Showing posts with label Underwriting Practice. Show all posts
Showing posts with label Underwriting Practice. Show all posts

Review of underwriting guidelines in respect of female lives | Insurance to pregnant ladies

No comments:
Review of underwriting guidelines in respect of female lives

A. Insurance to pregnant ladies

At present insurance to pregnant ladies is allowed if the proposal is submitted within first 24 weeks of pregnancy. All special reports as per the chart of special reports are required to be submitted for giving underwriting decision.

We have received representations for waiving certain special reports like CTMT and X-ray of chest as it is not advisable to undergo these reports during pregnancy. It has therefore been decided not to call for CTMT and X-ray of chest from pregnant ladies. However, reports of other tests done during the period of pregnancy are required to be submitted.

The rules regarding medical underwriting of pregnant ladies are revised as under:

Proposals on the lives of ladies who are pregnant at the time of proposal will be entertained subject to the following conditions:

i. Proposals are submitted within the first twenty four (24) weeks of pregnancy

ii. Proposals will not be entertained under the non-medical scheme.

iii. Full medical report (FMR) from our authorized medical examiner / DMR / TPA
should be obtained as per existing rules.

iv. All other special reports as per the special report chart except Chest X-Ray and
CTMT are to be called for.

v. Report from the attending gynaecologist in Form No 3341 (Revised) certifying
that the lady is under his / her care will be required.

i. Last check up report from the attending obstetrician / gynaecologist will be required.

ii. Reports of any medical tests done during pregnancy will be required to be submitted.

iii. Additional report like Sonography to be called for if opined by DMR/ZMR after reviewing the attending gynaecologist’s report and other medical tests submitted.

iv. The pregnant women should be falling under Female Category I & II only.

v. Maximum cover during the period of pregnancy will be restricted to Rs one crore. The insurance cover granted should be reasonable in relation to the proposer’s income.

vi. Proposals for cover in excess of Rs. one crore during the period of pregnancy could be considered only after referring to the reinsurer.

vii. Pure Term Insurance plans and plans having higher term insurance element will not be entertained.

viii. Special Moral Hazard Report by the competent authority in Form No 3251 should be obtained in all cases irrespective of the sum proposed or SUC. In no case the proposal is to be entertained on the basis of the ACR.

ix. Proposals from pregnant ladies who had a normal full time confinement and normal delivery and without any past history of abnormal delivery or abortion (miscarriage) due to septic will be accepted on the same terms as for a woman not pregnant.

x. Proposals from pregnant ladies with past history of complications or caesarian section to be accepted with a single extra of Rs. 2 per thousand (instead of lien of Rs. 500, i.e., – imposing of Clause 4A- Form No 3124A)


B. General guidelines in respect of female lives:

i. Clause 4 (B) is to be imposed on married women (housewives) falling under
Female Category III aged 18 years and above but less than and up to 30
years nearer birthday on the date of proposal

i. Guidelines for caesarian section and hysterectomy will be as given in the DMR guidelines.
ii. There is no change in the financial underwriting guidelines given in Circular ref. 1994/4 dated 1st March 2005.

Underwriting guidelines in respect of insurance on the lives of minor / major

No comments:
Underwriting guidelines in respect of insurance on the lives of minor / major
children

A. INSURANCE TO MINOR LIVES

At present there are no medical requirements under CDA plans (Table Nos. 41 & 50). Komal Jeevan (Table No. 159) is allowed to children up to age 10 years without medical examination and for Jeevan Kishore (Table No. 102) no medical examination is required if age at entry is less than 10 years. For other risk plans allowed to minor lives, full medical report and special reports as per the chart of special reports are required.

The above guidelines were reviewed and it has been decided to make the following changes in the rules relating to medical examination / special reports in respect of minor lives:

a. There will be uniform guidelines for all risk plans allowed to minor lives including T 102 & 159. However, Table Nos. 171 and 175 will continue to be allowed as per existing guidelines, i.e., satisfactory DGH.

b. No medical examination / special reports will be required up to SUC Rs. 8 lacs.

c. For SUC between Rs. 8 lacs and Rs. 25 lacs only juvenile FMR will be required for ages between 10 and 17 years.

d. Juvenile FMR will be required for SUC above Rs. 25 lacs in respect of all children irrespective of their age at entry / revival.

e. Special reports will be required for SUC Rs. 50 lacs and above for children with ages at entry / revival 5 years and above.

f. A special format for Full Medical Report for Juvenile lives (Juvenile FMR) has been designed. (Format enclosed).
g. Fees for Juvenile FMR and other guidelines (ME’s limit, requirement of juvenile FMR by DMR, validity of juvenile FMR, etc.) will be the same as applicable to FMR at present.

The revised guidelines in respect of minor lives are as under:

1. DEFERRED RISK (CDA) PLANS (TABLE NOS. 41 & 50)

a. Maximum SA Rs. one crore subject to twice the insurance on parents’ (father and mother put together) lives and adequacy of their income

b. Insurance on the lives of parents will not be insisted upon upto Rs. 2 lacs. However matching insurance is to be insisted upon if the proposer is a widow falling under female category III.

c. Proposals for SA in excess of Rs. one crore may be referred to CUS for individual consideration on merits of the case with special recommendations from MM or SDM.

d. Clause 76 is to be imposed if sum proposed is Rs. one crore or less.

e. Clause 76 is not to be imposed if sum proposed is more than Rs. one crore as medical underwriting is required to be done at proposal stage itself.

Medical requirement chart for CDA plans:

Sum Assured
Age
Below 5 years
5 to 9 years
10 to 17 years

Up to
Rs. 100 lacs

No medical requirements

No medical requirements, but height and weight to be mentioned in the ACR
Copy of latest school report

No medical requirements, but height and weight to be mentioned in the ACR
Copy of latest school report

Above Rs. 100 lacs
to
Rs. 250 lacs

i) Juvenile FMR
ii) Immunization
record of the child
iii) copy of latest
school report, if
attending school

i) Juvenile FMR
ii) copy of latest
school report

i) Juvenile FMR
ii) Haemogram
iii) SBT-12
iv) ECG
v) HbsAg
vi) Copy of latest
school report




2. OTHER PLANS

a. Maximum SA Rs. 50 lacs, but not exceeding the insurance on parents’ (father and mother put together) lives and adequacy of their income.

b. Insurance on lives of parents will not be insisted upon up to Rs. 2 lacs. However matching insurance is to be insisted upon if the proposer is a widow falling under female category III.

c. Proposals for SA in excess of Rs. 50 lacs may be referred to CUS for individual consideration on merits of the case with special recommendations from MM or SDM.

Medical requirement chart for other risk plans allowed to minors
(including T 102 & 159):

Sum Assured
Age Group
Below 5 years
5 to 9 years
10 to 17 years

Up to
Rs. 8 lacs

No medical requirements

No medical requirements, but height and weight to be mentioned in the ACR

No medical requirements, but height and weight to be mentioned in the ACR

Rs. 8,00,001
to Rs. 25 lacs

Immunization record of the child (no other medical requirement)

No medical requirements, but height and weight to be mentioned in the ACR

i) Juvenile FMR
ii) Copy of latest
school report

Rs. 25,00,001 to
Rs. 49,99,999

i) Juvenile FMR
ii) Immunization
record of the child iii) copy of latest
school report, if
attending school

i) Juvenile FMR
ii) Copy of latest
school report

i) Juvenile FMR
ii) Copy of latest
school record


Rs. 50,00,000 to
Rs. one crore

i) Juvenile FMR
ii) Immunization record
of the child
iii) copy of latest
school report, if
attending school

i) Juvenile FMR
ii) ECG
iii) Haemogram
iv) Serum Creatinine v) RUA
vi) Elisa test for HIV vii) HbsAg
viii) Copy of latest
school report

i) Juvenile FMR
ii) ECG
iii) Haemogram
iv) SBT-12
v) HbsAg
vi) Copy of latest
school report
Other restrictions:

i. Minimum entry age – as required for different plans

ii. Table Nos. 14, 48, 75, 93, 178 and 179 will be allowed to standard and sub-standard minor lives attracting EMR up to Class III due to overweight only. The remaining eligible plans will be allowed to standard lives only.

iii. Proposals on the lives of overweight minors attracting EMR Class IV and above may be sent to CUS for special individual consideration with recommendations from Marketing Manager.

iv. The life to be assured should have a properly developed physique (not according to percentage of weight. Lower height in stunted growth gives lower percentage of underweight. But it is not a developed physique).

v. Family History, Personal history of health and medical reports are satisfactory.

vi. All members of the family are adequately insured.

vii. Socio-economic status of the family is satisfactory.

viii. Clause 10(a) to be imposed.

ix. Revival under Table Nos. 102, 113, and 159 is allowed on substandard lives if EMR is due to overweight only.

While allowing insurance to minor children on the basis of parents’ income it should be ensured that all members of the family are adequately insured. As far as possible, parents should propose on the lives of all their children and not on the life of any particular child.


3. Premium Waiver Benefit (PWB) under children plans

At present PWB under children plans is allowed only under medical scheme.

It has now been decided to allow PWB under children’s plans on the lives of parents (males and females falling under Female Category I & II) under non-medical (special) scheme and non-medical (general) scheme to professionals.


B. INSURANCE TO MAJOR CHILDREN UP TO AGE 25 YEARS

At present major children / students are allowed insurance cover under non-medical (general) to others up to maximum SUC of Rs. 3 lacs.

As per the above revised guidelines minors will be allowed risk plans without any medical requirements up to SUC Rs. 8 lacs. In view of this revision it has been decided to allow major students up to age 25 years insurance cover up to SUC Rs. 8 lacs under non-medical (general) as shown below:
Non-medical (general) to Major students

Classes of Lives
Sum Assured (SUC)
Plans allowed

Major students not aged over 25 years

Rs. 8 lacs
All plans excluding Table Nos. 43, 52, 58, 164, 167, 177, Term rider and CI Rider

Notes:
a. A declaration is to be obtained from the major students as well as from their parents that they are regularly attending colleges / technical institutions.

b. Copy of passing certificate / appearance report at the examination of the just completed academic year is to be obtained.

c. Cover will, as usual, be allowed subject to matching insurance on parents’ lives and adequacy of their income.


C. MATCHING INSURANCE FOR ALLOWING COVER TO CHILDREN

At present minor and major children up to age 25 years are allowed insurance cover subject to matching insurance on the life proposer. If proposer is father, then only his insurance and income eligibility is considered. If father and mother both have matching insurance and income eligibility then both have to propose separately.

This matter was reviewed and it has been decided to consider matching insurance on the lives of parents and their income eligibility (insurance on the lives of both father and mother and their combined income eligibility) irrespective of whosoever proposes (father or mother) while allowing insurance cover to children.

D. SPECIAL REPORTS FOR AGES UP TO 35 YEARS

At present for SUC of Rs. 1 crore and above and age at entry up to 35 years CTMT is a manual requirement along with Rest ECG, Haemogram, SBT-18, RUA & Chest X-ray.
It has been decided not to call for CTMT for SUC Rs. 1 crore and above and age at entry up to 35 years.

Underwriting guidelines in respect of physically handicapped persons

No comments:
Underwriting guidelines in respect of physically handicapped persons

At present physically handicapped persons are classified into two Groups –

i. persons with Group A Deformity; and
ii. persons with Group B Deformity.

For Group A deformity the extra to be charged depends on the number of limbs lost and certain restrictions regarding plan, term, maturity age, etc. are imposed.

For Group B deformity the underlying disease is rated along with standard extra for loss of limbs and only endowment type of plans are allowed.

The present existing guidelines were reviewed and it has been decided to issue the following revised guidelines for underwriting of physically handicapped persons:

The physically handicapped persons are now classified into 6 groups as shown below:

PH Group
Description

PH Group I
Proponent with physical impairments as a result of accident
PH Group II
Proponents with physical impairments due to cerebral palsy
PH Group III
Proponents with physical impairment due to polio
PH Group IV
Proponents with physical impairment due to muscular dystrophy
PH Group V
Proponents with congenital (present since birth) physical impairments
PH Group VI
Proponents with physical impairments as a result of underlying diseases
In order to classify the various impairments into the above respective groups a special questionnaire (deformity questionnaire) has to be completed by the life assured and Medical Examiner. Further in all cases of deformity, the Medical Examiner in his medical report should give full details of deformity. (Copies of revised Deformity Questionnaire and C.N.S. Questionnaire are enclosed)

It should be noted that proposals on lives of persons who have physical impairments (physically handicapped), can be entertained only if the life to be assured is gainfully employed having adequate income of his / her own and capable of taking sufficient precautions to avoid accidents.

The competent authority giving MHR should give full details of physical deformity after detailed enquiry. He should also describe proposer’s daily routine, his occupation and sources of income.


Underwriting guidelines:

Proposals from physically handicapped persons (PH Group I to PH Group VI) are to be decided in accordance with the revised extra mortality ratings given in the DMR Guidelines. As mentioned therein some proposals may be required to be referred to ZUS / CUS for decision.

It may be noted that proposers with deformities mentioned at (a) to (d) below are to be treated as standard if they are otherwise standard lives:

a. with loss of one limb (including eye) due to accident
b. with loss of both the ears due to accident
c. absence of a limb since birth (congenital and non-progressive in nature)
d. Polio affected with no residual paralysis

There will be no restrictions on age at maturity, plan, term, etc.

Physically handicapped minor lives will be allowed only Table Nos. 41 & 50.


Irrespective of what has been stated above, any minor disability such as loss of fingers and toes etc. can be ignored provided Manager (NB & Actl) is satisfied, on the advice from the DMR that

i. Such a minor impairment will not in any way affect the free movements of
life to be assured;
ii. the grip is firm;
iii. thumb and / or forefinger is / are not missing; and
iv. the impairment is not due to any underlying diseases

Physically handicapped concession will be allowed as per existing practice.

Underwriting Practices for different plans

No comments:
Underwriting Practices

It has been decided to revise the present underwriting guidelines as shown below:

1. Actual sum assured for calculation of sum under consideration (SUC)

Actual SA under the various plans will be calculated as under

Plans
Actual SA

Table Nos. 133 (T No. 105 for revival only)

3 times of basic SA

Table Nos. 88 (T No. 104 for revival only)

2 times of basic SA

Table Nos. 103, 160, 168
(T. Nos. 110 & 121for revival only)

1.5 times of basic SA

All the remaining plans including Table Nos.
106, 107, 108, 43, 52, 58, 137 (T 94 for revival only), Term rider SA, Critical Illness SA

Basic SA

Table No. 140

Risk SA

Original Premium paying term less than or equal to 5 including single premium mode

Basic SA less premiums paid
(1.5 times under Table 168 with single premium mode )


There is no change in the method of calculation of SUC, i.e, the sum of “Actual Sum Assured” including term rider and CI SA under all the current proposals and policies taken in last two full years on the basis of date of commencement. There is also no change in method of calculation of sum under consideration under children’s plan (Table Nos. 41, 50, 102, 159 (T Nos. 101, 113, 80, 81 & 92 for revival) both for child’s life as well as for premium waiver benefit on proposer’s life.

Sum Under Consideration calculated as above will be the basis for

i. FMR by DMR
ii. Calling for special report
iii. For deciding MHR limits
iv. For determining underwriting authority

For Financial underwriting Total Rated up SA (TRSA) will be equal to sum of actual SA under all previous policies including actual SA under current proposal but excluding SA under critical illness rider.


2. Introduction for full medical report and special reports

There is no change in the present practice of introduction on the basis of sum proposed for full medical report and special reports.

Corporate Club Member Agents are authorized to introduce proponents for full medical report and special reports up to sum proposed of Rs. 1 crore.


3. Full Medical Report (FMR) by Divisional Medical Referee (DMR) / Zonal
Medical Referee (ZMR)

At present FMR by DMR / ZMR is required if

a. SUC is equal to or greater than Rs. 25 lacs; or
b. The age last birthday as on date of proposal (not dated back age) is 60 years or more and SUC is greater than or equal to Rs. 5 lacs.

While calculating SUC for determining FMR by DMR/ZMR basic SA under the current proposal is taken into account.

It has been decided that for determining FMR by DMR/ZMR, SUC will be calculated by taking into account the actual SA as shown under Table of Item No. 1 above.

For FMR other than by DMR/ZMR, the existing rules will continue.


4. Validity of Full Medical Report (FMR)

FMR is valid for 6 months if the life to be assured is a standard life and three months in the case of sub-standard lives. Before completing a proposal it should be ensured that the FMR is valid on the basis of underwriting decision, i.e., 6 months for standard lives and 3 months for substandard lives.


5. Requirement for Fresh FMR in subsequent proposal

At present in respect of subsequent proposal a fresh FMR is required if the sum proposed under the subsequent proposal is more than Rs. 1 lac.

It has been decided that a fresh FMR in subsequent proposal will not be required if

i. actual sum assured in the fresh proposal is less than or equal to Rs. five lacs
ii. original FMR is valid as per our rules
iii. original FMR is by a doctor of sufficient limit including sum proposed under subsequent proposal.

A fresh FMR will be required if any one of the above three conditions is not satisfied.


6. Insurance taken from other insurance companies

Insurance taken from other insurance companies will not be taken into account while calculating Sum Under Consideration for the purpose of FMR (by DMR or otherwise), calling for special report, for deciding MHR limits and for determining underwriting authority. However, for financial underwriting, the maximum allowable SA eligibility will be reduced to the extent of full insurance cover taken from other insurers.


7. Ceiling on medical fees

Vide our letter dated 27th November 1992 addressed to all RMs (Actl) we had prescribed the following ceiling on the maximum amount of fees payable to medical examiners:

Class of city or town
Maximum amount of fees that can be paid in one financial year for FMRs

A

Rs. 37,500
B
Rs. 30,000
C
Rs. 25,000

Vide our circular ref. 1737/4 dated 23rd December 2000 the ceiling on number of medical examinations per medical examiner was reviewed and the maximum number of medical examinations that can be done by a medical examiner was fixed depending on the class of city or town.

The charges payable for medical examinations were revised upwards vide our circulars No. 1597/4 dated 17th December 1996 and 1874/4 dated 14th June 2003.

It is clarified that there is no upper limit on the maximum amount of fees that can be paid to a medical examiner in a financial year. However, there is no change in the maximum number of examinations laid down vide circular ref. 1737/4 dated 23rd December 2000.


8. Reimbursement for FMR and special reports

It is clarified that the total amount to be reimbursed for FMR and special reports should not exceed Rs. 4 per thousand basic sum assured excluding SA under Term Rider and critical illness.


9. Table No. 91 – New Jana Raksha

Presently under T 91 a proposal could be considered on the basis of self declaration without charging non-standard age proof extra up to a maximum SA of Rs. 50,000/-. A special proposal form 320 (JP) is used for this purpose.

It has been decided to discontinue the use of proposal form No. 320 (JP). Proposal Form No. 300 will only be used. Wherever non-standard age proof (NSAP – I or II or III) is submitted a declaration from the client, agent and Dev. Officer / ABM(S) is to be obtained in Form No. 3260 to the effect that he is not able to submit any other standard age proof. No age proof extra will be charged for NSAP-II and NSAP-III under Table No. 91 if the above declaration is satisfactory.

Vide Circular No. 1973/4 dated 6th October 2004 the maximum allowable sum assured under Table No. 91 under Non-medical (General) has been increased to Rs. 1 lac. It is clarified that under non-medical (General) to Other category for proponents with ages 46 to 50 and producing non-standard age proof the maximum allowable SA under Table No. 91 will be Rs. 50,000.


10. Table No. 103 – Jeevan Chhaya

Under this plan there is a special provision to allow a proposal under non-medical both in respect of male and female lives upto Rs. 1 lac where the child is up to one year old.

It has been decided to withdraw the above special concession. Table No. 103 will be allowed under non-medical – special and general - as per the revised guidelines for Non-medical Schemes.


11. Age Proof – Clarifications to Circular Nos. 1925/4 and 1930/4

a. Ration Card

Vide circular ref. 1925/4 dated 31st December 2003, Ration Card was included as one of the age proofs under Non-Standard Age Proof – I (NSAP-I).

It has now been decided to exclude Ration Card from NSAP-I and include the same as one of the age proofs under Non-Standard Age Proof – III with the following additional guidelines:

· Ration Cards issued originally clearly mentioning the date of issue will only be accepted as age proof under NSAP - III.

· Ration cards where date of issue is not available or non-legible or altered or Duplicate ration card / renewed ration card will not be accepted as age proof.

b. Other clarifications

Under NSAP-I the condition regarding plans involving term insurance element is revised as under:

Plans involving term insurance elements (Table Nos. 43, 52, 58, 88, 89, 103, 106, 107, 108, 121, 133, 143, 150, 160, 164 and 168) will be allowed for total aggregate rated up SA of Rs. 5 lacs.

Under NSAP-III, the special condition ‘c’ is to be deleted. Table No. 152 cannot be allowed with NSAP-III as the minimum SA under the plan is Rs. 2 lacs and maximum allowable with NSAP-III is Rs. one lac.


12. Underwriting procedure under Jeevan Anurag – Table No. 168:

The following clarifications may be noted:

Jeevan Anurag Plan will be allowed with:

i. Standard age proof – without restriction on SA

ii. Non-standard age proof - I (NSAP-I) – maximum aggregate rated up SA of Rs. 5 lakhs under Table Nos. 43, 52, 58, 88, 89, 103, 106, 107, 108, 121, 133, 143, 150, 160, 164, 168 taken together.

iii. When occupational extra is charged. The occupation extra to be charged will be one and half times (1.5 times) the extra shown in Annexure I to circular No. 1721/4 dated 19th December 2003. Clause 86 can be imposed if desired. DAB can be allowed with Clause 85.


13. Insurance to Sub-standard Minors

Vide our Circular ref. 1749//4 dated 7th April 2001 it was decided to allow Table Nos. 11 & 14 to minor lives who are considered to be 50 % overweight having EMR Class III or less.
It has now been decided to allow Table Nos. 48, 75, 93, 152, 154, 155, 156 and 157 to sub-standard minor lives attracting EMR Class III or less on account of overweight only in addition to Table No. 14.

At present the maximum policy term in respect of minor lives is restricted to 40 years. It has now been decided to delete the restriction of maximum term.


14. Revival under Table No. 102, 113 and 159

The above Plans are allowed only to standard lives. As a result revival under these plans is regretted if the life assured happens to sub-standard minor at the time of revival.

It is decided to allow revival under the above three plans to sub-standard minor lives attracting EMR on account of overweight only.


15. Table No. 52 – Mortgage Redemption – Cost of medical examination

It is clarified that under Table No. 52 the cost of medical examination will be borne by the Corporation as per rules as stated in Circular No. 1855/4 dated 17th February 2003.
Necessary correction may be carried out on page 48 of the latest Underwriting Manual under Table No. 52.


16. Passport:

In respect of illiterate proponents it is clarified that passport is accepted as standard age proof without any restrictions on maturity age / premium ceasing age.


17. Occupation Extra

The rules for charging occupation extra under the various plans are given in Circular No. 1921/4 dated 17th December 2003.

The following revisions may be noted:

Plans
Multiple to be applied to Occupation Extra given in Annexure I to Circular No. 1921/4

Table No. 133 (T 105 for revival)

3 times
Table No. 88 (T 104 for revival)
2 times
Table No. 103 & 168
(T 110 & 121 for revival)

1.5 times
All the remaining plans including term rider, CI rider and PWB

Extra shown in Annexure I

Occupation extra shown in annexure I to Circular No. 1921/4 dated 17 Dec. 2003 are in respect of policies where the premiums are payable throughout the term of the policy. The factors to be used for the purpose of calculating equivalent extra premiums where mode of payment is single premium or limited payment (Table Nos. 48, 162, 167 & 168) are given in Annexure.
It may be noted that the above factors are also to be used for calculating equivalent extra premium in respect of Standard Extras.


The above instructions come into force with effect from 1st March 2005.

Female underwriting

No comments:
Underwriting Practices

1. Underwriting relaxations to women falling under Female Category III on the occasion
of International Women’s Day

World-over 8th March is being celebrated as the International Women’s Day. Considering the importance of this day, it has been decided to allow Table Nos. 140 (Bima Plus) and 143 (Bima Nivesh Triple Cover) to women falling under Female Category III within their overall limits.

The maximum cover including cover under Table No. 140 & 143 that can be allowed to different sub-categories of Category III women is as under:

Single women – Rs. 5 lakhs

Married women – Rs. 10 lakhs

Self-employed women – Rs. 1 lakh

Widows – Upto Rs. 1 lakh at DO level (up to Rs. 2 lakhs at ZO level)


2. Bima Nivesh Triple Cover – Table No. 143

Vide Circular Ref. Actl./1939/4 dated 4th March 2004 certain relaxations have been allowed under Table No. 143.

It is clarified that the relaxations allowed vide the above circular will be applicable if:

i. all previous proposals have been accepted at standard rates

ii. no adverse health factor is revealed in the current proposal form / DGH / FMR

If the above two conditions are not satisfied or if the proposal is under mail order business from NRIs, the relaxations will not be applicable and the following underwriting rules will be made applicable:


i. Only standard age proof will be accepted.

ii. Medical examination is a must.

iii. Sum under consideration (SUC) will be the basic sum assured under the plan

iv. Previous insurance under any of the plans is not be considered while calculating sum under consideration for medical and financial underwriting

v. Special reports, if applicable, are to be called for

vi. Plan is allowed to standard lives and sub-standard lives upto EMR Class III. Sub-standard lives with EMR Class IV to VI will be allowed with reinsurance.

vii. Occupational extra if chargeable will be two times the occupational extra rates.

viii. Plan will be allowed only to physically handicapped persons falling under Group A Deformity with loss of one limb at standard rates.

ix. Plan will be allowed to women falling under Female Category III within their overall maximum limits.
Powered by Blogger.