IRDA Exam
IRDA Exam Eligibility, Syllabus, Pattern, Registration,
Exam Date, Mock Test, Exam Fees, Admit Card,
Centres, Result
What is IRDA full form ?
IRDA full form is - Insurance Regulatory and Development Authority of India
What is the IRDA Exam SYLLABUS - IC38 Life
IC38 INSURANCE AGENTS (LIFE BRANCH)
SECTION I
CHAPTER 1: INTRODUCTION TO INSURANCE:
Life insurance – History and
evolution - History of insurance - Insurance through the ages - Modern concepts of
insurance - History of insurance in India - Life insurance industry - How
insurance works - Risk management techniques - Risk avoidance - Risk retention -
Risk reduction and control - Risk financing - Insurance vs Assurance - Insurance
as a tool for managing risk - Considerations before opting for Insurance - Role of
insurance in society - Insurance and Social Security.
CHAPTER 2: CUSTOMER SERVICE:
General concepts - Why Customer Service -
Quality of service - Customer service and insurance - Insurance agent’s role in
providing great customer service - The Point of Sale - Best advice - The proposal
stage - Acceptance stage - The claim stage - Grievance redressal - Integrated
Grievance Management System (IGMS) - The Consumer Protection Act, 1986 - The
Insurance Ombudsman - Communication process - Non-verbal communication -
Ethical behavior.
CHAPTER 3: GRIEVANCE REDRESSAL MECHANISM:
Consumer courts,Ombudsman - Integrated Grievance Management System (IGMS) - The Consumer
Protection Act, 1986 - The Insurance Ombudsman.
CHAPTER 4:REGULATORY ASPECTS OF INSURANCE AGENT:
DefinitionsAppointment of Insurance Agent by the Insurer- Appointment of Composite
Insurance Agent by the insurer- Insurance Agency Examination- Disqualification
to act as an Insurance Agent- Code of Conduct- Suspension of Appointment of an
Agent- Procedure for Cancellation of Agency- Effect of suspension/cancellation of
Agency appointment- Procedure to be followed in respect of resignation/surrender
of appointment by an insurance agent- General conditions for appointment of
Agents by the insurerCHAPTER 5: LEGAL PRINCIPLES OF AN INSURANCE CONTRACT: Insurance
contracts – Legal aspects and special features - Legal aspects of an insurance
contract - Elements of a valid contract - Insurance contracts – Special features -
Uberrima Fides or Utmost Good Faith - Measures implemented to reduce the risk -
Breach of Utmost Good Faith - Insurable interest - Gambling and insurance -
Proximate Cause - Contract of Adhesion – Indemnity – Subrogation.
SECTION 2
CHAPTER 6:WHAT LIFE INSURANCE INVOLVES:
Life insurance business –
Components, human life value, mutuality - The Asset – Human Life Value(HLV) -
The Risk - Level premiums - The Principle of Risk Pooling – Mutuality - The Life
Insurance Contract.
CHAPTER 7:FINANCIAL PLANNING:
Financial planning and the individual life
cycle – Definition - Types of Goals - Individual’s life cycle - Individual needs -
Financial products - Risk profile and investments - Role of financial planning -
Financial planning - When is the right time to start financial planning - Financial
planning – Types - Cash planning - Insurance planning - Investment planning -
Investment parameters - Retirement planning.
CHAPTER 8:LIFE INSURANCE PRODUCT I:
Overview of life insurance products
- What is a product - Purpose of life insurance products and needs covered -
Riders in Life Insurance Products - Traditional life insurance products - Term
insurance plans - Variants of Term Assurance - Whole life insurance - Endowment
assurance - Dividend method of profit participation.
CHAPTER 9: LIFE INSURANCE PRODUCT II:
Overview of non-traditional life
insurance products - Limitations of traditional products - The shifts - The appeal –
Needs met - Non-traditional life insurance products – Types.
CHAPTER 10: APPLICATION OF LIFE INSURANCE:
Married Women’s Property
Act - Beneficiaries under MWP Act & its features - Key man Insurance – Insurable
Losses - Mortgage Redemption Insurance (MRI).
CHAPTER 11: PRICING AND VALUATION OF LIFE INSURANCE:
Insurance
pricing – Basic elements – Premium – Rebates - Determining the premium -
Components of Premium - Mortality and Interest - Guiding Principles for
determining Amount of Loading - Expenses and reserves - Determination of
Surplus and bonus - Ways of Valuing Assets - Allocating the surplus - Bonus -
Types of reversionary bonuses.
CHAPTER 12: DOCUMENTATION – PROPOSAL STAGE:
Life insurance –
Proposal stage documentation – Prospectus - Proposal form – Different Reports -
Anti-Money Laundering (AML) - Know Your Customer (KYC) - Free-look period.
CHAPTER 13: DOCUMENTATION – POLICY CONDITION - I:
Policy stage
documentation - First Premium Receipt - Policy Document - Policy Document -
Standard Provisions - Specific Policy Provisions.
CHAPTER 14: DOCUMENTATION – POLICY CONDITION – II:
Policy conditions
and privileges - Grace period - Policy revival measures - Non-forfeiture provisions -
Special policy provisions and endorsements - Provisions related to nomination –
Assignment - Types of Assignment - Conditions for valid assignment - Nomination
Vs. Assignment - Duplicate Policy – Alteration.
CHAPTER 15: UNDERWRITING:
Underwriting purpose - Equity among risks -
Risk classification - Selection process - Fraud monitoring and role of agent as
primary underwriter - Methods of underwriting - Non-medical underwriting -
Conditions for non-medical underwriting - Rating factors in underwriting - Sources
of Occupational Hazards - Medical underwriting - Medical Factors that influence
an Underwriter’s Decision.
CHAPTER 16: PAYMENTS UNDER A LIFE INSURANCE POLICY:
Types of claims
and claims procedure - Concept of claims - Risk event and claim - Ascertaining
whether a claim event has occurred - Survival Benefit Payments - Surrender of
Policy - Rider Benefit - Death Claim - Forms to be submitted for Death Claim -
Claim Procedure for Life Insurance Policy - Role of an agent
SECTION 3
CHAPTER 17: INTRODUCTION TO HEALTH INSURANCE:
What is health care –
Definition of Health Determinants of Health – Levels of Healthcare – Levels of
health care – Types of health care – Factors affecting the health systems in India –
Evaluation of health insurance in India – Employees State Insurance Scheme -
Central Government health scheme – Commercial health insurance - Health
Insurance Market – Infrastructure Public health sector - Private sector providers –
Pharmaceutical industry – Insurance Providers – Intermediaries – Insurance
selling activities – Insurance Servicing activities – financial product distribution –
Other important organizations which form part of the health insurance market –
CHAPTER 18: INSURANCE DOCUMENTATION:
Proposal forms – Standard form
of Declaration – Nature of questions in a proposal form - Elements of Proposal –
Medical Questionnaire – Role of intermediary - Duty of an intermediary towards
prospect (client) – Acceptance of the Proposal –(Underwriting) – Note on
underwriting and processing of proposals – Premium receipts – Definition –
Payment of premium in advance - Method of payment of premium – Policy
Document - Conditions and warranties – Endorsements - Specimen Endorsements
– Interpretation of policies – Renewal Notice – Anti –Money laundering and know
your customer guidelines
CHAPTER 19: HEALTH INSURANCE PRODUCTS:
Classification of health
insurance product – Introduction – Definition – Features of health policies – Broad
classification of health insurance products – IRDA guidelines on standardization in
health insurance – Hospitalization indemnity product – Top up covers or high
deductible insurance plans – Senior citizen policy – fixed benefit covers – hospital
cash – critical illness – hospital daily cash policy – critical illness policy – long term
care insurance – combi-products – Package policies – Micro insurance and health
insurance for poor sections – Rashtriya Swasthya Bima Yojana - Pradhan Mantri
Suraksha Bima Yojana - Pradhan Mantri Jan-Dhan Yojana – Personal accident
and disability cover- overseas travel insurance – Group health cover – Special
products – Key terns in health policies
CHAPTER 20: HEALTH INSURANCE UNDERWRITING:
What is Underwriting –
Definition –need - Underwriting basic concepts – File and use guidelines – Other
health insurance regulations of IRDAI – Basic Principles of Insurance and tools for
underwriting -Underwriting process – Group health insurance – Underwriting of
overseas travel insurance - Underwriting of personal accident insurance
CHAPTER 21: HEALTH INSURANCE CLAIMS:
Claims management in insurance
– stakeholders in claim process – Role of claims management in insurance
company - Management of health insurance claims – Challenges in health
insurance – claims process in health insurance - Documentation of health
insurance claims – Claims reserving – Role of third party administrators – Claims
management –personal accident – overseas travel insurance
What is the IRDA Exam SYLLABUS - IC38 Non-Life
SYLLABUS
IC38 INSURANCE AGENTS (GENERAL BRANCH)
SECTION I
CHAPTER 1: INTRODUCTION TO INSURANCE:
Life insurance – History and
evolution - History of insurance - Insurance through the ages - Modern concepts of
insurance - History of insurance in India - Life insurance industry - How
insurance works - Risk management techniques - Risk avoidance - Risk retention -
Risk reduction and control - Risk financing - Insurance vs Assurance - Insurance
as a tool for managing risk - Considerations before opting for Insurance - Role of
insurance in society - Insurance and Social Security.
CHAPTER 2: CUSTOMER SERVICE:
General concepts - Why Customer Service -
Quality of service - Customer service and insurance - Insurance agent’s role in
providing great customer service - The Point of Sale - Best advice - The proposal
stage - Acceptance stage - The claim stage - Grievance redressal - Integrated
Grievance Management System (IGMS) - The Consumer Protection Act, 1986 - The
Insurance Ombudsman - Communication process - Non-verbal communication -
Ethical behavior.
CHAPTER 3: GRIEVANCE REDRESSAL MECHANISM:
Consumer courts,
Ombudsman - Integrated Grievance Management System (IGMS) - The Consumer
Protection Act, 1986 - The Insurance Ombudsman.
CHAPTER 4: REGULATORY ASPECTS OF INSURANCE AGENT:
DefinitionsAppointment of Insurance Agent by the Insurer- Appointment of Composite
Insurance Agent by the insurer- Insurance Agency Examination- Disqualification
to act as an Insurance Agent- Code of Conduct- Suspension of Appointment of an
Agent- Procedure for Cancellation of Agency- Effect of suspension/cancellation of
Agency appointment- Procedure to be followed in respect of resignation/surrender
of appointment by an insurance agent- General conditions for appointment of
Agents by the insurerCHAPTER 5: LEGAL PRINCIPLES OF AN INSURANCE CONTRACT: Insurance
contracts – Legal aspects and special features - Legal aspects of an insurance
contract - Elements of a valid contract - Insurance contracts – Special features -
Uberrima Fides or Utmost Good Faith - Measures implemented to reduce the risk -
Breach of Utmost Good Faith - Insurable interest - Gambling and insurance -
Proximate Cause - Contract of Adhesion – Indemnity – Subrogation.
SECTION 2
CHAPTER 6: PRINCIPLES OF INSURANCE:
Elements of Insurance: – Definition
– Exposure to risk - Degree of risk exposure - Basis of risk classification- Hazard -
Types of hazards – Mathematical principle of insurance (Risk pooling) - Conditions
for insuring a risk – The Insurance Contract – Insurance Contract legal aspects –
Special Features –Indemnity – Uberrima Fides or Utmost Good Faith – Insurable
interest – Proximate cause
CHAPTER 7: DOCUMENTATION:
Proposal forms – Roe of Role of intermediary -
Duty of an intermediary towards prospect – Acceptance of the proposal – Premium
receipt – Cover notes-Certificate of Insurance – Policy Document – Warranties –
Endorsements – Interpretation of policies – Renewal notice
CHAPTER 8: THEORY AND PRACTICE OF PREMIUM RATING:
– Underwriting
basics – Definition – Rate making basics – Rating factors – Hazard – Moral Hazard
– Physical hazard – Addressing physical hazards - Short Period scales – Minimum
Premium - Sum Insured – Deciding the sum insured
CHAPTER 9: PERSONAL AND RETAIL INSURANCE:
HOUSEHOLDER’S
INSURANCE: - Retail Insurance Products - Sum Insured and Premium -
Shopkeeper’s Insurance - Sum Insured and Premium - Motor Insurance – Its
coverages - ‘Third-Party Insurance’ - Exclusions - Sum Insured and Premium.
CHAPTER 10: COMMERCIAL INSURANCE: PROPERTY / FIRE INSURANCE: -
Variants of fire policy - Market Value or Reinstatement Value Policies - Declaration
Policy - Floater Policies - Business Interruption Insurance – Coverages - Burglary
Insurance - Risks covered under burglary insurance - Cash cover - Money
Insurance - Coverage of Money Insurance - Important exclusions - Fidelity
Guarantee Insurance - Bankers Indemnity Insurance - Jewelers’ Block Policy -
Engineering Insurance - Types of engineering insurance policies - Marine
Insurance - Marine Cargo Insurance - Different types of marine policies - Liability
Policies - Statutory liability – Types of Liability Policies.
CHAPTER 11: CLAIMS PROCEDURE:
Claims Settlement process – Importance of
settling claims - -limitations or notice of loss – Investigation and assessment –
Surveyors and loss assessors – Claim forms – Loss assessment and claim
settlement - Important Aspects in an insurance claims – categories of claim –
Discharge vouchers – Post settlement action – Selvage – Recoveries – Disputes
related to claims – Other disputes resolution mechanisms
SECTION 3
CHAPTER 12: INTRODUCTION TO HEALTH INSURANCE:
What is health care –
Definition of Health Determinants of Health – Levels of Healthcare – Levels of
health care – Types of health care – Factors affecting the health systems in India –
Evaluation of health insurance in India – Employees State Insurance Scheme -
Central Government health scheme – Commercial health insurance - Health
Insurance Market – Infrastructure Public health sector - Private sector providers –
Pharmaceutical industry – Insurance Providers – Intermediaries – Insurance
selling activities – Insurance Servicing activities – financial product distribution –
Other important organizations which form part of the health insurance market.
CHAPTER 13: INSURANCE DOCUMENTATION:
Proposal forms – Standard form
of Declaration – Nature of questions in a proposal form - Elements of Proposal –
Medical Questionnaire – Role of intermediary - Duty of an intermediary towards
prospect (client) – Acceptance of the Proposal –(Underwriting) – Note on
underwriting and processing of proposals – Premium receipts – Definition –
Payment of premium in advance - Method of payment of premium – Policy
Document - Conditions and warranties – Endorsements - Specimen Endorsements
– Interpretation of policies – Renewal Notice – Anti –Money laundering and know
your customer guidelines
CHAPTER 14: HEALTH INSURANCE PRODUCTS:
Classification of health
insurance product – Introduction – Definition – Features of health policies – Broad
classification of health insurance products – IRDA guidelines on standardization in
health insurance – Hospitalization indemnity product – Top up covers or high
deductible insurance plans – Senior citizen policy – fixed benefit covers – hospital
cash – critical illness – hospital daily cash policy – critical illness policy – long term
care insurance – combi-products – Package policies – Micro insurance and health
insurance for poor sections – Rashtriya Swasthya Bima Yojana - Pradhan Mantri
Suraksha Bima Yojana - Pradhan Mantri Jan-Dhan Yojana – Personal accident
and disability cover- overseas travel insurance – Group health cover – Special
products – Key terns in health policies
CHAPTER 15: HEALTH INSURANCE UNDERWRITING:
What is Underwriting –
Definition –need - Underwriting basic concepts – File and use guidelines – Other
health insurance regulations of IRDAI – Basic Principles of Insurance and tools for
underwriting -Underwriting process – Group health insurance – Underwriting of
overseas travel insurance - Underwriting of personal accident insurance
CHAPTER 16: HEALTH INSURANCE CLAIMS:
Claims management in insurance
– stakeholders in claim process – Role of claims management in insurance
company - Management of health insurance claims – Challenges in health
insurance – claims process in health insurance - Documentation of health
insurance claims – Claims reserving – Role of third party administrators – Claims
management –personal accident – overseas travel insurance
IC38 INSURANCE AGENTS (HEALTH INSURANCE)
What is the IRDA Exam IC38 INSURANCE AGENTS (HEALTH INSURANCE)
SECTION I
CHAPTER 1: INTRODUCTION TO INSURANCE:
Life insurance – History and
evolution - History of insurance - Insurance through the ages - Modern concepts of
insurance - History of insurance in India - Life insurance industry - How
insurance works - Risk management techniques - Risk avoidance - Risk retention -
Risk reduction and control - Risk financing - Insurance vs Assurance - Insurance
as a tool for managing risk - Considerations before opting for Insurance - Role of
insurance in society - Insurance and Social Security.
CHAPTER 2: CUSTOMER SERVICE:
General concepts - Why Customer Service -
Quality of service - Customer service and insurance - Insurance agent’s role in
providing great customer service - The Point of Sale - Best advice - The proposal
stage - Acceptance stage - The claim stage - Grievance redressal - Integrated
Grievance Management System (IGMS) - The Consumer Protection Act, 1986 - The
Insurance Ombudsman - Communication process - Non-verbal communication -
Ethical behavior.
CHAPTER 3: GRIEVANCE REDRESSAL MECHANISM:
Consumer courts,
Ombudsman - Integrated Grievance Management System (IGMS) - The Consumer
Protection Act, 1986 - The Insurance Ombudsman.
CHAPTER 4: REGULATORY ASPECTS OF INSURANCE AGENT:
DefinitionsAppointment of Insurance Agent by the Insurer- Appointment of Composite
Insurance Agent by the insurer- Insurance Agency Examination- Disqualification
to act as an Insurance Agent- Code of Conduct- Suspension of Appointment of an
Agent- Procedure for Cancellation of Agency- Effect of suspension/cancellation of
Agency appointment- Procedure to be followed in respect of resignation/surrender
of appointment by an insurance agent- General conditions for appointment of
Agents by the insurerCHAPTER 5: LEGAL PRINCIPLES OF AN INSURANCE CONTRACT: Insurance
contracts – Legal aspects and special features - Legal aspects of an insurance
contract - Elements of a valid contract - Insurance contracts – Special features -
Uberrima Fides or Utmost Good Faith - Measures implemented to reduce the risk -
Breach of Utmost Good Faith - Insurable interest - Gambling and insurance -
Proximate Cause - Contract of Adhesion – Indemnity – Subrogation.
SECTION 2
CHAPTER 6: INTRODUCTION TO HEALTH INSURANCE:
What is health care –
Definition of Health Determinants of Health – Levels of Healthcare – Levels of
health care – Types of health care – Factors affecting the health systems in India –
Evaluation of health insurance in India – Employees State Insurance Scheme -
Central Government health scheme – Commercial health insurance - Health
Insurance Market – Infrastructure Public health sector - Private sector providers –
Pharmaceutical industry – Insurance Providers – Intermediaries – Insurance
selling activities – Insurance Servicing activities – financial product distribution –
Other important organizations which form part of the health insurance market.
CHAPTER 7: INSURANCE DOCUMENTATION:
Proposal forms – Standard form of
Declaration – Nature of questions in a proposal form - Elements of Proposal –
Medical Questionnaire – Role of intermediary - Duty of an intermediary towards
prospect (client) – Acceptance of the Proposal –(Underwriting) – Note on
underwriting and processing of proposals – Premium receipts – Definition –
Payment of premium in advance - Method of payment of premium – Policy
Document - Conditions and warranties – Endorsements - Specimen Endorsements
– Interpretation of policies – Renewal Notice – Anti –Money laundering and know
your customer guidelines .
CHAPTER 8: HEALTH INSURANCE PRODUCTS:
Classification of health
insurance product – Introduction – Definition – Features of health policies – Broad
classification of health insurance products – IRDA guidelines on standardization in
health insurance – Hospitalization indemnity product – Top up covers or high
deductible insurance plans – Senior citizen policy – fixed benefit covers – hospital
cash – critical illness – hospital daily cash policy – critical illness policy – long term
care insurance – combi-products – Package policies – Micro insurance and health
insurance for poor sections – Rashtriya Swasthya Bima Yojana - Pradhan Mantri
Suraksha Bima Yojana - Pradhan Mantri Jan-Dhan Yojana – Personal accident
and disability cover- overseas travel insurance – Group health cover – Special
products – Key terns in health policies.
CHAPTER 9: HEALTH INSURANCE UNDERWRITING:
What is Underwriting –
Definition –need - Underwriting basic concepts – File and use guidelines – Other
health insurance regulations of IRDAI – Basic Principles of Insurance and tools for
underwriting -Underwriting process – Group health insurance – Underwriting of
overseas travel insurance - Underwriting of personal accident insurance
CHAPTER 10: HEALTH INSURANCE CLAIMS:
Claims management in insurance
– stakeholders in claim process – Role of claims management in insurance
company - Management of health insurance claims – Challenges in health
insurance – claims process in health insurance - Documentation of health
insurance claims – Claims reserving – Role of third party administrators – Claims
management –personal accident – overseas travel insurance
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