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        News and Press Release

        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.

        Regulatory requirements for life insurance claim settlement mandate prompt processing, disclosure on repudiation, and supervisory oversight. Regulation 14 requires prompt processing of death claims, timelines for settlement, disclosure of reasons for rejection, and interest for insurer delays; Regulation 17 mandates procedures and mechanisms to resolve policyholder and claimant complaints. IRDAI monitors insurer claims data to detect discrepancies, conducts onsite and focussed online inspections, and initiates regulatory or corrective measures if grave irregularities in claim settlement are found. Annexures provide multi-year tables of death claims paid by individual and group policies and complaint outcomes for denial or partial denial across insurers.
                          Cases where this provision is explicitly mentioned in the judgment/order text; may not be exhaustive. To view the complete list of cases mentioning this section, Click here.
                            Provisions expressly mentioned in the judgment/order text.

                                Regulatory requirements for life insurance claim settlement mandate prompt processing, disclosure on repudiation, and supervisory oversight.

                                Regulation 14 requires prompt processing of death claims, timelines for settlement, disclosure of reasons for rejection, and interest for insurer delays; Regulation 17 mandates procedures and mechanisms to resolve policyholder and claimant complaints. IRDAI monitors insurer claims data to detect discrepancies, conducts onsite and focussed online inspections, and initiates regulatory or corrective measures if grave irregularities in claim settlement are found. Annexures provide multi-year tables of death claims paid by individual and group policies and complaint outcomes for denial or partial denial across insurers.





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