Insurance Fraud has not been seriously addressed in India Insurers say they are forced to reject – or repudiate, in industry parlance – a lot of claims due to suppression of relevant facts such as medical history. Insurance non-disclosure is the biggest item, which is leading to repudiation. Customers should be willing to share more information proactively,” said Girish Kulkarni, managing director and chief executive of Star Union Dai-Ichi, which settled 92.86% claims during the year.
Private insurers namely Shriram Life, IndiaFirst Life Insurance and Canara HSBC OBC rejected nearly one in every five claims during 2013-14 .Whereas LIC improved its claims settlement ratio to 98.14% during the fiscal, according to the annual report of IRDA . ”
In 2013-14, insurers repudiated 18,423 claims for Rs 624 crore while 8,496 claims for a total of Rs 450 crore were pending.
Life insurance companies settled 8.56 lakh claims on individual policies with a total payout of Rs 10,860 crore during the fiscal. The settlement ratio of private sector insurers dropped to 88.31% from 88.65% while the percentage of repudiations during the fiscal was 8.03%. Insurers closely investigate claims which are reported early on during the term of a policy. Insurance companies have been dealing with organised frauds in life insurance, as a result of which they have been blacklisted in certain areas.
