Page 24 - Insurance Times June 2023

Similarly, for rejected claims subsequently allowed by a court One such parameter happens to be responsiveness on claims
of law, the consumer forum will attract a monetary penalty and surveyor handling. Most public sector general insurers
on both the official and the rejecting authority concerned. have miserably bad scores in this parameter. Thus, some kind
Regular on-site audits by the IRDAI have to be conducted of guaranteed settlement provision is likely to improve these
with its team and hired claims professionals from the disappointing scores.
industry. These can be retired insurance officials, chartered
engineers, accountants and lawyers. In conclusion, the actions which have become extremely
necessary for Indian claimants are the following:
The general insurers can consider an add-on coverage Personal accountability of settlement of any claim with
towards guaranteed claim settlement at a premium. This monetary penalty provisions.
will ensure the payment of non-fraudulent claims with
Strict adherence to the IRDAI's guidelines on claim
proper coverage of up to 75% of the claim amount, subject
settlement both in letter and in spirit. As one of the
to a maximum of Rs. 50 crores.
finest insurance regulators in the world, IRDAI has
always drafted the best possible guidelines for
It is completely understood that there are existing provisions
protecting policyholders' interests. It is incumbent on
for non-standard settlements of claims, but there is no
the other stakeholders to follow such guidelines with
guarantee of exercising such a mode of payment.
utmost honesty.The above regulation has to be
outcome-based to minimise the trust deficit.
A paid add-on coverage will at least assure the client of 75%
Understand that the documents required can be
recovery of the claim, up to Rs. 50 crores. This will be a
flexible. Surrogate documents/pieces of evidence can
significant relief to most clients with neither the
be looked into. The sole motive should be to help a
infrastructure nor the expertise to fight with the Insurer to
genuine claimant.
recover such a technically perceived deficient claim.
Finally, let there be a campaign by the insurers and the
The Insurance Brokers Association of India (IBAI) releases regulator and, if possible, by the judicial bodies. Let us, as
an annual report on the performance of various general an industry, find more reasons to help a genuine claimant
insurers based on precisely defined service parameters. than coming out with excuses to reject claims.

'Insurance for all' pivots on 3 As, says IRDAI Chief

Debasish Panda
The insurance regulator is working on a three-pronged approach - availability, accessibility and affordability - to ensure
'Insurance for All by 2047', its chairman Debasish Panda said.
"We are also working with the councils of both life and general insurance to have a UPI-like moment for the insurance
sector. A conceptual framework has been contemplated," Panda said, adding this is being proposed through the Bima
trinity - Bima Sugam, Bima Vistar and the woman-centric Bima Vahak.
The Insurance Regulatory Development Authority of India (IRDAI) chairman, who was speaking at the Confederation
of Indian Industry (CII) annual general meeting, said the challenge is to double the penetration of the Indian insurance
market in five to seven years and create greater awareness about insurance products.
Panda said that IRDAI is moving from a rule-based approach to a principle-based approach, that the opportunity to
invest in the insurance sector is immense given the size of the market and that India's insurance penetration is low.
As many as 70-odd regulations have been repealed, 1,000-odd circulars have been done away with and 79 returns
rationalised, he said.
On the issue of surety bonds, Panda said the IRDAI is working very closely with the insurers. "There are a few pain
points. We have already removed the additional solvency requirement," he said.

22 June 2023 The Insurance Times