Wealth Creation through Insurance

Insurance helps create wealth over long term

Jayant Dua, Financial Chronicle 23/2/2012

source: http://www.mydigitalfc.com/personal-finance/insurance-helps-create-wealth-over-long-term-228

We all have dreams and want to achieve key milestones of our lives like building our home, funding education of our children, providing the best lifestyle to our families and many more. In order to achieve these dreams, one should have a financial goal in mind and work towards achieving it.

All of these goals can be achieved over a period of time and, hence, need robust planning. Wealth-with-protection solutions from insurance companies have been designed to ensure that you can save for these long-term goals in a systematic manner to receive the benefit of life cover and provide protection to your family.

Wealth-with-protection solutions play a tripartite role of regular savings, protection and providing tax benefits.

How much insurance does one need? While there may be many ways to protect family against uncertainties of life, none has the charm of insurance products — the surest way to mitigate risk. Not just that, for working individuals, it is the best way to regulate savings. Some of the important things one must consider before investing in any insurance policy are – coverage, benefits in the long run, term and the premium amount to be paid and your income so that you do not face a concern over premiums.

Would it be a good move or a bad move? We need to first talk about fundamentals of insurance and then mull over the policy decisions.

Young professionals, today, are financially independent. They manage their finances and they also support their families, either partially or totally. In such a scenario, planning of your life insurance needs is absolutely critical so that in case of any unfortunate event like an accident or a sudden demise, the family doesn’t go through a financial trauma and plans for the family are not disturbed.

Why should I start planning my wealth savings now? Most people tend to push this investment for their older age, but one must realise that there are many benefits from buying these policies early on. When you opt for life insurance, you qualify for multiple benefits such as tax deductions, protection and capital gains over a longer period of time. It also instills the habit of saving, and builds financial discipline, thus, ensuring peace of mind in the long run.

The plans could be based on either traditional or unit-linked insurance policy (Ulip) platform. Types of wealth-with-protection solutions available in the market are as below:

>> Whole life plans: These plans enable one to meet financial goals and also gives financial security over an entire lifetime.

>> Single premium plans: Single premium plans strive to give a guaranteed return on maturity that is tax-free and the financial security of a life cover. Some plans give customers a choice of the single premium amount they want to invest.

>> Endowment policies: An endowment policy is a life insurance contract designed to pay a lump-sum after a specified term (on its maturity) or on death. Typical maturities are 10, 15 or 20 years up to a certain age limit. Some policies also pay out in the case of critical illness.
Policies are typically traditional with – profits or unit linked (including those with unitised with-profits funds).

>> Highest NAV products: As an informed investor, you appreciate the potential of equity markets to generate wealth over the long term. You also understand that market volatility can impact your investments and, hence, you are looking for investment options that enable you to diversify your risk to suit your investment needs. These policies can lock in your gains and safeguard your investments from potential downsides.

What make these policies so convenient are the other joint benefits that come along. The illustrations in the policies make these policies easy to understand and provide an overview of how your life insurance policy may perform over the years. Apart from creating wealth in the long run, these solutions also offer key benefits like death benefit and survival /maturity benefit. Riders or the special benefits can be availed by the policyholders in addition to the life insurance cover by paying a little additional premium. In some life insurance policies, you can also avail a loan against the life insurance policies.

Plans as per needs: You can avail insurance plans as per your needs and requirements. If you want to save for your child, you can go for children insurance plans providing you with returns at certain important milestones of your children’s life like their education and wedding. If you want to save for your retirement, you can invest in pension plans either in Ulips or in simple endowment plans depending upon your risk appetite.

Multiple investment options: There are two primary investment options within wealth-with-protection solutions in case of a Ulip, self-managed option and guaranteed option. The self-managed option gives you complete access to invest your premiums in well-established suite of investment funds, ranging from 100 per cent debt to 100 per cent equity. Guaranteed option is where your investments are fully managed by your insurance provider. Apart from these conventional options, companies also offer unique choices like trigger portfolio, lifecycle option to best manage your investments.

Begin doing what you want to do now. We are not living in eternity, we have only this moment, sparkling like a star in our hand and melting like a snowflake…wrote philosopher Francis Bacon Sr.

It is said that destiny is not by chance, but by choice. While this may or may not apply to all aspects of life, when it comes to financial security of our near and dear ones, it isn’t very far from the truth. One of the many steps to shape our financial destiny is to provide adequately for the future. That’s where insurance comes in. It is time we take steps to paint a fair picture of what one needs to provide for.

(The writer is a CEO of Birla Sun Life Insurance)


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why IRDA may be feeling Sebi-ish

As the life industry contracts, why Irda may be feeling Sebi-ish

Degrowth in the life insurance industry has brought the knives out. Its finally the industry vs the regulator. And that’s how it should be

Monika Halan, Mint 15/2/2012

source: http://www.livemint.com/2012/02/14214613/As-the-life-industry-contracts.html

The Rs2.9 trillion Indian life insurance industry has, for the first time since privatization in 2000, seen contraction over two consecutive financial years. Fiscal 2010-11 saw a shrinking of 20% and the full year 2011-12, estimates the insurance regulator, will contract 15%. This means that enough of us did not buy an additional policy last year or this year, or did not renew an ongoing policy, or that new investors were not found by insurance sellers.

It is a cause for worry when an industry stagnates. But if there is contraction, the worry changes to a call to action. While in most industries, it is the companies that get active and lobby the government for sops and policy relaxations, when it is the life insurance industry that sees the contraction, the wrinkle is equally on the brow of the government. You wouldn’t have guessed that the Rs1 lakh you did not fork over for another junk policy was going to cost the government its disinvestment plan. And that is partly the reason for the ministerial worry and action. A bit of history first. For decades the life insurance industry in India was synonymous with the Life Insurance Corporation of India (LIC) and being government-owned, this meant that its crores of assets became a sort of a default sovereign wealth fund for the Indian government. Market falling at an inconvenient time would see the call going from North Block to the office of the LIC chairman. The need to drum up interest for a public sector IPO would see help from the defacto investment chest for the government. With the entry of private sector firms, though the market share of the state-owned behemoth has fallen, its clout surely has not within the government in terms of the quantity of assets under management. The falling business numbers in life insurance in general and LIC in particular, therefore, have worried the ministry of finance mandarins enough to call for an industry meeting in Delhi. And the regulator was not invited.

The meeting held in Delhi two weeks ago with the life insurance chiefs saw the knives coming out. Unlike other times, this time it is not the media or the capital market regulator that was the target, but the Insurance Regulatory and Development Authority (Irda) itself. For an industry that is wary of going public against the regulator (insurance companies are not even allowed to form an independent association, they need to work through the Life Insurance Council, an Irda-constituted industry body) the mini free-for-all saw a public venting against the regulator. The industry is angry over flip-flops in regulation and knee-jerk reactions to issues. It accuses the regulator of killing the pension product and of not thinking through some of its decisions. A part of the angst has been about the attitude of the regulator that, they say, wants to project itself as a messiah of consumers and sees all companies as offenders. But, says one insurance CEO, hurting the companies may end up hurting the consumers.

I agree that some of the consumer-interest communication that goes out from Hyderabad, where Irda is based, is immature. Take, for instance, the TV ad that showed the consumer being saved by the super-man like regulator or the calls that the regulator’s staff seem to be making to customers to scare them into changing a unit-linked insurance policy (Ulip) to a traditional plan—but to be fair, some part of the clean-up by Irda, that was pushed by the government to do so in 2009, has been good for consumers. The Ulip product has got cleaned up to a large extent and no amount of mis-selling of traditional products will expose investors to the risk of short-term market movements. Given my past run-ins with the regulatory body, I did not think the day would come when this keyboard would bang out words in defence of the insurance watchdog, but I don’t see why Irda should be blamed for the insurance sector shrinking. The contraction has happened because companies greedy for business used the faulty Ulip product to cheat consumers. Twin pressures of losing the trust of investors and of the changed regulatory environment that makes mis-selling the Ulip not worth the effort have caused the dip in revenue and not the regulator.

Since its battle with the Securities and Exhange Board of India (Sebi) two years ago, Irda today may be more empathetic to its elder sibling, the capital market regulator. Accused of causing a decline in mutual fund assets under management two years ago for making mutual funds no-load, Sebi stuck to its stand and eventually the industry has settled down. Irda should remember that once the froth subsides and genuinely consumer friendly rules begin to take over, the business stabilizes and gives the industry a strong base.


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IRDA may Ban Commissions on Insurance

IRDA plans end to deceptive policies, upfront commission

Shilpy Sinha, Economic Times, 24/10/11

source: http://economictimes.indiatimes.com/personal-finance/insurance/insurance-news/irda-plans-end-to-deceptive-policies-upfront-commission/articleshow/10470480.cms

The Insurance Regulatory and Development Authority (IRDA) plans to ban misleading products and staggered commission for agents to ensure that policy buyers are not shortchanged.

The insurance industry, which is still evolving a decade after privatisation, needs new rules to ensure that consumers get the best and don’t get carried away by products that only promise high returns on paper, the regulator has said.

"One important problem is that what you mean by highest NAV,” J Hari Narayan, chairman, IRDA, told ET in an interview, referring to many insurers promising highest net asset value of the policy period to holders. "In certain markets, certain products are prohibited. That may be the best way to go.”

Insurance companies, bitten by the slump in sales after new rules curbing the Unit Linked Insurance Policies, are peddling many policies that on close scrutiny could be termed deceptive. One such is the promise of highest net asset value. But what they do not publicise is the calculation behind the NAV. These policies also charge 25 to 75 basis points as additional fees. A basis point is 0.01 percentage point.

"Suppose a company had Tata in its portfolio, over time it may change,” said Narayan. "At the time of maturity, which highest NAV are you talking about – the portfolio, or Tata. One of the major problems with the product is that how do you communicate to the policyholder. He may be thinking of the highest NAV of the Sensex. So, this is the whole issue.”

Prudential ICICI, Birla Sun Life, Bajaj Allianz, SBI Life, Reliance and Aegon Religare are some of the insurance companies that sell policies promising the highest NAV. These policies have tenure of 10 years with limited premium paying term of 5-7 years.

Though the highest NAV guarantee gives the impression that such products are pure equity products and pay the highest return during the course of the tenure, that is not always the case. When a 100 investment gains by 10-15%, a portion of the corpus is shifted to debt. At regular intervals, when there are gains, some funds are shifted to fixed income securities.

In a way, this could be a strategy where investors don’t get the highest NAV they would have received if they had remained invested in equties. The portfolio manager, to avoid liabilities for the company, could actually depress returns for investors.

Another area where investors lose out, commission to agents, could also be plugged.
As high as 40% of the policy premium in the first year on traditional products while 7-12% in Ulips, are paid to agents as commisssion. But once the policy gets running, the agent loses interest in serving the policy holder. So, to ensure that customers are serviced, the commissions could be rear-ended and paid at the later stages of the policy, than in early years.

"Korea has found that front-ending commision has led to unhealthy practices. So, the question is should we rear end it. A lot depends on the sales history and culture of the country,” Narayan added.


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Health Insurance is Essential

Insurance is essential to control healthcare costs

Neeraj Basur, Financial Chronical, 28/9/2011

source: http://www.mydigitalfc.com/personal-finance/insurance-essential-control-healthcare-costs-749

Life is full of surprises. Take for instance a hale and hearty 20-year-old college graduate who discovers that he has type-1 diabetes or the severe back pain a 35-year-old software engineer, a father of two, faces because of bad sitting posture. Two different incidents, but with the same repercussion on long-term health consequences that impacts one’s quality of life and not to forget the costs associated with such medical treatments that remains forever.

The importance of good healthcare is manifested when one comes across such incidents and adopting healthy lifestyles cannot be overemphasised. Though, in the unfortunate event of hospitalisation, the only viable way to reduce the impact of financial consequences arising from such incidents is health insurance.

Life insurance covers the risk of death and has gained in popularity over the years. What about the risk of poor health and the expenses incurred on it? One tends to forget that as important as it is to take care the financial needs of one’s dependents in the event of death, it is equally important to look at de-risking one’s poor health in their lifetime with health insurance. Health insurance guards against financial loss from illness or bodily injury and provides coverage for medicine, visits to the doctor or emergency room, hospital stays and other medical expenses.

Unlike life insurance, where one can arrive at how much cover one needs based on one’s assets, liabilities and an estimated number of years that one wishes to protect one’s financial dependents for; health insurance has no straight-jacket ways to arrive at the quantum of cover one should take. A lot depends on how much one can afford towards premium and realise the value of this insurance.

For instance in the 20s, one should definitely look for an entry-level basic health insurance plan starting with a minimum cover of Rs 2 lakh. Not only is the premium on health insurance low when you start early, it also builds a healthcare record for you that can go a long way in determining future policy benefits and premiums. Likewise, when you are married with children, your responsibilities increase and so do financial commitments. In such a situation, you should consider a family floater health insurance, which is a single umbrella policy protecting all the family members, including dependent parents, providing a coverage of at least Rs 3 lakh or more per member depending on your premium paying ability.

Despite offering great value, health insurance penetration is low in our country because of poor awareness and also the perception that there are no tangible benefits with this policy. A way out to increase penetration beyond the tax benefits could be to encourage those who are fit to buy health insurance with lower rates and offer the unhealthy the policy at a higher rates, rather than declining them complete cover. After all, taking a health insurance policy does not mean that you can keep illnesses and accidents at bay. But at least you can ensure that if they strike your family, you will be able to avail the best possible treatment without having to worry about the costs.

(Neeraj Basur is the chief financial officer of Max Bupa Health Insurance Company)


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Break free from BAD Insurance

Times of India, 14/3/2011

Alife insurance policy is a key component of a financial plan. Chosen well, it safeguards the financial future of a family if the breadwinner passes away. If, however, it is bought for the wrong reasons, the same policy can become a drain on resources and prevents the policyholder from meeting crucial financial goals. Bangalorebased marketing manager Jitendranath Patri is paying a premium of `1.06 lakh a year for six policies that give him a combined cover of `20.4 lakh. "I feel I have overinvested in insurance. These plans take up a huge chunk of my savings. I must resort to some course correction here," he says.

In Kolkata, Meraj Mubarki is agonising over his inability to save enough for his dream house. "I’m in a financial mess. My insurance policies take up too much of my savings, leaving me with very little for my house," says the 33-yearold college professor.Worse, it leaves this sole breadwinner grossly underinsured. Mubarki is covered for `6.75 lakh, though he needs an insurance of at least `60 lakh.

In Mumbai, software professional Amit Kolambkar is thoroughly miffed with the returns from his Ulips and feels cheated.

"The agent didn’t explain how the plan works and how I can decide my allocation to equity," he says. Getting stuck with an unsuitable insurance policy is a malady as widespread as the common cold. There’s one wrong insurance policy in almost every household.

What do you do if you find that you have the wrong insurance? Escaping from an insurance policy entails a very high cost. You can lose up to 50% of what you have paid. In extreme cases, you might have to forfeit your entire investment.

This is what keeps people from junking a plan, however unsuitable it is. "There is a psychological barrier of losing money, which is why people avoid exiting an insurance policy. But it is better to incur a loss at the initial stage rather than continue and compound the mistake," says Arvind A Rao, chief financial planner, Dreamz Infinite Financial Planners.We look at the options for policyholders who want to junk their insurance plans and explain the circumstances in which each should be exercised.


Let the policy lapse Don’t pay the premium and the policy ends automatically.

This is the easiest way to exit a policy. It is also the costliest if the policy has not completed three years. The premium paid in the first two years is forfeited and the policy ends. You also stand to lose the tax benefits availed of in the first two years on the premium payment. You get nothing, except freedom from the policy. Financial planners say this option should be chosen only if you realise that the policy is grossly unsuitable to your needs. "If the policy doesn’t meet your objective, it is better to let it lapse even though you stand to lose the premium for 1-2 years," says Pankaj Mathpal, managing director, Optima Money Managers. The rule is different for Ulips. Even if it is discontinued after the first year, the policyholder is entitled to some amount after paying surrender charges. However, this sum comes to him only after the lock-in period of five years (three years, if bought before 1 September 2010). The fund value, after imposing all charges and penalties, is frozen in the account and earns 3.5% returns till this period.


Surrender the policy

After three years, an insurance policy fetches a surrender value. If you have paid the premium for three years, your insurance policy would have built a reasonable corpus value. So, if the plan is surrendered after this period, the policyholder can get some money back. It will, however, be a fraction of what he has paid over three years because of the surrender charges levied by the insurer. In the third year, the surrender value is roughly 30% of the total premium paid, but this figure goes down as the term of the policy progresses. Till last year, insurers used to levy very high surrender charges on Ulips in the first three years. But last year, the Irda put a cap on these charges. This is `3,000 or 20% of the annual premium in the first year. For plans with a premium of over `25,000, the cap is higher at `6,000 or 6% of the annual premium. The surrender charges come down progressively to zero in the fifth year. "No surrender charge is levied on policies that are more than five years old," says Tripathy. Surrendering a policy gives you some money back, but it also ends the life cover. So, before you decide to junk your policy, find out if you have enough cover. Also, calculate the cost of a fresh insurance policy at the time. You might discover that the premium is very high because you are older.


Turn it into a paid-up policy Stop paying the premiums, but don’t discontinue the policy.

A better alternative to surrendering your insurance policy and losing the life cover is to turn it into a paid-up policy. As in the case of surrendering it, you can use this option only if you have paid the premium for three years and the policy has built up a minimum corpus. Instead of returning the money to the investor, the insurance company uses it to offer him a life cover. Every year, it deducts mortality charges from the corpus.

However, in case of traditional endowment and money-back plans, this cover is proportionate to the number of years for which the policy was in force. For instance, if a policy offers a life cover of `10 lakh for 20 years and the policyholder converts it into a paid-up plan after five years, the life cover will be reduced to about `5 lakh. On maturity of the plan, the diminished corpus and the accumulated bonus are given to the investor. This feature has been widely exploited by agents to mis-sell Ulips to gullible investors. Last year, the Irda issued new rules for Ulips. If the premium of a plan bought after 1 September 2010 is stopped, the policy will be discontinued.

This is meant to reduce the incidence of mis-selling. The paid-up option is by far the best way to exit an insurance policy because it gives the policyholder the best of both worlds. He is freed from the burden of paying the premium that are a drag on his finances, but continues to enjoy the life insurance cover that was the primary objective of the plan.


Let it continue

If close to maturity, pay the premium till the full term. Of course, if the insurance policy is only 2-3 years away from maturity, one should continue with it for the full term. This is because the painful period of high charges in the initial years has already gone and it doesn’t make sense to let go of the accumulated benefits at the fag end of the term.

If you are finding it difficult to pay the premium, withdraw from the Public Provident Fund or any other longterm investment to pay the premium for your policy. You could also consider taking a loan for this. The Life Insurance Corporation of India, for instance, offers loans against the policy for paying the premium.


VRIDHI’s view:

We frequently get calls from anxious investor’s who after buying a product are clueless on how much returns they would get, and at times when they want to exit the scheme it becomes a big hardship.

Not just calls, literally on every TV show of ours we get atleast one call on such topics.

Investors need to be Cautious with people who act as “One Medicine Doctor” What ever may be your requirement they would end up giving you only one solution!

Hence you may want to invest for retirement, you may need a protection, you may be trying to save for your children… whatever… A Insurance agent will give you one or more Insurance product for your needs & a Mutual Fund agent will give you one or more Mutual Fund solutions for all your needs!

Hence we repeat… “Play caution when dealing with One Medicine Doctors”



Investment Strategist & Retirement Planner

Desk Mobile: 98405-40575

LIC’s triple blow

Rs14,000 cr hole; loss at LIC MF; govt scrutiny

LIC’s problems echo those at Unit Trust of India a decade ago when its assured return scheme ran into trouble

Tamal Bandyopadhyay, Baiju Kalesh & Anirudh Laskar, Mint 16/11/10

Life Insurance Corp. of India (LIC), the country’s largest financial institution with an asset base of Rs12 trillion, is running a valuation deficit of around Rs14,000 crore in three plans of its guaranteed-return annuity policies—Jeevan Dhara, Jeevan Suraksha and Jeevan Akshay. Not all plans under these three brands are affected.

There are at least 1.3 million customers of these three plans, but none will be affected.

In a parallel development, all investments made by LIC during fiscals 2007-08 and 2008-09 are under the government’s scanner, following complaints made about its investments in a few companies.

The finance ministry is also closely looking at the exposure of its subsidiary, LIC Mutual Fund Asset Management Co. Ltd (LIC MF), to liquid and money market schemes that led to a loss of Rs120 crore. “The unitholders have nothing to worry. We’ll fix the responsibility and take stern action (against those responsible),” said a ministry official familiar with the development, who asked not to be identified.

Another person, who also did not want to be identified, said “heads will roll” in LIC MF.

While LIC MF has disclosed its loss in its half-yearly earnings and reported this to the capital market regulator, the notional loss or valuation deficit of LIC’s three guaranteed return pension schemes is not mentioned in its balance sheet as the insurer does not disclose its profits or losses across segments.

These plans were launched in the 1980s and the 1990s with assured returns of 11-12%, but with the drop in interest rates the actual yield on investments is much less than what investors have been earning. They were launched under the Jeevan Dhara, Jeevan Suraksha and Jeevan Akshay brands. Subsequent schemes launched under the same brands are not suffering from any notional losses.

These three loss-making old schemes are annuity plans, offering periodic payments after the retirement of a policyholder. They address the longevity risk and in some cases, inflation risk in a limited manner.

As the payout phase is usually long and uncertain, such schemes require the matching of assets and liabilities over a fairly long period.

“The valuation gap varies according to the movement of interest rates. In future, it can widen or even shrink. At the current interest rate scenario, the net present value of the deficit for these schemes, which will expire after a few decades, is around Rs14,000 crore,” said an LIC official, who asked not to be named.

Apart from the interest rate trend, the mortality rate will also have a bearing on the actual loss that LIC will suffer eventually. Mortality rates have been progressively coming down and this means longer payouts to the investors. The LIC official said that there is no plan to discontinue these schemes and added that LIC has a solvency margin of Rs46,000 crore and this is being used to take care of the valuation gap. “We’re using surpluses to make good this gap and not using other policyholders’ money,” he said.

A senior Insurance Regulatory and Development Authority (Irda) official said the regulator would not have approved these LIC schemes had it been in existence when they were launched. “There is indeed a deficit… This is not a good practice. We’d not have cleared such products if they were to come to us for approval,” the Irda official said, asking not to be identified.

“It would be unwise for LIC to build up such losses in their accounts. Pension funds are required to be handled very carefully,” he added.

If interest rates keep falling and the people covered under these LIC policies do not claim their incomes, the losses could build up further. “If it calls for a corrective action, we’d certainly act,” said Irda chairman J. Hari Narayan. Irda came into being in 1999.

The schemes

LIC introduced two personal pension plans, a deferred pension plan by name Jeevan Dhara and an immediate pension plan by name Jeevan Akshay in 1987-88, offering 1% assured return per month. The government had allowed premium on these two plans up to Rs40,000.

Both plans had managed to attract millions of customers due to tax incentives offered. Investments in such schemes were exempted from one’s income while computing tax. Demand for the schemes continued till 1992, when the government withdrew the tax incentive.

In 1996, once again, LIC introduced a deferred pension plan, Jeevan Suraksha. The government allowed premium of up to Rs10,000 for the policy.

The latest data available for these schemes shows that till March 2003, LIC had nearly 1.3 million customers covered under them.

The arithmetic

The premium money collected under annuity and pension plans is predominantly invested in government securities and highly-secured corporate bonds; some portion is also invested in equity.

Interest rates in India were regulated until 1997–98, when the medium and long-term rates were approximately 12-13%. Since then they started falling and simultaneously, the mortality rates too fell as life expectancy increased. Currently, the yield on the government’s benchmark 10-year bond is about 8.1%.

When an insurer launches a guaranteed annuity product, it assumes that the securities where the premium money is invested are fairly long-term in nature and will mature roughly during the payout phase (the period when the annuitants start claiming their income).

If investments mature before the people covered die or start claiming their income, the insurer needs to reinvest the money in other securities. If the reinvestments fetch interest rates lower than the returns guaranteed by the insurer, it starts incurring huge losses. The losses keep multiplying year-on-year and if the interest rates keep falling, the company may be badly hit.

“The interest rates fell more steeply than we had expected and the life expectancy has increased to 90 years for the policyholders,” the LIC official said.

Solvency issues

In order to ensure that the life insurers in India are capable of honouring claims against any of their policies any time, Irda stipulates that firms must maintain a solvency margin. The solvency margin is simply the excess of the value of assets over the value of life insurance liabilities and other liabilities of policyholders’ and shareholders’ funds.

Irda also specifies that for pension schemes, an insurer is required to recognize the risk of decline in future interest rates.

LIC has an overall solvency margin of Rs46,000 crore currently. A member of the Institute of Actuaries of India, who had earlier worked with LIC, said solvency margins are prudential measures and may not be sufficient to handle an insurer’s overall liabilities. An insurer needs to ensure it has the right kind of reserves, reinsurance or derivatives to back its guarantees credibly as far as annuities are concerned, he added, asking not to be identified.

The valuation deficit at LIC is somewhat reminiscent of the infamous US-64, the assured return scheme of the erstwhile Unit Trust of India (UTI), the nation’s oldest MF that crumbled under the burden of assured payouts to the millions of investors in US-64. The government had bailed out UTI and bifurcated it into two separate entities—Special Undertaking of UTI for managing all the tax-free assured return schemes, and UTI Asset Management Co. Ltd for managing the assets under other MF schemes.

The LIC official said that “it’s not fair to compare (LIC’s schemes) with US-64” as investments made by the pension schemes are all held to maturity and LIC does not need to value them in accordance with their market price or follow the so-called mark-to-market (MTM) accounting practice.

Losses in MF

LIC MF has posted a Rs120 crore loss following a new norm of capital market regulator Securities and Exchange Board of India (Sebi) that directs all MFs to value their investment in all securities maturing 91 days and above on an MTM basis.

In its effort to enhance transparency in valuation of debt schemes, Sebi in February had ordered all MFs to value all money market and debt securities, including floating rate securities, with residual maturity of up to 91 days on the basis of their market value.

Nearly 60% of the MF industry’s assets are in debt securities. The Rs7.13 trillion industry invests money under income schemes, liquid and money market schemes in such securities. At the end of September, LIC MF’s average assets were Rs19,726.97 crore and Rs16,911.18 crore of this was in debt funds, says Value Research, a Delhi-based MF tracker.

“We’ve a substantial holding in long-dated securities under our mutual fund business. We’re now strengthening our mutual fund team. Actions are being taken,” the LIC official said.

Sushobhan Sarkar, who used to head LIC’s MF business, has recently been made the head the insurer’s international operations, and Mohan Raj, an executive director, is now heading the MF business.

Govt investigation

A three-member panel constituted by the finance ministry is closely looking into all investments made by LIC in 2008 and 2009. Tarun Bajaj, joint secretary (insurance and banking), department of financial services; Sanjeev Kumar Jindal, director, department of financial services, and Ravneet Kaur, joint secretary (banking and insurance) are the members of the panel.

R. Gopalan, financial services secretary, said: “This is a routine investigation. Millions of policyholders’ money is involved and we should act responsibly.”

“Whenever there’s any complaint, the government examines if there is any merit in it. If there are verifiable facts, the government questions and checks the investment books. One of the recent complaints regarding LIC’s investments involved four to five firms. The investigations are going on and we’re cooperating fully,” the LIC official said.

A series of discussions between Mint and a number of LIC officials disclosed that LIC’s equity investment portfolio includes investments in 475 unlisted firms of which 14 are strategic investments, including those in the National Stock Exchange and the Bombay Stock Exchange.

The book value of such investment is around Rs1,521 crore.

Currently, LIC holds equities of at least 1,000 companies and the market value of these investments stood at Rs3.75 trillion as on 30 September.

“Our holdings are fairly long term in nature. Naturally, there is always a possibility of companies getting delisted, turning the stock illiquid,” a second LIC official said last week, asking not to be identified.

He also said, “There is no loss-making investment and if required LIC can liquidate its stake (in such companies) at substantial profit.”

However, another person familiar with LIC’s investments in illiquid stocks said the insurer is trying to “dispose of such investment fast at best possible way”. This person, who doesn’t work for LIC and asked not to be named, said no new investment is made by the insurer in any firm unless it is listed and has a track record of paying dividends for three consecutive years.

The insurer has an investment committee that meets roughly once in six weeks. Gopalan is one of the members of the committee.

According to Irda rules, a life insurer is permitted to invest at least 50% in government securities, 15% in securities of infrastructure-related companies and projects, and the remaining 35% in equities, non-convertible debentures, commercial papers, certificate of deposits and MFs.

The insurer plans to invest nearly Rs2 trillion this fiscal, including equity and other instruments. LIC’s net profit went up by 11% to Rs23,478 crore during 2009-10 against Rs21,152 crore in the previous fiscal.

Carry Cash to Hospital

Mint 13/7/10

Have a health insurance policy from a state-owned insurer? The next time you make a claim, remember to carry some cash even if you have a cashless policy, especially if you are visiting a big private sector hospital.

Four state-run insurers have withdrawn cashless facility from many private sector hospitals including big names such as Apollo Hospitals, Max Hospitals, Batra Hospitals and Escorts. It was first reported by The Times of India on Sunday. The reason, according to the insurance companies, is the twin rate card that some hospitals run. They charge patients carrying an insurance cover higher for the same procedure than others who may not have an insurance policy. Says N.K. Singh, general manager, Oriental Insurance Co. Ltd: “Currently, two rates are being quoted by the hospitals. For patients having insurance, a slightly escalated rate is charged. To sustain these escalated claims, we would have to increase our premiums. Also, this is not good for policyholders as he also loses out by way of a decreased sum insured for that year.”

With claims as high as 130-140% of premiums, the companies have been working on a solution for some time. Now, Oriental Insurance, New India Assurance Co. Ltd, National Insurance Co. Ltd and United India Insurance Co. Ltd have formed a preferred provider network (PPN) of hospitals that have agreed to charge within a certain price band. The PPN hospitals will continue to enjoy the cashless facility, but those outside, and this is where you need to begin worrying, will not. The big hospitals mentioned earlier are out of PPN for now as negotiations are still going on and that is where most of the urban mass affluent go with their ills and ailments. You will have to resort to the earlier practice of paying up at the hospital and then claiming reimbursement.

Considering that 60% of the health insurance business is still handled by state-run insurers, there is a huge chance that you will be affected by this change in rules. In order to bring some standardization in the way hospitals charge, state-run insurers have entered into pricing agreements with empanelled hospitals. Adds Singh: “We have spoken to our empanelled hospitals and have agreed on a fixed rate for 42 major medical procedures. The rates have been agreed upon depending on the hospital category, which is decided by the location, number of beds and facilities offered. All the hospitals that have agreed to this rate come under PPN and we will continue to offer cashless facility to them.”

Since the big names are conspicuous by their absence in this list of PPN and they account for 80% of the claims, a crisis is brewing in the industry and you are going to pay the price.

For those of you who prefer to go to one of these hospitals but have a health policy with a state-run insurer, the claim procedure may not be as smooth as it used to be. You will now have to be an active interface between the two parties and get your medical expenses reimbursed. Here’s a quick guide to what you would need to do in such a situation.

Reimbursement process

Typically, a health insurance policy reimburses expenses incurred during, before and after hospitalization. When you need to make a claim through the reimbursement mode, you need to file all the original documents with your third-party administrator (TPA), the intermediary who settles the claim between the hospital and the insurer.

These documents include discharge summary report, investigative report, scans, bills and receipts. In order to file the claim, you need to inform your insurer within seven days from the day of discharge and file the claim within the next 30 days.

Says Deepak Mendiratta, managing director, Health and Insurance Integrated, a health insurance consulting organization: “For planned medical procedures, insurers may also want you to intimate them 24 to 48 hours before you get admitted. However, after about a month your insurer may refuse to settle your claim unless you have a strong reason for delaying the claim filing procedure.”

The TPA gets your documents validated. On the non-medical side, your credentials are checked and on the medical side, TPAs look out for any policy exclusions or pre-existing diseases. Normally, this process takes about a month after which you get a cheque.

Remember that this process can get terribly delayed if the TPA finds any disparity and raises a query. The disparity could arise on account of non-submission of original documents or incomplete documents, claim on account of a pre-existing disease or a policy exclusion (the list of ailments that are not eligible for the cover as per your policy documents). The onus of filing the claim rests on you and, therefore, you need to ensure that you have all the documents in place.

Cashless process

If your hospital comes under PPN, you will still be able to avail the cashless facility. Though standardizing rates are still being worked out, that may not affect your claim process because you are not supposed to spend a single rupee on your own. In the hospital, you have to show your TPA card and fill the authorization form. The hospital then takes it up with the TPA. The TPA will check the documents and approve or reject the authorization. In the meantime, you will be admitted to the hospital and your treatment will begin. If the TPA rejects the authorization, you will have to foot the bill and then follow up with the TPA. On approval, your treatment is cashless.

At present, private insurers are not a part of the PPN system and are still offering cashless treatment to their policyholders. Says
Neeraj Basur, director, finance Max Bupa Health Insurance Co. Ltd: “We don’t have TPAs and we directly engage with the hospitals. This helps us to know their pricing and therefore we can assess if they are charging more from policyholders.”

Mint Money take

In case you have a claim coming up in the near future and have a policy from state-owned insurers, choose your hospital carefully or organize cash before you check in.