When I joined the insurance profession two and half decades ago, I thought insurance was a set of settled facts to be copied and memorized. Oops! That belief took a hard knock, recently.
Insurance, unlike other financial offerings, is excessively distinctive. It is a specialized area of practice that needs precise dexterity. In fact, we are told that as a career, insurance blends well with someone who has a combination of experience and technical education. Recent research has revealed that it takes at least seven years [10,000-hour rule] for one to be an all-rounder in insurance matters. According to the survey, the period is shorter for those who take technical studies.
Ask practitioners who have been in the industry for twenty years or more and they will persuasively tell you that standards and general knowledge in our market are deteriorating. At the Insurance Institute annual conference, I overheard someone lamenting that in the old days, a commitment to achieve the highest level of technical skills and expertise was the focus of every practitioner.
Today, most of us are good at harping a clause or two from a standard policy or reading from a computer screen. If we are challenged to decipher certain insurance phenomena, we immediately recoil into our cocoon, hang up, and take an early leave.
Ironically, there are more qualified persons today than there were twenty or thirty years ago. Ceteris paribus, standards, and client service ought to be higher today. We are living in the dot.com age. In order to survive, insurers must offer solutions instead of products. Ignoring this is imprudent and suicidal.
In many markets, it is refreshing and pleasing that insurers put aside issues of competition and started talking about matters of common interest. Recently, I was privileged to be in the company of fellow insurers and share notes over a drink [never mind the type of drink]. We discussed several issues, including workers' compensation insurance teasers.
Where there is a master-servant relationship, the Workers' Compensation Act requires that the master or employer must arrange insurance for the benefit of the servant or employee. Workers' compensation insurance covers the death or bodily injury of an employee. Suffice it to say that death or injury by the employee must be incurred in the course of and arising out of employment for which the servant was recruited.
Consider this case. A manager’s car catches fire. An IT manager rushes to the scene and in the process of putting off the fire, he gets injured severely. Does workers' compensation insurance pay the resultant claim? Apart from premium calculations, why do insurers require that employers should declare occupational categories of insured employees?
By the way, will workers' compensation insurers pay a claim of a watchman who is injured while splitting firewood at his boss’ house? Your guess is as good as mine.
The other teaser has to do with the temporal scope of cover. When does workers’ compensation cover commence? Does it start the moment an employee sets foot into his car [for those who drive private cars] or when he boards a minibus [for those who commute on public transport]? And when does it end?
Cover for workers' compensation starts the moment an employee sets foot on his employer’s recognized premises and automatically lapses when he is off it. Cover also applies to those who are in transit, commuting between offices of their employer or are traveling outside their usual workstations as long as they are on duty. This case has been presented, tried, and tested in competent courts of law, several times.
As the year comes to an end, individuals and institutions alike throw parties. It is not uncommon to see employees quarrelling and exchanging one or two blows after taking too many a bottle. Does workers' compensation insurance admit a claim if employees injure each other? The answer is a resounding no.
Why? One. Insurance responds to losses, damages, injuries, and deaths that are fortuitous by nature. In simple terms, events must be accidental in cause and effect as far as the insured person is concerned. Fighters go into such action with full knowledge of what they will do and the cost of their actions.
Two. Tell me, which employer or society tolerates fighting between employees? You and I live within the frameworks of legal systems. By virtue of this, we must find rules which are generally recognized as binding to regulate our lives. No insurer that I know, liquidated or active, covers events that are against public policy or events that would cause lawlessness. As individuals, living in a community, our relationships with each other are governed by public law. Need I say more?
Views from the top are that as insurers, we must learn to offer solutions, not products. This is a dot-com age.
Francis Maina ǀ General Manager - Minet Risk Solutions ǀ Minet Kenya
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