Page 13 - Life Insurance Today January 2018

5. “Complainant” means a policyholder or prospect 11. Words and expressions used and not defined in
or any beneficiary of an insurance policy who has these regulations, but defined in the Act, or the
filed a complaint or grievance against an insurer Insurance Regulatory and Development Authority
or a distribution channel Act, 1999 (41 of 1999) or the Insurance Rules,
1939 or any other regulations issued by the
6. “Cover” means an insurance contract whether in
Authority shall have the meanings respectively
the form of a policy or a cover note or a Certificate
of Insurance or any other form as approved by the assigned to them in those Acts or Rules or
Regulations;
Authority to evidence the existence of an
insurance contract;
5. Board approved policy for protection
7. “Distribution Channels” means persons and
entities authorised by the Authority to involve in of interests of policyholders:
sale and service of insurance products; 1. Every insurer shall have in place a board approved
8. “Proposal form” means a form to be filled in by policy for protection of policyholders’ interests
the prospect in written or electronic or any other which shall at the minimum, include
format as approved by the Authority, for (i) steps to be taken for enhancing Insurance
furnishing all material information as required by Awareness so as to educate prospects and
the insurer in respect of a risk, in order to enable policyholders about insurance products,
the insurer to take informed decision in the benefits and their rights and responsibilities.
context of underwriting the risk, and in the event (ii) service parameters including turnaround
of acceptance of the risk, to determine the rates, times for various services rendered.
advantages, terms and conditions of the cover to
be granted; (iii) procedure for expeditious resolution of
complaints
Explanation: “Material Information” for the (iv) steps to be taken to prevent mis-selling and
purpose of these regulations shall mean all unfair business practices at point of sale and
important, essential and relevant information
service.
sought by insurer in the proposal form and other
connected documents to enable him to take (v) steps to be taken to ensure that during policy
informed decision in the context of underwriting solicitation and sale stages, the prospects are
the risk; fully informed and made aware of the benefits
of the product being sold vis-a-vis the product
9. "Prospect” means any person who is a potential features attached thereto and the terms and
customer of an insurer and likely to enter into an conditions of the product so that the benefits
insurance contract either directly with the insurer
/ returns of the product are not mis-stated /
or through a distribution channel;
mis-represented.
10. “Prospectus”: means a document either in
physical or electronic or any other format issued 2. Every insurer shall display the service parameters
by the insurer to sell or promote the insurance and turnaround times as approved by the Board
products; in its website and keep the same updated as and
when the service parameters are revised by the
Explanation: Insurance products referred herein Board.
shall also include the riders offered, if any. Where
a rider is tied to a base policy all the terms and
conditions of the rider referred in the definition 6. Point of Sale:
shall be mentioned in the prospectus. Where a 1. A prospectus of any insurance product shall clearly
standalone rider is offered to a base product, a state
reference to the rider shall be made in the (i) (a) the Unique Identification Number (UIN)
prospectus of the base policy indicating the nature allotted by the Authority for the
of benefits flowing thereupon. concerned insurance product

“The price of anything is the amount of life you exchange for it”

Life Insurance Today January 2018 13

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