From the time an insurance claim is received, the policyholder will get real-time updates at every stage
Running from pillar to post for settling an insurance claim may soon be a thing of the past. The insurance regulator has instructed companies to provide live updates to policyholders on their claim settlement.
In a circular, Insurance Regulatory and Development Authority of India (IRDAI) has said there is a need to make available a tracking mechanism for policyholders to enable them to know the status of their claims.
At present, while insurers do send basic details of the claims, live updates are not provided.
How it will work
Immediately upon the intimation of the claim, a unique claims reference number will be created and notified electronically to the registered mobile number and e-mail id of the policyholder/claimant.
Subsequently, at every stage of the claim processing such as calling for further requirements, or arranging for a survey will have to be sent.
Lastly, communication of the final decision, be it admission or rejection or repudiation of claim and payment details such as through cheque or bank credit will have to be sent.
The notification sent to the policyholder/claimant containing the unique claims reference number shall also enable tracking the claims status by the policyholders/claimants themselves through the portal or website online.
Collect information, but make it voluntary
Insurers have also been asked to collect the mobile numbers and the e-mail ids of the policyholders both at the point of sale and also on an ongoing basis as part of policy servicing.However, IRDAI added that disclosure of this contact information by the policyholder is voluntary. Explicit consent has to be sought by the insurers and no unsolicited information can be sent to customers.
For all policy-related matters, be it new policy issuance, acceptance of proposal, renewal or policy lapse, IRDAI has asked insurers to send alerts through SMS, letter or email.
For health-insurance claims, even if a third party administrator is involved, IRDAI said it is the responsibility of insurers to ensure that status of a claim is notified at every stage.o the claimant at every stage of a claim.