Introduction: The Insurance Regulatory and Development Authority of India (IRDAI) has issued Circular no: IRDA/NL/CIR/MISC/146/7/2023 to all CEOs/CMDs of General Insurance Companies and Stand-Alone Health Insurance Companies. This circular addresses insurance claims related to floods in Himachal, Punjab, Haryana, and Delhi regions caused by recent floods in July 2023. The circular provides guidelines and recommendations for insurers to ensure immediate service response and efficient claims processing.
Analysis: Insurers are advised to mobilize all necessary resources, including outsourced functions such as investigators, surveyors, and loss adjusters, to provide immediate service response to flood-related claims. The circular recommends the appointment of a Nodal Claims Officer in each affected state/UT to oversee the claims response and suggests the designation of District Claims Service Heads for districts reporting a large number of claims. Insurers should publish the contact details of these officers on their websites and raise awareness through the press.
To assist claimants, insurers are instructed to activate and publicize 24×7 helplines and launch extensive awareness campaigns. Special Claims Desks with delegated Claims Settlement Teams should be set up at the district level in affected areas to expedite claims processing and release on-account interim payments for the early reinstatement of properties and businesses. Insurers must ensure prompt surveying of all claims and timely disbursement of claim payments within the stipulated timeline.
The circular emphasizes the use of electronic communication and digital processes for claim initiation and documentation. Insurers are expected to review and streamline claims processing by requesting only necessary documentation for efficient final settlement. Additionally, insurers are required to submit information related to flood claims to the IRDAI on a weekly basis for a month.
Conclusion: The IRDAI circular addresses the insurance claims related to floods in North India and provides insurers with guidelines to ensure a prompt and efficient claims response. By appointing Nodal Claims Officers, establishing special claims desks, activating helplines, and utilizing digital processes, insurers can streamline the claims settlement process and provide timely assistance to policyholders affected by the floods. The circular emphasizes the importance of expeditious claims processing and highlights the need for insurers to submit flood claim information to IRDAI regularly.
INSURANCE REGULATORY AND DEVELOPMENT AUTHORITY OF INDIA
Circular no: IRDA/NL/CIR/MISC/146/7/2023 Dated: 16th July, 2023
All CEOs /CMDs of all General Insurance Companies, and Stand-Alone Health Insurance Companies
Re: Insurance claims relating to Floods in Himachal, Punjab, Haryana and Delhi regions
Floods (July 2023) in various States of North India are expected to cause widespread loss to property (homes and businesses) and infrastructure.
2. General Insurers and Standalone Health Insurance Companies are advised to mobilise all resources to ensure immediate service response including outsourced functions such as investigators, surveyors and loss adjustors as under:
a. Nominate a Senior Executive in each affected State / UT to act as the Nodal Claims Officer overseeing the claims response. The Nodal Officer appointment should be communicated to the Chief Secretary/ Officer concerned of the State
b. Districts reporting large numbers of claims may be overseen by a designated District Claims Service Head.
b. The contact particulars of the State / District heads should be published on the Insurer website and necessary publicity may be also given in the press.
c. All Insurers should also activate, publish 24×7 helplines to respond / assist Claimants and launch extensive awareness campaign duly highlighting the measures taken.
d. Special Claims Desks at District level with adequate delegated Claims Settlement Teams are recommended to be set up in affected areas to facilitate claims speedy processing and settlements including release of on-account interim payments to assist early reinstatement of property/ businesses.
e. It needs to be ensured that all claims are surveyed immediately and claim payments/ on account payments are disbursed at the earliest and in any case not exceeding the stipulated timeline.
f. Adequate number of surveyor may be engaged immediately as required and if needed, consider engaging surveyor from neighboring areas as well.
g The insurer shall encourage the policyholder to use electronic communication wherever possible for correspondence while initiating the claim and filing all the relevant documents. Efforts shall be made to ensure that digital processes are resorted to the extent possible for assessment of claims.
h. Insurers are also expected to review and streamline processing of claims by ensuring only such documentation necessary to substantiate claim quantum, to ensure expeditious final settlement.
3. All General Insurers (including Standalone Health Insurers) are advised to submit information related to the flood claims to the IRDAI in the format attached on a weekly basis at nl-catastrophe@irdai.gov.in for a month.
-Sd/-
Randip Singh Jagpal
Executive Director (Non-Life)
