Introduction: The Insurance Regulatory and Development Authority of India (IRDAI) has issued a crucial circular (Ref. No: IRDAI/NL/CIR/MISC/215/12/2023) dated 09-12-2023, addressing insurance claims arising from the devastating Cyclone Michaung and subsequent heavy rains/floods in December 2023. This directive emphasizes the need for immediate and efficient response from all insurance companies to assist those affected by the widespread damage.
Detailed Analysis:
1. Mobilization of Resources:
- Insurers are urged to mobilize all resources, including outsourced functions like surveyors and loss adjustors.
- Appointment of a Nodal Claims Officer at a senior executive level is mandated, with communication to the Chief Secretary of the concerned state.
- Districts facing high claims are advised to have a designated District Claims Service Head.
2. Communication and Awareness:
- Contact details of State/District heads should be published on insurer websites for easy access.
- 24×7 helplines are to be activated and extensively publicized.
- An awareness campaign is recommended to highlight measures and encourage policyholders to utilize electronic communication for claims initiation.
3. Claims Processing and Settlement:
- Special Claims Desks at the district level are suggested for swift processing and settlements, including interim payments.
- Immediate engagement of surveyors and loss adjustors is stressed, with the option to deploy resources from neighboring states.
- Emphasis on electronic communication for claims initiation and streamlined processing to expedite final settlement.
4. Challenges with Death Certificates: In cases of claims involving loss of life where obtaining a death certificate is challenging, matching insured details with those published by government authorities may be considered.
Conclusion: The IRDAI’s circular provides a comprehensive framework for insurance companies to navigate the aftermath of Cyclone Michaung and subsequent floods. The guidelines aim to ensure swift and effective claims processing, timely settlements, and proactive assistance to policyholders. Insurers are encouraged to adhere to these directives, contributing to the restoration of normalcy for those impacted by the natural disaster.
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Insurance Regulatory and Development Authority of India
Ref. No: IRDAI/NL/CIR/MISC/215/12/2023
Date: 09-12-2023
CIRCULAR
Re: Insurance claims relating to Cyclone Michaung and subsequent heavy rains/floods
The Cyclone Michaung and subsequent heavy rains/floods (December 2023) are reported to have caused widespread loss to human lives, property (homes and businesses) and infrastructure in various states.
2. All Insurance Companies are advised to mobilise all resources to ensure immediate service response including outsourced functions such as Surveyors, Loss Adjustors and Specifically:
a. Nominate a Senior Executive to act as the Nodal Claims Officer overseeing the claims response. The Nodal Officer appointment should be communicated to the Chief Secretary concerned of the State
b. Districts reporting large numbers of claims may be overseen by a designated District Claims Service Head.
c. The contact particulars of the State / District heads should be published on the Insurer website and necessary publicity may be also given in the
d. All Insurers should also activate, publish 24×7 helplines to respond / assist Claimants and launch extensive awareness campaign duly highlighting the measures
e. Special Claims Desks at District level with adequate delegated Claims Settlement Authorities are recommended to be set up for affected areas to facilitate speedy processing of claims and settlements including release of on- account interim payments to assist early reinstatement of property/ businesses.
f. It needs to be ensured that all claims are surveyed immediately and claim payments/ on account payments are disbursed at the earliest.
g. Adequate number of Surveyors and Loss Adjustors be immediately engaged and if needed, resources from neighbouring States may be also deployed.
h. Insurers shall encourage Policyholders to use electronic communication wherever possible for correspondence while initiating the claim and filing all the relevant Efforts shall be made to ensure that digital processes are resorted to the extent possible for assessment of claims.
i. 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.
j. With regard to claims involving loss of life, where difficulty is experienced in obtaining a death certificate due to non-recovery of body etc., if the details of the Insured matches with the details of the deceased published by State/Central Government or appropriate/Govt. authorities., the claim may be considered without insisting for death
3. All Insurers (including Life and Standalone Health Insurers) are advised to submit information related to the Cyclone/flood claims to the IRDAI in the format attached on a weekly basis at nl-catastrophe@irdai.gov.in by General and Health Insurers and at life@irdai.gov.in by Life Insurers, for a
Sd/-
(Randip Singh Jagpal)
Executive Director (Non-Life)
