Page 32 - The Insurance Times June 2020
P. 32

While summing up -                                      that repair being satisfied by that repair - therefore,
                                                                 that issue of single repair quotation had been accepted
         All insurers claims settling officials are 'Working from Home'
         - so they are checking the survey reports scrupulously and  by us wholeheartedly'.
         for the fear of inflated claims where surveyors are  5. IRDAI requested the insurers to take urgent steps for
         sometimes colluded with the insured parties - for that  expeditious settlement of claims in the cyclone hit areas
         insurers' claim settling officials are asking some additional  and submit details of the same as advised above In view
         information from the surveyors like the following:      of Corona Virus (Covid-19) pandemic, the Insurers shall
         1. Copy of Balance Sheet, trading and P/L Account as at  encourage the policyholders to use electronic
             31.03.2018/ 31.03.2019 (which was Audited) &        communication wherever possible for correspondence
             31.03.2020 (Provisional) duly certified by CA with UDIN  while intimating the claim and filing all the relevant
             No.                                                 documents. So wherever the scanned document, bills,
                                                                 invoices has to be submitted by the surveyor - affixing
         2. Stock position from April, 2020 till loss dated 20.05.2020
             which are certified by CA with UDIN No.             the surveyor'sstamp & signature on all pages/
                                                                 documents (such as copies of purchase bill, stock
         3. For GST (comprising of CGST & SGST) Amount to be
                                                                 register, etc.) are mandatory.
             reversed back to the insured - Insured need to submit
             the Form No. 3B (Reversal of GST) with certification by  6. Insured must produce the purchase documents, viz.
             the Insured's Auditor/ CA's Certificationand Finished  challan, bills, invoices and also sale records etc. as also
             Goods' Cost Calculation with bifurcation of GST.    the item-wise stock position, Trading & P/L Account and
                                                                 other relevant records. During inspection all the books
         4. Labour Charges for shed repairing if allowed only from  of accounts had to be verified and to be justified that
             the single vendor - then surveyor should needs to give  those are in order by the Concerned Surveyor.
             justification like - 'In view of the above, although as per
             the view of the insurers 2/3 quotations are required  Finally when the salvage matter is resolved with the
             from other 2/3 vendors in normal situation - even may  quotations received from the independent, third party
             be expected in this instant claim settlement case but  salvage buyers as well as the offer of the insured for their
             considering the Covid-19 Pandemic that is prevailing at  retaining the damaged items - amongst them the highest
             the backdrop, with no train service available and very  bidder has to be allowed to lift / keep the salvage and
             scanty road transport service being available in the  thereafter, final survey report is to be submitted to the
             entire state of West Bengal - the Insured strongly stated  insurer, as usual.
             that they are unable to take such additional quotations
             from other repairers and since the matter of repairing  In case of Reinstatement Policy is issued the surveyor needs
             that Shed was their urgent & immediate dire need at  to confirm that the damaged items / properties / machines
             that moment of disaster and also directly related to the  are really reinstated in fully working conditions, if not then
             immediate revival of their factory's normalcy - the Shed  settlement may be based on the market value (as resorted
             was, therefore, simply repaired only by the available  in the normal course when the policy is without RIV Clause)
             Shed Repairer at their hand. Since the shed was already  on the lowest quotation submitted for repair - for the sake
             duly repaired by the said repairer so we had to recognize  of early settlement.

                   Insurers see up to 40% fall in non-Covid medical claims

           Insurance companies have reported a drastic fall in medical claims by policyholders during the nationwide lockdown.
           Outgo on nearly all ailments - digestive to psychiatric, or even cancer-related treatments - has sharply reduced through
           the lockdown, trends shared by leading insurers showed. Industry experts believe that the reduced number of claims
           is largely on the back of concerns among patients against visiting hospitals, and many patients are delaying non-essential
           surgeries to help prevent infections. Additionally, the number of accidents has reduced.
           "We have seen a 30-40% decline in non-Covid medical claims made at hospitals during the first few weeks of the
           lockdown," said Bhargav Dasgupta, CEO of ICICI Lombard. "The number of Covid related claims would be over and
           above these routine claims." This was reflected in the trends shared by other leading insurers as well. Standalone
           health player Max Bupa Health Insurance, for instance, said that while the highest claims in April had come from
           hospitalisation on account of unavoidable conditions such as genitourinary system (highest for chronic renal failure),
           cancer and childbirth; the claims for these respective conditions dropped by 40%, 42% and 45% as against March.

          32  The Insurance Times, June 2020
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