Classes of Insurance

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CONTENTS
PAGE
Learning Outcomes
An overview
Differences
between
general
insurance and life assurance
Classes of insurance
Compulsory classes of insurance
Common
Policy
Terms
and
Conditions
Chapter summary
Test your understanding
Suggested Answers

Learning Objectives
After studying this chapter you should be able to;

Differentiate between general insurance & Life Assurance

List the classes of insurance; scope of cover and their key exclusions

List the compulsory classes of insurance

Explain the key policy terms and conditions

Introduction
Insurance is classified into two major classes namely: General/Non Life
Insurance and Life Assurance.
In this chapter we shall differentiate between general insurance & Life
Assurance; review the scope of cover under the different classes of
insurance; compulsory classes of insurance and common policy terms and
conditions.
Various classes of insurance have continued to be developed in response to
societys needs and in this chapter we shall look at the main classes of
insurance offered in the Uganda Insurance market.

Differences between General/Non Life Insurance & Life assurance

General insurance policies are term policies which are renewed

annually that is period of cover is usually up to 12 months unlike life
assurances which are over 5 years.
Claims are usually in the very near future, e.g. car, household effects
and so on unlike in life where claims are made after some long time
say after 5 years with the exception of natural death that can occur
anytime after the inception of the policy
General Insurance might pay out which is not the case with life
assurance. Claim materializing is a must either at the occurrence of
the insured event or policy maturity.
It is concerned with property and liability insurances while life
assurance, it is concerned with life.

Categorization of General Insurance

1. Property Insurances. Examples: Fire and Related Perils; Theft (All
Risks; Money; Goods in Transit etc); Contractors All Risks;
Engineering; Domestic Package etc
2. Liability- Public Liability; Product Liability; Professional Indemnity;
Employers Liability; Workers Compensation
3. Guarantee
Insurances-Bonds
(
Performance;
Bid/Tender;
Immigration/Security Bond; Court Bond; Warehouse bonds
4. Transport Insurance- Motor Insurance ( Act Only; Third Party Only;
Third Party/Fire/Theft; Comprehensive); Marine and Aviation
insurances
5. Accident- Personal
Insurances

Accident;

Workers

Compensation;

Health

Categorization of Life Assurance

1. Ordinary
Life
Assurance-(
Endowment/Whole Life Assurance)

Term/

Endowment/Pure

2. Industrial/Group Life Assurances- Retirement Benefits Schemes;

Group Life and Annuities/ Investment Policies such as Unit linked/
Bonds Investments

Property Insurances
1. Fire and related perils (material damage)
Currently this class of insurance is yet to be embraced especially
among the private individual clients save for the few
organizations.
A Fire & Special perils policy provides insurance cover against the following
perils:Fire -is the actual ignition of something that should not be on fire, the
cause being accidental or fortuitous .There are exclusions under this peril,
however.
Lightening -Any loss caused by lightning is covered under fire policy
Explosions -of boilers or gases used for commercial purposes for example
oxy-acetylene gas used for welding..
This is in sharp contrast to the Standard Fire Policy which covers above to a
limited scope.
Special Perils

Chemical Perils: For example explosion, spontaneous ignition or

fermentation.

Natural Perils:- For example earthquakes, bush fire, tempest, storm,

flood, cyclone, typhoon e.t.c

Social perils:- perils arising as a result of communal living for

example riot, strike and civil commotion, malicious damages e.t.c.

Miscellaneous perils: For example sprinkler leakage, impact, aircraft

damages, bursting or overflowing of water tanks, etc.

Business Interruption Insurance

Many companies refer to business interruptions as consequential loss
or profit interruption policy. It is offered to protect future earnings of
an enterprise after fire damage. The fire and related perils policy
(material damage) covers a building and its contents. Loss of drifts
occasioned by fire or any other peril insured is not covered under the
material damage policy. It is covered under the business interruption
policy. The perils under the business interruption policy are the same
as those covered under the material damage policy, however
Long Term Agreements under Fire Policies

 Discount is given where the insured agrees to offer to renew a policy

for a term of three or five years and signs an agreement to that effect.
The insured is under obligation each year to renew the policy.
Policy Conditions

Policy conditions associated with fire policies are divided into general
and claims related. General conditions make the policy voidable if they
are not complied with and main ones are;

Any alteration to the risk

Warranties or undertakings to complied with

Reasonable care/precaution

Claims conditions are; Immediate notification in the event of a loss or

police notification

Fraud when proved will forfeit benefits under the policy

Reinstatement of sum insured

Insurers rights to follow claim and take possession.

Contribution where more than two policies cover same property, same
period, same insured and all are contracts of indemnity.

Average applies where underinsurance exists.

Subrogation rights the insured passes to insurer when claim has been
paid

Arbitration to resolve disputes arising from the policy.

2. Home insurance or Domestic Insurance Package

This class of insurance is subdivided into 5 sections as indicated below
Buildings and / or contents cover

People often use the terms "home insurance" or "household insurance"

in a general way to refer to insurance that covers any aspect of their
home and belongings. However, these policies are usually split into
separate sections - "buildings" and "contents" - and not all
policyholders will be covered under both sections. It is also possible to
buy a "contents-only" or a "buildings-only" policy.
While many homeowners buy both types of cover, some have only one.
There may be a very good reason for this. Typically, for example,
people who live in blocks of flats will only need to buy a policy to cover
their contents. This is because the landlord will be responsible for
arranging buildings insurance to cover the entire block. And some
policyholders obtain contents insurance from one insurer and

buildings insurance from another, because this may work out cheaper
than insuring both contents and buildings together.
Even if a policyholder has both contents and buildings insurance, the
scope of cover may vary so that, for example, an accidental damage
claim might succeed under one section but not under the other. the
needs and resources of their policyholders and that the policyholders
understand what they are buying.
buildings insurance covers the structure of the building, plus
permanent "fixtures and fittings" such as baths, fitted kitchens etc.
The test is - can it reasonably be removed and taken to another homeIf it can, then it is part of the "contents" and it will not generally be
covered by a buildings policy. Buildings policies usually include
outbuildings - garages, garden sheds etc.
contents insurance covers your possessions - your television set,
furniture, clothes etc. In other words, just about everything you would
take with you if you moved.

All Risks Section

Sudden and accidental direct physical destruction of or damage to the

property or theft whilst on the Insureds premises directly and wholly
attributable to any cause, such as fire, lightning, explosion, typhoon,
flood, breakage, etc., except as hereinafter provided, occurring during
the currency of the policy.

Liability Section

Bodily Injury and Property Damage Liability and related legal

expenses The Insurer will pay those sums that the Insured becomes
legally obligated to pay as damages because of bodily injury or
property damage to which this insurance applies.

Workers Compensation Act

Employers are legally obligated to take reasonable care to assure that

their workplaces are safe. Nevertheless, accidents happen. Workers
compensation insurance serves two purposes: It assures that injured
workers get medical care and compensation for a portion of the
income they lose while they are unable to return to work and it
usually protects employers from lawsuits by workers injured while
working.

Here this cover is limited to domestic servants such as house helpers;

gardeners and in case of death, the maximum compensation is 5years
earnings or 60 months as per the Workers Compensation Act 2000.

Workers receive benefits regardless of who was at fault in the

accident. If a worker is killed while working, workers compensation
provides death benefits for the workers dependents.

Accident Classes of Insurance

1. Theft Insurance

Covers items that is lost destroyed or damaged by Burglary or

Housebreaking or robbery (theft following upon an actual forcible and
violent entry of or exit from the premises by the person or persons
committing such theft) or Hold-up (Forcible removal by actual or
threatened violence against the insured or employee(s) of the Insured);

Any damage caused to premises resulting from burglary and/ or

housebreaking or any attempt threat, any time during policy period.

2. All Risks Policy

Sudden and accidental direct physical destruction of or damage to the

property or theft whilst on the Insureds premises directly and wholly
attributable to any cause, such as fire, lightning, explosion, typhoon,
flood, breakage, etc., except as hereinafter provided, occurring during
the currency of the policy.
Widest cover but has following exclusions;
Wear, tear, gradual deterioration, atmospheric conditions, vermin,
insects etc
Mechanical or electrical breakdown or derangement unless caused by
accidental external means
Breakage of glass and other brittle items unless caused by theft
Money and related items
Theft from motor vehicles unless property is contained in a locked
boot or locked locker forming an integral part of the vehicle.
Some item require valuation to be insured.

3. Money Insurance

Money Insurance policy provides cover for loss of money in transit

between the insured's premises and bank or post office, or other
specified places occasioned by robbery, theft or any other fortuitous
cause.

The policy also covers loss by burglary or housebreaking whilst money

is retained at Insured's premises in safe(s) or strong room.

Loss of money to include cash, bank and currency notes, cheques,

postal orders etc.

Extended to cover loss of money in hands of senior officials or at their

residence

Policy issued on transit basis or annual carry

Key Clause Warrant that insurer is not liable for loss from safe/strong
room opened by a key which has been left on the insureds premises
whilst closed for business

Escort Warranty stipulates amount to be carried with or without

armed guard

Exclusions include loss from fraud by employees discovered within 3

days, shortages due to error and omission, loss of money from strong
rooms due to use of a key, loss of money from unattended vehicles
and loss outside the geographical limits.

Plate Glass Insurance

Provides all risks cover to accidental breakages to fixed glass windows

etc.
Claim payment is based on current replacement of the glass
Exclusions include;
Any damage to frames
Costs of removal or replacement of any fittings or fixtures
Damage by fire or explosion.

Contractors All Risk

Contractors all risks insurance provides all risks cover in respect
of both temporary and permanent work in the course of their
construction. Cover also includes

Contract works (permanent and temporary works forming part of the

contract)
Removable of debris
Professional Fees
Free issue materials
Construction Equipment (Site offices, storage sheds, silos, scaffolding,
utilities etc)
Construction machinery (earthmoving equipment, cranes, site
vehicles)
Principals existing property Third party liability: Bodily injury &
Property Damage

Goods in Transit

Covering against all risk of loss and/or damage to the insured

goods whilst in transit by road and/or rail.
All risks cover on damage to insured goods by fire, theft and
accidental damage while in transit, loaded or unloaded from any
road train or temporary house.
Cover can be insured on basis of single transit, individual vehicle
and declaration.
Single transit is issued on short period basis and cover expires
when goods reach destination.
Individual basis is as above
Declaration basis is for many consignments. Insured declare
expected annual carrying; premium is a provisional and adjusted at
year end.

Exclusions are;
Loss or damage due to delay , loss of market, or any consequent
loss
Loss to money and other treasury notes, precious metal, watches
dangerous goods, livestock
Loss/damage fro wear and tear, depreciation or defects in goods
insured
Loss due to theft or pilferage by employees
Loss or damage due to confiscation by the state.

Engineering Insurances

The engineering insurance cover is intended to provide

compensation the insured in event of an insured plant being
damaged by an extraneous cause or through its own breakdown.
Under engineering insurance, the plant insured is grouped into six
headings:
Boilers and pressure plant for example, steam boilers. Steam
receivers, economisers and other pressure vessels, these are
covered under the boiler explosion policy.
Engine plant, for example steam engine ,gas and oil engines and
other plants subject to mechanical breakdown
Electrical plant, for example electric motors, generators,
transformers and all kinds of electrical equipment either rotating
plant or stationery plant.
Lifting machinery for example cranes of all types, tractors and
passengers, goods and service lifts. These items are insured under
crane policy or lift policy.
Miscellaneous plant, for example steam turbines and refrigerators
plant
Computers are covered under computer insurance policies.

Liability Insurance
Liability Public liability insurance will protect your business if you cause an
injury to a member of the public, or property belonging to another business
or individual.
You should consider taking out public liability insurance if members of the
public visit you at your place of work, or if you perform work at places of
work owned by third parties. There are several types of liability insurances
and some of these include:
Public Liability

A public liability insurance policy will protect your business from

claims made by third parties for injuries to the person, or damage to
property caused as a result of your business activities.
A typical policy will pay for the cost of putting right any damage, or
medical fees in the case of injuries. It will also cover the potentially

crippling costs of legally representing your business, related expenses,

and any damages your business is found to owe in relation to a claim.
Public liability insurance does not cover claims made by any of your
employees.
You are legally required to have this cover in place if you employ
anyone, and the penalties for failing to comply are severe.

Examples of public liability insurance claims

To help illustrate how public liability insurance works in practice, here are
some classic scenarios where public liability cover will protect your
business:

An electrician re-wires a building as part of a general refurbishment.

He doesnt fit the fuse box correctly, resulting in several circuits
getting burnt out.

You own a shop. One of your customers trips over some boxes of stock
you carelessly left in an aisle. The policy will cover the costs of treating
the injury caused to the customer.

Product Liability Insurance

Product liability insurance protects companies in the event that the

products they have manufactured injure someone or cause property
damage. In law suits, product liability insurance shields claims or
product defects of any nature. If you manufacture products to sell to
the public it is a good idea to get product liability insurance so you
can avoid unpleasant situations like a lawsuit that could possibly put
you into bankruptcy or cause you to go out of business.

Others covered include: losses or damages during testing,

supplying, altering or servicing such manufactured products.

Professional Indemnity

Professional indemnity insurance covers the cost of compensating

clients for loss or damage resulting from negligent services or advice
provided by a business or an individual.

If you offer your knowledge, skills or advice as part of your profession

either as a self-employed individual or for a company you should
consider taking out professional indemnity insurance.

Some professions are required to have professional indemnity

insurance by their professional bodies or regulators these include:
solicitors; Accountants, Architects; Medical practioneers; Insurance
brokers etc

Professional indemnity insurance protects you against claims for loss

or damage made by clients or third parties as a result of the impact

of negligent services you provided or negligent advice you offered.

Compensation claims can be brought against you even if you provided
a service or offered advice for free.
Employers Liability

The policy protects the insured against legal liability to pay

compensation, claimants costs and expenses in respect of bodily
injury sustained by employees arising out of, and in the course of the
employment.
Here, this caters for cases where an employees feels that the employer
was negligent much as one would have been compensated under the
workers compensation policy.

Workers Compensation

According to the Workers Act it is a statutory obligation for every

employer to compensate employees who sustain bodily injury by
accident or disease arising out of and in course of their employment.

Cover attaches from the time an employee sets off from home directly
to work, during the course of work and while travelling directly back
home until the employee reaches home.

Policy also covers employees when upcountry/out of station on official

duty

Policy covers employees only while in Uganda (Now modified to include

all other countries)

Natural diseases (malaria, headaches, stomachaches, fever etc) are

not covered unless they are as a result of an occupational disease
(Ref: 54 scheduled diseases)

Others benefits include: Death, Permanent disability; Temporary total

disability and medical expenses

The Act does not compel employers to insure but to compensate which
therefore leaves the employer with two options: Either: to retain the
risk and pay from their resources the amount of compensation or to
transfer the risk to an insurance company which option most
employers choose.

Group Personal Accident

Scope of cover similar to Workers Compensation

Optional to Workers Compensation but needs to satisfy the

requirements of the Workers Act (i.e. Benefit for Death/Permanent
Incapacity should be 5 years earnings plus cover for the 54 scheduled
diseases)

Capital Sum Insured can be based on employees earnings or fixed

Cover is on 24 Hour basis (both at work and at leisure) unlike

Workers Compensation which covers employees only whilst on duty

Cover is on worldwide basis unlike Workers Compensation which is

country specific

Policy is recommended for permanent employees from supervisory

roles upwards

Benefits:

Death- 60 months earnings/5 years earnings

Total Permanent Disablement (Unable to engage in any gainful
employment) -60 months earnings/5 years earnings
Partial Permanent Disablement (Not able to attend to a substantial
part of ones work permanently) - %-ages of 60 months earnings as set
out in the Act
Temporary Total Disablement (unable to attend to work temporarily)
actual weekly earnings up to 96 months
Temporary Partial Disablement (unable to attend to a substantial part
of work) percentages of actual weekly earnings up to 96 months
Medical expenses including hospitalization Limit agreed to per
employee
Funeral Expenses limit agreed to per employee
Transport and Incidental costs limit agreed to per employee
Artificial Appliances limit agreed to per employee
Evacuation costs limit agreed to per employee

Health Insurance

This policy covers the cost of treatment for illness and other medical
conditions. It covers doctors, surgeons and anaesthetist fees, hospital
bed charges, drugs and dressings, diagnostic procedures such as xrays, cost of theatre and nursing costs etc.

Guarantee Insurance

These are policies which cover the failure of a party to perform a particular
task or breach of trust.
Fidelity Guarantee

The policy covers the employer in respect of any direct financial loss
which he may suffer as a result of employees dishonesty.

Covers infidelity of employees/staff (theft of cash/stocks belonging to

the insured by employees/staff)

Cover can be arranged on individual (named) basis or blanket basis

Bonds Insurance
There are several classes under this sub category and these include;

Performance bond

Performance bonds are used when a contractor fails to complete

contractual work

Bid / Tender bond

Bid or tender bonds ate used when the cost of new tendering has to be
incurred, should the highest bidder fail to take up an offer

Immigration / security bonds

Immigration or security bonds are issued to non citizens whose

conduct the insurer guarantees. Should one fail to be of good conduct,
the insurance company undertakes to pay the costs of deportation /
or the consequences of his/ her bad conduct.

Court bonds given to administer estate

Customs bonds given as a guarantee to pay customs duty
Warehouse bond given as a guarantee to pay taxes for goods in the
warehouses

Transport Insurances
Motor Insurance
Act Only
Act only is the minimum cover required by the insurance (motor
vehicle Third party Risks) Act 1989.
Third party only/ Enhanced Third Party
A third party is any person outside the insurance contract. This level
of insurance covers the insureds legal liability towards third parties
arising out of the use of a motor vehicle. Such cover is wider than the
act only cover in that liability for property damage, as well as for the
death and injury is included.
Third party, Fire and Theft
In addition to the full third party cover, the third party, fire and theft
level of insurance cover includes loss or damage arising from fire or
theft butt only to the insured vehicle.
Comprehensive Cover
The comprehensive insurance level provides very wide cover. The term
comprehensive is somehow misleading, however; though it implies
that every conceivable risk is covered, this is not the case under

comprehensive policies. In addition for full third party ,fire and theft
cover, it covers own damage and also malicious damage.
The most commonly known are Private Cars, Commercial Vehicle and
Motor Cycle
Private Cars
Private Car policies are have restrictions to use as follows;
Social, domestic and pleasure purposes
Used by insured or representative on business
Carriage of goods for hire and reward
Usually confined to small cars used in a business
Commercial Vehicles

Used for transportation of Goods and services and people and other
commercial activities.

Commercial vehicle Insurance offered to goods carrying vehicles buses

and taxis used for transportation of goods and passengers for
commercial purposes.

Motor Insurance (internal and external) offered to companies involved

in selling or repairing motor vehicles. (expand)

Agricultural and Forestry Vehicles Insurance which are normally

restricted to moving in agricultural land. They may be exempt from
compulsory insurance because they are rarely used on public roads,
except from one part to another.

Special Types are used for specialized activities like construction ie

cranes, or medical services like ambulances fire engines etc.

Motor Cycles

Should be mechanically propelled and includes scooters and moppets

Basic cover is same as private car with the following differences;
Theft of accessories and spare parts only covered if the MC is stolen at
the same time.
No additional benefits like personal accident or medical expenses are
normally offered
Accessories and spare parts are covered only while on machine

COMESA Yellow Card

Initiated by UNCTAD in 1976 for CEMESA countries as a scheme for

Africa
COMESA replaced PTA countries and established in 1994.

Idea was to promote regional integration through trade and human

resource.
Purpose was to allow motorists passage through member countries by
producing a yellow card as a proof of minimum TP motor vehicle
insurance required by laws in countries to facilitate;
Inter-state traffic movements
Accidents victims to be compensated promptly
Act as incentive for trade facilitation
Enhance greater cooperation amongst insurance companies in the
trade members
A national bureau govt-designated in each country is responsible for
management and control of cards
Handling Agency dealing with claims was established
Every Underwriter to submit monthly returns
National Bureaus in each country to be notified and handle all claims
at handling fee of 3% of claim
Handling Agency can settle claims up to US$3 000

Marine Insurance

Oldest form of insurance leading to the birth of Lloyds Corporation.

Lloyds supplied info to merchants on tonnage, routes age of ship etc
Marine policy has the following covers;
Hull and liability of the vessel
Cargo that is goods carried
Freight which cost of transporting or hiring a ship.
Marine covers are perils of the sea and include fire, theft and collusion

Aviation Insurance
Aviation insurance is a class that requires a lot of reinsurance &
technical expertise. Large aircraft are insured with established
markets in Europe and most of these policies are taken to outside
reinsurers with no or little participation of the local reinsurers on
such risks. The policies are issued to cover the hull (the aircraft)
liability to passengers and the liability to others that is fire, theft,
accidents and legal liabilities.

LIFE ASSURANCE

In Uganda, life business is being revitalized. It had picked up during

the 1960s and 1980s but due to the economic turmoil, life business
was greatly affected. Long term business is called benefit policies.
Unlike in non life insurance, in life assurance the event being assured
is to happen that is death or maturity. We have individual/individual
or group life policies

Term Assurance

Term assurance is the simplest and oldest form of assurance and

provides for payment of the sum assured on death, provided death
occurs within a specified term. Should the life assured survive to the
end of the term, then the cover ceases and no money is payable.

This type of cover is cheap. It is suitable for young married men

earning low incomes. The aim is to provide reasonable sum for their
wives in the event of the husbands deaths.

Whole Life
The sum assured is payable to the death of the assured whenever it
occurs. Premiums are payable throughout the life of the assured or
until the retirement of the assured. Although premium payment may
cease at retirement, the policy will still be in force and if the assured
dies, later the policy will provide the benefit to the assureds
representatives.
Endowment

An endowment policy is a contract designed to pay a lump sum after a

specific term (on its 'maturity') or upon the death of the policy holder.
Typical maturities are ten, fifteen or twenty years up to a certain age
limit. Some policies also pay out in the case of critical illness.
Policies are typically include those with unitized with-profits funds
Endowments can be cashed in early (or surrendered) and the holder
then receives the surrender value which is determined by the
insurance company depending on how long the policy has been
running and how much has been paid into it.

Superannuation insurance businesses

The term superannuation refers to retirement benefits and group life
assurances and some of these include:

Retirement Benefits Schemes

The aim of the insured pension scheme is to ensure that some form of
pension is available on retirement. Life assurance companies perform a vital
role in running pension schemes by;
Organizing a whole scheme ,receiving premium contributions,
inventing funds and administering the pension;
managing funds of a pension scheme
Providing life assurance benefits for widows of scheme members who
die before retirement. Benefits for these eligible for the scheme relate
to service and salary.
Policies are usually issued insuring death in serve benefits for employees
who do not reach retirement age.

Group Life Assurance

Covers a group of people, usually who are the members of societies,

employees of a common employer, or professionals in a common
group.
Offered by an employer or large-scale entity (i.e. association or labor
organization) to its workers or members. Group life insurance is
typically offered as a piece of a larger employer or membership benefit
package. By purchasing coverage through a provider on a "wholesale"
basis for its members, the coverage costs each individual
worker/member much less than if they had to purchase an individual
policy.

From the above we can infer the following are the characteristics of Group
Life Insurance

there must be a group of people to be insured which should have

something in common other than the purpose of obtaining insurance
there must be a Master Policy Holder who will retain the contract on
the behalf of the member and the carriers
Such covers are typically available at a discount to the respective
individual rates.

Annuities
An annuity is a method by which a person can receive a yearly sum in
return for payment to an insurance company for a sum of money. It is
not a life assurance, though life assurance companies deal with it and
is based on actuarial principles. For example; if a person with a large
sum of money wants to provide on income for oneself when on
retirement, or at any other time, she or he can approach a life
assurance company and purchase an annuity.

Forms of Annuities
The annuity can start immediately ( that is immediate annuity or may
start at a future date ( that is deferred annuity ) . it can provide an
annuity for the life of the person ( the annuitant) or may be payable
irrespective of death for a certain period ( annuity certain )
Guaranteed annuity provides annuity for a guaranteed period until
the annuitant dies
Reversionary annuity provides for payment to annuitant that is wife
or death of another named person that is husband.
Joint and last survivor annuity; payable while two people husband
and wife are alive and on death of one, will continue at the same rate
or less rate on the life of survivor

Investment Policies
This is where insurance companies collect large sums of money some of
which is used for investment purposes.

Unit Linked
These are policies where the values of policy are linked to the investment
performance

Is a product offered by insurance companies that unlike a pure

insurance policy gives investors the benefits of both insurance and
investment under a single integrated plan.

This is basically a combination of insurance as well as investment.

A part of the premium paid is utilized to provide insurance cover to
the policy holder while the remaining portion is invested in various
equity and debt schemes. The money collected by the insurance
provider is utilized to form a pool of fund that is used to invest in
various markets instruments (debt and equity) depending on members
appetite
The sum assured payable on death or maturity will depend on returns
from investment.

Bond Investment

An investment bond is generally a single premium life insurance

policy. They have a small element of life insurance that is paid out
after your death. However, it is an investment rather than insurance
in the general sense.
An insurance company will take the premium and invest it for income
and or capital gains which accrue until a policyholder withdraws
money from the policy.
Bonds pay out income monthly or annually or accumulates interest to
make cash payment at the end of the term. Terms of one to five years
are common and the bond may be linked to some form of shares,
property or cash fund operated by the insurer.

Compulsory Insurances

Compulsory insurance is any type of insurance coverage that is

required by law before individuals or businesses may engage in
certain activities.

The idea behind this type of mandatory coverage is to protect the wellbeing of those who would otherwise be adversely affected if the events
covered in the terms of the policies were to take place.

Reasons for compulsory insurances

Provision of certain forms of insurance which are compulsory. The

funds must be available to compensate injured third parties- motor
third party insurance and professional indemnity policy for insurance
brokers.
State regulation need standardization in terms of benefits to
policyholders of such compulsory insurances
Most of the compulsory insurances are in areas which tend to concern
the public such as health and old age and these are services
Governments are expected to provide services
By making insurance compulsory, the insured is availed all the
expertise all the expertise of the insurer in the loss prevention.

Examples of Compulsory insurances in Uganda

The The Motor Vehicle Insurance (Third Party Risks) Act 1989
The Workers Compensation Act 2000
The National Social Security Fund (NSSSF)
Professional Indemnity for insurance Brokers
Now yet to be enacted, the National Health Insurance Scheme

Common Policy Terms & Conditions

PREMIUM RATES

The amount paid or payable for an insurance policy

It is in fulfillment of one of the conditions of a contract (
Consideration- Benefit Vs Detriment)
The Insurance Act does not impose standardized rates.
It requires general insurers to file a manual for the premium rates in
use with the Commissioners office
Life premium rates have to be approved by an actuary

Commission Rates

Fee paid to an agent or insurance sales-person as a percentage of

the policy premium. The percentage varies widely depending on
coverage, the insurer, and the marketing methods.
The Act restricts the payment of commission to a portion of
premiums of the business solicited by the agent. This is detailed in
the 11th schedule of the Act. A few examples include
Class of Business
Commission Rate
Most individual life policies
50% of the 1st year premium
20% of 2nd year premium
5% of the 3rd to 10th year
Premium

 Motor
12.5% of annual premium
Liability
20% of annual premium
Theft
10% of annual premium
Personal Accident
20% of annual premium
Workmens Compensation
20% of annual premium
NOTE: These are maximum rates and insurers are free to pay rates below to
their Agents
POLICY TERMS
The written contract effecting insurance, or the certificate thereof, by
whatever name called, and including all clause, riders, endorsements,
and papers attached thereto and made a part thereof.
The Act provides some of the following as the terms which have to be
incorporated in policies of insurance
Sum insured, premium and any other sum of money mentioned in the
policies shall be in Kenya shillings except in cases of marine and
aviation policies which may be stated in other currencies.
No policy shall be issued on the life or lives of any person or persons
without insurable interest

Policy Document

After the submission of the proposal,

Underwriting is done and risk is accepted.
A contract is made between the underwriter and the proposer.
There is need for evidence of the existence of that contract. This
therefore calls for a policy document.
This is a statement issued by the insurer as evidence of an existing
contract between the insurer and the insured.
It states the terms and conditions of the contract.
It includes the proposal form which is the basis for the contract.

Cover Notes

The proposer should be able to read and understand all the contents
of the policy
Courts of law will always refer to this document in case of any
dispute.
They are usually pre-printed and contain standard terms but
additional clauses and typed materials can be added.

Parts of a policy document

Heading
Preamble/ Recital clause
Operative clause
Exclusions
Conditions
Policy schedule

Signature and attestation

Heading
This includes;
o Name of the insurer
o Address of the place where business is conducted
o Company logo
Preamble/ Recital clause

This section emphasises that the proposal is the basis of the contract
and it is included in the policy
Premiums have been paid or there is an agreement to pay
A brief introduction of the type of perils covered.

Operative clause

It is also known as the insuring clause.

It gives in detail the perils covered under the contract as well as the
type of losses the insurer undertakes to pay.
It is the heart of the contract.

Exclusions

Under this part/ section, the type of losses that the insurer will not
pay are stipulated.
Such losses may be excluded because of;
o The risks are uninsurable
o Inadequacy of premiums

Conditions

These are provisions, rules of conduct, duties and obligations required

for coverage. If policy conditions are not met, the insurer can deny the
claim.
They are actions that the insured must take or continue to take for
the contract to be in force
Conditions apply in different ways;
o Precedent to the contract
o Subsequent to the contract
o Precedent to liability
In case any of them is broken, the insurer may not pay the claim.
They can be;
o Express
o Implied

Express conditions

These are conditions set by the insurer and they appear in the policy
for example
o Cancellation

o Subrogation
o Resolution of a dispute regarding the amount of claim
o Contribution in case of other policies on the same loss.
Implied conditions

These are conditions that must be complied with but they dont
appear in the policy for example:
The insured has insurable interest
The parties have disclosed all material facts
The subject matter of insurance can be identified

Policy schedule

This is where the policy is personalised. It makes the policy personal. It

includes information like;
Name of the insured
Address of the insured
Nature of the business
Period of insurance
Sum insured
Premiums
Policy number
References to special exclusions and conditions

Signature and attestation clause

In this section, an authorized official signs the document to make it

legally binding.

Cover note

Its a document evidencing issuance of an insurance policy and it

gives a summary of the information given in the certificate of
insurance.
In insurance a cover note is issued to an applicant, usually for a
month, to cover the risk until an official insurance policy document
can be prepared and delivered, and the appropriate premium paid to
the insurance company

Insurance certificate

An insurance certificate is a representation of the insurance

policy taken out.
It is a document used to verify that an entity is insured.

It entitles its holder to demand that the policy operates.

Endorsement

An endorsement is a written document attached to an insurance

policy that modifies the policy by changing the coverage afforded
under the policy.
An endorsement can add coverage for acts or things that are not
covered as a part of the original policy and can be added at the
inception of the policy or later during the term of the policy.
Also Known As: Rider, addendum, attachment.
This is documentary evidence of a change in the wording of an
existing policy or qualification of wording if the policy is written on
restricted terms.
Its a provision added to an existing insurance policy to modify its
coverage.

Renewal
Most contracts are annual but can be renewed on expiry.
There is no obligation on either party to renew the contract
Renewal means new terms and conditions
Renewal premiums are usually required before the policy expires but
some days of grace can be given
Sum Insured
Maximum liability on the subject matter of insurance
Premium rate applied on the sum insured.
Determination of limits of liability on policies whose exposure
cannot be determined in advance eg PL
For Life Policies, It is the ability for the Insured to pay up the
premium
Claims Process & Settlement

A demand made by the insured, or the insured's beneficiary, for

payment of the benefits as provided by the policy
Indemnity
Methods of providing indemnity:
Cash/Repair/Replacement/Reinstatement (New for old)
Exception to this principle are Life and personal accident
contracts. (Benefit contracts). Amount payable is normally agreed
to/specified at inception.
OTHER FACTORS WHICH LIMIT INDEMNITY
Policy limit- limit per incident/aggregate
Excess
Deductible- done voluntarily with the aim of premium discount and is
usually larger than excess

Franchise- insurer bears whole loss provided the franchise is exceeded

Average- under insurance

Claim Forms

Claim Forms
Questionnaire designed to extract details of loss from insured.
Contains info on name, address, circumstances, estimate of cost,
make etc
Claim file will be opened showing claim number, policy number,
address, period of insurance, sum insured, repair estimate
Should be completed in full and signed by insured
Information on claim form is compared with proposal forms to check
for non-disclosure of material facts
Insured may deal with on a without prejudice basis i.e. without
admitting liability to avoid unnecessary hardship to insured
Insurer can also make ex-gratia payments for commercial reasons
When claim is agreed at the a Discharge Voucher is signed by insured
to discharge all liabilities to the insurer

Role of Loss Adjusters

An independent claims specialist engaged by the insurer to

investigate, negotiate and agree on quantum on large claims.
Role is to investigate cause of loss, ascertain liability and confirm the
policy conditions and warranties were complied with.
Deal with many insurance companies therefore experience is much
broader
Produces various reports starting from initial interim and final
recommendations. Loss adjusters do the following;
Investigate cause of loss
Circumstances and extent of loss
Mitigation of loss and protection of salvage
Advices way forward in settling the claim
Check policy conditions, warranties
Collect evidence and advise on recovery (subrogation)
Verify sums insured, advise on policy liability and negotiate quantum
Check if peril is covered in the policy
Check on insurable interest and ensure that all conditions and
warranties are complied with.

Types of Claims

Property Claims/Material Damage are straightforward and easily

measurable.
Liability and Casualty Claims which involves property and personal
injury are a bit complex and sometimes require specialist opinion.
They normally involve lawyers

Motor Third Party Liability Claims. These arise as a result to

exposures to road users.
Damage arises from two fronts, third party property damage and third
party personal injury