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NEED FOR REGULATORY OVERSIGHT. Balance bet. interests of insurers, insured and other members of the publicEnsure fair termsLook into the adequacy of disclosures
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1. DE-TARIFFING PROGRAMME IN NON-LIFE INSURANCE
PRODUCT APPROVAL
FILE & USE PROCEDURE
By
PC James
ED, IRDA
3. RATING WATCH No excessive or unfairly discriminatory rates
Monitor inadequacy/ deficiency in rates
Compliance with Actuarial oversight
Analysis of costs through experience data
4. NEED TO REVIEW EXISTING FILE & USE REGULATIONS 2001 Removal of tariffs
Need for more comprehensive approach
Need to enforce more self-regulatory & governance norms
5. NEED FOR STANDARDISATION OF POLICIES/TERMS Helps Consumer
Insurer
Coinsurer
Reinsurer
Intermediary
Third Parties
Need for model policy/clauses at company level/industry level.
6. MODEL INSURANCE COVERS CAN BE IMPOSED BY Legislation
Regulation
Self-regulation
An effect of standard cover
- Derogation i.e., if less than standard cover draw insureds attention
7. ISSUE OF TIED INSURANCE Tied, ancillary, undisclosed insurance
Goods/services purchased insured charged but not informed
To be informed
Cost of insurance to be disclosed
Problem of excessive commissions to be avoided
8. REFUSAL OF COVER ISSUES Non-acceptance of proposal
Renew on special difficult, impossible terms
Cancellation of cover
Not renew existing cover
Disclose reasons except when an informant/employee is at risk
9. CANCELLATION ISSUES Types - automatic cancellation
- cancellation without notice
- cancellation immediately on notice
- 14 day notice period
- no allowance of misdirection of notice/delay in post
GIVE TIME/REASONS
10. (Contd) Effect of cancellation on further insurance
Cancellation owing to premium deficiency
Long term cover annual/installment cover facility automatic cancellation on failure to pay premium
Cancellation due to non-insurability issues
Avoidance of a cancellation clause in policy
11. RENEWAL ISSUES Renewal notice sent
not sent
not invited with reasons in writing
Types of renewal clauses
- non - cancellable
- guaranteed renewals
- non-renewable eg. Max. age
- optionally renewable
12. RATING ISSUES The Rate should be :
Adequate
- data driven
- competitive
- justifiable
Not unfairly discriminatory
- customer equity
- reg. compliant
Not excessive
Simple to administer
13. UNDER INSURANCE FOR PERSONAL INSURANCES First loss concept
Indexation, advertising, value calculators
15 to 20% relaxation
Minimum Premium whether higher S.I is possible, but not made clear
14. DIFFERENTIATION BETWEEN RISKS Red-lining eg. inner city, low income areas
Social implications - those who can least afford excluded
- unable to finance purchase
Differentiation - Race
- Sex
- Age
15. FILE & USE GUIDELINES (Proposed) Where product is governed by mandatory rates, terms, conditions, eg., Terrorism risk strict compliance required.
Products filed under earlier guidelines need not be re-filed. Unless changes are effected
Contd..
16. Contd No new product to be offered unless filed and IRDA has not raised query/objection within 30 days, and IRDA confirms satisfaction
If at any time even after File & Use is over, the product is not found appropriate or the terms not fair, IRDA may call for answers to the concerns, and replies if not satisfactory, may require suspension of the sale, and remodification
Contd..
17. Contd IRDA may require insurer to justify rates, terms, conditions
Any individually rated risk not filed shall be now filed, before offering to the client, as new or renewal
18. RESPONSIBILITY Documents shall be filed only under the signature of the Principal Officer
Principal Officer will remain responsible to comply with guidelines
A Compliance Officer to ensure compliance
Quarterly report to be submitted by Compliance Officer
19. CLASSIFICATION OF PRODUCTS Internal tariff rated products
Products packaged for individual clients
Covers determined by reference to international markets
Individual experience rated products
Exposure rated products
20. BASIC REQUIREMENTS FOR DESIGN OF PRODUCTS Underwriting/new product policy of the company to be placed before the Board
Delegation of authority to management must be subject to a clearly defined underwriting policy as laid down by the Board
Copy of this policy to be filed with IRDA
21. DRAFT FILE & USE PROCEDURES New Product Policy to cover :
Underwriting profit expectation
Whether each product to stand on its own or cross-subsidy among products sold to one client acceptable
Whether willing to write at a loss to develop market share
Contd.
22. DRAFT FILE & USE PROCEDURES (contd.) Margins in pricing for acquisition costs, expenses, reserves and profit
List of products that fall into each of the earlier mentioned 5 categories
Delegation of underwriting authority
Internal underwriting audit machinery
23. STATISTICAL SUPPORT The Appointed Actuary and underwriters to determine data requirement, compilation and analysis requirements
Certificate of the Actuary to accompany every filing
The periodicity of review of emerging statistics to be stated
24. DOCUMENTS REQUIRED TO BE FILED From A - particulars of the product
From B - certificate of Principal Officer
From C - certificate of Appointed Actuary
From D - certificate by Lawyer
Contd.
25. DOCUMENTS REQUIRED TO BE FILED (contd.) Copies of prospectus and other sales literature
Copy of the proposal form
Copy of the Policy form; standard endorsements
Copy of the underwriting Manual
26. DETARIFF ISSUES statement to be filed highlighting variations
where rate variation is more than 20% the basis to be justified by statistical evidence
after 1 year 20% variation to be justified from published market level experience
Changes in policy wording to be filed
Products for individual clients to be justified
27. PRACTICES IN OTHER MARKETS Product Approval Methods
- File & Use
- Use & File
- Prior Approval
28. DOCUMENTS TO THE CUSTOMER BEFORE/AFTER Before After
Brochure v
Prospectus v
Proposal v
Cover Note v
Policy v
Endorsements v
What is the penalty for non-delivery of policy
29. LEGIBILITY ILLEGIBILITY ISSUES In certain markets print sizes have been prescribed
Comprehensibility/Simple English
Regulation based on use of Flesch tests
30. OTHER CONSUMER ISSUES Clauses/conditions
Pre-existing
Portability, etc
English/vernacular
Other friendly features
Grievance Redressal