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*Disadvantages
FUNCTIONS OF INSURANCE
Insurance is defined as a co-operative device to spread
the loss caused by a particular risk over a number of
person who are exposed to it and who agree to ensure
themselves against that risk. Risk is uncertainty of a
financial loss. It should not be confused with the
chance of loss which Is the probable number of losses
out of a given number of exposures.
It should not be confused with peril which is defined as
the cause of loss or with hazard which is a condition
that may increase the chance of loss.
Finally, risk must not be confused with loss itself which
is the unintentional decline in or disappearance of
value arising from a contingency. Whenever there is
uncertainty with respect to a probable loss there is
risk.
Every risk involves the loss of the one or other kind.
The function of insurance is to spread the loss over a
large number of persons who are agreed to co-operate
each at time of loss. The risk cannot be averted but loss
occurring due to a certain risk can be distributed
amongst the agreed persons. They are agreed to share
the loss because the because the chances of loss, i.e
the time , amount to a person are not known.
Anybody of them may suffer loss to a given risk so, the
rest of the persons who are agreed will share the loss.
The larger the number of such persons the easier the
process of distribution of loss, in fact the loss is shared
by them by payment of premium which is calculated on
the probability of loss.
INSURANCE FRAUD
Insurance fraud is any act committed with the intent to
obtain a fraudulent from an insurance process. This
may occur when a claimant attempts to obtain some
benefits or advantage to which they are not otherwise
entitled, or when an insurer knowingly denies some
benefits that is due. According to the united states
Federal Bureau of Investigation the most common
schemes includes: Premium Diversion Fee Churning
Asset Diversion and workers compensation Fraud. The
perpetration in these schemes can be both insurance
claims filed with the intent to defraud an insurance
provider.
CAUSES
The “ chief motive in all insurance crimes is financial
profits. Insurance contracts provide both the insured
and the insurer with opportunities for exploitation.
According to the Coalition Against insurance Fraud, the
causes vary, but are usually centered on greed, and on
holes in the protection against fraud. Often those who
want commit insurance fraud views it as a low risk.
Another reason for fraud is over- insurance, when the
amount is greater than the actual value of the property
insured. This condition can be very difficult to avoid,
especially since an insurance provider might
sometimes encourage it in order obtain greater profits.
This allows fraudsters to make profits by destroying
their property because the payment they receive from
their insures is of greater value than the property they
destroy. Insurance companies are also susceptible to
fraud because its possible for fraudster to file claims
for the damges that never occurred.
INSURANCE AGENT
An insurance agent is a person or an entity that
represents of the interest of the insurer. According to
the current rules, an agent or corporate agent such as
a bank cant represent more than one insurance
company.
Since the insurer, also called the principal cant reach
out to all customers individually, he hires agents to do
this job. Agents are trained and licenced entities, so it’s
expected they understand financial needs of customer
and sell product that best suits customer interest.
Often that’s not the case. And agents they are not
accountable for the advice they give you, but the
principal or the insurance company is. So you can take
the insurance company to court or to insurance
Regulatory and development Authority for wrong
advice but not the agent. The insurer in turn can
reprimand the agent by cancelling his licence.
INSURANCE BROKERS
But you can drag an insurance broker to court. That’s
because a broker is the customers agent. A broker is
also a licenced and trained entity but with a different
mandate. The job of the broker is not to represent the
insurer but customers. Brokers have a fiduciary
responsibility towards the customer. A fiduciary legally
promise you to keep your interest paramount. So as
brokers they understand your needs and browse
through several insurers to get you the best- fit
product.
You can take your broker to the court in case he fails to
do his duties. You can also approach Irda who can
cancel the broker’s licence if found guilty. The idea
behind making banks insurance.
WHAT ARE DUTIES OF INSURANCE AGENTS
Leach Generation
As a saleperson, normally paid on commission the
insurance agent has the duty of generating leads for
insurance. This may include placing ads in a local
newspaper or website, going top community events
making cold calls and buying contact lists. Once he gets
names and numbers. Of prospects, he makes an initial
call to talk about policy needs or set up face to face
meeting with the prospect.
Interview
During an initial phone conversation or meeting with a
prospect, an insurance agent asks question and listens
to information on the prospects reads. He tries to
assets the buyers situation to figure out which types of
insurances and policy terms make the most sense.
Coverage needs, amount ,payments preferences and
budget are among the basis items discussed during this
initial meeting .
Sales
Like other sales professionals, insurance agents must
be skilled in the art of persuasion once he understands
the needs of a prospect, he can look over product
option to see what is the best match. He then makes a
recommendation to the prospect. While trying to
influence the prospect, it is important to take a long
term orientation. Many insurance agents sell a lot of
policies and hope to get continued business from new
customers including annual policy renewals. This
requires honesty and a customer-contered approach .
SERVICE
Larger insurance providers often have call centers or
supports teams that deal with basis customer service
question and claims. However, independent agents
and even those in offices with larger provides typically
function as the first point of service contact. If a
customer has a question about coverage or a claims,
he often calls his agent to discuses option or to get
information. He may also call to cancel policies or to
make additions or revisions to coverage.
POLICY HOLDER
Entity that owns an insurance policy and has the right
to exercise all privileges under the contract of
insurance, expect where restricted by the right of an
assignee . A policyholder may or may not be the
insured, or the sole or one of the beneficiaries of the
policy also called policy owner.