Type of
Policies
and Clauses
Rating
Factors
What
Is not
Covered
Working of
Claim Amount
Understand
client’s needs &
objectives
Underwriting
Considerations
Working of
Sum Insured
& Premium
The Top 10 hotspots
Material damage
proviso
Sum insured
Definition of gross
profit
Indemnity period
Policy type
•Increased costs of
working
•Locations at risk
•Policy extensions
•Perils
•Insurable interests
SUBJECT MATTER
•FIRE POLICY : MATERIAL PROPERTY
•LOP : BUSINESS OF THE INSURED, EARNING
CAPACITY
•DAMAGE TO PROPERTY LIKE BUILDING,
MACHINERY & STOCKS
•INTERUPTION TO NORMAL BUSINESS
ACTIVITY : TOTAL OR PARTIAL
REDUCTION IN OUTPUT / TURNOVER
REDUCTION IN PROFIT
INCREASE IN COST OF WORKING
WHAT IS INSURED ?
•GROSS PROFIT
STANDING CHARGES
NET PROFIT
INCREASE IN COST OF
WORKING
PERILS COVERED
ALL PERILS COVERED
UNDER THE MATERIAL
DAMAGE POLICY :
ADDITIONAL PRERILS IF
COVERED UNDER FIRE
POLICY MAYBE
INCLUDED (OPTIONAL).
UNDERWRITING CONSIDERATIONS
(other than Petrochemical risks)
OCCUPATION
PHYSICAL HAZARDS
IMPORTED / MADE TO ORDER
MACHINES
INDEMNITY PERIOD
SUM INSURED
PAST HISTORY OF CLAIMS / EVENTS
ADD ON COVERS
MORAL HAZARD / GENERAL
REPUTATION OF INSURED
OTHER INSURANCES / POTENTIAL
PERIOD OF INSURANCE
PERIOD OF INSURANCE: THE ANNUAL PERIOD
DURING WHICH THE INSURANCE COMPANY BEARS
THE RISK e.g. 01.07.2007 to 31.07.2008
INDEMNITY PERIOD : REPRESENTS INSURED’S
ESTIMATION OF THE MAXIMUM PERIOD REQUIRED
FOR NORMAL BUSINESS OPERATION TO BE
RESTORED FOLLOWING A LOSS
TO BE DECIDED AT THE TIME OF INCEPTION
INDEMNITY PERIOD
CAN BE ANY PERIOD BETWEEN 3 MONTHS TO 36
MONTHSe.g. if insured opts for a I.P. of 24 months
and the loss takes place on 30.7.2008, the maximum
period of interruption insurer can pay is upto
29.7.2010.
INTERRUPTION PERIOD: ACTUAL PERIOD OF
INTERRUPTION STARTING FROM THE DATE OF LOSS/
DAMAGE TILL THE DATE NORMAL OPERATION HAS BEEN
RESTORED.
CAN BE MORE/LESS THAN THE CHOSEN INDEMNITY
PERIOD -BUT INSURER’S LIABILITY IS RESTRICTED TO
THE LOWER OF THE TWO.
RATING FACTORS
PREMIUM RATING DEPENDS ON :
AVERAGE RATE APPLICABLE TO THE CONTENTS
OF THE PROCESS BLOCKS OF THE PREMISES
UNDER THE MATERIAL DAMAGE POLICY
INDEMNITY PERIOD CHOSEN
WHETHER THE PLANT IS CONTINUOUS OR NOT
PREMIUM RATING
Basis Rate =
125 % loading on average contents rate
under Fire policy
Profits Rate : Basic Rate is adjusted for
•Process involved : loading of 25% of
continuous plants (automatic or
semi automatic process) : Example
Cement factories, distilleries, sugar
factories, vegetable ghee factory.
•Indemnity Period selected
HOW TO FIX THE
SUM INSURED
PREFERABLY THE GROSS PROFIT SHOULD BE ARRIVED AT
FROM THE LAST YEARS ACCOUNT
IN CASE THE LAST YEARS ACCOUNTS HAVE BEEN AFFECTED
BY CERTAIN ABNORMAL CIRCUMSTANCES ---ACCOUNTS OF
THE PRECEDING YEAR(S) MAY BE CONSIDERED
OFTEN THE RESULTS OF 2 -3 YEARS ARE TAKEN IN TO
ACCOUNT TO UNDERSTAND THE TREND AND MAKE DUE
ADJUSTMENTS FOR THE FUTURE
IF THE CHOSEN I.P. IS MORE THAN 12 MONTHS THE GROSS
PROFIT NEEDS TO BE INCREASED PROPORTIONATELY
Definition of Gross Profit Last A/cs
Turnover 1,000,000 100%
Opening Stock 20,000 2%
Materials 350,000 35%
Direct Labour 250,000 25%
Closing Stock -20,000 -2%
COGS 600,000 60%
Gross Profit 400,000 40%
Overheads 300,000 30%
Net Profit 100,000 10%
Director asked for gross
profit of his business
and quotes 400,000
Last accounts for ABC Manufacturing Limited:
Definition of Gross ProfitTurnover 1,000,000
Closing Stock 20,000
Total 1,020,000
Opening Stock 20,000
Purchases 350,000
Total 370,000
Gross Profit 650,000
Rate of Gross Profit 65%
The amount by which:
i) the sum of the amount of the
Turnover and the amount of
the closing stock shall exceed
ii) the sum of the amounts of
the opening stock and the
amount of the uninsured
worked expenses
(i.e purchases & discounts
received)
What can we learn from this?
Uninsured working expenses
Only include those costs that truly vary with turnover
e.g. 100% reduction in turnover will result in 100%
reduction in purchases, but may not lead to 100%
reduction in direct labour/ wages.
When definitions don’t match
Accounts definition
400,000 @ 40% Rate of Gross Profit
Policy definition
650,000 @ 65% Rate of Gross Profit
Substantially underinsured as a result
Only 61.5% covered
Consider carefully what is and isn’t
included in uninsured working expenses
What can we learn from this?
Definition of Gross Profit
Make sure that you and your clients
are talking the same language.
Gross Profit v Gross Revenue
Gross Revenue policies may be more
appropriate for service type businesses
Hotels
Clubs
PR / Ad agencies / TV Channels
Private hospital / nursing home
Art galleries / Museums
Private schools etc.
STANDING CHARGES
Do not vary in direct proportion to any
reduction in business. EXAMPLES ARE
*Salary, Wages, all social security
contributions, perquisites, Pension
Interest on loans, bank overdraft & Deb.
Rent, rates and taxes
Depreciation
Power / Electricity charges (Minimum
charges), Water, Heating, Lighting
Research and Development
STANDING CHARGES
Advertisement and Publicity
Duties, licenses and patent fees
Director’s fees and remuneration
Legal, Auditing and other professional fee
Insurance premium
Conveyance, Stationery, Communication
Office and general establishment
Repairs and Renewals
Misc. exp. not exceeding 5% of total of
aforesaid insured standing charges
Break Even
Net Profit
Total Cost
Standing Charges
Variable Cost
UNITS
Costs
Turnover
GP
COSTS , TURNOVER AND GROSS PROFIT
SUM INSURED
IF OPERATIG IN PROFIT
Standing Charges plus
Net Profit
IF OPERATING IN LOSS
Standing Charges Less
Net Loss
= Sum Insured (if Indemnity period is = or
<12 Months)
X Indemnity Period / 12 months ((if
Indemnity period is >12 Months)
Example of premium workingTurnover 1,000,000,000
Production Cost 6,000,000,000
Standing Charges 5,000,000,000
Net Trading Loss 1,000,000,000
Gross Profit 4,000,000,000
Indemnity Period 9 Months
Type of Plant Continuous
Fire Premium rate 2.00
Basis Rate 2 X 125% = 2.50
Profit Rate 2.50 X 90% X 125% =
2.8125
Premium Amount Rs. 11,25,000
Clauses
Material Damage Provision
Departmental Clause : cost accounting
Return of Premium Clause : 50%
Accumulated Stocks Clause : shortage postponed
Alternative Basis Clause : in Turnover basis policy
Auditor’s fee clause
Trend Adjustment : Trend, Variations, Sp. Circumst.
New Business Clause
Insured’s Property storedat other locations
Supplier and customers premises extension
Loss due to accidental failure of public
electricity/gas/water supply due to M.D.
Material damage proviso
Typical BI policy definition
“…provided that at the time of the loss, destruction
or damage there shall be in force an insurance covering
the interest of the Insured in the property at the Premises
against such loss, destruction or damage and that payment
shall have been made or liability admitted therefore”
except due to Policy excess.
TYPES OF BI COVERS
•ON TURNOVER BASIS
•ON OUTPUT BASIS
•DIFFERENCE BASIS (Turnover)
•REVENUE BASIS
BASIS OF INSURANCE
TURNOVER BASIS:
USEFUL FOR ORGANISATIONS IN TRADING
ACTIVITY OR INVOLVED IN MANUFACTURING.
SUPPLY OF GOODS ON EXISTING BASIS WITH NO
ACCUMULATION OF STOCKS
REDUCTION IN TURNOVER WILL BE USED TO
ARRIVE AT THE INDEMNITY.
(Hence in case there is accumulation of stocks the
turnover level may still be maintained )
BASIS OF INSURANCE
OUTPUT BASIS:
REDUCTION IN THE OUTPUT IS USED TO
ARRIVE AT THE INDEMNITY.
THUS EVEN IF THERE ARE BUFFER STOCKS
THE LOSS CAN BE WORKED OUT AS THERE
IS GOING TO BE REDUCTION IN OUTPUT
CARE TO BE TAKEN IN CASE OF MULTI
PRODUCT UNIT
BASIS OF INSURANCE
DIFFERENCE BASIS:
GROSS PROFIT IS ARRIVED AT ON THE DIFFERENCE BASIS.
INSTEAD OF STNADING CHARGES, WORKING EXPENSES ARE
SPECIFIED.
All purchases (less discounts received), % of Annual Wage
roll, Power, Consumable Stores, Carriage, Packing Material,
Bad Debts, Discounts Allowed, Any other expenses to be
specified.
(Specification in this Difference basis are used on
Turnover basis, and not on output basis )
BASIS OF INSURANCE
REVENUE BASIS / GROSS FEES:
POLICY BROADLY FOLLOWS THE PATTERN OF
TURNOVER BUT TURNOVER IS REPLACED BY GROSS
REVENUE OR GROSS FEES
REVENUE BASIS FOR CLUBS, HOTELS, PRIVATE
SCHOOLS, PRIVATE HOSPITALS AND NURSING
HOMES; GROSS FEES BASIS FOR PROFESSIONALS
LIKE SOLICITORS, CHARTERED ACCOUNTANTS.
REVENUE : MONEY PAID OR PAYABLE TO THE
INSURED FOR SERVICES RENDERED IN THE COURSE
OF THE BUSINESS IN THE PREMISES
FEES : MONEY PAID OR PAYABLE TO THE INSURED
FOR SERVICES RENDERED IN COURSE OF THE
BUSINESS OF THE INSURED.
WHAT IS NOT COVERED
Under-insurance
Difference in value of stocks at the time of fire
and on subsequent replacement
Depreciation of undamaged stock after fire
Bad Debts
Loss of goodwill
Failure to recover book debts due to destruction of
records
Litigation costs or third party claims or
consequential loss claims generally
TERMS TO UNDERSTAND
SPECIFIED AND UNSPECIFIED STANDING
CHARGES
GROSS PROFIT
RATE OF GROSS PROFIT : Financial Year
ANNUAL TURNOVER : year before DOA
STANDARD TURNOVER
INDEMNITY AND INTERRUPTION PERIOD
REDUCTION IN TURNOVER
TREND ADJUSTMENT
INCREASE IN COST OF WORKING
ECONOMIC LIMIT
CLAIM WORKING : STEPS
1.Ascertain Annual G.P. (Specified Standing charge + N.P.)
2.Trend Adjustment to Gross Profit
3.Work out rate of Gross Profit (G.P. / Turnover for F.Y.)
4.Interruption period and actual turnover therein
5.Work out standard turnover (turnover during months /
days in preceding year corresponding to interruption
period) + Trend Adjustment
6.Ascertain Reduction in Turnover (Standard Turnover less
Actual Turnover during interruption period)
7.Apply rate of G.P. to reduction in turnover due to Accident
8.Reduce it by Saving in Standing charges
9.Calculate increase in cost of working : Apply rate of gross
profit to ‘reduction in turnover avoided’ and allow lower.
10.Adequacy of Sum Insured : Apply rate of gross profit to
adjusted Annual Turnover and compare with Sum insured
BI claims methodology
Standard turnover less actual turnover = Loss of
turnover
@ Rate of gross profit (turnover less specified working
expenses) = Loss of Gross Profit
Less Savings(adjustment for business overheads not
incurred)
Plus Increased Cost of Working(additional costs
incurred to mitigate loss)
All subject to adequacy of cover
ABC Manufacturing LimitedPre
Incident
Post
Incident
Claim
Turnover 1,000,000100%400,000100%600,000
Materials 350,00035%140,00035%
Gross Profit 650,00065%260,00065%390,000
Direct Labour250,00025%200,00050%(50,000)
Overheads 300,00030%240,00060%(60,000)
Net Profit 100,00010%(180,000)(45%)280,000
Projected Post-incidentClaim
Savings
Typical policy definition
“…less any sum saved during the Indemnity
Period in respect of such of the charges
and expenses of the Business payable
out of Gross Profit as may cease or be
reduced in consequence of the Incident.”
Under insurance
•Sum Insured = 715,0002004
Actual
2005
Anticipated
2005
Actual
Lost
Turnover
Turnover 1,100,0002,200,000 750,0001,450,000
Gross Profit 715,0001,430,000
Rate of GP 65% 65% 65%
Lost GP 942,500
2005
Actual
2006
Projected
2006
Actual
Lost
Turnover
•Limit of cover = 715,000 / 1,430,000 = 50%
•Settlement = 476,250