What is the difference between Claim Settlement Ratio and Claim Rejection Ratio?

CSR measures approved claims, whereas Claim Rejection Ratio (CRR) calculates the percentage of claims rejected by an insurer. A high CSR and a low CRR indicate a customer-friendly insurer.

How does a TPA help in cashless hospitalization?

TPAs coordinate between the insurer and the hospital to facilitate cashless hospitalization, ensuring that the policyholder’s medical expenses are directly settled with the network hospital as per policy terms.

What is the underwriting process for business insurance?

Business insurance underwriting evaluates industry type, company size, revenue, claims history, safety measures, employee risks, and business continuity plans. Depending on the policy type (e.g., liability, property, workers' compensation), underwriters assess specific risks before determining policy terms and premiums.

Does renters insurance cover temporary housing if my rental is damaged?

Yes, renters insurance provides coverage for additional living expenses, which pays for temporary housing, meals, and other costs if your rental becomes uninhabitable due to a covered event.

How does RBC relate to solvency requirements?

RBC is directly related to solvency, as it ensures that insurers hold enough capital to cover potential losses, reducing the likelihood of insolvency in challenging times.

What happens if the guaranty fund runs out of money?

If a guaranty fund exhausts its resources, additional assessments may be imposed on solvent insurers, or government intervention may be required. However, most guaranty funds are designed with reserve strategies to minimize such risks.

What government programs help with catastrophe insurance?

Government programs like the NFIP for floods and state-backed windstorm or earthquake insurance pools help provide coverage when private insurers limit or exclude high-risk disaster areas.

How do insurance companies assess risk?

Insurance companies assess risk through data analysis, underwriting procedures, historical loss data, and actuarial models to predict the likelihood and financial impact of various risks.