Life Insurance (though it shouldn't be) is to this day a very controversial issue. There seems to be a lot of different types of life insurance out there, but there are really only two kinds. They are Term Insurance and Whole Life (Cash Value) Insurance. Term Insurance is pure insurance. It protects you over a certain period of time. Whole Life Insurance is insurance plus a side account known as cash value. Generally speaking, consumer reports recommend term insurance as the most economical choice and they have for some time. But still, whole life insurance is the most prevalent in today's society. Which one should we buy?

Let's talk about the purpose of life insurance. Once we get the proper purpose of insurance down to a science, then everything else will fall into place. The purpose of life insurance is the same purpose as any other type of insurance. It is to "insure against loss of". Car insurance is to insure your car or someone else's car in case of an accident. So in other words, since you probably couldn't pay for the damage yourself, insurance is in place. Home owners insurance is to insure against loss of your home or items in it. So since you probably couldn't pay for a new house, you buy an insurance policy to cover it.

Life insurance is the same way. It is to insure against loss of your life. If you had a family, it would be impossible to support them after you died, so you buy life insurance so that if something were to happen to you, your family could replace your income. Life insurance is not to make you or your descendants rich or give them a reason to kill you. Life insurance is not to help you retire (or else it would be called retirement insurance)! Life insurance is to replace your income if you die. But the wicked ones have made us believe otherwise, so that they can overcharge us and sell all kinds of other things to us to get paid.

How Does Life Insurance Work?

Rather than make this complicated, I will give a very simple explanation on how and what goes down in an insurance policy. As a matter of fact, it will be over simplified because we would otherwise be here all day. This is an example. Let's say that you are 31 years old. A typical term insurance policy for 20 years for $200,000 would be about $20/month. Now... if you wanted to buy a whole life insurance policy for $200,000 you might pay $100/month for it. So instead of charging you $20 (which is the true cost) you will be overcharged by $80, which will then be put into a savings account.

Now, this $80 will continue to accumulate in a separate account for you. Typically speaking, if you want to get some of YOUR money out of the account, you can then BORROW IT from the account and pay it back with interest. Now... let's say you were to take $80 dollars a month and give it to your bank. If you went to withdraw the money from your bank account and they told you that you had to BORROW your own money from them and pay it back with interest, you would probably go clean upside somebody's head. But somehow, when it comes to insurance, this is okay

This stems from the fact that most people don't realize that they are borrowing their own money. The "agent" (of the insurance Matrix) rarely will explain it that way. You see, one of the ways that companies get rich, is by getting people to pay them, and then turn around and borrow their own money back and pay more interest! Home equity loans are another example of this, but that is a whole different sermon.

Deal or No Deal

Let us stick with the previous illustration. Let us say the one thousand 31 year olds ( all in good health) bought the aforementioned term policy (20 years, $200,000 dollars at $20/month). If these people were paying $20/month, that is $240 per year. If you take that and multiply it over the 20 year term then you will have $4800. So each individual will pay $4800 over the life of the term. Since one thousand individuals bought the policy, they will end up paying 4.8 million in premiums to the company. The insurance company has already calculated that around 20 people with good health (between the ages of 31 and 51) will die. So if 20 people pass away, then the company will have to pay out 20 x $200,000 or $4,000,000. So, if the company pays out $4,000,000 and takes in $4,800,000 it will then make a $800,000 profit.

This is of course OVER simplifying because a lot of people will cancel the policy (which will also bring down the number of death claims paid), and some of those premiums can be used to accumulate interest, but you can get a general idea of how things work.

On the other hand, let's look at whole life insurance. Let us say the one thousand 31 year olds (all in good health) bought the aforementioned whole life policy ($200,000 dollars at $100/month). These people are paying $100/month. That is $1200 per year. If the average person's lifespan (in good health people) goes to 75, then on average, the people will pay 44 years worth of premiums. If you take that and multiply it by $1200 you will get $52,800. So each individual will pay $52,800 over the life of the policy. Since one thousand individuals bought the policy, they will end up paying 52.8 million in premiums to the company. If you buy a whole life policy, the insurance company has already calculated the probability that you will die. What is that probability? 100%, because it is a whole life (till death do us part) insurance policy! This means that if everyone kept their policies, the insurance company would have to pay out 1000 x $200,000 = $2,000,000,000) That's right, two billion dollars!

Ladies and gentleman, how can a company afford to pay out two billion dollars knowing that it will only take in 52.8 million? Now just like in the previous example, this is an oversimplification as policies will lapse. As a matter of fact, MOST whole life policies do lapse because people can't afford them, I hope you see my point. Let's take the individual. A 31 year old male bought a policy in which he is suppose to pay in $52,800 and get $200,000 back? There no such thing as a free lunch. The company somehow has to weasel $147,200 out of him, JUST TO BREAK EVEN on this policy! Not to mention, pay the agents (who get paid much higher commissions on whole life policies), underwriters, insurance fees, advertising fees, 30 story buildings... etc, etc.

This doesn't even take into account these variable life and universal life policies that claim to be so good for your retirement. So you are going to pay $52,800 into a policy and this policy will make you rich, AND pay you the $200,000 death benefit, AND pay the agents, staff and fees? This has to be a rip off.

Well, how could they rip you off? Maybe for the first five years of the policy, no cash value will accumulate (you may want to check your policy). Maybe it's misrepresenting the value of the return (this is easy if the customer is not knowledgeable on exactly how investments work). Also, if you read my article on the Rule of 72 you can clearly see that giving your money to someone else to invest can lose you millions! You see, you may pay in $52,800 but that doesn't take into account how much money you LOSE by not investing it yourself! This is regardless of how well your agent may tell you the company will invest your money! Plain and simple, they have to get over on you somehow or they would go out of business!

How long do you need life insurance?

Let me explain what is called The Theory of Decreasing Responsibility, and maybe we can answer this question. Let's say that you and your spouse just got married and have a child. Like most people, when they are young they are also crazy, so they go out and buy a new car and a new house. Now, here you are with a young child and debt up to the neck! In this particular case, if one of you were to pass away, the loss of income would be devastating to the other spouse and the child. This is the case for life insurance. BUT, this is what happens. You and your spouse begin to pay off that debt. Your child gets older and less dependent on you. You start to build up your assets. Keep in mind that I am talking about REAL assets, not fake or phantom assets like equity in a home (which is just a fixed interest rate credit card)

In the end, the situation is like this. The child is out of the house and no longer dependent on you. You don't have any debt. You have enough money to live off of, and pay for your funeral (which now costs thousands of dollars because the DEATH INDUSTRY has found new ways to make money by having people spend more honor and money on a person after they die then they did while that person was alive). So... at this point, what do you need insurance for? Exactly... absolutely nothing! So why would you buy Whole Life (a.k.a. DEATH) Insurance? The idea of a 179 year old person with grown children who don't depend on him/her still paying insurance premiums is asinine to say the least.

As a matter of fact, the need for life insurance could be greatly decreased and quickly eliminated, if one would learn not to accumulate liabilities, and quickly accumulate wealth first. But I realize that this is almost impossible for most people in this materialistic, Middle Classed matrixed society. But anyway, let's take it a step further.

Confused Insurance Policies

This next statement is very obvious, but very profound. Living and dying are exact opposites of each other. Why do I say this? The purpose of investing is to accumulate enough money in case you live to retire. The purpose of buying insurance is to protect your family and loved ones if you die before you can retire. These are two diametrically opposed actions! So, if an "agent" waltzes into your home selling you a whole life insurance policy and telling you that it can insure your life AND it can help you retire, your Red Pill Question should be this:

"If this plan will help me retire securely, why will I always need insurance? And on the other hand, if I will be broke enough later on in life that I will still need insurance, then how is this a good retirement plan?"

Now if you ask an insurance agent those questions, she/he may become confused. This of course comes from selling confused policies that do two opposites at once.

Norman Dacey said it best in the book "What's Wrong With Your Life Insurance"

"No one could ever quarrel with the idea of providing protection for one's family while at the same time accumulating a fund for some such purpose as education or retirement. But if you try to do both of these jobs through the medium of one insurance policy, it is inevitable that both jobs will be done badly."

So you see, even though there are a lot of new variations of whole life, like variable life and universal life, with various bells and whistles (claiming to be better than the original, typical whole life policies), the Red Pill Question must always be asked! If you are going to buy insurance, then buy insurance! If you are going to invest, then invest. It's that simple. Don't let an insurance agent trick you into buying a whole life policy based on the assumption that you are too incompetent and undisciplined to invest your own money.

If you are afraid to invest your money because you don't know how, then educate yourself! It may take some time, but it is better than giving your money to somebody else so they can invest it for you (and get rich with it). How can a company be profitable when it takes the money from it's customers, invests it, and turns around and gives it's customers all of the profits?

And don't fall for the old "What if the term runs out and you can't get re-insured trick". Listen, there are a lot of term policies out there that are guaranteed renewable until an old age (75-100). Yes, the price is a lot higher, but you must realize that if you buy a whole life policy, you will have been duped out of even more money by the time you get to that point (if that even happens). This is also yet another reason to be smart with your money. Don't buy confused policies.

How much should you buy?

I normally recommend 8-10 times your yearly income as a good face amount for your insurance. Why so high? Here is the reason. Let's say that you make $50,000 per year. If you were to pass away, your family could take $500,000 (10 times $50,000) and put it into a fund that pays 10 percent (which will give them $40,000 per year) and not touch the principle. So what you have done is replaced your income.

This is another reason why Whole Life insurance is bad. It is impossible to afford the amount of insurance you need trying to buy super high priced policies. Term insurance is much cheaper. To add to this, don't let high face values scare you. If you have a lot of liabilities and you are worried about your family, it is much better to be underinsured than to have no insurance at all. Buy what you can manage. Don't get sold what you can't manage.

Insurance

What Type Of Life Insurance Is Best?

Life Insurance (though it shouldn't be) is to this day a very controversial issue. There seems to be a lot of different types of life insurance out there, but there are really only two kinds. They are Term Insurance and Whole Life (Cash Value) Insurance. Term Insurance is pure insurance. It protects you over a certain period of time. Whole Life Insurance is insurance plus a side account known as cash value. Generally speaking, consumer reports recommend term insurance as the most economical choice and they have for some time. But still, whole life insurance is the most prevalent in today's society. Which one should we buy?

Let's talk about the purpose of life insurance. Once we get the proper purpose of insurance down to a science, then everything else will fall into place. The purpose of life insurance is the same purpose as any other type of insurance. It is to "insure against loss of". Car insurance is to insure your car or someone else's car in case of an accident. So in other words, since you probably couldn't pay for the damage yourself, insurance is in place. Home owners insurance is to insure against loss of your home or items in it. So since you probably couldn't pay for a new house, you buy an insurance policy to cover it.

Life insurance is the same way. It is to insure against loss of your life. If you had a family, it would be impossible to support them after you died, so you buy life insurance so that if something were to happen to you, your family could replace your income. Life insurance is not to make you or your descendants rich or give them a reason to kill you. Life insurance is not to help you retire (or else it would be called retirement insurance)! Life insurance is to replace your income if you die. But the wicked ones have made us believe otherwise, so that they can overcharge us and sell all kinds of other things to us to get paid.

How Does Life Insurance Work?

Rather than make this complicated, I will give a very simple explanation on how and what goes down in an insurance policy. As a matter of fact, it will be over simplified because we would otherwise be here all day. This is an example. Let's say that you are 31 years old. A typical term insurance policy for 20 years for $200,000 would be about $20/month. Now... if you wanted to buy a whole life insurance policy for $200,000 you might pay $100/month for it. So instead of charging you $20 (which is the true cost) you will be overcharged by $80, which will then be put into a savings account.

Now, this $80 will continue to accumulate in a separate account for you. Typically speaking, if you want to get some of YOUR money out of the account, you can then BORROW IT from the account and pay it back with interest. Now... let's say you were to take $80 dollars a month and give it to your bank. If you went to withdraw the money from your bank account and they told you that you had to BORROW your own money from them and pay it back with interest, you would probably go clean upside somebody's head. But somehow, when it comes to insurance, this is okay

This stems from the fact that most people don't realize that they are borrowing their own money. The "agent" (of the insurance Matrix) rarely will explain it that way. You see, one of the ways that companies get rich, is by getting people to pay them, and then turn around and borrow their own money back and pay more interest! Home equity loans are another example of this, but that is a whole different sermon.

Deal or No Deal

Let us stick with the previous illustration. Let us say the one thousand 31 year olds ( all in good health) bought the aforementioned term policy (20 years, $200,000 dollars at $20/month). If these people were paying $20/month, that is $240 per year. If you take that and multiply it over the 20 year term then you will have $4800. So each individual will pay $4800 over the life of the term. Since one thousand individuals bought the policy, they will end up paying 4.8 million in premiums to the company. The insurance company has already calculated that around 20 people with good health (between the ages of 31 and 51) will die. So if 20 people pass away, then the company will have to pay out 20 x $200,000 or $4,000,000. So, if the company pays out $4,000,000 and takes in $4,800,000 it will then make a $800,000 profit.

This is of course OVER simplifying because a lot of people will cancel the policy (which will also bring down the number of death claims paid), and some of those premiums can be used to accumulate interest, but you can get a general idea of how things work.

On the other hand, let's look at whole life insurance. Let us say the one thousand 31 year olds (all in good health) bought the aforementioned whole life policy ($200,000 dollars at $100/month). These people are paying $100/month. That is $1200 per year. If the average person's lifespan (in good health people) goes to 75, then on average, the people will pay 44 years worth of premiums. If you take that and multiply it by $1200 you will get $52,800. So each individual will pay $52,800 over the life of the policy. Since one thousand individuals bought the policy, they will end up paying 52.8 million in premiums to the company. If you buy a whole life policy, the insurance company has already calculated the probability that you will die. What is that probability? 100%, because it is a whole life (till death do us part) insurance policy! This means that if everyone kept their policies, the insurance company would have to pay out 1000 x $200,000 = $2,000,000,000) That's right, two billion dollars!

Ladies and gentleman, how can a company afford to pay out two billion dollars knowing that it will only take in 52.8 million? Now just like in the previous example, this is an oversimplification as policies will lapse. As a matter of fact, MOST whole life policies do lapse because people can't afford them, I hope you see my point. Let's take the individual. A 31 year old male bought a policy in which he is suppose to pay in $52,800 and get $200,000 back? There no such thing as a free lunch. The company somehow has to weasel $147,200 out of him, JUST TO BREAK EVEN on this policy! Not to mention, pay the agents (who get paid much higher commissions on whole life policies), underwriters, insurance fees, advertising fees, 30 story buildings... etc, etc.

This doesn't even take into account these variable life and universal life policies that claim to be so good for your retirement. So you are going to pay $52,800 into a policy and this policy will make you rich, AND pay you the $200,000 death benefit, AND pay the agents, staff and fees? This has to be a rip off.

Well, how could they rip you off? Maybe for the first five years of the policy, no cash value will accumulate (you may want to check your policy). Maybe it's misrepresenting the value of the return (this is easy if the customer is not knowledgeable on exactly how investments work). Also, if you read my article on the Rule of 72 you can clearly see that giving your money to someone else to invest can lose you millions! You see, you may pay in $52,800 but that doesn't take into account how much money you LOSE by not investing it yourself! This is regardless of how well your agent may tell you the company will invest your money! Plain and simple, they have to get over on you somehow or they would go out of business!

How long do you need life insurance?

Let me explain what is called The Theory of Decreasing Responsibility, and maybe we can answer this question. Let's say that you and your spouse just got married and have a child. Like most people, when they are young they are also crazy, so they go out and buy a new car and a new house. Now, here you are with a young child and debt up to the neck! In this particular case, if one of you were to pass away, the loss of income would be devastating to the other spouse and the child. This is the case for life insurance. BUT, this is what happens. You and your spouse begin to pay off that debt. Your child gets older and less dependent on you. You start to build up your assets. Keep in mind that I am talking about REAL assets, not fake or phantom assets like equity in a home (which is just a fixed interest rate credit card)

In the end, the situation is like this. The child is out of the house and no longer dependent on you. You don't have any debt. You have enough money to live off of, and pay for your funeral (which now costs thousands of dollars because the DEATH INDUSTRY has found new ways to make money by having people spend more honor and money on a person after they die then they did while that person was alive). So... at this point, what do you need insurance for? Exactly... absolutely nothing! So why would you buy Whole Life (a.k.a. DEATH) Insurance? The idea of a 179 year old person with grown children who don't depend on him/her still paying insurance premiums is asinine to say the least.

As a matter of fact, the need for life insurance could be greatly decreased and quickly eliminated, if one would learn not to accumulate liabilities, and quickly accumulate wealth first. But I realize that this is almost impossible for most people in this materialistic, Middle Classed matrixed society. But anyway, let's take it a step further.

Confused Insurance Policies

This next statement is very obvious, but very profound. Living and dying are exact opposites of each other. Why do I say this? The purpose of investing is to accumulate enough money in case you live to retire. The purpose of buying insurance is to protect your family and loved ones if you die before you can retire. These are two diametrically opposed actions! So, if an "agent" waltzes into your home selling you a whole life insurance policy and telling you that it can insure your life AND it can help you retire, your Red Pill Question should be this:

"If this plan will help me retire securely, why will I always need insurance? And on the other hand, if I will be broke enough later on in life that I will still need insurance, then how is this a good retirement plan?"

Now if you ask an insurance agent those questions, she/he may become confused. This of course comes from selling confused policies that do two opposites at once.

Norman Dacey said it best in the book "What's Wrong With Your Life Insurance"

"No one could ever quarrel with the idea of providing protection for one's family while at the same time accumulating a fund for some such purpose as education or retirement. But if you try to do both of these jobs through the medium of one insurance policy, it is inevitable that both jobs will be done badly."

So you see, even though there are a lot of new variations of whole life, like variable life and universal life, with various bells and whistles (claiming to be better than the original, typical whole life policies), the Red Pill Question must always be asked! If you are going to buy insurance, then buy insurance! If you are going to invest, then invest. It's that simple. Don't let an insurance agent trick you into buying a whole life policy based on the assumption that you are too incompetent and undisciplined to invest your own money.

If you are afraid to invest your money because you don't know how, then educate yourself! It may take some time, but it is better than giving your money to somebody else so they can invest it for you (and get rich with it). How can a company be profitable when it takes the money from it's customers, invests it, and turns around and gives it's customers all of the profits?

And don't fall for the old "What if the term runs out and you can't get re-insured trick". Listen, there are a lot of term policies out there that are guaranteed renewable until an old age (75-100). Yes, the price is a lot higher, but you must realize that if you buy a whole life policy, you will have been duped out of even more money by the time you get to that point (if that even happens). This is also yet another reason to be smart with your money. Don't buy confused policies.

How much should you buy?

I normally recommend 8-10 times your yearly income as a good face amount for your insurance. Why so high? Here is the reason. Let's say that you make $50,000 per year. If you were to pass away, your family could take $500,000 (10 times $50,000) and put it into a fund that pays 10 percent (which will give them $40,000 per year) and not touch the principle. So what you have done is replaced your income.

This is another reason why Whole Life insurance is bad. It is impossible to afford the amount of insurance you need trying to buy super high priced policies. Term insurance is much cheaper. To add to this, don't let high face values scare you. If you have a lot of liabilities and you are worried about your family, it is much better to be underinsured than to have no insurance at all. Buy what you can manage. Don't get sold what you can't manage.

In this article we will explore the reasons that motivate employers to get group health insurance for employees and we will look at the advantages and disadvantages from both points of view.

Group Health Insurance VS Individual Private Health Insurance

Probably the most significant distinguishing characteristic of group insurance is the substitution of group underwriting for individual underwriting. In group cases, no individual evidence of insurability is usually required, and benefit levels can be substantial, with few, if any, important limitations.

Group underwriting normally is not concerned with the health or other insurability aspects of any particular individual. Instead, it aims to obtain a group of individual lives or, what is even more important, an aggregation of such groups of lives that will yield a predictable rate of mortality or morbidity. If a sufficient number of groups of lives is obtained, and if these groups are reasonably homogeneous in nature, then the mortality or morbidity rate will be predictable. The point is that the group becomes the unit of underwriting, and insurance principles may be applied to it just as in the case of the individual. To assure that the groups obtained will be reasonably homogeneous, the underwriting process in group insurance aims to control adverse selection by individuals within a group.

In underwriting group insurance, then, certain important features should be present that either are inherent in the nature of the group itself or may be applied in a positive way to avoid serious adverse selection such as:

Insurance Incidental to the Group: The insurance should be incidental to the group; that is, the members of the group should have come together for some purpose other than to obtain insurance. For example, the group insurance furnished to the employees of a given employer must not be the feature that motivates the formation and existence of the group.

Flow of Persons through the Group: There should be a steady flow of persons through the group; that is, there must be an influx of new young lives into the group and an out flow from the group of the older and impaired lives. With groups of actively working employees, it may be assumed that they are in average health.

Automatic Determination of Benefits: Group insurance underwriting commonly requires an automatic basis for determining the amount of benefits on individual lives, which is beyond the control of the employer or employees. If the amount of benefits taken were completely optional, it would be possible to select against the insurer because those in poor health would tend to insure heavily and the healthy ones might tend to elect minimum coverage.

As the group mechanism has evolved, however, insurers have responded to demands from the marketplace, particularly large employers, for more flexibility in the selection of benefits. This flexibility typically is expressed in optional amounts of life and health insurance in excess of basic coverage provided by the employer and in more health care financing choices. Also, increasingly popular cafeteria plans allow participating employees to select among an array of benefits using a predetermined allowance of employer funds. Individuals select, subject to certain basic coverage's being required, a combination of benefits that best meet his or her individual needs.

Minimum Participation by the Group: Another underwriting control is the requirement that substantially all eligible persons in a given group be covered by insurance. In plans in which the employee pays a portion of the premium (contributory), generally at least 75 percent of the eligible employees must join the plan if coverage is to be effective. In the case of noncontributory plans, 100 percent participation is required. By covering a large proportion of a given group, the insurance company gains a safeguard against an undue proportion of substandard lives. In cases in which employees refuse the insurance for religious or other reasons that do not involve any elements of selection, this rule is relaxed.

Third Party Sharing of Cost: A portion of the cost of a group plan ideally should be borne by the employer or some third party, such as a labor union or trade association. The noncontributory employer-pay-all plan is simple, and it gives the employer full control over the plan. It provides for insurance of all eligible employees and thus, eliminates any difficulties involved in connection with obtaining the consent of a sufficient number of employees to meet participation requirements. Also, there is no problem of distributing the cost among various employees, as in the contributory plan.

Contributory plans usually are less costly to the employer. Hence, with employee contributions, the employer is likely to arrange for more adequate protection for the employees. It can also be argued that, if the employee contributes toward his or her insurance, he or she will be more impressed with its value and will appreciate it more. On the other hand, the contributory plan has a number of disadvantages. Its operation is more complicated, and this at times, increases administrative cost considerably.

Each employee must consent to contribute toward his or her insurance, and as stated before, a minimum percentage of the eligible group must consent to enter the arrangement. New employees entering the business must be informed of their insurance privilege. If the plan is contributory, employees may not be entitled to the insurance until they have been with the company for a period of time. If they do not agree to be covered by the plan within a period of 31 days, they may be required to provide satisfactory evidence of insurability to become eligible. Some noncontributory plans also have these probationary periods.

Efficient Administrative Organization: A single administrative organization should be able and willing to act on behalf of the insured group. In the usual case, this is the employer. In the case of a contributory plan, there must be a reasonably simple method, such as payroll deduction, by which the master policy owner can collect premiums. An automatic method is desirable for both an administrative and underwriting perspective. A number of miscellaneous controls of underwriting significance are typically used in group insurance plans, but the preceding discussion permits an appreciation of the group underwriting underwriting theory. The discussion applies to groups with a large number of employees.

A majority of the groups, however, are not large. The group size is a significant factor in the underwriting process. In smaller plans, more restrictive underwriting practices relating to adverse section are used. These may include less liberal contract provisions, simple health status questions, and in some cases, detailed individual underwriting of group members.

Group Policy: A second characteristic of group insurance is the use of a group policy (contract) held by the owner as group policyholder and booklet-certificates or other summary evidence of insurance held by plan participants. Certificates provide information on the plan provisions and the steps required to file claims. The use of certificates and a master contract constitutes one of the sources of economy under the group approach. The master contract is a detailed document setting forth the contractual relationship between the group contract owner and the insurance company. The insured persons under the contract, usually employees and their beneficiaries, are not actually parties to the contract, although they may enforce their rights as third party beneficiaries. The four party relationship between the employer, insurer, employee, and dependents in a group insurance plan can create a number of interesting and unusual problems that are common only to group insurance.

Lower Cost: A third feature of group insurance is that it is usually lower-cost protection than that which is available in individual insurance. The nature of the group approach permits the use of mass distribution and mass administration methods that afford economies of operation not available in individual insurance. Also, because group insurance is not usually underwritten on an individual basis, the premiums are based upon an actuarial assessment of the group as a whole, so a given healthy individual can perhaps buy insurance at a lower cost. Employer subsidization of the cost is a critical factor in group insurance plan design. Probably the most significant savings in the cost of marketing group insurance lies in the fact that group commissions absorb a much smaller proportion of total premiums than commission for individual contracts.

The marketing system relieves the agent or broker of many duties, responsibilities, and expenses normally associated with selling or servicing of individual insurance. Because of the large premiums involved in many group insurance cases, the commission rates are considerably lower than for individual contracts and are usually graded downward as the premium increases. Some large group insurance buyer's deal directly with insurance companies and commissions are eliminated. In these cases, however, fees frequently are paid to the consultants involved. The nature of the administrative procedures permits simplified accounting techniques. The mechanics of premium collection are less involved, and experience refund procedures much simplified because there id only one party with whom to deal with such as the group policy owner.

Of course, the issuance of a large number of individual contracts is avoided and, because of the nature of group selection, the cost of medical examinations and inspection reports is minimized. Also, regulatory filings and other requirements are minimized. In the early days of group insurance, administration was simple. That is no longer true. Even with group term life insurance, for which there is no cash value, the push for accelerated death benefits, assignment to viatical companies, and estate or business planning record keeping means that the administration of coverage may be as complex as with an individual policy.

Flexibility: in contrast to individual contracts that must be taken as written, the larger employer usually has options in the design and preparation of the group insurance contract. Although the contracts follow a pattern and include certain standard provisions, there is considerably more flexibility here than in the case of individual contracts. The degree of flexibility permitted is, of course, a function of the size of the group involved. The group insurance program usually is an integral part of an employee benefit program and, in most cases, the contract can be molded to meet the objectives of the contract owner, as long as the request do not entail complicated administrative procedures, open the way to possibly serious adverse selection, or violate legal requirements.

Experience Rating: Another special feature of group insurance is that premiums often are subject to experience rating. The experience of the individual group may have an important bearing on dividends or premium-rate adjustments. The larger and, hence, the more reliable the experience of the particular group, the greater is the weight attached to its own experience in any single year. The knowledge that premiums net of dividends or premium rate adjustments will be based on the employers own experience gives the employer a vested interest in maintaining a favorable loss and expense record. For the largest employers, insurers may agree to complicated procedures to satisfy the employer's objectives because most such cases are experience rated and reflect the increased cost.

Some insurers experience rate based on the class or type of industry, or even based on the type of contract. For small groups, most insurance companies' use pooled rates under which a uniform rate is applied to all such groups, although it is becoming more common to apply separate pooled rates for groups with significantly better or worse experience than that of the total class. The point at which a group is large enough to be eligible for experience rating varies from company to company, based on that insurer's book of business and experience. The size and frequency of medical claims vary considerably across countries and among geographic regions within a country and must be considered in determining a group insurance rate. The composition (age, sex, and income level) of a group will also affect the experience of the group and, similarly, will be an important underwriting consideration. 

Advantages and Limitations of the Group Mechanism.

Advantages: The group insurance mechanism has proved to be a remarkably effective solution to the need for employee benefits for a number of reasons. The utilization of mass-distribution techniques has extended protection to large numbers of person s with little or no life or health insurance. The increasing complexity of industrial service economies has brought large numbers of persons together, and the group mechanism has enabled insurance companies to reach vast numbers of individuals within a relatively short period and at low cost. Group insurance also has extended protection to a large number of uninsurable persons. Equally important has been the fact that the employer usually pays a large share of the cost. Moreover, in most countries, including the United States, the deductibility of employer contributions and the favorable tax treatment of the benefits to employees make it a tax effective vehicle with which to provide benefits.

Another significant factor, and one of the more cogent motivations for the rapid development of group insurance, has been the continuing governmental role in the security benefits area. Within the United States, Old-Age. Survivors, Disability, and Health Insurance programs has expanded rapidly, but many observers believe that, had not group insurance provided substantial sums of life insurance, health insurance, and retirement protection, social insurance would have developed even more rapidly. As economies worldwide continue to reduce the size and scope of social insurance programs, we can expect the demand for group based security to grow even more.

Disadvantages: From the viewpoint of the employee, group insurance has one great limitation- the temporary nature of the coverage. Unless an employee converts his or her coverage to an individual policy which is usually ore expensive and provides less liberal coverage, the employee loses his or her insurance protection if the group plan is terminated and often also at retirement because employment is terminated. Group life and health protection is continued after retirement in a significant proportion of cases today in the United States, but often at reduced levels. Recently, with the introduction of a new U.S. accounting standard (FAS 106) requiring that the cost of such benefits be accrued and reflected in financial statements, an increasing number of employers have discontinued post retirement life and health benefits entirely. When such continued protection is not available, the temporary nature of the coverage is a serious limitation.

Retiree group health insurance often is provided as a supplement to Medicare. Another problem of potential significance involves individuals who may be lulled into complacency by having large amounts of group insurance during their working years. Many of these persons fail to recognize the need for, or are unwilling to face the cost of, individual insurance. Perhaps of even greater significance is the fact that the flexibility of the group approach is limited to the design of the master policy and does not extend to the individual covered employees. Furthermore, group plans typically fail to provide the mechanism for any analysis of the financial needs of the individual which is a service that is normally furnished by the agent or other advisor. Many agents, however, discuss group insurance coverage with individuals as a foundation for discussing the need for additional amounts of individual life and health insurance.

Insurance

Advantages and Disadvantages on Group Health Insurance VS Individual Health Insurance

In this article we will explore the reasons that motivate employers to get group health insurance for employees and we will look at the advantages and disadvantages from both points of view.

Group Health Insurance VS Individual Private Health Insurance

Probably the most significant distinguishing characteristic of group insurance is the substitution of group underwriting for individual underwriting. In group cases, no individual evidence of insurability is usually required, and benefit levels can be substantial, with few, if any, important limitations.

Group underwriting normally is not concerned with the health or other insurability aspects of any particular individual. Instead, it aims to obtain a group of individual lives or, what is even more important, an aggregation of such groups of lives that will yield a predictable rate of mortality or morbidity. If a sufficient number of groups of lives is obtained, and if these groups are reasonably homogeneous in nature, then the mortality or morbidity rate will be predictable. The point is that the group becomes the unit of underwriting, and insurance principles may be applied to it just as in the case of the individual. To assure that the groups obtained will be reasonably homogeneous, the underwriting process in group insurance aims to control adverse selection by individuals within a group.

In underwriting group insurance, then, certain important features should be present that either are inherent in the nature of the group itself or may be applied in a positive way to avoid serious adverse selection such as:

Insurance Incidental to the Group: The insurance should be incidental to the group; that is, the members of the group should have come together for some purpose other than to obtain insurance. For example, the group insurance furnished to the employees of a given employer must not be the feature that motivates the formation and existence of the group.

Flow of Persons through the Group: There should be a steady flow of persons through the group; that is, there must be an influx of new young lives into the group and an out flow from the group of the older and impaired lives. With groups of actively working employees, it may be assumed that they are in average health.

Automatic Determination of Benefits: Group insurance underwriting commonly requires an automatic basis for determining the amount of benefits on individual lives, which is beyond the control of the employer or employees. If the amount of benefits taken were completely optional, it would be possible to select against the insurer because those in poor health would tend to insure heavily and the healthy ones might tend to elect minimum coverage.

As the group mechanism has evolved, however, insurers have responded to demands from the marketplace, particularly large employers, for more flexibility in the selection of benefits. This flexibility typically is expressed in optional amounts of life and health insurance in excess of basic coverage provided by the employer and in more health care financing choices. Also, increasingly popular cafeteria plans allow participating employees to select among an array of benefits using a predetermined allowance of employer funds. Individuals select, subject to certain basic coverage's being required, a combination of benefits that best meet his or her individual needs.

Minimum Participation by the Group: Another underwriting control is the requirement that substantially all eligible persons in a given group be covered by insurance. In plans in which the employee pays a portion of the premium (contributory), generally at least 75 percent of the eligible employees must join the plan if coverage is to be effective. In the case of noncontributory plans, 100 percent participation is required. By covering a large proportion of a given group, the insurance company gains a safeguard against an undue proportion of substandard lives. In cases in which employees refuse the insurance for religious or other reasons that do not involve any elements of selection, this rule is relaxed.

Third Party Sharing of Cost: A portion of the cost of a group plan ideally should be borne by the employer or some third party, such as a labor union or trade association. The noncontributory employer-pay-all plan is simple, and it gives the employer full control over the plan. It provides for insurance of all eligible employees and thus, eliminates any difficulties involved in connection with obtaining the consent of a sufficient number of employees to meet participation requirements. Also, there is no problem of distributing the cost among various employees, as in the contributory plan.

Contributory plans usually are less costly to the employer. Hence, with employee contributions, the employer is likely to arrange for more adequate protection for the employees. It can also be argued that, if the employee contributes toward his or her insurance, he or she will be more impressed with its value and will appreciate it more. On the other hand, the contributory plan has a number of disadvantages. Its operation is more complicated, and this at times, increases administrative cost considerably.

Each employee must consent to contribute toward his or her insurance, and as stated before, a minimum percentage of the eligible group must consent to enter the arrangement. New employees entering the business must be informed of their insurance privilege. If the plan is contributory, employees may not be entitled to the insurance until they have been with the company for a period of time. If they do not agree to be covered by the plan within a period of 31 days, they may be required to provide satisfactory evidence of insurability to become eligible. Some noncontributory plans also have these probationary periods.

Efficient Administrative Organization: A single administrative organization should be able and willing to act on behalf of the insured group. In the usual case, this is the employer. In the case of a contributory plan, there must be a reasonably simple method, such as payroll deduction, by which the master policy owner can collect premiums. An automatic method is desirable for both an administrative and underwriting perspective. A number of miscellaneous controls of underwriting significance are typically used in group insurance plans, but the preceding discussion permits an appreciation of the group underwriting underwriting theory. The discussion applies to groups with a large number of employees.

A majority of the groups, however, are not large. The group size is a significant factor in the underwriting process. In smaller plans, more restrictive underwriting practices relating to adverse section are used. These may include less liberal contract provisions, simple health status questions, and in some cases, detailed individual underwriting of group members.

Group Policy: A second characteristic of group insurance is the use of a group policy (contract) held by the owner as group policyholder and booklet-certificates or other summary evidence of insurance held by plan participants. Certificates provide information on the plan provisions and the steps required to file claims. The use of certificates and a master contract constitutes one of the sources of economy under the group approach. The master contract is a detailed document setting forth the contractual relationship between the group contract owner and the insurance company. The insured persons under the contract, usually employees and their beneficiaries, are not actually parties to the contract, although they may enforce their rights as third party beneficiaries. The four party relationship between the employer, insurer, employee, and dependents in a group insurance plan can create a number of interesting and unusual problems that are common only to group insurance.

Lower Cost: A third feature of group insurance is that it is usually lower-cost protection than that which is available in individual insurance. The nature of the group approach permits the use of mass distribution and mass administration methods that afford economies of operation not available in individual insurance. Also, because group insurance is not usually underwritten on an individual basis, the premiums are based upon an actuarial assessment of the group as a whole, so a given healthy individual can perhaps buy insurance at a lower cost. Employer subsidization of the cost is a critical factor in group insurance plan design. Probably the most significant savings in the cost of marketing group insurance lies in the fact that group commissions absorb a much smaller proportion of total premiums than commission for individual contracts.

The marketing system relieves the agent or broker of many duties, responsibilities, and expenses normally associated with selling or servicing of individual insurance. Because of the large premiums involved in many group insurance cases, the commission rates are considerably lower than for individual contracts and are usually graded downward as the premium increases. Some large group insurance buyer's deal directly with insurance companies and commissions are eliminated. In these cases, however, fees frequently are paid to the consultants involved. The nature of the administrative procedures permits simplified accounting techniques. The mechanics of premium collection are less involved, and experience refund procedures much simplified because there id only one party with whom to deal with such as the group policy owner.

Of course, the issuance of a large number of individual contracts is avoided and, because of the nature of group selection, the cost of medical examinations and inspection reports is minimized. Also, regulatory filings and other requirements are minimized. In the early days of group insurance, administration was simple. That is no longer true. Even with group term life insurance, for which there is no cash value, the push for accelerated death benefits, assignment to viatical companies, and estate or business planning record keeping means that the administration of coverage may be as complex as with an individual policy.

Flexibility: in contrast to individual contracts that must be taken as written, the larger employer usually has options in the design and preparation of the group insurance contract. Although the contracts follow a pattern and include certain standard provisions, there is considerably more flexibility here than in the case of individual contracts. The degree of flexibility permitted is, of course, a function of the size of the group involved. The group insurance program usually is an integral part of an employee benefit program and, in most cases, the contract can be molded to meet the objectives of the contract owner, as long as the request do not entail complicated administrative procedures, open the way to possibly serious adverse selection, or violate legal requirements.

Experience Rating: Another special feature of group insurance is that premiums often are subject to experience rating. The experience of the individual group may have an important bearing on dividends or premium-rate adjustments. The larger and, hence, the more reliable the experience of the particular group, the greater is the weight attached to its own experience in any single year. The knowledge that premiums net of dividends or premium rate adjustments will be based on the employers own experience gives the employer a vested interest in maintaining a favorable loss and expense record. For the largest employers, insurers may agree to complicated procedures to satisfy the employer's objectives because most such cases are experience rated and reflect the increased cost.

Some insurers experience rate based on the class or type of industry, or even based on the type of contract. For small groups, most insurance companies' use pooled rates under which a uniform rate is applied to all such groups, although it is becoming more common to apply separate pooled rates for groups with significantly better or worse experience than that of the total class. The point at which a group is large enough to be eligible for experience rating varies from company to company, based on that insurer's book of business and experience. The size and frequency of medical claims vary considerably across countries and among geographic regions within a country and must be considered in determining a group insurance rate. The composition (age, sex, and income level) of a group will also affect the experience of the group and, similarly, will be an important underwriting consideration. 

Advantages and Limitations of the Group Mechanism.

Advantages: The group insurance mechanism has proved to be a remarkably effective solution to the need for employee benefits for a number of reasons. The utilization of mass-distribution techniques has extended protection to large numbers of person s with little or no life or health insurance. The increasing complexity of industrial service economies has brought large numbers of persons together, and the group mechanism has enabled insurance companies to reach vast numbers of individuals within a relatively short period and at low cost. Group insurance also has extended protection to a large number of uninsurable persons. Equally important has been the fact that the employer usually pays a large share of the cost. Moreover, in most countries, including the United States, the deductibility of employer contributions and the favorable tax treatment of the benefits to employees make it a tax effective vehicle with which to provide benefits.

Another significant factor, and one of the more cogent motivations for the rapid development of group insurance, has been the continuing governmental role in the security benefits area. Within the United States, Old-Age. Survivors, Disability, and Health Insurance programs has expanded rapidly, but many observers believe that, had not group insurance provided substantial sums of life insurance, health insurance, and retirement protection, social insurance would have developed even more rapidly. As economies worldwide continue to reduce the size and scope of social insurance programs, we can expect the demand for group based security to grow even more.

Disadvantages: From the viewpoint of the employee, group insurance has one great limitation- the temporary nature of the coverage. Unless an employee converts his or her coverage to an individual policy which is usually ore expensive and provides less liberal coverage, the employee loses his or her insurance protection if the group plan is terminated and often also at retirement because employment is terminated. Group life and health protection is continued after retirement in a significant proportion of cases today in the United States, but often at reduced levels. Recently, with the introduction of a new U.S. accounting standard (FAS 106) requiring that the cost of such benefits be accrued and reflected in financial statements, an increasing number of employers have discontinued post retirement life and health benefits entirely. When such continued protection is not available, the temporary nature of the coverage is a serious limitation.

Retiree group health insurance often is provided as a supplement to Medicare. Another problem of potential significance involves individuals who may be lulled into complacency by having large amounts of group insurance during their working years. Many of these persons fail to recognize the need for, or are unwilling to face the cost of, individual insurance. Perhaps of even greater significance is the fact that the flexibility of the group approach is limited to the design of the master policy and does not extend to the individual covered employees. Furthermore, group plans typically fail to provide the mechanism for any analysis of the financial needs of the individual which is a service that is normally furnished by the agent or other advisor. Many agents, however, discuss group insurance coverage with individuals as a foundation for discussing the need for additional amounts of individual life and health insurance.

Illness for non-work related injuries can be financially devastating. Insurance keeps you protected against disastrous health care expenses and lost wages. There are enormous health insurance plans available day-to-day, the insurance cost and its benefits vary from one plans to another. Before enrolling for a policy, an individual should consult with the insurance agencies, read the policy to get the complete information about the benefits and costs and also the way the plan works.

Today, there are many more kinds of health insurance to choose from than were available just a few years ago. Traditional differences between and among plans do not longer any more. Also, there is been an increased emphasis on the role of consumers in managing their own health care and health care finances. There is a focus on providing information on the cost of care and health care quality-at the level of the physician, physician group, and hospital-to help consumers and employers choose among the many options available to them. The things have changed a lot, when most people in the United States had health insurance has indemnity insurance (also called as fee-for-service or traditional insurance). This type of insurance coverage assumed that the medical provider i.e. doctor or physicians will be paid a fee for each service provided to the patient.

When we talk about health insurance, we usually mean the kind of insurance that pays medical bills, hospital bills, and typically, prescription drug costs. Nowadays, the insurance also covers Medicare and Mediaid that provides health insurance coverage for certain people, senior citizens, people with disabilities and also an individual and families with low income. Today, the online information helps an individual to compare two best insurance policies and choose best among it. The insurance help an individual for financial planning and accordingly choose the best suitable for the family. The policy helps to avoid the burden of expensive medical bills and ensure the penny paid in health plan is paid for your care. It protects you and your family financially in the event of an unexpected serious illness or injury that could be very expensive.

In spite of available health insurance help online, unfortunately many Americans are still uninsured or underinsured. Some may be eligible for private or government but may have difficulty in finding the maze of complex rules and insurance jargons. Many more may not even have chosen the plans due to non-affordability coverage or may not be eligible for any. To help you choose right plan, we give you an overview of programs and strategies for seeking free or reduced-cost health care and managing medical debts.

Why does an individual require health insurance?

As the science and medical care advances, the ways of treatment are also increasing simultaneously. The main purpose of health insurance is to help in paying for care. It protects you and your family members in an unexpected serious illness and injury that may be high in cost. Additionally, you are more likely to get regular and routine checkups, if you have an insurance policy. Every individual requires insurance policy because you cannot predict your illness, injury and your high paying medical bills. One must seriously consider the need for health insurance for own and family. We also know that there is interlinking between having health insurance and getting protective health care. The research states that people having health insurance are more likely to have a regular doctor and get care when it is needed.

How should one get health insurance?

Most of the people get health insurance through their employers or company which they belong to. This is formerly known as group insurance. Some individuals don't have access to group insurance. In this case, one may choose to purchase their own individual health insurance directly from public or privately owned insurance company. Most of the Americans in North America get health insurance through government programs that operate at National, State & Local Levels. Insurance- whether provided by your employer or purchased by you - can be both expensive and complex. To understand better option, you must take health insurance help from the experts and advisors.

Group Insurance: 

Group Insurance is basically offered by the employers or else by an organization of which you are a member of union, professional association wherein you may get group coverage. The employee has to choose between several plans been offered by an employer's including both indemnity insurance and managed care. Some employer may only offer one single plan. Some group plans may also include dental care with the health and medical benefits. Hence, it is a very important decision to be taken by and employee before choosing any insurance benefits offered by employer or an organization. It is also essential to compare plans to find the one that offers the benefits as per your need. Once you choose an insurance plan, you usually cannot switch over to another plan until next open season, usually set once a year.

In group health insurance, employer usually pays portion or all of the premiums. This means your costs for health insurance premiums will be lower than they would be if you paid the entire premium alone.

If you are a member of group insurance offered by an organization, you are benefited from being a member of a large group. You will have to pay lesser premium than an individual would be paying. However, the organization often does not pay a share of premium, meaning you are responsible to pay complete premium by yourself.

Individual Insurance: 

In an individual Insurance, you get the coverage directly from the Insurance Company. You don't have any access to the group insurance offered by an employer or an organization. When you buy you own insurance, you have to pay entire premium rather than sharing with an employer according to Group Insurance. In individual insurance, you do not share any cost of premium with your employer. You should analyze and choose an individual insurance plan that fits your needs at a price that you are willing to pay; you should also consult a tax advisor to find out whether you are eligible for any tax deduction as per the insurance plan.

Insurance variably differs from one company to another within an insurance industry, from one plan to another and one product to another. Hence, choosing right company, right product, right plan are the important criteria before choosing any plans.

Which type of health insurance is right for you?

Whether you choose group insurance or an individual insurance plan, you must carefully compare coverage and costs. You should compare the following important aspects like coverage and benefits, premiums, exclusions and limitations, access to hospitals, doctors, and other providers etc...

One must consider what kinds of services are covered by the plan? How are benefits being availed of health insurance plan; do you have to submit a claim? When do you need pre-approval to ensure coverage for care? What steps do you need to get the care of you and your family members need? You must ensure how does your insurance plan works. Don't wait until you need emergency care to ask questions.

I am an author having an experience of 28 years in Insurance Industry having done the in-depth study of Insurance. Considering some knowledge, I hereby have shared some information and views about insurance, also some facts, figures and recommendation which enables an individual to choose right insurance policy from right person.

Insurance

Health Insurance Help to Lower Your Premium

Illness for non-work related injuries can be financially devastating. Insurance keeps you protected against disastrous health care expenses and lost wages. There are enormous health insurance plans available day-to-day, the insurance cost and its benefits vary from one plans to another. Before enrolling for a policy, an individual should consult with the insurance agencies, read the policy to get the complete information about the benefits and costs and also the way the plan works.

Today, there are many more kinds of health insurance to choose from than were available just a few years ago. Traditional differences between and among plans do not longer any more. Also, there is been an increased emphasis on the role of consumers in managing their own health care and health care finances. There is a focus on providing information on the cost of care and health care quality-at the level of the physician, physician group, and hospital-to help consumers and employers choose among the many options available to them. The things have changed a lot, when most people in the United States had health insurance has indemnity insurance (also called as fee-for-service or traditional insurance). This type of insurance coverage assumed that the medical provider i.e. doctor or physicians will be paid a fee for each service provided to the patient.

When we talk about health insurance, we usually mean the kind of insurance that pays medical bills, hospital bills, and typically, prescription drug costs. Nowadays, the insurance also covers Medicare and Mediaid that provides health insurance coverage for certain people, senior citizens, people with disabilities and also an individual and families with low income. Today, the online information helps an individual to compare two best insurance policies and choose best among it. The insurance help an individual for financial planning and accordingly choose the best suitable for the family. The policy helps to avoid the burden of expensive medical bills and ensure the penny paid in health plan is paid for your care. It protects you and your family financially in the event of an unexpected serious illness or injury that could be very expensive.

In spite of available health insurance help online, unfortunately many Americans are still uninsured or underinsured. Some may be eligible for private or government but may have difficulty in finding the maze of complex rules and insurance jargons. Many more may not even have chosen the plans due to non-affordability coverage or may not be eligible for any. To help you choose right plan, we give you an overview of programs and strategies for seeking free or reduced-cost health care and managing medical debts.

Why does an individual require health insurance?

As the science and medical care advances, the ways of treatment are also increasing simultaneously. The main purpose of health insurance is to help in paying for care. It protects you and your family members in an unexpected serious illness and injury that may be high in cost. Additionally, you are more likely to get regular and routine checkups, if you have an insurance policy. Every individual requires insurance policy because you cannot predict your illness, injury and your high paying medical bills. One must seriously consider the need for health insurance for own and family. We also know that there is interlinking between having health insurance and getting protective health care. The research states that people having health insurance are more likely to have a regular doctor and get care when it is needed.

How should one get health insurance?

Most of the people get health insurance through their employers or company which they belong to. This is formerly known as group insurance. Some individuals don't have access to group insurance. In this case, one may choose to purchase their own individual health insurance directly from public or privately owned insurance company. Most of the Americans in North America get health insurance through government programs that operate at National, State & Local Levels. Insurance- whether provided by your employer or purchased by you - can be both expensive and complex. To understand better option, you must take health insurance help from the experts and advisors.

Group Insurance: 

Group Insurance is basically offered by the employers or else by an organization of which you are a member of union, professional association wherein you may get group coverage. The employee has to choose between several plans been offered by an employer's including both indemnity insurance and managed care. Some employer may only offer one single plan. Some group plans may also include dental care with the health and medical benefits. Hence, it is a very important decision to be taken by and employee before choosing any insurance benefits offered by employer or an organization. It is also essential to compare plans to find the one that offers the benefits as per your need. Once you choose an insurance plan, you usually cannot switch over to another plan until next open season, usually set once a year.

In group health insurance, employer usually pays portion or all of the premiums. This means your costs for health insurance premiums will be lower than they would be if you paid the entire premium alone.

If you are a member of group insurance offered by an organization, you are benefited from being a member of a large group. You will have to pay lesser premium than an individual would be paying. However, the organization often does not pay a share of premium, meaning you are responsible to pay complete premium by yourself.

Individual Insurance: 

In an individual Insurance, you get the coverage directly from the Insurance Company. You don't have any access to the group insurance offered by an employer or an organization. When you buy you own insurance, you have to pay entire premium rather than sharing with an employer according to Group Insurance. In individual insurance, you do not share any cost of premium with your employer. You should analyze and choose an individual insurance plan that fits your needs at a price that you are willing to pay; you should also consult a tax advisor to find out whether you are eligible for any tax deduction as per the insurance plan.

Insurance variably differs from one company to another within an insurance industry, from one plan to another and one product to another. Hence, choosing right company, right product, right plan are the important criteria before choosing any plans.

Which type of health insurance is right for you?

Whether you choose group insurance or an individual insurance plan, you must carefully compare coverage and costs. You should compare the following important aspects like coverage and benefits, premiums, exclusions and limitations, access to hospitals, doctors, and other providers etc...

One must consider what kinds of services are covered by the plan? How are benefits being availed of health insurance plan; do you have to submit a claim? When do you need pre-approval to ensure coverage for care? What steps do you need to get the care of you and your family members need? You must ensure how does your insurance plan works. Don't wait until you need emergency care to ask questions.

I am an author having an experience of 28 years in Insurance Industry having done the in-depth study of Insurance. Considering some knowledge, I hereby have shared some information and views about insurance, also some facts, figures and recommendation which enables an individual to choose right insurance policy from right person.

Introduction

The journey of insurance liberalization process in India is now over seven years old. The first major milestone in this journey has been the passing of Insurance Regulatory and Development Authority Act, 1999. This along with amendments to the Insurance Act 1983, LIC and GIC Acts paves the way for the entry of private players and possibly the privatization of the hitherto public monopolies LIC and GIC. Opening up of insurance to private sector including foreign participation has resulted into various opportunities and challenges.

Concept of Insurance

In our daily life, whenever there is uncertainly there is an involvement of risk. The instinct of security against such risk is one of the basic motivating forces for determining human attitudes. As a sequel to this quest for security, the concept of insurance must have been born. The urge to provide insurance or protection against the loss of life and property must have promoted people to make some sort of sacrifice willingly in order to achieve security through collective co-operation. In this sense, the story of insurance is probably as old as the story of mankind.

Life insurance in particular provides protection to household against the risk of premature death of its income earning member. Life insurance in modern times also provides protection against other life related risks such as that of longevity (i.e. risk of outliving of source of income) and risk of disabled and sickness (health insurance). The products provide for longevity are pensions and annuities (insurance against old age). Non-life insurance provides protection against accidents, property damage, theft and other liabilities. Non-life insurance contracts are typically shorter in duration as compared to life insurance contracts. The bundling together of risk coverage and saving is peculiar of life insurance. Life insurance provides both protection and investment.

Insurance is a boon to business concerns. Insurance provides short range and long range relief. The short-term relief is aimed at protecting the insured from loss of property and life by distributing the loss amongst large number of persons through the medium of professional risk bearers such as insurers. It enables a businessman to face an unforeseen loss and, therefore, he need not worry about the possible loss. The long-range object being the economic and industrial growth of the country by making an investment of huge funds available with insurers in the organized industry and commerce.

General Insurance

Prior to nationalizations of General insurance industry in 1973 the GIC Act was passed in the Parliament in 1971, but it came into effect in 1973. There was 107 General insurance companies including branches of foreign companies operating in the country upon nationalization, these companies were amalgamated and grouped into the following four subsidiaries of GIC such as National Insurance Co.Ltd., Calcutta; The New India Assurance Co. Ltd., Mumbai; The Oriental Insurance Co. Ltd., New Delhi and United India Insurance Co. Ltd., Chennai and Now delinked.

General insurance business in India is broadly divided into fire, marine and miscellaneous GIC apart from directly handling Aviation and Reinsurance business administers the Comprehensive Crop Insurance Scheme, Personal Accident Insurance, Social Security Scheme etc. The GIC and its subsidiaries in keeping with the objective of nationalization to spread the message of insurance far and wide and to provide insurance protection to weaker section of the society are making efforts to design new covers and also to popularize other non-traditional business.

Liberalization of Insurance

The comprehensive regulation of insurance business in India was brought into effect with the enactment of the Insurance Act, 1983. It tried to create a strong and powerful supervision and regulatory authority in the Controller of Insurance with powers to direct, advise, investigate, register and liquidate insurance companies etc. However, consequent upon the nationalization of insurance business, most of the regulatory functions were taken away from the Controller of Insurance and vested in the insurers themselves. The Government of India in 1993 had set up a high powered committee by R.N.Malhotra, former Governor, Reserve Bank of India, to examine the structure of the insurance industry and recommend changes to make it more efficient and competitive keeping in view the structural changes in other parts of the financial system on the country.

Malhotra Committee's Recommendations

The committee submitted its report in January 1994 recommending that private insurers be allowed to co-exist along with government companies like LIC and GIC companies. This recommendation had been prompted by several factors such as need for greater deeper insurance coverage in the economy, and a much a greater scale of mobilization of funds from the economy, and a much a greater scale of mobilization of funds from the economy for infrastructural development. Liberalization of the insurance sector is at least partly driven by fiscal necessity of tapping the big reserve of savings in the economy. Committee's recommendations were as follows:

o Raising the capital base of LIC and GIC up to Rs. 200 crores, half retained by the government and rest sold to the public at large with suitable reservations for its employees. 

o Private sector is granted to enter insurance industry with a minimum paid up capital of Rs. 100 crores. 

o Foreign insurance be allowed to enter by floating an Indian company preferably a joint venture with Indian partners. 

o Steps are initiated to set up a strong and effective insurance regulatory in the form of a statutory autonomous board on the lines of SEBI. 

o Limited number of private companies to be allowed in the sector. But no firm is allowed in the sector. But no firm is allowed to operate in both lines of insurance (life or non-life). 

o Tariff Advisory Committee (TAC) is delinked form GIC to function as a separate statuary body under necessary supervision by the insurance regulatory authority. 

oAll insurance companies be treated on equal footing and governed by the provisions of insurance Act. No special dispensation is given to government companies. 

oSetting up of a strong and effective regulatory body with independent source for financing before allowing private companies into sector.

competition to government sector:

Government companies have now to face competition to private sector insurance companies not only in issuing various range of insurance products but also in various aspects in terms of customer service, channels of distribution, effective techniques of selling the products etc. privatization of the insurance sector has opened the doors to innovations in the way business can be transacted.

New age insurance companies are embarking on new concepts and more cost effective way of transacting business. The idea is clear to cater to the maximum business at the lest cost. And slowly with time, the age-old norm prevalent with government companies to expand by setting up branches seems getting lost. Among the techniques that seem to catching up fast as an alternative to cater to the rural and social sector insurance is hub and spoke arrangement. These along with the participants of NGOs and Self Help Group (SHGs) have done with most of the selling of the rural and social sector policies.

The main challenges is from the commercial banks that have vast network of branches. In this regard, it is important to mention here that LIC has entered into an arrangement with Mangalore based Corporations Bank to leverage their infrastructure for mutual benefit with the insurance monolith acquiring a strategic stake 27 per cent, Corporation Bank has decided to abandon its plans of promoting a life insurance company. The bank will act as a corporate agent for LIC in future and receive commission on policies sold through its branches. LIC with its branch network of close to 2100 offices will allow Corporation Bank to set up extension centers. ATMs or branches with in its premises. Corporation Bank would in turn implement an effective Cash Flow Management System for LIC.

IRDA Act, 1999

Preamble of IRDA Act 1999 reads 'An Act to provide for the establishment of an authority to protect the interests of holders of insurance policies, to regulate, to promote and ensure orderly growth of the insurance industry and for matters connected therewith or incidental thereto.

Section 14 of IRDA Act, lays the duties, powers and functions of the authority. The powers and functions of the authority. The powers and functions of the Authority shall include the following.

o Issue to the applicant a certificate of registration, to renew, modify withdraw, suspend or cancel such registration. 

o To protect the interest of policy holders in all matters concerning nomination of policy, surrender value f policy, insurable interest, settlement of insurance claims, other terms and conditions of contract of insurance. 

o Specifying requisite qualification and practical training for insurance intermediates and agents. 

o Specifying code of conduct for surveyors and loss assessors. 

o Promoting efficiency in the conduct of insurance business 

o Promoting and regulating professional regulators connected with the insurance and reinsurance business. 

o Specifying the form and manner in which books of accounts will be maintained and statement of accounts rendered by insurers and insurance intermediaries. 

o Adjudication of disputes between insurers and intermediates. 

o Specifying the percentage of life insurance and general and general business to be undertaken by the insurers in rural or social sectors etc.

Section 25 provides that Insurance Advisory Committee will be constituted and shall consist of not more than 25 members.Section 26 provides that Authority may in consultation with Insurance Advisory Committee make regulations consists with this Act and the rules made there under to carry the purpose of this Act.Section 29 seeks amendment in certain provisions of Insurance Act, 1938 in the manner as set out in First Schedule. The amendments to the Insurance Act are consequential in order to empower IRDA to effectively regulate, promote, and ensure orderly growth of the Insurance industry.

Section 30 & 31seek to amend LIC Act 1956 and GIC Act 1972.

Impact of Liberalization

While nationalized insurance companies have done a commendable job in extending volume of the business opening up of insurance sector to private players was a necessity in the context of liberalization of financial sector. If traditional infrastructural and semipublic goods industries such as banking, airlines, telecom, power etc. have significant private sector presence, continuing state monopoly in provision of insurance was indefensible and therefore, the privatization of insurance has been done as discussed earlier. Its impact has to be seen in the form of creating various opportunities and challenges.

Opportunities

1. Privatization if Insurance was eliminated the monopolistic business of Life Insurance Corporation of India. It may help to cover the wide range of risk in general insurance and also in life insurance. It helps to introduce new range of products. 

2. It would also result in better customer services and help improve the variety and price of insurance products. 

3. The entry of new player would speed up the spread of both life and general insurance. It will increase the insurance penetration and measure of density. 

4. Entry of private players will ensure the mobilization of funds that can be utilized for the purpose of infrastructure development. 

5. Allowing of commercial banks into insurance business will help to mobilization of funds from the rural areas because of the availability of vast branches of the banks. 

6. Most important not the least tremendous employment opportunities will be created in the field of insurance which is a burning problem of the presence day today issues.

Current Scenario

After opening up of insurance in private sector, various leading private companies including joint ventures have entered the fields of insurance both life and non-life business. Tata - AIG, Birla Sun life, HDFC standard life Insurance, Reliance General Insurance, Royal Sundaram Alliance Insurance, Bajaj Auto Alliance, IFFCO Tokio General Insurance, INA Vysya Life Insurance, SBI Life Insurance, Dabur CJU Life Insurance and Max New York Life. SBI Life insurance has launched three products Sanjeevan, Sukhjeevan and Young Sanjeevan so far and it has already sold 320 policies under its plan.

Conclusion

From the above discussion we can conclude that the entry of private players in insurance business needful and justifiable in order to enhance the efficiency of operations, achieving greater density and insurance coverage in the country and for a greater mobilization of long term savings for long gestation infrastructure prefects. New players should not be treat as rivalries to government companies, but they can supplement in achieving the objective of growth of insurance business in india.

Insurance

Effect of Liberalisation in Insurance Industry

Introduction

The journey of insurance liberalization process in India is now over seven years old. The first major milestone in this journey has been the passing of Insurance Regulatory and Development Authority Act, 1999. This along with amendments to the Insurance Act 1983, LIC and GIC Acts paves the way for the entry of private players and possibly the privatization of the hitherto public monopolies LIC and GIC. Opening up of insurance to private sector including foreign participation has resulted into various opportunities and challenges.

Concept of Insurance

In our daily life, whenever there is uncertainly there is an involvement of risk. The instinct of security against such risk is one of the basic motivating forces for determining human attitudes. As a sequel to this quest for security, the concept of insurance must have been born. The urge to provide insurance or protection against the loss of life and property must have promoted people to make some sort of sacrifice willingly in order to achieve security through collective co-operation. In this sense, the story of insurance is probably as old as the story of mankind.

Life insurance in particular provides protection to household against the risk of premature death of its income earning member. Life insurance in modern times also provides protection against other life related risks such as that of longevity (i.e. risk of outliving of source of income) and risk of disabled and sickness (health insurance). The products provide for longevity are pensions and annuities (insurance against old age). Non-life insurance provides protection against accidents, property damage, theft and other liabilities. Non-life insurance contracts are typically shorter in duration as compared to life insurance contracts. The bundling together of risk coverage and saving is peculiar of life insurance. Life insurance provides both protection and investment.

Insurance is a boon to business concerns. Insurance provides short range and long range relief. The short-term relief is aimed at protecting the insured from loss of property and life by distributing the loss amongst large number of persons through the medium of professional risk bearers such as insurers. It enables a businessman to face an unforeseen loss and, therefore, he need not worry about the possible loss. The long-range object being the economic and industrial growth of the country by making an investment of huge funds available with insurers in the organized industry and commerce.

General Insurance

Prior to nationalizations of General insurance industry in 1973 the GIC Act was passed in the Parliament in 1971, but it came into effect in 1973. There was 107 General insurance companies including branches of foreign companies operating in the country upon nationalization, these companies were amalgamated and grouped into the following four subsidiaries of GIC such as National Insurance Co.Ltd., Calcutta; The New India Assurance Co. Ltd., Mumbai; The Oriental Insurance Co. Ltd., New Delhi and United India Insurance Co. Ltd., Chennai and Now delinked.

General insurance business in India is broadly divided into fire, marine and miscellaneous GIC apart from directly handling Aviation and Reinsurance business administers the Comprehensive Crop Insurance Scheme, Personal Accident Insurance, Social Security Scheme etc. The GIC and its subsidiaries in keeping with the objective of nationalization to spread the message of insurance far and wide and to provide insurance protection to weaker section of the society are making efforts to design new covers and also to popularize other non-traditional business.

Liberalization of Insurance

The comprehensive regulation of insurance business in India was brought into effect with the enactment of the Insurance Act, 1983. It tried to create a strong and powerful supervision and regulatory authority in the Controller of Insurance with powers to direct, advise, investigate, register and liquidate insurance companies etc. However, consequent upon the nationalization of insurance business, most of the regulatory functions were taken away from the Controller of Insurance and vested in the insurers themselves. The Government of India in 1993 had set up a high powered committee by R.N.Malhotra, former Governor, Reserve Bank of India, to examine the structure of the insurance industry and recommend changes to make it more efficient and competitive keeping in view the structural changes in other parts of the financial system on the country.

Malhotra Committee's Recommendations

The committee submitted its report in January 1994 recommending that private insurers be allowed to co-exist along with government companies like LIC and GIC companies. This recommendation had been prompted by several factors such as need for greater deeper insurance coverage in the economy, and a much a greater scale of mobilization of funds from the economy, and a much a greater scale of mobilization of funds from the economy for infrastructural development. Liberalization of the insurance sector is at least partly driven by fiscal necessity of tapping the big reserve of savings in the economy. Committee's recommendations were as follows:

o Raising the capital base of LIC and GIC up to Rs. 200 crores, half retained by the government and rest sold to the public at large with suitable reservations for its employees. 

o Private sector is granted to enter insurance industry with a minimum paid up capital of Rs. 100 crores. 

o Foreign insurance be allowed to enter by floating an Indian company preferably a joint venture with Indian partners. 

o Steps are initiated to set up a strong and effective insurance regulatory in the form of a statutory autonomous board on the lines of SEBI. 

o Limited number of private companies to be allowed in the sector. But no firm is allowed in the sector. But no firm is allowed to operate in both lines of insurance (life or non-life). 

o Tariff Advisory Committee (TAC) is delinked form GIC to function as a separate statuary body under necessary supervision by the insurance regulatory authority. 

oAll insurance companies be treated on equal footing and governed by the provisions of insurance Act. No special dispensation is given to government companies. 

oSetting up of a strong and effective regulatory body with independent source for financing before allowing private companies into sector.

competition to government sector:

Government companies have now to face competition to private sector insurance companies not only in issuing various range of insurance products but also in various aspects in terms of customer service, channels of distribution, effective techniques of selling the products etc. privatization of the insurance sector has opened the doors to innovations in the way business can be transacted.

New age insurance companies are embarking on new concepts and more cost effective way of transacting business. The idea is clear to cater to the maximum business at the lest cost. And slowly with time, the age-old norm prevalent with government companies to expand by setting up branches seems getting lost. Among the techniques that seem to catching up fast as an alternative to cater to the rural and social sector insurance is hub and spoke arrangement. These along with the participants of NGOs and Self Help Group (SHGs) have done with most of the selling of the rural and social sector policies.

The main challenges is from the commercial banks that have vast network of branches. In this regard, it is important to mention here that LIC has entered into an arrangement with Mangalore based Corporations Bank to leverage their infrastructure for mutual benefit with the insurance monolith acquiring a strategic stake 27 per cent, Corporation Bank has decided to abandon its plans of promoting a life insurance company. The bank will act as a corporate agent for LIC in future and receive commission on policies sold through its branches. LIC with its branch network of close to 2100 offices will allow Corporation Bank to set up extension centers. ATMs or branches with in its premises. Corporation Bank would in turn implement an effective Cash Flow Management System for LIC.

IRDA Act, 1999

Preamble of IRDA Act 1999 reads 'An Act to provide for the establishment of an authority to protect the interests of holders of insurance policies, to regulate, to promote and ensure orderly growth of the insurance industry and for matters connected therewith or incidental thereto.

Section 14 of IRDA Act, lays the duties, powers and functions of the authority. The powers and functions of the authority. The powers and functions of the Authority shall include the following.

o Issue to the applicant a certificate of registration, to renew, modify withdraw, suspend or cancel such registration. 

o To protect the interest of policy holders in all matters concerning nomination of policy, surrender value f policy, insurable interest, settlement of insurance claims, other terms and conditions of contract of insurance. 

o Specifying requisite qualification and practical training for insurance intermediates and agents. 

o Specifying code of conduct for surveyors and loss assessors. 

o Promoting efficiency in the conduct of insurance business 

o Promoting and regulating professional regulators connected with the insurance and reinsurance business. 

o Specifying the form and manner in which books of accounts will be maintained and statement of accounts rendered by insurers and insurance intermediaries. 

o Adjudication of disputes between insurers and intermediates. 

o Specifying the percentage of life insurance and general and general business to be undertaken by the insurers in rural or social sectors etc.

Section 25 provides that Insurance Advisory Committee will be constituted and shall consist of not more than 25 members.Section 26 provides that Authority may in consultation with Insurance Advisory Committee make regulations consists with this Act and the rules made there under to carry the purpose of this Act.Section 29 seeks amendment in certain provisions of Insurance Act, 1938 in the manner as set out in First Schedule. The amendments to the Insurance Act are consequential in order to empower IRDA to effectively regulate, promote, and ensure orderly growth of the Insurance industry.

Section 30 & 31seek to amend LIC Act 1956 and GIC Act 1972.

Impact of Liberalization

While nationalized insurance companies have done a commendable job in extending volume of the business opening up of insurance sector to private players was a necessity in the context of liberalization of financial sector. If traditional infrastructural and semipublic goods industries such as banking, airlines, telecom, power etc. have significant private sector presence, continuing state monopoly in provision of insurance was indefensible and therefore, the privatization of insurance has been done as discussed earlier. Its impact has to be seen in the form of creating various opportunities and challenges.

Opportunities

1. Privatization if Insurance was eliminated the monopolistic business of Life Insurance Corporation of India. It may help to cover the wide range of risk in general insurance and also in life insurance. It helps to introduce new range of products. 

2. It would also result in better customer services and help improve the variety and price of insurance products. 

3. The entry of new player would speed up the spread of both life and general insurance. It will increase the insurance penetration and measure of density. 

4. Entry of private players will ensure the mobilization of funds that can be utilized for the purpose of infrastructure development. 

5. Allowing of commercial banks into insurance business will help to mobilization of funds from the rural areas because of the availability of vast branches of the banks. 

6. Most important not the least tremendous employment opportunities will be created in the field of insurance which is a burning problem of the presence day today issues.

Current Scenario

After opening up of insurance in private sector, various leading private companies including joint ventures have entered the fields of insurance both life and non-life business. Tata - AIG, Birla Sun life, HDFC standard life Insurance, Reliance General Insurance, Royal Sundaram Alliance Insurance, Bajaj Auto Alliance, IFFCO Tokio General Insurance, INA Vysya Life Insurance, SBI Life Insurance, Dabur CJU Life Insurance and Max New York Life. SBI Life insurance has launched three products Sanjeevan, Sukhjeevan and Young Sanjeevan so far and it has already sold 320 policies under its plan.

Conclusion

From the above discussion we can conclude that the entry of private players in insurance business needful and justifiable in order to enhance the efficiency of operations, achieving greater density and insurance coverage in the country and for a greater mobilization of long term savings for long gestation infrastructure prefects. New players should not be treat as rivalries to government companies, but they can supplement in achieving the objective of growth of insurance business in india.

Welcome to the global business guide. In this context, we will be taking about the insurance industry, the general definition of insurance, adequate and precise explanation of the definition, brief talk about the history, the insurer, the insured, classes of insurance, the role of the underwriter in the industry and how you as an individual can benefit maximally when you get yourself, your car, your house, even that your business insure. We do hope you will enjoy reading this article and the essence of your quest for the topic above will be met.

Insurance is a financial institution classified as a non bank financial institution. They are important financial inter-mi diaries. It is believed to have originated from the ancient practices of inhabitants of the valleys of rivers Tigris and Euphrates in the present day Iraqi in about 4.000BC. History has it that in 1800BC, the Babylonians code of Hammurabi contained provisions which had elements of insurance in the laws that govern their commerce. But today what we have in the industry, both locally and internationally had moved from just an agreement between two persons into a very big industry across the globe.

Going by definition, we learn that insurance means a situation whereby someone protects his or herself against risk and reduce effects of uncertainties as well as distribute loss. Other explanation to this owe it to the situation whereby a certain amount of money when collected from someone by an insurance company agrees to pay a compensation or render services to that person if and whenever that person suffers the kind of loss specified in the insurance agreement; and from the explanation, this is where an insurance company comes into play since they are the people that will go into agreement with the person taking any insurance policy against any of his belongings. This industry has widely been believed as a means whereby people reduce the risk of unforeseen circumstances. As financial intermediaries, they act as middlemen between the surplus units and deficit units of the economy thereby sustaining the general growth of the economy.

One may ask, how do insurance companies generate the money used in compensating their policy holder when affected by any mishap? The answer to this question, will lead us into talking about the various means via which the insurance companies make their money and how their policy holders are compensated. The truth is that, the money they collect from their policy holder (i.e one that has an agreement with the insurance company) is invested in the form of premiums (an extra sum of money paid in addition to the normal cost of something. by BBC. Eng. dict) and that money is invested in Bonds, in stocks, mortgages (i.e house) and government securities (in our subsequent article, we will explain more of this: Bonds, stocks, mortgages and govt. securities). They generate income for themselves and those who are in their service. They invest their policy holder's money in better business that has short term maximum returns on investment and from there meet their numerous needs when needed in claims and losses. These funds themselves are invested, that not only do they earn interest to be added to the funds, but they also benefit the government, public authorities, and industries whose securities the investment are spread, because of the investment policy of the insurer (we will explain later), their reserve funds are not left idle butt are used productively.

Another way via which the insurance companies compensate those who are in their service is that the contribution of many is used to compensate the few among them who were affected by the misfortune insured against. So the loss of few people is share by many.

We hope that to this extend, you must have understood the above explanation about insurance company. Now the next thing we will be considering is the functions of the insurance companies.

Amongst other functions, the main function of the insurance company is risk bearing, the financial losses of individuals are judiciously distributed among many people, for example, in the case of fire, the policy holder in fire insurance pays a premium into a common pool, out of which those who suffer loss are compensated.

FUNCTIONS INCLUDE

1. The insurance industry encourages thrift (i.e money conservation) especially via it's life policies which provide funds for family, welfare and old age provisions. It provides employment opportunity for those that have the interest of working with the industry.

The insurance companies works hand in hand with commerce. It owes it's existence to commerce (i.e business in general both industrial etc) and commerce in return owes it's strong stability to insurance, this is because it helped in various ways to enhance the general trend in business.

Before we proceed further to other functions, let's explain this two terms: the insurer; the insured as it will aid us in our understanding.

The insured: This is the party affecting the insurance in other words, the individual or individuals which is taking the insurance policy. This can be done either directly or indirectly or via an agent or broker.

The insurer: This is the party providing the protection to cover by the policy. The insurer covers every other terms which includes the underwriter who is a senior official of an insurance company whose business lies in undertaking new business for the company.

The insurance company has a contract which promises to pay compensation at a future date for a consideration known as premium (i.e. the money paid by the insured to the insurer for the insurance cover provided in the policy). Like the way we have it in other contracts, i.e having it that contracts is based on the principles of offer and acceptance, consideration and capacity to contract. These contract, especially in insurance involves two parties i.e. the insurer and the insured.

FUNCTIONS 2

Insurer, by reason of their principal function accumulate large funds which they hold as custodians and out of which claims and losses are met. Like in some countries, their insurers operate in many parts of the world and earn vast sums in overseas market in terms of underwriting profit and investment income. This tells us that insurance forms a considerable part of that country's invisible exports.

As we continue in our functions, let's see the role of the insured and the insurer.

ROLES OF THE INSURED:

In insurance, when the proposer becomes insured the party effecting an insurance is known as the proposer throughout the negotiations, and until the contract is in full force. The insurer plays a vital role in making this aforementioned contract to come into force, knowing that in insurance contract, just like we said before is base on the principle of offer and acceptance, consideration and capacity to contract, the contracts are always evidenced in writing which is made up of various forms to be filled and signed. If the insured does not accept the insurance offer and giving meticulous consideration to that, there can hardly be capacity to contract i.e the insurance contract can never be. So, from this, we now learn that this two parties (i.e the insurer and the insured) must be involved before an insurance contract can becomes a policy.

ROLES OF THE INSURER

Here we are considering the roles of the insurer as a subsidiary functions of insurance; this is because in general sense (they have a very wide range of function), the insurer is the one providing the necessary insurance services, benefits to the insured, should any mishap, depending on the insurance policy undertaken. The insurer helps also in loss-prevention in the following ways:

We know that the extend to which loss prevention is seen, is mostly on property. An individual or a population can suffer great loss materially, if it were not for the intervention of loss prevention scheme by insurance companies to their policy holders.

The insurer also assists in boasting business venture: Many large -scale enterprise today can make their business in good faith, having transferred all their risk to the insurance company, in other words. The insurance companies help to maintain and to stabilize the atmosphere of the present day large-scale business and organizations.

Many questions had risen by on onlookers, as on how the policy holder can be compesated, should there be any mishap on the policy covered. It is better for us to note that the insurance company, when a loss is incurred to the policy holder can make for his or her loss, but that can only compensate him and make him return to his normal financial position before the occurrence of the incidence and not to profit him from the misfortune. This is generally because, no amount of financial compensation can pay adequately for the life and health of persons, so life and personal accidents are regarded as benefit policies. So let there be no misconception on this fact when mishap occurs, where the public is looking for the victim to be given everything lost, and having a meager compensation given to him or her. So let's not distrust insurance companies in this area, knowing that it's only the restoration to the exact position before the loss that is provided.

Now, as we have gone so far in understanding the functions of the insurance companies, the roles of the insured and the insurer, we will be proceeding forward to look at the various ways via which one can benefit from being insured in all spheres of life. For those who against all odds, accept insurance policy adequately, benefits, awaits them in areas like

1. pecuniary insurance

2. personal insurance

3. property insurance

4. liability insurance

We will take our time to give you enough explanation in all the sub-sections of these areas that will be of help to you.

1. PECUNIARY INSURANCE: This has to do with money or relating to something of such nature. This insurance policy benefits mostly company owners, directors, managers e.t.c This insurance policy provides cover to the employer against the loss of money unintentionally, or in a situation where an employee defrauds his or her employer on certain amount of money placed under his or her custody or in things relating to other occurrence/loss. Other policies under pecuniary insurance are; fidelity guarantee (known also as surety ship), legal expenses, credit insurance and business interruption insurance. All of these have their various function which in one way or the other relates to pecuniary. Like earlier stated, pecuniary insurance provides cover for C.E.O., M.D'S etc in case of loss of money either by intent or accident placed under the care of their employee or any officer of higher responsibility. These type of insurance cover, which their employee has will help to compensate them (i.e the employer's) and also ease the employee the fear and tension which the mishap might generate for him or her. It is therefore advisable you consider this policy very well as an MD, C.E.O. etc, especially with the assistance of your insurance broker so as to adequately know, and be directed properly on how to go about it.

2. PERSONAL INSURANCE

This involves all classes of life assurance and also accident policies. There are other types of person insurance, and the purpose of each is to meet the different need of individuals in their aim to provide for the future either for themselves or for their dependents. Other sub-divisions of personal insurance are:

i. Life assurance

ii. Personal accident and sickness insurance,

iii. Permanent health insurance,

iv. Social security

These sub-divisions has various similarities which come out at the end to meet the same aim, like in life assurance, personal accident and sickness insurance, this policy ensures that the policy holder when befallen by any misfortune, which resulted into permanent disability or death will still be able to fend for his or herself and also for his or her dependants in the case of death.

3. PROPERTY INSURANCE

Property insurance policy involves insurance cover for property should any risk of damage or loss by fire, accident, burglary or other risks that may occur. Under this, there are other sub-divisions which include:

i. Motor Insurance

ii. Marine Insurance

iii. Fire Insurance

iv. Burglary Insurance

v. Special peril Insurance

vi. All risk Insurance

In all these sub-divisions of property insurance, respective insurance cover is given to them all should there be any damage or loss relating to the type of policy the holder has.

4. LIABILITY INSURANCE

This provides cover for the insured against his legal liability to others. This can arise via negligence of the insured in failing to act in a reasonable manner. Such manners like crossing the road without properly looking on both side of the road which might result in accident. This may also arise via the insured's unlawful disturbance of another person in the enjoyment of his or property (i.e constituting a nuisance to them) or via the insured's trespass which is an unlawful act committed with force or violent on another person's property. Liability insurance is also sub-divided into employer's liability to his employee and public liability by the insured. The two sub-divisions of liability insurance owe their explanation to their respective liabilities, and since liability generally arises from lawsuits, liability policy covers only claims which the insured becomes legally obligated to.

We should also bear in mind that no insurance policy can prevent theft, fire, or other misfortune or the creation of legal liability, but can provide financial assistance in such situations. It does not also protect for example, the material property which is the subject matter of the insurance, but the financial interest of the insurer. This mean that the insurer can only get a financial compensation when any mishap happens to any thing insured against and not having the property restored back in case of fire or collapse (for building).

CONCLUSION

In all, we do hope that all these explanation will give you a better insight towards getting what you want on the good step to take while taking your insurance policy. But, always make sure that you don't do anything without first of all consulting your insurance broker ( who will take more time to tell you one-on-one the policy that will be suitable for you) before going to any insurance company knowing already that the cost of insurance is less than what would be the cost of insurance because the cost of insurance to industrialist for e.g is passed on to consumers along with other product cost and the consumers benefits from the existence of insurance via reduced prices. So make sure you get insured today. Till I see you again. Thank you.

Insurance

Insurance For Beginners

Welcome to the global business guide. In this context, we will be taking about the insurance industry, the general definition of insurance, adequate and precise explanation of the definition, brief talk about the history, the insurer, the insured, classes of insurance, the role of the underwriter in the industry and how you as an individual can benefit maximally when you get yourself, your car, your house, even that your business insure. We do hope you will enjoy reading this article and the essence of your quest for the topic above will be met.

Insurance is a financial institution classified as a non bank financial institution. They are important financial inter-mi diaries. It is believed to have originated from the ancient practices of inhabitants of the valleys of rivers Tigris and Euphrates in the present day Iraqi in about 4.000BC. History has it that in 1800BC, the Babylonians code of Hammurabi contained provisions which had elements of insurance in the laws that govern their commerce. But today what we have in the industry, both locally and internationally had moved from just an agreement between two persons into a very big industry across the globe.

Going by definition, we learn that insurance means a situation whereby someone protects his or herself against risk and reduce effects of uncertainties as well as distribute loss. Other explanation to this owe it to the situation whereby a certain amount of money when collected from someone by an insurance company agrees to pay a compensation or render services to that person if and whenever that person suffers the kind of loss specified in the insurance agreement; and from the explanation, this is where an insurance company comes into play since they are the people that will go into agreement with the person taking any insurance policy against any of his belongings. This industry has widely been believed as a means whereby people reduce the risk of unforeseen circumstances. As financial intermediaries, they act as middlemen between the surplus units and deficit units of the economy thereby sustaining the general growth of the economy.

One may ask, how do insurance companies generate the money used in compensating their policy holder when affected by any mishap? The answer to this question, will lead us into talking about the various means via which the insurance companies make their money and how their policy holders are compensated. The truth is that, the money they collect from their policy holder (i.e one that has an agreement with the insurance company) is invested in the form of premiums (an extra sum of money paid in addition to the normal cost of something. by BBC. Eng. dict) and that money is invested in Bonds, in stocks, mortgages (i.e house) and government securities (in our subsequent article, we will explain more of this: Bonds, stocks, mortgages and govt. securities). They generate income for themselves and those who are in their service. They invest their policy holder's money in better business that has short term maximum returns on investment and from there meet their numerous needs when needed in claims and losses. These funds themselves are invested, that not only do they earn interest to be added to the funds, but they also benefit the government, public authorities, and industries whose securities the investment are spread, because of the investment policy of the insurer (we will explain later), their reserve funds are not left idle butt are used productively.

Another way via which the insurance companies compensate those who are in their service is that the contribution of many is used to compensate the few among them who were affected by the misfortune insured against. So the loss of few people is share by many.

We hope that to this extend, you must have understood the above explanation about insurance company. Now the next thing we will be considering is the functions of the insurance companies.

Amongst other functions, the main function of the insurance company is risk bearing, the financial losses of individuals are judiciously distributed among many people, for example, in the case of fire, the policy holder in fire insurance pays a premium into a common pool, out of which those who suffer loss are compensated.

FUNCTIONS INCLUDE

1. The insurance industry encourages thrift (i.e money conservation) especially via it's life policies which provide funds for family, welfare and old age provisions. It provides employment opportunity for those that have the interest of working with the industry.

The insurance companies works hand in hand with commerce. It owes it's existence to commerce (i.e business in general both industrial etc) and commerce in return owes it's strong stability to insurance, this is because it helped in various ways to enhance the general trend in business.

Before we proceed further to other functions, let's explain this two terms: the insurer; the insured as it will aid us in our understanding.

The insured: This is the party affecting the insurance in other words, the individual or individuals which is taking the insurance policy. This can be done either directly or indirectly or via an agent or broker.

The insurer: This is the party providing the protection to cover by the policy. The insurer covers every other terms which includes the underwriter who is a senior official of an insurance company whose business lies in undertaking new business for the company.

The insurance company has a contract which promises to pay compensation at a future date for a consideration known as premium (i.e. the money paid by the insured to the insurer for the insurance cover provided in the policy). Like the way we have it in other contracts, i.e having it that contracts is based on the principles of offer and acceptance, consideration and capacity to contract. These contract, especially in insurance involves two parties i.e. the insurer and the insured.

FUNCTIONS 2

Insurer, by reason of their principal function accumulate large funds which they hold as custodians and out of which claims and losses are met. Like in some countries, their insurers operate in many parts of the world and earn vast sums in overseas market in terms of underwriting profit and investment income. This tells us that insurance forms a considerable part of that country's invisible exports.

As we continue in our functions, let's see the role of the insured and the insurer.

ROLES OF THE INSURED:

In insurance, when the proposer becomes insured the party effecting an insurance is known as the proposer throughout the negotiations, and until the contract is in full force. The insurer plays a vital role in making this aforementioned contract to come into force, knowing that in insurance contract, just like we said before is base on the principle of offer and acceptance, consideration and capacity to contract, the contracts are always evidenced in writing which is made up of various forms to be filled and signed. If the insured does not accept the insurance offer and giving meticulous consideration to that, there can hardly be capacity to contract i.e the insurance contract can never be. So, from this, we now learn that this two parties (i.e the insurer and the insured) must be involved before an insurance contract can becomes a policy.

ROLES OF THE INSURER

Here we are considering the roles of the insurer as a subsidiary functions of insurance; this is because in general sense (they have a very wide range of function), the insurer is the one providing the necessary insurance services, benefits to the insured, should any mishap, depending on the insurance policy undertaken. The insurer helps also in loss-prevention in the following ways:

We know that the extend to which loss prevention is seen, is mostly on property. An individual or a population can suffer great loss materially, if it were not for the intervention of loss prevention scheme by insurance companies to their policy holders.

The insurer also assists in boasting business venture: Many large -scale enterprise today can make their business in good faith, having transferred all their risk to the insurance company, in other words. The insurance companies help to maintain and to stabilize the atmosphere of the present day large-scale business and organizations.

Many questions had risen by on onlookers, as on how the policy holder can be compesated, should there be any mishap on the policy covered. It is better for us to note that the insurance company, when a loss is incurred to the policy holder can make for his or her loss, but that can only compensate him and make him return to his normal financial position before the occurrence of the incidence and not to profit him from the misfortune. This is generally because, no amount of financial compensation can pay adequately for the life and health of persons, so life and personal accidents are regarded as benefit policies. So let there be no misconception on this fact when mishap occurs, where the public is looking for the victim to be given everything lost, and having a meager compensation given to him or her. So let's not distrust insurance companies in this area, knowing that it's only the restoration to the exact position before the loss that is provided.

Now, as we have gone so far in understanding the functions of the insurance companies, the roles of the insured and the insurer, we will be proceeding forward to look at the various ways via which one can benefit from being insured in all spheres of life. For those who against all odds, accept insurance policy adequately, benefits, awaits them in areas like

1. pecuniary insurance

2. personal insurance

3. property insurance

4. liability insurance

We will take our time to give you enough explanation in all the sub-sections of these areas that will be of help to you.

1. PECUNIARY INSURANCE: This has to do with money or relating to something of such nature. This insurance policy benefits mostly company owners, directors, managers e.t.c This insurance policy provides cover to the employer against the loss of money unintentionally, or in a situation where an employee defrauds his or her employer on certain amount of money placed under his or her custody or in things relating to other occurrence/loss. Other policies under pecuniary insurance are; fidelity guarantee (known also as surety ship), legal expenses, credit insurance and business interruption insurance. All of these have their various function which in one way or the other relates to pecuniary. Like earlier stated, pecuniary insurance provides cover for C.E.O., M.D'S etc in case of loss of money either by intent or accident placed under the care of their employee or any officer of higher responsibility. These type of insurance cover, which their employee has will help to compensate them (i.e the employer's) and also ease the employee the fear and tension which the mishap might generate for him or her. It is therefore advisable you consider this policy very well as an MD, C.E.O. etc, especially with the assistance of your insurance broker so as to adequately know, and be directed properly on how to go about it.

2. PERSONAL INSURANCE

This involves all classes of life assurance and also accident policies. There are other types of person insurance, and the purpose of each is to meet the different need of individuals in their aim to provide for the future either for themselves or for their dependents. Other sub-divisions of personal insurance are:

i. Life assurance

ii. Personal accident and sickness insurance,

iii. Permanent health insurance,

iv. Social security

These sub-divisions has various similarities which come out at the end to meet the same aim, like in life assurance, personal accident and sickness insurance, this policy ensures that the policy holder when befallen by any misfortune, which resulted into permanent disability or death will still be able to fend for his or herself and also for his or her dependants in the case of death.

3. PROPERTY INSURANCE

Property insurance policy involves insurance cover for property should any risk of damage or loss by fire, accident, burglary or other risks that may occur. Under this, there are other sub-divisions which include:

i. Motor Insurance

ii. Marine Insurance

iii. Fire Insurance

iv. Burglary Insurance

v. Special peril Insurance

vi. All risk Insurance

In all these sub-divisions of property insurance, respective insurance cover is given to them all should there be any damage or loss relating to the type of policy the holder has.

4. LIABILITY INSURANCE

This provides cover for the insured against his legal liability to others. This can arise via negligence of the insured in failing to act in a reasonable manner. Such manners like crossing the road without properly looking on both side of the road which might result in accident. This may also arise via the insured's unlawful disturbance of another person in the enjoyment of his or property (i.e constituting a nuisance to them) or via the insured's trespass which is an unlawful act committed with force or violent on another person's property. Liability insurance is also sub-divided into employer's liability to his employee and public liability by the insured. The two sub-divisions of liability insurance owe their explanation to their respective liabilities, and since liability generally arises from lawsuits, liability policy covers only claims which the insured becomes legally obligated to.

We should also bear in mind that no insurance policy can prevent theft, fire, or other misfortune or the creation of legal liability, but can provide financial assistance in such situations. It does not also protect for example, the material property which is the subject matter of the insurance, but the financial interest of the insurer. This mean that the insurer can only get a financial compensation when any mishap happens to any thing insured against and not having the property restored back in case of fire or collapse (for building).

CONCLUSION

In all, we do hope that all these explanation will give you a better insight towards getting what you want on the good step to take while taking your insurance policy. But, always make sure that you don't do anything without first of all consulting your insurance broker ( who will take more time to tell you one-on-one the policy that will be suitable for you) before going to any insurance company knowing already that the cost of insurance is less than what would be the cost of insurance because the cost of insurance to industrialist for e.g is passed on to consumers along with other product cost and the consumers benefits from the existence of insurance via reduced prices. So make sure you get insured today. Till I see you again. Thank you.

Since its inception about fifty years ago, D&O insurance has evolved into a family of products responding differently to the needs of publicly traded companies, privately held businesses and not-for-profit entities and their respective board members, officers and trustees.

Directors' & Officers' Liability, Executive Liability or Management Liability insurance are essentially interchangeable terms. However, insuring agreements, definitions, exclusions and coverage options vary materially depending upon the type of policyholder being insured and the insurer underwriting the risk. Executive Liability insurance, once considered a necessity solely for publicly traded companies, particularly due to their exposure to shareholder litigation, has become recognized as an essential part of a risk transfer program for privately held companies and not-for-profit organizations.

Optimization of protection is a common goal shared by all types of organizations. In our opinion, the best way to achieve that objective is through engagement of highly experienced insurance, legal and financial advisors who work collaboratively with management to continually assess and treat these specialized enterprise risk exposures.

Private Company D&O Exposures

In 2005, Chubb Insurance Group, one of the largest underwriters of D&O insurance, conducted a survey of the D&O insurance purchasing trends of 450 private companies. A significant percentage of respondents gave the following reasons for not purchasing D&O insurance: 

• did not see the need for D&O insurance, 

• their D&O liability risk was low, 

• thought D&O risk is covered under other liability policies

The companies responding as non-purchasers of D&O insurance experienced at least one D&O claim in the five years preceding the survey. Results showed that private companies with 250 or more employees, were the subject of D&O litigation during the preceding five years and 20% of companies with 25 to 49 employees, experienced a D&O claim.

The survey revealed 43% of D&O litigation was brought by customers, 29% from regulatory agencies, and 11% from non-publicly traded equity securities holders. The average loss reported by the private companies was $380,000. Companies with D&O insurance experienced an average loss of $129,000. Companies without D&O insurance experienced an average loss of $480,000.

Some Common Examples of Private Company D&O Claims

• Major shareholder led buy-outs of minority shareholders alleging misrepresentations of the company's fair market value 

• purchaser of a company or its assets alleging misrepresentation 

• sale of company assets to entities controlled by the majority shareholder 

• creditors' committee or bankruptcy trustee claims 

• private equity investors and lenders' claims 

• vendors alleging misrepresentation in connection with an extension of credit 

• consumer protection and privacy claims

Private Company D&O Policy Considerations

Executive Liability insurance policies for privately held companies typically provide a combination or package of coverage that includes, but may not be limited to: Directors' & Officers' Liability, Employment Practices Liability, ERISA Fiduciary Liability and Commercial Crime/ Fidelity insurance.

D&O policies, whether underwritten on a stand-alone basis or in the form of a combination-type policy form, are underwritten on a "claims-made" basis. This means the claim must be made against the Insured and reported to the insurer during the same effective policy period, or under a specified Extended (claims) Reporting Period following the policy's expiration. This is a completely different coverage trigger from other liability policies such as Commercial General Liability that are traditionally underwritten with an "occurrence" trigger, which implicates the insurance policy that was in effect at the time of the accident, even if the claim is not reported until years later.

"Side A" coverage, which protects individual Insureds in the event the Insured entity is unable to indemnify individuals, is a standard agreement contained within many private company policy forms. These policies are generally structured with a shared policy limit among the various insuring agreements resulting in a more affordable insurance product tailored to small and mid-sized enterprises. For an additional premium, separate policy limits may be purchased for one or more of each distinct insuring agreement affording a more customized insurance package.

Also, policies should be evaluated to determine whether they extend coverage for covered "wrongful acts" committed by non-officers or directors, such as employees, independent contractors, leased, and part-time employees.

Imputation of Knowledge & Severability

Coverage can be materially affected if an Insured individual has knowledge of facts or circumstances or was involved in wrongful conduct that gave rise to the claim, prior to the effective date of policy under which the claim was reported. Policies differ as to whether and to what extent, the knowledge or conduct of one "bad actor" may be imputed to "innocent "individual Insureds and / or to the Insured entity.

"Severability", is an important provision in D&O policies that is often overlooked by policyholders until it threatens to void coverage during a serious pending claim. The severability clause can be drafted with varying degrees of flexibility-- from "partial" to "full severability." A "full severability" provision is always most preferable from an Insured's standpoint. Many D&O policies, impute the knowledge of certain policy-specified senior level officer positions to the Insured entity. That imputation of knowledge can operate to void coverage that might have otherwise been available to the Insured entity.

M&A and "Tail Coverage" Considerations

The "claims-made" coverage trigger is critically important in an M&A context where contingent liability risks are inherent. In these contexts, it's important to evaluate the seller's policies' options to purchase a "tail" or "extended reporting period" for each of the target company's policies containing a "claims-made" trigger.

A "tail" coverage option allows for the reporting of claims alleging "wrongful acts" that occurred during the expired policy period, yet were not actually asserted against the Insured until after the policy's expiration, but instead were asserted during the "extended reporting" or "tail" period. An acquiring company's insurance professional should work closely with legal counsel's due diligence team to identify and present alternatives to manage contingent exposures.

What a Director or Officer Doesn't Know Will Hurt Them

Directors' & Officers' Liability insurance policies were originally created solely to protect the personal assets of the individuals serving on public company boards and executive officers. In 1992, one of the most prominent D&O insurers led a major transformational change in D&O underwriting by expanding coverage to include certain claims against the insured entity. Entity coverage for publicly traded companies is typically restricted to securities claims, while privately held companies and not-for-profit organizations benefit from more comprehensive entity coverage because they lack the public securities risk exposure of publicly traded companies.

The "Claims- Made" Coverage Trigger

D&O policies are universally underwritten on a 'claims-made' basis. This translates to an unequivocal contractual requirement that the policyholder report claims made against an Insured to the insurer during the effective policy period. The only exception is in the case where an optional reporting 'tail' is purchased which affords the Insured the ability to report claims during a specified "extended reporting period," as long as the wrongful act occurred during the effective period of the immediately preceding policy.

Defense

D&O policies issued to public companies generally contain no explicit duty to defend and some require the Insured to select from a pre-approved panel of pre-qualified defense counsel. In contrast, many private company D&O policies do contain a provision placing the defense obligation squarely upon the insurer, and still other policies contain options allowing the defense to be tendered by the Insured to the insurer within a specific period of time. Some D&O policies contain defense cost provisions that require an allocation or sharing of the defense costs between the Insured and Insurer, based upon a determination of covered versus non-covered allegations.

Settlement Hammer

D&O policies typically contain a "settlement hammer" provision. This clause operates to limit an insurer's obligation to indemnify in the event the Insured refuses to consent to a settlement that is acceptable to the insurer. Some policies may express the amount the insurer will pay for covered loss under this circumstance as a percentage of the ultimate covered settlement or judgment. Other D&O policies may limit their economic exposure to the amount for which the case could have historically settled, but for the Insured's refusal.

Regulatory Proceedings and Investigations

Most D&O insurance policies afford qualified protection against "regulatory and governmental" investigations, "administrative or regulatory proceedings," and criminal proceedings. Policies often require the proceedings to be directed against a natural person Insured, to be commenced and maintained in a manner specified in the policy, such as a 'formal' order of investigation, and only for policy-defined defense expenses incurred after the issuance of a formal order or an indictment.

D&O policies' definitions and other corresponding provisions and exclusions vary, and should be carefully evaluated to determine whether they encompass informal investigations from the time a subpoena is received, or from the time an Insured person is identified in writing as a person against whom charges may be filed.

Learning the A,B,C's and D's of D&O Coverage

The three main Insuring Agreements found in public company D&O policies, are typically referenced as "Side A, B, and C coverage". They are sometime supplemented with an optional Coverage D.

"Side A "Coverage - Individual Insured Coverage

"Side A Coverage," also known as the "Non-Indemnifiable Loss Insuring Agreement," provides coverage to individual officers and directors against claims for their policy-defined wrongful acts in their official capacities, under fairly rare circumstances in which the Insured entity either cannot or will not provided indemnification.

The policy's "Side A" coverage for non-indemnifiable claims against directors and officers, almost universally provides that no retention is required to be paid by individual Insureds. A separate "Side A" limit may be available in addition to the traditional D&O policy's aggregate limit of liability. "Side A" excess D&O policies have become more commonplace in the past several years, and certain "Side A" excess policies may also offer "difference in conditions" ('DIC') coverage that generally provides a feature of 'dropping down' to respond to claims either not paid by the primary or underlying D&O policy insurer, or in the event indemnification is unavailable from the Insured entity, the underlying limits are eroded by covered claims against the entity, or the underlying D&O insurers deny coverage to the directors. Some Side A policies are underwritten as non-rescindable by the insurer. Purchasers of this coverage should also consider, if available, an option for reinstatement of policy limits for the outside directors, in the event of premature policy limit exhaustion.

"Side B" Coverage - Corporate Reimbursement Coverage 

This insuring agreement reimburses the Insured entity for covered loss under claim circumstances where the corporation is indemnifying its directors and officers. This provision does not afford any coverage to the Insured entity for its own potential liability, and is subject to a self-insured retention ("SIR") that must be paid by the Insured entity before an Insurer will make any payments. It's important to note that many Insureds do not realize they are contractually obligated to obtain the insurer's prior consent to incur costs and expenses, and only those costs and expenses approved in advance by the insurer will be deemed to have satisfied the Insured entity's SIR obligation. It's important for policyholders to understand they run a serious risk of losing some or all of their otherwise available coverage, if they incur legal expenses prior to reporting the claim, or if they enter into negotiations or reach a settlement agreement in principle without the insurer's prior knowledge and consent.

"Side C" Coverage - Entity Coverage

This insuring agreement affords coverage to the publicly traded Insured entity only for it own liability and is typically restricted to coverage for securities-related claims. "Securities Claims" is a policy-defined term, encompassing only claims arising from the Insured entity's own securities. Privately held companies and organizations are afforded substantively different coverage under this insuring agreement.

"Side D" Coverage - Outside Entity Insured Person Coverage

This insuring clause is available as an option on most D&O policies. It provides coverage to designated "Insured Persons", for their liability as a result of their membership on an "Outside Entity" board. This coverage applies on a "double excess" basis, meaning it is triggered after the exhaustion of any indemnification provided by the Outside Entity to the Outside Entity director, as well as any insurance coverage available from the Outside Entity. Traditional D&O policies typically extend automatic coverage to insured Individuals who are designated by the policyholder to participate as a board member of a not-for-profit organization.

Some Additional Considerations 

In addition to the topics highlighted earlier, D&O insurance purchasers should gain familiarity with how their policies may respond under bankruptcy situations, potential coverage issues arising from a Special Committee's investigative activity, potential issues involving priority of payments among Insureds, hidden D&O insurance program design flaws that can render excess D&O policies unresponsive to catastrophic claims, and the changing requirements of international D&O coverage to remain compliant with local country regulations. These topics will be covered in a future article.

This article provides general information and is neither intended to provide any legal advice nor to provide any advice with regard to the specific interpretation or operation of any insurance policy. Any insurance policy's applicability is highly fact specific. Qualified legal counsel should be consulted regarding laws that may apply with respect to policy coverage interpretation in the state in which the policy will be interpreted.

The author, James J. Ilardi, CPCU, is a Chartered Property and Casualty Underwriter and President of SECURA RISK GROUP, LLC.

SECURA RISK GROUP is a New York based, independent commercial insurance brokerage and advisory firm. The firm specializes in the evaluation, design and procurement of business insurance policies and insurance programs for privately held enterprises, publicly traded companies, non-profit organizations and professional service firms. SECURA RISK GROUP also provides claims advisory and support services.

Insurance

Executive Liability Insurance - Why Private Companies Need It

Since its inception about fifty years ago, D&O insurance has evolved into a family of products responding differently to the needs of publicly traded companies, privately held businesses and not-for-profit entities and their respective board members, officers and trustees.

Directors' & Officers' Liability, Executive Liability or Management Liability insurance are essentially interchangeable terms. However, insuring agreements, definitions, exclusions and coverage options vary materially depending upon the type of policyholder being insured and the insurer underwriting the risk. Executive Liability insurance, once considered a necessity solely for publicly traded companies, particularly due to their exposure to shareholder litigation, has become recognized as an essential part of a risk transfer program for privately held companies and not-for-profit organizations.

Optimization of protection is a common goal shared by all types of organizations. In our opinion, the best way to achieve that objective is through engagement of highly experienced insurance, legal and financial advisors who work collaboratively with management to continually assess and treat these specialized enterprise risk exposures.

Private Company D&O Exposures

In 2005, Chubb Insurance Group, one of the largest underwriters of D&O insurance, conducted a survey of the D&O insurance purchasing trends of 450 private companies. A significant percentage of respondents gave the following reasons for not purchasing D&O insurance: 

• did not see the need for D&O insurance, 

• their D&O liability risk was low, 

• thought D&O risk is covered under other liability policies

The companies responding as non-purchasers of D&O insurance experienced at least one D&O claim in the five years preceding the survey. Results showed that private companies with 250 or more employees, were the subject of D&O litigation during the preceding five years and 20% of companies with 25 to 49 employees, experienced a D&O claim.

The survey revealed 43% of D&O litigation was brought by customers, 29% from regulatory agencies, and 11% from non-publicly traded equity securities holders. The average loss reported by the private companies was $380,000. Companies with D&O insurance experienced an average loss of $129,000. Companies without D&O insurance experienced an average loss of $480,000.

Some Common Examples of Private Company D&O Claims

• Major shareholder led buy-outs of minority shareholders alleging misrepresentations of the company's fair market value 

• purchaser of a company or its assets alleging misrepresentation 

• sale of company assets to entities controlled by the majority shareholder 

• creditors' committee or bankruptcy trustee claims 

• private equity investors and lenders' claims 

• vendors alleging misrepresentation in connection with an extension of credit 

• consumer protection and privacy claims

Private Company D&O Policy Considerations

Executive Liability insurance policies for privately held companies typically provide a combination or package of coverage that includes, but may not be limited to: Directors' & Officers' Liability, Employment Practices Liability, ERISA Fiduciary Liability and Commercial Crime/ Fidelity insurance.

D&O policies, whether underwritten on a stand-alone basis or in the form of a combination-type policy form, are underwritten on a "claims-made" basis. This means the claim must be made against the Insured and reported to the insurer during the same effective policy period, or under a specified Extended (claims) Reporting Period following the policy's expiration. This is a completely different coverage trigger from other liability policies such as Commercial General Liability that are traditionally underwritten with an "occurrence" trigger, which implicates the insurance policy that was in effect at the time of the accident, even if the claim is not reported until years later.

"Side A" coverage, which protects individual Insureds in the event the Insured entity is unable to indemnify individuals, is a standard agreement contained within many private company policy forms. These policies are generally structured with a shared policy limit among the various insuring agreements resulting in a more affordable insurance product tailored to small and mid-sized enterprises. For an additional premium, separate policy limits may be purchased for one or more of each distinct insuring agreement affording a more customized insurance package.

Also, policies should be evaluated to determine whether they extend coverage for covered "wrongful acts" committed by non-officers or directors, such as employees, independent contractors, leased, and part-time employees.

Imputation of Knowledge & Severability

Coverage can be materially affected if an Insured individual has knowledge of facts or circumstances or was involved in wrongful conduct that gave rise to the claim, prior to the effective date of policy under which the claim was reported. Policies differ as to whether and to what extent, the knowledge or conduct of one "bad actor" may be imputed to "innocent "individual Insureds and / or to the Insured entity.

"Severability", is an important provision in D&O policies that is often overlooked by policyholders until it threatens to void coverage during a serious pending claim. The severability clause can be drafted with varying degrees of flexibility-- from "partial" to "full severability." A "full severability" provision is always most preferable from an Insured's standpoint. Many D&O policies, impute the knowledge of certain policy-specified senior level officer positions to the Insured entity. That imputation of knowledge can operate to void coverage that might have otherwise been available to the Insured entity.

M&A and "Tail Coverage" Considerations

The "claims-made" coverage trigger is critically important in an M&A context where contingent liability risks are inherent. In these contexts, it's important to evaluate the seller's policies' options to purchase a "tail" or "extended reporting period" for each of the target company's policies containing a "claims-made" trigger.

A "tail" coverage option allows for the reporting of claims alleging "wrongful acts" that occurred during the expired policy period, yet were not actually asserted against the Insured until after the policy's expiration, but instead were asserted during the "extended reporting" or "tail" period. An acquiring company's insurance professional should work closely with legal counsel's due diligence team to identify and present alternatives to manage contingent exposures.

What a Director or Officer Doesn't Know Will Hurt Them

Directors' & Officers' Liability insurance policies were originally created solely to protect the personal assets of the individuals serving on public company boards and executive officers. In 1992, one of the most prominent D&O insurers led a major transformational change in D&O underwriting by expanding coverage to include certain claims against the insured entity. Entity coverage for publicly traded companies is typically restricted to securities claims, while privately held companies and not-for-profit organizations benefit from more comprehensive entity coverage because they lack the public securities risk exposure of publicly traded companies.

The "Claims- Made" Coverage Trigger

D&O policies are universally underwritten on a 'claims-made' basis. This translates to an unequivocal contractual requirement that the policyholder report claims made against an Insured to the insurer during the effective policy period. The only exception is in the case where an optional reporting 'tail' is purchased which affords the Insured the ability to report claims during a specified "extended reporting period," as long as the wrongful act occurred during the effective period of the immediately preceding policy.

Defense

D&O policies issued to public companies generally contain no explicit duty to defend and some require the Insured to select from a pre-approved panel of pre-qualified defense counsel. In contrast, many private company D&O policies do contain a provision placing the defense obligation squarely upon the insurer, and still other policies contain options allowing the defense to be tendered by the Insured to the insurer within a specific period of time. Some D&O policies contain defense cost provisions that require an allocation or sharing of the defense costs between the Insured and Insurer, based upon a determination of covered versus non-covered allegations.

Settlement Hammer

D&O policies typically contain a "settlement hammer" provision. This clause operates to limit an insurer's obligation to indemnify in the event the Insured refuses to consent to a settlement that is acceptable to the insurer. Some policies may express the amount the insurer will pay for covered loss under this circumstance as a percentage of the ultimate covered settlement or judgment. Other D&O policies may limit their economic exposure to the amount for which the case could have historically settled, but for the Insured's refusal.

Regulatory Proceedings and Investigations

Most D&O insurance policies afford qualified protection against "regulatory and governmental" investigations, "administrative or regulatory proceedings," and criminal proceedings. Policies often require the proceedings to be directed against a natural person Insured, to be commenced and maintained in a manner specified in the policy, such as a 'formal' order of investigation, and only for policy-defined defense expenses incurred after the issuance of a formal order or an indictment.

D&O policies' definitions and other corresponding provisions and exclusions vary, and should be carefully evaluated to determine whether they encompass informal investigations from the time a subpoena is received, or from the time an Insured person is identified in writing as a person against whom charges may be filed.

Learning the A,B,C's and D's of D&O Coverage

The three main Insuring Agreements found in public company D&O policies, are typically referenced as "Side A, B, and C coverage". They are sometime supplemented with an optional Coverage D.

"Side A "Coverage - Individual Insured Coverage

"Side A Coverage," also known as the "Non-Indemnifiable Loss Insuring Agreement," provides coverage to individual officers and directors against claims for their policy-defined wrongful acts in their official capacities, under fairly rare circumstances in which the Insured entity either cannot or will not provided indemnification.

The policy's "Side A" coverage for non-indemnifiable claims against directors and officers, almost universally provides that no retention is required to be paid by individual Insureds. A separate "Side A" limit may be available in addition to the traditional D&O policy's aggregate limit of liability. "Side A" excess D&O policies have become more commonplace in the past several years, and certain "Side A" excess policies may also offer "difference in conditions" ('DIC') coverage that generally provides a feature of 'dropping down' to respond to claims either not paid by the primary or underlying D&O policy insurer, or in the event indemnification is unavailable from the Insured entity, the underlying limits are eroded by covered claims against the entity, or the underlying D&O insurers deny coverage to the directors. Some Side A policies are underwritten as non-rescindable by the insurer. Purchasers of this coverage should also consider, if available, an option for reinstatement of policy limits for the outside directors, in the event of premature policy limit exhaustion.

"Side B" Coverage - Corporate Reimbursement Coverage 

This insuring agreement reimburses the Insured entity for covered loss under claim circumstances where the corporation is indemnifying its directors and officers. This provision does not afford any coverage to the Insured entity for its own potential liability, and is subject to a self-insured retention ("SIR") that must be paid by the Insured entity before an Insurer will make any payments. It's important to note that many Insureds do not realize they are contractually obligated to obtain the insurer's prior consent to incur costs and expenses, and only those costs and expenses approved in advance by the insurer will be deemed to have satisfied the Insured entity's SIR obligation. It's important for policyholders to understand they run a serious risk of losing some or all of their otherwise available coverage, if they incur legal expenses prior to reporting the claim, or if they enter into negotiations or reach a settlement agreement in principle without the insurer's prior knowledge and consent.

"Side C" Coverage - Entity Coverage

This insuring agreement affords coverage to the publicly traded Insured entity only for it own liability and is typically restricted to coverage for securities-related claims. "Securities Claims" is a policy-defined term, encompassing only claims arising from the Insured entity's own securities. Privately held companies and organizations are afforded substantively different coverage under this insuring agreement.

"Side D" Coverage - Outside Entity Insured Person Coverage

This insuring clause is available as an option on most D&O policies. It provides coverage to designated "Insured Persons", for their liability as a result of their membership on an "Outside Entity" board. This coverage applies on a "double excess" basis, meaning it is triggered after the exhaustion of any indemnification provided by the Outside Entity to the Outside Entity director, as well as any insurance coverage available from the Outside Entity. Traditional D&O policies typically extend automatic coverage to insured Individuals who are designated by the policyholder to participate as a board member of a not-for-profit organization.

Some Additional Considerations 

In addition to the topics highlighted earlier, D&O insurance purchasers should gain familiarity with how their policies may respond under bankruptcy situations, potential coverage issues arising from a Special Committee's investigative activity, potential issues involving priority of payments among Insureds, hidden D&O insurance program design flaws that can render excess D&O policies unresponsive to catastrophic claims, and the changing requirements of international D&O coverage to remain compliant with local country regulations. These topics will be covered in a future article.

This article provides general information and is neither intended to provide any legal advice nor to provide any advice with regard to the specific interpretation or operation of any insurance policy. Any insurance policy's applicability is highly fact specific. Qualified legal counsel should be consulted regarding laws that may apply with respect to policy coverage interpretation in the state in which the policy will be interpreted.

The author, James J. Ilardi, CPCU, is a Chartered Property and Casualty Underwriter and President of SECURA RISK GROUP, LLC.

SECURA RISK GROUP is a New York based, independent commercial insurance brokerage and advisory firm. The firm specializes in the evaluation, design and procurement of business insurance policies and insurance programs for privately held enterprises, publicly traded companies, non-profit organizations and professional service firms. SECURA RISK GROUP also provides claims advisory and support services.

I want to start off this 2010 with an article regarding Life Insurance. Many people find this topic morbid but believe me when I say this contract is as important as a Will and should be taken just as seriously as health insurance. Due to the length in details of this article I have provided chapters for easy reading. I hope this will educate you on Life Insurance and the importance of its necessity. (Note: For better understanding "You" is the policy owner and the insured)

Chapters:

1= Introduction

2=When/If you have Life Insurance already

3= Difference between a Insurance Agent and Broker

4= Types of Policies

5= What are Riders and popular types of Riders

6= The medical exam

1) About general Life Insurance: 

This is a contract between you and an insurance company to pay a certain amount (the premium) to a company in exchange for a benefit (called the Death Benefit, face amount, or policy amount) to the beneficiary (the person you want to get paid in the time of your death). This can range based on the type of policy (which will be discussed momentarily), your health, your hobbies, the Insurance company, how much you can afford in premiums, AND the amount of the benefit. It sounds overwhelming but it is not if you have the right agent or broker.

Now many people can say that Life Insurance is like gambling. You are betting that you will die in a specific time and the insurance company bets you won't. If the insurer wins, they keep the premiums, if you win...well you die and the death benefit goes to the beneficiary. This is a very morbid way of looking at it and if that is the case you can say the same for health insurance, auto insurance, and rental insurance. The truth is, you need life insurance in order to ease the burden of your death. Example 1: A married couple, both professionals that earn very well for a living have a child and like any other family has monthly expenses and 1 of the couple has a death. The odds of the spouse going back to work the next day is very slim. Odds are in fact that your ability to function in your career will lower which RISK the cause of not being able to pay expenses or having to use one's savings or investments in order to pay for these expenses NOT INCLUDING the death tax and funeral expenses. This can be financially devastating. Example 2: lower middle income family, a death occurs to 1 of the income earners. How will the family be capable of maintaining their current financial lifestyle?

Life insurance is about the ability of lowering the risk of financial burden. This can be in the form of simple cash or taxes via estate planning.

KEY Definitions:

The Insured: The person that is covered by the insurance company (He/She does NOT have to the policy owner)

The (policy) Owner: The one that pays the premium, controls the beneficiary, and basically owns the contract (Does NOT have to the insured...hope you understand it can be either/or).

Face Amount: Also known as the death benefit. The amount to be paid to the beneficiary.

The Beneficiary: Is the person/persons/organization who will receive the face amount (death benefit)

2) When/If you have Life Insurance: 

First, you should review your beneficiaries once a year and your policy approximately once every 2-3 years. This is free! You need to make sure the beneficiaries are the people/person you want to get paid! Divorce, death, a disagreement, or anything of the sort can make you change your mind about a particular person to receive the benefit so make sure you have the right people, estate/trust, AND/OR organization (non-profit preferably) to receive the benefit. Furthermore, you need to review every 2-3 years because many companies can offer a lower premium OR raise the benefit if you renew your policy or if you find a competitor that sees you have been paying the premiums may compete for your business. Either way, this is something you should consider to either save money or raise the policy amount! This is a win-win for you so there should be no reason not to do this.

3) Life Insurance Agent or Broker, what is the difference?: 

The major difference is an Agent is usually an independent sales man that usually works with different insurance companies in order to give the client the best possible policy while the Broker works for a particular company. My personal advice: always choose an Agent. Not because I am one myself BUT because an agent can look out for your benefit by providing different quotes, types, riders that are available (explained later), AND pros/cons regarding each insurance company. If you don't like a particular insurance company, tell the agent and he should move on to the next carrier (if he persist for some odd reason, fire him). Buyers BEWARE: The Agent should get paid by the carrier that is chosen, not by you specifically. If an Agent asks for money upfront for anything, RUN! There are also Insurance consultants that you pay but to keep things simple, see an Agent. Consultants and Agents are also great in reviewing current policies in order to lower premiums or increase benefits.

4) Types of Policies: 

There are 2 main categories: Term and Permanent Insurance. Within each of the 2 categories have sub-categories. I will explain them at a glance in order for you to make the best possible choice for you and your loved ones. Remember, you can have estate/trust or a organization as the beneficiary. (Note: There are even more sub-sub-categories within these sub-categories but the difference are so small and self explanatory that I have not included it in this article. Once you speak to an agent you will have enough knowledge by this article that you will know what questions to ask and know if you agent is right for you).

Term Insurance: A temporary policy in which the beneficiary is paid only upon death of the insured (you) within a specific time period (hence the word "Term"). Term Insurance is usually less expensive with a smaller death benefit. Some do not require medical exams BUT expect to pay a higher premium since the risk of the insurance company is unknown. Also, term insurance normally does not accumulate cash value (explained in permanent insurance) but can be purchased on top of your permanent policy (for those that may have coverage already):

Convertible Term: Ability to convert policy to permanent. There are some REALLY GOOD policies that require no medical exam, driver history, or hazardous avocations at a certain point in order to convert to permanent coverage guaranteed with all the benefits that permanent insurance policies has to offer.

Renewable Term: Able to renew a term policy without evidence of insurability.

Level Term: Fixed premiums over a certain time period than increases (great for those that are young adults and expect within 10 years to have a increase in pay).

Increasing/Decreasing Term: Coverage increases or decreases throughout the term while the premium remains the same.

Group Term: Usually used for employers or associations. This covers several people in order to reduce premiums. (Great for small business owners)

Permanent Insurance: Just as the name states, this provides coverage throughout the lifetime of the insured. This also builds cash value which is fantastic for tax purposes because if you loan out money to yourself using this cash value there are no tax implications. Few policies may have in general withdrawal tax-free. However in most cases, If you withdraw the cash value you pay the only the taxes on the premiums (the amount that grew) which is fantastic. Just make sure your agent knows not to have the cash value grow larger than the death benefit otherwise it is subject to 10% taxes! Surrender charges may also apply when you withdrawal so PLEASE consult with an agent who can assist you with these details. You should consider Permanent Insurance if you have a family and don't mind an increase in premiums (amount you pay) by a few dollars compared to term.

Traditional Whole Life: Pay a fixed amount of premium in order to be covered for the insured's entire life which includes accumulating cash value.

Single-Premium Whole Life Insurance: Whole life insurance for 1 lump sum premium (usually that 1 lump sum is very large in order to get a great death benefit).

Participating Whole Life Insurance: Just like Traditional Whole life except it pays you dividends which can be used as cash OR pay your dividends for you! There is no guarantee that you will be paid the dividends, this is based on performance within the insurance company.

Limited Payment Whole Life Insurance: Limited payments for whole life but requires a higher premium since you are in fact paying for a shorter amount of time. This can be based on payment amounts (10, 20, 30, etc payments) or a particular age (whole life is paid up at age 65, 75, 85, etc).

Universal Life Insurance: Flexible premiums with flexible face amounts (the death benefit) with a unbundled pricing factors. Ex: If you pay X amount, you are covered for X amount.

Indexed Universal Life: Flexible premium/benefit with the cash value is tied to the performance of a particular financial index. Most insurance companies crediting rate (% of growth) will not go below zero.

Variable Life Insurance: Death Benefit and cash value fluctuates according to the investment performance from a separate account of investment options. Usually insurance policies guarantee the benefit will not fall below a specified minimum.

Variable Universal Life Insurance (also called Flexible Premium Variable Life Insurance & Universal Life II/2): A combination of Variable and Universal which has premium/death benefit flexibility as well as investment flexibility.

Last Survivor Universal Life Insurance (also called Survivorship or "Second to die" Insurance): Covers 2 people and the death benefit is only paid when both insurers have died. This is FANTASTIC and somewhat a necessity for families that pay estate taxes (usually High-Net-worth individuals).

5) Life Insurance Riders, what is it and why is it very important: 

Rider is the name of a benefit that is added to your policy. This provides special additions to the policy which can be blended and put together. There are SO MANY types of riders that I would have to write a different article regarding Riders (and insurance companies add new types of riders often) but I want to at least name the most popular (and in my opinion, the most important) that you should highly consider when choosing a policy. Riders add to the cost of the premium but don't take riders lightly; it can be a life saver!

Accidental Death Benefit Rider (AD&D): Additional death benefit will be paid to the beneficiary if you die from a result of an accident (ie: Car accidents, a fall down the stairs). This is especially important if the insurer travels often, relatively young, and has a family. Please note: You can buy AD&D Insurance separately.

Accidental Death & Dismemberment Rider: Same as above BUT if you lose 2 limbs or sight will pay the death benefit. Some policies may offer smaller amounts if losing 1 eye or 1 limb. This is great for those that work with their hands.

Disability Income Rider: You will receive a monthly income if you are totally and permanently disabled. You are guaranteed a specific level of income. Pay attention to this detail, depending on the policy it will either pay you depending on how long the disability lasts OR time frame of the rider.

Guaranteed Insurability Rider: Ability to purchase additional coverage in intervals based on age or policy years without having to check insurance eligibility.

Level Term Rider: Gives you a fixed amount of term insurance added to your permanent policy. This rider can add 3-5 times the death benefit or your policy. Not a bad deal!

Waiver of Premium Rider: If you become disabled which results to the inability to work/earn income, the waiver will exempt you from paying the premiums while your policy is still in force! There is a huge gap between policies and insurance companies so the devils in the details with this rider.

Family Income Benefit Rider: In case of death of the insurer, this rider will provide income for a specific time period for your family.

Accelerated Death Benefit Rider: An insurer that is diagnosed with a terminal illness will receive 25-40% of the death benefit of the base policy (The decision is made between the insurer and the insurance company). This will lower the death benefit however depending on your finances or living lifestyle, this rider should not be taken lightly and should seriously be considered.

Long-Term Care Rider: If the insurer's health compels to stay in a nursing home or receive care at home, this rider will provide monthly payments. Please Note: Long Term Care insurance can be bought separately for more benefit.

6) The Medical Exam: 

This section is not to scary you away but to mentally (and possibly physically) prepare you for the medical exam so this way you know what to expect and can get the lowest possible premiums while receiving the highest possible death benefit. This really shouldn't be a concern if you work out regularly and maintain a healthy eating habit (notice I said habit and not diet. Diets don't work for long term).

The exam is mandatory for most insurance policies. Many term insurance do not require one but expect a low death benefit and/or higher premium. The idea of the exam is not just to see if you're insurable but to also see how much they will charge the insurer/policy owner. The exam is done by a "paramedical" professional that are independent contractors hired by the insurance company who either come to your home or has an office where you/the insurer visit. They are licensed health professionals so they know what to look for! In very few cases the insurance company may ask for an "Attending Physician Statement (APS)" from your doctor. This must be provided by your doctor and NOT copies by you. TIP: The "paramedical" job is to give the insurance company a reason to increase your premiums so don't give any details that are not asked.

First part (either called Part 1 or Part A) is complete by the Agent or by you. Part 2/B is the paramedical or physician portion. The best bet is to have your agent contact a paramedical that specializes in mobile exams for an easier exam for you. Paramedical will contact you to schedule an appointment. The exam is not optional so it's not a matter of yes or no but when and where. This entire exam will cost you nothing except time so make the time, life insurance is important!

The paramedical/physician will take your medical history (questions), physical measurements of height and weight, blood pressure, pulse, blood, and urine. Additional tests will vary based on age and policy amount (yes, the higher the death benefit = the more tests that must be provided). Now if the policy is substantial, the insurance company may not send a paramedical but require an actual Medical Doctor to exam you. Of course, this is chosen by the insurance company so remember my tip earlier! This exam may even include a treadmill test and additional crazy exams in order to see if you qualify for that substantial amount and low premium. On the flip side, if you choose a low insurance policy, you will just have a paramedical doing simple tests that mentioned earlier with no additional exams.

What they are looking for: Paramedical/Physicians are looking for health conditions that may shorten your life. Remember, insurance companies are here to make a business and if you're a liability then it might be a risk they do not want to take or raise the premium to make the risk tolerable. Blood and urine is taken to see the following:

- your antibodies or antigens to HIV

- Cholesterol and related lipids

- Antibodies to hepatitis

- Liver/kidney disorders

- Diabetes

- Immunity disorders

- Prostate specific antigen (PSA)

- Drug tests such as cocaine

The Results: They are sent directly to the insurance company's home office underwriters for review. Many times you can request (must be written request) to receive a copy of the results however many insurance companies will automatically do this. Many times they will find abnormalities but it's usually not a concern and just speak to your medical professional for a follow up (remember: the insurance company will look at these exams with a "fine tooth cone" in order to see what the risk are). The underwriters will look at the exam results and the application (remember part 1/a? well, now they want to see if your also lying) and determine the premium amount. Smokers pay more; any nicotine in your system will consider you a smoker, even if it is just socially.

The premium is determined by a category that you fit in. This really depends on the insurance company on how they factor but the general rule is if you are a higher risk, you pay higher premium. If you are standard risk, you will pay a standard premium, and if you are a preferred risk, you will pay a low premium.

You can decline the policy after you receive the final quote after the exam but do remember this: All results will become part of the MIB group's database (Medical information Bureau). This is a clearinghouse of medical information that insurance companies use to store information after you apply for Life/Health/Disability Income/Long Term care/Critical Illness insurance. So for seven years it will be on database. You can receive a free report annually (like a credit check) at their website which I included at the bottom of this article.

Now that you know practically everything there is to know about life insurance. I hope you realize how important it is. It may seem like a lot but the hardest part is simply choosing what type of policy is right for you. This can be done with the help of your Agent. In the end, everyone is different and everyone should analyze their own situation and need for the beneficiaries. If you have even the slightest concern for a loved one regarding what will happen if you was no longer with us then you should consider life insurance. There truly is a feeling a relief once you know you and your loved ones are covered regardless of how much you or that person makes. For many that feel that their loved ones don't need the death benefit due to whatever the case may be ("they earn enough money to survive" is the biggest reason I hear against life insurance), this can be a simple last gesture of "I love you" or appreciation for them being part of your life.

Insurance

Everything About Life Insurance!

I want to start off this 2010 with an article regarding Life Insurance. Many people find this topic morbid but believe me when I say this contract is as important as a Will and should be taken just as seriously as health insurance. Due to the length in details of this article I have provided chapters for easy reading. I hope this will educate you on Life Insurance and the importance of its necessity. (Note: For better understanding "You" is the policy owner and the insured)

Chapters:

1= Introduction

2=When/If you have Life Insurance already

3= Difference between a Insurance Agent and Broker

4= Types of Policies

5= What are Riders and popular types of Riders

6= The medical exam

1) About general Life Insurance: 

This is a contract between you and an insurance company to pay a certain amount (the premium) to a company in exchange for a benefit (called the Death Benefit, face amount, or policy amount) to the beneficiary (the person you want to get paid in the time of your death). This can range based on the type of policy (which will be discussed momentarily), your health, your hobbies, the Insurance company, how much you can afford in premiums, AND the amount of the benefit. It sounds overwhelming but it is not if you have the right agent or broker.

Now many people can say that Life Insurance is like gambling. You are betting that you will die in a specific time and the insurance company bets you won't. If the insurer wins, they keep the premiums, if you win...well you die and the death benefit goes to the beneficiary. This is a very morbid way of looking at it and if that is the case you can say the same for health insurance, auto insurance, and rental insurance. The truth is, you need life insurance in order to ease the burden of your death. Example 1: A married couple, both professionals that earn very well for a living have a child and like any other family has monthly expenses and 1 of the couple has a death. The odds of the spouse going back to work the next day is very slim. Odds are in fact that your ability to function in your career will lower which RISK the cause of not being able to pay expenses or having to use one's savings or investments in order to pay for these expenses NOT INCLUDING the death tax and funeral expenses. This can be financially devastating. Example 2: lower middle income family, a death occurs to 1 of the income earners. How will the family be capable of maintaining their current financial lifestyle?

Life insurance is about the ability of lowering the risk of financial burden. This can be in the form of simple cash or taxes via estate planning.

KEY Definitions:

The Insured: The person that is covered by the insurance company (He/She does NOT have to the policy owner)

The (policy) Owner: The one that pays the premium, controls the beneficiary, and basically owns the contract (Does NOT have to the insured...hope you understand it can be either/or).

Face Amount: Also known as the death benefit. The amount to be paid to the beneficiary.

The Beneficiary: Is the person/persons/organization who will receive the face amount (death benefit)

2) When/If you have Life Insurance: 

First, you should review your beneficiaries once a year and your policy approximately once every 2-3 years. This is free! You need to make sure the beneficiaries are the people/person you want to get paid! Divorce, death, a disagreement, or anything of the sort can make you change your mind about a particular person to receive the benefit so make sure you have the right people, estate/trust, AND/OR organization (non-profit preferably) to receive the benefit. Furthermore, you need to review every 2-3 years because many companies can offer a lower premium OR raise the benefit if you renew your policy or if you find a competitor that sees you have been paying the premiums may compete for your business. Either way, this is something you should consider to either save money or raise the policy amount! This is a win-win for you so there should be no reason not to do this.

3) Life Insurance Agent or Broker, what is the difference?: 

The major difference is an Agent is usually an independent sales man that usually works with different insurance companies in order to give the client the best possible policy while the Broker works for a particular company. My personal advice: always choose an Agent. Not because I am one myself BUT because an agent can look out for your benefit by providing different quotes, types, riders that are available (explained later), AND pros/cons regarding each insurance company. If you don't like a particular insurance company, tell the agent and he should move on to the next carrier (if he persist for some odd reason, fire him). Buyers BEWARE: The Agent should get paid by the carrier that is chosen, not by you specifically. If an Agent asks for money upfront for anything, RUN! There are also Insurance consultants that you pay but to keep things simple, see an Agent. Consultants and Agents are also great in reviewing current policies in order to lower premiums or increase benefits.

4) Types of Policies: 

There are 2 main categories: Term and Permanent Insurance. Within each of the 2 categories have sub-categories. I will explain them at a glance in order for you to make the best possible choice for you and your loved ones. Remember, you can have estate/trust or a organization as the beneficiary. (Note: There are even more sub-sub-categories within these sub-categories but the difference are so small and self explanatory that I have not included it in this article. Once you speak to an agent you will have enough knowledge by this article that you will know what questions to ask and know if you agent is right for you).

Term Insurance: A temporary policy in which the beneficiary is paid only upon death of the insured (you) within a specific time period (hence the word "Term"). Term Insurance is usually less expensive with a smaller death benefit. Some do not require medical exams BUT expect to pay a higher premium since the risk of the insurance company is unknown. Also, term insurance normally does not accumulate cash value (explained in permanent insurance) but can be purchased on top of your permanent policy (for those that may have coverage already):

Convertible Term: Ability to convert policy to permanent. There are some REALLY GOOD policies that require no medical exam, driver history, or hazardous avocations at a certain point in order to convert to permanent coverage guaranteed with all the benefits that permanent insurance policies has to offer.

Renewable Term: Able to renew a term policy without evidence of insurability.

Level Term: Fixed premiums over a certain time period than increases (great for those that are young adults and expect within 10 years to have a increase in pay).

Increasing/Decreasing Term: Coverage increases or decreases throughout the term while the premium remains the same.

Group Term: Usually used for employers or associations. This covers several people in order to reduce premiums. (Great for small business owners)

Permanent Insurance: Just as the name states, this provides coverage throughout the lifetime of the insured. This also builds cash value which is fantastic for tax purposes because if you loan out money to yourself using this cash value there are no tax implications. Few policies may have in general withdrawal tax-free. However in most cases, If you withdraw the cash value you pay the only the taxes on the premiums (the amount that grew) which is fantastic. Just make sure your agent knows not to have the cash value grow larger than the death benefit otherwise it is subject to 10% taxes! Surrender charges may also apply when you withdrawal so PLEASE consult with an agent who can assist you with these details. You should consider Permanent Insurance if you have a family and don't mind an increase in premiums (amount you pay) by a few dollars compared to term.

Traditional Whole Life: Pay a fixed amount of premium in order to be covered for the insured's entire life which includes accumulating cash value.

Single-Premium Whole Life Insurance: Whole life insurance for 1 lump sum premium (usually that 1 lump sum is very large in order to get a great death benefit).

Participating Whole Life Insurance: Just like Traditional Whole life except it pays you dividends which can be used as cash OR pay your dividends for you! There is no guarantee that you will be paid the dividends, this is based on performance within the insurance company.

Limited Payment Whole Life Insurance: Limited payments for whole life but requires a higher premium since you are in fact paying for a shorter amount of time. This can be based on payment amounts (10, 20, 30, etc payments) or a particular age (whole life is paid up at age 65, 75, 85, etc).

Universal Life Insurance: Flexible premiums with flexible face amounts (the death benefit) with a unbundled pricing factors. Ex: If you pay X amount, you are covered for X amount.

Indexed Universal Life: Flexible premium/benefit with the cash value is tied to the performance of a particular financial index. Most insurance companies crediting rate (% of growth) will not go below zero.

Variable Life Insurance: Death Benefit and cash value fluctuates according to the investment performance from a separate account of investment options. Usually insurance policies guarantee the benefit will not fall below a specified minimum.

Variable Universal Life Insurance (also called Flexible Premium Variable Life Insurance & Universal Life II/2): A combination of Variable and Universal which has premium/death benefit flexibility as well as investment flexibility.

Last Survivor Universal Life Insurance (also called Survivorship or "Second to die" Insurance): Covers 2 people and the death benefit is only paid when both insurers have died. This is FANTASTIC and somewhat a necessity for families that pay estate taxes (usually High-Net-worth individuals).

5) Life Insurance Riders, what is it and why is it very important: 

Rider is the name of a benefit that is added to your policy. This provides special additions to the policy which can be blended and put together. There are SO MANY types of riders that I would have to write a different article regarding Riders (and insurance companies add new types of riders often) but I want to at least name the most popular (and in my opinion, the most important) that you should highly consider when choosing a policy. Riders add to the cost of the premium but don't take riders lightly; it can be a life saver!

Accidental Death Benefit Rider (AD&D): Additional death benefit will be paid to the beneficiary if you die from a result of an accident (ie: Car accidents, a fall down the stairs). This is especially important if the insurer travels often, relatively young, and has a family. Please note: You can buy AD&D Insurance separately.

Accidental Death & Dismemberment Rider: Same as above BUT if you lose 2 limbs or sight will pay the death benefit. Some policies may offer smaller amounts if losing 1 eye or 1 limb. This is great for those that work with their hands.

Disability Income Rider: You will receive a monthly income if you are totally and permanently disabled. You are guaranteed a specific level of income. Pay attention to this detail, depending on the policy it will either pay you depending on how long the disability lasts OR time frame of the rider.

Guaranteed Insurability Rider: Ability to purchase additional coverage in intervals based on age or policy years without having to check insurance eligibility.

Level Term Rider: Gives you a fixed amount of term insurance added to your permanent policy. This rider can add 3-5 times the death benefit or your policy. Not a bad deal!

Waiver of Premium Rider: If you become disabled which results to the inability to work/earn income, the waiver will exempt you from paying the premiums while your policy is still in force! There is a huge gap between policies and insurance companies so the devils in the details with this rider.

Family Income Benefit Rider: In case of death of the insurer, this rider will provide income for a specific time period for your family.

Accelerated Death Benefit Rider: An insurer that is diagnosed with a terminal illness will receive 25-40% of the death benefit of the base policy (The decision is made between the insurer and the insurance company). This will lower the death benefit however depending on your finances or living lifestyle, this rider should not be taken lightly and should seriously be considered.

Long-Term Care Rider: If the insurer's health compels to stay in a nursing home or receive care at home, this rider will provide monthly payments. Please Note: Long Term Care insurance can be bought separately for more benefit.

6) The Medical Exam: 

This section is not to scary you away but to mentally (and possibly physically) prepare you for the medical exam so this way you know what to expect and can get the lowest possible premiums while receiving the highest possible death benefit. This really shouldn't be a concern if you work out regularly and maintain a healthy eating habit (notice I said habit and not diet. Diets don't work for long term).

The exam is mandatory for most insurance policies. Many term insurance do not require one but expect a low death benefit and/or higher premium. The idea of the exam is not just to see if you're insurable but to also see how much they will charge the insurer/policy owner. The exam is done by a "paramedical" professional that are independent contractors hired by the insurance company who either come to your home or has an office where you/the insurer visit. They are licensed health professionals so they know what to look for! In very few cases the insurance company may ask for an "Attending Physician Statement (APS)" from your doctor. This must be provided by your doctor and NOT copies by you. TIP: The "paramedical" job is to give the insurance company a reason to increase your premiums so don't give any details that are not asked.

First part (either called Part 1 or Part A) is complete by the Agent or by you. Part 2/B is the paramedical or physician portion. The best bet is to have your agent contact a paramedical that specializes in mobile exams for an easier exam for you. Paramedical will contact you to schedule an appointment. The exam is not optional so it's not a matter of yes or no but when and where. This entire exam will cost you nothing except time so make the time, life insurance is important!

The paramedical/physician will take your medical history (questions), physical measurements of height and weight, blood pressure, pulse, blood, and urine. Additional tests will vary based on age and policy amount (yes, the higher the death benefit = the more tests that must be provided). Now if the policy is substantial, the insurance company may not send a paramedical but require an actual Medical Doctor to exam you. Of course, this is chosen by the insurance company so remember my tip earlier! This exam may even include a treadmill test and additional crazy exams in order to see if you qualify for that substantial amount and low premium. On the flip side, if you choose a low insurance policy, you will just have a paramedical doing simple tests that mentioned earlier with no additional exams.

What they are looking for: Paramedical/Physicians are looking for health conditions that may shorten your life. Remember, insurance companies are here to make a business and if you're a liability then it might be a risk they do not want to take or raise the premium to make the risk tolerable. Blood and urine is taken to see the following:

- your antibodies or antigens to HIV

- Cholesterol and related lipids

- Antibodies to hepatitis

- Liver/kidney disorders

- Diabetes

- Immunity disorders

- Prostate specific antigen (PSA)

- Drug tests such as cocaine

The Results: They are sent directly to the insurance company's home office underwriters for review. Many times you can request (must be written request) to receive a copy of the results however many insurance companies will automatically do this. Many times they will find abnormalities but it's usually not a concern and just speak to your medical professional for a follow up (remember: the insurance company will look at these exams with a "fine tooth cone" in order to see what the risk are). The underwriters will look at the exam results and the application (remember part 1/a? well, now they want to see if your also lying) and determine the premium amount. Smokers pay more; any nicotine in your system will consider you a smoker, even if it is just socially.

The premium is determined by a category that you fit in. This really depends on the insurance company on how they factor but the general rule is if you are a higher risk, you pay higher premium. If you are standard risk, you will pay a standard premium, and if you are a preferred risk, you will pay a low premium.

You can decline the policy after you receive the final quote after the exam but do remember this: All results will become part of the MIB group's database (Medical information Bureau). This is a clearinghouse of medical information that insurance companies use to store information after you apply for Life/Health/Disability Income/Long Term care/Critical Illness insurance. So for seven years it will be on database. You can receive a free report annually (like a credit check) at their website which I included at the bottom of this article.

Now that you know practically everything there is to know about life insurance. I hope you realize how important it is. It may seem like a lot but the hardest part is simply choosing what type of policy is right for you. This can be done with the help of your Agent. In the end, everyone is different and everyone should analyze their own situation and need for the beneficiaries. If you have even the slightest concern for a loved one regarding what will happen if you was no longer with us then you should consider life insurance. There truly is a feeling a relief once you know you and your loved ones are covered regardless of how much you or that person makes. For many that feel that their loved ones don't need the death benefit due to whatever the case may be ("they earn enough money to survive" is the biggest reason I hear against life insurance), this can be a simple last gesture of "I love you" or appreciation for them being part of your life.