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underwriting procedure for life insurance

1-What is Selection:

Selection is the term used to describe the consideration given to an application for insurance(  proposal) form for insurance to determine whether the life proposed  is insurable or not .if insurable , what term are offered?.

How long does it take to get approved for life insurance?

The assumption based on mortality ratio and other factors used in setting the premium rates and the sales objectives of the corporation require that the lives proposed for the insurance be properly screened so that mortality ratio remains within the anticipated limits and at the same times sales objectives are met.

2-Sub standard risk:

What does substandard risk mean in insurance?

The selection process is necessary under the principle that every assured should contribute his fair share towards risk involved –only those lives who are exposed to comparable degree of risk should be placed in the same premium class .those subject to a higher than normal mortality are said to be sub standard or impaired risk as their chances of surviving form year to year are impaired .such lives are either accepted only with extra premium or with sum restrictions ,or postponed or declined as the merits of individual case warrant.

3-Insurable interest:

What are types of risk?

Insurable interest is defined as one”s financial interest in the subject matter of insurance .in life insurance , subject matter of insurance is one “s life .accordingly a creditor has an insurable interest in the debitor”s life to the extent of his debt. A partner has an insurable interest in the life of other partner(S) to the extent of his stake in the business.the proposer in such cases shall be beneficiaries. Unless the beneficiary stands to lose rather then the gain by the death of assured , the insurance contract without adequate insurable interest and insurance without insurable interest is a “mere wager/in law and is prohibited.

A person has an unlimited insurable interest in his /her own life but there should be proper relationship between the amount of assurance probable loss and the proposer “s capacity to pay the premiums.

4-Characteristics of insurability:

What does insurability mean?

1-there should be exist a possibility of financial loss on death or disability of the life proposed .

2-the proposer /life proposed would not like the loss to occur and irrespective of sentiment of good intention bound to do everything possible to avoid and avert the loss.

3-the quantum of loss is measurable and is well excess of the proposed cover.

4-the proposer has the capacity  to bear the cost of desired cover easily.

5-there is sufficient number of broadly similar lives, seeking insurance, so as to allow the law of large number tomo perate.

What are the characteristics of an ideally insurable risk?

Absence of first to factors signifies moral hazard which is just un-insurable. The third and forth factor depend upon the nature and extent of income and financial status of the life proposed as well as of the proposer . they are meant to ensure that in case of a possible claim. No one benefits beyond the insurance cover which partly compensates/replace the income and /or financial loss.

Reinsurance market insists that financial underwriting is at least as important ,if not more, as the medical underwriting the federal ombudsman (wafaqi mohtasib)has also taken very serious view of some lapses on this account and on number of occasions, has directed greater scrutiny  and checking of the financial status, which should commensurate with the desire insurance.

Hence , while handing proposal with extra ordinary feature and/or higher sums at risk, reliable information and evidence be sought to establish income and financial status ,justify the desired cover the report submitted by the field personnel must also be first hand reports and not be in retrospect.

The fifth factor refer to limitation within which an insurer has to operate there may exist some risk and genuine  needs, which may not be insurable just because insurer doses not have sufficiently large portfolio of similar risks, insuring  one or two uncommon risks in isolation is more akin to gambling rather then assurance.

5-Factors influenceing  insurability:

What are the factors affecting risk?

1-proposal form

A-Age

B-sex

C-Marital status

D-Occupation-accident &health hazard associated with the poor environment, which is usally dependent on occupation.

E-Plan of insurance

 F-Amount of insurance

G-Nomination

 H-Avocation/past time

 I-Place of residence

2-medical examination and declaration:

What is health declaration?

A-identification of the person to be examined.

B-built, Height, weight and its distribution

C-Family history —the influence of inherited characteristics and environmental factors.

D-Physical condition or characteristics such as pulse rate heart sound blood pressure , condition of lungs and other organ .

E-Personal history of illness ,ailments/surgeries, accident and resultants.

3-AGENT’S REPORT

inspection report insurance

Including  confidential reports of SM/AM to SH& ZH

A-Verification of financial worth to prevent speculation.

B- insurability

C-Moral hazard and anti-selection.

The underwriter must evaluate the proposal form medical examination/declaration and agents report to determine the PURPOSE of the insurance and asses the amount of insurance including that already in-force or applied for.

Since the proposal form together with proposal statement of health , forms the basis of contract between the proposer and the corporation  any incorrect or misleading answers.given may render the policy null void with for forfeiture of premium (s) No claim would be payable if the policy was issued on the basis of untrue statements.

6-Overwriting and blank column (s) of proposal form:

To help in underwriting a proposal from and for fair assessment of the risk each and every question must be clearly answered .column(s) left blank or marked with dashes ,over writing erasing or use of white fluid in any column of the proposal form are not acceptable .these will entail fresh requirements thereby delaying the process of the proposal and causing in convenience to the office ,field force and the proposer .however,any correction made in any column of the proposal from after cutting the original writing under full signature of the proposer shall be acceptable.

7-duty of marketing  personnel:

What are the duties and responsibilities of a marketer?

marketing force is expected  to place business with complete disclosure of facts . Any proved falsification , misstatement , concealment in procuring and reporting the business by them will result in strict action that may include their termination /demotion or forfeiture of benefits.

8-Nomination:

What means nominee?

What are the benefits of nomination?

Under the provisions of section 72 of insurance ordinance 2000, the policy holder can nominate person whom he/she desires the benefits under his/her policy be paid in case of a claim by his/her death. similarly the policy holder has got the right to change or cancel the previous nomination or substitute by a fresh one, naming person on revised basis according to his/her requirements. This right can be exercised by the policy holder at any time and for as many time and for as many times as he/she desires provided the policy is in-force but there must exist a definite relationship between the assured and the nominee .

9-Guardianship:

What does it mean to have legal guardianship?

policies affected for the benefit of minor children without appointment of guardian, result into difficulties by the claimant in obtaining guardianship certificate form competent courts. In order to guard against such a situation, the appointment of a guardian must be insisted at the time of proposal CNIC number and consent(signature)of guardian in writing are required.

10-Assignment:

What are the two types of assignments in life insurance?

What is a collateral assignment of a life insurance policy?

Assignment conventionally are two types absolute and collateral .to protect the assignee fully, written notice must be given to the corporation .assignment of a policy whether with or without consideration ,may be mad only by an endorsement upon the policy itself or by a separate instrument ,signed in either case , by the assignor and dully attested(means attested in the manner required for financial future obligation by article 17 of the qanoon-e-shahadat order,1984) specifically setting forth the fact of assignment.

On reassignment it is incumbent on the policy holder to re designate the nominee in the absence of which death proceed become payable only to the E”state” of the assured.

11-The underwriter:

What is the role of an underwriter?

The underwriter freedom to underwrite is paramount therefore ,the under writer will have discretion to decline ,reduce ,modify the proposal or cut out of rider. even if the case appears to be  acceptable

What an underwriter does?

,if he/she believes that assurance is excessive in relation to the economic status or otherwise not bona-fide. Similarly he/she has the discretion to take whatever measure (including asking for further medical/other requirements) he/she deems appropriate on medical or occupational or any other ground whatsoever.

12-COMPLETION OF PROPOSAL FORM:

1-proposal form should be filled in clearly in one ink and  pen and in one hand writing preferably in block letters.

2-answer to question should be simple , clear and free  form ambiguities. Answer tend to create confusion should be avoided. For example against the column relating to occupation ,word like business service should be avoided. Full description of work /duties should be given. Like wise the answer shoulf be given in YES or NO(dash nil n/a are not accepted).

3-every proposal form must accompany an attested and self attested Photostat copy of document as proof of age .no policy shall be issued without age admission.  

4-Complete names and code of the field channels should be written on proposal forms agency channel should be verified by the agency department,  concerned Area mangers or by a sales manger  specially authorized for this purpose ,in writing by the zonal head .in no case subsequent change(S) be allowed unless it is proved documentarily that it happened through  mistake.

5-A non medical proposal form must be used where the proposer qualifies for non- medical scheme and likewise a medical proposal form for a case falling under medical scheme as for as possible .    

6-all Photostat copies of CNIC and documents submitted by the applicant should  bear his/her signature also ;apart from attestation by authorized SM/AM.

7-Copies of document ,signature and thumb impressions should be attested/verified by the Area-manger or those  sales mangers who have been dully authorized for the purpose. Such a attestation will be assumed to have been made after the attesting  officer has seen the genuine .orignal document and signature or thumb impressions affixed before him.any excuse in good faith is not acceptable.

8-where the nominee is a minor a guardian should be name with his/her NIC number in the proposal form who must also affix his/her signature /thumb impression in the relevant space .thumb impression must be verified .

9- thumb impression should be clear , neat and affixed with the help of a stamp pad . in exceptional circumstance , where stamp pad is not available ,any other ink may be used in a manner so that grooves of thumb are clearly seen in the impression.

10-No alteration , cutting easer etc.or used of white fluid in the answer is acceptable however correction after clear cutting at the original writings may be accepted ,if verified by signature of the proposer .

11-in case ,signature of the proposer on proposal form, NIC and other document differ the concerned area manger/ sector head should be certify those under his/her signature and official stamp with following wording;

I identifyMr————as proposer under proposal no———/holder of policy no———-and certify that he/she has signed the proposal form —-personal statement —– declaration of good health before me .

12-proposals  of life assurance form retired defense personnel, should always  carry a self attestedcopy of discharge certificate of service book in which medical category of proposed assured is clearly mentioned.

13-If answer relating to supplementary contracts at the proposal form, is first ticked and then crossed out or deleted, a confirmation in waiting from the proposer would be sought preferably on amendment form . alteration of any kind must be avoided . a straight line should cross out the question other then those ticked

14-if the proposer signs the paper in urdu or affixes his/her thumb impressions the vernacular declaration must also be signed by the same person who is witnessing the proposal.

15-if an NIC has been issued with in 13 months of the date of proposal from and no other evidence of age is available a medical report by a senior medical examiner of state life at the proposers cost and sector head s certification of the genuineness of NIC and date of birth in writing should be required.

16-Full detail of previous policies /proposal must be given in reply to the question asked in proposal form.

17-If more  than  one proposal forms are simultaneously submitted on one s life it is  necessary to give cross reference of all proposal also a part form all the due requirements a separate personal statement dully completed (in original)must be submitted ,for each submitted proposal photostat copies are not acceptable .

18- a proposal under ND scheme must be submitted with all the papers verified by Area mangers/authorized sales mangers and fully yearly premium with an authentic age proof .any shot premium debit to commission if allowed shall constitute part of the full premium. Also remember that an ND policy cannot be back dated even for a single day except that the commencement date shall always be ,as in all other cases, the 1st of the month of issue of the policy.

19-A proposal under GPF or salary saving scheme must accompany a Photostat copy of NIC dully attested by an authorized officer of the proposer s organization also, detailed statement of accounts on the latter head of that organization dully signed by its authorized officer should accompany the cheque. The chque amount shal not be accepted  without such a list on simple paper shall not be accepted.

20-services of only authorized medical examines and clinics should be availed for the purpose of medical examination reports an in no case authorized doctors /clinics we approached for the purpose .also ,remember that female doctor is allowed to examine male lives proposed .females lives proposed can be examine by a senior medical male examiner provided they( females ) consent to it in writing and the sum assured is not more than RS.200,000/- .no reimbursement will be made for utilizing the doctors/clinics not on our pane.

21-Where medical /clinical report have been called for at proposer own cost the proposer should be asked to attach with the proposal form relevant receipt s obtained from doctor/laboratory as a proof of payment made .

22-RECONSIDERATION OF DEFERRED OR DECLINED CASES:No fresh medical /clinical test should be arranged in deferred /decline cases unless permission for the same has been obtained form functional head of new business department similarly medical examination /clinical test should  not be arranged on the lives falling in non medical scheme  unless specifically asked in written by the underwriter otherwise , the cost in all such a case shall be debited to the concerned field channel .

23-No proposal form amendment form personal statement DGH or any other form shall be accepted unless the signature /thumb impression by the proposer or attested officer bear the date under his/her signature or in the columns provided for.

24-While completing agents /field officer confidential report at the end of the proposal form or a separate confidential report by those higher ups in the channel . utmost care must be exercised to extract and report true state of affairs in response to each question after make necessary inquiries /investigation . while undertaking the risk under writer assumes that the reporting official has given the report after make a such inquiry.

The medical and other requirements will be quoted by the underwriting department after assessment of the facts given in the proposal and the personal statement,

 13-   Adult lives:

Minimum age is at entry is 18 years

Lives between the age of exact 18 years and nearest birthday 19 years may be entertained at the rate of premium chargable for age 20 years.

Maximum age at entry (exact age)

Standard lives Normal  condition         Special  condition                   60 years       65 years
Sub standard lives Normal condition Special condition 55 years 60 years

14-Special condition mean where:

1- all examination and test have been conducted by the most reliable examiner , laboratories etc. of the area named by the underwriter and under supervision of some senior field personnel with the minimum routine requirements of FMR, PUR , CHEST X-RAYS,ECG, and BS. 

2-Definite and authentic age proof is provided .evidence listed at (4)to(8) in the chapter on age proof will not be entertained.

3-the under writer may call for any additional requirement deemed necessary for the assessment of the risk.

4- the cost of MR and PUR will be borne by state life .the cost of chest X-rays ECG, BS and other medical requirement shall be borne by the proposer which will be reimbursed only if proposal is completed for a sum-assured RS,100,000/-

5-TIR may be allowed up to entry age 60 and FIB/AIB/ADB up to entry age 55.

6-FMR on female life should be done only by female examiner named by the underwriter.

15-Minor lives:

all person below the age of 18 years i. e before reaching their 18th birth day come under the category of minor lives. Proposal on minor lives  may be entertained within the following rules;

1-available tables and age limitations.

TABLE AGE NEAREST BIRTHDAY AT ENTRY
MINMUM                  MAXIMUM
01 10 YEARS       BELOW 18 YEARS
03 10 YEARS        BELOW 18 YEARS
07 01 YEARS        05 YEARS

2-Only first class standard lives be entertained no sub standard life be permitted.

3-Preferably real father or mother should be propose for assurance of children.

4-The proposer under table 01/03 should have existing assurance on his/her own life for double the sum proposed  on minor life unless he/she is proved uninsurable .

5-There should be a balanced assurance program for the family e. g all insurable  brother/sisters are insured for an equal amount instead of singling out of any one child unless there are legitimate reasons for such a preference , and  the underwriter have had an opportunity , to satisfy him / her –self through necessary investigations.

6-Maximum sum assured available to minor life below is RS.200,00/-however the sum assured exceeding RS200,000/- may be considered if the child is income tax payer or owns property in his /her own name and the need for insurance is clearly established  .

7-Finance status of the proposer shall have to be established.

8-Non-medical scheme is not available for juveniles applying for a separate insurance policy .for children aged 10 years (nearest birthday )and above minimum requirement will be full medical report by an authorized medical examiner.

9-For children aged below 10 years ( nearest birthday) proposed under child protection policy (07)) non – medical scheme is available up to sum-assured of RS150,000/- on completion of prescribed non- medical juvenile proposal form.

10-Definite and authentic age proof of the minor life must be furnished with the proposal.

11-ADB supplementary contract can be issued if desired at the age of five years or more to the child.

12-GI rider can be issued if desired on minor lives who have crossed their 10th birthday.

13-Underwriter shall satisfy him/herself about the existence of the source of income to continue payment of premium in the absence of payer .

14-Working minor are not entertained .

15- proposal of miners below the age of 10 years under table 01 and 03 may be entertained in special circumstances only by obtaining permission from PHS division P.O on case to case basis.

16-An additional supplementary proposal in plan 01 and 03 as the case may be required as per annexure ‘G”

16-Non-medical scheme:

1-Non- medical scheme applies to all lives proposed except where otherwise provided in minor lives and female lives rules.

2-as a part of routine study the underwriter should have a random medical check of approximately one-tenth of non-medical cases and arrange physical investigation of medical and non medical of   cases of at least 3%of cases of each area and the finding be report to concerned zonal head and regional in-charge –PHS under intimation to Division head (PHS), Principal office, on monthly basis.

3-besides calling for medical report as a random check, the under writer may call for medical examination under supervision in cases of doubtfull nature or where unfavorable feature are involved.

4-lives aged below 18 years(except table 07 where non- medical limit is RS 1,50,000/-TSAR) & fifty- five (55) will always be  medical examined .

5-flight crew would mean only pilots , co-pilots, flight engineer, navigators etc but not air hostesses stewards pursers etc.

6-attested copy of NIC for identification purpose must accompany the proposal.

7- a non-medical proposal will be processed only if accompanied with full  premium. This condition will not apply if the policy is to be financed through provident fund but NTU fee of RS200/ will be charged if such proposal remain incomplete after 3 months if a proposal is submitted without full premium deposit the same may be processed at the request and on written undertaking by the sales representative that not taken up fee of RS 200/-may be charged to his account if the case remain incomplete after 3 months if it could not be recovered from the sales Representative then it should be recovered from sales officer and/or sales manger.

8-AIB,ADB,WP,TIR,RPR,&GI may be attached according to nature of plan.sum assured under TIR,RPR,& GI will be counted in calculation  of the total sum at risk.

9-FIB may be allowed up to 50% of the sum assured of basic policy subject maximum of 60% of steady yearly earned income if FIB exceed 25%, the commuted value of whole of FIB will be accounted for in calculation of total sum at risk.

10-SWP may be allowed up to half of the relevant non-medical limits.

    11-the additional requirement for substandard lives will be determined on case to case basis by the underwriter.

12-For lives below the age 18 years reference by made to minor lives insurance rule..

13-The limits indicate will embrace all in-force policies proposed within last three years.

14-minimum premium is RS 2,250/-(effect from January 1,2003)the minimum premium will be increased by RS 2,50/-at the beginning of years 2004 so as to reach RS.2500/- there is no minimum sum assured limit.

17-Determination  of routine underwriting  requirements

Routine underwriting requirements shall be determined on the basis of SAR (sum at risk) , which includes:

1-Sum-assured desired under the basic policy.

2-Commuted value or entire FIB ,if proposed in excess of 25% of basic sum- assured . corresponding concession shall be available to child protection and child education & marriage plan , which have an in built10% and 24% FIB respectively .total FIB on life should not exceed 60 % of approximate steady annual income .

For example under 20 years endowment  for 100,000/- with AIB and FIB of RS 20,000/-per annum (20%) the TSAR for underwriting requirements purpose will be RS-100,000/- how ever if the amount of FIB is increased to RS-40,000/-per annum 40%. TSAR for under writing purpose under this policy will be as below:

BASIC   RS.100,000/-
COMMUTED VALUE UNDER FIB 40,000 X 11.78 RS.471,200/-
TSAR FOR UNDER WRITING REQUIREMENT PURPOSE RS.571,200/-

3-Sum-assured under term insurance rider and GI rider if desired

4-50% of sum assured if RPR is desired.

5- Total sum at risk under all existing policy/ies with the corporation (including FIB and TIR etc if attached ) for determination the medical requirements, the total sum at risk all such policies on the same life ,which were issued three or more  years before the date of new proposal will not be taken into consideration .

For instance, for a policy applied for January 1,2003policies issued before January 1, 2000 will not be taken into account for determination the total sum at risk.

6-One and half times of sum- assured will be taken at sum at risk for underwriting purpose , under MUHFIZ PLUS plan (table 78)and case of refund of premium  supplementary  contract similarly under SHADABAD PLAN (table 36)double of the sum –assured shall be taken into account.

7-in-Substandard cases the additional medical requirements will be determined by the under writer on individual merits.

8-ADB , AIB , WP supplementary contract will not be taken into account for this purpose

18-Sum at risk for reinsurance purposes:

Sum at risk for reinsurance purpose includes:

1-basic sum assured

2-TIR

3-FIB (including in-built and supplementary contract) please note that whole amount of FIB is ceded to the reinsure

4-in-built fixed period income in MUHAFIZ PLUS plan .

5 – sum at risk of all previous in-force policies irrespective of period.

If sum at risk on the basis of above calculation exceed the retention limit of RS2,500,000/-then the excess amount will be ceded and all underwriting requirement will based on the total sum at risk example of sum at risk for reinsurance purpose is given below:

Sum –assured RS-30,00,000/-
Supplementary contract AIB,FIB10% FOR 20 YEARS TIR ONE TIME
Table &term 03/20
Previous policies RS-100,000( issued in1990 without rider ) RS-250,000(issued in1996 with AIB)

CALCULATION:

Basic sum assured  +TIR(one time)+commuted value of FIB=30,00,000+30,00,000+35,34,000=95,34,000/-

 Previous policies =100,000+250,000= 350,000/

  Sum at risk for reinsurance =95,34,000+350,000=98,84,000/-

Underwriting requirement shall be based on RS 98,84,000/-

TERM OF FIB FACTOR TERM OF FIB FACTOR TERM OF FIB FACTOR
1 0.97 16 10.38 31 14.31
2 1.88 17 10.76 32 14.47
3 2.75 18 11.12 33 14.62
4 3.56 19 11.46 34 14.76
5 4.33 20 11.78 35 14.89
6 5.05 21` 12.08 36 15.02
7 5.73 22 12.37 37 15.14
8 6.38 23 12.64 38 15.25
9 6.99 24 12.89 39 15.36
10 7.56 25 13.13 40 15.46
11 8.10 26 13.36 41 15.55
12 8.61 27 13.57 42 15.64
13 9.09 28 13.77 43 15.72
14 9.55 29 13.96 44 15.80
15 9.98 30 14.14 45 15.88

This chart is exclusively for determine the SAR for medical and reinsurance purposes.

20-Proposer s signature on documents submitted with the proposal:

All documents in support of financial status , Photocopies of age proof and identification , medical reports etc . must bear the proposer s signature and submitted dully attested by the authorized sales mangers and above. The under writer has the discretion to call for the original to compare them with copies submitted .

21-Miscellaneous rules regarding medical examination:

1-a proposer should be taken for a medical examination only to authorized examiner in the proposer own locality unless necessitated and explained otherwise .

2- medical examination should be carried out only at the doctor ‘s clinic

3-medical examination of the proposer at his residence , office  ,at any place other than the consulting room or dispensary of the medical examiner would not be permitted .in such area where medical examiner is not available government hospital ‘s medical officer may conduct the medical examination with the prior permission of under writer.

4-a lady doctor should not be asked under any circumstance to be examine a male life . such a report will not be accepted no fee will be paid thereon.

5-in case of medical examination on the field personnel’s own life the underwriter shall decided by which examiner he is to be examined .

6-medical reports from a medical examiner shall not be accepted in case , where:

A-he is related to any member of field channel.

B-he has financial interest in the case beyond his medical fees.

C-the proposer or agent is his employer. Employee or immediate colleague in the service.

7- the medical examiner should be instructed to forwards the report when completed ,direct to the concerned underwriting department of the corporation .

8-the abbreviations used for a medical /clinical examination in this underwriting guideline stand for the following;

MR——  medical report by an authorized examiner with appropriate limit.       

PUR—-pathological urinalysis report

ECG—-electro cardiogram at rest (12 leads)

EX-ECG——-electro cardiogram after exercise with double master ‘s exercise test on Swiss Re pattern.

BS—–blood studies (ESR,CBC,FBS,HB) cholesterol blood urea

HIV—-human immune deficiency virus antibody test

 22- Medical examination of subsequent proposals:

A standard medical report and PUR remain in-force for six month and all other test remain in-force for one year .further proposal within the medical examiner ‘s limit can be entertained during that periods for standard lives. Other medical test remain valid for one year if standard in nature.

PUR shall have to be submitted with medical report what ever required.

23-rules regarding special medical examination:

1-in case of certain proposal, depending upon the age ,sum assured and adverse feature in the family history or medical reports, special medical reports   may be necessary in addition to the usual routine medical reports.

2-It should be noted that the under writer has discretion  to call for such or other additional special medical report if the special circumstance of any particular case warrants the need of such reports.

24- Medical examination of females lives;

Females life should be examined only by appointed lady doctor or male gynecologist authorized to examine ladies however, males medical examiner may examine the female lives with the sum assured upt to 200,000/-provided the female life has no objective to that effect .the NOC shall be in writing and attached with the proposal.

25-Backdate:

1-A policy  may be allowed to back dated for a period not exceeding six months provided; 

w.e.f 01- 07 -2003

a-proposer sends a separately signed request specifying the desired date of the commencement.

b-full late fee is paid at the current rate if the back dating period stretches back beyond 15 days however,no late fee will be charged for three(3) months of the backdating on cases issued in june and December .

c-Separate receipt for late fee may be issue if required.

2-In order to remove any possible doubt it is clarified that through as  a matter of practice , the date of issue of a latter of acceptance or the date of receipt of full premium is taken as the date of commencement , yet for the purpose of backdating request to commence the policy form a date prior to the date of proposal will be considered as backdate and the period of backdating will be equal to the difference between the date of receipt of proposal (new business) and date of commencement,

if ealier ,the period of mandatory backdating as per para5 bellow shall not be accounted for .

3-In the event of backdating , the medical requirement shall be based on actual age entertained on the date of receipt of proposal .

4-Backdate is not allowed even for a day in ND scheme except to the first day of current month which is mandatory as a matter of practice.

5-date of commencement on the policy schedule as matter of practice must be the first of the month dyring which policy was issued .doing so shall not attract any additional requirement in medical or late fee etc.  

26-Minimum premium:

What is minimum and deposit premium?

In view of the cost involved in the issuance of receipt and maintenance of account and realizing the fact that policies with greater frequency and lesser amount of premium are more prone to lapse , the minimum acceptable installment of premium is presently RS 2250/-and with effect from 01-01-2004 onwards it will be RS 2,500/-

27-Insurance of female lives :

Insurance will be available to females as per following categorization.

Category A;

Those with independent and  self-earned income from employment  in government department ,  school , collages, universities , multinational companies ,banks well established private firms or by practicing as a qualified lawyer ,qualifier medical practitioner qualified accountant or owner of business (if actively managed by her)should be treated at par with males .qualification must  normally be substantiated with the proof of vocation.

CategoryB:

Those with independent earned income from business as sleeping partner (or not actively  engaged ) form land ,investment ,share ,or service in private un-regulated ,non recognized small organization .

No restriction to plan insurance  supplementary contract and sum assured would apply however, qualifications must be normally be substantiated with proof of source of income ,health requirements to be treated at par with males up to 02 lac full medical report /other test shall apply beyond (02) lac sum at risk.

Category C:

House and other with no independent earned income having unsteady source of income from vocation like tailoring ,handicraft, milk selling ,animals &birds breeding tutoring  fall under this category ,full medical report /other test sales mangers/area mangers report shall be required and the sum at risk will be rusticated to 200,000/-without any rider .

In case of house wives in table 19 following provision shall be apply:

1-House wives at least matric.

Treat, at par with males without any rider , full medical report by lady doctor and other test etc. applicable and proof of education are required .

2-Under matric (including illiterate ) housewives.

Polices without any rider on females lives  may be entertained provided medical on female life is conducted by the lady doctor and sales manger/Area Manager”s satisfactory report is submitted . in case of illiterate proponent , sector head ‘s separate satisfactory moral hazard exclusion report will be required.

EQUIVALENT INSURANCE

 Insurance equal to the insurance of husband be given to married ladies which fall under the category   “C “( inclusive literate and illiterate )as per other conditions illustrated at category “C

Category D:

Female who don’t fall under any of the categories A to C are not insurable & their proposals should be declined.

28-General conditions;

1-the standard females lives proposals will be accepted at the lower premium rate applicable to their ages reduced by 2 years for basic plan of insurance and riders.

2-If lady proposed is pregnant , exclusion clause for one year will be applied form the date of issue consent of the proposer should be obtained in writing endorsement should also be made on policy document/schedule.  in jeevansathi policies , if female life is pregnant but otherwise insurable a joint life policy deferred until three months , after child birth . in the meantime a single life policy may be issued on males life .the single life policy may be converted to joint life policy, such as table 19, three months after childbirth after completing medical requirements.

3-where medical examination are necessary female life should be examined preferably by lady doctor with appropriate limits.except as provided for at para24page 12

4-all will be available to females lives in A&B category on the same term as  males ,where , the SWP is granted , the premium will be charged at double male rate .

5-sub-standard lives will be acceptable subject to appropriate rating . conession of 2 year in age will not  be allowed to substandard lives and for H&S rider .

6- other term and condition will be the same as for males lives.

29-N.D policies to female lives:

ND policies to  females lives under the category A,B& C  are available if they are medically proved uninsurable . ND policies to category D are not available.

30-Discount in age;

(2) year discount in age is permissible to  standard life females only.

For the purposes of premium calculation, following point will apply;

1-actual age will be shown in proposal form and policy schedule .two year age discount (rate down) will be given for premium calculation only .

2-two year age discount (rate down) will not apply for H&S and SWP rider and SWP premium rate will be charged at double the male rate.

3-where, tabular rate is minimum 20 years the minimum rate will apply even if a female is 21 years  or less.

4-under child protection plan, two years age discount (rate down) will apply females payer only and not to female child.

5-under the table 17,age discount (rate down)will be apply both to determine term of insurance and rated down age for premium rate , please see the following  illustration.

Actual age &term applied for  Rated down age &term                 of  insurance applicable premium
30 years/40 years 28 years /40 years Rs.26.40
35 years /35 years 33years /37 years RS29.28

  6-Under jeevan sathi and joint life policies female ‘s age will be reduced by two years (if standard )before  applying the uniform seniority table .please see the following illustration.

Male life                   Female life difference in age Deduct from the age of older life
  Actual age Reduced age    
40years 35years 33years 7 years 3years
35 years 32years 30 years 5 years 2 years

7-If initial age of a female is higher than the maximum permitted under the table ,she can’t get the benefit of two years age discount (rate down) merely to get benefit of the table.

31-Illiterate proposers:

Moral hazard and other related risk loom large in case of illiterate lives .this entail a greater responsibility on the agent ,as he/she must exercise great care in selecting illiterate lives .

Medical proposals should be entertained from illiterate lives ,provided such persons have adequate means of paying premium , their income is stable and they are found medically fit.

Filed officers /agent confidential  report should be filled in by authorized senior sales officer(at least 3 years experience in this grade) or sales manger .

Thumb impression of the life proposed on the proposal from should be attested be the sales manger .thumb impression where required should carefully be a fixed with the help of stamp pad , so as to ensure that thumb grooves  are seen distinctly and tally with those on the NIC.

32-AGE PROOF:

Each policy issued by state life carries stipulation that no benefits will be payable unless the age of the assured is admitted .hence,the age proof should be obtained with the proposal and no policy should be issued unless satisfactory age proof is made available .

A–for standard adult lives below 60 years and substandard lives below 55 years of the age ,following document listed in order of preference may be entertained as age proof.

1- national identity card issued by Pakistan government of Pakistan is invariable required with every proposal for identification purpose and it should as such also be accepted as evidence of age.

2-Certificate of qualification or a certified extract form the record of any board of secondary & higher education / universities ,if the date of birth is stated therein.

3-Certified extract form the government records such as service book civil list, etc or form the service record of autonomous bodies ,local bodies ,semi-government institutions etc.

4-certified extract from municipal birth register or some other similar public registration record .

5-recently issue NIC is not generally acceptable as age proof if however,it is proved that no evidence of definite age proof exists or available and concerned sector head certifies the genuineness of NIC and date of birth in writing ,then underwriter may accept NIC in such a case.

6-Domicile and PRC or nationality certificate ,if it bear the date of birth ,issued by the competent government authority /ies

       7-Passport issued at least a year ago.

8-Any other document like driving license ,government permit or license bearing age or date of birth ,which was issued at least 2 years or more years before the date of proposal.

Notes;

  1. For minor lives their registration number with the NADRA along with certificate ,school certificate etc. may be considered as age proof.
  2. For standard lives of 60 years or over and substandard lives of 55 years or over ,documents listed at 5 and 8 will not be entertained .
  3. Document in evidence of age should normally be submitted in original these will be return after scrutiny,if however a Photostat  of true copy is submitted it must bear signature /thumb print of the proponent and attested by gazetted officer or authorized officer of state life .
  • Any such document as domicile certificate, passport, identity card etc. issued within one year before the date of proposal or sub sequent to that day, require extra care and caution but may accepted at the discretion of the under writer ,if age is verified by sector head.
  • If a document bear the year of birth of birth without the date and month ,1st January of that year will be assumed as the date of birth .

33-Financial underwriter:

While underwriting a proposal underwriter has to take into consideration the amount of insurance payable  on death  of the assured in comparison with possible  loss of income which would otherwise be suffered by the legal heirs on death of the life assured.

34-general guidelines.;

1-financial worth of a proposer should commensurate with TSAR which includes sum assured +FIB+TIR+SWP+RPR and TSAR reserved on previous policies  .

2-annual premium of present proposal and previous should not preferably be more than 20% of proponent ‘s income ,otherwise check the possibility of moral hazard and over insurance .such a case should be referred to zonal underwriting committee to eliminate the above aspect. However ,possibility of understanding the income should kept in mind while underwriting such a case .

3-AIB cover (on proponent’s  life) should not be more than three time of the proponent annual income and be according to the sum assured maximum accident cover available under ADB/AIB is  rupees 4million.

4- case up to two(2) lacs TSAR may be accepted on the sales officer report and witness . case up to t (5) lacs TSAR may be accepted on sales officer’s report dully witnessed by the sales manger .

5-it is preferred to have documentary evidence of the financial worth in all exceeding RS 5lacs (total sum at risk) including sum assured +FIB+TIR+RPR+TSAR of previous policies .however if the concerned sales manger complete the agents confidential report on proposal from than the documentary evidence of income may not be insisted unless.

A–the TSAR is up to RS 10 lacs and the sales manger ‘s confidential report on prescribed performa dully verified by the area manger is submitted .

B–where, the TSAR exceed RS 10 lacs but is below RS25 lacs the area manger should give a separate confidential report on prescribed proforma dully verified by the sector head.

c-where ,TSAR is between RS 25 lacs to RS 50 lacs , the sector head should give confidential report   dully verified by the zonal head on prescribed performas.

D- where, TSAR is over RS 50lac  all the due requirements including following are to furnished ;

1-independent confidential report dully verified by the zonal head .

2-swiss RE financial questionnaire from

3-direct evidence of income OR financial worth justifying the cover applied for.

Note:

1-house wives or females having no steady income should be considered in the light of laid down of female rule, however annual premium of a house wife should not be exceed 8% of her husband’s income.      

2-Non-medical case where the field officer ‘s report has been completed by newly promoted S.O                                                            need to be underwritten cautiously.

3-A random check through enquiry by the underwriter may be made to verify the authenticity of the financial worth as reported in the confidential reports ,either before or after issuance of the policy and any material variation should be reported to Zonal head for necessary action.

Specimen of formats of confidential report referred above are annexure .

35-Amendment to proposal form:

Whenever any changes is desired before issuance of a policy , an amendment form (ANNEXURE A). stating the full particular of the change duly signed by the life proposed and the proposer in the same form and style as on the original proposal be obtained the amendment may be allowed if it is in conformity with the underwriting rule .

Where the desired changes entails some medical examination and/or test than cost will be borne by the proponent .he shall submit the receipt(s) of fee paid to that effect before the amendment is considered.

36-Concurrent proposal:

If a proposal has not been result into policy for any reason within 6(SIX) months of the date of receipt(in any underwriting department)of the proposal and fresh proposal is/are received on the same life under agencies other than those in which 1st  proposal was received, it /these will dealt with as under :

1-the sum-assured and F.Y.P given in subsequent proposal(s)is equal to less than those given in the 1st proposal when submitted then full credit on completion  there fore will be given to the sales representative  who secured the first proposal.

2-if the sum assured and F.Y.P given in subsequent  proposal is more than that given in the first proposal , the credit on completion will be given to the sales representative whose first proposal received for the balance , if any, credit will be given the sales representative who submitted subsequent proposal(s).

3-it may be clarified that any amendment (s)received  one the first proposal with the regard to sum assured or F.Y.P before the receipt of 2nd or subsequent proposals will not be taken into consideration while the credit and sum assured and the F.Y.P shown in the first proposal when received in the underwriting department as described hereafter.

A-Non- medical:

the priority of submission of proposal under non-medical scheme shall be determine on the which the proposal form and personnel statement completed in all respect along with the payment of the first premium in full .was received by the underwriting department however, in case the policy is to be financed out of G.P FUND(where it is not necessary that the full first premium be deposited with proposal) the right for credit of the first securing  agent shall stand till the validity of letter of acceptance.

B-Medical:

The priority of submission of proposal shall  be determine on the basis of date on which the proposal form completed in all respects with the medical reports and other routine medical requirement as per underwriting  rules, is received in the respective underwriting department .

37-Payments of outstanding premiums:

If new proposal is submitted and premium of previous policy (ies) are due the case may be entertained subject to payment of out- standing premiums under the previous policy (ies).

38-Incomplete or cancelled proposal:

If a proposal is not finalized into policy within six 6 months of its submission , it may be filled as a”not taken up case” not taken up fee equal to full medical expense or Rs200/whichever is higher , will be realize form the deposit , it will be debited to and recoverable form the account of concerned sales representative .

Not taken up fee will not be charged where:

1-Some additional medical requirements such as x-rays ECG etc where called at the proposers own cost:

2-The case has been counter offered with the extra premium. Or lien

3-The proposal is post pond or declined however, if there was history of previous declinature or postponement and the fresh medical was arranged without prior permission of the under writer the concession will not apply;

Under non-medical proposal , if the sales representative could not collect full premium, acceptance latter may be issue at his/her request on written undertaking that not taken up fee of RS200/- it may  be charged if the case may remain incomplete after thee months.

39-Previous declined or postponed cases:

If the life proposed has ever been declined or refused insurance permanently or temporarily , the sales representative while soliciting his fresh proposal should be;

1-Ensure that a period of at least one year  has elapsed since the declinature and the specified period of postponement has expired .

2-Get only proposal and personel statement completed.

3-Obtained full detailed of all previous proposals/policies if necessary , a separate not may be obtained from the life proposed ,

4-Submit the proposal and personal statement along with the complete details of all previous proposal /policies to underwriting department:

5-Not arrange any medical examination without the advice of the under writer.

The medical and other requirements will be quoted by the underwriting department after assessment of the facts given in the proposal and the personal statement,

40-Change of agency in postponed cases:

In a post pond case ,if the requirements are not furnished within two months of the expiry of postponed period fresh proposal in different agency may be entertained .

Cost of all medical examination /test arranged without prior permission will be realized from the deposit  if any,or recovered form the sales Representative  ‘s account unless the proposal result in a policy justifying all such  requirements.

41-Acceptance with extra:

When it is necessary to levy extra premium or lien of standardized physical  extra ,following requirements be call for;

1-an acceptance letter (two copies)be issued by new business department .consent of the proposer on the prescribed format signed by the proposer in the same form and style as on the original proposal from.

2-decleration of good health signed by the proposer in the same form and style as on the original proposal form from after 31 days of last decleration.

Unless these requirements are submitted and satisfactory ,the policy will not be issued  even if the balance of premium received.

42-Surrender /paid up /forfeiture/lapsed  of  old  policies:

If a previous policy/policies on the same life has/ have been converted into paid up ,surrendered , lapsed or forfeit under the non-forfeiture prevision of the policy /policies within a periods of 6 months before and after the selling of new policy no commission and over -riding commission  etc will be payable to any field worker to the extent of the premium applicable to the lapsed /surrendered/auto-paid up/auto surrendered  sum assured of previous policy(ies) where the commission has been paid on such policy ,it will be recovered from the field worker concerned in lump sum as soon as irregularity is detected.

The commission and over –riding commission etc on the new policy will not be payable , in case it is financed by surrendering a paid up policy even if it was converted paid up insurance more than 6 months ago.   

43-Previous lapsed /auto paid  policies:

If previous policies are lapsed ,auto paid up or auto surrendered condition for less than five years , than the proposer should be  insisted to upon to revive /reinstate his previous policy/ ies , before issuance of the new policy.

Issuance of the new policy may be considered after reinstatement /revival of paid up ,  lapsed policy (ies) unless the proposer could establish that there is any concrete reason to purchase a new policy and losing the benefit of privous policy to the satisfaction of zonal underwriting committee.

 44- Policies under the provision of the married women’s property act 1874:

Policies under section 6 of the MWP act 1874 can be issued to the males male lives only  for the absolute benefit of their wives or children.

A MWP declaration should be submitted along with the proposal form . in column meant for nomination on the proposal ,instead of writing the name of nominee(s) under section 72 of insurance 2000, the words under married women property act 1874 should be written

A female can effect a policy under section 5 of the MWP act on her life or on the life of her husband for her own benefits in the ordinary manner.

45-Revival /re-instatement of policies :

A policy may be revived or reinstated within five years of lapsation ,auto surrender or auto paid up date .in special cases where policy remain auto surrendered or paid up for more than five years consideration for revival /reinstatement may be given subject to the condition that remaining term to maturity will not be less than 10 years.

Important points for revival/re-instatement;

1-all underwriting requirement while considering revival or reinstatement should be based on attained age and remaining term.

2-if a policy is rated up at the time of revival then extra mortality shall also be calculated on current age .extra premium will be charged from the current due premium and not arrears of premiums.

3-all medical case involving consideration invariably be referred to the under writer of appropriate underwriting authority limit.

4-requirement under auto-paid up policy should be based on the difference between the total sum at risk and the paid up value before reinstatement of original sum assured and benefits .

5-if a female is pregnant at the time of revival /reinstatement of the policy than it may be revived /reinstated subject to pregnancy exclusion clause under table 03& 05where as cases under table 19be deferred .

6-all  case of higher ages and more than high sum assured referred to new business department.

7-premium of ADB/AIB/TIR for the period under which policy remained lapsed or auto surrendered or auto paid up should not be charged as arrears

8-Decision of the underwriter will be final and he/she may call for any requirements as deemed fit.

46-Underwriting requirements;

A brief summary of the usual underwriter requirements is given here under;

S# Period of lapsed /auto-surrender /paid –up  Underwriting                                      requirements
  Non-medical medical
01 Premium being paid after  grace period but with in 3months under lapse policy                              Policy may be revived subject to condition that insured is alive and is in good health                 Policy may be revived subject to condition that insured is alive and is in good health
02 Premium being paid after 3month but with in 6 months of laps,auto-surrender ,auto paid up date of policy 1-latefee 2-decelaratrion of good health 1-late fee 2-declaration of good health in standard cases or personal statement/application for medical revival under sub –standard cases.  
03 Premium being paid after 6 months but with in 9 months of lapse ,auto-surrender ,Auto paid up date of policy 1-late fee   2- application for non-medical under revival Standard life Same as non-medical          requirements Sub-standard life 1-late fee 2-application of medical revival 3-all medical reports According to current age or as prescribed by the underwriter
04 Premium being paid after 9 months but with in 12 months of lapse auto-surrender ,auto- paid up date of policy. 1-late fee 2-non-medical revival application Standard life 1-late fee  2-application for revival Substandard life 1-late fee 2-application for medical revival 3-all medical reports According to current age as prescribed  by underwriter
05 Premium being paid after 12 months of laps,auto-surrender auto –paid up date of policy. 1-late fee 2-non-medical Revival application Standard & substandard life 1-late fee 2-application for medical revival 3-all medical reports According to current age or as prescribed by the under writer

47-Key man insurance :

The purchase and maintenance of insurance one the life of key -man  should be authorized by the borad of directors of the company or corporate body .in partnership cases a partner resolution should be made available .a latter by the employer indicating such resolution or decision should be attached with the proposal .

Usual proposal form and supplementary proposal form should be should be completed .proposal form should be signed by the key – man and authorized officer of the firm .supplementary proposal form is to be signed by the authorized officer of the firm .

In case of proposal with the large sum assured ,the underwriting  department /reinsurance may required additional information , proformas , declarations, other documents and report concerning financial aspect .these may include key- man questionnaire balance sheet of the firm prove of income of the keyman and inspection report from an authorized officer of state life .

48-Non-declinature (N.D) scheme.

subject to the following  rules a policy under N.D scheme may be allowed to all those who, irrespective of  their state life of health qualify for insurance .

1- Only endowment assurance plan (table 03) and anticipated endowment plan( table 05) are available .

2-no supplementary benefits is allowed

3-this case is available to person aged 20 years to exact 58 years(both males and females) definite age proof is required at the time of proposal .

4-N.D extra will be charged as per rate prescribed in the rate book.

5-the usual occupational extra will be charged if the proposer follows a hazardous occupational i.e or take part in hazardous sport.if the occupation or pass time of the proposer is so hazardous that the proposer would ordinary to be declined , than under the N.D scheme it may be charged to cover the extra hazard.

6-sum assured per life under all policies shall not exceed rupees one &half million  any existing non-ND policies will not be counted toward the maximum.

7-full annual premium must be deposited along-with the  proposal form otherwise, it will not be processed  (Any permissible debit to agency commission shall count towards part of the full premium

8-Back-dating is not allowed even for a day except to the first day of current month which is mandatory as a matter of practice.

9-ND declaration will be obtained duly signed and witnessed.

10-if a subsequent proposal with all tests/medical examination done under the supervision of the underwriter accepted at usual terms and conditions, the existing ND policy (ies) will be regularized from the date  accordingly.

11- Life cover does not start immediately under a policy written under ND scheme.

It will gradually build up-to 100% as fellows:

A)     Death In First Policy Year

No payment of claim except where death occurred by accident as defined in the policy document.

B)     Death in second policy year

Payment of sum assured only if death occurred by accident as defined in the policy otherwise refund of second year ‘s premium only.

C)     Death in the third policy year

Payment of full sum assured and bonuses as provide for in the policy.

12- under the ND policy,31 days grace periods will be strictly observed if a policy is lapsed it may be revived in one of the following two ways:

1-ordinary revival

The policy can be revived  by payment of arrears of premium with late fee and providing such medical evidence as “state life “ may deem fit, free of cost to state life in this case the policy will be underwritten  a fresh and if revived full cover may even start from the date of revival.

2-special revival :

The policy can be revived under this method by paying the arrears of premium with late fee and fresh declaration of ND .the death benefits payable in the next two years after such a revival would be detailed below;

A-death in first policy year after revival / reinstatement.

Surrender value of the policy or full sum assured as per 11(1)  above

B- Death in second policy year after revival surrender value of the policy ,or one annual premium ,whichever is greater or as per11 (2) b .

13- After the completed at least two year form the revival  date , usual death benefit as of ordinary policy will be available .ANF option will also be available under this policy.

14-an ND policy will get exactly the same bonuses as it had been underwritten under the normal plan.

Supplementary contracts:

49-Accidental death benefit (ADB)

1-It may be offer to ages 5 to 55 years females under category A&B only can be offered also to avail this benefits.

2-maximum term of this supplementary benefits is not  allowed to exceed the premium paying term of the basic policy ,or 60 years of age of the life proposed whichever is ealier.

3-maximum permissible total sum assured (principle sum) under all accidental covers is RS.40,00,00/-this limit include all accidental supplementary benefits as well as the built in accident cover (as is the case with T-14, T-18,T-36.and T-78) under all existing policies on the same life.

4-normally ,the sum assured for ADB should not be more than (a)sum assured of the basic policy or (b)three times the total annual income of the life proposed ,whichever is less.

5-normal rate for standard lives with completely non-hazardous occupation is RS.1.25 per one thousand sum assured.

6-premimum is charged according to heath and occupation of the life proposed ,for occupation ,which call for occupational extra ,this supplementary benefit may be available at one and a half time or double the normal rate .presence of some extra ordinary hazard and /or physical impairment may cause refusal of this supplementary benefits or further increase in the premium rate.

7-this supplementary benefits may not be attached with the policies issued under the table 07(on child life if age is less than 5 years) 09,14,18,22,23,36,71and N.D scheme.

50-Accidental indemnity benefit (AIB)

1-It may be offered to self supporting men and ladies (ladies in category A&B  )

2-it is available to adult lives between 18 to 55years of age of a term that ends on or before age 60 years it is not available to minor lives.

3-maximum term of this supplementary benefit is not to be allowed to exceed the premium paying term of the basic policy.

4-maximum permissible total sum assured (principle sum) under all accidental covers is RS.40,00,000/-this limit include all accidental supplementary benefits as well as built -in accidental cover (as is the case with T-14,T-18,T-36,TandT-78) under all existing policies on same life.

5-normally,the principle sum(sum assured) for AIB should not be more than (a) sum assured of the basic policy or (b)three times the annual income of the proposed ,whichever is less.

6-the rate of the premium for standard lives will range RS 4/- toRS-10/-per thousand  depending on occupational rating of the life proposed (please see occupational rating manual) rate may also be increased due to physical extra.

7-premium is charged according to the health and occupation of the life proposed .presence of some extra ordinary hazard and /or physical impairment may cause refusal of this supplementary benefit or further increase in premium rate.

8-This supplementary benefit may not be attached to policies issued under T-07 (on child”s life) 09, 18, 22, 23, 71, AND ND Scheme. This rider may also not be attached with policies having ADB as supplementary benefit.

9-As the War and Aviation Risks fall under the Excluded Risks of the contract, it is not allowed to offer this supplementary benefits to Armed Forces Personnel.

10-For the purpose of this rider, sum assured will be equal to Rs.25000/- each unit of Big Deal (T-14). 

51-Family income benefit (FIB)

1-It may be offered to self supporting males and females ,who are gainfully employed .

2-it is available to adult lives 18 to 55years of age for a term that end on or before age 65 years it is not available for minors lives.

3-maximum term is not exceed the premium paying term of the basic policy.

4-it can be selected form 10% to 50% of the sum assured of the basic policy provided the income benefit so desired remain within 60% of approximate assessable earned income of life proposed .

5-the normal rates are only for standard lives with completely non-hazardous occupation of the life proposed .presence of some extra ordinary hazard and /or physical impairment  may cause refusal of this supplementary benefit or further increase in premium rate.

6-it may not be attached beyond 40%of sum assured under table 07 policies on the life of payer.the FIB under table 75 &76 should not be more than26% of the basic sum assured .FIB under table 18could be attached up to 25% of basic sum assured .

7-it is not available with plan 09,14,22,23,24,25,71 and N.D scheme also on the life of child.    

52-Guaranteed insurability(GI):

  1. It is available to stand male and female lives who follow non-hazardous occupation ,profession and pursuits.it is not available with the policies carrying an occupation or aviation extra premium or issued to personnel of armed forces.
  2. It will be offered for option dates as prescribed in the premium rate book.
  3. Face amount of the basic policy must be RS. 15000/-or more the basic policy must be under a permanent plan i.e endowment etc.with the premium payment period extending to the policy anniversary age 40 (i.e the last option date ) or beyond.
  4. Minimum amount of GI supplementary benefits is RS.15000/- and maximum RS.50,000/-if the sum assured of basic policy is greater than RS.50,000/-the amount of GI supplementary benefits must be restricted to RS.50,000/-in case of BIG DEAL policy, face amount of the basic policy would be the bonus sharing component i.e RS.25,000/-per unit of big deal.
  5. Only one GI supplementary benefit will be issued on the life of any one person.it is available only to assured under life policies.
  6. It is available only to assure under life policy.
  7. It is attached at the time of issue of  the basic policy.
  8. Issuance of the GI supplementary benefit will not prevent addition of other types of supplementary benefit (TIR, FIB, etc if otherwise permissible)  but the GI will apply to the basic policy only.
  9. In determining medical examination requirement ,this supplementary benefits will be disregarded for issuance of ages under 20 years for ages 20 years  and over .the basic amount of the supplementary benefits will be added to the T.S.A.R of the policy ,to arrive at the revised T.S.A.R. for determining the underwriting requirements.
  10. It may not be attached to the policy issued under table -07( on child ‘s life) 09,18,19,22,23,24,25,36,71,73,75,76,77,78 and N.D .Scheme.

53-HOSPITAL AND SURGICAL RIDER (H&S):

1-This supplementary benefits can be issued only to standard males and females of category A who are gainfully employed between ages 18 and 50 it is not available to minors lives.

2-it may be attached to new and existing policies issued under whole life .endowment assurance and big deal plans provided the basic sum assured of the policy is at least 25,000/-( one unit case in big deal)

3-it cannot be underwritten under non-medical scheme. All examinations in connection with the benefits it will be performed by one of the doctor mentioned in the list of examiners specially approved for this supplementary benfits.

4-maximum term is not allowed to exceed the premium paying term  of the basic policy.

5-it is not available with a policy on a quarterly or monthly  mode of payment .

-no action will be taken on the proposal submitted with a such a mode of payment .

6-A request for the supplementary benefits must be made in the appropriate column relating to supplementary benefits of the proposal form.

7-it is not available with the policies issued under T-07( on child life ) 09,18,22,23,24,25,71,7375,76,77,78, and N.D scheme.

8-on the payment of double amount of premium ,the benefits and their limits may be doubled .

9-this premium may be increased by state life at any time after third policy anniversary by giving at least three months notice.

10-at present ,it is limited to person living in or near cities where hospital and doctors have been approved by state life for hospitalization and medical examination ,changes in residence to any of the city  covered by the scheme. Will be permissible without affecting the benefits in case however,a policy holder change his permanent residence to the city other than those covered by this scheme ,he/she may on request ,get the H&S cancelled with a refund of the unearned  portion of premium on pro-rata basic.

54-Refund of premium rider (RPR)

1-RPR may be offered at the age from 20 to 60 years

2-the available term ranges 10 to 25 years.

3-it is available to only those policies which are rated standard .it is not available to those policies where extra premium is charged .

4-it can be attached to the table 03,05,07and 36 only.

5-the premium rates are quoted as percentage of premium payable under the policy excluding the premium for RPR.

6-the sum at risk for this rider for underwritten purpose will be equal to 50% of the basic sum assured  under the policy to which it is attached.

55-Special waiver of premium (SWP):

1-swp may be offered to self supporting males and females in category A, who are gainfully employed .females will be charged at doubled the males rates.

2-it is available to adult lives between 20 t0 55 years of age for a term that end on or before age 60 years .it is not available to minor lives.

3-maximum term is not allowed to exceed the premium paying term of the basic policy . SWP may not be attached to policies carrying W.P supplementary benefit as the latter’s benefits are already incorporated in SWP.

4-if desired with the policy proposed under non-medical scheme, the non-medical limits will be half of the regular non-medical seheme.

5- premium is charged according to health and occupation of the life proposed. Presence of extra ordinary hazard and/or physical Impairment may cause refusal of this and further increase in the premium rate .

6-the premium may be increased by the state life any time after third policy anniversary after giving at least 3 month’s notice.

7-it may not be issued to policies issued under T-07,09,18,22,23,24,25,36.71,73,75,76.77 and N.D scheme .

8-as the war and aviation risk fall under the excluded risk of the contract,it is not available to offered it to   armed forced personnel.

56-Waiver of premium (WP)

1-It may be offered to sell-supporting males and females (in category A) . who are gain fully employed .females will be charged at double the male rates.

2-it is available to adult lives between 18 to 55years of age for the term that end on or before age 60 years .it is not available to minors lives.

3-maximum term of this supplementary benefits is not allowed to excess the premium paying term of the basic policy.

4-Maximum possible total sum assured (principle sum) under all accident cover is RS.40,00,000/- the limit include all accident cover (as is the case with T-14,T-18 and T-36) under all  existing policies on the same life.

5-the normal rate for standard lives with completely non-hazardous occupations vary between RS.0.50 and RS.1.00 per thousand sum assured depending on the age at the entry of the proposer.

6-premium is charged according to the health and occupation of the life proposed .presence of some extra ordinary hazard and /or physical impairment may cause refusal or further increase in the premium rate.

7-it may not be available to policies carrying AIB or SWP supplementary benefits as its benefits are all ready incorporated in these supplementary benefits.

8-it may not be available to policies under T-07,09,18,22,23,24,25,36,71,73,77 and ND scheme.

9-as the war and aviation risk fall exclude risk of the contract ,it is not advisable to offer this supplementary benefits to armed forces personnel.

57-Term insurance rider (T.I.R.)

 1-It may be offered to sell-supporting males and females in category A only.

2-it is available to adult lives between 20 to 60 years of age for a term that end on or before age 70 years.it is not available to minor lives.

3-maximum term is not allowed to exceed the premium paying term of the basic policy.

4-presence of extra ordinary hazard and /or some physical impairment may cause refusal or further increase in the premium rate .

5-occupation extra will be charged as per rate charged on the basic life premium.

6-it may not be attached to the policies underT-07 ( child’s life) 09,14,18,22,23,24,25,71 and N.D scheme.

It can be issued upto following maximum limits:

A In case where an FIB is attached or FIB is up to25% of the basic sum assured Three time of the basic sum assured
B In case where FIB is above 25% of the basic sum assured Two times the basic sum assured  

  58- Healthy life style:

Existing and prospective policy holder whose policies are in the annual mode of premium payment and family income benefit riders(FIBR) is attached to them and who maintain a Healthy life style (HLS) are entitled for increase in the annual FIB by 25% without charging any addition  premium.

A healthy life style (HLS) mean that

1-life assured does not smoke chew or sniff tobacco in any shape of form.(if a person used tobacco previously but has give up totally at least 24 months ago he will also be eligible).

2-life assured is total abstainer from heroin, alcohol and all other intoxicants and narcotics.

AND

3-the hight and weight and all other physical characteristics, family history, occupation , pastime and other factor of life assured are with in normal underwriting limits for AOR (accepted as proposed at ordinary rates).

The main features and conditions for increase in FIB are explained below:

This increase will be apply to :

1-new proposed policies issued with FIB rider with a minimum basic sum assured 0f Rs. 100,000/- but for all children’s  policies the minimum required basic sum assured will only Rs.50,000/-

2-all existing policies irrespective of the minimum basic sum assured which are in-force with FIBR with up to-date premium positions and whose remaining term is 10 year or more.

3-all existing policies which at present have no FIB, but with which the policyholders wish to attach fib on supplication, where sum assured is Rs100.000/- (at least Rs.50,000 under children’s  policies) and which are in-force, by payment of premium, for at least three years and remaining term is 10 years or more,

Increase will also be given under policies where a built in FIB is available like child protection policies (Table 07), child education & Marriage plan (table 75) and SHEHNAI POLICY (TABLE 77), If all other conditions are complied with.

Increase will be given under policies accepted at ordinary rates (AOR) Policies accepted at extra mortality or with restrictions imposed due to height, weight, other physical characteristics family history, occupation and pastime etc.will not be eligible for this increase.

Total  increase in FIB under all policies on single life is limited to Rs.30.000/-p.a it means that if the total FIB before enhancement on all policies on the same life is Rs.120,000p.a or more than the total enhancement will be limited is rs.30,000/- on all policies.

If the assured has two or more policies with FIBR then the enhancement will be made for the first policy with the largest outstanding FIB term then working backwards till the maximum enhancement of Rs. 30,000/- is achieved.

Increase will not apply to policies which have already resulted into claims.

Only policies with annual mode of premium payment will qualify for the increase.

PROCEDURE

  1. For new policies the usual proposal form will be completed and the premium calculated and deposited as through there is no enhancement. However proposal should accompany:
  2. Healthy life style questionsnnaire;(Annexure E)
  3. Application for increase. (annexure F)
  4. For existing policies with already attached FIBR the life insured should Submit;
  5. Healthy life style questionnaire;
  6. Declaration of good health
  7. Application for increase;
  8. Original policy documents.

3-for existing policies without FIBR the life assured should pay the basic FIBR premium in addition to the foregoing formalities;

It is not approved by the underwriter, then the FIB will be increased by 25% and an HLS endorsement will be made on The policy document as per specimen attached at an Annexure”c”.

UDERWRITING REQUIREMENTS

 Initially no additional underwriting requirements  are required for increased 25% FIB under new or existing  policies except healthy life style questionnaire. It means that if the HLS increase applies to a case with 25% FIBR, the FIB being 25% + (25% OF 25)= 31.25% The underwriting requirements will be as those applicable to basic rate i.e 25% and not 31.25% unless specifically asked for by the underwriter in any case. However, state life reserves the right to verify the fact through any medical tests or otherwise at any time or times during currency of the policy.

ILLUSTRATION

1.for existing policy the enhanced value of FIBR should be calculated in the following manner.The calculation is illustrated for a policyholder having  a policy with FIBR and qualifying for the HLS FIB increase without paying additional premium. Suppose the basic sum assured is Rs100,000\=with 20% FIBR(i.e Rs20,000\= per annum)

Step 1 Multiply existing FIB percentage by a factor of 1.25 to obtain enhanced FIB percentage.

For the illustrated policy it means  multiplying 20% by 1.25 resulting in an enhanced FIB percentage of (20%   multiply 1.25)=25%

 Step 2 multiply the basic sum assured by the enhanced FIB percentage to obtain the enhanced amount of FIB of (Rs. 100,000/- multiply 25%)= Rs 25,000/- per annum.

For illustrated  policy it means multiplying the basic sum assured of Rs.100,000/- by 25% resulting in The Enhanced amount of FIB of (Rs. 100,000 multiply 25%)= Rs. 25,000/- per annum

2-In this way, existing FIB amount of Rs.20,000/- under the policy will be increased by 25% i.e an increase of Rs. 5,000/- enhancing the FIB amount to Rs.25,000/-

SALIENT FEATURE OF LIFE INSURANCE PLANS OFFERD BY STATE LIFE INSURANCE CORPORATION OF PAKISTAN

plan Age minimum at entry Age maximum at entry Age (max) on maturity Allowable rider
WHOLE LIFE (01) 10 65 85 NO RESTICAON EXCEPT RPR
ENDOWMENT (03) 10 65 75 NO RESTICATION
PROGRESSIVE ENDOWMENT (04) 20 50 70 NO RESTICATON EXCEPT RPR
ANTICIPATED ENDOWMENT(05) 20 57 75 NO RESTICATION
JOINT LIFE (06) 20 65-INDIVIDED LIFE 50 –EQUINALENT AGE 75-INDIVIDED LIFE 70-EQUIVALENT AGE NORESTICATION EXCEPT RPR
CHILD PROTECTION(07) 01-CHILD 20 ADULT 15 CHILD 50 ADULT 25 CHILD 65 ADULT PAYER-NO RESTICATION [email protected] 5
SINGLE PREMIUM (09) 20 60 70 NOT ANY
FAMILY PENSSION(12) 20 52 70 NO RESTICATION EXCEPT RPR
BIG DEAL(14)          SPECIAL REBATES 20 45 55 AIB,WP,SWP,GI,H&S
OPTIONAL MATURITY(17) 20 45 70 NO RESTICATION EXCEPT RPR
RURALLIFE (18)     NO POLICY FEE SPECIAL REBATES 20 55 75 FIB ONLY
JEEVAN SATHI(19) 20 65 INDIVIDUAL LIFE 50EQULANT AGE 75 INDIVIDUAL LIFE 70 EQULENT AGE NO RESTICATION EXCEPT RPR & GI
MORTGAGE(22) 20 62 RISK CEASING AGE 70 NOT ANY
MORTGAGE(23) 20 65   NOT ANY
NEGEHBAN PLAN (24) 20 60 RISK CEASING AGE 70 ADB.AIB
NEGEHBAN PLAN PLAN(25) 20 60 RISK CASING AGE 70 ADB ,AIB
SHADABAD PLAN (36) 20     60 70 TIR,RPR,FIB,SWP,AIB,H&S
PERSONEL PENSSION SCHEME (71) 18 NO LIMIT NO LIMIT T.T.I,T.A.I.B.T.A.D.B
SUNEHRI PLAN (73)NOTE 1-MINIMUM SUM ASSURED RS.50,000/-2-MODE IS YEARLY 3-NO POLICY FEE ON REBATE IN HIGHER SUM ASSURED CASES MUST BE 20 YEARS 60 70 FIB,TIR,ADB,AIB
CHILD EDUCATION &MARRIAGE PLAN(75) 01 CHILD LIFE MUST BE 20 YEARS ADULT LIFE 15-CHILD 60 ADULT 25 CHILD 70 ADULT AIB,ADB,FIBTIR,WP,SWP
CHILD EDUCATION &MARRIAGE PLAN(76) 01 CHILD LIFE MUST BE 20 YEARS ADULT LIFE 15-CHILD 60 ADULT 25 CHILD 70 ADULT AIB,ADB,FIBTIR,WP,SWP
SHEHNAI POLICY(77) NOTE 1-MINIMUM SUM ASSURED RS.50,000/-2-MODE IS YEARLY 3-NO POLICY FEE ON REBATE IN HIGHER SUM ASSURED CASES 01-CHILDMUST BE 20 YEARS ADULT LIFE 15-CHILD 60 ADULT 25 CHILD 70 ADULT AIB,ADB,FIB,TIR,
MUHAFIZ PLUS(78) 20 55 70 AIB,ADB,TIR,WP,SWP
RIDER AGE (MIN)@ ENTRY AGE (MAX)@ ENTRY AGE (MAX) ON MATURITY ALLOWABLE PLAN
TERM INSURANCE RIDER-TIR 20 60 70 01,03,04,05,06,07(PAYER’S LIFE)12,17,19,36,73,75,76,77,,78
FAMILY INCOME BENEFIT RIDER-FIB 18 55 65 01,03,04,05,06,07(PAYER’S LIFE )12,14,17,18,19,36,73,75,76,77,78
ACCIDENTAL INDEMNITY BENEFIT-AIB 18 55 60 01,03,04,05,06,07(PAYER S LIFE)12,14,17,19,24,25,36,7375,76,77,78
ACCIDENTAL DEATH BENEFIT-ADB 05 55 60 01,03,04,05,06,07(PAYER LIFE &CHILD LIFE @AGE 5)12,17,19,24,2573,75,76,77,78
WAIVER OF PREMIUM-WP 18 50 60 01,03,04,05,07,(PAYER ‘S LIFE),12,14,17,19,75,76,78
SPECIAL WAIVER OF PREMIUM -SWP 20 50 60 01,03,04,05,06,07(PAYER ‘S LIFE),12,14,17,19,78
HOSPITAL& SURGICAL –H&S 18 50 60 01,03,04,05,06,07(PAYER’S LIFE),12,14,1719,36
GUARANTEED INSURABILTY -GI 10 37 40 01,03,04,05,06,07(PAYER’S LIFE)12,14,17
REFUND PREMIUM RIDER-RPR 20 60 70 03,05,07,36
TAHAFFUZ TERM INSURANCE SUPP; CONTRACT. 18 60 ONCOMPLETION OF SIXTH POLICY YEAR 71
TAHAFFUZ ACCID;DEATH BENEFIT SUPP;CONTRACT 18 60 ON COMPLETION OF SIXTH POLICY YEAR 71
TAHAFFUZ AIB SUPP; CONTRACT 18 60 ON COMPLETION OF THE SIXTH POLICY YEAR 71

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