Diwali Wishes

GET DETAILS OF UNCLAIMED INSURANCE ONLINE

Come April, You Can Get Details of Unclaimed Insurance Online

 

This will also help nominees not having access to relevant documents - Preeti Kulkarni (The Economic Times – 25/02/2014)

Insurance customers and their nominees don’t have to suffer inordinate delays in claim settlement anymore. A new circular from Insurance Regulatory and Development Authority (Irda) is going to change the current opaque scenario from April 1. 

“While unclaimed amount is not uncommon in insurance sector, a steep increase in unclaimed amount is a cause of concern,” the regulator said in the circular that put out the figures of unclaimed insurance proceeds in the public domain for the first time. The unclaimed amount swelled from . 3,037 crore in 2011-12 to . 4,865 crore in 2012-13 — an increase of over 60%. The unclaimed money is the result of insurance proceeds that have failed to reach policyholders or their nominees in time for various reasons. Needless to say, it completely defeats the entire purpose of buying an insurance cover. 

Transparency in Procedure 

From April, a policyholder or nominee will be able to access information about the policy. Irda has asked insurance companies to display details like policyholders’ names and address, maturity proceeds, death benefit and premium due for refund, among other things, unclaimed for over six months, on their websites. 

“Several thousands of crores of unclaimed amount might be lying with insurance companies. There is no reason why insurers should absorb this amount,” says P Nandagopal, MD and CEO, IndiaFirst Life Insurance. “Now, policyholders or their nominees will be able to access information pertaining to their own policies and claim the amount due to them,” he adds. 

Insurers may not allow unfettered access to their database to prevent frauds, but if you have a cover, you can run a check and obtain the details of your policy. 

Many policyholders often misplace original policy documents, and this could result in them forgetting about a policy. It also could lead to their nominees not having access to the relevant documents when they need them. 

These problems will be solved once companies start displaying details on their website. Once they get the information, they can go ahead with claiming the due amount . “The nominees have to intimate the insurance company about the policyholder’s demise, specifying the reason for the death. Then, the insurer will send across the claim form relevant to the cause of death. The claim processing begins after the nominees furnish the documents asked for in the form,” said certified financial planner Harshvardhan Roongta, CEO, Roongta Securities. 

Benefits of Direct Transfer 

Irda has also asked insurance companies to transfer proceeds from policies to the registered bank accounts of policyholders and nominees. Even existing policyholders will be given the option of receiving the funds electronically. For new policies, insurers will seek these details at the time of buying the policy. In case of non-life insurance policies, these details will be collected at the time of renewals or claims. “This is a very good move. It will curb frauds, where unclaimed cheques are discounted and encashed by others. This is a rampant practice,” says Roongta. 

It will also help claim amounts — maturity proceeds, death benefits, or reimbursement claims in health and motor insurance — to reach you sooner. “The move will improve the efficiency and accelerate the pace of claim disbursal, as the claim amount will be directly transferred to the bank accounts,” says Arvind Laddha, CEO, Vantage Insurance Brokers.  

DEDUCTION IN RESPECT OF MEDICAL TREATMENT UNDER INCOME TAX

Section 80DDB. Where an assessee who is resident in India has, during the previous year, actually paid any amount for the medical treatment of such disease or ailment as may be specified in the rules made in this behalf by the Board—

          (a)  for himself or a dependant, in case the assessee is an individual; or

          (b)  for any member of a Hindu undivided family, in case the assessee is a Hindu undivided family,

the assessee shall be allowed a deduction of the amount actually paid or a sum of forty thousand rupees, whichever is less, in respect of that previous year in which such amount was actually paid :

Provided that no such deduction shall be allowed unless the assessee furnishes with the return of income, a certificate in such form, as may be prescribed^89-90, from a neurologist, an oncologist, a urologist, a haematologist, an immunologist or such other specialist, as may be prescribed, working in a Government hospital :

Provided further that the deduction under this section shall be reduced by the amount received, if any, under an insurance from an insurer, or reimbursed by an employer, for the medical treatment of the person referred to in clause (a) or clause (b) :

Provided also that where the amount actually paid is in respect of the assessee or his dependant or any member of a Hindu undivided family of the assessee and who is a senior citizen, the provisions of this section shall have effect as if for the words “forty thousand rupees”, the words “sixty thousand rupees” had been substituted.

Explanation.—For the purposes of this section,—

           (i)  “dependant” means—

      (a)  in the case of an individual, the spouse, children, parents, brothers and sisters of the individual or any of them,

      (b)  in the case of a Hindu undivided family, a member of the Hindu undivided family,

                dependant wholly or mainly on such individual or Hindu undivided family for his support and maintenance;

          (ii)  “Government hospital” includes a departmental dispensary whether full-time or part-time established and run by a Department of the Government for the medical attendance and treatment of a class or classes of Government servants and members of their families, a hospital maintained by a local authority and any other hospital with which arrangements have been made by the Government for the treatment of Government servants;

         (iii)  “insurer”⁹¹ shall have the meaning assigned to it in clause (9) of section 2 of the Insurance Act, 1938 (4 of 1938);

         (iv)  “senior citizen” means an individual resident in India who is of the age of sixty-five years or more at any time during the relevant previous year.]

Specified diseases and ailments for the purpose of deduction under section 80DDB.

11DD.  (1) For the purposes of section 80DDB, the following shall be the eligible diseases or ailments :

               (i)   Neurological Diseases where the disability level has been certified to be of 40% and above,—

        (a)   Dementia ;

        (b)   Dystonia Musculorum Deformans ;

        (c)   Motor Neuron Disease ;

        (d)   Ataxia ;

        (e)   Chorea ;

         (f)   Hemiballismus ;

        (g)   Aphasia ;

        (h)   Parkinsons Disease ;

              (ii)   Malignant Cancers ;

            (iii)   Full Blown Acquired Immuno-Deficiency Syndrome (AIDS) ;

             (iv)   Chronic Renal failure ;

              (v)   Hematological disorders :

         (i)   Hemophilia ;

        (ii)   Thalassaemia.

(2) The certificate in respect of the diseases or ailments specified in sub-rule (1) shall be issued by the following specialists working in a Government hospital—

(a)     for diseases or ailments mentioned in clause (i) of sub-rule (1) - a Neurologist having a Doctorate of Medicine (D.M.) degree in Neurology or any equivalent degree, which is recognised by the Medical Council of India;

(b)     for diseases or ailments mentioned in clause (ii) of sub-rule (1) - an Oncologist having a Doctorate of Medicine (D.M.) degree in Oncology or any equivalent degree which is recognised by the Medical Council of India;

(c)     for diseases or ailments mentioned in clause (iv) of sub-rule (1) - a Nephrologist having a Doctorate of Medicine (D.M.) degree in Nephrology or a Urologist having a Master of Chirurgiae (M.Ch.) degree in Urology or any equivalent degree, which is recognised by the Medical Council of India;

(d)     for diseases or ailments mentioned in clause (v) of sub-rule (1) - a specialist having a Doctorate of Medicine (D.M.) degree in Hematology or any equivalent degree, which is recognised by the Medical Council of India :

Provided that where in respect of any diseases or ailments specified in sub-rule (1), no specialist has been specified or where the specialist specified is not posted in the Government hospital in which the patient is receiving the treatment, such certificate, with prior approval of the Head of that hospital, may be issued by any other specialist working full-time in that hospital and having a post-graduate degree in General or Internal Medicine, which is recognised by the Medical Council of India.

(3) The certificate from the prescribed authority to be furnished along with the return of income shall be in Form No. 10-I.]

DON'T GET LURED BY LOW PREMIUM, CHECK CO'S SETTLEMENT RECORD TOO....

Claim settlement ratio and other data tell you which insurer is more reliable. Would your life insurance policy really take care of the financial needs of your dependents as insurers promise to do after your death? Don’t take them for granted. Insurance regulator IRDA’s annual reports for 2012-13 reveal that of the total 23 private life insurers, only five have a claim-settlement ratio of over 90% (in terms of number of policies), despite many of them having completed 10 years of operations. The figure tells you that many insurers are tight-fisted when it comes to passing on the benefits to nominees. According to financial advisors, it’s time insurance buyers, especially those considering pure protection-term covers, take their eyes off the claims of lowest premium and highest benefits, and pay a more attention to the claim settlement record of the insurance company. “Claims settlement ratio, along with related data, is the only objective yardstick for the consumer to determine which insurance company is preferable and more reliable,” says consumer activist Jehangir Gai. IRDA’s data reveals LIC had the best claim settlement ratio of 97.73% among life insurers in the country. Private life insurers’ average settlement record was at 88.65%. Of the 23 private life insurers, only five — ICICI Prudential Life, SBI Life, HDFC Life, Max Life and Kotak Life — have a claim settlement record of over 90%. Shriram Life, Aegon Religare, Edelweiss Tokio and DLF Pramerica Life are at the bottom of the list. Insurers say wrong information provided by policyholders in the proposal form or non-disclosure of facts are the key reasons for rejection of claims. Often, they claim, this is because many policyholders leave the paperwork to agents. So, apart from completing the form yourself when you have zeroed in on an insurance product, next time ask your insurance advisor for the claim settlement record of the insurer. Even before asking him for details, you can visit the website of the insurance regulator and go through the industry data to ensure the advisor doesn’t take you for a ride. “Customers should exercise caution while buying a policy. They should select a company which has a claims settlement ratio of above 95%,” says Kalpana Sampat, chief of branch operations (underwriting and claims), ICICI Prudential Life. However, please note the distinction: new companies typically tend to have a high claim-rejection ratio. As older companies see more of non-early claims, their overall rejection ratio seems lower. Insurers are not allowed to reject claims citing non-disclosure of facts, if the policy has been in force for more than two years. For a newer company, which is bound to have more early claims, the overall repudiation ratio seems higher as most claims are likely to be early claims, requiring investigation. However, do not stop at just examining the claim-settlement record. Claim pending ratio would help you in ascertaining the time taken by insurer to settle claims. According to the IRDA annual report, private insurers’ claim-pending ratio stood at 7.68% (pending for 3-6 months). LIC’s ratio was higher at 15.47%. A high claim pending ratio usually points to the company’s inefficiency in processing claims, particularly, if the proportion of claims pending for more than six months is higher. “While considering claims-pending ratio, ageing of claims pending should be considered. There are three bands — within three months, three to six months and greater than six months. As per policyholder protection guidelines, all claims should be decided within six months. There should not be too many claims pending for more than three months,” says P Ravi Kutumbarao, head-technical, Bajaj Allianz Life Insurance. Turnaround time for claim settlement is crucial as well. You will get an indication of the time taken by a company to settle claims. While choosing an insurer, check whether a huge proportion of claims has been settled after a delay of more than 180 days. Source : Preeti Kulkarni – The Economic Times – 16/01/2014