Chapter 3: South African specific products Flashcards
List the different individual life insurance product types: (5)
- Risk products
- Investment products
- Universal life products
- Annuity products
- Conventional with-profits products
Define Risk Products:
Risk products (or protection products) are products that provide mainly risk cover. This implies that benefits are provided in the case of a life event, such as death disability or critical illness.
The following aspects of a policy may vary from one policyholder to the next: (7)
- Term of the policy
- Choice of disability and critical illness benefits
- Standalone or accelerator benefits
- Premium frequency
- Premium paying pattern with level or increasing premiums
- Level of cover
- Future cover option
The risk to the company (of risk products in general):
- Pricing of the events covered.
- Risk of anti-selection
- Selective withdrawals
- Reputational risk
The following are ways to mitigate the risks to the company: (7)
- Underwriting
- Waiting preiods
- Premiums are often only guaranteed for a limited number of years, after which the insurer can revise the rates
- In general, age limits are applied to the various benefits
- Clear disclosure, to mitigate reputational risk
- Reinsurance
- Retention incentives, for example cash back benefits
Critical illness benefits
The benefit under a critical illness policy is typically a lump sum that is payable if the policyholder suffers one of the defined conditions.
The product may also be structured to provide regular income.
The critical illness benefit may be payable in any of the following ways:
- Upon the happening of an event, independent of the extent.
- On reaching a defined degree of impairment.
- On undergoing a surgical procedure
There are four characteristics of an illness or condition that make it appropriate for inclusion in a critical illness product: (4)
- It is a condition perceived by the public to be serious and to occur frequently.
- Each condition covered can be defined clearly so that there is no ambiguity at claim stage.
- Sufficient data is available to price the benefit.
- There is ability to avoid anti-selection.
List the four major diseases covered by SCIDEP: (4)
- Cancer
- Heart attack
- Coronary artery bypass graft (CABG)
- Stroke
From the policyholder’s perspective, a variety of needs are met by a critical illness policy: (6)
- Income can be provided from the lump sum via the purchase of an annuity when the individual cannot work as a result of his/her critical illness.
- Medical costs can be funded when the critical illness requires surgery or other expensive treatment.
- The benefit can be be designed to repay a mortgage or other loan when the policyholder’s health is in question following the diagnosis of critical illness.
- Business partners can purchase critical illness policies on the lives of each other such that the benefits will fund the buyout of the stake in the partnership.
- It can meet needs such as recuperation after illness, taxation planning, and medical aids.
- A change in lifestyle can be funded where it is necessary to improve the claimant’s health, for example, moving to a less stressful (and lower-paying) job following a heart attack.
Permanent disability cover:
Permanent disability cover complements critical illness cover, despite the different nature of the criteria for payment.
For permanent disability benefits, there are three main definition types: (3)
- Occupation based
- Related to activities of daily living (ADLs) and activities of daily working (ADWs) as claim criteria
- Referring to functional impairment and physical impairment.
Definitions of activities of daily living (ADLs), as per SCIDEP, include: (6)
- Feeding
- Dressing
- Washing
- Toileting
- Mobility
- Transfer
Income protection (IP):
The aim of an income protection product is to replace part of the income that an insured would have earned if he/she becomes unable to work due to accident or illness.
The product there pays a benefit in the form of a regular income, usually on a monthly basis, during the period of incapacity.
Risks to the company of IP products: (4)
- Morbidity risk - there is a risk of greater than expected claims.
- The administration, underwriting, and claims management are typically more complex than for other life insurance products.
- Claims assessment is difficult due to non objective criteria for claims.
- There is also a risk of moral hazard.