""FLASH NEWS""

"" Listing of state general insurers may be staggered.""...""" New India Assurance launches “New India Premier Mediclaim Policy” with exclusive features and Sum Insured upto Rs. 1 crore""".... “The tentative decrease in D.A. Slabs is 9 for the months from February,2017 to April,2017 - The net number of slabs for Feb.,2017 stands at 469"".."" ALL MEMBERS OF NFGIE/GICEU: PL ENSURE PAYING LEVY ON WAGE REVISION IMMEDIATELY ON RECEIPT OF ARREARS TO THE RESPECTIVE STATE /REGIONAL UNITS TO STRENGTHEN FINANCIAL POSITION OF NFGIE AS WELL AS STATE UNITS OF GICEU""....."" WAGE ARREARS WILL BE PAID ON 05th FEB.,2016""...."" WAGE REVISION FILE WAS CLEARED BY FINANCE MINISTRY ON THURSDAY 14TH JAN.,2016 ONLY. EXPECTING NOTIFICATION AT ANY TIME. HOWEVER, ON TUESDAY 19TH JAN.2016 GIPSA GOVERNING BODY MEETING HELD AT 'GOA'. PAYMENT DATE MAY BE DECIDED BY GIPSA AUTHORITY.""..."" NEXT ROUND OF DISCUSSIONS WITH GIPSA ON 04TH, 5TH & 6TH nOV., 2015 AT HOTEL GOLCONDA,HYDERABAD- NFGIE SLOT FOR DISCUSSIONS ON WAGE REVISION WITH GIPSA AT 2 PM ON 04.11.2015""...""Received a call from Mr A K Singhal, Advisor, GIPSA to our National Federation General Secretary, Mr P S Bajpai regarding the next round of Wage Talks on 29th October 2015 (Thursday) at Mumbai. Detailed Circular follows.""..."" We have been informed by Mr. Vasant Khande,Mumbai that Mr. Ashish Shelar,MLA and BJP President of Mumbai is going to attend our NFGIE conference on 1st October,2015 in Chennai""...""Wage revision and Pension Option – Programme of Agitation::: 1. Lunch Hour demonstrations in all centres on 15th and 23rd September.2. Signature campaign (memorandum addressed to Finance Minister) to complete by 23rdSeptember.;3. No late sitting in offices and no work on Saturdays, Sundays and Holidays w.e.f. 23rd September, 2015;4. Joint Employees meetings in all offices to campaign;5. Perspective of strike actions in October ""......"23RD JULY IS NEW INDIA'S FOUNDATION DAY(23RD JULY, 1919). ON THIS HAPPY OCCASSION, LET ALL NEW INDIANS TO RE-DEDICATE THEMSELVES ONCE AGAIN TO BRING BACK IT'S GLORY AND TO RETAIN NO.1 POSITION WITH PROFITS




""NEW INDIA ASSURANCE BEATS COMPETITION, GETS $9.5 BILLION AIR INDIA DEAL. One of India’s biggest public sector general insurer, New India Assurance (NIA) led consortium of public sector insurance companies has been awarded the contract to insure Air India’s huge fleet of 126 aircrafts worth 9.5 billion dollars. The consortium outbid the tender submitted by private general insurance companies, for this contract floated by Air India. NIA will insure Air India for 9.5 billion insurance cover for a premium of $22.5 million, which would be a one of the biggest aircraft insurance deals in the whole of Southeast Asia. PSU insurers continue to insure Air India for 4th year in a row"".....""Thank u all for staging a successful DHARNA today (06.7.2015) all over India as part of JFTU programme. At Mumbai we met Chairman GIPSA who informed that ministry is insisting on wage settlement on bank line only. Still they are pursuing with the ministry for getting sanction for a better package for PSGI Companies citing various factors. Due to this GIPSA is delaying resumption of wage negotiation. More stringent TU action is needed by JFTU against Ministry of Finance stand. JFTU will decide its further programme....Than 'Q'...Sujit Bagchi,General Secretary, "NFGIE""...""


TOTAL WEB VIEWERS

Sunday, October 30, 2011

IndiaFirst Life plans prepaid health insurance card

Dear Viewers,
IndiaFirst Life Insurance, which has 30-40 per cent of its revenues coming from investment products, wants to reduce its focus on that segment.
“Given the current market conditions, business is currently low in the investment product segment. We want to focus more on other segments now, and make sure there is equal balance,” Dr P. Nandagopal (Ex-OFFICER in New India Assurance), Managing Director and CEO, IndiaFirst Life Insurance, told Business Line.

The insurer, which began operations in November 2009, saw Rs 700 crore of new business during the last fiscal. Since it began operations, the company has seen premium income of Rs 900 crore.

“This year, we hope to maintain a 30-40 per cent growth rate,” said Dr Nandagopal.
According to him, IndiaFirst Life also plans to come out with a prepaid benefit card for the health insurance segment. The prepaid card will be issued along with the policy document, said Dr Nandagopal, adding that policyholders can swipe the card at the hospital and make claims.
Distribution channels

On distribution channels, he said that the company has expanded its alternative distribution channels by entering into third-party distribution agreements with regional rural banks and agencies.
“We expect 10 per cent of our retail business to come from them by this fiscal-end,” he added.
........EDITOR

D K Mehrotra tipped to be next LIC Chairman

DEAR VIEWERS,
A high level panel headed by the Finance Secretary Mr R S Gujral is understood to have zeroed in on acting chairman Mr D K Mehrotra to head the country’s largest insurer LIC. The panel interviewed five candidates here today including Mr Mehrotra for the post of regular Chairman.

Besides Mr Mehrotra, Mr Sushobhan Sarkar, executive director, international operations, Ms D Vijayalakshmi, executive director, investment, Ms Thangam Matthew, executive director, underwriting and reinsurance and Mr D D Singh, zonal manager, south, appeared in the interview, sources said.

Department of Personnel & Training (DoPT) Secretary Ms Alka Sirohi, Financial Services Secretary Mr D K Mittal, IRDA Chairman Mr J Hari Narayan, among others, were part of the panel, sources said.

The panel will now recommend the name to the Appointments Committee of the Cabinet (ACC) for final approval. Mr Mehrotra is the only candidate who is at the managing director level, while the other candidates are executive directors.

LIC has been without a full-time chairman since May, when the then-Chairman T S Vijayan’s five-year term ended and the government did not to grant him extension despite his having about two year service tenure left.
As an interim arrangement, the Additional Secretary in the Finance Ministry, Mr Rakesh Singh, was appointed as the LIC Chairman. Subsequently, Mr D K Mehrotra, LIC Managing Director, was asked to officiate as the chairman of the country’s largest insurer.

The selection panel had met in June to take a call on finalising names for the new Chairman, but could not reach a decision, candidates did not have the required clearance of the Central Vigilance Commission (CVC).

........EDITOR

OUR UNION BLOG VIEWERS STATISTICS - WORLD WIDE AS ON 30-10-2011

DEAR VIEWERS,

WE ARE PUBLISHING HERE UNDER THE VIEWERS DATA AS ON DATE  ACROSS THE WORLD.

WE EXPRESS OUR SINCERE THANKS T0 ALL THE VIEWERS  FOR BROWSING THIS BLOG. 

......EDIOR

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Delay in intimation or submission of documents not a reason to reject claims

DEAR VIEWERS,

Life insurance and non-life insurance companies define specific timelines within which a policyholder must intimate the insurer in respect of any claims. On delay of claim intimation or submission of documents to the insurance company, the claims get rejected. This issue has come to the notice of the Insurance Regulatory and Development Authority (IRDA), who has issued the circular to insurance companies.

The new circular is applicable to all life insurance and non-life insurance companies and states although the current contractual obligation imposes conditions that any and all claims must be intimidated to the insurer within specified number of days for effective post claim activities like investigation, loss assessment etc; this condition should not prevent settlement of genuine claims, particularly when there is a delay in intimation or document submission due to unavoidable circumstances.

This notice has been issued in the wake of several complaints received by the IRDA wherein insurance companies have rejected claims of policyholders on grounds of delay in the prescribed process.

The regulator has advised insurance companies to take a decision based on sound logic and valid grounds. Rejecting claims purely on technical grounds and in a mechanical manner will result in loss of policyholders’ confidence in the insurance industry. This will also result in excessive court cases and tiresome proceedings.
Insurance Claims

Insurance companies must see the merits and good spirit of the clause without compromising on bad claims. All insurers have been asked to ascertain the complete reasons for the delay (in any) before ruling out the claims.

Further the regulator has ordered all insurance companies to make amendments in their policy documents to clarify this to the policyholders.

The new judgement will surely be a blessing to several policyholders who have genuinely been unable to notify their insurer or submit requisite documents in time. The regulator gives high priority to concerns and issues faced by policyholders.
 
.....EDITOR

Tuesday, October 25, 2011

"" H A P P Y D I W A L I ""

DEAR MEMBERS,VIEWERS AND WELWISHERS,



WITH SEASONS GREETINGS,

M. HANUMANTHA RAO     T. GOPALA KRISHNA
                                PRESIDENT             GENERAL SECRETARY

Saturday, October 22, 2011

Third-party motor pool provisioning to be raised

Dear Viewers,
The ghost of commercial third-party motor pool losses is back to haunt general insurance companies. Based on an independent report by the actuary of UK government, the Insurance Regulatory and Development Authority (Irda) may increase the reserve or provisioning requirement for the third-party commercial motor portfolio of general insurance companies from 153 per cent to 175 per cent. If implemented, this would result in the industry taking a hit of '10,000 crore.
The timing could not have been worse. Just when the industry was beginning to recover from the '10,250-crore hit it took last year on account of commercial thirdparty motor pool losses that resulted in most general insurance companies slipping into the red, this would be a bitter pill to swallow
The UK actuary report, which studied the asset-liability of the third-party motor portfolio, has prescribed a reserve requirement of 205 per cent on the thirdparty motor pool portfolio. Given the losses and provisions made last year, Irda may initially settle for 175 per cent,” said a senior Irda official.

However, before implementing the norms, a draft report by the regulator would invite feedback from the industry.

“We have asked for some small clarifications from the UK actuary. After that, it would be made available to the industry. Only after deliberating the issue with the industry stakeholders, would it be implemented,” he said.
The UK actuary was assigned the task after the earlier report by eminent actuary, K P Sharma, suggested provisioning of 153 per cent. Consequently, in March, Irda increased the provisioning requirement for the commercial thirdparty motor pool losses from 136 per cent to 153 per cent.
This hit the solvency margins of many insurance companies, which prompted the insurance regulator to relax the solvency requirement from 150 per cent to 135 per cent for 2010-11. Based on the industry feedback, the regulator decided to conduct a peer review on the issue and had appointed the actuary of the UK government.

Only four of the 24 private general insurance companies in the country reported profits during 2010-11, on account of higher provisioning for third-party motor pool losses. To provide some relief to insurers, third-party premiums were increased by roughly 10-60 per cent, which insurers say was not sufficient.

“We are yet to see the report. But the rise in the provisioning requirement would be hard to absorb. Last year, the provisioning requirement was increased from 136 per cent to 153 per cent, and this impacted the profitability of all the general insurance companies. Though third-party premium rates were raised, it was not sufficient,” said asenior official at a private general insurance company.

The motor portfolio, which accounts for around 43 per cent of the total premiums, has been the ‘Achilles heel’ for general insurance companies in India, owing to inherent commercial third-party losses.

Total premiums collected by general insurance companies stood at around '44,000 crore in 2010-11, of which motor premiums accounted for '18,000 crore.  Typically, third-party liabilities account for 35 per cent of the total motor premiums.

In a bid to distribute the losses among insurers, Indian Motor Third-Party Insurance Pool was set up in April 2007 for commercial vehicle third-party insurance businesses. The share of each insurer was decided according to its market share in all lines of businesses.
........EDITOR

Rs 9 CRORES INSURANCE COVER FOR SUNDAY'S ODI CRICKET

DEAR VIEWERS,
Unseasonal showers and the July 13 serial blasts in Mumbai have forced the Mumbai Cricket Association (MCA) to buy an insurance cover of Rs 9 crore for the India-England one-day international at Wankhede stadium on Sunday 23rd OCT,2011.

Sources said MCA will shell out a premium of Rs 5 lakh for a special contingency policy for event cancellation from Oriental Insurance Company (OIC). The policy will protect MCA against financial losses owing to cancellation of matches due to bad weather, natural disasters, terrorism-related incidents or abandonment due to death of a prime minister or president. The cricket association cannot claim compensation if a ball is bowled before the match is called off.

"The cover for the India-England ODI is higher by Rs 1 crore compared to the policy for the India-Australia bilateral series match at D Y Patil Stadium on November 11, 2009," he added.

The India-Australia match was abandoned without a ball being bowled due to incessant rain. A source said, "There has been an increase in premium of the reinsurance market by at least 40% in the past six months. The local insurance company that offers the cover for such events has to peg the premium rates with those prevailing in the reinsurance market."

India is bracketed under the 'extreme risk category' in the terror index of the reinsurance market. The country's record in the terror index got further sullied following the July blasts in Mumbai in July and the bomb blast outside the Delhi high court last month.

Last week, the Anti-Terrorism Squad received an alert of plans to target the Chhatrapati Shivaji international airport on the eve of Diwali. Leander Dias, OIC administrative officer, said, "We cannot disclose financial figures to the media as these are confidential matters."

Apart from terror, rain is a major concern for cricket administrators. The earliest the monsoon withdrew from Mumbai in the last few years was October 7 in 2005. It withdrew as late as October 24 last year.

An insurance official said, "MCA is wary about the weather as the rain refuses to go away. They don't want to take chances as the India-Australia match had met a similar fate."

...... EDITOR

INSURANCE SCHEME TO HELP "STUDENTS GET UNINTERRRUPTED EDUCATION"

DEAR VIEWERS,
Students face a big challenge in completing their education in case of death of the head of the family or their financial provider. To ensure that such students complete their education without any interruption, the Maharasthra Government is working on an insurance scheme for students pursuing higher and technical education courses.

Commenting on this, Rajesh Tope, Higher and Technical Education Minister said that the scheme will be applicable to all professional degree and diploma courses like MBA, hotel management, engineering, pharmacy, that fall under the purview of his ministry.


Giving details of this insurance scheme, he added, "In case of death of a student's guardian or the head of the family, Rs 4.5 lakh will be given, whereas, in case of the death of a student, the family will get Rs 1 lakh."

Once the scheme is introduced, a nominal insurance premium will have to be paid by the students or the college itself can pay for it from their 'Students Welfare Fund' to Life Insurance Corporation of India (LIC).
 
..... EDITOR

New rules for insurance companies to appoint actuaries

DEAR VIEWERS,
Insurance Regulatory and Development Authority (IRDA) has sent the proposed norms to insurance companies, with the intent to tighten norms for appointment of actuaries.

Actuaries are experts who assess the financial impact enabling companies to take financial decisions. They provide their expert services for pricing the products based on a complete analysis and balance their role in business management with responsibility for safeguarding the financial interests of the public.

According to the draft of the proposed norms which has been sent to the insurers, an actuary should be an employee of the insurance company and must be below the age of 65 years.

Most insurers obtain services from actuaries who work as part time consultants. Only about 5 or 6 general insurance companies have employed full-time actuaries. Moreover, most of them who work as consultants are over 65 years of age.

The regulator said that until October 2012, qualified actuary should not be more than 70 years; and from 2013, in order to be eligible for appointment by an insurance company, an actuary will have to be below 65 years

.... EDITOR

Agent relationship with employee of insurance company redefined by IRDA

DEAR VIEWERS,
In February this year, Insurance Regulatory and Development Authority (IRDA) had come up with stringent guidelines, disallowing relatives of any employee of an insurance company to work as an agent for the same insurer. Previous draft of IRDA defined the term ‘relative’ to include spouse, parents, sisters, daughters, brothers, sons, daughters-in-law and sons-in-law.

On Wednesday, IRDA released a new circular modifying the term ‘relative’ and narrowing it down to include only spouse, dependent children or dependent step children, whether residing with the employee of an insurance company or not. The clause however, is applicable only to those insurance agents who are licensed or whose agency is transferred to another insurer on or after July 1st 2011.

This new circular should come as a relief to several insurance agents, as the earlier classification implied less scope for distant relatives to work for an insurance company



Life insurance companies, non-life insurance companies and IRDA realize the importance of agents for the growth of the insurance industry as a whole. At a recent Insurance Summit 2011, organised by Associated Chambers of Commerce and Industry of India (ASSOCHAM), IRDA Chairman J Hari Narayan made this clear by stating, “We do need agents and we need to do something about the agency channel.”

“One of the things is to require renewal of agent licenses on certain level of persistency. We need to have a regulatory call on this as insurance industry depends on agent persistency. IRDA has made some changes, we have tied up with some institutions for books to help agents learn,” he said.

The IRDA Chairman also said, “We should have two levels of insurance agents; one is we have a regular agents, then we are looking at senior agents.” Senior agents will be those who are more experienced and have served in the role for a good number of years. This will help fulfill their aspirational goals and to help keep them motivated.

........ EDITOR

"JOB LOSS COVER " could be the next innovative insurance product

Dear Viewers,
Recession or no recession; the fear of losing a job is prevalent across different classes of salaried individuals. In such a scenario, an insurance policy that would cover the policyholder in case of a job loss may well be the next innovative and ground-breaking idea.

The thought of losing a job itself is a discomforting factor, knowing that the unemployment rate in 2010 hovered around 10% in India. Unlike in western countries, an average salaried individual in India would have a higher number of dependents. If the breadwinner of the family loses his or her job, then the entire family falls into a financial crisis. An insurance policy that would compensate an individual in case of a job loss will be a boon not only to him but also to the entire family. Such a policy, if launched, should most probably fly off the shelf.
 
Insurance companies are closely watching the latest trends and demand for such a standalone insurance policy. According to a senior official of a private general insurance company, they have been considering a job loss cover for quite some time now.
 
T A Ramalingam, Head - Underwriting, Bajaj Allianz General Insurance said that over the last 6 months, queries regarding comprehensive job loss cover has increased. “Depending on the customer requirements and the product feasibility, we may consider offering this cover as part of a package policy for other customer segments that have financial relationships with financial institutions. It can cover a certain percentage of the gross monthly salary of the insured person, in case of a covered contingency,” he added.
 
If a job-loss cover is introduced in the Indian markets, it would come with a lot of conditions and exclusions attached. Insurance companies, underwriting teams, appointed actuaries will have to study the markets, changing trends, risks involved and various other factors in detail, before they can launch such a product.

....EDITOR

Thursday, October 6, 2011

PAN is must for payment of premium above Rs 50,000 in Cash: I.R.D.A.

DEAR VIEWERS & MEMBERS,
Insurance regulator Irda on Thursday 06th October, 2011 said that quoting PAN number would be mandatory for making cash payments of more than Rs 50,000 in insurance premium, a move which would help the authority track sources of funds.

"With a view to ensuring that premiums are paid out of clearly identifiable sources of funds, it has been decided to permit premium/proposal deposits remittances in cash beyond Rs.50,000 per transaction subject to the customer quoting PAN," Irda said in a circular.

The guidelines, which aim at curbing money laundering and dealing with the menace of terror financing in the insurance sector, would take effect from November 1.

IRDA said it would be the responsibility of the insurers to verify the details of Permanent Account Number (PAN), which is issued to tax payers.

In view of increasing threat of terror financing, the Insurance Regulatory and Development Authority (Irda) said, "It becomes imperative to obtain the details of the person or entity funding the premium."

It further said that any cash transaction above Rs 10 lakh, and integrally connected cash transactions above Rs 10 lakh per month, should be reported to the Financial Intelligence Unit-India (FIU-IND) by 15th of the every succeeding month.

Insurers, it added, should also lay down proper mechanisms to check any kind of attempts to avoid disclosure of PAN details.
....EDITOR

Cautious IRDA delays Bancassurance norms to mend hitches

Dear Viewers,
The insurance industry will have to wait a while longer for IRDA's guidelines on bancassurance because the insurance regulator is yet to iron out a few challenges and problems, reports CNBC-TV18's Mitra Joshi and Gopika Gopakumar.

Bancassurance, also known as Bank Insurance Model (BIM), is a move that will allow banks to tie-up with two insurance companies to increase distribution — one focussed on life insurance, and one on the non-life part of the business. However, the industry itself is split over whether the new bancassurance norms should be released.

The industry is divided into two different groups on the new bancassurance norms. "There are people who already have strong bancassurance tie-ups and hence, don't want to loose those tie-ups or dilute them by ensuring that the bank has an option. And, there are those who don't have strong tie-ups, and it will mean extra distribution to them. It will also enhance their reach by many folds," said Sanjiv Bajaj, managing director of Bajaj Capital

For IRDA, however, the question goes beyond this. It forsees challenges to on-ground implementation, and has delayed releasing the guidelines.

The key areas of concern pointed out by the IRDA include issues pertaining to training, licensing and certification of the employees selling these insurance products. There is also the fear that mis-selling can also rise. Also, since banks will become virtual brokers, there is potential for a conflict of interest over the products sold.

These concerns aside, the IRDA agrees that bancassurance will bring much-needed business to the insurance industry as it deepens the market and ensures better quality of sales. And, it is these positive aspects that have the Life Insurance Council pushing for quick release of bancassurance norms.

“We would certainly want this to come out quickly. We are losing time, especially in a market which is depressed, economic sentiment is low, people are getting investor averse, saving averse. Institutions like banks wherein customers have implicit faith could be an ideal distribution partner with insuring proper cheques and balances,” said SB Mathur, the secretary general of Life Insurance Council.

However, IRDA is adamant that it will release the guidelines only when it is sure the customer's interests remain protected.
.....EDITOR

I.R.D.A. may allow Insurers to invest in Derivatives & Commodity futures in Gold and Silver

DEAR VIEWERS,
In order to hedge risk in the falling interest rate and equity market scenario, the Insurance Regulatory and Development Authority (IRDA) is planning to allow insurance companies to invest in derivatives such as equity futures and options, credit default swaps, stock indexed options, commodity futures in gold and silver and interest rate swaps.

The regulator said the investment committee formed to look into the Insurance Amendment Bill had proposed that insurers be allowed to invest in these derivatives. Derivatives are a category of financial instruments and their value is derived partly from one or more underlying asset and help companies to hedge against fluctuations in equity, foreign exchange and interest rates.

Industry experts said insurers would be permitted to use equity derivatives for hedging risks only. "Irda may only allow us to hedge and not to speculate. We need to see to what extent we can take exposure. So the regulation may not be of big help," said a senior executive of a large life insurance company.

The move will help insurers to hedge their risk and protect returns of policyholders. It will also open up other avenues of investment for their investment portfolio.

At present, insurers can invest 50% of their funds in government securities, 15% in infrastructure projects and the rest 35% in other approved securities. From ULIP funds, insurers can invest a large part of the investment in equity, depending upon the policyholder's choice.
- - - - EDITOR

'TPAs Acting as Insurance Firms'

Dear Viewers,
Third party administrators (TPAs) are functioning as de facto insurance companies and settling mediclaims that they are not authorized to do, the Bombay high court was told on Tuesday 29th Sept, 2011.

A division bench of Chief Justice Mohit Shah and Justice Roshan Dalvi was hearing a petition filed by social activist Gaurang Damani highlighting the plight of more than 7 crore consumers of medical insurance, especially after TPAs stopped offering cashless benefits. The Insurance Regulatory Development Authority, the regulatory body, has filed an affidavit stating that it was not a silent spectator to the dispute that arose between insurers and hospitals and the row had been settled; the hospitals have now agreed to negotiate treatment rates, IRDA advocate Paritosh Jaiswal has submitted in court, adding that approximately 170 hospitals in Mumbai are now offering cashless benefits.

However, Damani cited 1,500 nursing homes and hospitals in the city that have stopped offering the cashless facility. "Cashless was the best option for mediclaim policy holders. Suddenly, in July 2010, the offer was withdrawn," said Damani, adding that every year, premiums of Rs 11,000 crore were paid as medical insurance.

According to him, medical insurance was not classified as life or general insurance policies and there is no specific guideline to process the claims. "Settling claims is the core activity of insurance companies and not that of TPAs, who are mere intermediaries," said Damani. "TPAs are acting as de facto insurance companies and even writing cheques to consumers." Damani says TPAs are offered financial incentives to reduce claim ratio and given discretionary powers that they abuse to settle the same claims at different rates.

He cited instances where TPAs had settled for different rates when they claimed reimbursement for the same illness at the same hospital. TPAs have also reportedly held on to cheques, delaying payments to consumers. "The TPAs operate arbitrarily," added Damani.

The judges have now directed Damani to prepare a note, suggesting some ways to resolve the problem amicably, and submit it in 10 days.
.....EDITOR

IRDA, PENSION REGULATOR " PFRDA " TO LOCK HORNS....

DEAR VIEWERS,
Two years after tensions rose between the pension and insurance regulator over commissions, a fresh round of friction between the two is in the offing.

The latest cause for friction is Pension Fund Regulatory and Development Authority's move to list life insurers to provide annuities to subscribers of the National Pension System (NPS). The NPS, which is administered and regulated by PFRDA, accumulates savings for a regular monthly annuity payment after retirement for government employees and those in the unorganized sector. However, the conversion of the accumulated savings into a monthly income stream can only be done by a life insurance company as per law.

PFRDA has invited expressions of interest (EoI) from life companies. In its invitation for EoI, it has said that annuities will be bought directly by the annuitants from the list of Annuity Service Providers (ASPs) approved by PFRDA from among the schemes accepted by PFRDA. PFRDA has also outlined seven options which life insurers can provide.

According to a senior official from the life industry, if PFRDA is going to allow only select companies to provide annuities, pricing might be an issue for selection. However, insurers can quote a price for an annuity plan only after their product is approved by the regulator.

Recently, the Insurance Regulatory and Development Authority (IRDA) had expressed reservations over a proposal to allow agents of life insurance companies to distribute pension products. IRDA chairman J Harinarayan , at a recent insurance summit, had said that life insurance companies were not mandated to act as intermediaries for third-parties.

In 2009, a committee headed by former pension regulator D Swarup had proposed that commission for insurance agents be scrapped completely and all agents should be converted into independent financial advisers who would be regulated by a Financial Well-Being Board of India (FINWEB).

The planners were expected to advise on all products, including those administered by PFRDA. The proposals were, however, never implemented by the government.

Earlier too there was an issue of who would regulate pension plans after the formation of PFRDA. Although the PFRDA's mandate was to manage pension plans in the government and unorganized sector, the insurance regulator made it clear that any pension plan floated by an insurance company would be its sole jurisdiction.

COLLISION COURSE
The NPS-regulated by PFRDA-accumulates savings for a regular monthly annuity payment after retirement. But the conversion of the accumulated savings into a monthly income stream can only be done by insurers as per law. PFRDA has invited expressions of interest from life companies and has also outlined seven options which life insurers can provide.
......EDITOR

IRDA tells insurers to honour the spirit of contract, reject claims only on 'valid grounds'

Dear Viewers,
You land up in a hospital on a medical emergency. The treatment costs a bomb. Your only solace is your medical insurance policy, which you have kept alive for 10 years - that too, without even making a claim - by paying annual premiums without fail. You file a claim to get the reimbursement of the hospitalisation expenses. However, to your horror, the insurance company rejects the claim, citing technical reason. You feel you are watching Michael Moor's Sicko all over again, this time as a victim of an evil health insurance company.

Such Kafkaesque scenario is not unheard of in the health insurance sector. Consumer activist Jehangir Gai narrates such an incident where a policyholder's hospitalisation claim was rejected because the insurer was intimated after the stipulated deadline. The fact that the policyholder was not in a position to intimate within the timeframe as he was hospitalised on an emergency and remained indisposed for a while failed to convince the insurance firm.

Explains Gai: "Sometimes, a person is admitted to hospital in an emergency (such as in the case of sudden appendicitis or heart attack) and his priority then is not to trace the policy document and intimate the insurance company. If a person forgets to inform the insurance company within the prescribed period (maximum seven days), then the claim is rejected even if it is submitted in time, within 30 days of discharge."

Then, there are cases where the claim-settlement process is stalled on the grounds that the original documents like discharge card, pathological test reports, X-rays, etc, were not submitted. "The original bills have to be submitted but not the documents, as these are required for subsequent follow-up treatment. There is no condition in a policy that requires the original reports to be handed over; just the copies would suffice. Yet, claims are rejected for non-submission of the original reports," he says.

Regulator steps in ::

In fact, so commonplace are cases of policyholders being dissatisfied with the insurers' claim-approval record that the Insurance Regulatory and Development Authority (Irda) has had to issue a circular to life as well as health insurance companies asking them to refrain from repudiating genuine claims on the grounds that they are time-barred.

"Insurers' decision to reject a claim shall be based on sound logic and valid grounds. It may be noted that such limitation clause does not work in isolation and is not absolute. One needs to see the merits and good spirit of the clause, without compromising on bad claims. Rejection of claims purely on technical grounds in a mechanical fashion will result in policyholders losing confidence in the insurance industry, giving rise to excessive litigation," the note warns.

----- EDITOR

DASARA GREETINGS - 2011

DEAR VIEWERS,
WITH WARM GREETINGS,
Yours-in-Service,
M. HANUMANTHA RAO       T. GOPALA KRISHNA
                           PRESIDENT              GENERAL SECRETARY