Client Protection Principles: Model Law
Annex 3: Key  Facts (Insurance)
The following represents a list of key information clients should be receive  further to their insurance policy.
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Pricing
 
 
What is the full cost of the insurance?  (separated out from cost of credit  and other products)
 
Provide breakdown of all premiums, deductibles, co-payments, etc
 
When and how must the beneficiary submit payment?
 
How is the insurance priced?
Benefits
 
What insurance is offered and what (specifically) does it c over?
 
 
What, if any, are the policy’s exclusions?
 
Who are the beneficiaries of the policy? How c an the client change  policy beneficiaries?
Terms and Conditions
 
Clearly provide name of insurance issuer/underwriter as well as direct c ontact information.
 
Is insurance coverage mandatory or voluntary?
 
What is the term of the  insurance policy? When does it expire?
 
What is the status of the insurance policy once credit is repaid/renewed/restructured?
 
Who can modify the terms of coverage and under what circumstances?
 
Who can modify the relevant terms and conditions? How and under what circumstances?
Claims
 
 
How can beneficiaries claim insurance? What documentation is needed?
 
Are benefits claimed as costs are incurred (e.g. displaying documentation  during a medical visit) or are beneficiaries reimbursed after the fact  (indemnity)?
 
What is the timeframe for adjudicating insurance claims? Disbursal of benefits?
 
What information will client receive  upon filing a claim?  Following successful/unsuccessful adjudication?
 
Does the client have the  opportunity to appeal an unsuccessful claim? If so, how?
 
Where and how can the client launch a  complaint (both with insurance provider and with credit provider)?
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 Source:  https://centerforfinancialinclusionblog.files.wordpress.com/2012/06/smart_insurance.pdf
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