
and also third-party person or property from any financial damages caused. It also includes a personal
accident cover for the owner-driver. One must go for comprehensive insurance to ensure full safety for
your bike.

However, due to extensive coverage, this kind of insurance is more expensive than the third-party bike
insurance policy. At the same time, in comprehensive insurance, the insured has the full liberty of adding
optional riders such as zero depreciation cover, engine protection, key replacement and so on at an extra
premium cost.

Standalone Own-Damage (OD)

— 53 —
This kind of bike insurance covers damages caused to your own vehicle, in the unfortunate event of
accident or mishap. In this plan, the insured receives the financial protection for their own insured bike.
This policy does not cover any damages caused to third-party persons or property.

The insured has an option to buy a third-party policy and own-damage policy either from the same
insurance company or from different ones. An insured can also enhance the scope of coverage of an own-
damage insurance policy by purchasing add-on covers.

Difference Between Third-Party Insurance And Comprehensive

Insurance Policy

Third Party Bike Insurance Policy Comprehensive Bike Insuran

Provides basic coverage which covers legal and Provides wider coverage which cov
financial obligations arising from third-party. damages as well as third-party

Mandatory to have third-party insurance under the

Not a mandatory requirem
Motor Vehicles Act, 1988.

Expensive than third-party as it provid

Cheapest form of bike insurance
coverage.

Add-ons are not available with third-party bike

Add-ons are available with compre
insurance.

Does not cover own damage to the bike or bodily Covers own damages to the vehicle
injuries to the owner-drives accident and natural or man-mad

Add-On Covers For Bike Insurance Policy

— 54 —
Zero Depreciation Cover: if a bike owner purchases this cover along with the policy, then they don’t have
to pay for the cost of depreciation of your vehicle and thus you would be able to claim for a bigger amount.

Road Assistance: This add-on is useful in providing any kind of emergency help which a bike owner
might require in case of a mechanical breakdown of their bike in the middle of a road. With this cover, one
gets the services such as fixing bike issues on the spot, provides free drop to reach your destination, covers
the cost of getting the bike to the garage and so on.

Consumables Cover: While making the claims, generally the cost of damaged nuts, bolts and other
consumables are not covered under basic insurance policy. However, this add-on helps you to cover the
expenses of consumables damaged due to an accident.

Engine Protection Or Gear Box Protection Cover: We all know that replacing important bike parts such
as engine and gearbox can be very expensive, but when you apply for its protection add-on cover, the same
thing can be replaced at zero cost. However, the cost of the engine and gearbox would be only covered, if it
has been damaged due to accident or any unfortunate mishap.

Return to Invoice Cover: This cover allows the bike owner to avail the full invoice price of their bike, if the
bike has been damaged totally or in case of theft.

Tyre Protection Cover: Tyre is an important component of a bike or any two-wheeler. Any wear and tear
of tyre due to accidental damage gets covered, if the bike owner has opted for tyre protection cover.

Above-mentioned add-ons are the most useful ones which can be easily clubbed with the comprehensive
bike insurance policy with an aim to make the coverage most beneficial. The other add-ons which are also
available such as key protection cover, NCB protection, any loss of personal belongings and passenger
assistance cover.

Bike Insurance Claim Settlement Process

The bike owner can raise the claim either via cashless claim or by reimbursement claim process. The claim
settlement process for both cashless and reimbursement is different from each other. Let’s understand one
by one the claim settlement process for filing claims under both the options.

Steps to File Cashless Claims

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  Step 1: Notify your insurance company by contacting them directly. You can use their
mentioned toll-free number or visit their website.

 Step 2: Now, register your claim and always save the claim reference number for future
use.

 Step 3: The insurance company assigns a surveyor or a claim inspector who is

responsible for assessing the damage incurred to your vehicle. This assessment will be
later submitted by the surveyor to the insurance company.

 Step 4: Once the insurance company approves the claim report, your bike will be
transferred to the nearest network garage for repair work.

 Step 5: After analyzing the documents submitted by you, the insurance company will
settle the bill directly with the garage and thus the claim will be settled via cashless
process.

Step To File Reimbursement Claims:

 Step 1: Notify your insurance company by contacting them directly. You can use their
mentioned toll-free number or visit their website.

 Step 2: Now, register your claim and always save the claim reference number for future
use.

 Step 3: Take your damaged bike to the nearest garage and get the bike repaired. Settle
the final bill and pay directly to the garage.

 Step 4: Submit the respective original bills, necessary documents and claim settlement
form to the insurance company to initiate the process of claim.

 Step 5: Once the claim is approved, the insurance company will compensate you and thus
the claim amount will be reimbursed.

Documents Required to File A Bike Insurance Claim

 Signed and filled claim settlement form.

 Copy of an insurance policy.

 Copy of license.

— 56 —
  Copy of Registration Certificate of your bike.

 FIR copy is required in case of a huge accident or theft.

 Original invoice/bills of repair.

Car Insurance
All automobile owners in India are required by law to carry third-party liability insurance. If your
desired vehicle is not protected by third-party insurance, you cannot drive it. Moreover, immediately
following an accident, one must file a claim with the insurance provider.

The insurance provider checks the supporting documentation, and if the claim is legitimate, the insurer
compensates for the car's damages.

This blog will discuss personal damage insurance and its claim settlement procedure. So, if you are
wondering how to claim car insurance for own damage and are curious about the car insurance claim
process for own damage, read on!

Understanding Own Damage Car Insurance

A standalone Own-Damage Insurance was released in September 2019 by a mandate from the Insurance
Regulatory Development Authority of India (IRDAI).

So, what exactly is Own Damage Car Insurance?

— 57 —
Purchasing a car entails several additional costs. Own Damage Auto Insurance is helpful if the
automobile sustains damage from a natural disaster, such as a hurricane, earthquake, flood, etc.

Besides offering compensation for exterior catastrophes, it includes artificial disasters, vandalism,
rioting, and terrorist strikes. Additionally, an Own Damage Cover enables you to add riders to the policy
to expand the range of coverage.

Learning How To Claim Car Insurance For Own Damage Step-by-Step

If you are wondering how to claim car insurance for own damage, do not fuss, as this process is pretty
systematic.

After an accident, filing a claim with your car insurance provider requires a thorough grasp of the
process.

The steps on how to claim insurance for car damage are listed below-

Step 1: Notify Your Insurance Company

Call your insurance provider to inform them about the incident and provide details about the car's
damages.

Be sure not to conceal any details from your insurance because doing so might make it more difficult to
resolve disputes.

Step 2: Report an FIR to the Police

If necessary, a First Information Report (FIR) should be filed as soon as possible after the accident is
reported to the police.

For example, when a theft, a car accident, or a fire occurs, an FIR is necessary.

On the other hand, you might not need to file an FIR if the damage is only tiny scrapes and dents. Also,
you will need it if a third party is involved in the incident.

— 58 —
 Step 3: Use Photographic Proof

Take as many photos as possible of the accident site and the damage.

To enable the own damage insurance provider to assess the extent of the material damages and
appropriately pay the claim, make sure the images are clear and the injuries are discernible.

Step 4: Provide the Insurance Company with the Necessary Documents

The insurance company needs specific paperwork to process the claim, including a print of the insurance
policy, the FIR, the owner’s license, the driver's copy of the car registration certificate, and all the other
required documents.

Step 5: Fix Your Car

You may take your car to a shop to get it fixed. But instead, you might request that your insurance
provider pay to fix the car.

If the insurer accepts your claim, you will either be paid back or made whole for your loss.

Step 6: Claim Settlement Process

In the event of a cashless claim settlement procedure, the repair expenses are deposited with the network
garage upon receipt of the surveyor's final report.

If you choose the reimbursement settlement claim method, claims are resolved once you give your
insurance repair amount receipts.

You should be aware that although your own damage insurance provider will contribute a necessary
portion to the cost of repairing the automobile, you will still be responsible for paying a mandatory
deductible.

Documents Required to Claim Car Insurance For Own Damage

— 59 —
One would need specific documentation to settle the reimbursement to submit a claim for the damaged
cars.

These are the documents that you will need throughout the car insurance claim process for own damage-

 A Printout of the Insurance Contract.

 A Printout of the Police Department's FIR Report.

 Properly Completed and Signed Claim Form.

 A Duplicate of the Vehicle Registration Document.

 A Duplicate of the Current Driver's Licence.

 Information on the Repair Cost Estimates.

 Original Copies of the Medical Receipts are Required in Cases of Bodily Injury.

 Copy of the Original Receipt for Any Additional Costs Incurred.

— 60 —
 NRI ACCIDENT POLICY
Physical loss to an individual due to an accidental injury ( including fatal)

Who can be Insured ?

Any individual or group of individuals ( through employer, association, and

institution etc) aged between 12 and 70. Subject to medical examination at 70,
a person can be covered up to 80.

Insured against what risk ?

Death or disablement from accidental bodily injury ( anywhere in the world).

What will Policy Pay ?

When an accidental injury being the sole and direct cause results ( during the
period of insurance) in:

On payment of extra premium, medical expenses incurred up to 25 % of claim

or 10 % of Sum Insured can be covered.

Policy also pays for education fund for dependant children (2) of deceased
insured and expenses of carriage of dead body of insured from accident site
( as per details in policy)
— 61 —
Attractive cumulative bonus at the time of renewal, by way of increasing the
Sum Insured by 5 % for each completed claim free year of insurance
( maximum of 50 % CSI ) without collecting extra premium as per policy.

What will policy not pay ?

 Compensation under more than one clause for same

period of disability not exceeding capital sum insured
 Any payment after admission of a claim for 50 % / 100
% of Capital Sum Insured
 Any claim in the same period of insurance exceeding
the Capital Sum Insured
 Suicide, attempt there at, VD, criminal breach of
law,accidental death/injury under influence of
liquor/drugs
 Pregnancy related claim
 War and nuclear perils
 Note
Particulars of cover, liability and exclusion given
above are not complete or exhaustive.

Our nearest branch office may be approached for

complete details.

Related Policies

 Road Safety Package Policy

 Mediclaim Policy
 Overseas Mediclaim Policy for Business & Holiday
 Overseas Mediclaim Policy Employment & Studies

— 62 —
 Overseas Mediclaim Policy for Corporate Frequent
Travellers
 Janata Personal Accident
 Gramin Accident.

CHAPTER-4
— 63 —
INSURANCE REALTED TO FIRE, MARINE , BURGLARY,
LIVE STOCK,AND THEIR CLAIM PROCEDURE.

INSURANCE LATEST SCHEMES AND POLICIES AND

GROWTH RATE OF INSURANCE SECTOR FROM 1947 TO
PRESENT.

FIRE INSURACE AND ITS RELAETD

MATTER

What Is Fire Insurance?

Fire insurance is a form of property insurance that covers damage and losses caused by fire.
Most policies come with some form of fire protection, but homeowners may be able to
purchase additional coverage in case their property is lost or damaged because of fire.

Purchasing additional fire coverage helps to cover the cost of replacement, repair, or
reconstruction of property above the limit set by the property insurance policy. Fire insurance
policies typically contain general exclusions such as war, nuclear risks, and similar perils.
Damage caused by a fire set deliberately is also typically not covered.

— 64 —
 Types of fire insurance policies in India
The following are the types of fire insurance policies that are available in India:
1. Valued policy: A predetermined value is given for an item or property by the insurer in this policy.
Since the value of a property or an item that has been damaged in the fire cannot be ascertained, the
insurer fixes their value in advance at the time of purchase of the policy. During the time of claim, it is
this predetermined amount that is paid to the policyholder.
2. Average policy: In this policy, you as the policyholder can have the insured amount to be less than
the actual value of your property. If the value of your property is Rs.30 Lakhs, you can set the insured
value at Rs.20 Lakhs. The compensation amount will not exceed this level.
3. Specific policy: The compensation amount in this policy is fixed. For example, if the damaged item
was worth Rs.5 Lakhs and the coverage of the policy is Rs.3 Lakhs, you would receive only Rs.3 Lakhs
as that is the maximum amount of compensation offered under the policy. However, if the amount of
loss is within the coverage amount, you get full compensation.
4. Floating policy: In this policy, you as a business owner can secure more than one property of yours
under its coverage. If your properties are in different cities, the policy will cover all of them. 5.
Consequential loss policy: If vital machinery and equipment of your business get damaged in a fire,
you would get compensated for those losses in this policy. This policy ensures that your business does
not remain shut for long due to the loss of machinery.
6. Comprehensive policy: This policy offers extensive coverage. It offers coverage not only against
damage caused by fire but also against the damage which may happen due to natural and manmade
calamities. It also covers damages and loss caused due to the theft.
7. Replacement policy: In this policy, if your property gets completely damaged, you are compensated
either with the depreciated value being considered. Or you are compensated as per the actual value of
your property. Always make sure to know the purpose for which you are buying the policy and choose
the fire insurance coverage accordingly.

What are the inclusions and exclusions?

Listed below are the inclusions and exclusions of this type of general insurance coverage*: Inclusions:
 Loss of valuable property due to fire
 Loss of goods due to fire
 Cost of temporary accommodation due to damage to your property
 Amount compensated to the firefighting servicemen
 Fire caused to short-circuit or faulty connection
Exclusions:
 Fire caused due to emergencies such as war, rioting, or earthquake
 Fire caused due to ill intentions
 Fire caused during the burglary
Some policies also provide coverage for other types of losses, such as loss of rent or damage to third-
party property. Policyholders need to understand the specifics of their policy and the types of losses that
— 65 —
it covers.
Step-by-Step Fire Insurance Claim Process

The fire insurance claim process is very straightforward. Here is how you can raise a claim:

Step-1: Inform the Insurer and Seek Advance Financial Help

First things first, inform the insurer right after your insured property has met with a fire accident.

If you do not have any funds to deal with the losses, then you can ask for available financial assistance from your insurance company for
immediate actions such as vacating the place, temporary accommodation, etc. These advance payouts can be settled at the time of final
settlement.

Step 2: Estimate the Total Losses and Damages

In order to file a claim, you must provide enough proof and evidence to the insurance provider. Not only that, but you also need to provide
the closest possible estimate of the total damage you have sustained.

This figure will help your insurer determine the final compensation amount. Below are some things to keep in mind when estimating the
losses:

Do not throw away burnt items.

Do not start any repair or recovery work.

Take enough pictures/videos of damaged items.

Step 3: Raise a Claim

Coming to the most important step: filing the fire insurance claim. Most of the reputed insurance companies allow you to make claims
online. All you need to do is visit the official website, fill out the fire insurance claim form, and submit all the required proofs and
documents.

Step 4: Investigation By the Insurance Company

Once your claims settlement application is received, the insurance company sends an appointed surveyor to verify the claim request and
estimate the actual loss or damage the insured property has suffered.

The surveyor will investigate the entire case and create a report that plays a major role in determining the claims settlement amount. It is
recommended to keep all the policy-related documents in place as they can be used for the investigation.

Step 5: Final Settlement

After going through the report submitted by the surveyor, the insurance provider will provide you with a settlement amount as per the terms
and conditions of your policy.

But this is not the end. If you are not satisfied with the compensation or have any other issue, you can raise a complaint to get it resolved
before closing the claim.

Documents Required for Fire Insurance Claim

Incorrect or insufficient documents can delay your fire insurance claim settlement. Here is a document checklist for filing a fire insurance
claim:

Original fire insurance policy

— 66 —
Duly filled fire insurance claim form

Photographs and video clips of the incident

Newspaper recordings or clips of the damage

FIR report

Forensic report (if applicable)

Conclusion
As one can see, a fire insurance policy can provide financial protection against losses or damages
caused by fire and mitigate the financial impact of fire-related incidents. If you wish to get financial
coverage for your property not just from fire, but also from other factors, you can also consider opting
for home insurance to safeguard your property and the valuables in it.

MARINE INSURANCE
The fundamental principles of Marine Insurance are drawn from the Marine
Insurance Act, 1963* As in all contracts of insurance on property, the contract
of Marine Insurance is based on the fundamental principles of Indemnity,
Insurable Interest, Utmost Good Faith, Proximate Cause, Subrogation and
Contribution. Practitioners of Marine Insurance must familiarize themselves
with the Act and uphold these Principles when negotiating Contracts and
settling claims under the contract.

FEATURES OF MARINE INSURANCE

Offer & Acceptance: It is a prerequisite to any contract. Similarly, the goods
under marine (transit) insurance will be insured after the offer is accepted by
the insurance company.

— 67 —
2) Payment of premium: An owner must ensure that the premium is paid well
in advance so that the risk can be covered.
3)Contract of Indemnity: Marine insurance is contract of indemnity and the
insurance company is liable only to the extent of actual loss suffered.
4) Utmost good faith: The owner of goods to be transported must disclose all
the relevant information to the insurance company while insuring their goods.
5) Insurable Interest: The marine insurance will be valid if the person is
having insurable interest at the time of loss.
6) Contribution: If a person insures his goods with two insurance companies,
then in case of marine loss both the insurance companies will pay the loss to
the owner proportionately.
7)Period of marine Insurance: The period of insurance in the policy is for the
normal time taken for a transit. Generally, the period of open marine insurance
will not exceed one year.
8) Deliberate Act: If goods are damaged or loss occurs during transit because
of deliberate act of an owner then that damage or loss will not be covered
under the policy.
9) Claims: To get the compensation under marine insurance the owner must
inform the insurance company immediately so that the insurance company can
take necessary steps to determine the loss.
OPERATION OF MARINE INSURANCE Marine insurance plays an
important role in domestic trade as well as in international trade. Most
contracts of sale require that the goods must be covered, either by the seller or
the buyer, against loss or damage.

Understanding of the Marine Cargo Insurance Claim Procedure

While conducting any business, there can be a wide variety of risks. Problems do not
come knocking on doors with prior information; as a business owner, you need to be
prepared for every unforeseen circumstance that occurs in your business.

— 68 —
With a marine insurance policy by your side, you will be assured that the insurance
company will provide the claim if something happens during the transit. But you need
to carry out the claim procedure to get the settlement money or claim amount.

If the loss happened during the transit, the policyholder needs to file the marine
insurance claim to the provider. There are various steps involved in getting the claim
amount, which we have broken down for you.

Step 1: Assess the Damage or Loss - The first step before filing for a marine insurance
claim is thoroughly assessing the damage or loss during transit. If needed, prepare a list
of items that are missing or lost. Also assess the reason behind the loss, such as natural
calamities like thunderstorms, etc. Knowing all that will help you with the insurance
claim procedure.

Step 2: Notify the Insurance Company - Once you know all about the damage and
loss, and what caused it, the next step is to notify the insurance company about the
incident. To have a smooth claim process, it is mandatory to inform the insurance
company within the decided duration listed on your policy. If, by chance, you cannot
inform the insurance provider, then someone on your behalf can also do it.

Step 3: Assess the Care Techniques - After informing the insurance company, ensure
you have adopted all the care procedures and techniques to curtail the losses. The
policyholder needs to follow the procedure required to protect goods imperative of
insurance. A careless act on their end can lead to claim rejection.

Step 4: Survey - Upon receiving the request for claim, the insurance provider or
company will send the surveyor to assess the loss and damages. The work of a surveyor
is to analyse the severity of damage and what causes it. All these things will help him
understand whether the kind of damage is covered under the policy. The surveyor might
ask you some questions regarding the incident. Do not hide anything from the surveyor.

Step 5: Final Report and Claim- The surveyor will prepare a detailed report regarding
the incident after the survey. After analysing the report, the insurance company accepts
or rejects the claim request. If the damage is due to theft, it is best to file a police report,
as it will be needed in the documentation and paperwork of marine insurance claim
requests.

Documents Required for Maritime Insurance Claim Settlement

— 69 —
Documentation is an essential element of the marine insurance claim procedure.
Improper paperwork can delay the claim settlement procedure. Sometimes, when the
documents submitted are wrong, the claim request can be rejected.

Below is the list of documents that need to be submitted for the procedure for settlement
of claims in marine insurance.

Claim Form - The claim form is the first thing you must fill out with all the details. The
insurance provider's website lets you easily download the marine claim form. The claim
form is very detailed, containing comprehensive details about the policyholder policy,
such as policy number, date, type of policy and more.

Original Insurance Copy - Further, with the claim form, it is essential to submit the
original marine insurance certificate or copy. This certificate is issued to policyholders
when taking out the marine insurance policy. This is a crucial document as it contains
all the information about policy, like policy number, inclusion and exclusion, etc.

Bill of Lading Copy - BOL or bill of lading is the document shippers get from the
carrier provider. In the transit business, it is the acknowledgement receipt from the
carrier provider. Not just this, this document also has information about the shipment
and where it needs to be delivered. At the time of maritime insurance claims, this
document needs to be submitted by the policyholder.

Survey Report - Along with other documents, the policyholder must submit a copy of
the survey report given by the surveyor. The positive survey report supports the claim
settlement in your favour.

Original Invoice - Another document that needs to be submitted with the marine
insurance claim form is the original invoice for damage done to goods and equipment.
Along with that, the weight notes and packing list also need to be submitted.

Shipping Specification - This is the form or document with detailed information about
the shipping the insurance company needs.

Correspondence Exchanged - The document refers to written communication between

parties involved in the insurance transaction.

Claim Bill - Policyholders must submit the estimated claim amount with details to the
insurance provider.

— 70 —
With the documentation above, a policyholder must also submit a copy of the monthly
declaration of transits and a carrier's consignment note. The insurance provider may also
request a damage or non-delivery certificate if your items are lost, damaged, or partially
absent.

Conclusion
There are various kinds of risks associated with cargo and transport business. No matter
how cautious or prepared you are, even minor damage or loss can affect the whole
business procedure. That is why having marine insurance is essential, as it provides
financial stability to the business.

Tata AIG provides risk-free and hassle-free marine insurance policies with features like
flexible coverage options and prompt claim settlement to reduce customers’ financial
impact.

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 BURGLARY INSRUANCE
It is a type of insurance policy that provides coverage for loss or damage to property
resulting from a burglary. It is designed to provide financial protection to homeowners,
renters, and businesses against the financial impact of a burglary.

Burglary insurance policies can be broadly classified into the following three types-

 Full Value Insurance

This type of burglary insurance policy covers the entire worth of the insured property.

 First Loss Insurance

When there is a low probability of a total loss, first-loss insurance allows the
policyholder to choose a percentage of the assets to be insured.

 Stock Declaration Insurance

This policy is advantageous when a big number of stocks fluctuate regularly within a
fiscal year. Here, the sum assured is fixed at the maximum expected stock value by the
policyholder.

What Does Burglary Insurance Policy Covers?

The coverage provided by burglary insurance varies depending on the policy and the insurance
company. However, most burglary insurance policies cover the following:

 Stolen Property
Burglary insurance typically covers stolen properties by providing compensation to the policyholder for
the value of the stolen items. The coverage amount will depend on the limits of the policy and the value
of the stolen property.

Most burglary insurance policies use one of two methods to calculate the value of the stolen property:
actual cash value or replacement cost value. Actual cash value coverage will compensate the
policyholder for the current value of the stolen property, taking into account depreciation. Replacement
cost value coverage, on the other hand, will compensate the policyholder for the cost of replacing the
stolen property with a new item of similar kind and quality, without taking into account depreciation.
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  Property Damage
Burglary insurance can cover property damage resulting from burglary, such as broken windows,
damaged doors, or other types of damage to the property. Most burglary insurance policies cover
property damage under a separate coverage limit, which is typically referred to as "dwelling coverage"
or "building coverage." This coverage is designed to provide financial protection for the structure of the
property, including any damage resulting from a burglary.

To make a claim for property damage, the policyholder will need to provide documentation to support
their claim, such as photos or repair estimates for the damaged property. The insurance company may
also require an inspection of the property to assess the extent of the damage.

 Business Interruption
Burglary insurance can cover business interruption resulting from a burglary, which refers to the lost
income and expenses related to the interruption of business operations. This coverage may also include
expenses related to relocating the business temporarily or permanently. This coverage is important for
businesses that rely on their physical location or inventory to operate and generate revenue.

To make a claim for business interruption, the policyholder will typically need to provide documentation
to support their claims, such as financial statements and records of lost revenue during the interruption
period.

 Replacement Costs
Burglary insurance compensates the policyholder for the full cost of replacing stolen or damaged
property with a new item of similar kind and quality. Here, the policyholder is not limited to receiving
only the actual cash value (which considers depreciation) of the stolen or damaged item. Instead, the
policyholder receives compensation for the full cost of replacing the item with a new one of comparable
quality and specifications. To determine the replacement cost value, the insurance company may require
the policyholder to provide documentation such as receipts, invoices, or professional appraisals that
establish the cost of the stolen or damaged items.

 Legal Fees
Burglary insurance may provide coverage for legal fees associated with defending against a lawsuit
resulting from a burglary. These expenses can include attorney fees, court costs, and other legal-related
expenses. It's important for policyholders to review their burglary insurance policy carefully to
understand if legal fee coverage is included and any limitations or conditions associated with it. Some
policies may have specific exclusions or restrictions on the types of legal expenses covered or the
circumstances in which coverage applies.

Exclusions Offered Under Burglary Insurance Policy

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Here is a list of some of the common exclusions mentioned in a burglary insurance policy:

 Coverage for precious gems, jewellery, business books, cash, designs, plans, etc. unless
specifically covered.
 Loss or Damage(s) where an insured or his staff/family member was involved in the actual theft
 When the property of the insured is left uninhabited for 7 or more days in a row.
 If material alterations are done to the premise that increases the risk.
 If the asset rights have been transferred to another individual(s) by the insured through a will or
by operation of law.
 Damage(s) that result from a nuclear peril
 Damage(s) caused by war, a foreign enemy's act, invasion, etc.
 Any damage(s) caused by nationalization, seizure, etc. by Government authorities
 Damages resulting from any sort of consequential loss.
 Damage(s) caused by riots, strikes, civil unrest, and so on.

LIVE STOCK INSURANCE

The Livestock Insurance Scheme, a centrally sponsored scheme, which was implemented on a
pilot basis during 2005-06 and 2006-07 of the 10th Five Year Plan and 2007-08 of the 11th Five
Year Plan in 100 selected districts. The scheme is being implemented on a regular basis from
2008-09 in 100 newly selected districts of the country. Under the scheme, the crossbred and high
yielding cattle and buffaloes are being insured at maximum of their current market price. The
premium of the insurance is subsidized to the tune of 50%. The entire cost of the subsidy is being
borne by the Central Government. The benefit of subsidy is being provided to a maximum of 2
animals per beneficiary for a policy of maximum of three years. The scheme is being implemented
in all states except Goa through the State Livestock Development Boards of respective states.
The scheme is proposed to be extended to 100 old districts covered during pilot period and more
species of livestock including indigenous cattle, yak & mithun.

The Livestock Insurance Scheme has been formulated with the twin objective of providing
protection mechanism to the farmers and cattle rearers against any eventual loss of their animals
due to death and to demonstrate the benefit of the insurance of livestock to the people and
popularize it with the ultimate goal of attaining qualitative improvement in livestock and their
products.

 Animals to be covered under the scheme and selection of beneficiaries:

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 All those female cattle/buffalo yielding at least 1500 litre of milk per lactation are to be
considered high yielding and hence can be insured under the scheme for maximum of their
current market value. Animals covered under any other insurance scheme/plan scheme will
not be covered under this scheme. Benefit of subsidy is to be restricted to two animals per
beneficiary and is to be given for one time insurance of an animal up to a maximum period
of three years. The farmers will have to be encouraged to go for a three-year policy which is
likely to be more economical and useful for getting the real benefit of insurance on
occurrence of natural calamities like flood and drought etc. However, if a livestock owner
prefers to have an insurance policy for less than three years period for valid reasons,
benefit of the subsidy under the scheme would be available to them also, with the
restriction that no subsidy would be available for further extension of the policy. Field
performance recorders of the NPCBB could also be involved for identification of
beneficiaries. The Gram Panchayats will assist the Insurance Companies in identifying the
beneficiaries.

 Settlement of Claims:
The method of settlement of claim should be very simple and expeditious to avoid
unnecessary hardship to the insured. While entering into contract with the insurance
company, the procedure to be adopted/documents needed for settlement of claim should be
clearly spelt out. In case of claim becoming due, the payment of insured amount should be
made within 15 days positively after submission of requisite documents. While insuring the
animal, CEOs must ensure that clear cut procedures are put in place for settlement of
claims and the required documents are listed and the same is made available to concerned
beneficiaries along with the policy documents.

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 INSURANCE NEW SCHEMES AND POLICIES

1. Pradhan Mantri Jan Arogya Yojana (PMJAY)

2. Aam Admi Bima Yojana (AABY)

3. Rashtriya Swasthiya Bima Yojana (RSBY)

4. Employment State Insurance Scheme (ESIS)]

5. Central Government Health Scheme (CGHS)

6. Universal Health Insurance Scheme (UHIS)

7. Awaz Health Insurance Scheme

8. Bhamashah Swasthya Bima Yojana

9. Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS)

10. Karunya Arogya Suraksha Paddhati (KASP)

11. Mahatma Jyotiba Phule Jan Arogya Yojana Scheme (MJPJAY)

12. Mukhyamantri Amrutam Yojana (MAY)

13. Pradhan Mantri Suraksha Bima Yojana (PMSBY)

14. Rajiv Aarogyasri Community Health Insurance Scheme (RACHI)

15. Yeshasvini Health Insurance Scheme

16. West Bengal Health Scheme

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 GROWTH OF INSURANCE SECTOR FROM 1947 TO PRESENT

The advent of life insurance business in India

1818
Advent of life insurance business in India
1818 saw the advent of life insurance business in India with the establishment of the Oriental Life Insurance Company in Calcutta.
This Company however failed in 1834. In 1829, the Madras Equitable had begun transacting life insurance business in the Madras
Presidency. 1870 saw the enactment of the British Insurance Act and in the last three decades of the nineteenth century, the Bombay
Mutual (1871), Oriental (1874) and Empire of India (1897) were started in the Bombay Residency. This era, however, was dominated
by foreign insurance offices which did good business in India, namely Albert Life Assurance, Royal Insurance, Liverpool and London
Globe Insurance and the Indian offices were up for hard competition from the foreign companies..

1914
Government of India started publishing returns
In 1914, the Government of India started publishing returns of Insurance Companies in India. The Indian Life Assurance Companies
Act, 1912 was the first statutory measure to regulate life business. In 1928, the Indian Insurance Companies Act was enacted to enable
the Government to collect statistical information about both life and non-life business transacted in India by Indian and foreign
insurers including provident insurance societies. In 1938, with a view to protecting the interest of the Insurance public, the earlier
legislation was consolidated and amended by the Insurance Act, 1938 with comprehensive provisions for effective control over the
activities of insurers.

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 1950
The Insurance Amendment Act of 1950 abolished Principal Agencies
The Insurance Amendment Act of 1950 abolished Principal Agencies. However, there were a large number of insurance companies
and the level of competition was high. There were also allegations of unfair trade practices. The Government of India, therefore,
decided to nationalize insurance business..

1956
Life Insurance Corporation came into existance
An Ordinance was issued on 19th January, 1956 nationalising the Life Insurance sector and Life Insurance Corporation came into
existence in the same year. The LIC absorbed 154 Indian, 16 non-Indian insurers as also 75 provident societies—245 Indian and
foreign insurers in all. The LIC had monopoly till the late 90s when the Insurance sector was reopened to the private sector.

The history of general insurance

The history of general insurance dates back to the Industrial Revolution in the west and the consequent growth of sea-faring trade and
commerce in the 17th century. It came to India as a legacy of British occupation.

1850
The British establish the Triton Insurance Company Ltd
General Insurance in India has its roots in the establishment of Triton Insurance Company Ltd., in the year 1850 in Calcutta by the
British.

1907
The Indian Mercantile Insurance Ltd, was set up
In 1907, the Indian Mercantile Insurance Ltd, was set up. This was the first company to transact all classes of general insurance
business.

1957
General Insurance Council is formed
1957 saw the formation of the General Insurance Council, a wing of the Insurance Association of India. The General Insurance
Council framed a code of conduct for ensuring fair conduct and sound business practices.

1968
Insurance Act was amended
In 1968, the Insurance Act was amended to regulate investments and set minimum solvency margins. The Tariff Advisory Committee
was also set up then.

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 1973
General insurance business was nationalized
In 1972 with the passing of the General Insurance Business (Nationalisation) Act, general insurance business was nationalized with
effect from 1st January, 1973. 107 insurers were amalgamated and grouped into four companies, namely National Insurance Company
Ltd., the New India Assurance Company Ltd., the Oriental Insurance Company Ltd and the United India Insurance Company Ltd. The
General Insurance Corporation of India was incorporated as a company in 1971 and it commence business on January 1st 1973.

April, 2000
The IRDA was incorporated as a statutory body
Following the recommendations of the Malhotra Committee report, in 1999, the Insurance Regulatory and Development Authority
(IRDA) was constituted as an autonomous body to regulate and develop the insurance industry. The IRDA was incorporated as a
statutory body in April, 2000. The key objectives of the IRDA include promotion of competition so as to enhance customer
satisfaction through increased consumer choice and lower premiums, while ensuring the financial security of the insurance market.

August 2000
The IRDA opened up the market
The IRDA opened up the market in August 2000 with the invitation for application for registrations. Foreign companies were allowed
ownership of up to 26%. The Authority has the power to frame regulations under Section 114A of the Insurance Act, 1938 and has
from 2000 onwards framed various regulations ranging from registration of companies for carrying on insurance business to protection
of policyholders’ interests.

December, 2000
the subsidiaries of the General Insurance Corporation of India were restructured as independent companies
In December, 2000, the subsidiaries of the General Insurance Corporation of India were restructured as independent companies and at
the same time GIC was converted into a national re-insurer.

July, 2002
Parliament passed a bill de-linking the four subsidiaries from GIC in July, 2002.
Today there are 34 general insurance companies including the ECGC and Agriculture Insurance Corporation of India and 24 life
insurance companies operating in the country.
The insurance sector is a colossal one and is growing at a speedy rate of 15-20%. Together with banking services, insurance services
add about 7% to the country’s GDP. A well-developed and evolved insurance sector is a boon for economic development as it
provides long- term funds for infrastructure development at the same time strengthening the risk taking ability of the country.

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— 80 —
 CHAPTER-5
PERCENTAGE OF DIFFERENT POLICY HOLDERS IN INDIA.
BIBILOGRAPHY

GENERAL INSURANCE HOLDERS PERCENTAGE

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From the above picture we can see that the general insurance policy holders
are got increased gradually from the year 2010 to 2013 in ( million).

HEALTH INSURANCE POLICY HOLDERS PERCENTAGE IN INDIA

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Compared to general insurance, in INDIA the health insurance industry sector
has faced so many up and downs from the year 2001 to 2022. But at present
the health insurance sector is at stable position.
By taking the example of above picture we can notice that.

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VEHICLE INSURANCE POLICY HOLDERS PERCENTAGE IN INDIA

From the above picture we can notice that half of the vehicles are getting
insured this shows that the ratio of accidents was got reduced.

CONCLUSION
A structural report on insurance sector in INDIA based on some reports and
statistics. Which shows, different types of policies that cover under insurance
sector and their claim procedure.
The development of insurance sector in INDIA from 1818 to present has
increased to a level by implementing and bring some changes in the insurance
policies.

BIBILOGRAPHY
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https://uiic.co.in/en/node/2089

https://www.bajajallianz.com/blog/knowledgebytes/fire-insurance-coverage-
and-claim-process.html

https://sme.icicilombard.com/blogs/claims-process-in-marine-
insurance#:~:text=Claim%20Resolution,settlement%20amount%20by%20the
%20insurer.

THE END

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