The claims settlement ratio for Max New York Life (MNYL) has fallen from 90% (2008-09) to 65% (2009-10). As usual, LIC is the topper. Look out for key ratios of claims settlement, repudiation and pending cases before buying insurance
The claims settlement ratio for Max New York Life (MNYL) has fallen from 90% (2008-09) to 65% (2009-10). The 'claims settlement ratio' is the number of claims settled with respect to claims received.
MNYL has settled 3,943 claims out of the 6,019 claims it had received in 2009-10.
The 'claims repudiated ratio' is the number of claims rejected with respect to claims received. MNYL has rejected 12% claims (741 out of 6,019). The 'claims pending ratio' is the number of claims pending (not settled, nor rejected) with respect to claims received. MNYL has 22% pending claims (1,335 out of 6,019).
Claims experience has to be one of the most important factors to consider before finalising life insurers, because every insurer will love to collect premiums, but few insurers will feel the same about claim payments.
MNYL started its operations in 2000 and hence should have a better claims settlement ratio as well as lower claims repudiation and pending ratios. However, this was not the case for 2009-10 data, when compared to the data for 2008-09.
Moneylife emailed the corporate communications department of MNYL last week to get a clarification, but we have not received a reply from them. MNYL has a mix of traditional and ULIP (unit-linked insurance plans) products. It has a ULIP child plan and recently came out with a traditional child plan. But if a settlement problem arises for death claims, how can a policyholder's child be ensured higher education or cash flow in absence of her earning parent?
The Insurance Regulatory and Development Authority (IRDA) has sent a warning letter to MNYL. The letter dated 24 January 2011 mentions that the insurer admittedly defaulted on non-payment of penal interest for claims settled beyond six months and repudiation/investigation of claims beyond six months.
IRDA has noted that the insurer has largely attributed the above default to process infirmities and inadequate quality of resources. IRDA has also noted that the insurer has reviewed all cases beyond six months and paid the penal interest admissible. MNYL has put a process in place to ensure that penal interest is paid as a rule in respect of cases where admitted beyond six months and investigations/repudiations are completed within six months without fail.
Can IRDA publish claims settlement, repudiation and pending ratios sooner every year? The 2009-10 data came out in end-December 2010. It will also help if the regulator puts out this important data in public eyes by publishing it in leading newspapers/magazines, rather than keeping it in a 526-page report that the public may not even bother to read-let alone understand it.
Instead of ULIPs 'ke chaar sutra' published in newspapers that carry not-so-great information for readers, why not highlight all the warnings and penalties levied by IRDA in newspaper/magazine advertisements? This will also deter insurance companies from committing any lapses. An insurance company repudiating a legitimate claim is a severe financial blow to the surviving family.
Please read 'IRDA yet to disclose claims repudiation ratio for 2009-10 '
Claims settlement, repudiation and pending ratios are important factors to be considered before buying insurance. These ratios have to be looked at from the viewpoint that life insurance companies that were started recently are bound to have lower settlement and higher pending claims.
This is because any death claim that happens within three years of policy issuance gets scrutinised for its veracity. It can take time for claim settlement and there is even a possibility of claim repudiation. The longer an insurance company has been in existence, the ratios should start looking favourable for the entity.
Insurance company inefficiencies or poor underwriting practices can be a reason for high repudiation ratios. It can also be due to incorrect/hidden details in policy forms filled by a policyholder with or without abetment from an agent. It is imperative that the policyholder fills up the policy form completely and in good faith without the agent filling any policyholder personal data. An ethical agent who is properly trained by the insurer will not mislead the potential customer just for getting commission. The policyholder will be at a loss because the policy form will be scrutinised only at the time of claim.
The other reason can be policyholders themselves indulging in fraud. As far as fraudulent claims are concerned, the insurer has every right to repudiate the claim.
Insurance companies launched since 2007 have less than 50% claims settled except Star Union Dai-ichi (59%) and IndiaFirst (54%).
Future Generali (launched in 2007) had claims settlement ratio of 57% in 2008-09 and is down to 39% in 2009-10. The claims repudiation is almost the same in both the year groups (30%). The claims pending have increased from 13% in 2008-09 to 31% in 2009-10. It is typical of life insurance companies which have recently (2007 or later) entered the market getting hit by claims and taking their time to settle claims, due to the need for verification of authenticity of claims.
Bharti AXA Life unveiled its new brand positioning last year - "Jeevan Suraksha Ka Naya Nazariya." It has a service guarantee of "Release of Fund Value within 48 hours" of receiving claim intimation. The settlement promise is only applicable for unit-linked insurance plans (ULIPs) and not for any other insurance plan including term insurance. The promise is to settle only the fund value of the plan and not the sum assured. In 2009-10, Bharti AXA Life had 77.80% claims settled, 22.20% claims repudiated and 0% pending. Zero pending shows that Bharti AXA certainly is making quick decisions on claims.
Shriram Life launched its operation in the year 2005, but its claim settlement for the year 2009-10 has been only 40%, claims repudiation is 20% and claims pending stands at 40%.
Tata AIG launched in 2001 still does not match its peers in claims settlement, repudiation and pending ratios even with the name of the biggest business group in India attached to it.
Private insurers are struggling to break even. With new ULIP regulations driving business away from ULIPs to traditional plans as well as lowering of new business premium collection in crucial months for tax-savings, insurance companies will surely scrutinise claims to a greater extent in the future.
Moneylife has going beyond what insurance companies want you to know and mainline publications want you to read. Read our recent insurance articles:
Birla Sun Life Foresight ULIP: Is this the start of a new concept in the market?
Life insurance business nosedives in crucial month of January:
Insurance: Entering by the back door
LIC Samridhi Plus offers highest NAV-a new plan based on an old idea
Bajaj Allianz Cash Rich: A traditional plan can never make you cash rich
Maharashtra chief minister Prithviraj Chavan said that the government will introduce a bill giving 50% reservation to women in local government bodies in the ensuing budget session of the state legislature
Mumbai: On the occasion of Women's Day, Maharashtra chief minister Prithviraj Chavan brought a smile on the faces of women by announcing 50% reservation for the fairer sex in local self government bodies soon, reports PTI.
"We will introduce the bill of giving 50% reservation to women in local government bodies in the ensuing budget session of the state legislature," Mr Chavan said today while interacting with a group of women journalists here.
The Centre has already taken a decision to give 50% quota to women and the state government will abide by it, Mr Chavan said.
Expressing hope about 33% reservation for women in assemblies and the Parliament, Mr Chavan said, "We are trying our best to pass the Bill in the Lok Sabha. It has been already approved in Rajya Sabha when I was the parliamentary affairs minister."
The ally of Congress in the state government, the Nationalist Congress Party (NCP) had already proposed to increase quota for women at local bodies from 33% to 50%. In the party meeting held here last month, NCP chief and Union agriculture minister Sharad Pawar asked his ministers to meet the CM and make the demand.
Mr Chavan who has completed four months in office said he is settled in his new job and expressed confidence that he would deliver with his current team of ministers.
"There is a huge difference between functioning of national and state politics but I am always used to work hard," he said.
The apex court contemplated invoking terror charges under anti-terror law owing to Mr Khan's alleged links with various arms dealers and those involved with terror-related activities, threatening the country's security
New Delhi: The Supreme Court today mulled invoking terror and other stringent penal charges against Pune stud owner Hasan Ali Khan, accused of massive money laundering and tax evasion, for his alleged links with arm dealers and people linked to terror activities, reports PTI.
A bench of justices B Sudershan Reddy and SS Nijjar also asked the Union government to examine if the case registered against him for possessing fake passports could be probed by the Central Bureau of Investigation (CBI).
The bench contemplated invoking terror charges under anti-terror law Unlawful Activities Prevention Act and other stringent provisions of the Indian Penal Code owing to Mr Khan's alleged links with various arms dealers and those involved with terror-related activities, threatening the country's security.
The bench expressed displeasure that the probe against Mr Khan in the fake passport case had not proceeded in the right direction with right speed "as nothing is moving despite the magnitude of the issue."
The court made the observations and issued directions while hearing a public interest litigation filed by eminent jurist Ram Jethmalani, seeking repatriation of huge corpus of black money stashed in banks abroad by unscrupulous Indian citizens.
Mr Khan was arrested last night by the Enforcement Directorate (ED) which carried out searches at his Pune home and that of his associates' premises in several cities, cracking the whip to meet today's Supreme Court deadline.
53-year-old Mr Ali, who was detained in Pune, was brought to Mumbai later and was grilled by the ED for nearly six hours before being put under arrest.
The apex court also asked the government to furnish details of the four officials probing the case against Mr Khan, who were abruptly transferred midway into the investigation.
The government responded to the query saying the officials were on deputation with the ED and were repatriated.
Solicitor General Gopal Subramaniam, however, assured the court that he would take up the matter with the government and see that the officials are retained.
The government also admitted that the court was justified in seeking Mr Khan's custodial interrogation as the charges against him warranted such questioning.
"It is a case in which a case is made out for custodial interrogation," Mr Subramaniam said.
The Solicitor General also admitted that one of the investigating officers, a deputy commissioner of police, was earlier harassed apparently by his superiors as he had the courage to take on Mr Khan in the fake passport case.
Meanwhile, senior counsel Anil Divan, appearing for petitioner Mr Jethmalani, expressed serious apprehension about Mr Khan's life as he had enough material to expose the powers-that-be behind his various murky deals.
The counsel recalled that Ashutosh Asthana, a key accused in the Ghaziabad provident fund scam, was found dead under mysterious circumstances in Dasna jail of the district during the CBI probe into the case.
Meanwhile, the ED submitted to the court in a sealed cover its status report on the probe into the case related to black money in which they also mentioned Mr Khan's arrest last night.
Mr Subramaniam also told the court that besides the ED report, he would also furnish a status report relating to the investigation so far conducted by the Income Tax department.
The bench posted the matter for further hearing to 18th March.