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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 |
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Aegon Religare Life Insurance Company Limited | 508 | 1 | 571 | 0 | 530 | 13 |
|
Aviva Life Insurance Company India Limited | 1255 | 2068 | 1128 | 1206 | 1056 | 490 |
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Bajaj Allianz Life Insurance Company Limited | 16404 | 148840 | 14887 | 201422 | 13176 | 197425 |
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Bharti Axa Life Insurance Company Limited | 1009 | 175 | 811 | 205 | 860 | 291 |
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Canara HSBC Oriental Bank of Commerce Life Insurance |
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Company Limited | 531 | 525 | 620 | 141 | 797 | 928 |
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DHFL Pramerica Life Insurance Company Limited | 460 | 15733 | 428 | 27149 | 572 | 48236 |
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Edelweiss Tokio Life Insurance Company Limited | 120 | 1269 | 153 | 1429 | 180 | 2068 |
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Exide Life Insurance Company Limited | 2889 | 697 | 2866 | 1441 | 3250 | 1585 |
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Future Generali India Life Insurance Company Limited | 1381 | 198 | 1223 | 12746 | 1202 | 767 |
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HDFC Standard Life Insurance Company Limited | 11811 | 13742 | 12421 | 38025 | 12289 | 72946 |
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ICICI Prudential Life Insurance Company Limited | 10615 | 1876 | 10539 | 1774 | 11216 | 2665 |
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IDBI Federal Life Insurance Company Limited | 920 | 1753 | 962 | 2906 | 1068 | 1290 |
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India First Life Insurance Company Limited | 1359 | 6197 | 1439 | 7123 | 1626 | 8579 |
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Kotak Mahindra Old Mutual Life Insurance Limited | 2465 | 34501 | 2583 | 46049 | 2881 | 48572 |
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Max Life Insurance Company Limited | 8895 | 3688 | 9606 | 5531 | 10152 | 7932 |
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PNB Met Life India Insurance Company Limited | 2641 | 1915 | 3380 | 1749 | 3726 | 1264 |
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Reliance Nippon Life Insurance Company Limited | 13714 | 6354 | 10473 | 12266 | 8553 | 7262 |
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Sahara India Life Insurance Company Ltd. | 717 | 67 | 654 | 88 | 556 | 7 |
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SBI Life Insurance Company Limited | 15037 | 19523 | 17027 | 23172 | 18274 | 32915 |
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Shriram Life Insurance Company Limited | 1512 | 14575 | 1859 | 32634 | 2524 | 32424 |
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Star Union Dai-ichi Life Insurance Company Limited | 1102 | 4740 | 1238 | 5456 | 1145 | 4448 |
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Tata AIA Life Insurance Company Limited | 3205 | 1147 | 2599 | 695 | 2793 | 576 |
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Private Life Insurers- Total | 104922 | 281893 | 103194 | 425155 | 103718 | 477276 |
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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
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| 2015-16 |
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| 2016-17 |
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| 2017-18 |
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Insurer Name | In favour | Partially in favour | Reject | Total | In favour | Partially in favour | Reject | Total | In favour | Partially in favour | Reject | Total |
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AEGON Religare Life Insurance Company Limited |
| 2 | 1 | 3 |
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| 1 | 1 |
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| 2 | 2 |
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Aviva Life Insurance Company India Limited |
| 2 | 7 | 9 |
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| 5 | 5 |
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Bajaj Allianz Life Insurance Company Limited | 4 | 5 | 9 | 18 | 4 |
| 6 | 10 | 5 | 1 | 4 | 10 |
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Bharti-Axa Life Insurance Company Limited |
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| 2 | 2 |
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| 10 | 10 | 1 | 1 | 6 | 8 |
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Birla SunLife Insurance Company Limited | 1 |
| 6 | 7 |
| 2 | 2 | 4 | 3 | 2 | 14 | 19 |
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Canara HSBC Oriental Bank of Commerce Life Insurance | 1 | 1 | 2 | 4 |
| 2 | 1 | 3 | 1 | 1 | 1 | 3 |
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Company Limited |
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DHFL Pramerica Life Insurance Company Limited |
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| 2 | 2 |
| 2 | 1 | 3 |
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| 2 | 2 |
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Exide Life Insurance Company Limited | 2 | 1 | 5 | 8 |
| 1 | 8 | 9 |
| 2 | 6 | 8 |
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Future Generali India Life Insurance Company Limited | 3 | 5 | 10 | 18 |
| 4 | 8 | 12 |
| 1 | 2 | 3 |
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HDFC Standard Life Insurance Company Limited |
| 1 | 24 | 25 | 7 | 1 | 50 | 58 | 28 |
| 44 | 72 |
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ICICI Prudential Life Insurance Company Limited | 10 | 6 | 80 | 96 | 5 | 5 | 38 | 48 | 4 | 9 | 47 | 60 |
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IDBI Federal Life Insurance Company Limited | 4 |
| 19 | 23 | 7 | 1 | 15 | 23 | 1 |
| 11 | 12 |
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IndiaFirst Life Insurance Company Limited | 4 | 1 | 15 | 20 | 24 | 4 | 66 | 94 | 49 |
| 88 | 137 |
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Kotak Mahindra Old Mutual Life Insurance Limited | 1 |
| 8 | 9 |
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| 24 | 24 |
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| 4 | 4 |
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Max Life Insurance Company Limited | 11 |
| 74 | 85 | 2 |
| 55 | 57 | 4 | 1 | 58 | 63 |
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PNB MetLife India Insurance Company Limited | 2 |
| 5 | 7 | 4 |
| 15 | 19 | 7 |
| 19 | 26 |
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Reliance Nippon Life Insurance Company Limited | 4 | 3 | 26 | 33 | 1 | 2 | 30 | 33 | 1 |
| 10 | 11 |
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SBI Life Insurance Co. Limited | 6 | 5 | 29 | 40 | 2 | 1 | 11 | 14 | 3 | 5 | 17 | 25 |
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Shriram Life Insurance Company Limited |
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| 2 | 2 |
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| 5 | 5 |
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| 10 | 10 |
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Star Union Dai-ichi Life Insurance Company Limited | 1 |
| 4 | 5 | 1 |
| 4 | 5 | 2 | 1 | 8 | 11 |
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Tata AIA Life Insurance Company Limited | 4 | 3 | 69 | 76 | 3 | 1 | 38 | 42 | 3 | 1 | 29 | 33 |
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Private Life Insurers - Total | 58 | 35 | 399 | 492 | 60 | 26 | 393 | 479 | 112 | 25 | 382 | 519 |
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Life Insurance Corporation of India | 49 | 11 | 10 | 70 | 64 | 10 | 11 | 85 | 42 | 12 | 12 | 66 |
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TOTAL | 107 | 46 | 409 | 562 | 124 | 36 | 404 | 564 | 154 | 37 | 394 | 585 |
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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.Press 'Enter' after typing page number.