General
Every consumer has some rights and the same applies to insurance consumers also.
They are
Policy holder's protection regulation published by IRDA. This regulation explains
dos and don'ts at Point of Sale, Proposal for insurance, Grievance redressal procedure,
Matters to be stated in life & general insurance policies, Claims procedure in respect
of life & general insurance policies and Policyholders Servicing
Arbitration
All insurance policies provide the dispute resolution method thro arbitration for
quantum disputes. This mechanism is cost effective method and would require only
shorter period to resolve disputes
Ombudsman
Any disputes relating to deficiency in service , policy issuance and claim related
issues would be dealt by this method for disputes up to Rs.20 lacs. This mechanism
is available for only individuals and proprietorship entities.
RTI Act
It provides customers the right to get copies of all official records without taking
the recourse of legal battle.
Checklist to buy a insurance
Here is a simple checklist of the actions that you need to take while buying your
insurance. Though these suggestions are made generally for business, it equally
applies to individual needs also
Appoint insurance broker or insurance adviser
The selected broker should have personal knowledge of your trade and/or your risk
exposures
The broker should be in a convenient location for your offices and your main business
operations
Details of the main people who will work on your account should be provided
Information about the level of fees, commissions and other broker remuneration should
be furnished in full and detailed when requested by the customer
Ask your broker for details of the Professional Indemnity (PI) or Errors and Omissions
(E&O) insurance that they have purchased (insuranzone has a limit of Rs.3.5 crores
and this limit is monitored by IRDA)
Undertake assessment of hazards / risk exposures
Undertake an assessment to identify what could happen that would impact your business
Identify the insurance that you are obliged to purchase for legal and contractual
reasons
Decide what levels of deductible (or excess or first bearing amount in claims as
not payable) are appropriate for your business and your risk appetite
Improve standards of risk control / loss control
Evaluate the existing standards of risk and safety, and property control protection
Identify situations where better control of risks is appropriate and cost effective
Plan actions that will limit damage or reduce costs in the event of a loss, as well
as actions that will reduce the likelihood and severity of an incident
Review business continuity arrangements
Analyze the loss events that could seriously disrupt your business operations
Determine whether sufficient controls are in place to minimize the potential disruption
Design and implement improved controls, as appropriate and cost effective
Implement procedures for the testing of business continuity and disaster recovery
plans
Decide on likely extent of insurance purchase
Complete the insurance needs assessment described in the Risk Assessment Table (RAT)
Take final decisions on the categories of insurance that you intend to purchase
(depending on price)
Identify the amount of insurance cover that you intend to purchase / limit of indemnity
that is required
Life insurance
Here are some questions to ask you:
How much of the family income do I provide? If I were to die early, how would my
survivors, especially my children, get by? Does anyone else depend on me financially,
such as a parent, grandparent, brother or sister?
Do I have children for whom I'd like to set aside money to finish their education
in the event of my death?
How will my family pay final expenses and repay debts after my death?
Do I have family members or organizations to which I would like to leave money?
How will inflation affect future needs?
Some decisions to be made
Review your own insurance needs and circumstances. Choose the kind of policy that
has benefits that most closely fit your needs. Ask your broker to help you.
Be sure that you can handle premium payments. Can you afford the initial premium?
If the premium increases later and you still need insurance, can you still afford
it?
Don't sign an insurance application until you review it carefully. Ensure all the
answers are complete and accurate.
Don't buy life insurance unless you intend to stick with your plan. It may turn
out to be very costly if you quit during the early years of the policy.
Read your policy carefully. Ask your broker about anything that is not clear to
you.
Review your life insurance program with your broker every few years to keep up with
changes in your income and your needs.
Claims procedures
General Claims Procedures
Inform insuranzone immediately after an accident.
Prevent properties from further damages.
Take photographs of damages (and video graph if the loss is large in your opinion,
say beyond Rs.15.00 lacs-applicable to property insurance)
Prepare occurrence report in detail giving details of the accident, date & time,
witness if any
Prepare estimate of the loss by giving detailed description of asset, quantity,
unit price and total value.(applicable to property insurance)
Segregate damaged assets from undamaged assets after the survey and with his permission.(applicable
to property insurance)
Provide details to surveyor about the loss and co-operate with him to complete his
survey
Report to police for theft / burglary / dishonesty / fire major loses and fire brigade
for fire loses and obtains reports from the respective govt. agencies
Obtain quotation for repair and/or for replacement from 2 to 3 repairers/suppliers
and dealers
Obtain meteorological department report for flood and cyclone claim.
Collect paper cuttings if the accident/theft/flood/cyclone are reported by the press.
In case of Burglary/theft/loss of cash/crime by employees/third party injury and/or
Property damage/any fatal injury to employees, inform police without fail and collect
FIR from them.
Conduct internal enquiry for losses as in 12.
Collect Non-Traceable certificate from police, usually it is issued after the expiry
of 90 days from the date of occurrence for theft / burglary / dishonesty claims.
In case of delay in obtaining police certificate the insurer may be asked to make
an on account payment.
Notify damages on the reverse of all copies of consignment note in case of marine
transit loss.
Registered Letter with AD card addressed to the carrier claiming compensation for
losses and/or damages in Marine transit to be sent immediately after delivery without
any delay.
In case of personal injury obtain medical certificate from the attending doctors
in claim form or separately.
Forward all notices and summons served on you to the insurance company with a copy
marked to insuranzone.
Protection important records: It is important and a must to preserve records in
a place of safety other than the premises insured. Log books for machinery O&M,
movement register, Fire drills register etc. are important ones.
Motor Claims Procedures
Report the matter to insuranzone immediately (to assist you in a better way) and
in turn insuranzone will inform the same to the insurer or you may inform directly.
In case of accident involved with any third party, then report the matter to the
police. If no third party is involved no need for an FIR.
Take photograph of the vehicle at the accident spot and take the vehicle (or tow
the vehicle, if crippled) to the dealer for preparing the estimate and the same
must be submitted to the surveyor or insurer. The vehicle must be inspected by the
surveyor at the dealer's workshop only. Do not carry out the repair before the survey.
Original RC is required along with a photo copy (Original will be verified by the
insurer or by the surveyor and returned)
Original DL is required along with a photo copy of the driver who was on the wheels
at the time of accident. For parked vehicle this is not required (Original will
be verified by the insurer or by the surveyor and returned)
Provide a copy of the policy to the surveyor
Complete the claim form in all respects and hand over to the surveyor
In case of theft of vehicle, an NTC (non traceable certificate) issued by the police
be produced and normally this will be issued after 90 days.
In case of any delay in obtaining the NTC, you may request the insurer an on account
payment
After repairs, pay the differential amount (difference between the actual amount
and the insurance claim) to the repairer, sign the satisfaction voucher, collect
copies of bills and receipts and take delivery of the vehicle.
Selecting your insurance company
When you choose insurers the following criteria must be in your mind in selecting
the Insurance Firm.
Premium Competitiveness
Professionalism and Technical Expertise.
Turnaround time of quotation slips.
Flexibility and Willingness to negotiate.
Consistency of attitudes and Products.
Policy terms, conditions, exclusions and warranties.
Document accuracy.
Personal relationship & rapport.
Underwriting Services.
Claims Handling.
Financial Stability of the insurer.
How to select your insurance agent or broker
Dos
Before selecting an Agent or Broker there are some basic questions you need answered
by the Agent or Broker especially when you look for expertise? For example:
Do you need personal lines insurance or business insurance or both?
Are you looking for special services such as special risk management services or
technical advice alone?
Would you prefer to work with a small or large broking firm or with individual Agent?
Ask the Agent or brokers you've selected to give you an expression of interest or
a proposal. From the expression of interest you could get the feel of the right
broker from the following
Their qualifications and registration with official
bodies or associations
Who would service your account?
Their past experience in the Insurance Industry
Their range of services
Size of their "typical" client presently handling
References.
If yours is a business entity, you might then ask the broker to make a presentation.
At the presentation you should look for:
Business compatibility
Level of commitment
How they propose to solve your insurance problems
The competitive advantages of their firm over any others you may have selected.
Once you've made a decision, include a review period in the relationship with your
broker. This allows both parties to discuss issues of concern and see if the relationship
is working.
(insuranzone qualifies the above criteria)
Don'ts
Don't buy insurance from many intermediaries (Agents & Brokers) as no one would
come to your rescue when you are in need
Don't buy insurance from persons or firms who are selling insurance also as one
of the financial services and look for only full time Agents or Brokers exclusively
into insurance Advisory & Servicing
Don't be carried away by ads as you would not get a right product