Irdai: No Claim Rejection for Lack of Documents
Jun 11, 2024 20:47
Irdai has issued a circular stating that general insurance companies cannot reject claims for lack of documents. The circular also mandates customer-centric insurance solutions, including policy cancellation and timely claim settlements.
New Delhi, Jun 11 (PTI) General insurance companies cannot reject claims for want of documents, the Insurance Regulatory and Development Authority of India (Irdai) said on Tuesday.
The master circular is part of reforms in the general insurance business, especially post-de-notification of all the tariffs and policy wordings, ushering in a new era of measures for simplified and customer-centric insurance solutions.
The comprehensive master circular on general insurance business also repeals 13 circulars.
Irdai said the provision of easy-to-understand insurance products tailored to meet the individual needs of the customers, providing them with ample choices and enhancing their insurance experience has now been enabled.
"No claim shall be rejected for want of documents. Required documents are to be called at the time of underwriting the proposal. The customer may be asked to submit only those documents necessary and related to claim settlement (if cashless is not available)," the circular said.
Further, retail customers can cancel the policy anytime by informing the insurer. The insurer can cancel the policy only on grounds of established fraud.
The insurer should refund a proportionate premium for the unexpired policy period on cancellation, the circular said.
Irdai has also provided strict timelines for the settlement of claims, including for the appointment of surveyors and submission of their reports.
It will be the duty of the insurer to obtain timely survey reports, Irdai said.
"Additional options of 'pay as you drive'/ 'pay as you go' to be given as a first choice to the customer in motor insurance," the circular said and added there should be no burden on the customer for disposal of salvage.
It further said that homeowners' "fire" policy should have the option to choose add-on covers such as flood, cyclone, earthquake, landslide, rockslide, terrorism or to opt-out from comprehensive fire and allied peril policy.
Insurers will also have to give a Customer Information Sheet (CIS) to provide clear and concise policy details, including scope of coverage, exclusions, warranties, and claim settlement processes
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