Insurance Underwriting
Insurance Underwriting
Insurance Underwriting
Accepts Applications
Evaluates Declines
risk A Underwrite C Applications
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The decision
decision to
to
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provide insurance
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coverage
coverage or or not
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commonly referred
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Determines appropriate contribution
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Underwriting
Factors In Underwriting
The factors used during the underwriting process varies somewhat
based upon the type of Takaful being underwritten. If people are
being covered, such as under life, health and disability Takaful, key
factors used in the underwriting process may include:
Age
Sex
Health and health history
Financial condition
Personal habits
Size of the Policy
Current cover in force
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Underwriting
Factors In Underwriting
If property is covered, as in homeowners, automobile, and
commercial property Takaful, underwriters may review factors such
as:
Type of business
Size of business
Financial condition of the business
Financial condition of owners
Business cycles affecting the business
Liability exposures
Experience of key employees and owners
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Past losses experienced by the business.
Underwriting
Types of Underwriters
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Underwriting
Types of Underwriters - Property and
Casualty Underwriters
Within the property and casualty field, underwriters often specialize
in a particular type of property or casualty coverage. Within this
field there may be:
fire underwriters
homeowners underwriters
automobile insurance underwriters
inland marine underwriters
commercial property underwriters
personal property underwriters
commercial general liability underwriters
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professional liability underwriters
Underwriting
Workers Compensation underwriters
Types of Underwriters - Property and
Casualty Underwriters
These underwriters, whether they perform underwriting tasks for one line of
Takaful or for many lines, must understand the risks involved with each line
of Takaful for which they underwrite and the available and practical methods
of dealing with these risks. They must also be able to gather and understand
the various resources used to evaluate each application and determine
whether the applicant meets company underwriting standards. Such
resources may include:
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Underwriting
Types of Underwriters - Life and
Health Underwriters
Another area of specialty for underwriters is life and health Takaful. A life
and health Takaful underwriter is familiar with things such as the impact
of medical history and other health issues on insurability. The health or
life underwriter is able to read and understand medical reports such as
the attending physician statement.
Due to the extensive regulatory environment surrounding life insurance,
life Takaful underwriters are also must be very familiar with state and
federal regulations regarding life coverage.
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Underwriting
Types of Underwriters - Liability
Underwriters
Liability underwriters must be:
Familiar with current trends in court judgments and with liability laws in
order to property evaluate high-risk applicants.
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Underwriting
Underwriting Decisions
When evaluating applicants, underwriters determine whether cover on
the applicant will be:
rejected;
issued on a substandard basis;
issued on a standard basis; or
issued on a preferred basis.
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Underwriting
Underwriting Decisions: Rejecting
Applicants
Operators reject applications for Takaful when they find that the applicant
represents a risk that falls outside of the underwriting standards established
by the management. These underwriting standards take into consideration
many items, such as:
Shariah compliance
Regulations that require the operator to establish adequate rates;
laws that mandate that certain factors cannot be used to reject an application
insurance principles such as insurability and indemnity
the marketplace in which the operator promote its products, and
the surplus the operator hopes to make to protect the pool.
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Underwriting
Underwriting Decisions: Issuing Policies on
a Substandard Basis
The decision to issue a policy on a substandard basis occurs when a risk is
not deemed to be outside underwriting standards, but is considered to be of
high risk within those standards. The operator generally has three basic
options when it offers a substandard policy issue to an applicant. It may:
A. issue the policy with a higher contribution than would be required
for a standard policy
B. issue the policy with limited benefits
C. issue the policy with certain exclusions
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Underwriting
Underwriting Decisions: Issuing Policies
on a Standard Basis
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Underwriting
Underwriting Decisions: Issuing Policies
on a Preferred Basis
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Underwriting
Monitor Underwriting
Decisions
Once a policy is issued, underwriters continue to monitor the policy
from an underwriting perspective. Such monitoring is done at:
- policy renewal,
- commonly every six or twelve months, and
- as claims occur.
Depending upon the type of policy and its provisions regarding rate
increases, rates may be increased at renewal, or the operator may
make the decision not to renew the policy.
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Underwriting
Monitor Underwriting
Decisions
The agent also has a role in the monitoring of underwriting decisions. The
agent should meet with each client on an annual basis to review coverages and
ensure all information on file with the operator is accurate and up-to-date. This
review of coverage also serves the purpose of making sure the clients
insurance needs are properly met.
Contact between the agent and participant outside of the annual review may
also result in the receipt by the agent of updated policy information. Updating
policy information is an important part of the ongoing underwriting process.
The agent must promptly and accurately submit such information to the
operators home office.
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Underwriting
Summary
The factors used during the underwriting process vary based upon the type of Takaful being
underwritten.
Underwriting involves the examination and evaluation of application forms and supporting documents,
assigning rates to a policy or declining to issue a policy.
Generally, underwriters work as specialists for a particular line or lines of Takaful.
Underwriters have four options when underwriting an application. These include determining whether
the cover on the applicant will be rejected, issued on a substandard basis, issued on a standard basis,
or issued on a preferred basis.
Once underwriting is complete and a policy issued, the underwriting decision is monitored as claims
are received and upon renewal. The agent also is responsible to assist in monitoring participants
through each contact with them, and must forward appropriate updates to policy information promptly
and accurately to the operator.
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Underwriting
The Underwriting Process
1- Establishing An Application File
2- Applicable Factors for Underwriting
3- Determining Rates
4- Terms at Policy Issue
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Underwriting
The Underwriting Process
1- Establishing An Application File
Insure that the application (proposal) is complete, and
meets the underwriting standards
Insurable Interest
Elements Of A Valid Contract
Insurable Risk
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Underwriting
The Underwriting Process
Elements Of A Valid Contract
Another important factor an underwriter will look for in any Takaful
proposal form is verifying that it complies with rules surrounding legal
and valid contracts. Takaful contracts, like all contracts, must include
four elements in order to be legal and valid:
1. Consideration
2. Agreement or assent of the parties
3. Competent Parties
4. Legal purpose or legal subject matter
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Underwriting
The Underwriting Process
2- Applicable Factors for Underwriting
Family Takaful, information related to the medical history of the insured is
weighed, as are the occupation and hobbies of the insured.
Property Takaful, the property may be inspected or documents may have to be
submitted that verify the value and condition of the property described in the
application.
liability Takaful covering a business, site inspections and contracts used by the
business, as well as other documents related to the business and its operations,
may be required. Liability coverage for a home or auto Takaful policy may also
require an inspection of the property.
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Underwriting
The Underwriting Process
3- Determining Rates
Once all the information pertaining to the application and supporting
documentation is evaluated, the underwriters determine whether a policy should be
issued, and if so, what contribution should be charged. As was discussed, policies
may generally be issued with standard rates, substandard rates or preferred rates.
Rate Determination Methods:
a) Judgment Rating
b) Manual Rating
c) Merit Rating:
)Experience Merit Rating
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Underwriting )Retrospective Merit Rating
)Scheduled Merit Rating
The Underwriting Process
a) Judgment Rating
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Underwriting
The Underwriting Process
b) Manual Rating
Commonly used, especially in heavily regulated lines of
insurance.
Under manual rating, pre-determined rates found in manuals
are used to set rates for each policy.
Manual rates may be promulgated by the regulator, or may be
developed within the insurance company or Takaful operator.
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Underwriting
The Underwriting Process
c) Merit Rating
Under merit rating, manual rates are used and then modified based
on specific characteristics of the risks.
Modifications to rates may be based on the experience of the
participant over a specified period prior to and sometimes including
the policy period or on the experience of the specific participant
during the policy period, or on a schedule that quantifies applicable
risk characteristics.
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Underwriting
The Underwriting Process
Experience Merit Rating
When the experience of the participant over a specified period is
used, the applicant is generally asked about relevant behavior or
occurrences applicable to the insurance coverage. This type of merit
rating is known as experience rating. For example, a driver may be
asked about traffic violations that occurred during the last three
years. Rates are based in part on the number of such violations over
this period.
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Underwriting
The Underwriting Process
Retrospective Merit Rating
Another type of merit rating involves the underwriter reviewing the
loss experience during the policy period and setting a rate based on
that loss experience. This type of merit rating is known as
retrospective rating. This sort of rate setting is often done in
commercial lines of Takaful.
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Underwriting
The Underwriting Process
Scheduled Merit Rating
A third type of merit rating, scheduled rating, is a sophisticated form
of manual rating. Manual rates are used as the base rate, and rates
are added or subtracted from this base rate based on amounts
determined for various risk characteristics. For example, the use of
certain fireproof construction materials may result in a reduction of
the standard rate under this type of rating system.
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Underwriting
The Underwriting Process
4- Terms at Policy Issue
Besides setting specified rates, the applicant may be required to meet
underwriting requirements in order for policy to be issued or remain in
force. For example, a business may be required to install a sprinkler
system, a homeowner may be required to add railing to a deck, and an
individual with a valuable coin collection may be required to place it in a
safety deposit box in order for the Takaful to apply.
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Underwriting
Underwriting Resources
Many resources are used during the underwriting process. The most important of
these resources are:
1- The proposal form
2- Professional reports,
3- site inspections,
4- insurance maps,
5- insurance company files and
6- industry statistical reports and data.
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Underwriting
The Role of the Agent in the
Underwriting Process
The agent is crucial in the underwriting process. Agents are often referred to as field
underwriters, or even simply as underwriters.
This is because:
they gather underwriting information,
evaluate risk,
often do a preliminary assignment of contribution,
may authorize preliminary coverage,
and may reject proposal forms on behalf of the operator.
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During the underwriting process, the agent is often responsible to gather additional
documentation and information to assist the home office underwriting team.
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The Role of the Agent in the
Underwriting Process
1) Suitability
An important part of the agents function in underwriting is determining a
suitable product for the client. Agents involved in offering Family Takaful
products are most affected by the requirements and processes involved in
suggesting suitable products.
2) Determining Client Needs
Often the Takaful Operator the agent represents provides procedures and forms
to aid in determining a client's needs.
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Underwriting
The Role of the Agent in the
Underwriting Process
3) Providing Product Suggestions
The agent may want to spend time analyzing the information gleaned from the
discussion with the client, and meet with the client in a few days or in the next week
to discuss the agents recommendations. Whenever the agent begins to discuss
product and plan options with the client, the agent has a responsibility to provide
clear and accurate information about the programs discussed. It is important for the
agent to explain both the risks and benefits of any product or plan offered to the
client.
4) Documentation
Whether or not the client actually participates in the offered product, the agent
should keep a detailed record of the information gathered from meetings with the
Sound client, and the documentation, brochures and other information shared with the client
Underwriting about the product. Such a file will not only help the agent should there ever be a
question about the suitability of the agents recommendations, but will also assist the
agent in his or her ongoing relationship with the client.
The Role of the Agent in the
Underwriting Process
5) Taking the Application
After the agent has recommended a suitable product, the agent is responsible to take
the proposal form. It is critical that the agent ensure that the proposal is as accurate
and complete as possible. Almost every piece of information on the application is used
to get a fair and accurate picture of the risk to be covered. The agent has a
responsibility to the operator to faithfully represent the applicant on the proposal, and
the proposer also must provide accurate information to the agent.
6) Additional Underwriting Duties
The agent may undertake underwriting duties after a policy is in force. Changes in
coverage may require a full or partial underwriting process to be carried out. If new
property is acquired, for example, a change in coverage form and documentation
Sound about that property may need to be submitted to the underwriters. Additional
Underwriting contribution may need to be collected and a site inspection performed as well.
Depending upon the line of Takaful to which a change is made, other tasks may need
to be performed by the agent in order to effect the change in coverage.
Thank
you