How is the limit of liability determined?

The limit of liability is determined based on factors such as the type of coverage, policy terms, and the insured’s needs. Policyholders typically choose coverage limits based on potential risks, legal requirements, and the insurer’s underwriting guidelines. Higher limits generally result in higher premiums.

What are smart contracts, and how do they improve insurance?

Smart contracts, powered by blockchain, automate policy execution by triggering payouts based on predefined conditions, reducing fraud, administrative costs, and disputes in claims processing.

What is the NAIC Market Conduct Annual Statement (MCAS)?

The MCAS is a regulatory tool used to analyze insurers’ market conduct and identify potential unfair practices affecting policyholders.

Does cyber insurance always cover ransom payments?

Not always. Some policies cover ransom payments, while others may exclude them or require approval before payment. Insurers often assess the necessity of payment and compliance with regulations before covering the cost.

How much does an HMO plan typically cost?

HMO plans generally have lower premiums, copays, and out-of-pocket costs compared to PPOs, but they require members to use in-network providers for coverage.

Should I regularly update my replacement cost coverage?

Yes, property values and construction costs change over time, so updating ensures adequate coverage.

Where can I check an insurer’s Claim Settlement Ratio?

CSR data is published in the insurer’s annual report and regulatory bodies’ websites like IRDAI (India), NAIC (USA), FCA (UK), or APRA (Australia). Many financial websites also provide comparative CSR data.

What is the role of a TPA in health insurance?

In health insurance, TPAs manage cashless claim facilities, maintain a network of hospitals, process claims, assist in medical approvals, and handle the grievance redressal process for policyholders.