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1 Islamic Perspective of Health Insurance Health & Disability Insurance Hailey College of Banking & Finance Punjab University ISLAMIC PERSPECTIVE OF HEALTH INSURANCE” BBA (Hons.) I&RM 8 th Semester 2011 Submitted To: Sir. M. Imran Group Members: M. Shazib Nawaz (mi07bba051 ) Rameez Hussain (mi07bba055 ) Faraz Khalid (mi07bba009 ) Bilal Haroon (mi07bba030 ) Abdul Rauf Ijaz (mi07bba049 ) Hailey College of Banking & Finance Punjab University HEALTH & DISABILITY INSURANCE
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Page 1: Health & disability insurance

1Islamic Perspective of Health InsuranceHealth & Disability Insurance

Hailey College of Banking & FinancePunjab University

“ISLAMIC PERSPECTIVE OF HEALTH INSURANCE”

BBA (Hons.)

I&RM 8th Semester

2011

Submitted To:

Sir. M. Imran

Group Members:

M. Shazib Nawaz (mi07bba051)

Rameez Hussain (mi07bba055)

Faraz Khalid (mi07bba009)

Bilal Haroon (mi07bba030)

Abdul Rauf Ijaz (mi07bba049)

Hailey College of Banking & Finance

Punjab UniversityH E A LT H & D I S A B I L I T Y I N S U R A N C E

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Acknowledgment:

My deep appreciation goes to my group member in HEALTH

INSURANCE Project with whom the opportunity was provided to discuss, debate, & expound on some of the core ideas put

forth in this Project.

Special Thanks to my respected Sir. (Sir. M. Imran) who helped

us to finalize many of the concepts & processes put forth

in the Project.

I Thank Sir. M. Imran, teacher of the Hailey College of

Banking & Finance Hailey College of Banking & Finance

Punjab University

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Department, of Punjab University, who continued to provide an environment & the

resources that made the preparation of this project

possible.

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Insurance:Insurance is a form of risk management primarily used to hedge against

the risk of a contingent, uncertain loss. Insurance is defined as the equitable

transfer of the risk of a loss, from one entity to another, in exchange for

payment. An insurer is a company selling the insurance; an insured, or

policyholder, is the person or entity buying the insurance policy. The

insurance rate is a factor used to determine the amount to be charged for a

certain amount of insurance coverage, called the premium. Risk

management, the practice of appraising and controlling risk, has evolved as

a discrete field of study and practice.

The transaction involves the insured assuming a guaranteed and known

relatively small loss in the form of payment to the insurer in exchange for the

insurer's promise to compensate (indemnify) the insured in the case of a

financial (personal) loss. The insured receives a contract, called

the insurance policy, which details the conditions and circumstances under

which the insured will be financially compensated.

Insurance Principles:

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Insurance involves pooling funds from many insured entities (known as exposures) to pay for the losses that some may incur. The insured entities are therefore protected from risk for a fee, with the fee being dependent

upon the frequency and severity of the event occurring. In order to be insurable, the risk insured against must meet certain characteristics in order

to be an insurable risk. Insurance is a commercial enterprise and a major part of the financial services industry, but individual entities can also self-

insure d through saving money for possible future losses.

Effects:

Insurance can have various effects on society through the way that it

changes who bears the cost of losses and damage. On one hand it can

increase fraud, on the other it can help societies and individuals prepare for

catastrophes and mitigate the effects of catastrophes on both households

and societies.

Insurance can influence the probability of losses through moral

hazard, insurance fraud, and preventive steps by the insurance company.

Insurance scholars have typically used morale hazard to refer to the

increased loss due to unintentional carelessness and moral hazard to refer to

increased risk due to intentional carelessness or indifference.[6] Insurers

attempt to address carelessness through inspections, policy provisions

requiring certain types of maintenance, and possible discounts for loss

mitigation efforts. While in theory insurers could encourage investment in

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loss reduction, some commentators have argued that in practice insurers

had historically not aggressively pursued loss control measures - particularly

to prevent disaster losses such as hurricanes - because of concerns over rate

reductions and legal battles. However, since about 1996 insurers began to

take a more active role in loss mitigation, such as through building codes.

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Health Care:

Health care is the diagnosis, treatment, and prevention of disease, illness,

injury, and other physical and mental impairments in humans. Health care is

delivered by practitioners

in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and

other care providers. The exact configuration of health care systems varies

from country to country, but in all cases requires a robust financing

mechanism; a well-trained and adequately-paid workforce; reliable

information on which to base decisions and policies; and well maintained

facilities and logistics to deliver quality medicines and technologies.

Health Care Industry:The delivery of modern health care depends on an expanding group of

trained professionals coming together as an interdisciplinary team.

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The health-care industry incorporates several sectors that are dedicated to

providing health care services and products. According to industry and

market classifications, such as the Global Industry Classification

Standard and the Industry Classification Benchmark, the health-care industry

includes health care equipment and services as well as

pharmaceuticals, biotechnology and life sciences. The particular sectors

associated with these groups are: biotechnology, diagnostic substances,

drug delivery, drug manufacturers, hospitals, medical equipment,

instruments, and diagnostic laboratories.

According to the United Nations system the International Standard Industrial

Classification, health care generally consists of hospital activities, medical

and dental practice activities, and other human health activities. The last

class consists of all activities for human health not performed by hospitals,

physicians or dentists. This involves activities of, or under the supervision of,

nurses, midwives, physiotherapists, scientific or diagnostic laboratories,

pathology clinics, home, or other para-medical practitioners in the field of

optometry, hydrotherapy, medical massage, yoga therapy, music therapy,

occupational therapy, speech therapy, chiropody, homeopathy, chiropractics,

acupuncture, etc.

Philosophy:

The philosophy of healthcare attempts to synthesize the general meaning of

the healthcare industry as an social institution. Through the study of people,

processes, politics, and ethics in the healthcare industry, a workable

philosophy of healthcare develops. And as a social philosophy, healthcare

represents the primary means by which people improve the overall quality of

their daily lives. The ultimate purpose of healthcare philosophy is to provide

an analytic framework for the collection and analysis of all pertinent data in

the healthcare industry, especially for fields

like biotechnology, chiropractic, medicine, and nursing.

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Health Care by Country:

Health care systems are composed of individuals and organizations that aim to meet the health care needs of target populations. There are a wide variety of health care systems around the world. In some countries, the health care system planning is distributed among market participants, whereas in others

planning is made more centrally among governments, trade unions, charities, religious, or other co-ordinate bodies to deliver planned health care

services targeted to the populations they serve.

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Health Insurance:

Health insurance is insurance against the risk of incurring medical expenses. By estimating the overall risk of health care expenses, an insurer

can develop a routine finance structure, such as a monthly premium or payroll tax, to ensure that money is available to pay for the health care

benefits specified in the insurance agreement. The benefit is administered by a central organization such as a government agency, private business, or

not-for-profit entity.

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History:

In the late 19th century, "accident insurance" began to be available, which

operated much like modern disability insurance. This payment model

continued until the start of the 20th century in some jurisdictions (like

California), where all laws regulating health insurance actually referred to

disability insurance.

Accident insurance was first offered in the United States by the Franklin

Health Assurance Company of Massachusetts. This firm, founded in 1850,

offered insurance against injuries arising from railroad and steamboat

accidents. Sixty organizations were offering accident insurance in the U.S. by

1866, but the industry consolidated rapidly soon thereafter. While there were

earlier experiments, the origins of sickness coverage in the U.S. effectively

date from 1890. The first employer-sponsored group disability policy was

issued in 1911.

Before the development of medical expense insurance, patients were

expected to pay health care costs out of their own pockets, under what is

known as the fee-for-service business model. During the middle to late 20th

century, traditional disability insurance evolved into modern health

insurance programs. Today, most comprehensive private health insurance

programs cover the cost of routine, preventive, and emergency health care

procedures, and most prescription drugs, but this is not always the case.

Hospital and medical expense policies were introduced during the first half of

the 20th century. During the 1920s, individual hospitals began offering

services to individuals on a pre-paid basis, eventually leading to the

development of Blue Cross organizations. The predecessors of today's Health

Maintenance Organizations (HMOs) originated beginning in 1929, through

the 1930s and on during World War II.

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Importance:

Why do we need healthcare insurance?

The benefits of healthcare insurance are clear: it relieves you and your family the burden of unexpected medical emergencies. It is very important

because of the ever-increasing rise of medical costs, expensive visits to specialist doctors, the possibility of hospitalization and treatment, and the

need for routine medical checkups.

If you still don't have a healthcare insurance, it is crucial that you consider purchasing one. There are four types of healthcare insurance available:

Health Maintenance Organization (HMO), Point Of Service (POS), Fee-For-Service Plan (FFS) or Traditional Indemnity, and Preferred Provider

Organization (PPO). Below are the advantages and disadvantages of each healthcare plan:

Health Maintenance Organization:

One advantage of an HMO plan is that there are no coinsurance expenses or deductibles, only a co-payment. Also the cost of employee contributions and

premiums are low because of the cost control features. Paperwork is also minimal because since you're not required to submit claims.

On the minus side, you're only allowed to see a healthcare provider under the HMO network. There's also more cost controls elements like referrals, authorizations, etc. Lastly, a specialist can only be recommended by your

primary care doctor.

Point of Service:

With a POS plan, you can choose to go to a doctor not included in the POS network and still get coverage. However, the amount covered is significantly

less than if you go to a physician within the network. The POS plan also provides you with more well-being services and preventive care such as

health club discounts and workshops on quitting smoking.

Fee-For-Service:

One advantage of FFS is that it lets you choose healthcare providers you want. You may want to purchase this plan if you want to have your own

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doctor and if you're willing to pay more for healthcare insurance. One of the major disadvantages, however, is that there's no cost control, which explains

the high premiums. Another disadvantage is the absence of financial incentives to minimize your financial responsibility.

Preferred Provider Organization:

PPO is a combination of HMO and FFS plans. Here are some of the advantages this plan: seeing physicians in the PPO network has financial

incentives; you're allowed to go to a doctor who's not within the network at a reduced rate; and many services only need a co payment for outpatient

prescriptions or visits.

The PPO plan has also some disadvantages. Coinsurance and deductibles are applied for many services like hospitalization. Also, employee contribution

and premiums are much higher compared to an HMO plan, but substantially lower than an FFS plan. Lastly, it is the medical provider who submits the

claims.

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Health Care in the Light of Islam:

General Information:

The word “Islam” means peace and submission to the will of Allah (translated literally as “the God”); those who follow Islam are called Muslims. Islam is

one of the three Abrahamic religions after Judaism and Christianity. In the 7 th century C.E. Islam emerged in the Arabian Peninsula, or present day Saudi Arabia. Muslims believe that there is only one God and that Muhammad was

the last Prophet of God. They also believe that God revealed teachings to Muhammad, which are recorded in the Islamic Holy Scripture: the Qur'an. 

The Qur'an advises Muslims on their religious duties, including the five pillars, or religious obligations, including confession of faith, prayer, fasting,

charity, and pilgrimage.

Muslims consider the Prophet Muhammad as an exemplar and they try to emulate his deeds in their own lives by following his traditions and

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the Qur'anicinstructions. Such teachings have historically influenced attitudes and practices toward different aspects of life including birth, illness,

and death and dying, as well as the development of political, social and economic structures. These factors often impact policies on health care and shape Muslim sub-communities' attitudes about receiving medical treatment

from the larger non-Muslim society.

During the early period of development, Islam was influenced by different factors including the cultural practices of newly conquered lands. Muslim

rulers in these regions had to be rather flexible and they adopted and improvised many existing local practices; therefore, innovations in health

care practice were accepted provided that they did not conflict with Islamic Law (Shari'ah).

Shari'ah considers Muslims as one community (Ummah) and prescribes their activity from birth to death. Measures for basic health care in Islamic Law

include diet and personal hygiene. Due to differences between local personal habits, different interpretations of the Shari'ah developed during the early period of Islam. These interpretations resulted in the development of five distinct schools of   Fiqh,   or Islamic jurisprudence . Although these schools

interpret the Shari'ah based on their own theological approach, they share nearly the same fundamental beliefs on the matter of death and dying.

Pre-Modern Medicine in Islamic Experience:

There are no specific codes for medical treatment of physical illnesses in the Qur'an. In Islamic tradition the difference between health and illness was,

and still is, perceived as balance and imbalance or the Humoral Theory. Muslims have historically sought the Qur'an as a healing source in times of

psychological and spiritual distress. When experiencing physical illness, Muslims have also been open to the rituals and medicinal practices of

different traditions, including those of non-Muslims. The following sayings of the Prophet are used to encourage patients to seek proper treatments in

time of illness:

"There is no disease that Allah has created, except that He also has created its remedy." Volume 7, Book 71, Number 58

“Taking proper care of one's health is the right of the body.” Bukhari as-Sawm 55, an-Nikah 89, Muslim as-siyyam 183, 193, Nisai

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“The Prophet not only instructed sick people to take medicine, but he himself invited expert physicians for this purpose.” D.o.H. p.50, As-

Suyuti's Medicine of the Prophet p.125

Historically, there has been a close relationship between religion and medicine and its practices. Muslims have been open to accept, use and

improve non-Muslim as well as pre-Islamic healing rituals. They have adopted and improvised many practices such as home-made herbal and medicinal tonics, dietary restrictions, and amulets to ward off bad spirits.

They also have adopted practices such as male circumcision, cupping, bloodletting, cauterization and ligaturing. During the pre-modern era, Islamic medical and other sciences leaned heavily upon local medical practices, as

well as on works translated from Greek. These influences resulted in the further advancement of medical sciences, especially in the 11th and 12th

century.

Modern Period:

One of the most significant changes in Islamic history occurred toward the end of the Ottoman period. During this transition the previously united

Islamic world was fragmented into many newly independent Muslim countries due to the dissolution of the Ottoman Empire and the expansion of Western colonialism. These changes resulted in socio-political appropriation and adaptation of European influences, such as constitutional models and family law, as well as accepted medical treatments. As the result state-

supported public and local health clinics were established and local therapeutic traditions experienced decline. By the end of the 19th to the

beginning of the 20th centuries in many Muslim states/nations, the aim of state-sponsored health clinics was to eliminate local diseases and to provide

education about reproduction.

While European medical practices were strong influences in early modern Muslim societies, it should also be noted that the sciences in Europe did not

arise in a vacuum.

Contemporary Approach:

Contemporary Muslims' approach to health care is still strongly based on preventative measures. In many cases, although Muslim patients seek a

curative process through surgical or medical means, they still look to their religious and cultural heritage to address their spiritual, social and cultural

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needs. Preventative healthcare strategies in Muslim experience include: personal hygiene, dietary measures such as the restriction in eating specific ingredients (such as pork and its byproducts, and drinking alcohol), and the avoidance of addictive habits such as smoking tobacco or over-consumption

of food.

The Muslim population in the US is very diverse and colorful. The cultural background of different Muslim groups might influence the way in which they

respond to illness and other life crises. For example, some Muslims may perceive a sudden death or illness as a sign of punishment, or a test from God. Moreover, when an immigrant Muslim family moves to a larger non-

Muslim society they may adopt certain elements of their new cultural environment. However, one aspect that is usually the same regardless of

country of origin is in relation to the practices surrounding death and dying.

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Quranic Perspective About health care:

The traditions of Prophet Muhammad teach us to cherish good health and realize its true value as one of God’s countless bounties.

“And when your Lord proclaimed, “If you give thanks, I will give you more; but if you are thankless, lo!  My

punishment is dire.” (Quran 14:7)

Islam’s holistic approach to health includes treating our bodies with respect and nourishing them with, not only faith, but also with lawful, nutritious food.  A major part of living life according to the Creator’s

instructions is implementing a suitable diet.  Choosing wholesome food and avoiding the unwholesome is essential to good health.  God says in the

Quran, “Eat of the good things which We have provided for you.” (Quran 2:173)  “Eat of what is lawful and wholesome on the earth.”

(Quran 2:168)

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The Quran contains many verses of advice about healthy eating that relate to the interconnectedness of physical and spiritual health. 

Encouragement to eat only good and pure food is often combined with warnings to remember God and avoid Satan.  Healthy eating not only

satisfies hunger but also has an effect on how well we worship.

“O mankind, eat from whatever is on earth [that is] lawful and good and do not follow the footsteps of Satan. Indeed, he is to you a clear enemy.”  (Quran

2:168)

If one becomes obsessed with food or indulges in too much unwholesome or junk food he or she may become physically weak or distracted from his primary purpose of serving God.  On the other hand, if one concentrated

exclusively on spiritual endeavours and neglected their health and nutrition, weakness injury or illness would also result in failure to carry out obligatory

worship.  The guidance found in the Quran and the traditions of Prophet Muhammad advise humankind to maintain a balance between these two

extremes.

A healthy diet is balanced with a mixture of all the foods God has provided for His creation.  The variety satisfies all the body’s needs for

carbohydrates, minerals, vitamins, proteins, fats and amino acids.  Numerous verses of Quran mention the foods God has provided for us to

nourish and maintain our bodies.  It is not an exhaustive list of dietary requirements but rather a general idea of the types of food that maintain a

healthy body and prevent illness.

“He created cattle that give you warmth, benefits and food to eat.” (Quran l6:5)

“It is He who subdued the seas, from which you eat fresh fish.” (Quran 16:l4)

“It is He who sends down water from the sky with which He brings up corn, olives, dates and grapes and other

fruit.” (Quran 16:11)

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“In cattle too you have a worthy lesson.  We give you to drink of that which is in their bellies, between the undigested food and blood: pure milk, a pleasant beverage for those who drink it.” (Quran l6:66)

“There emerges from their bellies a drink, varying in colors, in which there is healing for people.  Indeed in that is a sign for a people who give thought. .” (Quran

16:69)

“And it is He Who produces gardens trellised and untrellised, and date palms, and crops of different

shape and taste (its fruits and its seeds) and olives, and pomegranates, similar (in kind) and different (in taste).  Eat of their fruit when they ripen...” (Quran

6:141)

“…and from it (the earth) we produced grain for their sustenance.” (Quran 36:33)

God has also provided us with a list of foods that are forbidden and apart from these everything else is considered lawful.

“Forbidden to you (for food) are: dead animals - cattle-beast not slaughtered, blood, the flesh of swine, and

the meat of that which has been slaughtered as a sacrifice for other than God...”  (Quran 5:3)  “...and

intoxicants.” (Quran 5:91-92)

While sweets and junk food are not forbidden they must be eaten sparingly as part of a balanced diet, designed to maintain optimum health. 

Many of the most common chronic illnesses today derive from unhealthy eating habits.  Coronary heart disease, hypertension, diabetes, obesity and

depression have all been linked to inadequate diets.  The traditions of Prophet Muhammad praise moderation as a way of maintaining good health and the Quran stresses the need to strike a balance between any extremes.

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True believers need healthy bodies and minds in order to worship God in the correct way.  To maintain a sound mind, a pure heart and a healthy body

special attention must be paid to health.  The heart and the mind are nourished by remembrance of God, and worship performed in a lawful way, and the body is nourished by partaking of the good and lawful food God has

provided.  Attention to diet and nutrition is a part of the holistic health system inherent in Islam.

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Depiction of healthcare in the light of Prophet & Islamic Scholars:

Prophet Muhammad advised his followers, to work, to be energetic, and to start their day early, all of which are conditions for a healthy body.  He

said “O God, make the early morning hours blessed for my nation.” Obesity or an inadequate diet, laziness and weakness are all afflictions for which we will be called to account.  Even though preventing illness or injury is often out of our control, there are many conditions brought on or made worse by

our own lack of attention to diet and fitness.  Prophet Muhammad, may Allah praise him, said, “Any action without the remembrance of God is either a

diversion or heedlessness excepting four acts: Walking from target to target [during archery practice], training a horse, playing with one’s family, and

learning to swim.”

The Prophet Muhammad and his Companions were naturally physically fit.  Life was tougher, long distances were covered on foot, men hunted and

farmed their food to survive, and there were no useless recreations to produce laziness and waste many hours of otherwise constructive time.  The

21st century contains many distractions and forms of entertainment that encourage laziness and induce ill health.

It will also be of interest to note that problems faced by the physicians & the patients today are not any different from the problems faced in earlier periods of history, would like to quote some sayings of Prophet Muhammad

(PBUH) on the responsibilities of physicians.

“A person who practices art of healing when he is not acquainted with medicine, will be responsible for his actions”

In other Hadith, The Prophet said:

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“O servants of ALLAH, seek treatment for ALLAH has not sent down any illness without sending down its treatment.”

Islamic teachings made treatment mandatory when it was definitely available, & also if holding off this treatment would be harmful. But if one is

unsure of any benefit from a treatment & any harm is feared, then it is discouraged. These principles were designed to discourage quackery &

protect the patients.

Respected Islamic scholar Imam Ibnul-Qayyem stated that movement helped the body get rid of waste food in a very normal way and strengthened the body’s immune system.  He also stated that each bodily organ has its own sport (or movement) that suited it and that horse riding, archery, wrestling

and racing, were sports that benefitted the whole body .

Islam encourages anything that promotes refreshing the mind or revitalising the body provided it does not lead to or involve sin, cause harm,

or hamper or delay religious obligations.  The traditions of Prophet Muhammad undoubtedly encourage involvement in sporting activities as a

way to promote a   healthy lifestyle and encourage brotherly love and family togetherness.

In a narration recorded by Imam Bukhari (a scholar who compiled Prophetic Traditions) it states that “The Prophet passed by some people from the tribe of Aslam while they were competing in archery (in the market).  He said to them, ‘Shoot children of Ishmael (Prophet) your father was a skilled

marksman.  Shoot and I am with so and so.’  One of the two teams therein stopped shooting.  The Prophet asked, ‘why do not you shoot?’  They answered, ‘How could we shoot while you are with them (the other

team).  He then said, ‘Shoot and I am with you all.”  In another tradition Prophet Muhammad’s beloved wife Aisha mentions their love of games and sports.  She said, “I raced with the Prophet and I beat him.  Later when I had put on some weight, we raced again and he won.  Then he said, ‘this cancels

that (referring to the previous race).’”

A true believer recognizes the wonder of the human body and is grateful to the Creator.  This gratitude is shown in the care and attention given to

maintaining optimum health.  Islam’s holistic approach to health covers all aspects of the mind, body and soul.  A truly health conscious person blends

diet, nutrition and exercise with the remembrance of God and an intention to fulfill all their religious obligations.

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Health Insurance in the Light of Islam:

Sharia’h:

Before I elucidate further the Islamic perspective of insurance, the reader needs to appraise the meaning ofShari’ah: simply, Shari’ah means the

Islamic way of life as derived from the Qur-ān and the traditions (Sunnah) of Prophet Muhammad. For Muslims the word of Allah is His law and His law is the command of Allah. It refers to both the Islamic system of law and the

totality of the Islamic way of life.The traditions of the Prophet Muhammad (pbuh) being divinely inspired are not only interpretive of Qur-ānic verses but also complementary to them. I

quote two ayath 4:59 , and 4:80 of An-Nissah from the Holy Qur-ān:

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