Page 223 - Ebook health insurance IC27

Sashi Publications

Important Points to Remember

Parameters for Consumer protection

1. Transparency
 Since insurance is an intangible contract where promises shall be fulfilled in future,

there should be utmost transparency
 This will help to avoid dissonance later at the time of claims
 There must be transparency at every stage of policy life-cycle
 In all customer contact stages like website, e-mails, letter, branch, Call Centre it

should be information driven
 The more information is given small points more will be the dispute. So try to be

transparent

2. Customer centric service
 Deliver promises made
 Deliver fast service with quality
 Good service must be offered at every stage of interaction with the policyholder

and not just at the time of sales
 The customer care officer should not have the sole responsibility of customer service.

Every person in the insurance company must have a customer centric approach

3. Ability to settle genuine claims promptly
 For insureds the utility of insurance is known at the time of claim settlement.
 Insurance companies must put in place a robust claim assessment process so that

genuine claims are processed speedily
 In case of claims which are exaggerated or fraud is suspected, the claim should be

fully verified and then paid or rejected

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