6. IINNSSUURRAANNCCEE
DDeeffiinniittiioonn::
“An arrangement by which a company or the state undertakes to provide a guarantee
of compensation for specified loss, damage, illness, death or any certain defined event
occurs in return for payment of a specified premium.”
CCoonnttrraacctt ooff IInnssuurraannccee::
”Insurance is a contract between two parties whereby one party agrees to undertake
the risk of another in exchange for consideration known as premium and promises to
pay a fixed sum of money to the other party on happening of an uncertain event
(death) or after the expiry of a certain period in case of life insurance or to indemnify
the other party on happening of an uncertain event in case of general insurance. The
party bearing the risk is known as the insurer or assurer and the party whose risk is
covered is known as the Insured or Assured”
Insurance contracts are generally considered contracts of adhesion because
the insurer draws up the contract and the insured has little or no ability to
make material changes to it. This is interpreted to mean that the insurer
bears the burden if there is any ambiguity in any terms of the contract.
Insurance contracts are aleatory in that the amounts exchanged by the
insured and insurer are unequal and depend upon uncertain future events.
Insurance contracts are unilateral, meaning that only the insurer makes
legally enforceable promises in the contract. The insured is not required to
pay the premiums, but the insurer is required to pay the benefits under the
contract if the insured has paid the premiums and met certain other basic
provisions.
Insurance contracts are governed by theprincipleof utmost goodfaith which
requires both parties of the insurance contact to deal in good faith and
in particular it imparts on the insured a duty to disclose all material facts
which relate to the risk to be covered.
7. TTYYPPEESS OOFF IINNSSUURRAANNCCEE
There are two main types of insurance which are as follows.
1) Life assurance
2) General insurance
11)) LLiiffee AAssssuurraannccee::
Life assurance policy insures the life of the insured. The insurance company is
legally bound to provide a monetary benefit to a decedent's family or the beneficiary
after the death of the policyholder. The proceeds are paid to the beneficiary either in a
lump sum amount or an annuity.
Life assurance include following types of insurance:
Whole of the life policy
Term life policy
Endowment policy
22)) GGeenneerraall IInnssuurraannccee::
General insurance is basically an insurance policy that protects you against losses and
damages other than those covered by life insurance. For more comprehensive
coverage, it is vital for you to know about the risks covered to ensure that you and
your family are protected from unforeseen losses.
It is of two types:
A. Marine Insurance
B. Non-Marine insurance
AA.. MMaarriinnee IInnssuurraannccee::
Insurance against loss by damage or destruction of cargo, freight, merchandise, or the
means or instruments of transportation and communication whether on land, sea, or
air. It is further divided into two
Ocean cargo
Inland transit
Marine hull
BB.. NNoonn--MMaarriinnee iinnssuurraannccee::
Property insurance
Health insurance
Home insurance
Fire insurance etc.
8. TTYYPPEESS OOFF IINNSSUURRAANNCCEE
Sources of Funds
premium
Dividend
income
Interest
Equity
Uses of Funds
Corporate
Bonds
Govt.
securities
Shares
Properties
Insurance
Life
Assurance
Whole of the
lifepolicy
Term life
policy
endowment
policy
General
insurance
Non-Marine
insurance
Health
Property
Education etc
Marine
insurance
Ocean cargo
Inland Transit
MarineHull
IINNSSUURRAANNCCEE CCOOMMPPAANNIIEESS
9. BBrriieeff HHiissttoorryy::
The Life Insurance Business in Pakistan was nationalized during March 1972.
Initially Life Insurance business of 32 Insurance Companies was merged and placed
under three Beema Units named “A”, “B” and “C” Beema Units. However, later these
Beema Units were merged and effective November 1, 1972 the Management of the
Life Insurance Business was consolidated and entrusted to the State Life Insurance
Corporation of Pakistan.
State Life Insurance Corporation of Pakistan is headed by a Chairman and assisted by
the Executive Directors appointed by Federal Government. Up to July 2000 the
Corporation was run by Board of Directors constituted under Life Insurance
(Nationalization) Order 1972. In July 2000, under Insurance Ordinance 2000, the
Federal Government reconstituted the Board of Directors of State Life which runs
the affair of this Corporation.
The basic structure of the Corporation consists of Six Regional Offices, Thirty Two
Zonal Offices, a few Sub-Zonal Offices, 180 Sector Offices, and a network of 1073
Area Offices across the country for Individual Life Insurance; Four Zonal Offices and 6
Sector Offices with 21 Sector Heads for Group & Pension are involved in the
Marketing of Life Insurance Plans policies and products offered by State Life and a
Principal Office. The Zonal Offices deal exclusively with Sales and Marketing.
Underwriting of Life Insurance Policies and the Policyholder's Services. Regional
Offices, each headed by a Regional Chief, supervise business activities of the Zones
functioning under them. The Principal Office, based at Karachi, is responsible for
corporate activities such as investment, real estate, actuarial, overseas operations,
etc.
10. MMaajjoorr OObbjjeeccttiivveess::
To run life insurance business on sound line.
To run life insurance business on sound line.
To provide more efficient service to the policyholders.
To maximize the return to the policyholders by economizing on expenses and
increasing the yield on investment.
To make life insurance a more effective means of mobilizing national savings.
To widen the area of operation of life insurance and making it available to as large
a section of the population as possible, extending it from the comparatively more
affluent sections of society to the common man in towns and villages.
To use the policyholders’€™ fund in the wider interest of the community.
MMiissssiioonn::
“To remain the leading insurer in the country by extending the benefits of insurance to
all sections of society and meeting our commitments to our policy holders and the
nation.”
QQuuaalliittyy PPoolliiccyy::
To ensure satisfaction of our valued policyholders in processing new business,
providing after sales service and optimizing return on Life Fund through a quality
culture and to maintain ourselves leading life insurer in Pakistan.
11. MMaajjoorr AAcchhiieevveemmeennttss::
The major function of the State Life Insurance Corporation of Pakistan is to carry out
Life Insurance Business; however, it is also involved in the other related business
activities such as investment of policyholders fund in Government securities, Stock
market, Real Estate etc. The major achievements of State Life are as under:
On the commencement of the operations, the Corporation took a very important
step by effecting reduction up to 33% in the premiums on the past and potential
Life Policies for the benefit of the Policyholders.
State Life is profitable organization and it paid Rs.5.860 billion as dividend to the
Government of Pakistan since its inception in 1972.
State Life has played very vital role in the economy by providing employment to
the people of the country as permanent employees and as part of its marketing
force and by investing the huge funds in different sectors of the economy. The
Investment Portfolio of State Life as at 31.12.2014 stands at Rs.445.074 billions.
Investment portfolio also includes investment in Real Estate which stands at a
book value of Rs.2.955 billion as at 31.12.2014 whereas it fair value is around
Rs.26.562 billion in the same period.
The Paid up Capital increased from Rs.10 million in 1972 to Rs.3,000 million in
2014.
The Premium income increased from Rs.0.317 billion in 1972 to 76.342 billion in
2014. Similarly Investment income including rental income increased from
Rs.0.81 billion in 1972 to 50.715 billion in 2014.
Total statutory fund of State Life stands at Rs.450.025 billion in 2014 as against
Rs.1.494 billion in 1972
State Life is smoothly striving towards its objective of making life insurance
available to large section of the society by extending it to common man. As at
December, 2014 the total number of policies enforce under individual life were
4.997 million and number of lives covered under group life insurance were 8.732
million.
12. OORRGGAANNIIZZAATTIIOONNAALL SSTTRRUUCCTTUURREE
It is headed by chairman who is a CHIEF EXECUTIVE of the corporation and
appointed by the government the other administrative level and authorities is give n
below
BBooaarrdd ooff ddiirreeccttoorrss::
It comprises of 7 members who are responsible for making plans and policies to
achieve the set goals of the organization.
EExxeeccuuttiivvee DDiirreeccttoorrss::
It comprises of 4 members responsible for implementation of policies and directives
of the board of directors.
RReeggiioonnss::
There are 4 regions in Pakistan headed by regional chiefs responsible for looking after
all the zones under his administration.
ZZoonneess:
There are 26 zones in Pakistan headed by the zonal head responsible for procurement
of business to achieve the set business target of the organization.
The basic structure of the Corporation consists of Four Regional Offices, Twenty-Six
Zonal Offices, a few Sub-Zonal Offices, 111 Sector Offices, and a network of 461
Area
Offices across the country for Individual Life Insurance; Four Zonal Offices and 6
Sector
Offices with 20 Sector Heads for Group & Pension are involved in the Marketing of
Life Insurance Plans policies and products offered by State Life and a Principal
Office. The Zonal
Offices deal exclusively with Sales and Marketing. Under writing of Life Insurance
policies and the Policyholder’s Services. Regional Offices, each headed by a Regional
Chief, super vise business activities of the Zones functioning under them. The
Principal
Office, based at Karachi, is responsible for corporate activities such as investment,
real estate, actuarial, overseas operations, etc.
16. II
FFUUTTUURREE OOUUTTLLOOOOKK
Takaful insurance is another line of business which offers bright prospects in the
future. The Takaful rules were published by the Securities and Exchange
Commission of Pakistan (SECP) in 2005. In 2012, the SECP issued revised
Takaful rules allowing Conventional Insurers to initiate window Takaful
operations. State Life’s Board has also granted approval for initiating Takaful
Insurance. In this regard, a working committee has been constituted to formulate a
business plan to enter this market and setup operations accordingly. It is
anticipated that State Life will be formally able to start Takaful Operations
shortly.
Bancassurance is an alternate distribution channel to sell life insurance products
through banks. This line of insurance business ensures wide coverage at lesser
procurement cost. During the last quarter of 2012, this channel started its
operations after State Life signed an agreement with the United Bank Limited and
in 2013, also signed agreements with First Women Bank Limited and Bank
Alfalah. State Life has started to gain firm ground in this channel and negotiations
with more banks are underway. Recently, bancassurance agreements have been
signed with National Bank of Pakistan, NIB Bank, Samba Bank and Summit
Bank. Bolstered with State Life’s reputation in the market, its bancassurance
channel is steadily showing sustainable growth and will undoubtedly contribute to
significant all round improvement in the financial performance of state Life in
coming years while providing a new avenue for business growth.
State Life entered into an agreement with the Government of Pakistan to provide
Life and Health Insurance services to families covered under the Benazir Income
Support Program (BISP). We intend to expand our Health Insurance Operations
beyond the scope of BISP and provide competitive insurance packages that would
ultimately provide diversification to benchmark services that dene State Life
Insurance Corporation as the largest insurance provider of the country.
State Life has further enhanced the network of its zones in Pakistan. In this regard,
new zones have been created at Jhang, Vehari, Jhelum and Narowal. Besides, the
number of regions has been raised to six with the inclusion of Faisalabad Region.
It is expected that these new centers will further contribute in expanding and
carrying out the Pakistan business more convincingly
State Life also plans to enter this line of business. With the implementation of IT
infrastructure enhancements, which is in hand, State Life would be in a position to
enter this market segment also.
17. PPOOLLIICCYY HHOOLLDDEERR SSEERRVVIICCEESS ((PPHHSS))
DDEEPPAARRTTMMEENNTT
IInnttrroodduuccttiioonn::
Policyholder service is one of the most important departments in stat life insurance.
Better services to policyholders are of course, necessary and fundamental for carrying
good reputation among policyholders, which help in retaining business and increasing
new business. Therefore policyholder’s service, counters have been establishing in
majority of the zonal offices to provide one window services to the valued policy
holders. This department is divided into following sections:
Claim Section
Surrender Section
Loan Section
Alteration Section.
Suspense Account Section.
Lapse & Revival Section.
Each and every section of this department plays an important role and they provide
different services to policyholders.
CCllaaiimm SSeeccttiioonn::
This section is always busy in entertaining claims of the policyholders. It has its own
investigators and they investigate all claims and then recommend that a claim amount
may be given to the nominees of the claimants or not. They also look into all such
maturity claims and those policies which fall, mature all payments and the claim
section of the policyholder services (PHS) give houses.
Claim section has two further sections.
I. Individual life claims
II. Group & pension claims
II.. IInnddiivviidduuaall lliiffee ccllaaiimmss::
In this section claims are of three types:
a) Maturity claims
b) Death claims
c) Other claims
18. aa)) PPrroocceedduurree ffoorr MMaattuurriittyy CCllaaiimmss::
For collecting maturity benefits, policyholders are requested to send a written request
along with following documents to their servicing State Life zonal office:
Original policy document
Copy of National Identity Card
Maturity discharge voucher duly verified by policy holder’s bank
If policy holder’s signature has changed over the years, he/she should send us
their three specimen signatures of old and new styles.
Immediately on receipt of above documents, SLIC process the case further for
payment of amount due, if any, against maturity claim under above policy.
bb))PPrroocceedduurree ffoorr DDeeaatthh CCllaaiimmss::
Death claims are further divided into two categories. Early death claim and non-early
death claims. Death within the first two years is known as early death and after that it
is non-early death claim. In case of early death claim they do a comprehensive
inquiry. This inquiry may be from the general public, hospital. Police station etc. then
they make a report. In case of suicide within the first 13 months, they just pay the
premium amount which is paid in installments.
In case of death the nominees should make death certificate for the policy
holder. It may be gross the hospital, Nazim, Political Agent, etc.
Then they issue 4 forms i.e. A, B, C. Form ‘A’ will be filled by the nominee.
Form ‘B’ is for Attended Doctor, Form ‘C’ if a policy holder is govt. employ,
than this form should be filled (All these forms should be attested).
If the amount is less than 300,000 then they call a meeting of zonal claim
committee (ZCC) and this committee makes decision.
If amount is more than 300,000 then they forward all documents to regional
claim committee (RCC Islamabad).
if amount is more than 500,000 then this is the case of central claim committee
after approving gram ZCC the claim file again to claim section, have they
issue cheques and make vouchers thus payment is made.
19. cc)) PPrroocceedduurree ffoorr OOtthheerr CCllaaiimmss::
Other claims are of two types:
Survival Benefit Claim
If policy holder’s Anticipated Endowment Assurance policy has completed
1/3rd or 2/3rd term of the policy, policy holder can withdraw a sum equal to
25% of the sum insured of his/her policy.
Injury Claim
If policy contains an Accidental Death & Indemnity Benefit (AIB)
supplementary cover, and policy holder have sustained an injury as specified
in the contract, he/she can apply to SLIC for an injury claim within 20 days of
sustaining the accident.
Following documents are required to claim any of the above type:
1. Original policy document
2. Copy of National Identity Card
3. Survival Benefit discharge voucher duly verified by policy holder’s bank
4. If policy holder’s signature has changed over the years, he/she should send us
their three specimen signatures of old and new styles.
Immediately on receipt of above documents, SLIC will process the case for payment
of amount due, if any, against survival benefit claim under above policy.
20. IIII.. GGrroouupp && ppeennssiioonn ccllaaiimmss::
In this section claims are of two types:
a) Death claims.
b) Injury or disability claims.
aa)) PPrroocceedduurree ffoorr DDeeaatthh CCllaaiimmss ((GG&&PP))::
When a claim occurs first of all a letter is sent to claim department from employer
of that person about his injury or death. Then when death comes into notice of
claim department first of all a letter of condolence is sent to employer and a set of
claim forms is enclosed and some documents are initially required like:
Death certificate issued by the municipality in original or its photocopy
dually attested.
Physicians’ statement
A copy of policy report (if applicable)
Post mortem report (if applicable)
Attested photocopy of NIC of deceased.
When all these requirements are completed and sent to claims department then it
is checked first of all that it is a new claim and it is not already paid. If there is no
duplication then
For all new claims it is entered in computer data base and it is given a claim
number and name of deceased and date of death is saved.
Separate file of every claim is prepared and all documents are attached in it.
Then file will be sent to premium collection department for entitlement certificate.
It shows the position of policy, sum assured, name and department of deceased
and policy is in force and premium up to date is paid and if there is any
requirement as:
Outstanding premium
Attested documentation is not complete
Any other requirement.
It is intimated to employer to fulfill all requirements. And on completion of all
requirements further processing starts (Entitlement certificate is not required for
government claims).
21. If claim is payable and all requirements and documents are complete then it is
approved by:
Claim committee: This involves three members Manager Claims, Manager
B&A, Manager PHS.
Audited.
Approved by zonal head
In case claim is exceeding Rs.10,00,000 then it is approved by Divisional Claim
Committee in Karachi.
Once claim is approved and ready for payment firs a voucher is prepared and
maintained. There are four types of vouchers i.e. for each claim there is a different
voucher. Each voucher has its own and different color. It includes;
Surrender voucher
Loan voucher
Death claim voucher
Maturity voucher
Voucher is made by concerned section. After this these vouchers are sent to
payment department. Payment department will send the voucher to audit
department and they make the audit of all the vouchers and other related
documents.
After approving from audit department these vouchers comes again to payment
section. Usually payments are made in cheques, they make cheque first then the
cheque is sign by this (payment department) and then these cheques are forward to
concerned department (PHS department) for second sign.
The vouchers remains in the concerned department for the purposes of punching
and cheques are issued.
Now cheque forwarding letter is sent to employer and cheque is dispatched to
client.
When there is any dispute on payment of claims as if policy was not in force or there
was outstanding premium. So claims department stops payment of claim then these
cases can be filed in court or ombudsman office by client or nominee. So all these
cases are also handled separately and complete documentation is maintained for these
files. All this type of claims are called Legal claims.
22. RREECCOOMMMMEENNDDAATTIIOONN
SLIC is market leader and it has so strong management structure and there is
transparency of business management but I will like to give some recommendations.
Better training courses should be arranged for the uplifting and improving the
quality of employees’ work.
There is also a problem of work overload for the employees and it should be
control properly so that the employees are motivated. Responsibilities are also not
equally divided between employees.
System and operations should be more defined and organized.
SLIC management should give more incentives to the staff because they are the
asset of company. There are so many incentives for officers but staff is ignored.
IT lapses should be improved.
Expenditures must be control, which are very high.
SLIC is advertising only on Pakistan TV and Radio Pakistan but now there are
uncountable private channels where SLIC is not giving advertisement. It should
properly advertise and Communicate to public about the products provided by it,
so that more customers will be attracted.
Islamic mode of insurance is emerging rapidly so SLIC should reorganize its
strategies and introduce some pure Islamic products or invest only in interest free
business.
24. AAPPPPEENNDDIIXX ((AA))
IInnssuurreedd:: The person known as thepolicyholder,aperson with insurance coverage
IInnssuurreerr:: A company licensed to transact the business of insurance and issue
insurance policies..
PPoolliiccyy:: It's thewritten contract between an insurance company and its insured. It
defines what thecompany agrees to cover for what periodof time and describes the
obligationsandresponsibilitiesof theinsured.
PPrreemmiiuumm:: It's theamount of money a policy-holderpaysforinsurance protection
CCllaaiimm:: It's thenoticeto theinsurance companythat under theterms of a policy,a
loss may be covered.
IInnddeemmnniittyy:: Legal principle that specifies an insured should not collect more than
the actual cash value of a loss but should be restored to approximately the same
financial position as existed before the loss.
AAggeenntt: A licensed person or organization that sells insurance and represents the
insurance company to the policyholder.
BBrrookkeerr: An organization or person paid by the policyholder to look for insurance
on their behalf.
DDeedduuccttiibbllee: It's the amount of the loss, which the insured is responsible to pay
before the insurance company pays the benefits.
EExxppiirraattiioonn DDaattee: This is the date on which the policy ends.
GGrraaccee PPeerriioodd: A period (usually 30 or 31 days) following each insurance premium
due date, other than the first due date, during which an overdue premium may be
paid. All pro visions of the policy remain in force throughout this period.
LLiimmiitt: It's the maximum amount paid by the insurance company under the terms
of a policy.
UUnnddeerrwwrriittiinngg: The process of classifying applicants for insurance by identifying
characteristics such as age, gender, health, occupation and hobbies. People with
similar characteristics are grouped together and are charged a premium based o n
the group's level of risk.
BBIIBBLLIIOOGGRRAAPPHHYY
Annual Report for the year 2014, StateLife InsuranceCorporation.
Annual Report for the year 2013, StateLife Insurance Corporation.
James C Van Horne, Fundamental of Financial Management,
Edition, Prentice-Hall International, Inc. P # 128 – 144.
25. Tahaffuz “An In-housemagazine” State Life Insurance Corporation
of Pakistan, 2002, P # 5,6.
Tahaffuz “An In-housemagazine” State Life Insurance Corporation
of Pakistan, 2003, P # 8,9,10.
www.Statelife.com.pk
www.wikipedia.org
www.businessdictionary.com
www.investopedia.com