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Life Insurance Underwriting Essentials

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0% found this document useful (0 votes)
21 views20 pages

Life Insurance Underwriting Essentials

Uploaded by

Priyanshi Gandhi
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd

Life Insurance Underwriting

PGDM Course 2201


Life Insurance: Module 7 of 10
Trimester I- 2025-26
Sumesh Sheth
e
Conten
t
Life Insurance Underwriting

 Meaning and Need for Underwriting


 Proposal form and other forms required for
underwriting
 Numerical and Judgmental underwriting
method
 Standard Lives and Sub-standard Lives
Meaning and Need for
Underwriting
 Insurance is based upon the concept of
“pooling resources- sharing risks”
 Its expected that everyone joins the pool with full and
correct disclosures so that their risk is assessed correctly
 If anyone joins pool with an intention to profit from it
(anti-selection) then other members will bear the cost
 Therefore, there must be a mechanism to protect other
members of the pool
 Underwriting is thus a mechanism that checks anti-
selection and asses the risks to decide the
price(premium)
Underwriting
Underwriting is thus a mechanism by which the
insurer will :
 Analyse all the given information
 Asses the risks
 Take a Decision on the acceptance of the risks
 If accepted decide the terms and price of
acceptance(premium)which the new entrant
has to pay to join the pool
Life Insurance
Underwriting

• Life Insurance covers the risk associated with mortality


• Mortality is primarily linked to Age
• Mortality is also based on number of secondary factors
like : occupation, location, habits ,gender etc…
• standard mortality tables : Indicate probability of death
for a given age and gender
• Primary method of assessing mortality is by comparing
it with standard mortality table
Proposal form and other forms
required for underwriting

 Life Insurers collect substantial data to assess the mortality risk


 Data is also collected to comply with FATF’s (Financial Action
Task Force) Guidelines on CFT(Countering finance for terrorism)
and AML(anti-money laundering) .
 These are implemented in India in the form of Prevention of
Money Laundering Act, 2002 (PMLA) and subsequent IRDA
guidelines to know your customer(KYC)
 This data is collected in the proposal form and other
documents
Proposal form
 Definition as per IRDAI’s (Protection of Policyholders’
Interests) Regulations, 2017:
“Proposal form” means a form to be filled in by the prospect in
written or electronic or any other format as approved by the
Authority, for furnishing all material information as required by
the insurer in respect of a risk, in order to enable the insurer to
take informed decision in the context of underwriting the risk,
and in the event of acceptance of the risk, to determine the rates,
advantages, terms and conditions of the cover to be granted;
 IRDA Standard Proposal Form for life insurance ..
Proposal form: Typical Details required

1. Basic Personal Information


 Name/Gender/Date of Birth/ Age/Age Proof Submitted
 Place of Residence /Contact Details
 Photo
2. KYC
 PAN/AADHAR
 Documentary proof
Proposal form: Typical Details required

[Link] Related:
 Family details/Dependents
[Link]/Employment Details
 Hazardous/High risk Occupations
5. Financial Condition
 Income/Income proof
 Previous Insurance
Proposal form: Typical Details required

[Link] Information/Medical Information


 Physical condition and Build
 Personal health history /Family History
 Habits
7. Female Lives additional information
8. Declarations
9. Nomination
Some Other forms required for
underwriting

 Proof of :
Age
Residence
Income
 Report by Field Personnel/Moral Hazard Report
 Medical Reports
 Report by officers of the Insurer
 Benefit Illustration(BI) signed by the customer and the intermediary
 Other documents, If required
Judgmental
Underwriting
 This relies on the personal judgment of the
Underwriter to decide on the acceptance or
otherwise of a risk.
 This method is highly subjective and dependent on
the underwriter.
 The Underwriter uses his expertise to decide:
o whether to accept
o If yes, then at what terms and
condition
Judgmental
Underwriting
Advantages-
Experience based underwriting can be more useful in case of large
value ,complex cases
Possible to spot inconsistencies by a trained eye which is difficult to spot in
a system driven process
Disadvantages-
 If more adverse features are involved, it becomes very prolonged with
no standard norms established.
 Not possible to use when the volume of underwriting is very large.
 It is highly subjective
 Thus, there can not be any Consistency in underwriting as Its ‘person
driven’ and not ‘system driven’
 Difficulty in finding/replacing good underwriters
Numerical Underwriting
 It’s a standardized, system driven method (RULE BASED UW)
 The risks are assessed by rating the various factors affecting
mortality by assigning points(+ve or –ve) to arrive at the
Rating.
 Every favorable factor is rated by giving them credit points,
while every unfavorable factor is given debit points.
 After evaluating every factor affecting mortality, the total
EMR(Extra Mortality Rating) is arrived at.
 The total EMR thus arrived at are then used to classify the
risk.
 Often done through a software with some human oversite
Numerical Underwriting
Advantages :
 Removes subjectivity
 Ensures uniformity in decision
 Helps in assessing multiple factors simultaneously
 Easy to understand
 Standardized and hence easy to administer
 System Driven-ensuring :
Ease and speed of use for handling large volumes
 Can be used by anyone with minimal training
Disadvantages:
 Chances of making error increases with speed
 Individual impairments are considered for the extra risk factor each of them
contributes, it does not consider the impact of all of them in totality on the
mortality
 The method involves charging level extra premium for substandard lives throughout
the period of policy, despite the risk being of reducing nature
 Not suitable for handling complex , high value proposals
Life Insurance
Underwriting

 Underwriter will take a decision based


upon study of all information and
documents
 Underwriter has the following choices
 Accept
 Postpone/Defer
 Decline
Life Insurance
Underwriting
 In case of acceptance ,underwriter will classify the Proposed life as
per the risk levels into:
Standard Life
Sub-Standard Life
 Standard lives will be charged standard premium rates(At ordinary
rates or at Tabular premium)
 Substandard lives are charged extra premium over standard rates
as chances of mortality are higher
 Underwriter may accept with a lien (eg:- In case of recent recovery
from a medical condition )
 Add some exclusions/restrictive clauses
Life Insurance
Underwriting

 Life Insurance Underwriting is :


Science as well as Art
 Underwriter is the “guardian of the pool”
 Current changes in section 45 of Insurance Act 1938,has made
role of underwriter more relevant
 He needs to do a tightrope walk between –
business need &
the need to protect from adverse selection
 Underwriting Philosophy of the company as disclosed
LI UW : Emerging Trends

 Databases
Eg:-In August 2023 Lok Sabha passed the Registration of Births and Deaths (Amendment) Bill
that seeks to build a comprehensive database of births and deaths in India

 DLT(Distributed Ledger technology) for UW


 Use of AI
 Rule based Automated UW
 Genome Research
Q&A

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