The Insurance Regulatory and Development Authority of India (IRDAI) has recently issued a circular addressed to all CEOs and CMDs of General and Stand-Alone Health Insurance Companies. This comes in the wake of the devastating floods that have affected Himachal Pradesh, leading to significant damage to properties and infrastructure.
IRDAI’s Directives to Insurance Companies
1. Mobilisation of Resources
Insurance providers are urged to harness all available resources for an immediate response. This includes enlisting third-party services like Surveyors, Loss Adjustors, and Investigators.
2. Designation of Authorities
- Nodal Claims Officer: Every insurer should nominate a Senior Executive as the Nodal Claims Officer to manage the claims arising from the disaster. Their details must be promptly communicated to the State’s Chief Secretary.
- District Claims Service Head: In districts with a high number of claims, a specific District Claims Service Head should oversee the process.
3. Transparency and Communication
- Insurers must publicize contact details of the State and District heads on their official websites. Press announcements will further ensure that the information reaches a wider audience.
- To enhance accessibility, insurers should establish 24×7 helplines to guide and aid claimants. Additionally, a robust awareness campaign is crucial to inform the public about the proactive measures taken by the company.
4. Claims Desk and Speedy Processing
- Establishing Special Claims Desks at the district level will empower affected regions with efficient claims processing and settlements.
- Companies are advised to roll out interim payments, ensuring swift restoration of damaged properties and businesses.
5. Immediate Survey and Deployment
- A swift survey of all claims is paramount, alongside disbursing claim payments promptly.
- Companies should employ a sufficient number of Surveyors and Loss Adjustors. If required, resources from neighboring states can be enlisted for aid.
6. Embracing Digitalization
- Policyholders should be encouraged to use electronic means for correspondence during the claim initiation and while submitting necessary documents.
- Efforts should concentrate on leveraging digital processes for assessing claims to the highest degree feasible.
7. Streamlining Documentation
- Insurers need to revisit their claims processing methods. The objective should be to request only vital documentation that substantiates the claim amount, ensuring a swift final settlement.
8. Reporting to IRDAI
- All General and Standalone Health Insurers must relay flood claim-related data to IRDAI weekly for the subsequent month.
Conclusion
IRDAI’s prompt guidelines post the Himachal Pradesh floods signify its commitment to efficient, transparent, and rapid claims processing. By directing insurance companies to take comprehensive measures, it ensures that affected policyholders receive timely assistance, highlighting the pivotal role of regulatory bodies during natural calamities.
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INSURANCE REGULATORY AND DEVELOPMENT AUTHORITY OF INDIA
Circular no: IRDAI/NL/CI R/MISC/161/08/2023
Dated: 24th August, 2023
All CEOs / CMDs of all General Insurance Companies, and Stand-Alone Health Insurance Companies
Re: Insurance claims relating to Floods in Himachal Pradesh
The ongoing Floods in Himachal Pradesh have caused 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 Surveyors, Loss Adjustors and Investigators. 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 immediately.
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 press.
d. All Insurers should also activate, publish 24×7 helplines to respond / assist Claimants and launch extensive awareness campaign duly highlighting the measures taken.
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 documents. 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.
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-catastropheirdai.gov.in for a month.
Press Release
IRDAI advised Insurance Companies to settle Himachal Pradesh flood Claims on Fast Track
The ongoing Floods in Himachal Pradesh have caused widespread loss to property (homes and businesses) and infrastructure. The Sector Regulator IRDAI issued instructions to all General Insurers and Standalone Health Insurance Companies to mobilise all resources to ensure immediate service response including engaging the services of Surveyors, Loss Adjustors and Investigators for quick settlement of claims arising out of the havoc created by the floods.
The insurers have been advised to communicate the nomination of a Senior Executive to the Chief Secretary immediately. Districts reporting large numbers of claims to oversee by a designated District Claims Service Head. The insurers to give wide publicity on the contact details of these officers in their websites and also in the media.
Insurers are advised to respond/assist the claimants through their 24×7 helplines, special claims desks at district level with delegated Claims Settlement Authorities for speedy processing and settlement of claims. Insurers have been advised to settle claim payments/on account payments at the earliest and also encourage policyholders to use electronic communication wherever possible for correspondence.
