Under Section 14(1) (b) of the Insurance Act, 1938, all Insurers are required to maintain a record of every claim with date of the claim, the name and address of the claimant and the date on which claim was discharged, or, in the case of claim which is rejected, the date of rejection and the ground there of.

 

Further with the amendment to Sec. 45 of the Insurance Act, 1938 it would be more meaningful and useful to maintain claim records with classification aligned to the amended provisions of Section 45 i.e 3 years from date of the policy. Therefore, the Authority, under the provisions of Section 14 of IRDA Act, 1999 directs all Life Insurers to maintain separate classification of records of death claims as given below

 

1.Claims arising with date of death/contingency being within three years from the date of commencement of risk of the policy or the date of revival or the date of rider to the policy whichever is later.

 

2.Claim arising with date of death/contingency after three years from the date of commencement of risk of the policy or revival or date of the rider to the policy whichever is later.

 

Further in order to bring standardization and uniformity in reporting of the Claims Rejected / Claims Repudiated across the Life Insurance Industry, Insurers are advised to report rejections & repudiations separately as given below

 

Claims Rejected: -Where claim cannot be considered due to non-admissibility resulting from the policy terms and conditions.

 

Claims Repudiated: Where claim cannot be considered due to non-admissibility available under the provisions of Section 45.

 

All Life Insurers are required to furnish the above mentioned data to the Authority in the prescribed returns attached for the financial year 2016-17 onwards.