Executive Liability Insurance – Why Private Companies Need It

Since its inception about fifty years ago, D&O insurance has evolved into a family of products responding differently to the needs of publicly traded companies, privately held businesses and not-for-profit entities and their respective board members, officers and trustees.

Directors’ & Officers’ Liability, Executive Liability or Management Liability insurance are essentially interchangeable terms. However, insuring agreements, definitions, exclusions and coverage options vary materially depending upon the type of policyholder being insured and the insurer underwriting the risk. Executive Liability insurance, once considered a necessity solely for publicly traded companies, particularly due to their exposure to shareholder litigation, has become recognized as an essential part of a risk transfer program for privately held companies and not-for-profit organizations.

Optimization of protection is a common goal shared by all types of organizations. In our opinion, the best way to achieve that objective is through engagement of highly experienced insurance, legal and financial advisors who work collaboratively with management to continually assess and treat these specialized enterprise risk exposures.

Private Company D&O Exposures

In 2005, Chubb Insurance Group, one of the largest underwriters of D&O insurance, conducted a survey of the D&O insurance purchasing trends of 450 private companies. A significant percentage of respondents gave the following reasons for not purchasing D&O insurance:
• did not see the need for D&O insurance,
• their D&O liability risk was low,
• thought D&O risk is covered under other liability policies

The companies responding as non-purchasers of D&O insurance experienced at least one D&O claim in the five years preceding the survey. Results showed that private companies with 250 or more employees, were the subject of D&O litigation during the preceding five years and 20% of companies with 25 to 49 employees, experienced a D&O claim.

The survey revealed 43% of D&O litigation was brought by customers, 29% from regulatory agencies, and 11% from non-publicly traded equity securities holders. The average loss reported by the private companies was $380,000. Companies with D&O insurance experienced an average loss of $129,000. Companies without D&O insurance experienced an average loss of $480,000.

Some Common Examples of Private Company D&O Claims

• Major shareholder led buy-outs of minority shareholders alleging misrepresentations of the company’s fair market value
• purchaser of a company or its assets alleging misrepresentation
• sale of company assets to entities controlled by the majority shareholder
• creditors’ committee or bankruptcy trustee claims
• private equity investors and lenders’ claims
• vendors alleging misrepresentation in connection with an extension of credit
• consumer protection and privacy claims

Private Company D&O Policy Considerations

Executive Liability insurance policies for privately held companies typically provide a combination or package of coverage that includes, but may not be limited to: Directors’ & Officers’ Liability, Employment Practices Liability, ERISA Fiduciary Liability and Commercial Crime/ Fidelity insurance.

D&O policies, whether underwritten on a stand-alone basis or in the form of a combination-type policy form, are underwritten on a “claims-made” basis. This means the claim must be made against the Insured and reported to the insurer during the same effective policy period, or under a specified Extended (claims) Reporting Period following the policy’s expiration. This is a completely different coverage trigger from other liability policies such as Commercial General Liability that are traditionally underwritten with an “occurrence” trigger, which implicates the insurance policy that was in effect at the time of the accident, even if the claim is not reported until years later.

“Side A” coverage, which protects individual Insureds in the event the Insured entity is unable to indemnify individuals, is a standard agreement contained within many private company policy forms. These policies are generally structured with a shared policy limit among the various insuring agreements resulting in a more affordable insurance product tailored to small and mid-sized enterprises. For an additional premium, separate policy limits may be purchased for one or more of each distinct insuring agreement affording a more customized insurance package.

Also, policies should be evaluated to determine whether they extend coverage for covered “wrongful acts” committed by non-officers or directors, such as employees, independent contractors, leased, and part-time employees.

Imputation of Knowledge & Severability

Coverage can be materially affected if an Insured individual has knowledge of facts or circumstances or was involved in wrongful conduct that gave rise to the claim, prior to the effective date of policy under which the claim was reported. Policies differ as to whether and to what extent, the knowledge or conduct of one “bad actor” may be imputed to “innocent “individual Insureds and / or to the Insured entity.

“Severability”, is an important provision in D&O policies that is often overlooked by policyholders until it threatens to void coverage during a serious pending claim. The severability clause can be drafted with varying degrees of flexibility– from “partial” to “full severability.” A “full severability” provision is always most preferable from an Insured’s standpoint. Many D&O policies, impute the knowledge of certain policy-specified senior level officer positions to the Insured entity. That imputation of knowledge can operate to void coverage that might have otherwise been available to the Insured entity.

M&A and “Tail Coverage” Considerations

The “claims-made” coverage trigger is critically important in an M&A context where contingent liability risks are inherent. In these contexts, it’s important to evaluate the seller’s policies’ options to purchase a “tail” or “extended reporting period” for each of the target company’s policies containing a “claims-made” trigger.

A “tail” coverage option allows for the reporting of claims alleging “wrongful acts” that occurred during the expired policy period, yet were not actually asserted against the Insured until after the policy’s expiration, but instead were asserted during the “extended reporting” or “tail” period. An acquiring company’s insurance professional should work closely with legal counsel’s due diligence team to identify and present alternatives to manage contingent exposures.

What a Director or Officer Doesn’t Know Will Hurt Them

Directors’ & Officers’ Liability insurance policies were originally created solely to protect the personal assets of the individuals serving on public company boards and executive officers. In 1992, one of the most prominent D&O insurers led a major transformational change in D&O underwriting by expanding coverage to include certain claims against the insured entity. Entity coverage for publicly traded companies is typically restricted to securities claims, while privately held companies and not-for-profit organizations benefit from more comprehensive entity coverage because they lack the public securities risk exposure of publicly traded companies.

The “Claims- Made” Coverage Trigger

D&O policies are universally underwritten on a ‘claims-made’ basis. This translates to an unequivocal contractual requirement that the policyholder report claims made against an Insured to the insurer during the effective policy period. The only exception is in the case where an optional reporting ‘tail’ is purchased which affords the Insured the ability to report claims during a specified “extended reporting period,” as long as the wrongful act occurred during the effective period of the immediately preceding policy.

Defense

D&O policies issued to public companies generally contain no explicit duty to defend and some require the Insured to select from a pre-approved panel of pre-qualified defense counsel. In contrast, many private company D&O policies do contain a provision placing the defense obligation squarely upon the insurer, and still other policies contain options allowing the defense to be tendered by the Insured to the insurer within a specific period of time. Some D&O policies contain defense cost provisions that require an allocation or sharing of the defense costs between the Insured and Insurer, based upon a determination of covered versus non-covered allegations.

Settlement Hammer

D&O policies typically contain a “settlement hammer” provision. This clause operates to limit an insurer’s obligation to indemnify in the event the Insured refuses to consent to a settlement that is acceptable to the insurer. Some policies may express the amount the insurer will pay for covered loss under this circumstance as a percentage of the ultimate covered settlement or judgment. Other D&O policies may limit their economic exposure to the amount for which the case could have historically settled, but for the Insured’s refusal.

Regulatory Proceedings and Investigations

Most D&O insurance policies afford qualified protection against “regulatory and governmental” investigations, “administrative or regulatory proceedings,” and criminal proceedings. Policies often require the proceedings to be directed against a natural person Insured, to be commenced and maintained in a manner specified in the policy, such as a ‘formal’ order of investigation, and only for policy-defined defense expenses incurred after the issuance of a formal order or an indictment.

D&O policies’ definitions and other corresponding provisions and exclusions vary, and should be carefully evaluated to determine whether they encompass informal investigations from the time a subpoena is received, or from the time an Insured person is identified in writing as a person against whom charges may be filed.

Learning the A,B,C’s and D’s of D&O Coverage

The three main Insuring Agreements found in public company D&O policies, are typically referenced as “Side A, B, and C coverage”. They are sometime supplemented with an optional Coverage D.

“Side A “Coverage – Individual Insured Coverage

“Side A Coverage,” also known as the “Non-Indemnifiable Loss Insuring Agreement,” provides coverage to individual officers and directors against claims for their policy-defined wrongful acts in their official capacities, under fairly rare circumstances in which the Insured entity either cannot or will not provided indemnification.

The policy’s “Side A” coverage for non-indemnifiable claims against directors and officers, almost universally provides that no retention is required to be paid by individual Insureds. A separate “Side A” limit may be available in addition to the traditional D&O policy’s aggregate limit of liability. “Side A” excess D&O policies have become more commonplace in the past several years, and certain “Side A” excess policies may also offer “difference in conditions” (‘DIC’) coverage that generally provides a feature of ‘dropping down’ to respond to claims either not paid by the primary or underlying D&O policy insurer, or in the event indemnification is unavailable from the Insured entity, the underlying limits are eroded by covered claims against the entity, or the underlying D&O insurers deny coverage to the directors. Some Side A policies are underwritten as non-rescindable by the insurer. Purchasers of this coverage should also consider, if available, an option for reinstatement of policy limits for the outside directors, in the event of premature policy limit exhaustion.

“Side B” Coverage – Corporate Reimbursement Coverage
This insuring agreement reimburses the Insured entity for covered loss under claim circumstances where the corporation is indemnifying its directors and officers. This provision does not afford any coverage to the Insured entity for its own potential liability, and is subject to a self-insured retention (“SIR”) that must be paid by the Insured entity before an Insurer will make any payments. It’s important to note that many Insureds do not realize they are contractually obligated to obtain the insurer’s prior consent to incur costs and expenses, and only those costs and expenses approved in advance by the insurer will be deemed to have satisfied the Insured entity’s SIR obligation. It’s important for policyholders to understand they run a serious risk of losing some or all of their otherwise available coverage, if they incur legal expenses prior to reporting the claim, or if they enter into negotiations or reach a settlement agreement in principle without the insurer’s prior knowledge and consent.

“Side C” Coverage – Entity Coverage

This insuring agreement affords coverage to the publicly traded Insured entity only for it own liability and is typically restricted to coverage for securities-related claims. “Securities Claims” is a policy-defined term, encompassing only claims arising from the Insured entity’s own securities. Privately held companies and organizations are afforded substantively different coverage under this insuring agreement.

“Side D” Coverage – Outside Entity Insured Person Coverage

This insuring clause is available as an option on most D&O policies. It provides coverage to designated “Insured Persons”, for their liability as a result of their membership on an “Outside Entity” board. This coverage applies on a “double excess” basis, meaning it is triggered after the exhaustion of any indemnification provided by the Outside Entity to the Outside Entity director, as well as any insurance coverage available from the Outside Entity. Traditional D&O policies typically extend automatic coverage to insured Individuals who are designated by the policyholder to participate as a board member of a not-for-profit organization.

Some Additional Considerations
In addition to the topics highlighted earlier, D&O insurance purchasers should gain familiarity with how their policies may respond under bankruptcy situations, potential coverage issues arising from a Special Committee’s investigative activity, potential issues involving priority of payments among Insureds, hidden D&O insurance program design flaws that can render excess D&O policies unresponsive to catastrophic claims, and the changing requirements of international D&O coverage to remain compliant with local country regulations. These topics will be covered in a future article.

This article provides general information and is neither intended to provide any legal advice nor to provide any advice with regard to the specific interpretation or operation of any insurance policy. Any insurance policy’s applicability is highly fact specific. Qualified legal counsel should be consulted regarding laws that may apply with respect to policy coverage interpretation in the state in which the policy will be interpreted.

What Type Of Life Insurance Is Best?

Life Insurance (though it shouldn’t be) is to this day a very controversial issue. There seems to be a lot of different types of life insurance out there, but there are really only two kinds. They are Term Insurance and Whole Life (Cash Value) Insurance. Term Insurance is pure insurance. It protects you over a certain period of time. Whole Life Insurance is insurance plus a side account known as cash value. Generally speaking, consumer reports recommend term insurance as the most economical choice and they have for some time. But still, whole life insurance is the most prevalent in today’s society. Which one should we buy?

Let’s talk about the purpose of life insurance. Once we get the proper purpose of insurance down to a science, then everything else will fall into place. The purpose of life insurance is the same purpose as any other type of insurance. It is to “insure against loss of”. Car insurance is to insure your car or someone else’s car in case of an accident. So in other words, since you probably couldn’t pay for the damage yourself, insurance is in place. Home owners insurance is to insure against loss of your home or items in it. So since you probably couldn’t pay for a new house, you buy an insurance policy to cover it.

Life insurance is the same way. It is to insure against loss of your life. If you had a family, it would be impossible to support them after you died, so you buy life insurance so that if something were to happen to you, your family could replace your income. Life insurance is not to make you or your descendants rich or give them a reason to kill you. Life insurance is not to help you retire (or else it would be called retirement insurance)! Life insurance is to replace your income if you die. But the wicked ones have made us believe otherwise, so that they can overcharge us and sell all kinds of other things to us to get paid.

How Does Life Insurance Work?

Rather than make this complicated, I will give a very simple explanation on how and what goes down in an insurance policy. As a matter of fact, it will be over simplified because we would otherwise be here all day. This is an example. Let’s say that you are 31 years old. A typical term insurance policy for 20 years for $200,000 would be about $20/month. Now… if you wanted to buy a whole life insurance policy for $200,000 you might pay $100/month for it. So instead of charging you $20 (which is the true cost) you will be overcharged by $80, which will then be put into a savings account.

Now, this $80 will continue to accumulate in a separate account for you. Typically speaking, if you want to get some of YOUR money out of the account, you can then BORROW IT from the account and pay it back with interest. Now… let’s say you were to take $80 dollars a month and give it to your bank. If you went to withdraw the money from your bank account and they told you that you had to BORROW your own money from them and pay it back with interest, you would probably go clean upside somebody’s head. But somehow, when it comes to insurance, this is okay

This stems from the fact that most people don’t realize that they are borrowing their own money. The “agent” (of the insurance Matrix) rarely will explain it that way. You see, one of the ways that companies get rich, is by getting people to pay them, and then turn around and borrow their own money back and pay more interest! Home equity loans are another example of this, but that is a whole different sermon.

Deal or No Deal

Let us stick with the previous illustration. Let us say the one thousand 31 year olds ( all in good health) bought the aforementioned term policy (20 years, $200,000 dollars at $20/month). If these people were paying $20/month, that is $240 per year. If you take that and multiply it over the 20 year term then you will have $4800. So each individual will pay $4800 over the life of the term. Since one thousand individuals bought the policy, they will end up paying 4.8 million in premiums to the company. The insurance company has already calculated that around 20 people with good health (between the ages of 31 and 51) will die. So if 20 people pass away, then the company will have to pay out 20 x $200,000 or $4,000,000. So, if the company pays out $4,000,000 and takes in $4,800,000 it will then make a $800,000 profit.

This is of course OVER simplifying because a lot of people will cancel the policy (which will also bring down the number of death claims paid), and some of those premiums can be used to accumulate interest, but you can get a general idea of how things work.

On the other hand, let’s look at whole life insurance. Let us say the one thousand 31 year olds (all in good health) bought the aforementioned whole life policy ($200,000 dollars at $100/month). These people are paying $100/month. That is $1200 per year. If the average person’s lifespan (in good health people) goes to 75, then on average, the people will pay 44 years worth of premiums. If you take that and multiply it by $1200 you will get $52,800. So each individual will pay $52,800 over the life of the policy. Since one thousand individuals bought the policy, they will end up paying 52.8 million in premiums to the company. If you buy a whole life policy, the insurance company has already calculated the probability that you will die. What is that probability? 100%, because it is a whole life (till death do us part) insurance policy! This means that if everyone kept their policies, the insurance company would have to pay out 1000 x $200,000 = $2,000,000,000) That’s right, two billion dollars!

Ladies and gentleman, how can a company afford to pay out two billion dollars knowing that it will only take in 52.8 million? Now just like in the previous example, this is an oversimplification as policies will lapse. As a matter of fact, MOST whole life policies do lapse because people can’t afford them, I hope you see my point. Let’s take the individual. A 31 year old male bought a policy in which he is suppose to pay in $52,800 and get $200,000 back? There no such thing as a free lunch. The company somehow has to weasel $147,200 out of him, JUST TO BREAK EVEN on this policy! Not to mention, pay the agents (who get paid much higher commissions on whole life policies), underwriters, insurance fees, advertising fees, 30 story buildings… etc, etc.

This doesn’t even take into account these variable life and universal life policies that claim to be so good for your retirement. So you are going to pay $52,800 into a policy and this policy will make you rich, AND pay you the $200,000 death benefit, AND pay the agents, staff and fees? This has to be a rip off.

Well, how could they rip you off? Maybe for the first five years of the policy, no cash value will accumulate (you may want to check your policy). Maybe it’s misrepresenting the value of the return (this is easy if the customer is not knowledgeable on exactly how investments work). Also, if you read my article on the Rule of 72 you can clearly see that giving your money to someone else to invest can lose you millions! You see, you may pay in $52,800 but that doesn’t take into account how much money you LOSE by not investing it yourself! This is regardless of how well your agent may tell you the company will invest your money! Plain and simple, they have to get over on you somehow or they would go out of business!

How long do you need life insurance?

Let me explain what is called The Theory of Decreasing Responsibility, and maybe we can answer this question. Let’s say that you and your spouse just got married and have a child. Like most people, when they are young they are also crazy, so they go out and buy a new car and a new house. Now, here you are with a young child and debt up to the neck! In this particular case, if one of you were to pass away, the loss of income would be devastating to the other spouse and the child. This is the case for life insurance. BUT, this is what happens. You and your spouse begin to pay off that debt. Your child gets older and less dependent on you. You start to build up your assets. Keep in mind that I am talking about REAL assets, not fake or phantom assets like equity in a home (which is just a fixed interest rate credit card)

In the end, the situation is like this. The child is out of the house and no longer dependent on you. You don’t have any debt. You have enough money to live off of, and pay for your funeral (which now costs thousands of dollars because the DEATH INDUSTRY has found new ways to make money by having people spend more honor and money on a person after they die then they did while that person was alive). So… at this point, what do you need insurance for? Exactly… absolutely nothing! So why would you buy Whole Life (a.k.a. DEATH) Insurance? The idea of a 179 year old person with grown children who don’t depend on him/her still paying insurance premiums is asinine to say the least.

As a matter of fact, the need for life insurance could be greatly decreased and quickly eliminated, if one would learn not to accumulate liabilities, and quickly accumulate wealth first. But I realize that this is almost impossible for most people in this materialistic, Middle Classed matrixed society. But anyway, let’s take it a step further.

Confused Insurance Policies

This next statement is very obvious, but very profound. Living and dying are exact opposites of each other. Why do I say this? The purpose of investing is to accumulate enough money in case you live to retire. The purpose of buying insurance is to protect your family and loved ones if you die before you can retire. These are two diametrically opposed actions! So, if an “agent” waltzes into your home selling you a whole life insurance policy and telling you that it can insure your life AND it can help you retire, your Red Pill Question should be this:

“If this plan will help me retire securely, why will I always need insurance? And on the other hand, if I will be broke enough later on in life that I will still need insurance, then how is this a good retirement plan?”

Now if you ask an insurance agent those questions, she/he may become confused. This of course comes from selling confused policies that do two opposites at once.

Norman Dacey said it best in the book “What’s Wrong With Your Life Insurance”

“No one could ever quarrel with the idea of providing protection for one’s family while at the same time accumulating a fund for some such purpose as education or retirement. But if you try to do both of these jobs through the medium of one insurance policy, it is inevitable that both jobs will be done badly.”

So you see, even though there are a lot of new variations of whole life, like variable life and universal life, with various bells and whistles (claiming to be better than the original, typical whole life policies), the Red Pill Question must always be asked! If you are going to buy insurance, then buy insurance! If you are going to invest, then invest. It’s that simple. Don’t let an insurance agent trick you into buying a whole life policy based on the assumption that you are too incompetent and undisciplined to invest your own money.

If you are afraid to invest your money because you don’t know how, then educate yourself! It may take some time, but it is better than giving your money to somebody else so they can invest it for you (and get rich with it). How can a company be profitable when it takes the money from it’s customers, invests it, and turns around and gives it’s customers all of the profits?

And don’t fall for the old “What if the term runs out and you can’t get re-insured trick”. Listen, there are a lot of term policies out there that are guaranteed renewable until an old age (75-100). Yes, the price is a lot higher, but you must realize that if you buy a whole life policy, you will have been duped out of even more money by the time you get to that point (if that even happens). This is also yet another reason to be smart with your money. Don’t buy confused policies.

How much should you buy?

I normally recommend 8-10 times your yearly income as a good face amount for your insurance. Why so high? Here is the reason. Let’s say that you make $50,000 per year. If you were to pass away, your family could take $500,000 (10 times $50,000) and put it into a fund that pays 10 percent (which will give them $40,000 per year) and not touch the principle. So what you have done is replaced your income.

This is another reason why Whole Life insurance is bad. It is impossible to afford the amount of insurance you need trying to buy super high priced policies. Term insurance is much cheaper. To add to this, don’t let high face values scare you. If you have a lot of liabilities and you are worried about your family, it is much better to be underinsured than to have no insurance at all. Buy what you can manage. Don’t get sold what you can’t manage.

Insurance Law – An Indian Perspective

INTRODUCTION

“Insurance should be bought to protect you against a calamity that would otherwise be financially devastating.”

In simple terms, insurance allows someone who suffers a loss or accident to be compensated for the effects of their misfortune. It lets you protect yourself against everyday risks to your health, home and financial situation.

Insurance in India started without any regulation in the Nineteenth Century. It was a typical story of a colonial epoch: few British insurance companies dominating the market serving mostly large urban centers. After the independence, it took a theatrical turn. Insurance was nationalized. First, the life insurance companies were nationalized in 1956, and then the general insurance business was nationalized in 1972. It was only in 1999 that the private insurance companies have been allowed back into the business of insurance with a maximum of 26% of foreign holding.

“The insurance industry is enormous and can be quite intimidating. Insurance is being sold for almost anything and everything you can imagine. Determining what’s right for you can be a very daunting task.”

Concepts of insurance have been extended beyond the coverage of tangible asset. Now the risk of losses due to sudden changes in currency exchange rates, political disturbance, negligence and liability for the damages can also be covered.

But if a person thoughtfully invests in insurance for his property prior to any unexpected contingency then he will be suitably compensated for his loss as soon as the extent of damage is ascertained.

The entry of the State Bank of India with its proposal of bank assurance brings a new dynamics in the game. The collective experience of the other countries in Asia has already deregulated their markets and has allowed foreign companies to participate. If the experience of the other countries is any guide, the dominance of the Life Insurance Corporation and the General Insurance Corporation is not going to disappear any time soon.
The aim of all insurance is to compensate the owner against loss arising from a variety of risks, which he anticipates, to his life, property and business. Insurance is mainly of two types: life insurance and general insurance. General insurance means Fire, Marine and Miscellaneous insurance which includes insurance against burglary or theft, fidelity guarantee, insurance for employer’s liability, and insurance of motor vehicles, livestock and crops.

LIFE INSURANCE IN INDIA

“Life insurance is the heartfelt love letter ever written.

It calms down the crying of a hungry baby at night. It relieves the heart of a bereaved widow.

It is the comforting whisper in the dark silent hours of the night.”

Life insurance made its debut in India well over 100 years ago. Its salient features are not as widely understood in our country as they ought to be. There is no statutory definition of life insurance, but it has been defined as a contract of insurance whereby the insured agrees to pay certain sums called premiums, at specified time, and in consideration thereof the insurer agreed to pay certain sums of money on certain condition sand in specified way upon happening of a particular event contingent upon the duration of human life.

Life insurance is superior to other forms of savings!

“There is no death. Life Insurance exalts life and defeats death.

It is the premium we pay for the freedom of living after death.”

Savings through life insurance guarantee full protection against risk of death of the saver. In life insurance, on death, the full sum assured is payable (with bonuses wherever applicable) whereas in other savings schemes, only the amount saved (with interest) is payable.

The essential features of life insurance are a) it is a contract relating to human life, which b) provides for payment of lump-sum amount, and c) the amount is paid after the expiry of certain period or on the death of the assured. The very purpose and object of the assured in taking policies from life insurance companies is to safeguard the interest of his dependents viz., wife and children as the case may be, in the even of premature death of the assured as a result of the happening in any contingency. A life insurance policy is also generally accepted as security for even a commercial loan.

NON-LIFE INSURANCE

“Every asset has a value and the business of general insurance is related to the protection of economic value of assets.”

Non-life insurance means insurance other than life insurance such as fire, marine, accident, medical, motor vehicle and household insurance. Assets would have been created through the efforts of owner, which can be in the form of building, vehicles, machinery and other tangible properties. Since tangible property has a physical shape and consistency, it is subject to many risks ranging from fire, allied perils to theft and robbery.
Few of the General Insurance policies are:

Property Insurance: The home is most valued possession. The policy is designed to cover the various risks under a single policy. It provides protection for property and interest of the insured and family.

Health Insurance: It provides cover, which takes care of medical expenses following hospitalization from sudden illness or accident.
Personal Accident Insurance: This insurance policy provides compensation for loss of life or injury (partial or permanent) caused by an accident. This includes reimbursement of cost of treatment and the use of hospital facilities for the treatment.

Travel Insurance: The policy covers the insured against various eventualities while traveling abroad. It covers the insured against personal accident, medical expenses and repatriation, loss of checked baggage, passport etc.

Liability Insurance: This policy indemnifies the Directors or Officers or other professionals against loss arising from claims made against them by reason of any wrongful Act in their Official capacity.

Motor Insurance: Motor Vehicles Act states that every motor vehicle plying on the road has to be insured, with at least Liability only policy. There are two types of policy one covering the act of liability, while other covers insurers all liability and damage caused to one’s vehicles.

JOURNEY FROM AN INFANT TO ADOLESCENCE!

Historical Perspective

The history of life insurance in India dates back to 1818 when it was conceived as a means to provide for English Widows. Interestingly in those days a higher premium was charged for Indian lives than the non-Indian lives as Indian lives were considered more risky for coverage.

The Bombay Mutual Life Insurance Society started its business in 1870. It was the first company to charge same premium for both Indian and non-Indian lives. The Oriental Assurance Company was established in 1880. The General insurance business in India, on the other hand, can trace its roots to the Triton (Tital) Insurance Company Limited, the first general insurance company established in the year 1850 in Calcutta by the British. Till the end of nineteenth century insurance business was almost entirely in the hands of overseas companies.

Insurance regulation formally began in India with the passing of the Life Insurance Companies Act of 1912 and the Provident Fund Act of 1912. Several frauds during 20’s and 30’s desecrated insurance business in India. By 1938 there were 176 insurance companies. The first comprehensive legislation was introduced with the Insurance Act of 1938 that provided strict State Control over insurance business. The insurance business grew at a faster pace after independence. Indian companies strengthened their hold on this business but despite the growth that was witnessed, insurance remained an urban phenomenon.

The Government of India in 1956, brought together over 240 private life insurers and provident societies under one nationalized monopoly corporation and Life Insurance Corporation (LIC) was born. Nationalization was justified on the grounds that it would create much needed funds for rapid industrialization. This was in conformity with the Government’s chosen path of State lead planning and development.

The (non-life) insurance business continued to prosper with the private sector till 1972. Their operations were restricted to organized trade and industry in large cities. The general insurance industry was nationalized in 1972. With this, nearly 107 insurers were amalgamated and grouped into four companies – National Insurance Company, New India Assurance Company, Oriental Insurance Company and United India Insurance Company. These were subsidiaries of the General Insurance Company (GIC).

The life insurance industry was nationalized under the Life Insurance Corporation (LIC) Act of India. In some ways, the LIC has become very flourishing. Regardless of being a monopoly, it has some 60-70 million policyholders. Given that the Indian middle-class is around 250-300 million, the LIC has managed to capture some 30 odd percent of it. Around 48% of the customers of the LIC are from rural and semi-urban areas. This probably would not have happened had the charter of the LIC not specifically set out the goal of serving the rural areas. A high saving rate in India is one of the exogenous factors that have helped the LIC to grow rapidly in recent years. Despite the saving rate being high in India (compared with other countries with a similar level of development), Indians display high degree of risk aversion. Thus, nearly half of the investments are in physical assets (like property and gold). Around twenty three percent are in (low yielding but safe) bank deposits. In addition, some 1.3 percent of the GDP are in life insurance related savings vehicles. This figure has doubled between 1985 and 1995.

A World viewpoint – Life Insurance in India

In many countries, insurance has been a form of savings. In many developed countries, a significant fraction of domestic saving is in the form of donation insurance plans. This is not surprising. The prominence of some developing countries is more surprising. For example, South Africa features at the number two spot. India is nestled between Chile and Italy. This is even more surprising given the levels of economic development in Chile and Italy. Thus, we can conclude that there is an insurance culture in India despite a low per capita income. This promises well for future growth. Specifically, when the income level improves, insurance (especially life) is likely to grow rapidly.

INSURANCE SECTOR REFORM:

Committee Reports: One Known, One Anonymous!

Although Indian markets were privatized and opened up to foreign companies in a number of sectors in 1991, insurance remained out of bounds on both counts. The government wanted to proceed with caution. With pressure from the opposition, the government (at the time, dominated by the Congress Party) decided to set up a committee headed by Mr. R. N. Malhotra (the then Governor of the Reserve Bank of India).

Malhotra Committee

Liberalization of the Indian insurance market was suggested in a report released in 1994 by the Malhotra Committee, indicating that the market should be opened to private-sector competition, and eventually, foreign private-sector competition. It also investigated the level of satisfaction of the customers of the LIC. Inquisitively, the level of customer satisfaction seemed to be high.

In 1993, Malhotra Committee – headed by former Finance Secretary and RBI Governor Mr. R. N. Malhotra – was formed to evaluate the Indian insurance industry and recommend its future course. The Malhotra committee was set up with the aim of complementing the reforms initiated in the financial sector. The reforms were aimed at creating a more efficient and competitive financial system suitable for the needs of the economy keeping in mind the structural changes presently happening and recognizing that insurance is an important part of the overall financial system where it was necessary to address the need for similar reforms. In 1994, the committee submitted the report and some of the key recommendations included:

o Structure

Government bet in the insurance Companies to be brought down to 50%. Government should take over the holdings of GIC and its subsidiaries so that these subsidiaries can act as independent corporations. All the insurance companies should be given greater freedom to operate.
Competition

Private Companies with a minimum paid up capital of Rs.1 billion should be allowed to enter the sector. No Company should deal in both Life and General Insurance through a single entity. Foreign companies may be allowed to enter the industry in collaboration with the domestic companies. Postal Life Insurance should be allowed to operate in the rural market. Only one State Level Life Insurance Company should be allowed to operate in each state.

o Regulatory Body

The Insurance Act should be changed. An Insurance Regulatory body should be set up. Controller of Insurance – a part of the Finance Ministry- should be made Independent.

o Investments

Compulsory Investments of LIC Life Fund in government securities to be reduced from 75% to 50%. GIC and its subsidiaries are not to hold more than 5% in any company (there current holdings to be brought down to this level over a period of time).

o Customer Service

LIC should pay interest on delays in payments beyond 30 days. Insurance companies must be encouraged to set up unit linked pension plans. Computerization of operations and updating of technology to be carried out in the insurance industry. The committee accentuated that in order to improve the customer services and increase the coverage of insurance policies, industry should be opened up to competition. But at the same time, the committee felt the need to exercise caution as any failure on the part of new competitors could ruin the public confidence in the industry. Hence, it was decided to allow competition in a limited way by stipulating the minimum capital requirement of Rs.100 crores.

The committee felt the need to provide greater autonomy to insurance companies in order to improve their performance and enable them to act as independent companies with economic motives. For this purpose, it had proposed setting up an independent regulatory body – The Insurance Regulatory and Development Authority.

Reforms in the Insurance sector were initiated with the passage of the IRDA Bill in Parliament in December 1999. The IRDA since its incorporation as a statutory body in April 2000 has meticulously stuck to its schedule of framing regulations and registering the private sector insurance companies.

Since being set up as an independent statutory body the IRDA has put in a framework of globally compatible regulations. The other decision taken at the same time to provide the supporting systems to the insurance sector and in particular the life insurance companies was the launch of the IRDA online service for issue and renewal of licenses to agents. The approval of institutions for imparting training to agents has also ensured that the insurance companies would have a trained workforce of insurance agents in place to sell their products.

The Government of India liberalized the insurance sector in March 2000 with the passage of the Insurance Regulatory and Development Authority (IRDA) Bill, lifting all entry restrictions for private players and allowing foreign players to enter the market with some limits on direct foreign ownership. Under the current guidelines, there is a 26 percent equity lid for foreign partners in an insurance company. There is a proposal to increase this limit to 49 percent.

The opening up of the sector is likely to lead to greater spread and deepening of insurance in India and this may also include restructuring and revitalizing of the public sector companies. In the private sector 12 life insurance and 8 general insurance companies have been registered. A host of private Insurance companies operating in both life and non-life segments have started selling their insurance policies since 2001

Mukherjee Committee

Immediately after the publication of the Malhotra Committee Report, a new committee, Mukherjee Committee was set up to make concrete plans for the requirements of the newly formed insurance companies. Recommendations of the Mukherjee Committee were never disclosed to the public. But, from the information that filtered out it became clear that the committee recommended the inclusion of certain ratios in insurance company balance sheets to ensure transparency in accounting. But the Finance Minister objected to it and it was argued by him, probably on the advice of some of the potential competitors, that it could affect the prospects of a developing insurance company.

LAW COMMISSION OF INDIA ON REVISION OF THE INSURANCE ACT 1938 – 190th Law Commission Report

The Law Commission on 16th June 2003 released a Consultation Paper on the Revision of the Insurance Act, 1938. The previous exercise to amend the Insurance Act, 1938 was undertaken in 1999 at the time of enactment of the Insurance Regulatory Development Authority Act, 1999 (IRDA Act).

The Commission undertook the present exercise in the context of the changed policy that has permitted private insurance companies both in the life and non-life sectors. A need has been felt to toughen the regulatory mechanism even while streamlining the existing legislation with a view to removing portions that have become superfluous as a consequence of the recent changes.

Among the major areas of changes, the Consultation paper suggested the following:

a. merging of the provisions of the IRDA Act with the Insurance Act to avoid multiplicity of legislations;

b. deletion of redundant and transitory provisions in the Insurance Act, 1938;

c. Amendments reflect the changed policy of permitting private insurance companies and strengthening the regulatory mechanism;

d. Providing for stringent norms regarding maintenance of ‘solvency margin’ and investments by both public sector and private sector insurance companies;

e. Providing for a full-fledged grievance redressal mechanism that includes:

o The constitution of Grievance Redressal Authorities (GRAs) comprising one judicial and two technical members to deal with complaints/claims of policyholders against insurers (the GRAs are expected to replace the present system of insurer appointed Ombudsman);

o Appointment of adjudicating officers by the IRDA to determine and levy penalties on defaulting insurers, insurance intermediaries and insurance agents;

o Providing for an appeal against the decisions of the IRDA, GRAs and adjudicating officers to an Insurance Appellate Tribunal (IAT) comprising a judge (sitting or retired) of the Supreme Court/Chief Justice of a High Court as presiding officer and two other members having sufficient experience in insurance matters;

o Providing for a statutory appeal to the Supreme Court against the decisions of the IAT.

LIFE & NON-LIFE INSURANCE – Development and Growth!

The year 2006 turned out to be a momentous year for the insurance sector as regulator the Insurance Regulatory Development Authority Act, laid the foundation for free pricing general insurance from 2007, while many companies announced plans to attack into the sector.

Both domestic and foreign players robustly pursued their long-pending demand for increasing the FDI limit from 26 per cent to 49 per cent and toward the fag end of the year, the Government sent the Comprehensive Insurance Bill to Group of Ministers for consideration amid strong reservation from Left parties. The Bill is likely to be taken up in the Budget session of Parliament.

The infiltration rates of health and other non-life insurances in India are well below the international level. These facts indicate immense growth potential of the insurance sector. The hike in FDI limit to 49 per cent was proposed by the Government last year. This has not been operationalized as legislative changes are required for such hike. Since opening up of the insurance sector in 1999, foreign investments of Rs. 8.7 billion have tipped into the Indian market and 21 private companies have been granted licenses.

The involvement of the private insurers in various industry segments has increased on account of both their capturing a part of the business which was earlier underwritten by the public sector insurers and also creating additional business boulevards. To this effect, the public sector insurers have been unable to draw upon their inherent strengths to capture additional premium. Of the growth in premium in 2004-05, 66.27 per cent has been captured by the private insurers despite having 20 per cent market share.

The life insurance industry recorded a premium income of Rs.82854.80 crore during the financial year 2004-05 as against Rs.66653.75 crore in the previous financial year, recording a growth of 24.31 per cent. The contribution of first year premium, single premium and renewal premium to the total premium was Rs.15881.33 crore (19.16 per cent); Rs.10336.30 crore (12.47 per cent); and Rs.56637.16 crore (68.36 per cent), respectively. In the year 2000-01, when the industry was opened up to the private players, the life insurance premium was Rs.34,898.48 crore which constituted of Rs. 6996.95 crore of first year premium, Rs. 25191.07 crore of renewal premium and Rs. 2740.45 crore of single premium. Post opening up, single premium had declined from Rs.9, 194.07 crore in the year 2001-02 to Rs.5674.14 crore in 2002-03 with the withdrawal of the guaranteed return policies. Though it went up marginally in 2003-04 to Rs.5936.50 crore (4.62 per cent growth) 2004-05, however, witnessed a significant shift with the single premium income rising to Rs. 10336.30 crore showing 74.11 per cent growth over 2003-04.

The size of life insurance market increased on the strength of growth in the economy and concomitant increase in per capita income. This resulted in a favourable growth in total premium both for LIC (18.25 per cent) and to the new insurers (147.65 per cent) in 2004-05. The higher growth for the new insurers is to be viewed in the context of a low base in 2003- 04. However, the new insurers have improved their market share from 4.68 in 2003-04 to 9.33 in 2004-05.

The segment wise break up of fire, marine and miscellaneous segments in case of the public sector insurers was Rs.2411.38 crore, Rs.982.99 crore and Rs.10578.59 crore, i.e., a growth of (-)1.43 per cent, 1.81 per cent and 6.58 per cent. The public sector insurers reported growth in Motor and Health segments (9 and 24 per cent). These segments accounted for 45 and 10 per cent of the business underwritten by the public sector insurers. Fire and “Others” accounted for 17.26 and 11 per cent of the premium underwritten. Aviation, Liability, “Others” and Fire recorded negative growth of 29, 21, 3.58 and 1.43 per cent. In no other country that opened at the same time as India have foreign companies been able to grab a 22 per cent market share in the life segment and about 20 per cent in the general insurance segment. The share of foreign insurers in other competing Asian markets is not more than 5 to 10 per cent.

The life insurance sector grew new premium at a rate not seen before while the general insurance sector grew at a faster rate. Two new players entered into life insurance – Shriram Life and Bharti Axa Life – taking the total number of life players to 16. There was one new entrant to the non-life sector in the form of a standalone health insurance company – Star Health and Allied Insurance, taking the non-life players to 14.

A large number of companies, mostly nationalized banks (about 14) such as Bank of India and Punjab National Bank, have announced plans to enter the insurance sector and some of them have also formed joint ventures.

The proposed change in FDI cap is part of the comprehensive amendments to insurance laws – The Insurance Act of 1999, LIC Act, 1956 and IRDA Act, 1999. After the proposed amendments in the insurance laws LIC would be able to maintain reserves while insurance companies would be able to raise resources other than equity.

About 14 banks are in queue to enter insurance sector and the year 2006 saw several joint venture announcements while others scout partners. Bank of India has teamed up with Union Bank and Japanese insurance major Dai-ichi Mutual Life while PNB tied up with Vijaya Bank and Principal for foraying into life insurance. Allahabad Bank, Karnataka Bank, Indian Overseas Bank, Dabur Investment Corporation and Sompo Japan Insurance Inc have tied up for forming a non-life insurance company while Bank of Maharashtra has tied up with Shriram Group and South Africa’s Sanlam group for non-life insurance venture.

CONCLUSION

It seems cynical that the LIC and the GIC will wither and die within the next decade or two. The IRDA has taken “at a snail’s pace” approach. It has been very cautious in granting licenses. It has set up fairly strict standards for all aspects of the insurance business (with the probable exception of the disclosure requirements). The regulators always walk a fine line. Too many regulations kill the motivation of the newcomers; too relaxed regulations may induce failure and fraud that led to nationalization in the first place. India is not unique among the developing countries where the insurance business has been opened up to foreign competitors.

The insurance business is at a critical stage in India. Over the next couple of decades we are likely to witness high growth in the insurance sector for two reasons namely; financial deregulation always speeds up the development of the insurance sector and growth in per capita GDP also helps the insurance business to grow.