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Frequently asked questions

  • General Questions on Insurance

  • Auto Insurance

  • Life Insurance

  • Health Insurance





    General Questions on Insurance

    What is the logic of insurance?

    It is a system by which the losses suffered by a few are spread over many, exposed to similar risks. Insurance is a protection against financial loss arising on the happening of an unexpected event. Insurance companies collect premiums to provide for this protection. A loss is paid out of the premiums collected from the insuring public and the Insurance Companies act as trustees to the amount collected.

    What is the difference between Agent & a Broker?

    Agent is the representative of Insurance Company whereas broker is the representative of the consumer or policyholder.

    What are Insurance Brokerage houses?

    World over insurance brokerage houses are large, sometimes even larger than the insurance companies themselves. They provide reinsurance to insurance companies. In many markets, brokers provide non-life insurance as well as group life and group mortgage insurance. In countries like Japan, the broker is not empowered to conclude contracts, accept representations, and to receive insurance premiums. In such cases minimum capital requirements and solvency margins are not needed. In general an insurance broker would provide the following services:

    What is reinsurance?

    The very fundamental principle of spreading of the risk is actually practised by the insurance companies by reinsuring the risks that they have insured.

    What is underwriting?

    Underwriting of a risk involves consideration of material facts on the basis of which a decision will be taken whether to accept the risk and if so at what rate of premium.

    Auto Insurance

    When can an auto insurance policy be renewed?

    The policy has to be renewed before the expiry of the period and any delay in renewal of the policy attracts a penalty for renewal. There are other hassles involved too, like a surveyor (inspector) from the insurance company will inspect the vehicle again. Besides, most importantly, it is an offence by law to drive an uninsured car.

    How an insurance claim can be filed in the event of complete damage to the vehicle?

    Complete damage or total loss (as it is popularly known) occurs in the event of the vehicle being beyond repair after an accident or fire etc. In such cases, the insurance company declares the car as a ‘total loss’.

    Typically, one can claim total loss damages as follows:

    ‘Total Loss claims’ could take a long time depending on how quickly or otherwise you are able to arrange for reports from the police and the fire brigade. To enable the process go smoothly, it is advised to keep all documents related to the vehicle handy. However, vehicle surveyors are a moody lot, and one may have to bargain a bit to increase the claim amount from the insurance company.

    How a damage insurance claim can be filed in the event of an accident?

    In the event of an accident, which involves damage to the vehicle, one makes an ‘accident claim’ to the insurance company. An ‘accident claim’ covers the cost of repair to the car and the cost of replacing damaged parts to the extent covered by the insurance policy.

    Typically, the procedure to claim ‘accident insurance’ is as follows:

    • Inform the insurance company about the accident, the time, date and place of the accident. Insurance companies have forms for filling these details and one can obtain these forms from any branch of the insurance company.
    • File a First Information Report (FIR) at the police station closest to the place of mishap. Documents related to the vehicle like registration book, tax paid receipt, insurance papers, driving licence, etc. are needed while lodging the FIR.
    • Take the vehicle to a reputed workshop for repair and get a repair estimate from the workshop.
    • Submit the estimate to the insurance company.
    • A surveyor from the insurance company will come for an inspection of the vehicle, and to assess the cost of restoring the vehicle to its pre-accident condition.
    • Based upon the surveyor’s report, the insurance company will make a final settlement of the estimate and the deal is closed.

    ‘Accident claims’ are normally processed quickly enough. To enable the process go smoothly, it is advised to keep all documents related to the vehicle handy. However, vehicle surveyors are a moody lot, and one may have to bargain a bit to increase the claim amount from the insurance company.

    How an insurance claim be filed incase the insured vehicle is stolen?

    Thefts insurance claims take longer to settle as the RTO and police are required to submit their report stating that vehicle has not been recovered. Now this report gets done only after an investigation by both the authorities, which could take a long time. Six months is the conservative estimate.

    Typically, one can claim ‘theft insurance’ by following these steps:

    • Inform the nearest police station about the theft and file a FIR
    • Inform the insurance company.
    • Inform about the stolen car and documents to the concerned registration authority and get duplicate document issued.
    • Make the claim for insurance in the prescribed claim form of the insurance company.

    What are the rules about insurance transfer when transferring vehicle from one person to another. Is old policy transfers to the buyer or he has to take new policy. Is there any time limit about it?

    Yes, the old policy can be transferred in the name of buyer by submitting the copy of Form 29/30 and copy of Registration book/Owner book. The above process preferably should be done within 30 days.

    Health Insurance

    How are the Life and Health sub-sectors clearly differentiated? What would be the rough estimate of Health Insurance potential, monetarily, covering the currently insurable population in India?

    Whereas the Life insurance coverage are linked to the Life of the Insured Person, the Health Insurance Coverage provide indemnity against hospitalisation expenditure due to illness.

    Is mediclaim a good policy or good only as tax saving device?

    The main purpose of Mediclaim policy is to provide the Insured towards expenditure against illness. This is the only one policy available as on date towards the above cause. In our opinion the tax benefit accruing out of the premium paid should be considered as a bonus.

    In case a mediclaim/personal accident claim, there is a fracture out of an accident and there is no admission in the h ospital and the doctor sends the patient home. Can the insurance company repudiate liability under the reason that there was no hospitilisation?

    Under Mediclaim Insurance, the admissiblity of claim is directly depended on opinion of the Medical Practitioner as far as the need hospitalisation is concerned. Therefore, the claim cannot be repudiated on the description on the underwriters. Under Personal Accident Insurance the reimbursement of Medical expenses would be admissible only if a Medical Benefits Extension has been included in the policy by payment of necessary extra premium. If this is the case the admissibility of the claim would be again on the basis of the opinion of the Medical Practitioner regarding hospitalisation.

    Who are currently the players in the third party administration in the country?

    At present, third party administration in the Insurance is not existing in India. However, under the recently past IRDA bill and with the opening of the Insurance Sector to private organisation it will come into effect in near future.

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