CS PROFESSIONAL ELECTIVE 3 - INSURANCE – LAW AND PRACTICE

MODULE 3 ELECTIVE PAPER 3

INSURANCE – LAW AND PRACTICE

Understanding and Managing Risk

1. Risk Management – Perils – Nature – Risk Analysis – Planning – Control – Mechanism for Transfer of risk – Insurance and Reinsurance

General Principles and Concepts of Insurance

1. Insurable Interest – Indemnity – Uberrimae fidei – Proximate Cause – Subrogation and Contribution – Differentiation Insurance and Guarantee – Insurance and Wager – Disclosure – Moral Hazards

Insurance Contract and Indian Market Conditions

1. Nature of Insurance Contract – Features of Insurance Contract – Types of Insurance – Concept of Intermediaries – Market Players and their Roles – Agents, Brokers, Surveyors & Loss Assessors, Health Third Party Administrators, Certification of Insurance Professionals, Training Organizations.

Regulatory Environment – Specific Legislations

1. Regulation of Insurance Business, Insurance Act, Insurance Regulatory and Development Act, Powers and Functions of IRDA, Relevant Regulations and Guidelines issued by IRDA, Licensing, Audit & Supervision, Investments, Amalgamation and Transfer, Grievance Redressal, Rural and Social Sector obligations, Micro Insurance, Financial inclusion, Product Approval.

Regulatory Environment – General

1. Other Relevant Legislation (Motor Vehicles Act, Marine Insurance Act, Employees State Insurance Act etc.), Consumer Protection, Courts, Tribunals, Insurance Ombudsmen, Arbitration.

International Regulatory Framework

1. International Association of Insurance Supervisors – Future Trends

Life Insurance – Practices, Procedures

1. Application of Principles in Life Insurance Contract — Representation – Assignment and Nomination – Title and Claims – Tax Law Implications – Concept of Trusts in Life Policy – Stamp Duties – Role and Function of Life Insurance Companies.

Life Insurance & Pension Products

1. Life Insurance Products – Proposals, Policy and documentation

General Insurance – Practices and Procedures – Focus Underwriting

1. Application of Principles in General Insurance Contracts – Structure of the Policy – Insurance Documentation – Underwriting and Rating – Disclosure – Terms and Conditions

General Insurance – Practices and Procedures – Focus Claims

1. Claims Procedures – Underinsurance – Condition of Average – Recovery – Salvage.

General Insurance Products

1. Property Insurance (Fire and Engineering)

2. Marine Insurance (Hull and Cargo)

3. Motor Insurance

4. Business Interruption

5. Liability Insurance (Public, Products, Professional, Directors & Officers etc.)

6. Personal Lines (Health, Accident, Travel, Residential Premises etc.)

7. Rural and Agricultural

8. Micro-Insurance

9. Other Miscellaneous lines (Burglary, Bankers’ Risks, Fidelity etc.)

Ethics and Corporate Governance Framework for Insurance Companies

1. Financial Statements, Protection of Policy holders, Concept of Treating Customers Fairly (TCF), Actuarial and Other Certifications