In order to mitigate the hardship caused to the affected insured population because of cyclones Tauktae and Yass in states such as Maharashtra, Gujarat, Odisha and West Bengal, Insurance Regulatory and Development Authority of India (Irdai) has issued guidelines to life, general and standalone health insurance companies for speedy registration and settlement of eligible claims
Guidelines from Irdai
Insurance companies will have to nominate a senior officer at the company level who would act as a nodal officer for the affected states. The officer will coordinate the receipt, processing, and settlement of all eligible claims. The nodal officer will establish contact with the chief secretary or the officer concerned of the state governments for subsequent follow-up.
General insurers have to ensure that all claims are surveyed immediately by engaging an adequate number of surveyors and claim payments are disbursed at the earliest. Insurers will encourage policyholders to use electronic communication for filing the claim and ensure digital processes for assessment of claims.
For life insurers, the regulator’s guidelines underline immediate action to ensure that all reported claims are registered and eligible claims are settled promptly. Special attention is to be given to Pradhan Mantri Jeevan Jyoti Bima Yojana (PMJJBY) claims. In case of loss of life, where there is difficulty in obtaining a death certificate due to non-recovery of body, the process followed in the case of Chennai floods in 2015 will have to be considered. Irdai has asked insurers to submit a weekly state-wise progress report on claims settled. PMJJBY claims data need to be submitted separately in total claims.
How to file general insurance claims
If a person has a householder’s policy, house policy, motor policy, he can file for claims settlement. The policyholder should not remove items from the place of occurrence as the insurer will depute a loss assessor to inspect the affected site or the damaged property. All the items must be allowed for inspection in the ‘as is where’ condition. If he is unable to locate the insurance policy, he should intimate the company.
Home insurance policies cover both building and household goods and a policyholder can claim the cost of repairing the building as well as furniture, electronic goods, clothing, etc. In the claims form, the policyholder must give personal details and the details of the damage. An assessor from the insurance company will assess the damage and the claims amount will be fixed. If the policyholder is not satisfied with the assessment of loss made by the insurer, then he must insist that the insurance company review the assessment before signing the discharge voucher for settlement of claims.
For motor insurance claims, policyholders must inform the insurance company within one month, providing all the relevant documents and photographs of the damaged or submerged vehicle. The company will send a service personnel from a garage where the company has a tie-up to access the damage. The service person will inform the company about the extent of the damage and the estimated cost of the repair. The insurance company will get the vehicle towed to a network garage for the repair and cashless claims.
A policyholder must note that barring a zero depreciation policy, the policyholder will have to bear some cost of the repair such as plastic parts. If the car was submerged under water, the policyholder must not start the engine as the insurance company will not pay for any losses if the owner tries to start the engine of the vehicle in a waterlogged condition and damages it.
How to file life insurance claims
For life insurance, the nominee of the deceased policyholder will have to contact the insurance company, submit a claim form, death certificate, original policy document (most insurers will not insist on the original policy document if it is lost during the cyclone). In case there is difficulty in getting a death certificate, the nominee can register the claim based on a certificate of death from any local government authority or post-mortem report. Insurers can also refer to the list of missing persons or deaths as issued by the government during situations such as cyclone or flood.
In PMJJBY, the nominee of the insured policyholder can claim Rs 2 lakh on death. The risk cover is provided to people in the 18- 55 years age group. The nominee will have to approach the bank where the policyholder had a savings account and submit the claims form, discharge receipt, death certificate and a cancelled cheque of the nominee’s bank account.
After receiving the death intimation, the bank will check whether the cover for the said member was in-force on the date of his death, verify the claim form and the nominee details from the records available with it and then submit the documents to the insurance company for claims payout.
