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Settlement of Insurance Claims

August 11, 2018

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The details of claims paid upon death of the insured person by the life insurance companies during the years 2015-16, 2016-17 and 2017-18, are given at ‘Annexure A’.

The details of complaints against the said companies for denial/partial denial of claims upon death of insured person, during the years 2015-16, 2016-17 and 2017-18, is at ‘Annexure B’.

As per Regulation 14 of Insurance Regulatory and Development Authority of India (Protection of Policyholders’ Interest) Regulations, 2017, certain procedures such as immediate processing upon receiving a death claim, adhering to timelines for settlement of a death claim, reasons to be stated on rejection or repudiation of the claim, interest to be paid due to delay on the part of insurer etc. are required to be followed by insurers for claim settlement in respect of a life insurance policy.

Regulation 17 of the said Regulations states that every insurer shall have in place proper procedures and effective mechanism to expeditiously resolve complaints and grievances of policyholders and claimants efficiently.

As per Insurance Regulatory and Development Authority of India (IRDAI), based on the analysis of claims data of life insurers, if any variation or abnormal discrepancies are noticed, the same are taken up with the insurers. These variations/ deviations/discrepancies noticed are also thoroughly checked by the Inspection Department of the Authority during regular onsite inspection. The Authority also conducts focussed online inspection. In case any grave irregularity is noticed in the claim settlement by the insurer, regulatory and corrective measures are initiated accordingly. 

Annexure A referred to in reply to Lok Sabha Unstarred Question No. 4097 for 10th August, 2018

Number of claims paid upon death of the insured person by the life insurance companies

Life Insurers

FY 2015-16

FY 2016-17

FY 2017-18

 

Individual

Group

Individual

Group

Individual

Group

 

Aditya Birla Sun Life Insurance Company Limited

6372

2309

5727

1948

5292

4593

 

Aegon Religare Life Insurance Company Limited

508

1

571

0

530

13

 

Aviva Life Insurance Company India Limited

1255

2068

1128

1206

1056

490

 

Bajaj Allianz Life Insurance Company Limited

16404

148840

14887

201422

13176

197425

 

Bharti Axa Life Insurance Company Limited

1009

175

811

205

860

291

 

Canara HSBC Oriental Bank of Commerce Life Insurance

 

 

 

 

 

 

 

Company Limited

531

525

620

141

797

928

 

DHFL Pramerica Life Insurance Company Limited

460

15733

428

27149

572

48236

 

Edelweiss Tokio Life Insurance Company Limited

120

1269

153

1429

180

2068

 

Exide Life Insurance Company Limited

2889

697

2866

1441

3250

1585

 

Future Generali India Life Insurance Company Limited

1381

198

1223

12746

1202

767

 

HDFC Standard Life Insurance Company Limited

11811

13742

12421

38025

12289

72946

 

ICICI Prudential Life Insurance Company Limited

10615

1876

10539

1774

11216

2665

 

IDBI Federal Life Insurance Company Limited

920

1753

962

2906

1068

1290

 

India First Life Insurance Company Limited

1359

6197

1439

7123

1626

8579

 

Kotak Mahindra Old Mutual Life Insurance Limited

2465

34501

2583

46049

2881

48572

 

Max Life Insurance Company Limited

8895

3688

9606

5531

10152

7932

 

PNB Met Life India Insurance Company Limited

2641

1915

3380

1749

3726

1264

 

Reliance Nippon Life Insurance Company Limited

13714

6354

10473

12266

8553

7262

 

Sahara India Life Insurance Company Ltd.

717

67

654

88

556

7

 

SBI Life Insurance Company Limited

15037

19523

17027

23172

18274

32915

 

Shriram Life Insurance Company Limited

1512

14575

1859

32634

2524

32424

 

Star Union Dai-ichi Life Insurance Company Limited

1102

4740

1238

5456

1145

4448

 

Tata AIA Life Insurance Company Limited

3205

1147

2599

695

2793

576

 

Private Life Insurers- Total

104922

281893

103194

425155

103718

477276

 

Life Insurance Corporation of India

749249

246745

756399

290148

724596

284103

 

Life Insurers- Total

854171

528638

859593

715303

828314

761379

 

Source: Insurance Regulatory and Development Authority of India (IRDAI)

Annexure B referred to in reply to Lok Sabha Unstarred Question No. 4097 for 10th August, 2018

Number of complaints for denial/partial denial of claims upon death of insured person by life insurers

 

 

2015-16

 

 

2016-17

 

 

2017-18

 

 

Insurer Name

In favour

Partially in favour

Reject

Total

In favour

Partially in favour

Reject

Total

In favour

Partially in favour

Reject

Total

 

 

 

AEGON Religare Life Insurance Company Limited

 

2

1

3

 

 

1

1

 

 

2

2

 

Aviva Life Insurance Company India Limited

 

2

7

9

 

 

5

5

 

 

 

 

 

Bajaj Allianz Life Insurance Company Limited

4

5

9

18

4

 

6

10

5

1

4

10

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Bharti-Axa Life Insurance Company Limited

 

 

2

2

 

 

10

10

1

1

6

8

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Birla SunLife Insurance Company Limited

1

 

6

7

 

2

2

4

3

2

14

19

 

Canara HSBC Oriental Bank of Commerce Life Insurance

1

1

2

4

 

2

1

3

1

1

1

3

 

Company Limited

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DHFL Pramerica Life Insurance Company Limited

 

 

2

2

 

2

1

3

 

 

2

2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Exide Life Insurance Company Limited

2

1

5

8

 

1

8

9

 

2

6

8

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Future Generali India Life Insurance Company Limited

3

5

10

18

 

4

8

12

 

1

2

3

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HDFC Standard Life Insurance Company Limited

 

1

24

25

7

1

50

58

28

 

44

72

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ICICI Prudential Life Insurance Company Limited

10

6

80

96

5

5

38

48

4

9

47

60

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IDBI Federal Life Insurance Company Limited

4

 

19

23

7

1

15

23

1

 

11

12

 

IndiaFirst Life Insurance Company Limited

4

1

15

20

24

4

66

94

49

 

88

137

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Kotak Mahindra Old Mutual Life Insurance Limited

1

 

8

9

 

 

24

24

 

 

4

4

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Max Life Insurance Company Limited

11

 

74

85

2

 

55

57

4

1

58

63

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PNB MetLife India Insurance Company Limited

2

 

5

7

4

 

15

19

7

 

19

26

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Reliance Nippon Life Insurance Company Limited

4

3

26

33

1

2

30

33

1

 

10

11

 

SBI Life Insurance Co. Limited

6

5

29

40

2

1

11

14

3

5

17

25

 

Shriram Life Insurance Company Limited

 

 

2

2

 

 

5

5

 

 

10

10

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Star Union Dai-ichi Life Insurance Company Limited

1

 

4

5

1

 

4

5

2

1

8

11

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Tata AIA Life Insurance Company Limited

4

3

69

76

3

1

38

42

3

1

29

33

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Private Life Insurers - Total

58

35

399

492

60

26

393

479

112

25

382

519

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Life Insurance Corporation of India

49

11

10

70

64

10

11

85

42

12

12

66

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL

107

46

409

562

124

36

404

564

154

37

394

585

 

Source: Insurance Regulatory and Development Authority of India (IRDAI)

This was stated by Shri Shiv Pratap Shukla, Minister of State for Finance in a Written reply to a question in Lok Sabha.

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