Fat Rejection! IRDA Refuses Demands To Include Weight Loss Surgeries In Mediclaim.

IRDA rejects demands to include weight loss surgeries in health insurance

IRDA rejects demands to include weight loss surgeries in health insurance

This should have been a no-brainer. But the number of people who consider their weight a life-destroying reality, not so much.

And so despite vehement arguments from Bariatric surgeons on how bariatric surgery, that is, weight loss surgery ‘saves lives’, IRDA was not impressed.

The pro-coverage lobby’s arguments were hardly as frivolous as they sound and according to bariatric surgeon Dr Sanjay Borude, who operates on around 20 patients a month, said barely one per cent of the patients who opt to go under the knife do it for sheer cosmetic purposes. According to Dr. Borude, most of the patients who opt for weight-loss surgery are suffering from life-threatening ailments, a huge chunk of which cannot be conducted because of lack of funds.

Bariatric surgery is categorised by the insurance companies as a procedure done for cosmetic purposes, hence it is not covered in the insurance, despite repeated protests by the bariatric surgeons.  The Insurance Regulatory and Development Authority (IRDA) rejected the demand to include bariatric surgery in the medical insurance despite arguments to the contrary.

We say, surgeons many have had a point but sometimes perceptions can seriously hinder our and in this case, IRDA’s view of facts on the ground.

No mediclaim for weight-loss surgeries: IRDA (Mumbai Mirror)

 

 

Misselling No More! IRDA Comes Out With A Framework To Curb Insurance Frauds.

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IRDA To Curb The Insurance Frauds, Cheating Agents Menace, Comes Out With A Framework.

IRDA To Curb The Insurance Frauds, Cheating Agents Menace, Comes Out With A Framework.(Picture Credit: topcontentcenter.com)

Just because you are not paranoid, doesn’t mean your insurance agent is not out there to cheat you!

For the longest period of time, we have been resonating with this sentiment, urging our readers to be on guard against the misselling tactics of the insurance agents. For a glimpse of our concerns and take on this issue, see 5 Shocking Misselling Tactics Of Insurance Agents.

Our paranoia hasn’t been without a reason and the statistics emerging from within the insurance industry with respect to the cheating insurance agents has done nothing to quell our fears. However, the regulator IRDA seems to have been bothered by these concerns as much as the ‘aam junta‘ and after a long long while, decided to do something concrete about it.

IRDA has come out with a framework for monitoring frauds in the insurance sector and asked insurers to carry out due diligence on their staff, including agents. The circular issued by IRDA to the insurers directs them to lay down procedures to carry out the due diligence on the personnel (management/staff)/ insurance agent/ corporate agent/ intermediary/ TPAs before appointment with them. It is required that insurers understand the nature of fraud and take steps to minimise the vulnerability of their operations to fraud.

The insurers are required to submit a compliance report with the regulator by June 30, 2013.

A rigorous due dilligence of the employees, especially agents, if done right, is one of the most effective methods to curb fraudulent practices and to that extent IRDA’s has taken a step in the right direction.

IRDA has classified frauds in the insurance sector under three heads — claim fraud or policyholder fraud, intermediary fraud and internal fraud. It has also asked the insurance companies to frame anti-fraud policy and said that the company’s board would review the policy on an annual basis.

Insurer have been directed to inform both potential and existing clients about their anti-fraud policies and highlight the consequences of submitting false statement for the benefit of policyholder in the insurance contract.

We really hope that the move doesn’t turn out be another damp squid and does succeed in actually curbing this menace at least to some extent.

IRDA comes out with framework for monitoring insurance frauds (Business Standard)

Consumer Alert! LIC A Better Bet For Consumers Than Private Insurers, Says IRDA.

LIC better at paying claims than private players according to IRDA

LIC better at paying claims than private players according to IRDA

This one is for all those who have weathered every doubt, every cynic and every critic in the country to uphold one single belief–Bima lena to Bhartiya Jeevan Bima Nigam se hi lena!

As far as we are concerned, choosing among insurers is like choosing between the rock and a very hard place. If we could, we would have hung all the insurers upside down in the nearest well till they promised to treat the consumers fairly.

But of course, it is not possible. Insurers are huge corporate structures and while they exhibit all human evil, they are hardly human enough to be hung–upside down or otherwise.

While we struggle to choose the lesser evil amongst the insurers, it seems IRDA does not have a similar difficulty–they have a clear-cut favorite.

No prizes for guessing–it is the LIC!

According to IRDA’s annual report, LIC’s claim settlement ratio is better than the two dozen odd private insurers in the country.

According to the report, LIC has settled 97.42 per cent cases relating to death claims during 2011-12 compared to 89.34 per cent by private sector companies. The industry average worked out to be 96.26 per cent.

As per the report, settlement ratio of LIC increased to 97.42 per cent during the year 2011-12 when compared to 97.03 per cent during the previous year and the private insurers repudiated higher number of claims as compared to LIC.

Of course, a claim settlement percentage as high as 90% is surreal for us lesser mortals. For all we know, we have been reporting only repudiations all through the year with alarming frequency.

The report, however, re-establishes LIC’s comparative credibility in the Insurance sector–a proposition that Tadka agrees with, making insurance the one of the rare sectors where a government organization a better bet for the consumers than the private players.

LIC better at paying claims than private insurers: Irda report (Business Today)

Policy Holders Rejoice! IRDA To Introduce Demat Insurance Policies.

IRDA To Introduce Demat Insurance Policies.

IRDA To Introduce Demat Insurance Policies.

I distinctly remember the old insurance files that elders in my family maintained with reams of pilicy documents neatly (and sometimes not so neatly) tucked inside. The modern ones got better but only slightly with files that were brighter, trendier and slightly better looking than their older counterparts. The file however was and has been a constant for anybody who took their insurance (or tax planning) seriously.

But all that is set to change.

IRDA has almost finalized the plan to approve insurance repositories which will allow materialization of demat policies. For the uninitiated, demat policies will be paperless version of the policies that can be maintained and managed virtually. This is an excellent move because it prevents physical damage tp policy documents which are required to be maintained for several years.

Other benefits shall include one time KYC (Know Your Customer) to be applicable across all insurers and policies purchased from them. The regulator is ready to give 5 companies approval to build repositories.

This announcement was made in 15th Insurance Summit.

IRDA To Introduce Demat Insurance Policies (Indiainfoline)

5 Shocking Misselling Tactics Of Insurance Agents That Everybody Ought To Know About!

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5 Shocking Misselling Tactics Of Insurance Agents That Everybody Ought To Know About

5 Shocking Misselling Tactics Of Insurance Agents That Everybody Ought To Know About

A scary looking man grins at the camera, benignly shaking his head with utmost sincerity. An animated devil like creature, although way less scary than his grinning human counterpart, disappears with a poof behind the grinning face. One of the prominent insurance companies in the country flashes its logo with an attractive jingle and some tagline about honesty.

Once I get past my mortification at the aesthetics (or lack of it) of this advertisement, I realize that this ad may well have been an unintended satire on the perceived ugliness (literal and figurative) of all the insurance agents in the country combined. The underlying message is well meaning-that the agents of ‘X’ company are honest. But, the ad is also representative of a very disturbing reality of the insurance industry-the unruffled acceptance of dishonest, misselling tactics. So much so that a particular company deemed it fit to project the absence of these tactics as its USP.

I may not have gone so far. Every week, hundreds of misselling and dishonest insurance agents’ related complaints land on our desks at Akosha. The sheer number and magnitude of these complaints in itself is a proof of the extent to which this racket is flourishing in the country.

IRDA or the insurance regulator has been constantly trying to curb these practices with all sorts of measures and regulations and is all set to come up with revised guidelines for life insurance industry. The efforts have met with reasonable success. And yet, an industry that thrives on innovation in ways to cheat continues to do what it does the best-cheat.

Misguiding about terms and conditions of a policy, unrealistic prediction of returns are the sort of tactics that most of us are aware of of-whether or not that awareness saves us from being cheated is a different story. So, leveraging on our benefit of being exposed to the widest variety of insurance related complaints possible, we decided to compile 5 such unique misselling tactics employed by insurance agents that shocked and impressed us, although in a perverse manner:

1.       Fraudsters claiming to be IRDA representatives- When a consumer called Mishrilal first came to us with a complaint about fraudulent calls from people claiming to be IRDA representatives, we could hardly estimate the extent of this ongoing scam. These so called IRDA representatives claim that some ‘bonus’ has accumulated with respect to their policies and which is being allegedly polished off by their agents. All they are required to do is deposit some amount with these ‘representatives’ and they will ensure that the bonus is transferred to the policy holder. What happens after the amount is given is anybody’s guess.  Authorities having realized the gravity of the scam have been trying to warn the consumers against such fraudsters. We understand that this is hardly a matter involving the agents directly but what really stumps us is the accuracy of the information that these so called representatives usually have with respect to the policy holdings of their victims, an obvious indication of insider involvement. A simple way to address this issue is always checking the credentials and insisting on identity proof of whichever individual the consumer is dealing with.

2.       Selling Policies Without Consumer Consent- Another spin to the very same IRDA representative fraud is when these so called representatives take the money from the policy holders and then instead of vanishing with the money, very ‘honestly’ invest it in buying another policy for the consumer, albeit without his consent. These agents then conveniently vanish, leaving a hassled consumer in their wake, with his hard earned money stuck in a policy he never actually intended to buy. In most circumstances, it is next to impossible to get such policies cancelled. This fraud redefines misspelling by agents, dragging it into the territory of pure fraud.

3.       Selling The Wrong Policy- Ok. So you were very clear what plan you wanted and with what company. Everything was in order. But what if your agent, without your consent goes ahead and invests your money in a completely different plan? Horrifying thought, especially when huge sum of money is involved. This is what precisely happened with a consumer we came across while doing a story on ULIP( For pros and cons of Unit Linked Plans or ULIP, read this story To ULIP Or Not To ULIP). Amit Jamwal never intended to buy a ULIP. All he wanted was a simple term plan. But his agent, nevertheless, went ahead and invested his money in a ULIP. To make situation worst, disappeared without giving him proper documents. Jamwal is now stuck with a policy he never wanted, with hefty charges and two premiums paid. “I hate all agents”, he says before slamming the phone down. Understandable emotions. We empathize, barring the fact that the poor kid who was talking to him was a harmless budding lawyer-journalist. He neither was nor intends to be an agent-ever!

4.       Skirting The Free Look Period- For the uninitiated, free look period is a 15 day period starting from the date of issue of your policy within which you can opt out of the policy without any charges and with full refund (barring cuts for medical tests, stamp duty charges etc.) if you are not in agreement with the terms and conditions of the policy. This period is stipulated by IRDA during which the holder can cancel the policy or switch to another. However, agents have been increasingly coming up with ways to ensure that the policy holders are not able to use this period for what it is intended. The most common way to get past this period is non-delivery of policy documents within the free-look period, denying the holder an opportunity to examine his policy and its terms and conditions. Our only advice in all such circumstances is vigilance- cancel your policy the moment your agent even remotely tries to stall or unnecessarily delay the delivery of documents during the free-look period.

5.       Selling Policies That Are Not Needed Or That Are Not In Accordance With The Financial Goals/Condition Of The Holder- This is probably the most complicated aspect of misselling and usually happens with individuals who are relatively new to the field of investment. The result is a policy holder who is stuck with a life insurance policy that protects him only till the age of 35 years and consumes 15% of his salary as premium. To address this issue, IRDA has proposed that the company should assess the needs of the holder in detail before issuing him a policy and have for this purpose, have a detailed form that covers all aspects like income, goals and risk appetite of the holder.

As we had stated earlier and as is evident from the proposals, IRDA is constantly trying to curb this menace of misselling at a macro lever. However, no such attempts can be entirely successful without awareness and vigilance at the micro level. Consumers opting for insurance must abide by a certain thumb rules like-check for credentials, identity proof of the agents, always take second opinions, never rely on one agent completely and most importantly, be very paranoid, almost clinically-in this case, that is the only thing that can save you.

 

 

 

Choosing Insurance Policy Made Easy! MyInsuraneClub Gets Regulatory Approval To Be Insurance Aggregator

MyInsuranceClub To Be An Online Insurance Agrregator

MyInsuranceClub To Be An Online Insurance Agrregator

Ever wondered how convenient it would be for you to chose an insurance if you could get a table comparing ALL the available policies in one place? Wonder no more. Such a platform is now a reality with MyInsuranceClub.com becoming the first online web aggregator to get a regulatory approval from IRDA.

For average consumers, this means that MyInsuranceClub.com will become one safe and transparent platform where consumers can compare the premiums and then proceed to buy the policy online from the respective insurer’s website. This is a platform which shall enable the insurers to choose a policy which meets their preferences in terms of brand, pricing and benefits. Online insurance aggregation is a fairly successful model abroad and it is expected to meet a similar success in India as well.

MyInsuranceClub Gets IRDA Nod To Be The Online Web Aggregator (Indian Express)