2.7

Criteria to evaluate various life insurance products

This sub‑topic covers the key criteria used to evaluate different life insurance products. Understanding these criteria helps you compare term, endowment, ULIP, whole‑life and pension policies and choose the most suitable one for a client. The exam frequently asks for the most important factor to consider for each product type and may present scenario‑based questions.

Learning Objectives

  • 1Identify the major evaluation parameters for life insurance products.
  • 2Explain how each parameter impacts client suitability.
  • 3Calculate and interpret the Claim Settlement Ratio (CSR).
  • 4Apply the criteria to solve NISM‑style comparison questions.

Key Evaluation Parameters

When an investment adviser assesses a life insurance product, the first step is to list the parameters that affect both the protection and the investment component. The most common parameters are coverage (sum assured), premium amount and payment frequency, policy term, claim settlement ratio, surrender value, tax benefits, and optional riders.

Each parameter carries a different weight depending on the client’s age, income, risk appetite and financial goals. For example, a young professional looking for pure protection will prioritize a high coverage‑to‑premium ratio and a strong claim settlement record, whereas a retiree may value liquidity and tax efficiency more.

Exam questions often present a client profile and ask which parameter should be examined first, or they may give a table of product features and ask you to identify the most suitable product. Remember to map the client’s objective to the relevant criteria before answering.

  • Coverage – determines the protection amount.
  • Premium – affects affordability and cash‑flow planning.
  • Liquidity – important for early withdrawals or surrender.

Coverage and Sum Assured

The sum assured is the amount the insurer promises to pay on death or maturity, subject to policy terms. For pure term plans, the sum assured is the only benefit, while for endowment or ULIP plans it co‑exists with a savings component.

When comparing policies, look at the ratio of sum assured to annual premium (coverage ratio). A higher ratio indicates better protection per rupee spent. However, a very high ratio may come with restrictive policy terms or limited riders.

Exam tip: Do not confuse the sum assured with the maturity benefit in participating policies; the latter may be higher due to bonuses or fund performance.

ℹ️Common Exam Trap

Students often treat the guaranteed maturity amount as the sum assured. Remember, the sum assured is the guaranteed death benefit; the maturity amount may include bonuses or market‑linked returns.

Premium Structure

Premiums can be paid annually, semi‑annually, quarterly or monthly. The frequency influences the total outflow because insurers add a loading for more frequent payments.

For evaluation, calculate the annualised premium – the total premium paid in a year regardless of payment mode. This helps compare policies on a like‑for‑like basis.

Exam relevance: A question may give monthly premium figures for two policies and ask which one is cheaper on an annual basis. Convert the monthly amount to annual by multiplying by 12 and adding the applicable loading if mentioned.

Policy Term and Maturity

Policy term is the duration for which coverage is provided. Term insurance typically matches the client’s income‑earning period, while endowment and ULIP policies have a fixed maturity date that may be longer than the protection need.

Shorter terms reduce total premium outgo but also limit the chance to build cash value. Longer terms increase the chance of higher surrender value but also raise the total premium paid.

Exam focus: You may be asked to select the appropriate term for a 30‑year‑old with a 20‑year mortgage. The correct answer will align the policy term with the mortgage tenure, ensuring coverage until the loan is cleared.

Claim Settlement Ratio (CSR)

Formula: Claim Settlement Ratio (CSR)
CsCr×100\frac{C_{s}}{C_{r}} \times 100

Where:

C_{s}= Number of claims settled by the insurer in a financial year
C_{r}= Number of claims received by the insurer in the same period

Worked Example

Given C_{s}= 9,800 and C_{r}= 10,000: Step 1: CSR = (9,800 ÷ 10,000) × 100 Step 2: CSR = 0.98 × 100 = 98% Verification: (9,800 ÷ 10,000) × 100 = 98%.

ℹ️Exam Tip on CSR

CSR figures are published by IRDAI and insurers' annual reports. The exam expects you to know that a higher CSR indicates better claim‑paying ability, but also verify the time‑frame (usually the last fiscal year).

Surrender Value and Liquidity

Surrender value is the amount payable to the policyholder if the contract is terminated before maturity. It is typically a percentage of the accrued cash value, decreasing in the early years of the policy.

Liquidity is crucial for clients who may need early access to funds. Evaluate the free‑look period (usually 15 days) and the surrender charge schedule. A lower surrender charge after the first 3‑5 years is preferable for investors with medium‑term horizons.

Exam scenario: You may be asked to choose between two ULIP plans where one offers a higher surrender value after year 5. The correct answer will be the plan with the higher post‑year‑5 surrender value, assuming other factors are equal.

Tax Benefits under Section 80C & 10(10D)

Premiums paid for life insurance qualify for deduction under Section 80C up to ₹1.5 lakh per annum. Additionally, the death benefit is tax‑free under Section 10(10D) for policies issued after 1 April 2012, provided the sum assured does not exceed 10 times the annual premium.

When evaluating products, check whether the policy meets the 10× rule. ULIP policies often exceed this limit, making the death benefit partially taxable.

Exam relevance: A multiple‑choice question may present two policies and ask which one offers full tax exemption on the death benefit. Apply the 10× rule to determine the correct answer.

Riders and Additional Benefits

Riders such as accidental death benefit, critical illness, waiver of premium, and term‑to‑term conversion enhance the base policy. While they increase protection, they also raise the overall premium.

Evaluate riders based on the client’s risk profile. For a high‑risk profession, an accidental death rider may be essential, whereas a critical illness rider is valuable for middle‑aged clients with family health concerns.

Exam tip: Questions often ask which rider is mandatory for a ULIP to qualify for tax exemption. The answer is the “critical illness rider” is not mandatory; only the base policy must satisfy the 10× rule.

Comparative Table of Evaluation Criteria

Key criteria across common life‑insurance product types

Product TypeTypical CoveragePremium FrequencyLiquidity (Surrender Value)Tax Benefit (80C / 10(10D))
Term InsurancePure death benefit, high SA per premiumAnnual / Semi‑annualNo surrender value (pure protection)Premium deductible under 80C; death benefit tax‑free under 10(10D)
EndowmentDeath benefit + guaranteed maturity amountAnnual / QuarterlyPartial surrender after 3‑5 yearsPremium deductible under 80C; maturity amount tax‑free if 10× rule met
ULIPDeath benefit + market‑linked fund valueAnnual / MonthlyFund value can be withdrawn (subject to surrender charge)Premium deductible under 80C; death benefit tax‑free if 10× rule satisfied
Whole LifeLifetime coverage, cash value growsAnnualHigh surrender value after 10 yearsPremium deductible under 80C; death benefit tax‑free under 10(10D)
Pension (Annuity)Regular income after retirementSingle premium or regularLimited liquidity; surrender may attract penaltyPremium deductible under 80C; annuity income taxed as per slab

Chart: Claim Settlement Ratios of Major Insurers

Claim Settlement Ratio (CSR) – FY 2023‑24 (Top 5 Indian Life Insurers)

Example: Evaluating Two Policies for a 35‑Year‑Old Client

Scenario

Rohan, 35, earns ₹12 lakh per annum and wants a 20‑year protection plan. He is considering (i) a term policy with SA ₹5 million, annual premium ₹12,000 and CSR 98%, and (ii) an endowment policy with SA ₹5 million, annual premium ₹25,000, CSR 95%, and a guaranteed maturity benefit of ₹6 million after 20 years.

Solution

Step 1: Compute coverage‑to‑premium ratio. Term: 5,000,000 ÷ 12,000 ≈ 416.7. Endowment: 5,000,000 ÷ 25,000 = 200. The term policy offers a much higher protection per rupee. Step 2: Check liquidity. Endowment provides surrender value after 5 years, but Rohan may need funds earlier, making the term policy less liquid. Step 3: Tax benefit – both premiums are deductible under 80C, but the endowment’s maturity amount is taxable if the 10× rule is breached (here SA 5 million vs premium 25,000 → 200×, so death benefit is tax‑free, but maturity may be taxable). Step 4: CSR – term policy’s CSR 98% is superior to 95% for the endowment. Conclusion: For pure protection and cost efficiency, the term policy is the better fit.

Conclusion

The example shows how evaluating coverage ratio, liquidity, CSR and tax implications leads to the correct recommendation for a protection‑focused client.

Exam Takeaways

  • Coverage ratio (Sum Assured ÷ Premium) is the primary metric for pure protection products.
  • Claim Settlement Ratio = (Claims Settled ÷ Claims Received) × 100; a higher CSR indicates better claim‑paying ability.
  • Premium frequency affects total cost – always annualise premiums before comparison.
  • Surrender value improves after the initial 3‑5 years; assess liquidity needs before choosing endowment or ULIP.
  • Tax benefits require the 10× rule for death benefit exemption under Section 10(10D).
  • Riders add protection but increase premium; match riders to the client’s risk profile.
  • Use a comparison table to quickly spot differences across product types during exam questions.
  • Remember that CSR data is published annually by IRDAI; the latest figure should be used for the exam.

Practice Questions

8 questions on Criteria to evaluate various life insurance products

1

How is the Claim Settlement Ratio (CSR) calculated?

2

Which evaluation parameter is considered the primary metric for pure protection life‑insurance products?

3

If an insurer settled 9,800 claims out of 10,000 received in a financial year, what is its CSR?

4

Rohan is comparing a term policy (SA ₹5 million, premium ₹12,000) with an endowment policy (SA ₹5 million, premium ₹25,000). Which policy offers the higher coverage‑to‑premium ratio?

5

A 30‑year‑old client has a 20‑year mortgage and wants life‑insurance coverage until the loan is cleared. Which policy term is most appropriate?

6

A ULIP has a sum assured of ₹8 million and an annual premium of ₹600,000. Does the death benefit qualify for full tax exemption under Section 10(10D)?

7

Which of the following life‑insurance product types provides no surrender value?

8

For a young professional whose primary objective is pure protection, which evaluation parameter should be examined first?

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