Professional Documents
Culture Documents
EMPOWERED BY
FIRST SALES ACADEMY (FSA)
Reaching out to you
PART A
(The Basics of Insurance)
16
PART C
(Life Insurance)
1116
1
The Basics of Insurance
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The Basics of Insurance
Risk Definition
Risk Categories
Risk Management
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Risk Definition
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Risk Categories
Fundamental Risk
Particular Risk
Pure Risk
Speculative Risk
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Peril, Hazard, and Loss
PERIL
:
HAZARD
: LOSS
:
(,)
RISK
:
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,,
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Risk Management
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Risk Handling Methods
Prevent
Retain
Avoid
Control
Transfer
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1.
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2.
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3.
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4.
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5.
,
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?
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?
Life Fund
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?
Fortuitous events
:,.
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Insurance & Takaful
, Takaful /
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Insurance & Takaful
Riba ()
-Tabarru ()
-Mudharabah ()
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Syariah Advisory Council of Bank Negara Malaysia (SAC)
SAC 19975
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Social
Creation of Benefits
Employment
Financial
Peace of
Mind/
Protection
Cost Security
Loss Stabilization
Capital for Control
Compelled Investment
Saving
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Insurable
Interest
Homogenous
Pure Risks
Exposures
Particular
Risks
Public Policy Financial
Value
Fortuitous
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Life & General Insurance
Life
-
- //
General
-
.
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The Insurance Market
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Insurance Industry Performance
(54%)
2012 Penetration Rate New Business Total Premium
2012
RM 8.20
billion
2011
RM 7.92
billion
20123.6%
Malaysia Life Insurance Industry Grew
2012
RM 15.180
billion
2011
RM 14.029
General Insurance Industry
billion
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2
Basic Principles of Insurance
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Basic Principles of Insurance
Insurable Interest
Indemnity
Subrogation
Contribution
Proximate Cause
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Basic Principles of Insurance
Principle of
Utmost Good
Faith
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Utmost Good Faith
(Uberrima Fides)
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Insurers Rights
Innocent Fraudulent
Breach Breach
1. ?
2. ?
3. ?
4. ?
5. ?
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2013FSA9
9241
a.
b.
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9256
Consumer Insurance Contract (Individual)
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Basic Principles of Insurance
Insurable
Principle of Interest
Utmost Good
Faith
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: :
,
,,
,
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Insurable Interest
?
:
:
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2013FSA83
()
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Basic Principles of Insurance
Principle of Insurable
Utmost Good Interest
Faith
Assignment
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Assignment
!
!
()
()
,
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2013FSA10
10216
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Basic Principles of Insurance
Principle of Insurable
Utmost Good Interest
Faith
Assignment
Indemnity
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Indemnity
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()
Property
+
Liability
Pecuniary
Marine
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Basic Principles of Insurance
Principle of Insurable
Utmost Good Interest
Faith
Assignment
Indemnity
Principle of
Subrogation
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Principle of Subrogation
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,
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.
&
Tort / Common Law Accident
Contract
Money policy
,
Salvage
Fire
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Basic Principles of Insurance
Principle of Insurable
Utmost Good Interest
Faith
Assignment
Indemnity
Principle of
Contribution Principle of
Subrogation
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Principle of Contribution
()
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Basic Principles of Insurance
Principle of Insurable
Utmost Good Interest
Faith
Assignment
Principle of
Proximate
Cause
Indemnity
Principle of
Contribution Principle of
Subrogation
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Principle of Proximate Cause
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Operation of a Single Cause
Perils
Insured Peril Uninsured Peril Excluded Peril
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Concurrent Causes
Separable Losses
Liability for loss caused by
insured peril only
Concurrent Causes
Inseparable Losses
Full liability
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Successive Causes
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3
Legislation and Consumer Protection
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Legislation and Consumer Protection
1965
2011 - PIDM
2010 (PDPA)
2001
2010
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FSAIFSA2013630
1989
1983 IBA)
BAFIA)
1996 (IA)
2003 PSA)
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FSA 2013IFSA 2013
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1965 Companies Act 1965
CCM)/SSM
Annual Returns
Statutory Report
Dissolution of a Company
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1965 Companies Act 1965
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2011
Malaysia Deposit Insurance Corporation Act 2011
(PIDM)
PIDM
:
RM250,000
RM500,000
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Financial Consumer Literacy & Education
(CEP)
Insurance Info
insurance
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Financial Consumer Complaints & Disputes
FMB
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Financial Consumer Complaints & Disputes
<RM200K
<RM100K
<RM5K
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Financial Consumer Complaints & Disputes
BNMLINK
FMB
FMB
/
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Financial Consumer Complaints & Disputes
Lodge
State essential Sort details in Keep original
complaint in
information sensible order documents
writing
BNMLINK
Financial Mediation Bank Negara Malaysia Laman
Informasi Nasihat and Khidmat
Bureau (FMB) (BNMLINK)
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Personal Data Protection Act 2010 (PDPA)
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Personal Data Protection Act 2010 (PDPA)
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2001
Panti-Mondey Launcering and Anti-Terrorism Financiang Act 2001 (AMLATFA)
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2001
Panti-Mondey Launcering and Anti-Terrorism Financiang Act 2001 (AMLATFA)
Placement Layering Integration
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2001
Panti-Mondey Launcering and Anti-Terrorism Financiang Act 2001 (AMLATFA)
20139
(CDD)
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2010
Competition Act 2010
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2010
Competition Act 2010
Malaysian Competition Commission (MyCC)
2010
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4
The Insurance Contract
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The Insurance Contract
Unenforceable Contracts
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The Law of Contract
1950
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Offer & Acceptance
Intention to Create a Legal
Relationship
Consideration
Capacity of Contract
Legal Form
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,
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15
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5
Law of Agency
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Law of Agency
Duties of an insurance agent to the principal
Authority of agents
Insurance Contracts formed through an agent
Termination of agency
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Law of Agency
Principal
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()
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Pay the agreed remuneration
Indemnify the agent
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Actual Authority Express Actual
Authority
Implied Actual Authority
Apparent / Ostensible Authority
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()
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-2013 7
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-2013 7
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6
Introduction to Medical and Health Insurance
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Introduction to Medical and Health Insurance
Introduction
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Introduction
Medical and Health Insurance (MHI)
General Life
Stand-alone policy Stand-alone policy and/or rider
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Medical and Health Insurance (MHI)
/
/
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Types of Medical and Health Insurance (MHI) Products
(HSI)
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:-
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(HSI)
36
60% - 70%
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MCO
Emergency of Managed Care Organizations (MCO)
BNMMCO
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Regulations Applicable to MHI
1 Jan 2006 1 Jan 2010
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15
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Group Medical and Health Insurance
75%
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Cost Containment Measures
(deductible)
(20%)
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Renewal of Medical and Health Insurance
30
/
/
/
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Automatic Termination of a Policy
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Personal Income Tax Exemption
MHI + = RM 3,000
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Life Insurance
11
Legal Aspects of Life Insurance
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Legal Aspects of Life Insurance
Misstatement of Age
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Introduction
2013 FSA 8
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Legal Aspects of Life Insurance
Misstatement of Age
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1016 -
16
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,30%
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Non-payment
Non-forteiture Condition
Paid-up Policy
-
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Paid Up Policy
:-
a)
b)
c)
d)
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Disclosure Requirement
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2013 FSA 93
(2)
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12
Life Insurance Products
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Life Insurance Products
Introduction
Supplementary Contracts
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Introduction
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Life Insurance Policies
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Term Insurance
/:
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Whole Life Assurance
3
Sum Assured
Premium
Continuous Payment
@ 100
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-
/ (e.g.60)
Endowment Insurance
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Investment-linked Life Insurance Policies
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),,
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Life Insurance Policies
Life-Annuity Plan
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:
Purchase
Money
$ $ $ $ $ $ $
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Purchase
Money Deferred
$ $ $ $ $
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20138%
10
RM3,000
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Critical Illness Insurance
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Group Insurance
10
-
1660(
-
-
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Supplementary Contracts
Rider Personal Accident (PA) Waiver of Premium
Provision
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Participating Contracts
Sum Assured
Age
Non-participating Contracts
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13
Life Insurance Premium Rating
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Life Insurance Premium Rating
Introduction
Costing the Risk
Level Premiums
Gross and Net Premiums
Loading for Contingencies
Group Insurance Premium
Personal Income Tax Relief
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Life Insurance Premium Rating
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Costing the Risk
:
Mortality
Investment returns
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- Mortality
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- Investment Returns
4%
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- Expenses
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Level Premiums
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Gross and Net Premiums
= +
Net Premium = Pure Risk Premium + Interest
= +
+
Gross Premium = Net Premium + Management Expenses
and Contingencies + Profit
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Loading for Contingencies
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Personal Income Tax Relief
RM
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Group Insurance Premium
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14
Life Insurance Underwriting & Document
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Life Insurance Underwriting & Document
Introduction
Risk Selection
Underwriting Guidelines
Assumption of Risk
Role of the Insurance Agent in the Underwriting Process
Insurance Documents
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Risk Selection
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Risk Selection
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Risk Selection
- -
- : - :
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Underwriting Guidelines
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Underwriting Guidelines
Risk Classification
Standard Risks Sub-Standard Risks
Uninsurable Risks
Below Average Risks
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Risks Classification
/
Acceptable on standard terms & Acceptable, but with extra premiums,
premiums loadings, and/or limited coverage
Without any adverse risk factors With health / occupational hazards
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Risks Classification
May not be accepted / may be deferred Rejected or declined
for a specific period
Unclear illnesses Terminal illnesses
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Handling Adverse Risks
/
Adverse selection or Anti-selection
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Assumption of Risk
-
15
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Insurance Documents
The Proposal Form
AgentsReport
Medical The Policy Form
Examiners Report
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15
Life Insurance Claims
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Life Insurance Claims
Introduction
Types of Claims
Death Claims
Maturity Claims
Critical Illness Insurance Claims
Total and Permanent Disability Claims
Personal Accident Claims
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- The Claims Process
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Types of Claims
Maturity
Permanent and Total
Disability
Death
Critical Illness
Other benefits under
riders
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Death Claims
/ /
()
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Death Claims
2013 10
, 195623
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Death Claims
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Death Claims
1958
6
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Death Claims
Death Claims FSA 2013
RM100,000
RM100,000
2013 -
/
/
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+
1% (
60
)
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Maturity Claims
Discharge Form
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Critical Illness Insurance Claims
36
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Total and Permanent Disability Claims
TPD TPD claim form
TPD medical report
Original policy document
/ Other supporting test/laboratory report
and investigation
Police report (for TPD caused by accidents)
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Personal Accident Claims
report
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16
Code of Practice for Life
Insurance Agents
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Code of Practice for Life Insurance Agents
Introduction
Code of Ethics
Code of Practice
Disclosure Requirements
Existing Policyholders
Claims
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Insurance Agent
Code of Ethics
Integrity
Fairness
Honesty
Code of Conduct
Accountable
Responsible
Professional
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Code of Ethics
1
2
3
4
6
7
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Code of Practice
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Selling Life Insurance
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Providing Insurance Coverage
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Disclosure Requirements
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Disclosure Requirements
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Disclosure Requirements
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Disclosure Requirements
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Accounts & Financial Aspects
- Keep proper
account of all financial transactions
-
Acknowledge receipt of all money received
-
Remit any such monies so collected in strict conformity with his agency appointment
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Existing Policyholders
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Claims
Agent is required to assist policy owner / his
beneficiary to notify insurer of a claim within the time stipulated
The claim notification should be supported with relevant supporting documents
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All The Best & Thank you
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