The Insurance Regulatory and Development Authority of India (IRDAI) has introduced new timelines for various services provided by insurance companies, aimed at improving accountability and customer service. The key change is a reduction in the time allowed for settling death claims, along with stricter guidelines for handling other insurance-related processes.
Reduced Timelines for Death Claims
In life insurance, death claims that do not require investigation must now be settled within 15 days, down from the previous limit of 30 days. For early death claims that require investigation, the new resolution period is 45 days, reduced from the earlier guideline of “not later than 90 days.”
Faster Processing of Other Claims
- Maturity claims, survival benefits, and annuity payments: These should now be settled on their due dates.
- Policy surrenders and partial withdrawals: These must be processed within seven days, ensuring timely access to funds for policyholders.
Improved Communication with Policyholders
Insurance companies are required to send premium due intimations and provide information on policy payments (such as maturity or survival benefits) at least one month before the due date. This ensures that policyholders are well-informed and can make timely payments.
Stricter Guidelines for New Policies
For new business proposals, insurance companies must:
- Process proposals and request any additional information within seven days.
- Provide a copy of the policy and proposal form to the policyholder within 15 days.
Health Insurance Timelines
- Cashless claims: These must be settled within three hours.
- Non-cashless claims: These must be resolved within 15 days.
For customers opting for free-look cancellation of their health insurance policy, insurers must process the refund within seven days of receiving the request.
Unit-Linked Insurance Policies (ULIPs)
Services such as switch requests and top-up requests in ULIPs must be processed within seven days. Additionally, services related to policy loans and alterations in policy conditions are bound by the same seven-day timeline.
Handling Customer Complaints
Insurance companies are required to:
- Acknowledge complaints immediately and initiate action within 14 days.
- If unresolved, they must inform the complainant within 14 days from the original complaint date.
Master Circular Highlights
The IRDAI’s Master Circular on Protection of Policyholders’ Interests consolidates key policyholder entitlements. Insurers must provide Customer Information Sheets (CIS) with detailed policy information and make these available in regional languages. Additionally, both life and health insurance policies are required to offer a 30-day free-look period, allowing policyholders time to review and cancel their policies if needed.
