The Insurance Regulatory and Development Authority of India (IRDAI) in a bid to strengthen governance measures in Insurers’ operations has released a new Master Circular on Operations and Allied Matters of Insurers while repealing 11 previous circulars.
Under this, IRDAI has mandated each Insurer to constitute an advertisement committee, approved by the board of directors, and appoint a senior-level officer of the distribution channel to examine and approve advertisements, to enhance transparency and accountability.
For efficient and speedy grievance redressal of policyholders, Insurers must implement a tech-based robust mechanism aiming for “zero grievances,” ensuring regular customer interface, awareness campaigns, facilitating submission and registration of online grievances with an internal escalation matrix and Ombudsman.
Resolution time is of the essence with an immediate written acknowledgment, if sought further information to be collected once within one week, and the final resolution letter should occur within two weeks.
Advertisements for participating insurance products must disclose the risk factors such as projected bonus is not guaranteed, past performance does not indicate future bonuses and product performance is subject to the insurer’s overall performance.
Insurers must adopt a phygital approach (both physical and digital) to open places of business and make insurance accessible in remote locations of India.
Insurers can outsource permitted activities only if it is cost-efficient and under the oversight of a board-appointed committee.
Policyholders must get an option to avail of services even if and when an insurance intermediary has ceased its association with the insurer.
Insurers must streamline group insurance business with a focus on Insurers issuing a “Certificate of Insurance’ to all members of a non-employer-employee group scheme, consent of nominee/ policyholder/ beneficiary is necessary for repayment of outstanding loan from the proceeds of an assigned policyholder, no claim shall be denied for non-availability of details of members of the group in group Mediclaim policy.
For unclaimed amounts, policyholders can access information with any insurers in one place.