In a move that would greatly ease settlement of insurance claims for customers, sector regulator IRDAI proposed to increase the limits for self-assessment of damage on Friday. The current limit for self-declaration by customers for motor accident claims is Rs.50,000, and for fire, home, marine, engineering and other insurance claims it is Rs.1 lakh. Anything above that limit would have to be assessed by an insurance surveyor.
With the new proposal, customers can self-declare in case of motor accidents up to Rs.75,000, and for non-motor claims up to Rs.1.5 lakh. IRDAI on Friday released its draft exposure for amending the Insurance Surveyors and Loss Assessors Regulations.
“The enhancement of limits for small claims will help to utilise the manpower available within the insurance company for survey work up to the loss limits so that such small claims are settled expeditiously,” said IRDAI.
The relaxation comes at a time when insurance companies are using app-based artificial intelligence to assess claims. Many of the companies are now setting claims based on videos shot by the policyholder on their mobile phones.
Source: Economic Times
Health insurance holders may soon get vouchers for a yoga centre, gymnasium memberships, and even for buying protein supplements, with IRDAI proposing new guidelines to promote wellness among people.
In its 'Exposure Draft on Guidelines on Wellness and Preventive Features/Benefits,' the watchdog said policyholders could be offered health-specific services by network providers or other empanelled hospitals for outpatient consultations or treatments, pharmaceuticals, health check-ups, and diagnostics.
According to the regulator, this can be done by offering outpatient consultations or treatments, health check-ups, and diagnostics, redeemable vouchers to obtain protein supplements and discount vouchers for membership in yoga centers or gymnasiums for participating in fitness activities.
The guidelines will specify the rewards that can be offered as wellness benefits in the health insurance products and how those benefits can be utilised would be mentioned in the policy contract, as per the draft.
Source: The Economic Times
IRDAI has exempted claims which have documentary evidence of the value of loss in the form of police reports, short-landing or non-delivery certificates issued by port trusts, railways, or other public or semi-government authorities. The cases which have a certificate for dutiable items from excise authorities and sling loss claims certified by harbour authorities from customary assessment by licensed surveyors are also excluded.
Motor claim on account of theft or injury/death to third parties and claims under health insurance policies, including travel and personal accident covers, are also exempted. Claims under Workmen’s Compensation/ Benefit policies under the Employees Compensation (Amendment) Act, 2009 and claims under public liability policies, including third-party liability, professional indemnity, products liability and personal liability except where liability arising out of property damage or defect to physical property/goods are involved too come under the category.
The regulator exempts aviation Hull Insurance claims and Cyber Insurance claims, those under money insurance including cash in transit policies, all risks, and burglary insurance policies on personal effects and jewellery and those under Race Horses insurance policies and Live-stock insurance policies too.
Further, claims concerning loss or damage to the crop, trees, plantations, and forests that are covered by government-sponsored schemes, loss, or damage to tea in transit from gardens in India also do not need assessment.
Source: The Asian Age