Business environment’ll determine success of PRA —Expert

Adediji

By Nike Popoola

The Managing Director, Pensionscope Group, Peter Tai Adediji, has called on government at all levels to create a favourable business environment for employers to enable them to meet up with the 2.5 per cent increased contribution to workers’ Retirement Savings Account provided in the recently signed pension law.

According to a statement by the firm, the increase from 7.5 per cent to 10 per cent for employers’ contribution may be counter – productive if adequate measures are not put in place to improve the harsh environment in which employers operate.

He noted that many employers might default in meeting the requirement due to the heavy overheads they were presently bearing.

Adediji lauded the efforts of the government in increasing the contribution to the workers’ Retirement Saving Accounts.

He said, "This new law, Pension Reform Act 2014, brought significant reviews to the PRA 2004. One of such is the upward review of the minimum rate of pension contribution from 15 per cent, with employee and employer contributing 7.5 per cent apiece to a minimum of 18 per cent with contribution from employee and employer increasing to eight and 10 per cent, respectively.

"With this increase in rates of contribution, pension funds would now increase in size to the advantage of the employee and the economy as a whole."

Adediji also called on employers and employees to embrace the scheme and make sacrifices capable of providing a secure future for workers.

"It is important for government at all levels to improve the living standards of the generality of workers in order to reduce the burden of the additional contribution. The present situation of workers where salaries have been swallowed up by all sorts of loans meet before the next pay calls for caution.

Source: Punch

Key remedies for a rejected insurance claim

Experts give appeals 50% chance of success with proper legwork

By Tom Murphy

Stay true to this principle and you can improve your odds of successfully fighting a health insurer’s claim rejection.

Experts who help with the appeals process say patients have a 50 percent chance or better of prevailing. They say a winning argument may require heavy doses of research and persistence, but the end result is a decision that can stave off thousands of dollars in medical bills.

Certainly understanding the limits of your insurance, before you seek care, will help you avoid the frustration of having your claim denied. But if you get to the point where you need to appeal, here are some important points to remember.

Starting an appeal: Learn all you can about why your claim was rejected and don’t be afraid to ask questions. If the insurer deems your care to be not medically necessary, request an explanation that includes the insurer’s policy language and any information used in making the decision. Keep records of who you spoke with and when.

"Take down notes and get the language down as cleanly as possible," said Stephen Parente, a professor of health finance and insurance at the University of Minnesota.

Maintaining a calm demeanor can help you think rationally, and it may make customer service representatives more inclined to help.

Learn the insurer’s appeal process, including any deadlines. A missed deadline can sink an appeal regardless of how strong your case is.

Building your case: Sometimes a claim is denied due to a clerical error, such as the wrong code being used for a medical procedure. A good starting point is to check with your provider’s billing office to make sure your claim was coded correctly. If something is amiss, you can probably get it cleared up with a few phone calls.

Other cases may require an appeal letter. Your letter should lay out the reasons you believe your care should be covered. Ask your doctor to review your argument and offer input.

A physician can help detail how all treatment alternatives were exhausted before you started receiving the care an insurer deemed not medically necessary.

The insurer will want more than your doctor’s word, so be prepared to include any confidential medical records that support your case.

Make sure you directly address the insurer’s reason for denying coverage. Not doing so is the biggest mistake people make in filing appeals, according to Cheryl Fish-Parcham, private insurance program director for the health advocacy group Families USA.

Submit your appeals by certified mail so you can document when the insurer receives them and that you met any specified deadlines.

Be persistent. If the first appeal doesn’t work, the insurer should outline additional options that may include an appeal to a medical director who was not involved in the decision.

Going outside the insurer: If you’re not happy with the insurer’s internal review, seek an examination from an independent reviewer. Be mindful of any deadlines for making such a request.

Some patients with employer-sponsored health plans also may be able to turn to their company for help. Companies with self-funded coverage actually pay the medical bills and hire insurers to administer their plans.

Even if the employer declines to overturn the insurer’s decision, it can be important for companies to be brought into the appeals conversation so that they can consider making coverage adjustments over time.

Check with your human resources department to see if your coverage is self-funded and if they can help you understand the appeals process or put you in touch with the right insurance representative.

Seeking help: If you’re not comfortable shaping your argument, or you’re not physically up to it, you have a few options for outside help. Some states offer consumer assistance programs, and your insurer should provide you with contact information for the program in your state.

Help is also available from nonprofit agencies like Patient Advocate Foundation and The Jennifer Jaff Center, which can assist with appeals in cases involving chronic, life-threatening or debilitating illnesses.

For-profit companies like Medical Billing Advocates of America also work on insurance denials.

Source: The Associated Press

Chinese Insurance Policies Cover Some Really Bizarre Things

　
By Clare Baldwin and Diana Chan,
Your child throws a tantrum and smashes something? Take out "naughty child insurance." Similarly, buy cover against your bride becoming pregnant before the honeymoon, your team being knocked out of the soccer World Cup, burning your tongue eating hotpot or if smog ruins your holiday.

Quirky, maybe, but China's insurers are turning to ever more creative ways to drum up business in a market where growth has stalled and penetration rates of around 3 percent, half the global average, are little changed from a decade ago. Premiums in China are less than $278 billion a year, way below the $1.3 trillion paid in the United States and below even the UK's $330 billion, according to Munich Re and Swiss Re data.

"It's consumer acquisition, a way to engage new customers," said Joseph Ngai, who heads the Greater China financial institutions practice at McKinsey in Hong Kong. "It's primarily marketing."

While most of these policies are short-term promotions, they offer insight into daily concerns in the world's most-populous nation - such as marriage and children.

Ping An Insurance Group Co of China Ltd <601318.SS> <2318.HK>, the world's second-biggest life insurer by market value, has offered an "Accidental Pregnancy Before Honeymoon" policy to cover the cost of having to unexpectedly cancel a honeymoon. It also offered a payout just to wives in the case of divorce, and another policy, akin to an investment plan, that paid out - after a certain period - if a couple stayed together, local and state media have reported.

Last year, Ping An offered another policy incentivizing couples to marry in the 10 days leading up to this year's Nov. 11 "Singles Day". The policies, which went on sale at midnight and included 12-month membership to an online matchmaking site, sold out in 10 minutes, the official China Daily newspaper reported.

In an emailed response to Reuters for this article, Ping An Property & Casualty said it seeks to "solve or alleviate real life problems." While it still sells "innovative" products, it said it is no longer offering pregnancy, marriage and singles insurance.

Sino-Life Group Ltd <8296.HK>, Sunshine Insurance Group and Anbang Insurance Group also sold married couples "concubine-proof", "red rose" and "rich flower" insurance policies, according to the China Daily and the companies' websites.

For young children, there's now insurance for recalled infant milk formula, and for little ones who get out of hand People's Insurance Group of China Co Ltd (PICC) <1339.HK> offers a policy against "mischievous and destructive" habits. The policy - tagline: "Why not let us pay for the child's fault?" - costs 44 yuan ($7.16) and provides cover up to 100,000 yuan for 12 months.

Chongqing-based Ancheng sells a similar policy in three different versions, with parents of the naughtiest children paying 116 yuan for a 5,000 yuan payout.

Many insurers have latched on to this wave of creative policy marketing, with Ancheng, Ping An and ZhongAn, backed by Ping An and internet giants Alibaba Group Holding Ltd <ipo-baba.n> and Tencent Holdings Ltd <0700.HK>, among the more aggressive.



WORLD CUP "HEARTBREAK"

During the recent soccer World Cup in Brazil, Ancheng and ZhongAn offered policies allowing Chinese customers to pay for protection against over-drinking, being attacked by hooligans and a "Heartbreak" policy for when their favorite team was eliminated. Uptake wasn't huge, but the policies succeeded in winning plenty of media coverage.

For the industry's regulators, though, some of these policies skirt too close to a Chinese love of gambling. In June, the regulator said it would increase penalties for insurers selling products with "gambling or gaming" properties.

A policy has to offer "meaningful cover" and not just a financial bet, said Guanjun Jiang, a China-based Milliman actuary, adding that a WeChat group with about 100 actuaries and other professionals criticized the World Cup policies as "gimmicks" that didn't adhere to the principles of insurance.

ZhongAn confirmed it sold the World Cup over-drinking and hooligan policies. Ancheng did not respond to requests for comment.

Other attention-grabbing tactics cover Chinese cultural events. Ancheng has a policy covering any medical costs resulting from burns while eating hotpot, a Chinese tradition involving cooking raw meat and vegetables in a boiling pot of soup placed at the center of the table.

Other Ping An and PICC policies - which were quickly shut down by the China Insurance Regulatory Commission - paid out if city smog levels topped a certain level for a specified period, if customers were hospitalized due to smog, or if tourists spent at least two days in a smoggy city.

And foreign insurers, too, have tried their luck.

During last year's Mid-Autumn Festival, Germany's Allianz <alvg.de> teamed up with Alibaba's Taobao insurance to guarantee sightings of the full moon, paying out between 50 and 188 yuan - and in some cases a pack of moon cakes - if bad weather obscured the view.

(Editing by Ian Geoghegan)

Source: Reuters

Mansard Insurance opens welcome centres in Uyo, Enugu

Mansard Insurance Logo

Chuks Udo Okonta

Mansard Insurance plc, in keeping with its strategy on retail expansion and drive to make insurance products and services readily accessible to Nigerians has opened two new Welcome Centres in Enugu, Enugu State and Uyo, Akwa Ibom State.

A statement by the company said the Enugu Centre, is located at Suite A5, Bethel Plaza, Garden Avenue, Enugu State, while that of Uyo at Number 110, Abak Road, Uyo, Akwa-Ibom State.

The firm noted that the Uyo Centre was formally declared opened at a brief ceremony on Friday August 22, 2014 by the Special Adviser to the Commissioner of Youth & Sports, Akwa Ibom State – Ese Umoh, adding that at the tape cutting event, Umoh appreciated the management of the underwriting firm for coming to State to empower the youths and also increase the awareness and benefits of risk management.

It noted that the ceremony was followed by an awareness walk to sensitize the residents of Uyo on the usefulness of insurance.

The Mansard Welcome Centres provide opportunity to purchase Mansard’s products and services in the life, non-life and health insurance segments. Customers may also receive after sales services at the centres.

In the last quarter, four new Mansard Welcome Centres were opened, in the South West; at 15/17 Opebi Road Lagos State and Broking House in Dugbe Ibadan Oyo State, in the North West; at Minna Central Business District, Niger State and at Angwar Rimi GRA, Kaduna North, and Kaduna State.

The new Mansard Welcome Centres in Enugu and Uyo brings to nineteen, the number of such centre across Nigeria.

Mansard Insurance plc, was incorporated in 1989 as a private limited liability company and is registered as a composite company with the National Insurance Commission of Nigeria (NAICOM). The Company offers life and non-life insurance products and services to individuals and institutions across Nigeria whilst also offering Investment Management and Health Maintenance solutions through its two subsidiaries, Mansard Investments Limited and Mansard Health Limited respectively. The company also recently received NAICOM’s approval for Micro Insurance Operations.

The company was listed on the Nigeria Stock Exchange (NSE) in November 2009 and has Market Capitalisation in excess of N24 billion remaining the biggest insurance company on the Nigerian Stock Exchange.

GIC Re keen on more foreign buyouts; in talks with a Lloyds co

Expecting competition to increase manifold once the Bill seeking to raise FDI in insurance sector gets the nod, the country's sole re-insurer GIC Re is planning an aggressive inorganic growth strategy to ramp-up its global footprint.

The Insurance Amendment Bill, pending for Parliamentary approval, seeks to increase Foreign Direct Investment in the sector, including the reinsurance segment, to 49 per cent from the present 26 per cent.







The industry is expecting at least 10-15 global re- insurers to enter the domestic market once the new Insurance Bill is passed, directly competing with the state-run GIC Re.

"We are expanding our operations on foreign soil. We have acquired Saxum Re, a South African firm, early this year and we are working on to acquire one from Llyods in London," GIC Re chairman and managing director A K Roy told PTI.

"We are waiting for the right opportunity for this. We are also venturing into the US markets, which is the world's largest general insurance market," he said.

However, the chairman did not offer any details about the geographies that his company is scouting for acquisitions, the time line or the size his war chest for buyouts.

Roy also said at GIC Re, expansion is an ongoing process and that expansion has to be stabilised and streamlined so that it starts generating revenue and profits.

"If there is any entity available which gives us a business sense anywhere in the world, we are ready to acquire the same," he said.

The city-based re-insurer gets almost 50 per cent of its Rs 15,000 crore premium income from overseas markets and targets to be one of the fifth largest globally by 2025 and is therefore keen to expand overseas to fuel growth and expansion.

Roy said the company does not want to grow its domestic business beyond 50 per cent of its global premium to better manage risks.

"We are already overexposed in the domestic market and we can't go any further, because of the risk factor involved in it. Reinsurance is always a cross-boarder business," he said.

Roy explained that GIC Re is not going to overseas markets only for the sake of expansion. "It depends on a lot of back- end preparations and it requires manpower too. But, at the same time if a good opportunity for expansion comes, we will look at it," he said.

"With the Saxum Re buy, we will be able to cover the entire African continent. We are already one of the leading re-insurers in that region. Because it's a new company, we are ready to infuse capital into it whatever is required," he said, adding that the company expects to launch operations with from the acquired South African company from January.

Roy further said low pricing prevailing in international markets has hit his company too. "We have got 50 per cent of our exposure in the overseas market. So, if the prices are down globally, then it will do affect my business as well."

But, Roy was soon to add that he does not have any plans to cut down global exposure.

On the investment returns he said the company said had made a profit of Rs 3,000 crore from investment income last fiscal.

"High investment income does help us grow our profitability, but not the revenue. We would like to grow our profitability globally and increase our premium income from overseas market. Increasing revenue is one thing while making profit is another," he said.

Source: The Economic Times

Ebola fears stalking a continent as insurers face claims for cancelled travels even in parts of Africa unaffected by the outbreak

By Alex Hawkes

The Ebola outbreak in West Africa is beginning to take a toll on international business with London-based insurers facing claims for cancelled travel and events.

Insurers say they are receiving claims relating to the outbreak and, while payouts are rare because policies routinely exclude epidemics, claims are beginning to underline a reluctance to do business even in parts of Africa unaffected by the outbreak.

Amanda Lewis, an underwriter at insurer Aegis, said: ‘The outbreak has caused some isolated event cancellations. Losses are being reported into the London market and I would expect that to gain some momentum.’
The outbreak has been focused on Guinea, Liberia, Sierra Leone and Nigeria, but it is thought it has affected attendance at conferences in South Africa, thousands of miles away.

‘People’s perception is that it is the whole of Africa. The detail gets lost in the hysteria,’ said Lewis.

Insurers started to exclude disease outbreaks in standard contracts following the SARS epidemic in 2002-3.

Even when disease is covered, insurance contracts do not generally cover losses caused by the fear of a disease rather than the disease itself, Lewis added.


Source: Daily Mail

Ebola - Researcher Urges Health Workers to Take Insurance Policies

OBINNA Chilekezie, Principal Researcher, Independent Insurance Researchers (IIR), has advised health workers to take up health and life insurance policies.

Chilekezie gave the advice on Sunday in Lagos in an interview with the News Agency of Nigeria (NAN).

He said that people have relegated the importance of insurance to their lives to the background.

Ebola Virus (EBOV) is no respecter of persons. Health workers are at a greater risk of being infested by the virus.

It had shown that no matter how many times you wash your hands or wear protective gears, you can still be infested with the virus.

Even though Medical Professional Indemnity is one of the compulsory insurances, but many hospitals do not buy the policy.

With this Ebola Virus, it is necessary for health workers to ensure that they have insurance policies.

The world is a global village and nobody knows another sickness that will be introduced to Nigeria," he said.

He, however, stressed the need for insurance companies to brace- up for the settlement of life insurance claims arising from deaths from the outbreak of Ebola in the country.

Once anybody that is already insured dies, the insurance company is obliged to settle claim arising from it.

And once the death rate increases among the health workers and they are insured, their families will be paid," he said.

He said that federal, states and local governments should also use the opportunity and ensure that people take up compulsory insurance policies.

Source: Independent