e Marketing in General Insurance

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E-MA RKETIN G - GE NERA L INSU RANC E

INTRODUCTION

E Marketing is the Marketing side of eCommerce - company efforts to

communicate about, promote, and sell products and services over the

Internet. E-marketing is a type of marketing that can be defined as achieving

objectives through the use of electronic communications technology such as

Internet, e-mail, Ebooks, database, and mobile phone. It is a more general

term than online marketing which is limited to the use of internet technology

to attain marketing objectives.

E-mail marketing is one of the most effective ways to keep in touch with

customers. It is generally cost-effective, and if done properly, can help build

brand awareness and loyalty. At a typical cost of only a few rupees per

message, it's a bargain compared to traditional direct mail or more. In

addition, response rates on e-mail marketing are strong, depending on the

industry and format. Response rates for traditional mail averages tend to be

very low.

One of the benefits of email marketing is the demographic information thatcustomers provide when signing up for your email newsletter. Discovering

who your customers really are age, gender, income and special interests,

for example can help you target your products and services to their needs.

Effective marketing, planning and promotion begin with current information

about the marketplace. Visit your local library online, talk to customers on

toll free through & telemarketing and sms service as latest development,

study the advertising of other businesses in your community, and consult

with any relevant industry associations through internet. This interactive tool

will help to assess your e-marketing strengths and weaknesses in thedemographic area.

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Online marketing is marketing on the Internet. It is a type ofe-marketing,

which in turn is a type ofe-commerce. Internet marketing is a component of

electronic commerce. Internet marketing can include information

management, public relations, customer service, and sales. Electronic

commerce and Internet marketing have become popular as Internet access is

becoming more widely available and used. Well over one third of consumers

who have Internet access in their homes report using the Internet to make

purchases. Some of the benefits associated with Internet marketing include

the availability of information.

Consumers can log onto the Internet and learn about products, as well as

purchase them, at any hour. Companies that use Internet marketing can also

save money because of a reduced need for a sales force. Overall, Internet

marketing can help expand from a local market to both national and

international marketplaces.

E-Commerce has redefined the marketplace, altered business strategies, and

allowed global competition between local businesses. The term electronic

commerce has evolved from meaning simply electronic shopping to

representing all aspects of business and market processes enabled by the

Internet and other digital technologies.

Today's business emphasis is on e-commerce - rapid electronic interactions

enabled by the Internet and other connected computer and telephone

networks. Rapidly business transactions and unparallelled access toinformation is changing consumer behavior and expectations. Many small

businesses assume that the Internet has little value to them because they feel

that their product or service cannot be easily sold online. But inexpensive

information processing and electronic media can help most small businesses

provide better, faster customer service and communication.

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Why is insurance necessary?

The question contains the answer within itself. After all, life is fraught with

tensions and apprehensions regarding the future and what it holds for the

individual. Despite all the planning and preparation one might make, no one

can accurately guarantee or predict how or when death might result and the

circumstances that might ensue in its aftermath.

We are not saying that life and existence are constantly fraught with danger

and uncertainty. But then it is essential that you plan for the future. The

chances for a fatality or an injury to occur to the average individual may not

be particularly high but then no one can really afford to completely disregard

his or her future and what it holds.

People generally regard insurance as a scheme when and where you have tolose a lot to gain a little. Nevertheless, insurance is still the most reliable tool

an individual can use to plan for his future.

General insurance made easy for you. This is an attempt to help you

understand some basic concepts of general insurance in order to help you

identify your insurance needs and to facilitate your decision making process.

General Insurance is all about protecting / covering yourself against all kind

of insurable risks. General insurance policies, including automobile and

homeowners policies, provide payments depending on the loss from a particular financial event. General insurance typically comprises any

insurance that is not determined to be life insurance, and is called property

and casualty insurance.

The reason to provide you conceptual knowledge on general insurance

products health insurance, motor insurance, travel insurance to empower

you to take a final decision. We have touched upon topics like why you

should insure, how much insurance you need, the policies that suit you best,

points to ponder while reading the fine print, identify your insurance needs

etc are covered. This is a sincere attempt to take you through the basics andto unravel the complexities of general insurance. System whereby

individuals and companies concerned about potential hazards pay premiums

to an insurance company, which reimburses (in whole or part) them in the

event of loss. The insurer profits by investing the premiums it receives.

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IFFCO-TOKIO General Insurance (ITGI).

ITGI is Indias trusted insurance company. It simplifies customers life by

providing them tailor made products and quality services, thus helping them

take informed investment decisions.

It is a joint venture between The Indian Farmers Fertiliser Co-operative

(IFFCO) and its associates and Tokio Marine and Nichido Fire Group, the

largest listed insurance group in Japan.

ITGI was incorporated on December 4, 2000 and has its head office in

Gurgaon, Haryana.

We are among India's top three private-sector general insurance companies

with 92 offices and a country-wide network of 480 exclusive point ofpresence.

In our constant effort to provide our customers with "the life they deserve",

we offer a wide range of over 40 uniquely customized policies covering a

wide range of customers, from farmers to some of India's largest automobile

manufacturers.

We see ourselves as a "people's company"; our principal aim is to provide

benefits for the common man who traditionally lacks knowledge and access

to quality insurance products. To achieve this, we have leveraged the deepknowledge of IFFCO by studying 600 of the country's 602 districts before

drawing up our business plan.

We closely follow the rigorous global financial standards of the Millea

group, combining sound financial management with rapid growth. ITGI is

the only private general insurance company in India to have made five

consecutive years of profit. We are also one of the few to report

underwriting profits within four years of operations.

We also believe in focusing on creative solutions to provide optimum

service to our customers. We are the only company in the country to have a

100%-owned distribution channel to service our retail customers.

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INSURANCE DISTRIBUTION CHANNELS:

INTRODUCTION :-

Risks are inherent in every aspect of life. They are present in whatever we

do everyday and all businesses face the threat of losses that may neveroccur. Worrying about these possibilities hardly makes life pleasant. Of

course, it is impossible to eliminate risks - but they can be controlled,

lessened or minimized. That is exactly what risk management is all about.

We at ITGI have established a proficient risk management team to provide

customized, need-based solutions. Armed with a high level of domain

knowledge in a wide range of industry verticals, our risk management

experts identify and evaluate the risk exposures of your facility or business

to provide a comprehensive risk management solution based on your specialneeds. As a part of our value-added services, we also provide

recommendations for loss reduction and risk mitigation and continuously

update you about international best practices.

ITGI caters to almost all areas of risk management. Below is a list of some

of our mainstream services:

Underwriting survey/Loss control Survey/Risk management survey

Natural hazard risk evaluation

Business continuity planning Business interruption and interdependency risk analysis

Marine loss control surveys

Safety management

Risk assessment studies/Safety audits Consequence analysis study.

The insurance marketplace is undergoing a transformation that may

eventually lead to significant changes in how consumers purchase insurance

products. A variety of distribution channels are currently used in this market

place, and some insurers utilize a combination of distribution channels.

These include the Internet-led channels, company-led channels, bank-led

channels, and agent-led channels.

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Of these distribution channels, the most discussed and anticipated

channel is the Internet-led channel. The widespread diffusion of the Internet

has created an explosion in the growth of electronic channels, including

direct channels as electronic markets, or electronic intermediaries over

which multiple buyers and sellers do business, and other cybermediaries

.Prior to the advent of the Internet, most purchasers of insurance products

used traditional agent-led distribution channels such as direct writers or

independent agents. Given its reliance on traditional channels, the insurance

marketplace has only recently begun to reflect this broader growth in

electronic channels. The Internet was expected to have a major negative

impact on the traditional agent-led distribution channel. However,

consumers have not shown a marked preference for purchasing insurance

product via the Internet. Currently, less than two percent of insurance

products are purchased via the Internet.

Although less frequently used, company-led distribution channels

through mediums such as direct mail or telephone call centers have seen

increasing growth. While an agent is still required in this setting, this person

typically does not meet with the insured.

With the passage of the Financial Modernization Act of 1999, growth

of the bank-led channel was predicted for the U.S. market. The results of a

recent American Bank Insurance Association survey indicate that insurance

represents a very small percentage of total bank revenue, but bankers predict

an increase in marketing efforts.

While it is true that insurance purchasers today have more options available

than they did five years ago, it is unclear if and when these channels will

dominate existing insurance distribution channels. Several obvious factors

that impact on a channels adoption are consumer

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1. Insurance Distribution Channels:

ATTITUDES AND PREFERENCES

In particular, it may be that consumers consider insurance products

to be more complex than originally thought. Consumers still do not vieweven personal lines insurance products to be commodity products.

The purpose of this paper is to discuss the transitions that are

occurring in property/liability insurance distribution channels. As part of this

discussion, we describe some of the factors that are impacting on the

adoption of alternative channels (e.g., the Internet), provide an overview of

the academic literature on innovation adoption and insurance distribution

channels, and comment on the near-term future for insurance distribution

channels.

EXPECTATIONS V. REALITY

The growth of the Internet has led to a great deal of speculation and

discussion regarding its potential impact on traditional distribution channels.

For example, the meeting topic for the 2000 International Insurance Society

meeting was The Power of Leadership in the Knowledge Millennium. Part

of the focus of the presentations at that meeting was on the changing

channels of distribution. Some trade publications during that time period

included articles suggesting that insurance agents were faced with the strongpossibility of being replaced with a more efficient and less-costly Internet-

led distribution channel. The same was true for travel agents during that time

period. Interestingly, the experience of insurance agents and travel agents

has been very different.

The travel industry has indeed seen a growth of the Internet-led

distribution channel for a wide variety of travel-related purchases including

plane tickets, hotel reservations, and car rentals. Examples of cybermarkets

operating today include Expedia, Travelocity, and Orbitz. Additionally, sites

like Priceline.com allow consumers to make offers for various travelservices including airline travel. Other sites, like SkyAuction.com, create an

auction market for travel services. Finally, consumers can purchase tickets

online directly from airlines. As the Internet-led channel has grown for

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travel-related types of services, travel agents have come under increasing

pressure and airlines have reduced the commissions paid to travel agents.

2 Insurance Distribution Channels:

The experience of insurance agents has been much different. Recentfigures suggest that online sales accounts for less than 2% of total premium

volume. Although there have been some changes in the areas of

commissions and production requirements, agents continue to be the primary

distribution channel for insurance products. A recent National Underwriter

article reported the results of a survey of four insurance industry associations

(the National Association of Independent Insurers, the National Association

of Mutual Insurance Companies, the American Insurance Association, and

the Alliance of American Insurers). All four of these associations indicated

an expectation that the traditional agent-led distribution channel willcontinue to be a major distribution channel for insurers.

While the adoption rate of the Internet as a distribution channel has

been low, we have seen widespread adoption of the Internet as a support

channel. Insurers are using the Internet to provide general information on

financial services products (e.g., insurance, investments) and planning

involving the use of these products, to provide specific information on the

company and its product lines, to provide administrative support to its

policyholders, and to serve as a prospecting and communication tool for its

agent-led channel. For example, Celent Communications surveyed majorU.S. property/liability insurers regarding Internet usage. The six main usage

areas were (1) agent access to quotes, (2) agent extranet, (3) policyholder

account access, (4) customer live quotes, (5) customer quote request, and (6)

agent locator. Of these six, the two most frequently used were the agent

locator (over 60%) and the agent extranet (approximately 40%). These

results clearly indicate that for property/liability insurers, the web is being

used as an information or communication tool, as well as a prospecting tool

for insurers agents.

INNOVATION ADOPTION

To gain a better understanding of what factors tend to drive the

adoption of one channel over another, it is helpful to examine some of the

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existing literature on innovation adoption and insurance distribution

channels.

The Internet Channel

One factor that leads to the adoption of an innovation is howwidespread it is. Rogers (1995) suggests that widespread diffusion of an

innovation will lead to significant changes in the environment.

3 Insurance Distribution Channels:

MARKET CHANNELS

As noted above, we have seen widespread diffusion of the usage of

the Internet in both the travel and insurance industries; however, the

adoption patterns have been quite different.

The ability to reduce the transactions costs of interaction between

buyers and sellers has always been acknowledged as a central motivation for

the use of the web. Predictions of disintermediation and cyber mediation are

typically based on the reduced transaction costs of electronic interaction

between sellers and buyers; for example, in book retailing or online stock

trading.

Trust is another factor that drives or affects the adoption of theInternet-led channel and others examined privacy and security as it relates to

choosing an Internet channel. The widespread popularity of online stores or

online auctions provide some indication that consumers trust the channel

sufficiently to provide personal and financial information via a secure part of

the channel. Additionally, secure support channels like Paypal have been

created to provide secure payment channels for purchases.

Technological improvements alone cannot safeguard a company's digital

risks. Whether managing the risk of a computer virus, electronic theft of

confidential information or the loss of business interruption due to acomputer attack, a Total Risk Management Approach is required which

combines best in class technology, risk information and insurance.

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VEHICLE INSURANCE

INTRODUCTION:

Speed has become the essence of life in the present day economic and social

conditions. Every body wants everything fast enough to enjoy the fruits ofany labour which has been put in. In this labour man is being replaced by

machine in almost all spheres of activity. The latest is Computer trying to

replace the human brain. Though it is impossible to achieve the speed of

thought, the human efforts will always endeavor to achieve that speed.

When we talk of speed, Motor Vehicle is perhaps or sure enough, a tool used

by majority of human beings in every walk of life as aid, either to transport

himself or to transport material useful for his existence. As a means of

transport, Motor vehicle is of immense importance in respect of both the

human amenities and the commerce.

The number of vehicles on the road has been on increase and it is quite

likely that it may over-flow the capacity of the road and parking places.

Many vehicles are required to be kept in the streets at night and thus are

exposed to various risks from human elements as well as natural elements.

The number of persons holding driving license is increasing and the

employers with all the care they may take in choosing a good driver. Do get

reckless driver on their pay roll which fact comes to the knowledge onlywhen a serious accident, sometimes involving loss of life happens, and are

thus exposed to risks.

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VHEICLE INSURANCE CONTRACTS

Motor Insurance Contracts are subject to the basic principles applicable to

property and liability insurance in general, These principles are-

1) Utmost good faith: Contracts of Motor Insurance are governed by thedoctrine of utmost good faith. The doctrine imposes a legal obligation on the

proposer to disclose material facts to the Insurers. The use of proposal forms

is compulsory and the declaration clause in the form converts the common

law duty into a contractual duty of utmost good faith. The effect of this is

that the answers given in the proposal become warranties. The answers are

required to be literally true and correct. Any wrong answer, irrespective of

its materiality, will render the contract violable by Insurers.

2) Insurable Interest: This is the legal right to insure. The essentials ofinsurable interest are-

i) the existence of property exposed to loss, damage or a potential

liability:

ii) such property or liability must be the subject matter of insurance:

iii) such property or liability must be the subject matter of the property

or creation of liability and must benefit by the preservation of the

property or the absence of liability.

3) Indemnity: Insurance contract are contracts of indemnity that is to say, the

insured is placed after a loss, as far as possible, in the same position as he

was immediately before the loss. This principle ensures that the Insured does

not make a profit out of his loss.

4) Subrogation & Contribution: Subrogation is the transfer of rights from the

insured to the insurer when the loss or damage to the vehicle is caused by

negligence of another person. The Insurers exercise these rights to recover

the loss from the person responsible. Under common law subrogationoperates only after the claim is paid. A Policy condition, however, provides

for subrogation before the payment of the claim.

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Contribution arises when there is double insurance, that is, when the same

vehicle is insured under two policies. According to Policy condition the loss

is shared pro-rata between the two insurers. The Contribution condition is

specially worded in private car policies because the owner is also covered

for Third Party liability while driving cars not belonging to him.

Proximate Cause: The doctrine of proximate cause applies to Motor

insurance as to other classes of insurance. The loss or damage to the vehicle

is indemnified only if it is proximately caused by one of the insured perils.

The doctrine also applies to Third Party claims. The Third party injury or

property damage must be proximately caused by the negligence of the

insured for which he is held legally liable to pay damages.

TYPES OF MOTOR VEHICLES:

A Motor Vehicle has been defined in the Motor Vehicle Act, 1939 as a

mechanically propelled vehicle adopted for use upon road where the power

of propulsion is transmitted thereto from an external or internal source and

includes a chassis to which a body has not been attached and a trailer but

does not include a vehicle running upon fixed rails. For purpose of

insurance, Motor vehicles are classified into 3 broad categories, viz

1) Private Cars

2) Motor Cycles and Scooter

3) Commercial Vehicles.

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PRIVATE CARS: These are

a) vehicles used solely for social, domestic and pleasure purposes;

b) Cars of private type including station wagons, used for social, domestic

and pleasure purposes and for the business or professional

purposes(excluding the carriage of goods other than samples) of the insured

or used by the Insureds employees for such purposes,

c) Three wheeled cars (including cabin scooter used for private purposes)

MOTOR CYCLES:

a) Motor cycles (with or without sidecars)

b) Auto cycles or mechanically assisted pedal cycles.

c) Motor Scooters (with or without sidecars)

d) A three-wheeler invalid carriage.

COMMERCIAL VEHICLES

A) Goods carrying vehicles (own goods). These are vehicles used under aPrivate Carriers permit within the meaning of the Motor Vehicles Act,

1939. The Act defines a Private Carrier as an owner of a transport vehicle

other than a public carrier who uses the vehicles solely for the carriage of

goods which are his property or the carriage of which is necessary for the

purpose of his business not being a business of providing transport

GOODS CARRYING VEHICLES (General cartage). These are vehicles

used under a Public Carrier Permit within the meaning of the M.V. Act.

1939. The Act defines a public carrier as an owner of a transport vehicle

who transports or undertakes to transport goods or any class of goods, for

another person at any time and in any public place for hire or reward,

whether in pursuance of the terms of a contract or agreement or otherwise.

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TRAILERS: Any truck, cart carriage or other vehicle without means of self-

propulsion including agricultural implements drawn or hauled by any self

propelled vehicle.

PASSENGER CARRYING VEHICLES:

I) Buses including tourist buses:

ii) Hotel/School omnibuses.

iii) Air-line buses

PASSENGER CARRYING VEHICLES FOR HIRE:

i) Taxis or Private car type vehicles plying for public hire

ii) Private type Taxis let out on private hire direct from the Owner with or

without meters and driven by the Owner or an employee of the Owner.

iii) Private car type vehicles let out on Private Hire and driven by the Hirer

or any driver with his permission.

iv) Private car type vehicles owned by Hotels and hired by them to their

guests.

v)passenger carrying vehicles (Motorized Rickshaws).

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MISCELLANEOUS AND SPECIAL TYPES OF VEHICLES

Category D

1) Agricultural Tractors Pedestrian Controlled.

2) Trailer fitted as Cinema Film Recording and publicity vans.

3) Delivery Truck Pedestrian Controlled.

4) Trailers- Duest carts, water carts, etc .

5) Trailers Fire Brigade and Salvage Corps.

6) Plan Loader.

7) Trailers- Mobile Plant.

8) Trailers fitted as Mobile Shop and Canteen.

9) Trailers Tar spraying.

10) Trailers- Clearing and Levelling plant.

11) Traction Engine Tractors: Agriculural and Forestry spraying plant

i) Agricultural sprayer.

ii) Tar sprayers

12. Trailers towed by Tractors.

13) Lawn Mowers.

14) Cranes- Trailers and Tractors fitted with Lift apparatus.

15) Hearses

16) Ambulances.

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17) Breakdown vehicles

18) Cinema film recording and publicity vans.

19) Dispensaries.

20) Dampers.

21) Dust carts, water carts, road sweepers, etc.

22) Electric Trolleys or Tractors.

23) Fire Brigade and Salvage corps. Vehicles.

24) Footpath rollers.

25) Fork lift Trucks.

26). Mobile shops & Canteen Vehicles.

27) Mobile Surgeries & Dispensaries.

28) Refuse Carts.

29) Road Rollers

Road Sprinklers also used as Fire Fighting vehicles.

30) Traction Engine Tractors- Tractors used with one or more Angle Dozers,

bulldozers etc.

31) Cranes

I) Breakdown vehicles. II) Goods carrying vehicles.

32) Excavators.

33) Levelers

34) Site clearing and leveling plant etc.

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c) any State Transport Undertaking( for example, where such undertaking is

carried on by a State Government or any Road Transport Corporation

established under the Road Transport Corporation Act, 1950).

The above exemption is made only if a fund is established and maintained

by that authority for meeting any liability arising out of the use of any

vehicle. The fund has to be established in accordance with the Rules framed

under the Act.

Types of Motor Insurance Covers:

There are two types of cover granted under Motor Insurance. Policy A

provides Liability Cover and Policy B provides Comprehensive cover.

Third Party Policy has been withdrawn from 1

st

April 1990.

1) Policy A - Act Liability Policy provides an indemnity in respect of

legal liability for death or bodily injury to members of public or damage to

their property, compulsorily insurable under the provisions of Motor

Vehicles Act, 1988.

Limits of Liability:-

b) Policy B - Comprehensive Policy is wider cover. In addition tocovering the insureds legal liabilities to third party, both for bodily injury

and damage to property, this policy covers loss or damage to the vehicle-

&/or theft of vehicle and/or accessories whilst fitted thereon -

a) by fire, explosion, self-ignition or lightening;

b) by burglary, housebreaking or theft;

c) by riot and strike;

d) by earthquake (fire and shock damage);

e) by flood, typhoon, hurricane, storm, tempest, inundation, cyclone,

hailstorm, frost;

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f) by accidental external means;

g) by terrorist activity;

h) whilst in transit by road, rail, inland waterway, lift, elevator or air;

i) by landslide / rockslide

The Recital clause of both form of policies states-

(i) that the proposal and declaration shall be the basis of the contract of

insurance and are deemed to be incorporated therein.

(ii) that the insured has applied to the company for insurance and has paid

or agreed to pay the premium as consideration for the insurance afforded by

the policy for the period specified.

The contract is not to pay the loss to the insured but to indemnify him

against his loss.

Protection and Removal Costs:

If the motor car is disabled by reason of loss or damage coveredunder the policy, the insurer will bear reasonable cost of protectionand removal to the nearest repairers and of redelivery to the insuredbut not exceeding in all Rs. 1,500/- in respect of any accident.

Authorization for Repair

The insured may authorize repairs necessitated by damage covered under the

policy, provided that:-

(a) the estimated cost of such repairs does not exceed Rs.500/-

(b) the insurer is furnished forthwith a detailed estimate of the cost, and

(c) the insured gives the insurer every assistance to see that such repair is

necessary and the charge reasonable.

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(a) consequential loss, depreciation, wear and tear, mechanical or electrical

breakdown , failures and breakage; and

(b) damage to tyres unless the motor car is damaged at the same time when

the liability of the insurer is limited to 50% of the cost of replacement;

(c) any accidental loss or damage suffered whilst the insured or any person

driving with the knowledge and consent of the insured is under the influence

of intoxicating liquor or drug.

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FOR ONLINE RENEWAL INTIMATION OF POLICY .

ONLINE RENEWAL NOTICE SENT TO CLIENT

CLIENT AGENT DETAILS

NAME

SUB: RENEWAL OF POLICY NO: ____________

PREMIUM DETAILS

SUM INSURED

VEHICLE DETAILS

GROSS PREM.

S.TAX

NET PAYABLE PREM.

HYPOTHECATION ( IF ANY )

AUTHORISED SIGNATORY

**************************************************

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FIRE INSURANCE

GENERAL RULES AND REGULATIONS:

These rules and regulations are applicable to all sections of the Tariff.

1. POLICY

(a) Only Standard Fire and Special Perils Policy (hereinafter

referred to as Policy) with the permitted Add-on covers (as

appearing under Section VIII) if any, can be issued.

Note: - Unless otherwise specifically provided for, this tariff is

applicable to land-based properties only.

(b) The wording of the policy shall be as shown in Section II of the

Tariff.

(c) Policy (ies) should be read together with proposal forms(s),

scheduled specification, endorsements, warranties and clauses

as one contract.

(d) Policy (ies) covering Buildings and/or contents shall show

block wise separate amounts on (i) Building (ii) Machinery and

accessories (iii) Stock and Stock-in-Process and (iv) Furniture

and other contents.

(e) It is permissible to exclude Storm, Tempest, Flood and

Inundation group of perils (hereinafter referred to as STFI)and/or Riot, Strike, Malicious Damage perils (hereinafter

referred to as RSMD) at inception of the Policy only by

deleting the relevant perils from the Policy.

The deletion shall apply for the entire property in one

complex/compound/location covering the entire interest of the

Insured under one or more policy (ies) without any option for

selection. Reduction in premium rates for such deletion(s) may

be allowed as shown under the relevant sections of the Tariff.

When these perils are deleted from the scope of the policy, thegeneral exclusions shall include these perils. Terrorism cover

will be separate cover which can be granted only in conjunction

with RSMD. Terrorism will not be given in isolation without

RSMD cover. (Circular No.FT/1/2002 dtd 13/03/02)

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(f) Any risk, which has not been provided for in the Tariff, shall be

referred to the Committee for rating. Provisional rate of Rs.

2.50 per mille shall be charged in such cases for covering the

risks under Standard Fire and Special Perils Policy. No

discounts and/or agency commission shall be allowed on this

rate. For add-on covers, additional rates provided in section

VIII shall be charged.

(g) Rates shown under this tariff are minimum rates. Insures may

charge rate higher than those given under the tariff.

2. VALUED POLICY(IES)

Valued Policy (ies) can be issued only for properties whose MarketValue cannot be ascertained e.g. Curios, Works of Art,

Manuscripts, Obsolete machinery and the like subject to the

valuation certificate being submitted and found acceptable by the

insurers.

3. LONG TERM POLICIES

Policies for a period exceeding 12 months shall not be issued

except for Dwellings.

4. MID-TERM COVER

Generally, it is not permissible to grant mid-term cover for STFI

and/or RSMD perils. The following provisions shall apply, where

such covers are granted midterm:

(a) Insurers must receive specific advice from the insured

accompanied by payment of the required additional premium in

cash or by draft. This additional premium shall not be adjusted

against existing Cash deposits or debited to Bank guarantee.(b) Mid-term cover shall be granted for the entire property at one


Insured under one or more policy (ies). Insured shall not have

any option for selection.

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(c) Cover shall commence 15 days after the receipt of the

premium.

NB: Endorsement to be issued in this regard

(d) The premium rates as under shall be charged on short periodscale (as per Rule 8) on full sum insured at one


insured for the balance period i.e. up to the expiry of the policy.

5. PAYMENT OF PREMIUM

Premium shall be paid in full and shall not be accepted in

instalments or by deferred payments in any form.

N.B.:- It is not permissible to split sum insured of the same

property under various policies for different periods of insurance to

derive advantage of deferred instalments for payment of premium.

Notwithstanding the above, different policies may be issued for

stocks where circumstances necessitate issuance of such

policies.

6. MINIMUM PREMIUM

Minimum premium shall be Rs.100/- per policy except for risks

rateable under Section III and Tiny Sector Industries under

Section IV where the minimum premium shall be Rs. 50/ per

policy.

7. PARTIAL INSURANCE

It is not permissible

(a) To issue a policy covering only certain portions of a building.

Notwithstanding this, the plinth and foundations or only the

foundation of a building may be excluded.

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-do- 9 months 85% of the Annual rate

For a period

exceeding

9 months The full Annual rate

N.B.: Extension of short period policy (ies) shall not be permitted.

9. LOADING FOR KUTCHA CONSTRUCTION

Building(s) having walls and/or roofs of wooden planks/thatched

leaves and/or grass/hay of any kind/bamboo/plastic cloth/asphalt

cloth/canvas/tarpaulin and the like shall be treated as Kutcha

construction for rating.

An additional rate of Rs.4.00%o shall be charged for such

building(s) and/or contents thereof.

Note: - Temporary sheds (attached to buildings) erected during the

monsoon solely for the purpose of monsoon protection arepermitted without loading provided such sheds are not used for

storage purpose.

10. RULES FOR CANCELLATIONS

For Cancellation of insurance policy.

10.1 At the option of the insured:-

10.1.1 Retention of premium shall be at Short Period Scale for theperiod the policy has been in force, subject to the retention

of minimum premium by the Insurer.

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10.1.2 During the currency, if a policy is replaced with the same

insurer by a new annual one covering the identical property,

11. MID-TERM REVISION IN SUM INSURED:

Mid-term revision in sum insured shall be allowed as follows:

Increase in sum insured: On pro-rata basis

Decrease in sum insured: On short-period

scale.

12. ESCALATION CLAUSE:

It will be in order for Insurers to allow automatic regular increase

in the Sum Insured throughout the period of the policy in return for

an additional premium to be paid in advance. The terms and

conditions for this extension shall be as follows.

(a) The selected percentage increase shall not exceed 25% of the

Sum Insured.

(b) The additional premium, payable tin advance, will be at 50% of

the full rate, to be charged on the selected percentage increase.

(c) The Sum Insured at any point of time would be assessed after

application of the Escalation Clause.

(d) Escalation Clause will apply to policies covering Building,

Machinery and Accessories only and will not apply to policies

covering stock.

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13. FLOATER POLICY

Floater Policy (ies) can be issued for stocks at various locations

under one Sum Insured (The Standard Floater Clause I, Annexure

A shall be attached to such policies).

Note: - Unspecified location shall not be allowed.

Rating: The rate shall be the highest rate applicable to insureds

stocks at any location with a loading of 10%.

N.B.1: In case Stocks in a process block are covered under the

Floater Policy and the rate for process block is higher than the

storage rate, the process rate plus 10% loading shall

apply.

14. DECLARATION POLICIES

To take care of frequent fluctuations in stocks/stock values,

Declaration Policy(ies) can be granted subject to the following

conditions (Standard Declaration Clause J, Annexure A shall be

attached to such policies, refer page no:97):

(a) The minimum sum insured shall be Rs 1 Crore in one or more

locations and the sum insured shall not be less than Rs. 25 lakhsin at least one of these locations. It is necessary that the

declared values should approximate to this figure at sometime

during the policy year.

(b) Monthly declarations based on a) the average of the values at

risk on each day of the month or b) the highest value at risk

during the month shall be submitted by the Insured latest by the

last day of the succeeding month. If declarations are not

received within the specified period, the full sum insured under

the policy shall be deemed to have been declared.

(c) Reduction in sum insured shall not be allowed under anycircumstances.

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(d) Refund of premium on adjustment based on the

declaration/cancellation shall not exceed 50% of the total

premium. In case the total sum insured at the risk including

50% of the declared sum insured for declaration policy exceeds

Rs. 50crs, the risk will qualify for claim experience discount /

loading. (Letter no.Fire/453[591] dtd 23/05/01)

(e) The basis of value for declaration shall be the Market Value

anterior to the loss.

15. FLOATER DECLARATION POLICIES

1. Floater Declaration Policy (ies) can be issued subject to a

minimum sum insured of Rs 2 Crores and compliance with theRules for Floater and Declaration Policies respectively except that

the minimum retention shall be 80% of the annual premium.

2. Special rates under Floater Declaration policy granted for the

stocks of Central Warehousing/ State Warehousing Corporation

and Marketing Federation owned by State Govt. (Circular

No.FT/4/2001 dtd 09/02/01)

16. CLAIMS EXPERIENCE DISCOUNT/LOADING

Risks having sum insured (on buildings and contents of all blocks

in one compound of one complex in one location) above Rs.50

Crores rateable under Sectio IV, V, VI &VII of this tariff shall

attract claims experience discounts/loadings based on the incurred

claims experience of all the policies

covering the Insureds interest for the preceding 36 months

excluding the expiring policy period. (If there is any break in

insurance, available 36 months experience shall be taken into

account) as per the table given below.

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17. FIRE EXTINGUISHING APPLIANCES DISCOUNT

The discounts as per the scale given below may be granted by the

Insurers to detached or segregated (as per the Committees Building

Regulations) blocks of the risks protected by Fire Extinguishing

appliances rateable under Section III, IV, V, VI and VII of the

Tariff [except for Floater and/or Floater Declaration Policy(ies)]

subject to the following:

For Professionals:

a. Should be Graduate Engineer with 5 years experience in the Fire

Protection field or Diploma Engineer with 10 years related

experience.

b. Should have handled at least 3 projects for which proposals

submitted were approved and full discounts granted for the Fire

Protection systems by T AC or Insurance Companies.

Information in this connection should be provided to the

Insurance Company in the following format:

18. RATING OF RISKS IN MULTIPLE OCCUPANCY

INDUSTRIAL ESTATE

Risks in Multiple Occupancy Industrial Estate shall be rated Per

se. If the entire building of the Industrial Estate is insured under

one sum insured, a rate of Rs. 1.80%o shall be chargeable to

building.

19. SILENT RISK

Risks rateable under Sectio IV and V are allowed silent rates as per

the following table.The silent rates are not applicable if a risk goes

silent following a loss under the policy.

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20. Voluntary Deductibles

On receipt of application from the insured, Insurer may consider

suitable discounts for voluntary deductibles as per the scale shown

in the table below. The discounts are applicable under the

Standard Fire and Special Perils Policy as well as for the add-on

covers.

GENERAL CONDITIONS

1. THIS POLICY shall be voidable in the event of mis-

representation, mis-description or non-disclosure of any material

particular.

2. All insurances under this policy shall cease on expiry of seven

days from the date of fall or displacement of any building or part

thereof or of the whole or any part of any range of buildings or of

any structure of which such building forms part.

PROVIDED such a fall or displacement is not caused by insured

peril, loss or damage which is covered by this policy or would becovered if such building, range of buildings or structure were

insured under this policy.

Notwithstanding the above, the company subject to an express

notice being given as soon as possible but not later than seven days

of any such fall or displacement may agree to continue the insurance

subject to revised rates, terms and conditions as may be decided by it

and confirmed in writing to this effect.

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3. Under any of the following circumstances the insurance ceased

to attach as regards the property effected unless the Insured, before

the occurrence of any loss or damage, obtains the sanction of the

Company signified by endorsement upon the policy by or on behalf

of the Company:-

(a) If the trade or manufacture carried on be altered, or

if the nature of the occupation of or other circumstances affecting

the building insured or containing the insured property be

changed in such a way as to increase the risk of loss or damage

by Insured Perils.

(b) If the building insured or containing the insured

property becomes unoccupied and so remains for a period ofmore than 30 days.

(c) If the interest in the property passes from the insured

otherwise than by will or operation of law.

4. This insurance does not cover any loss or damage to property

which, at the time of the happening of such loss or damage, is

insured by or would, but for the existence of this policy, be insured

by any marine policy or policies except in respect of any excess beyond the amount which would have been payable under the

marine policy or policies had this insurance not been effected.

5. This insurance may be terminated at any time at the request of

the Insured, in which case the Company will retain the premium at

customary short period rate for the time the policy has been in force.

This insurance may also at any time be terminated at the option of

the Company, on 15days notice to that effect being given to theInsured, in which case the Company shall be liable to repay on

demand a rateable proportion of the premium for the unexpired term

from the date of the cancellation.

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6. (i) On the happening of any loss or damage, the Insured shall

forthwith give notice thereof to the Company and shall within 15

days after the loss or damage, or such further time as the Company

may in writing allow in that behalf, deliver to the Company.

(a) A claim in writing for the loss or damage containing as

particular an account as may be reasonably practicable of all the

several articles or items or property damaged or destroyed, and of

the amount of the loss or damage thereto respectively, having

regard to their value at the time of the loss or damage not

including profit of any kind.

(b)Particulars of all other insurance, if any

The Insured shall also at all times at his own expense produce,

procure and give to the Company all such further particulars,

plans, specification books, vouchers, invoices, and duplicates or

copies thereof, documents, investigation reports

(internal/external), proofs and information with respect to the

claim and the origin and cause of the loss and the circumstances

under which the loss or damage occurred, and any matter

touching the liability or the amount of the liability or the amount

of the liability of the Company as may be reasonable required byor on behalf of the Company together with a declaration on oath

or in other legal form of the truth of the claim and of any matters

connected therewith.

No claim under this policy shall be payable unless the terms of

this condition have been complied with.

(ii) In no case whatsoever shall the company be liable for any loss or

damage after the expiry of 12 months from the happening of the loss

or damage unless the claim is the subject of pending action orarbitration; it being expressly agreed and declared that if the

Company shall disclaim liability for any claim hereunder and such

claim shall not within 12 calendar months from the date of the

disclaimer have been made the subject matter of a suit in a court of

law then the claim shall for all purposes be deemed to have been

abandoned and shall not thereafter be recoverable hereunder.

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7. On the happening of loss or damage to any of the property

insured by this policy, the Company may

1. Enter and take and keep possession of the building or

premises where the loss or damage has happened.

2. Take possession of or require to be delivered to it any

property of the Insured in the building or on the premises at the

time of the loss or damage.

3. Keep possession of any such property and examine, sort,

arrange, remove or otherwise deal with the same.

The powers conferred by this condition shall be exercisable by the

Company at any time until notice in writing is given by the insured

that he makes no claim under the policy, or if any claim is made,until such claim is finally determined or withdrawn, and the

Company shall not by any act done in the exercise or purported

exercise of its powers hereunder, incur any liability to the Insured or

diminish its rights to rely upon any of the conditions of this policy in

answer to any claim.

8. If the claim be in any respect fraudulent, or if any false declaration

be made or used in support thereof or if any fraudulent means or

devices are used by the Insured or any one acting on his behalf to

obtain any benefits under the policy or if the loss or damage beoccasioned by the wilful act, or with the connivance of the Insured,

all benefits under this policy shall be forfeited.

9. If the Company at its option, reinstate or replace the property

damaged or destroyed, or any part thereof, instead of paying the

amount of the loss or damage, or joint with any other Company or

Insurer(s) in so doing the Company shall not be bound to reinstate

exactly or completely but only as circumstances permit and in

reasonably sufficient manner, and in no case shall the Company be

bound to expend more in reinstatement than it would have cost to

reinstate such property as it was at the time of the occurrence of such

loss or damage nor more than the sum insured by the Company

thereon. If the Company so elect to reinstate or replace any property

the insured shall at his own expense furnish the Company with such

plans, specification, measurements, quantities and such other

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particulars as the Company may require, and no acts done, or caused

to be done, by the Company with a view to reinstatement or

replacement shall be deemed an election by the company to reinstate

or replace.

If in any case the Company shall be unable to reinstate or repair the

property hereby insured, because of any municipal or other

regulations in force affecting the alignment of streets or the

construction of buildings or otherwise, the Company shall, in every

such case, only be liable to pay such sum as would be requisite to

reinstate or repair such property if the same could lawfully be

reinstated to its former condition.

10.If the property hereby insured shall at the breaking out of any fire or at

the commencement of any destruction of or damage to the propertyby any other peril hereby insured against be collectively of greater

value than the sum insured thereon, then the Insured shall be

considered as being his own insurer for the difference and shall bear

a rateable proportion of the loss accordingly. Every item, if more

than one, of the policy shall be separately subject to this condition.

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MEDISHIELD INSURANCE

MEANING DEFINATION & SCOPE:

The Medi-shield policy of ITGI is meant for people at large. In the time of

increasing cost of living, the expenses for medical treatment have gone up

substantially and at the same time, the population has also become

vulnerable towards contracting disease and sustaining injury due to factors

of fast life, urbanisation, stress, congestion, pollution etc. In order to

mitigate the financial hardship of the population who have to spend a larger

sum for taking any treatment, IFFCO-TOKIO General Insurance Company

Ltd. has decided to launch this cover, which can be offered to any Company,

Club, and Association for their members.

1. SCOPE OF COVER:

The Medi-shield Policy covers Hospitalisation/Domiciliary

Hospitalisation Expenses for illness, disease sustained under the

following heads of Expenses, which are reasonably and necessarily

incurred by or on behalf of Insured person:

A) Room Rent, Boarding Expenses as provided by the

Hospital/Nursing Home.

B) Nursing Expenses.

C) Surgeon, Anaesthetist Medical Practitioner, Consultants,

Specialist fees.

2. LIMIT OF LIABILITY:

The liability of the company in respect of all claims admitted during

the period of Insurance shall not exceed the Sum Insured per Insuredperson as mentioned in the Schedule.

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3. IMPORTANT DEFINITIONS:

A) Hospital/Nursing Home:

It means any institution with in India established for indoor care

and treatment of sickness, injuries and which:

a) Has been registered as a Hospital or Nursing Home with the

local authorities and Is under the supervision of a registered and

qualified Medical Practitioner.

OR

b) Should comply with minimum criteria as under:

i. It should have at least 15 in-patients Beds.

ii. Fully equipped operation theatres of its own wherever surgical

operation are carrying out.

iii. Fully qualified Nursing Staff under its employment round the clock.

iv. Fully qualified Doctor(s) should be in charge round the clock.

The requirement of operation theatre may be waived for such

establishments, which provide treatment under discipline, which do not

resort to Surgery such as Ayurvedic and Psychiatric treatment. However,

the other criteria could remain unaltered except for very emergency situationwhere the criteria of any of the criteria can be referred for claim purpose

seeing the availability of good Hospital in the nearby area with minimum

No. of beds.

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B) Surgical Operation:

It Means Manual and/or operative procedures for correction of

deformities and defects, repairs of injuries, diagnosis and cure

of diseases, relief of suffering and prolongation of life.

C) Minimum period:

Expenses on hospitalisation for a minimum period of 24 hours

are admissible. However, this limit is not applied to specific

treatment i.e. Dialysis, Chemotherapy, Radiotherapy, Eye

Surgery, Dental Surgery, Lithotripsy (Kidney stone removal),

Tonsillectomy, D&C taken in the Hospital/Nursing Home andthe Insured is discharged on the same day, the treatment will be

considered to be taken under hospitalisation Benefits. For

other treatments, where hospitalisation is less than 24 hours,

the following guidelines may be adopted:

a) The treatment should be such that it necessitates

Hospitalisation and procedure involved required specialised

infrastructure facilities which are available in the Hospital.

b b) Due to technological advances, Hospitalisation periodrequired is less than 24 hours.

D) Domiciliary Hospitalisation:

It means Medical treatment for a period exceeding three days

for such illness/disease/injury which in the normal course

would require care and treatment at a hospital/nursing home but

actually taken whilst confined at home in India under any of the

following circumstances namely:-

i. The condition of the patient is such that he/she cannot be removed to

the hospital/nursing home

Or

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ii. The patient cannot be removed to hospital/nursing Home for lack of

accommodation therein.

E) ANY ONE ILLNESS:

Any one illness will be deemed to mean continuous period ofillness and it includes relapse within 45 days from the date of

last consultation with the Hospital/Nursing Home where

treatment may have been taken. Occurrence of same illness

after a lapse of 45 days as stated above will be considered as

fresh illness for the purpose of this policy.

F) PRE-HOSPITALISATION

Relevant medical expenses incurred during period unto 30 days

prior to hospitalisation on disease/illness/injury sustained will

be considered as part of Hospitalisation claim.

G) POST-HOSPITALISATION

Relevant medical expenses incurred during period unto 60 days

after Hospitalisation on disease/illness/injury sustained will be

considered as part of Hospitalisation claim.

H) MEDICAL PRACTITIONER means a person who holds adegree/diploma of a recognised institution and is registered by

Medical Council of respective State of India. The term

Medical Practitioner would include Physician, Specialist and

Surgeon.

I) QUALIFIED NURSE means a person who holds a certificate of

a recognised Nursing Council and who is employed on

recommendations of the attending Medical Practitioner.

J) PRE-EXISTING CONDITION:

It means an injury and/or sickness and/or its symptoms which

exists when the cover incepts for the first time. Complication

arising from pre-existing disease will be considered part of pre-

existing condition.

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4. EXCLUSIONS:

The Company shall not be liable to make any payment under

this policy in respect of any expenses whatsoever incurred by any

Insured Person in connection with or in respect of:-

i. All diseases injuries which are in pre-existing condition when

the cover incepts for the first time.

ii. Any disease other than those stated in clause c) below,

contracted by the insured person during the first 30 days from the

commencement date of the policy. This exclusion shall not however,

apply if in the opinion of panel of medical practitioners constituted by

the company for the purpose, the insured person could not have

known of the existence of the disease or any symptoms or complaints

thereof at the time of making the proposal for insurance to the

company. This condition shall not however apply in case of the

insured person having been covered under this scheme or group

insurance scheme with any of the Indian insurance companies for a

continuous period of preceding 12 months without any break.

iii. During the first year of the operation of the policy, the expenses

on treatment of diseases such as Cataract, Benign ProsteticHyperthrophy, Hysterectomy for Menorrahagia or Fibromyoma,

Hernia, Hydrocele, Congenital Internal Disease, Fistulainanus, Piles,

Sinusitis and related disorders are not payable. If these diseases are

pre-existing at the time of proposal they will not be covered even

during subsequent period of renewal too.

iv. War and Nuclear Risk:

v. Circumcision unless necessary for treatment of a disease not

excluded hereunder or as may be necessitated due to an accident,

Vaccination or inoculation or change of life or cosmetic or aesthetic

treatment of any description, plastic surgery other than as may be

necessitated due to an accident or as a part of any illness.

vi. The cost of spectacles and contact lenses, hearing aids.

vii. Dental treatment or surgery of any kind unless requiring

hospitalization.

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viii. Convalescence, general debility, Run-down condition or rest

cure, congenital external disease or defects or anomalies, sterility,venereal disease, intentional self-injury and use of intoxicating

drugs/alcohol.

ix. All expenses arising out of any condition directly or indirectly

caused to or associated with Human T-Cell Lymphotropic Virus Type

III (III-LB-III) or Lymphadinopathy Associated Virus (LAV) or the

Mutants Derivative or variations Deficiency Syndrome or any

Syndrome or condition of a similar kind commonly referred to as

AIDS.

5. AGE LIMIT:

This insurance is available to persons between the age of 5 years and

80 years. Children between the age of 3 months and 5 years of age

can be covered provided one or both parents are covered concurrently.

Though persons above 75 years have to be avoided if they wantcoverage on stand-alone basis.

However, WE will grant coverage to persons above 75 years of age if

they are cases of renewals and have been covered with us for a period

of at least 3 years.

EXTENSION OF POLICY PERIOD

In case the Insured Person who is covered under Medi-shield Policy

has to go abroad for 15 days and accordingly he buys an OverseasMediclaim Policy for that 15 days and submits the proof of Overseas

MEDISHIELD Policy to the company. In that event the period of Insurance

in respect of that Insured Person will be extended by 15 days. Alternatively

if the Insured person is part of family and/or Group and the period of

Insurance is to be same for everyone in the family, then in that case the pro-

rata premium for the period when he was abroad will be available as Refund

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10.GROUP DISCOUNT:

The Group discount is permissible as per the following scale

depending upon the total number of Insured persons covered under the

Group Policy at the inception. Increase/Decrease in the size of the

Group during the currency of the Policy is permissible. The final

Group discount (Increase/Decrease) will be adjusted on the last day of

the Policy Posted provided that the Policy is renewed for the next 12

months:

Note: Minimum No. in a Group to be eligible for this Policy is 15.

However, the discount would be available if No. of persons in the

Group is 25 and above.

LOW CLAIM RATIO DISCOUNT (BONUS)

Low Claim Ratio Discount at the following scale will be allowed on

the Total premium at renewal only depending upon the incurred claims ratio

for the entire group insured under the Medi-shield Insurance Policy for thepreceding 3 completed years excluding the year immediately preceding the

date of renewal. Where the Medi-shield Insurance Policy has not been in

force for 3 completed years such shorter period of completed years

excluding the year immediately preceding the date of renewal will be taken

into account.

12.DETAILS OF INSURED PERSON:

The Insured shall be required to furnish a complete l is t of Insured

Persons in the following format according to Sum Insured. Anyaddit ions and deletions during the currency of the policy should beintimated to the Company in the same format.

13. SUM INSURED:

Minimum Rs.15,000/- with multiples of Rs. 5,000/- thereafter, with

maximum Sum Insured of Rs.5,00,000/-

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14. PAYMENT OF PREMIUM

Depending upon the age of the insured person(s) and sum insured

selected for that person,

15. MATERNITY EXPENSES BENEFIT:

This is an optional cover which can be obtained on payment of 10%

of the totalbasic premium for all the Insured Persons under the Policy.

Total basic premium means the total premium computed before

applying Medi-shield Discount and/or High Claim Ratio Loading.

Low Claim Discount and special discount in lieu of agency

commission.Option for Maternity Benefits has to be exercised at the

inception of the policy period and no refund is allowable in case of

Insureds cancellation of this option during currency of the policyThe

maximum benefit allowable under this clause will be upto Rs.50,000/-

or the Sum Insured opted by the member of the group.

EXTENSIONS UNDER MEDISHIELD POLICY

1) EDUCATION COST :

a) COVERAGE:

This Policy can be extended to cover the education cost of

the Insured Person provided tha t the Insured person i s

attending University, College or School and such Insured

person who is a student falls sick or sustains injury leading

to admission of l iabil i ty under MEDISHIELD Policy andsolely and directly as a result of such sickness or injury, the

s tude nt ( Insured Per son) is unable to c omplete the

Semester/Academic year of education he/she is pursuing

and does not get Degree/Diploma/Certificate/Promotion to

next class/ seme ste r/academic year with the r est of

classmates, then in that case WE will pay for

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e) EXCLUSIONS:

WE will not be liable for

i) Books and Reading Material.

ii) Any cost as a consequence of alteration in the courseprogramme.

iii) Any fixed cost/expenses which has already been incurred

by student in previous academic year/semester/class.

iv) Cost and expenses if such student is not insured under

MEDISHIELD of this Policy and the claim has not been

admitted there.

f) RATE: 1) Rs.100 per School going Student

c 2)Rs.200 for College going Student

CEO will have discretion to change the limit of Indemnity, Premium

rate in exceptional cases.

2) AMBULANCE CHARGES:

In case of Insured person falling sick and getting hospitalised, and the

claim having been admitted and become payable by us WE will pay

for Ambulance charges up to Rs.1000/- for Insured Person forHospitalisation. This amount is payable only if the Insured person has

been admitted following Emergency situation.

3) COST OF TRAVEL:

The Policy can be extended to cover the Cost of Travel for one of

relation of Insured Person, friend or colleague to meet the Insured

person who has been admitted in a Hospital outside the city, town or

the village where his principal place of residence is located and also

for return travel expenses for the sick Insured person. The scheme isas under:

Cost of Travel for any relation, friend, colleague or any other

nominated person: In the event of Insured person falling sick outside

the principal place of residence and claim having been admitted under

Hospitalisation and Domiciliary Hospitalisation claim, then WE

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would pay for cost of travel expenses for one of the relation, friend,

colleague of Insured person or a nominated person by the Insured

Person or his/her spouse to join him/her for both outward/return

journey. This benefit is available only if the Insured person has been

hospitalised as a consequence of emergency sickness and the trip has

been planned for professional business or holiday purpose, but not for

treatment of disease or any related disease or a consequential

complication thereof, following which the Insured person has been

hospitalised. The Maximum liability would be restricted to

Rs.15,000/- or actual expenses whichever is lower in any one period

of Insurance. The prescribed rate would be Rs.30/- per Insured person

4) COST OF SUPPORTING ITEMS:

In the event of insured person having been hospitalized and the claim

having been admitted under Hospitalization or Domiciliary

Hospitalization, a and claim becomes payable, WE would reimburse

the cost of purchase of supporting items such as Crutches, Stretcher,

tricycle, wheel chairs, Intra ocular Lens, spectacles..

5) Discounts for Reducing Pre and Post Hospitalisation Period:

The Medi-shield Policy provides for reimbursement of Pre-Hospitalisation Expenses upto 30 days and Post Hospitalisation period

upto 60 days. However, in the Policy designed by ITGI, the pre and

post Hospitalisation period can be reduced to Nil days. Accordingly

for every reduction in this Pre Hospitalisation period by 1 week, the

discount would be 0.5% of the premium and it can be done pro-rata

basis for remaining days thereof. Further for the post Hospitalisation

period, the reduction in the period by every week would entitle the

Insured to earn the discount of 1% at the rate of per week and pro-

rata of 1% for remaining days thereof. Discounts will be followed in

majority of cases, but CEO of ITGI will have discretion to change it.

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6) Hospital Daily Cash:

The Medi-shield Policy offers the Sum Insured on overall basis

without any sub limit for various Expenses nor for any limitation or

expenses on no. of days basis. However, the Policy designed by ITGI

has this flexibility that the Overall Sum Insured chosen by Insured can

be apportioned for No. of days and a Hospital daily Cash cover can be

granted. Supposing there is Sum Insured of Rs.1 lac and no. of days

is 30 days then the cover can be granted for Rs.3333/- per day. This

Policy will have same terms, conditions as that for Medi-shield Policy

CLAIM SETTLEMENT PROCEDURE:

On admission of Insured person in the Hospital, our Medical

Representative will visit the Hospital and discuss the expenses withAttendant Doctor and accordingly the claim will be settled on

agreement with sum Insured. Hospital and us without asking the bills

on the basis of our limit per day is opted by Insured.The daily limit

fixed and discount in lieu of that will be changed according to

situation at the discretion of CEO,in exceptional cases, and also the

claim settlement procedure.

7) FLOATER POLICY:

The family with coverage for every member in the family can beallowed to have a family floater i.e. for all or none basis. However for

being eligible, the minimum Sum Insured is prescribed depending

upon the No. of persons in the family.

Member Minimum Sum Insured

A family of 6 persons Rs.75, 000/-

A family of 5 persons Rs.90, 000/-

A family of 4 persons Rs.1.00 Lacs



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In this family floater, the underwriting should be done in a such way

that the average age of the Insured persons should not be more than 50

years in case of family size of 4 members and above, and 45 years in

case of people with family size of 3 and 45 years in case of family of

2 persons.

RATING FOR FLOATER POLICY:

The Premium must be taken for each individual Insured person

depending upon their age and the Sum Insured and the family floater

would be loaded on total premium for all members of the family.

Further for purpose of floater, there will not be selectivity such as in

the family of 4 persons covered under Medi-shield Policy, the floaterfamily with loading would not be applied for only 2 persons and the

remaining 2 persons can be left. It will be for all members covered

under the Medi-shield Policy.e.g. This Overall premium will be

calculated in following way. However the CEO will have the

discretion to waive this condition of minimum sum insured according

to the size of the family and allow the loading on flat basis taking into

account the average size of the group without any upper limit of

individual person.

CLAIM MANAGEMENT GUIDELINES

The following aspects are important in loading of claims under

MEDISHIELD Policy:

1) Intimation of Claim:

Preliminary Notice of claim with particulars relating to Policy

Nos., Name of Insured Person in respect of whom claim is made.

Nature of Illness/Injury and Name and address of the attending

Medical Practitioner/Hospital/Nursing Home should be given bythe Insured Person to the company with in 7 days from the date of

Hospitalization/Domiciliary Hospitalization. .Final claim along

with receipted Bills/Cash Memos, Claim form and list of

documents as listed in the Claim form should be submitted to the

company within 30 days from the date of completion of treatment.

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2) Processing of Claims:

The following supporting documents are required for the purpose of

scrutiny:

A) Hospitalization Claims

I. Duly completed claim form.

II. Bills, receipts and discharge certificate/card from the hospital.

III. Cash memos from the hospital/chemist(s), supported by proper

prescription.

IV. Receipt and Pathological test reports from a Pathologist supported by

the note from the attending medical Practitioner/Surgeon demanding

such pathological tests.

V. Surgeons certificate stating nature of operation performed andsurgeons bill and receipt.

VI. Attending doctors Consultants/Specialists/Anaesthetists etc. bill and

receipt is fully cured.

B) Domiciliary Hospitalization Claims

In case of domiciliary Hospitalization Claims, apart from I) to iv) and

vi) as shown above the following documents is also required:-

Certificate from the attending Medical Practitioner, giving reasonslike severity of disease, for allowing treatment at home. To confirm

whether Domiciliary Hospitalization as in fact required. Similarly,

clinical nothings contained in the certificate is to be verified.

The above documents are normally required to be submitted within 15

days of completion of the treatment.

3) The policy is subject to following time limits:

a) Pre-Hospitalization : 30 daysb) Post-Hospitalization : 60 days

Where recurrence of same disease is within 45 days the 60 days limit

will apply overall

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4) The following issues may be specially looked into:

a) Family doctors frequent visits to the hospital.

b) That claim does not fall within waiting period and first year exclusion.

c) That continuity of the cover has been maintained.

d) That the Hospital/Nursing home should conform to requirement of the

policy.

e) That the disease for which claim has been made is not excluded under

the policy.

f) In case, previous medical history is not shown on discharge

card/narrative/discharge summary of the hospital/admission papers of

the hospital should be called for after taking authority letter from the

insured.

g) Enquiries with family physician of the claimant to ensure that claim

are not in respect of pre-existing disease for which he was consultedearlier.

h) Period of treatment in case of Domiciliary Hospitalization Claim since

company is liable only if period of treatment exceeds three days.

i) That all cash memos for purchase of medicines are in conformity with

the prescription of attending medical practitioner/surgeon during the

period of treatment.

j) That all bills of the hospital are supported by corresponding receipts.

k) That figures and/or dates of purchase in the cash memos are not

altered by way of eraser super imposition of writing or added writing

with a different ink.

l) That admission to hospital is not for routine check up.

m) That treatment taken is in line with nature of disease.

n) Those pathological reports are submitted in case of operation.

o) That hospitalization and domiciliary hospitalization benefit is not

clubbed together.

In case of death of insured after having incurred medical expenses the

amount of admissible claim should be reimbursed to legal representative of

the deceased or any other insured family member submitting original billscash memos etc. after obtaining proper declaration by that person to the

effect that the person claiming reimbursement of expenses actually incurred

such expenses for the treatment of the insured person.

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5) On account Payment MEDISHIELD Policy:

In exceptional circumstances where the claim is in respect of major diseases

on account of payment up to 80% of the expenses/eligible amount whicheveris lower may .

6) Panel Doctors:

a) In case of difference of opinion between claimants doctor and

companys panel doctor which can not be resolved should be referred

to a specialist for decision.

b) Where suspicions are aroused in relation to disease allegedly suffered

linked to pre-existing condition, such claims may be referred to a

doctor for investigation from panel maintained by regional office.

Reference to panel doctor/referee for investigation should not be made

in routine but selectively on merits.

c) To ensure that panel doctors opinion is conclusive.

7) Claims Minimisation:

a) For frequent claims and for the same ailment consideration may begiven whether to renew or otherwise. Underwriting department and

R.O. should be kept informed.

b) In case of claim under group MEDISHIELD Policy, employees record

should be verified to ensure that he has taken leave for the period for

which he is claiming.

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Policy has 12 sections which appear in the risk screen as under

POLICY IN THE POLISY 400 SYSTEM

Enter Issue

CLIENTALE CRM

Two major aspects of marketing are the recruitment of new customers

(acquisition) and the retention and expansion of relationships with existingcustomers (customer base management or customer relationship

management).

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Contract Header Screen

Risk Screen

EnterF6

Cover Screen

Additional Cover

Screen


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GENERAL INSURANCE

NEW CUSTOMER EXISTING CUSTOMERCUSTOMERGUIDELINES

e.g. new policy e.g. renewal of insurance e.g.various products motor fire ,medclaim etc.

FLOW CHART WITH GUIDELINES

E-METHODS OF SERVICES:

The website serves the e-method for all the customer and service to beprovided and the others so on: as under:

Accountability. Credibility. Authenticity. These are the hallmarks of

effective Customer Service the website servers. In a world of rapidly-

evolving technology, the hallmarks desperately need an update. It is

important to show how the best in the business keep their customers happy

and, more importantly, coming back for more.As soon as the customer types

the site of ITGI which is as under (www.itgi.co.in )

The website opens and theskip intro is to be clicked to know the ITGI.

The web page is designed as to on the right hand side displays the WHATS

NEW? Product. The below that the display for those is mentioned if U R IN

HURRY THEN CLICK Leave your name and number and we will contact

you. And submit button is displayed. The products update and manual

guidelines as explained above is available on the website and all

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http://www.itgi.co.in/http://www.itgi.co.in/


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downloadable information is been placed on the website so as to meet the

customer requirements. Newsletter gives all the necessary details on the site

with latest updates. New customer can go through all the website and choose

for an product such as to fit his needs , the premium payment amt . Can be

obtained by him through quotes emailed to the client by the company

according the type of cover been selected by the client and the payment to be

made particular mode is been intimated. The client can pay through his bank

account or through credit/debit card etc.after filling all the necessary details

and gets the insurance policy document. Thus the website serves a boon to

E-marketing process

E-RENEWALS:

E-Renewal is a secure, Web-based process that allows registrants, licensees,

or companies to renew products or licenses in multiple states with a single

transaction.

E-Renewal Products

The Network offers three E-Renewal programs:

Product

Renewals

Motor Products - includes submission of labels and other

documents.

Business

productsFIRE, MARINE , BURGLARY , ALL RISKS ETC.

Individual

productsIndividual mediclaim , personal accident , etc.

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http://www.krsnetwork.com/eRenewals/default.asp?aud=12&tab=prhttp://www.krsnetwork.com/eRenewals/default.asp?aud=12&tab=prhttp://www.krsnetwork.com/eRenewals/default.asp?aud=12&tab=bushttp://www.krsnetwork.com/eRenewals/default.asp?aud=12&tab=bushttp://www.krsnetwork.com/eRenewals/default.asp?aud=12&tab=indhttp://www.krsnetwork.com/eRenewals/default.asp?aud=12&tab=indhttp://www.krsnetwork.com/eRenewals/default.asp?aud=12&tab=prhttp://www.krsnetwork.com/eRenewals/default.asp?aud=12&tab=prhttp://www.krsnetwork.com/eRenewals/default.asp?aud=12&tab=bushttp://www.krsnetwork.com/eRenewals/default.asp?aud=12&tab=bushttp://www.krsnetwork.com/eRenewals/default.asp?aud=12&tab=indhttp://www.krsnetwork.com/eRenewals/default.asp?aud=12&tab=ind


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Payment

Secured transactions.

You may pay by check or credit card

A convenience fee (which may vary by state) may be charged for

the electronic renewal of registrations or licenses.

Accessing This Service

Contact the Networkto obtain a User Name and Password.

Logon to www.itgi.co.in

Forgot your User Name or Password?

Send us an e-mail containing your company name and license number.

[email protected]

THE TOLL FREE NUBMER SERVICE:

THE TOLL FREE NUMBER SERVICE TO THE CUSTOMER IS

PROVIDED AS UNDER.ENABLES THE CUSTOMER TO ENQUIRE

ABOUT THE POLICY STATUS,RENEWAL DATE , PRODUCT

INFORMATION, HEALTH SERVICES INFORMATION ETC.AT JUST

CLICK AND DIAL METHOD Toll free of itgi is : Call us at our TOLL

FREE 1800-345-3303

Toll-free numbers are very common and have proven successful for

businesses, particularly in the areas of customer service and telemarketing.Toll-free service provides potential customers and others with a free and

convenient way to contact businesses.

Toll free numbers work very easily. First, you would select a toll free service

provider. During the application process, you would need to select a "ring

to" number. A "ring to" number is the phone number you would like your

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mailto:[email protected]:[email protected]:[email protected]:[email protected]


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toll free service to ri

Documents

e Marketing in General Insurance