What is the difference between loss ratio and combined ratio?

The loss ratio only accounts for claims paid relative to premiums earned, while the combined ratio includes both the loss ratio and the expense ratio (operating costs and commissions). A combined ratio below 100% suggests profitability, whereas a ratio above 100% indicates financial losses.

What industries employ actuaries?

Actuaries work in various industries, including insurance, pensions, healthcare, finance, investments, government, risk management, and consulting firms, where they analyze and predict financial risks.

How does IRDAI ensure transparency in the insurance sector?

IRDAI enforces transparency by requiring insurers to disclose clear and accurate information about their policies, terms, premiums, and claim procedures to consumers.

What is a "cargo insurance certificate"?

A cargo insurance certificate is a document issued by the insurer that provides proof of coverage for goods being transported. It includes details of the insurance policy, such as coverage limits and terms.

Are prescription drugs covered in PPO plans?

Most PPO plans include prescription drug coverage, but copays and coinsurance rates vary based on whether the medication is generic, brand-name, or specialty.

Can insurance reserves be released or reduced?

Yes, if claim estimates decrease or risks change, insurers may release excess reserves, improving their financial performance and profitability.

Can coinsurance change within the same insurance plan?

Yes, some plans have different coinsurance rates for different types of care. For example, hospital stays might have 20% coinsurance, while specialist visits could have 30% coinsurance. Always check your policy for specific details.

How do insurance regulatory authorities handle complaints?

They provide platforms for policyholders to file complaints, investigate disputes, and may intervene if insurers fail to resolve issues fairly.