Davraj

SadamAyub

M.Abdullah

Naveed Iqbal

Mi12MBA056 Mi12MBA073

Mi12MBA045Mi12MBA038

• Insurance…?• Assurance• What is• Products • Underwriting • Claim management/Handling• SW0T Analysis• Recommendations

Purpose of Presentation!

a contract between an insured and an insurer

, where the insurer promises to pay a

designated beneficiary a sum of money in

exchange for a premium, upon the death of

the insured person

Sun Life Financial Inc. is an international financial services company known primarily as a life insurance company, but also has a strong presence in investment management with over $494, established in 1871In World WAR II, the British Crown Jewels as well as the gold reserves of several European countries were moved to what is now known as the Old Sun Life Building for safekeeping.

• A multinational Company• Working in more than 50

countries• 1st company of Canada

having largest customer base in Life insurance

• 1st priority of public due to good repute

• Largest company with regard to its Capital base

• Canadian $640 billion

Products

Products Under the SUN

Sun life

Life Insurance

Health insurance

Disability insurance

Life Insurance

Sun Life Term Insurance

Universal Sun Life Insurance

Work Place Life Insurance

• Term life insurance provides temporary protection for temporary needs. It also has some flexibility, so you can adjust your insurance as your needs change.

• It provides several guarantees.• you can choose between:• Term life insurance - provides coverage for one person Joint term life

insurance - one policy that covers 2 people who share a joint risk (e.g. a mortgage

• Simplest form of insurance• Sun will pay Sum assured on occurrence of Death• Simple and easy to understandable conditions• No maturity value and no Loan Value

Sun life Term insurance

An all-in-one way to protect and build your moneyUniversal Life insurance is one solution that combines 2 important aspects of financial planning:• Permanent insurance protection for lifelong peace of mind, plus • Investment account options that can grow your savings, tax-deferred

universal Sun life

• We believe that a healthy workforce is integral to the success of any business. That’s why we offer the products and services you need to help keep you and your family healthy. Consider it an investment into your well-being.

Work Place Life Insurance

Health & dental Dental Drugs Hospital expenses in your province Vision care Paramedical services and equipment Travel

Work Place Life Insurance

Personal health

Insurance

Disability Insurance

Critical illness

Insurance

Long term Care

Insurance

Health Insurance

Personal health insurance provides affordable coverage for:• unexpected health expenses • many ongoing health-related services not covered

by provincial plans.

Basic Plan

Standard Plan

Enhanced Plan

Personal health

Insurance

• Disability insurance is designed to protect you from the possible loss of income due to any mishap with you during normal life events .

• When you're unable to work as defined by the coverage you've chosen

• You receive a recurring monthly payment• It replaces a portion of your income if you're unable to

work

Disability Insurance

• Critical illness insurance offers help paying costs associated with life-altering illnesses. If you become sick with an illness covered by your policy and survive the waiting period, you receive a lump sum cash payment

• Expenses related to coping with and recovering from a serious illness

• When you are diagnosed with and meet the requirements of a covered condition

• You receive a lump sum cash payment

• Cost of your care over a lengthy period

• When you're unable to perform two or more activities of daily living or require continual supervision due to deterioration in mental abilities

• Reimburses your expenses or pays a benefit

• May be a regular recurring payment or a reimbursement style plan to cover the cost of care

Long term Care

Insurance

Sadam Ayub Mi12mbA073

Underwriting

What is underwriting?

• Underwriting is the process of – Examining, accepting or rejecting insurance risks, and – Classifying those selected, in order to charge the appropriate

premium for each.

• The purpose of underwriting is to spread the risk among a pool of insured in a manner that is equitable for the insured and profitable for the insurer.

What is underwriting?

Underwriter

B

C

D

AEvaluates

risk

Accepts Applications

Declines Applications

Determines appropriate premium

The decision to provide insurance coverage or

not is commonly referred to as an

underwriting decision

The decision to provide insurance coverage or

not is commonly referred to as an

underwriting decision

These decisions greatly affect the success or failure of an insurance company

How Underwriting done at Sun Life?

1. Occupation

2. Avocation

3. Hobbies

4. Residence

5. Moral Hazard

1. Insurable Interest

2. Income Protection

3. Persistency

4. Net Worth

1. Build

2. Habits

3. Personal Medical History

4. Family Medical History

Risk Factors in Life Insurance• The various risk factors to be assessed prior to underwriting

decision are:1. Medical 2. Financial 3. Personal

Life Insurance Risk FactorsLife Insurance Risk Factors

321

Risk Factors in Life Insurance

7 Factors

F1

F6

F2

F3

F7Age

Gender

Build

Lifestyle Habits

F5 F4Family Medical

History Personal Medical

History

Factors affecting Medical Underwriting

• Application Form• Medium Of Relationship• Medium Between Insured And Insurer• Representative Of Both Parties• Accurate Information• Helper In Decision Making

Application form filling

• Name• Address• Marital status• Age• Date of birth• Nationality• Application and

nominee details

Elements in Application Form

• Hazardous risk questions• Aviation / Armed forces

question• Covers with other companies• Smoking , alcohol• Health questions• Occupation

• Financial Questionnaire• Assets Liability Statement• Juvenile Questionnaire• Housewife Questionnaire• Mode Of Payment

Some Important Aspects

• Two categories:

• Gainfully employed women with earned income / unearned income, pays income tax, single or married, good educational and social background.

• Assessment of this category of female is per normal any earning individual.

• Non-working woman, dependent on husband.

• This group is referred as 'Housewife'.• This category is again classified in to 2

categories depending on the Husband’s insurance status.

Maximum Sum Assured (Life) available to each category:

Category 1Category 2

Husband has Life insurance Husband has no Life insurance

Subject to normal underwriting

Lesser of 10x husband’s annual income or Rs. 1,000,000

Lesser of 5x husband’s annual income or Rs. 1,000,000

Female life underwriting

M. Abdullah Mi12MbA057

Claim Handling

• Claim• Claim reporting• Receipt of claim• Claim files and procedure• Fraud• Settlement

Claim Handling And Settlement

HOD Claims assesses whether the claim is payable under the terms and conditions of policy and if payable what should be the quantum of claim.

Claim Management ProcedureIt consists of following steps; Claims reporting Receipt of claim by the insurance company Claim files & procedures Fraud detection & prevention Claim processing Claim payment

Claim

When claim arises, insured has following duties:

To try to minimize the loss To report the claim timely To cooperate in investigation To provide official documents To authorize the insurance company to conduct

inspectionTo fill an appropriate claim form

CLAIMS REPORTING

After receiving intimation of claim, the insurance company must; Send an acknowledgement to the insured Inform the insured, in case of any delay Ask for documents required in settling the

claim

RECEIPT OF CLAIM

Once a claim has been filed, it must contain following documents; Intimation letter Claim form duly filled and signed by insured Summary sheet showing review of the claim Date of loss and Reporting date Description of claim Assessment date Copy of loss adjuster’s and investigator’s report Estimated cost of damage Amount of payment

Claim Files & Procedure

Fraud…?

In case of fraudulent intention found, claim can

be repudiated.

Settlement Of Claims

• Payment of money• Paying for repairs• Replacement• Reinstatement

A claim can be settled in following ways

Dav Raj Mi12MbA041

SWOT Analysis

Strong and well capitalized company Large customer base Innovative products Customer loyalty Effective advertisement Less cost due to line authority Brand name

How Much Strong Are We?

Standard &Poor’s

Moody’s A.M. Best DBRS

Sun life Assurance company

AA-Very strong

AAExcellent

A+Superior

IC-1Superior

Sun life And health insurance company (U.S)

AA-Very strong

AStrong

A+Superior

Not rated yet

Rating of Sun Life

Work Inefficiencies Low premium income due to more competition Economic recession More Fraudulent claims Adverse underwriting by agent

Drawbacks

Opportunities

Expand business worldwide Improve online marketing Correcting underwriting cycle Start programs of insurance awareness Special discount and free gifts More and more advertisement Effective Customer relation system

High Operating cost Low cost products by competitors Over all world recession Dumping from fresh entrance Changing laws about healthcare

Threats

Summing up!No doubt sun life insurance is one of the leading players of insurance sector. But

there are some grounds on which is performance is not according to its

expectations. Reasons may includes more fraudulent claims settlement. We can say if the claim settlement department work effectively the company may become Top

insurance company of world.More over , underwriting management

system is doing according to rules , that’s why premium charge accordingly.

Customers want discount but Sun life refuse, its also a cause of low

development.Reasonable rebate should be given to

regular customers