PCE – Part B General Insurance

AIA confidential and proprietary information. Not for distribution.

AIA.COM

PCE – Part B General Insurance

• Revision 01 (25/11/2011)


CHAPTER 14

How much do you understand about General Insurance?

Share only 1 point about GI that comes across to your mind…

CHARACTERISTICS OF GENERALINSURANCE PRODUCTS (OVERVIEW)


9.1 Introduction

9.2 Characteristics of General Insurance Products

CHAPTER 14 :

CHARACTERISTICS OF GENERAL

INSURANCE PRODUCTS (OVERVIEW)


• General insurance provides cover against risks usually not covered by life insurance.

• In general, not every policy will eventually become a claim.

14.1 : Introduction


• General insurance contracts are short-term contracts

with varying premiums at renewals.• General insurance contracts are contracts of

indemnity.• Payment of a claim does not terminate a general

insurance contract• The risk to be insured does not necessarily increase

with time

14.2 : Characteristics of General Insurance Products


CLASSES OF GENERAL INSURANCE BUSINESS &

GENERAL TAKAFUL BUSINESS

CHAPTER 15


CHAPTER 15

CLASSES OF GENERAL INSURANCE BUSINESS & GENERAL TAKAFUL BUSINESS

How many classes of General Insurance available in the market?

Please name me 1…


15.1 Marine Insurance15.2 Fire Insurance15.3 Motor Insurance15.4 Miscellaneous Accident Insurance15.5 Types of Takaful Business

CHAPTER 15



15.1 : Marine Insurance

Type of policy

- Hull

- Cargo

- Freight

- Building Risk

Subject matter of insurance

- Vessel, machinery & limited collision liability

- Cargo (goods carried on the vessel)

- Freight (money/fee charged for carriage of goods by the vessel)

- Vessel under construction



Institute CargoClauses A

Institute CargoClauses C

Institute CargoClauses B



Perils A B C

Clauses

Striking, stranding, capsizing Fire, explosion, collision

Earthquake, volcanic eruption, lightning

Jettison, general average & salvage

Discharge of cargo at port of distress



Perils A B C

Clauses

Washing overboard Entry of sea water into vessel

Total loss of package(loading/discharge)

Pirates and thieves

Deliberate damage or destruction


15.2 : Fire Insurance

Fire Insurance Consequential Loss

Houseowner Householder



Type of policy

- Fire - Houseowner- Householder- Consequential Loss

Subject matter of insurance

- Buildings and contents- Private dwellings- Household content- Insured’s profit



CHAPTER 15

Perils A B C

War, nuclear

Earthquake, volcanic eruption

Subterranean fire, flood

A: Standard FireB: Standard HouseownerC: Standard Householder

Burning of property by authority

Fire, lightning, explosion (domestic gas)

#: Extension is available

# #



Perils A B C

Overflowing of water tanks

Typhoon, hurricane, windstorm

Burning of forest & bush lallang


Removal of debris, architect fee, rental

Aircraft damage, impact damage

#

#: Extension is available, : Extension with condition

#

# # # # #



Perils A B C

Spontaneous combustion

Subsidence or landslip

Plate glass


Riot, strike and malicious damage

Fermentation, natural heating

#: Extension is available, : Extension with condition # # #

# # ## # ## # ## # #


15.2 : Fire Insurance (Consequential Loss)

Basic Cover (i) Loss of gross profit due to reduction of turnover (total amount of goods or services sold)(ii) Additional expense to minimize loss of turnover

Exclusion

Similar to fire policy

Extension

(i) Similar to fire policy(ii) Loss of gross profit arising from business interruption in other’s premises


10.3 : Motor Insurance (Types of Vehicles)

Private Car Motorcycle

Commercial Vehicle


15.3 : Motor Insurance (Types of Cover)

Act Only Third Party Only

Third Party, Fire & Theft

Comprehensive


15.3 : Motor Insurance (Types of Cover)

Act Only Death/Bodily injury to 3rd party

3rd Party Cover Act only + 3rd party property

3rd Party, Fire & Theft

3rd Party + Loss/Damage to insured vehicle by fire or theft

Comprehensive 3rd Party, Fire & Theft + Accidental Damage + medical Expense + Personal Accident


15.4 : Miscellaneous Accident Insurance

Theft Insurance Liability Insurance

Personal Accident

Fidelity Guarantee

Engineering Insurance

Aviation Insurance


15.4.1 : Theft Insurance

Burglary Insurance

All Risks Insurance

Goods in Transit

Money Insurance


15.4.2 : Liability Insurance

Products Liability

Employers’ Liability

Professional Indemnity

Public Liability

Workmen’s Compensation


15.4.3 : Personal Accident (Types of Benefit)

Death Permanent Disablement

Temporary Disablement

Medical Expenses


15.4.4.1 : Fidelity Guarantee (Types of Policies)

Individual Policy

Blanket Policy

Collective Policy


15.4.4.2 : Bonds (The 3 Parties)

Employer Surety(Insurer)

Contractor


15.4.5 : Engineering Insurance

Erection All Risks

Machinery Breakdown

Contractors’ All Risks

Electronic Equipment

Boiler Explosion


15.4.6: Aviation Insurance

Freight Liability

Loss of Licence

Personal Accident


15.4.7 Medical And Health Insurance (MHI)- A policy of insurance on disease, sickness or medical

expense that provides specified benefits against risks of persons becoming totally or partially incapacitated as a result of sickness or accident.

- Policy benefits are usually paid out in the manner according to the policy type or cover purchased as follows:

• reimbursement of medical expenses • lump sum payment of the sum insured, or• an allowance for the period the policyowner is

hospitalized.


Basic Cover1) Hospitalization and Surgical Insurance. - Common Policy Extensions/ Benefits: a) Outpatient Clinical Insurance b) Maternity Benefit 2) Major Medical Insurance 3) Dread Disease/ Critical Illness Insurance 4) Disability Income Insurance 5) Hospital Income Insurance

CHAPTER 15



Policy Benefit Limitations

a. General Waiting PeriodShall not exceed 30 days from policy effective date

b. Specified IllnessesShall not exceed 120 days from policy effective date

c. Co-payments

CHAPTER 15


Exclusions1) Pre-existing conditions

2) Congenital abnormalities or deformities including hereditary conditions

3) Plastic/ Cosmetic surgery, circumcision and eye examination

4) Pregnancy, childbirth, miscarriage and abortion

5) Disabilities arising out of duties of employment that are covered under workmen’s compensation insurance

CHAPTER 15


Exclusions6) Psychotic, mental or nervous disorders

7) Sickness or injury arising from racing of any kind (except foot racing)

8) Expenses incurred for sex changes

9) Investigation and treatment of sleep and snoring disorders, hormone replacement therapy and alternative therapy

10)Costs of services of a non-medical nature such as television,telephones etc

11) Private flying other than as a fare paying passenger

CHAPTER 15


Golfers Insurance Basic Cover

1) Liability to the public2) Personal Accident

3)Golfing Equipment/ Golf Clubs

4)Hole in one expenses

CHAPTER 15


Exclusions- War risks, riot strike and civil commotion

- Wear & Tear, depreciation, gradual deterioration or any process of repairing

- Loss destruction/ Damage directly caused by or contributed to by or arising from radioactive or nuclear risks

- Terrorism risk

CHAPTER 15



15.5 : Takaful Business• General Takaful business is all takaful business which is

not Family Takaful Business• General Takaful scheme is short-term Tabaruk Contract• Participants in the scheme agree to pay entire

contributions to create General Takaful Fund• After deducting operational costs, the surplus shall be

shared between participants and Takaful company

according to Principle of Mudharabah

CHAPTER 15



PRACTICE OF GENERAL INSURANCE-RISK ASSESSMENT, UNDERWRITING & RATING

CHAPTER 16


Who are involving in the process of Underwriting?

CHAPTER 16

PRACTICE OF GENERAL INSURANCE-RISK ASSESSMENT, UNDERWRITING& RATING


CHAPTER 16

PRACTICE OF GENERAL INSURANCE-RISK ASSESSMENT, UNDERWRITING& RATING

16.1 Underwriting16.2 The Underwriting Process16.3 Determination of Premiums, Terms & Conditions16.4 Confirmation of Acceptance16.5 Reinsurance & Coinsurance16.6 Rating16.7 Minimum Premium16.8 Minimum Sum Insured16.9 Refund of Premium16.10/12 How to Use Tariff


16.1 : Underwriting

CHAPTER 16

• The purpose of underwriting is to

- Guard against anti-selection

- Charge a premium that is commensurate with the

risk transferred • When anti-selection exists within a class of risks,

the

actual loss will be greater than the expected loss

because the class of risks does not represent a

randomly selected group (Law of Large Number)


16.2 : The Underwriting Process

CHAPTER 16

• Underwriting can be defined as:

- A process of assessment and selection of risks

- Determination of premium, terms and conditions


16.2 : The Underwriting Process - Physical Hazards

CHAPTER 16

Fire - Type of construction, Height of Building- Nature of Flooring, Type of Occupancy etc

Motor - Type of vehicle, Cubic capacity, Use of Vehicle- Age & condition of vehicle, Modification on Vehicle

Burglary - Nature of Stock, Situation- Type of Construction, Security Precaution

Personal Accident

- Age of Person, Type of Occupation- Health & Physical Condition, Hobbies


16.2 : The Underwriting Process- Moral Hazards

CHAPTER 16

Carelessness Fraud

Unreasonableness


16.3 : Determination of Premiums, Terms & Conditions

CHAPTER 16

Risk Improvement

Warranties

Exclusion Restricted Cover

Excess Franchise


16.4 : Confirmation of Acceptance

CHAPTER 16

• If the terms and conditions are acceptable to proposer,

the insurer will usually issue cover note as evidence of

temporary cover.


16.5 : Reinsurance & Coinsurance

CHAPTER 16

• Reinsurance is an arrangement where the insurer

reinsures/cedes the part of risk assumed which is in

excess of his retention to reinsurer

• Coinsurance is an arrangement between two or more

insurers to share original risk


16.6 : Rating

CHAPTER 16

Class Merit

Individual


16.7/8 : Minimum Premium /Minimum Sum Insured

CHAPTER 16

Minimum PremiumFire RM 50

Private Car RM 50

Workmen Compensation RM 35

Motorcycle RM 20


16.10/12 : How to Use Tariff

CHAPTER 16

Fire Motor

Workmen Compensation


16.9 : Refund of Premium

CHAPTER 16

• Premium is refundable due to

- Failure of consideration

- Provision in the policy


INSURANCE DOCUMENTS

CHAPTER 17


Why do we need to fill up a Proposal Form?

CHAPTER 17


CHAPTER 17

Part A : Overview

• The Proposal Form• The Cover Note• The Certificate of Insurance• The Policy Form• Endorsement• Renewal Notice• Renewal Certificate• Claims Form• Discharge Form


CHAPTER 17

Part B : Proposal Form

1. An insurance contract is effected when the offer made by one party (the proposer) is accepted by the other party (the insurer).

2. It is a document drafted by insurer in the form of questionnaires to gather information required to access a risk being proposed.

3. Proposal Forms are not used in Marine Cargo Insurance and For Large Risks


CHAPTER 17

Part B : Proposal Form

17.1.1 : The Structure of A Proposal Form

It is divided into 5 sections:-(a) Requirements of Insurance Act, 1996

(b) Questions of a General Nature

(c) Insurance related Questions

(d) Declaration

(e) Signature


CHAPTER 17

17.1.1 : The Structure of A Proposal Form(a) Requirements of Insurance Act, 1996 Subsection 149(4)

You are to disclose in the proposal from, fully and

faithfully all the facts which you know or ought to

know, otherwise the policy issued hereunder may

be invalidated.


CHAPTER 17

17.1.1 : The Structure of A Proposal Form(b) Questions of a General Nature

• Proposer’s Name• Proposer’s Address• Risk Address• Proposer’s Occupation• Previous and Present Insurance• Loss Experience• Sum Assured• Subject Matter


CHAPTER 17

17.1.1 : The Structure of A Proposal Form(c) Insurance Related Questions Some examples:-

Fire Insurance Motor Insurance

Type of construction and Cubic capacity use of the building

Whether building is detached Year of manufacture or adjoined to another

Type of power used Driving offences

Occupation of adjoining Cover required building (left & right)


CHAPTER 17

Part C : The Cover NoteA Cover Note is issued:-

in advance of a policy when negotiation is completed

during the course of negotiation

when a survey has to be carried out


CHAPTER 17

A Cover Note :-

a temporary policy

evidence of the insurance contract

provides the usual coverage found in a standard policy

provides that the insurance is subject to Tariff warranties if the risk proposed is governed by a Tariff


CHAPTER 17

Part D : The Certificate of Insurance A certificate of Insurance is issued when insurance is made compulsory by law

The marine certificates (not compulsory by law) are issued by mutual agreement between Insured and Insurer

The marine certificate provides evidence of insurance to interested parties including banks and consignees


CHAPTER 17

Part E : The Policy Form A policy is a document drafted by the insurer

A policy has to be stamped

Use the wording provided by the Tariff if the insurance is governed by Tariff

Types of policy form :- * Scheduled * Narrative


CHAPTER 17

17.4.1 : The structure of a Scheduled Policy Form

Heading The Preamble or Recital Clause The Operative or Insurance Clause Exclusion The Schedule Attestation or Signature Clause Conditions


CHAPTER 17

17.4.1.5 : The Schedule

The information in the schedule:-

Insured name and address

Premium

Policy number

Date of issue

Agency

Risk covered

Period of Insurance

Property Insured

Sum Insured

Warranties applicable


CHAPTER

12.4.1.7 : ConditionsClassification of conditions:-

(i) Express

(ii) Implied

(iii) the time that conditions need to be fulfilled

* Conditions Precedent to Contract

* Conditions Subsequent to Contract

* Conditions Precedent to Liability


CHAPTER 17

17.4.2 : Policy RegisterSection 47 of Insurance Act 1996 - every insurer shall

maintain an up-to-date register of all policies and none of

them shall be removed as long as the insurer is still liable for

these policies.


CHAPTER 17

Part F : Endorsement(a) Endorsements are used to modify The Terms & The Standard Policy Document

The endorsement form part of the policy

In certain classes of business, the attachment of endorsement to the policy is compulsory.

Eg. Workmen’s Compensation Insurance and Motor Insurance


CHAPTER 17

(b) Endorsements May Incorporate Alterations to an Existing Policy

Variation in Sum Insured

Change of Insurable Interest

Extension of insurance

Change of risk

Transfer of property to another location

Cancellation of insurance

Change in name and address


CHAPTER 17

Part G : Renewal Notice Insurers usually issue a renewal notice one month in advance of the date of expiry

Important notes in renewal notice:-

* A note advising the insured to disclose any materials alterations in the risk since the inception of policy (or last renewal date)

* “No risk can be assumed unless the premium is paid in advance”


CHAPTER 17

Part H : Renewal Certificate

Renewal Certificate will be issued if the renewal is on similar terms as the original contract

If the renewal is on different terms, a fresh policy is usually issued


CHAPTER 17

Part I : Claim Form

Claim forms are documents drafted by the insurers to gather information relevant to assessing claims

The issue of a claim form does not constitute an admission of liability on the part of the insurance

Claim forms are not used in marine insurance except in respect of inland transit claims


CHAPTER 17

Part J : Discharge(i) Claims Settlement Methods

settlement with an insured in respect of an insured loss(own loss); or

settlement with 3rd party on behalf of an insured in respect of the insured’s liability for loss caused to the 3rd party(Liability to 3rd party)

(ii) The Purpose of a Discharge

To avoid the possibility of any further claims being made in relation to the loss


CHAPTER 17

Part J : Discharge

(iii) The Declaration Section of The Discharge Form

[a] “Own loss” declaration stating that the insured claimant:-

has received a sum of money from the insurer

the money received is in full satisfaction of his claim under the policy in relation to that loss


CHAPTER 17

Part J : Discharge

(iii) The Declaration Section of The Discharge Form

[b] “Liability to 3rd party” declaration stating that the 3rd party claimant:-

has received a sum of money from the insurer

the money received is paid by the insurer on behalf of the insured, and

the money received is in full satisfaction of the 3rd party’s right to claim from the insured

person in respect of the loss


CHAPTER 17

Part J : Discharge

(iv) If Settlements is Not by CASH...

The insurers would issue a discharge form known as completion / satisfaction note which usually incorporates a declaration stating that:-

The repair, reinstatement and/or replacement has been effected by a person (on behalf of the insurer), and

They are carried out to the satisfaction of the claimant


CHAPTER 17

Part J : Discharge

(v) Other information Provided by a Discharge Form

Name and identity of the claimant

Details of the loss:-* date and time of loss* place of loss* parties affected* subjected matter of loss* Signature of attesting witness, if required


PRACTICE OF GENERAL INSURANCE: CLAIMS

CHAPTER 18


What are our roles in facilitating a Claim?

CHAPTER 18 : CLAIMS


CHAPTER 18

Part A : Overview

Claims Procedure Claims Documentation Settlement of Claims Recoveries from Reinsurers, Co-insurers, Subrogation and Contribution Repudiation of Liability by insurers Average Claims Settlement Agreement Disputes Post-Settlement Action


CHAPTER 18

Part B : Claims Procedure

18.1.1 : Notification of Loss

Immediate notification of loss is expected

The Duty of Good Faith requires the Insured to minimize the loss


CHAPTER 18

18.1.2 : Checking Coverage

Notice of loss received

Preliminary check

valid claim exists

Claim Form/ Accident Report Form


CHAPTER 18

18.1.2 : Checking Coverage

Conditions for a Valid Claim

Is the policy in force?

Has premium been paid?

Is the loss caused by an insured peril?

Is the subject matter affected by the loss the same as that insured under the policy?

Has notice of loss been given without undue delay?


CHAPTER 18

18.1.4 : Investigation of The Claim

A small claim will usually be paid on the basis of documents submitted by the claimant

Advice is sought from loss adjustors in setting large and complicated claims

Claim investigation involves ascertaining:-

* The validity of a claim

* The amount of loss


CHAPTER 18

18.1.5 :Ascertaining the Amount of Loss

Property damage or loss claims:Proof of the value of lost items or estimates of

repair, replacement or reinstatement.

Liability claims:Subjection of negotiation between the insurer and

the person who has suffered injury or property damage


CHAPTER 18

Part B : Claims Procedure

18.1.6 :Ascertain Subrogation rights & Contribution Duties

Notice of loss received

Preliminary check valid claim exists

Claim Form/ Accident Report Form

Investigation of the Claim

Ascertaining the amount of loss

Ascertain Subrogation rights & Contribution Duties


CHAPTER 18 : CLAIMS

Part C : Claim Document

The documents required vary with the type and nature of the claim.

Fire Insurance

Photographs

Technician report (where applicable)

Purchase invoices, repair bills, sales record and other related documents

Police report (where damage is extensive)

Fire brigade report (where damage is extensive)


CHAPTER 18 : CLAIMS

Part D : Settlement of Claims

Methods of Settling a Claim

Cash-payment of claim by cheque, or

Repair

Replacement

Reinstatement


CHAPTER 18 : CLAIMS

Part F :Repudiation of Liability by Insurers

Repudiation of liability is based on several grounds:-

There was no loss or damage as reported;

The loss or damage for which a claim has been made was not caused by a peril or was excluded by the policy; or

The policy has been rendered void as a result of a breach in condition (implied / express) or warranty


CHAPTER 18 : CLAIMS

Part G :Average

When under-insurance exists, the policy is subject to average

Amount = Sum Insured x Amount of Payable Value of property Loss

The principle of average is therefore applied to penalise the insured who has underinsured his property


CHAPTER 18 : CLAIMS

Part H :Claims Settlement Agreement Most motor insurers subscribe to a claim settlement agreement known as the “Knock-For-Knock” Agreement

The participating insurers agree to pay the cost of repairing their own comprehensively insured cars regardless of who is to blame


CHAPTER 18

Advantages of the “Knock-For-Knock” Agreement

Enable motor insurers to speed up settlement of claims and reduce legal and administration expenses

Disadvantage of the “Knock-For-Knock” Agreement

Withdrawal of policyholder’s NCD upon settlement of any claim

Normally, the policyholder will claim against the negligent motorist’s insurer and thereby retain his NCD


CHAPTER 18 : CLAIMS

Part I :Disputes• Disputes may involve one of the two issues:- the question of whether the insurer is liable; or the quantum of loss, if the insurer is liable

• Dispute is resolved through the following channels:-

Negotiation

Litigation

Arbitration

Insurance Mediation Bureau


CHAPTER 18 : CLAIMS

Part J :Post-Settlement Action

Terminate the policy; or

Reduce the sum insured, and reinstate if requested by insured, in which event new terms and conditions may be imposed


CHAPTER 18


18.9.1 : Terminate Policy

a total loss arising under the policy; or

the full sum insured under the policy; or

a capital sum benefit under a personal accident

policy; or any claim under a fidelity guarantee policy


CHAPTER 18


18.9.2 : Reduce Sum Insured and Reinstate, if requested

18.9.3: Impose New Terms and Conditions


PRACTICE OF GENERAL INSURANCE : POLICY FORMS

CHAPTER 19


CHAPTER 19 : POLICY FORMS

What information can we obtain from Policy Forms?


PART A : OVERVIEW


• Fire Policy

• Private Motor Car Policy


19.1 FIRE POLICY • Heading• Recital Clause• Operative Clause• Conditions• Exclusion• Schedule• Attestation



19.1 FIRE POLICY Heading• Consists of the Company’s name and address

Recital Clause• Insured has proposed to the company• Proposal and declaration is basis of contract• Insured has paid or agreed to pay premium



19.1 FIRE POLICY Operative Clause• Coverage• Payment of loss• Compliance of condition• Option to pay cash, repair, reinstate or replace• Maximum liability of the company



19.1 FIRE POLICY Condition• Misrepresentation• Premium Payment• Other insurance• Fall or displacement of building• Unoccupancy• Refund of premium



19.1 FIRE POLICY Condition• Notification of loss• Fire Brigade charges etc• Subrogation• Fraudulent Claim• Average clause• Reinstatement of sum insured• Arbitration



19.1 FIRE POLICY Exclusion• Theft during or after fire, War, Pollution• Burning of property by public authority• Subterranean fire, Convulsion of nature• Bush fire, Explosion (except domestic use)• Precious stone, work of art, drawing, stamps• Spontaneous fermentation, combustion



19.1 FIRE POLICY Reasons for Exclusion• Cover by other appropriate policy• Further inquiry on the risk• Additional premium is necessary• The risk is uninsurable



19.1 FIRE POLICY Schedule• Name of insurer• Name and address of insured• Business/Occupation• Location of property insured• Period of insurance, premium & sum insured• Endorsement and warrantiesAttestation• This has the effect of binding insurer



19.2 PRIVATE MOTOR CAR POLICY • Heading• Recital Clause/Preamble• Operative Clause• General Exclusion• Conditions• Schedule• Attestation



19.2 PRIVATE MOTOR CAR POLICY Operative Clause• Section I: Loss or damage• Section II: Liability to 3rd Party• Section III: Medical Insurance• Section IV: Accidents to Insured



19.2 PRIVATE MOTOR CAR POLICY Operative ClauseSection I: Loss or damage• Accidental collision or overturning• Fire or lightning, house breaking or theft• Malicious act• Direct sea route or whilst in transit



19.2 PRIVATE MOTOR CAR POLICY Operative ClauseSection I: Exclusion• Consequential loss, depreciation• Mechanical breakdown• Act of cheating • Criminal breach of trust



19.2 PRIVATE MOTOR CAR POLICY Operative ClauseSection II: Liability to 3rd Party• Death or bodily injury to 3rd party• Damage to property belonging to 3rd party



19.2 PRIVATE MOTOR CAR POLICY Operative ClauseSection III: Medical Insurance• Bodily injury sustained by insured or driver Section IV:

Accidents to Insured• Bodily injury sustained by insured



PRACTICE OF GENERAL INSURANCE:ETHICS AND CODE OF CONDUCT

CHAPTER 20


What are the good

Ethics and Code of Conduct?

CHAPTER 20 :

ETHICS AND CODE OF CONDUCT


OVERVIEW• The Essential of Inter-Company Agreement on

General Insurance Business• Commission• Cash-Before-Cover• Guidelines on Claim Settlement Practices

CHAPTER 20 :



20.1: ICAGIB (Objectives)• Promote and protect the interests of the general

insurance industry• Regulate and control the conduct of every

person transacting general insurance business• Monitor tariffs, commissions & remuneration

CHAPTER 20 :



20.1.1: Dealings with Agents• Authorized agents• Restriction on payment• Compliance with regulations• Scope of agency• Suspension and Cancellation• Information

CHAPTER 20 :



20.1.5: General Insurance Business for All Intermediaries (Exclude Insurance Broker) • General sales principles• Factors to be observed when explaining contract• Disclosure of underwriting information• Accounts and financial aspect• Documentation, existing policyholder and claim

CHAPTER 20 :



20.1.5(a): General Sales Principles • Make prior appointment• Identify own self• Recommend policy suitable to needs • Recommend other specialist when necessary• Treat all information by prospect confidential

CHAPTER 20 : ETHICS AND CODE OF CONDUCT


20.1.5(b): Explaining A Contract • Identify insurance company• Explain all essential provision• Draw attention to exclusion/restriction

20.1.5(c): Disclosure of Underwriting Information • Proposal forms are fully & accurately completed• All answers are prospect’s own responsibility

CHAPTER 20 :



20.1.5(d): Accounts and Financial Aspect• Keep proper account• Distinguish premium from other payment• Remit money collected

20.1.5(e-g): Documentation, Policyholder & Claim • Provide all documentation to policyholder• Render appropriate after sales service• Inform insurer immediately should claim arise

CHAPTER 20 :



20.2: Commission• No discount or rebate is allowed

20.3: Cash Before Cover • Part XV Regulation 65 of the Insurance Regulation

1996 provides that an insurer or its insurance

agent shall not assume motor policy unless the

premium has been paid

CHAPTER 20 : ETHICS AND CODE OF CONDUCT


20.4: GUIDELINES ON CLAIMS SETTLEMENTPart I: Deal with claims other than motor- Claim procedure - Disclosure of material factPart II: Deal with motor insurance claims- Own damage - Total loss- Theft - Subrogation- 3rd Party

CHAPTER 20 :



Thank You

Date post:	25-Feb-2016
Category:	Documents
Upload:	miles
View:	446 times
Download:	13 times

PCE – Part B General Insurance

Documents