Shashi Kant Dahuja

Nowadays we are seeing most of the car pooling ride apps on our mobiles, Here my question is that will Insurance companies cover OD claims and TP Claims when they use it as a Pooling ride. As it was registered under a Private car and as per MV act we should not use it for Commercial usage.

2

1 Comment

#General #Insurance #market #share #GWP #April 24. GI Industry clocked 29.6 K Cr premium with a growth of 16% Top Four Insurance companies. Newindia Assurance Company seen a #degrowth in Market share from 19.75% to 17.72 with 3.93% Growth at 5259 Cr leading the industry . ICICI Lombard General Insurance Company Limited with impressive growth of 22.65% had reached a market share of 11.34% Bajaj Allianz General Insurance with 45.42% Growth had grabbed 8% market share United India Insurance Co. Ltd. on 4th position had seen a growth of 11% with market share drop from 7.11% to 6.82% Companies whose market share decrease from last FY are #Godigit #TataAiG #Oriental #chola #Iffco #LIBERTY #Aic Maximum growth of 54% from #Magma #Zuno #standalone #health insurance companies are still leading the industry growth with more than 23% Star Health and Allied Insurance Co. Ltd Niva Bupa Health Insurance Care Insurance Aditya Birla Health Insurance Company Limited #data courtesy CD

103

4 Comments

ICICI Lombard General Insurance Company Limited Q1 PAT up at Rs 580 crore on motor, health insurance boost India's #ICICILombard General Insurance reported a nearly 49% jump in first-quarter #profit , helped by an increase in #premiums in its #motor and #health #insurance segments. #Profit after #tax rose to 5.80 billion rupees ($69.4 million) for the quarter ended June 30 from 3.90 billion rupees a year earlier. General insurance, especially the motor and health segments, has seen rapid #growth in the country in recent years with a rise in vehicle sales and improved awareness following the Covid-19 pandemic and resultant medical costs. Motor insurance, which accounts for half of ICICI Lombard's business, grew around 12%, while premiums from its retail health insurance and corporate health insurance units grew about 19% and 24%, respectively. #Combined ratio, a key profitability metric for an insurance firm's underwriting business, improved to 102.3% from 103.8% a year earlier. A lower ratio indicates the insurer is earning more through premiums in relation to its claims paid and operating expense incurred.

234

3 Comments

HEALTH INSURANCE REGULATION Is Health Insurance Regulation happening at its basics. Insurance is a sharing of risk. Many people are contributing a small amount called premium towards a corpus and it will get distributed towards the hospital bills of unhealthy situations of the same set of people. If this corpus is not utilised properly, it's a clear case of limitations in regulation. I will explain a case, which I had attended last week. One of my customers is advised for a small procedure at famous/ reputed hospital. They have taken primary approval from the insurance company for 2.8 lacs and pre-authorization is approved too. At the time of discharge, (around 6pm), Hospital people have sent the final bill of 1.71 lacs, and i have spoken to the claims department and they have approved 1.71 lacs, around 9.30 pm. The customer was happy and was about to leave. By then, hospital people had realised that, their primary expected bill was 2.8 and then by 10 pm, they had sent a request to the insurance company saying, there was a mistake and the final bill is 2.8 lacs. The insurance company started seeking the reason for this second claim and it went on till the next morning. I had a heating exchange of discussion with the hospital and finally they had sent a revised bill of 1.8 lac in the morning. The insurance company has settled 1.8 lac, by increasing another 9k from early settled amount 1.71 lacs. What is the conclusion....Was 2.8 lac of estimation correct? Or 1.8 lac is correct. If they had asked for 2.8 lac, as the final bill, the insurance company might have settled. So a clear loss of 1 lac from the insurance corpus fund of all customers right ?? Why hospital is charging so high amount, when it's coming from an insurance company. Need a proper check /regulation on this....

8

6 Comments

General Insurance Industry highlights up to July 2024... * Overall GI Industry's premium is 1000 bn. * Pvt companies are dominating in general insurance as they are holding 65% of the market share whereas in Life Insurance PSU company i.e LIC alone is holding 60% market share. * In the GI industry a chunk of the business is from Health & Accident which is contributing 45% of the premium. *In Health Segment, Group Health is like a B2B which contributes 232 bn whereas Retail Health contributes 142bn. * In Retail Health, StarcHealth Insurance is in top position because they have strong agents network. * In Group Health, PSU company i.e.New India Assurance holds top position because they cover most of the govt. organisation empolyees. #information #insuranceindustry #Generalinsurance #growth #DataAnalytics #powerbi #productanalysis

22

2 Comments

Average health insurance claims size rises 11.35% YoY in FY24: ACKO Report The average #healthinsuranceclaim size in India for FY24 has risen by 11.35 per cent, reaching Rs 70,558, up from Rs 62,548 in FY23, driven by a surge in healthcare expenses, said the #ACKO India Health Report 2024. According to the report, men on average claimed Rs 77,543, while women claimed Rs 69,553 (excluding maternity claims). The report highlighted that #medicalinflation in India is currently at 14 per cent. The costs of common medical procedures have escalated, with angioplasty (PTCA) costs soaring from Rs 1-1.5 lakh in 2018 to Rs 2-3 lakh in 2024, and projections suggest that the cost could reach Rs 6-7 lakh by 2030. Similarly, kidney transplant costs have doubled, from Rs 5-8 lakh in 2018 to Rs 10-15 lakh in 2024, with expectations of surpassing Rs 20 lakh by 2030. The largest claim related to heart disease, specifically for a cardiac procedure filed in the past year, exceeded Rs 1.1 crore, while the biggest kidney disease-related claim topped Rs 24 lakh, underscoring the severe financial impact of serious health conditions, the report said. The report also showed a sharp rise in hospitalisations due to neoplasms (tumours, both benign and malignant) and heart conditions as people age. Notably, hospitalisations for neoplasms saw a jump of 2.8 times from ages 31-40 (3.81 per cent) to 41-50 (10.61 per cent). Similarly, claims related to heart and circulatory system diseases saw a threefold increase between the ages of 31-40 (2.24 per cent) and 41-50 (6.88 per cent). #healthinsurance #healthclaims #NHA #ACKOIndiaHealtReport2024 Read more at: https://lnkd.in/dX2iTGsU

11

3 Comments

The health insurance segment emerged as the primary driver of growth, witnessing a remarkable increase in premiums, breaching the Rs 1 trillion mark and marking a 20.2 per cent growth for FY24, according to the data by Care Edge Ratings. Motor insurance, comprising approximately 50 per cent of the non-life insurance industry excluding health, experienced steady growth, reaching Rs 91,781.3 crore, with a growth rate of 12.9 per cent in FY24. Read more at: https://lnkd.in/drPgGkqh

4

Bajaj Allianz Life Insurance Company has been ordered by the Employees' Provident Fund Organisation (EPFO) to pay a default amount of ₹121 crore towards provident fund (PF) contributions within 60 days. This comes after a lengthy investigation, highlighting the company's lack of adherence to payment of PF for its own employees. As a responsible corporate citizen, it's essential to prioritize the welfare of employees, including timely payment of provident funds. This not only reflects the company's commitment to its workforce but also upholds its legal obligations. Mind it they are in the busines of settlement of claims ??? can we say chirag tale Andra..? #EmployeeWelfare #StatutoryCompliance #CorporateResponsibility https://lnkd.in/g7Gaz2av

62

15 Comments

Motor insurance in India is often misunderstood by many consumers, leading to several misconceptions: 1. Third-Party vs. Comprehensive Coverage: Many believe third-party insurance is sufficient, unaware that it only covers damages to others. Comprehensive insurance, which covers own vehicle damage and theft, is often overlooked. 2. Premium vs. Coverage: Consumers often choose policies with lower premiums, not realizing that such policies might offer limited coverage. This can lead to inadequate financial protection in case of major accidents or theft. 3. No-Claim Bonus (NCB): There's a misconception that making small claims annually will not impact future premiums. In reality, preserving the NCB by avoiding minor claims can result in significant premium discounts over time. 4. Add-ons : Many consumers are unaware of useful add-ons like zero depreciation cover, engine protect cover, and roadside assistance, which can provide extensive coverage and peace of mind. 5. Claim Process : Some believe the claim process is cumbersome and not worth the hassle. However, with digital advancements, the process has become more streamlined and user-friendly. 6. Scope of Coverage : There is often confusion about what is covered under a policy, leading to surprises during claims. It is crucial to read and understand the policy document thoroughly. 7. Transferability : When selling a vehicle, many do not realize the importance of transferring the insurance policy to the new owner, which can lead to complications in future claims. Addressing these misconceptions through awareness and education can help consumers make informed decisions, ensuring they are adequately protected and benefiting fully from their motor insurance policies. IBAI - Insurance Brokers Association of India Square Insurance Brokers Pvt. Ltd. Prudent Insurance Brokers Pvt Ltd. InsuranceDekho Hero Insurance Broking National Insurance Co. Ltd

7

1 Comment

Allianz considering an exit from #Bajaj insurance JVs German company Allianz SE is considering an exit from its #lifeinsurance and #generalinsurance joint ventures with Bajaj Finserv Group. Bajaj Finserv holds a 74% stake, while Allianz holds 26%. Discussions are in early stages and no formal proposal has been made. Allianz aims to ensure a smooth transition with minimal disruption. Bajaj Finserv holds a 74 per cent stake in the JV. It's shares were trading at Rs 1744.05 apiece on the BSE, down 0.85 per cent. Allianz, which holds the remaining 26%, has indicated its strategic priorities have shifted, prompting the potential exit. Allianz plans to exit Bajaj Allianz Life Insurance . and Bajaj Allianz General Insurance Allianz General Insurance Co. because its Indian partner isn’t allowing the German insurer to raise its stakes at a discounted price, the report said citing sources.

222

3 Comments

IRDAI Silver Jubilee 25 years of the Indian #insurance industry: Here are the hits and misses-The first of 2 part column: #Detariffing and #portability are two milestones ahead of the Insurance Act amendment that made health insurance an independent line of business and raised FDI limits to 49%. The Insurance Regulatory and Development Authority of India (#IRDAI) has turned 25 this year. How does the industry plan to celebrate the silver jubilee? Breaking years of stagnation, the Indian insurance industry recently welcomed six new entrants. In the general and health insurance sectors, the latest addition comes after a five-year gap. In the life insurance industry, the gap is longer – 12 years. Let’s start by rewinding to the pre-IRDAI era. An ordinance was issued on January 19, 1956 nationalising the life insurance sector. That year, the Life Insurance Corporation of India (LIC) came into being, absorbing 154 Indian and 16 foreign insurers along with 75 provident societies. Read more at: https://lnkd.in/drkf5ncq

36

2 Comments

Not Having Valid Fitness Certificate For Vehicle Is Ground For Insurance Claim Repudiation: NCDRC. IN United India Insurance Co. Ltd. Vs. Amandeep Singh ( R.P. No. 303/2022) Complainant got a taxi insured with United India Insurance/insurer. The taxi met with an accident when hit by an unknown vehicle. The complainant informed the insurer, and the authorized repairer assessed it as a total loss claim. The insurer approved the claim but did not pay it as the financer (Kotak Mahindra) demanded full payment upfront to issue the NOC for cancellation of registration. Despite legal notice, the insurer did not pay the claim, so the complainant filed a complaint before the District Forum. The District Forum allowed the Complaint. Aggrieved by the District Forum's order, the insurer appealed to the State Commission of Chandigarh, but the appeal was dismissed. Consequently, the insurer filed a revision petition before the National Commission. Held:- If a vehicle without a valid registration is used/driven in a public place, it would constitute a fundamental breach of the insurance policy terms, even if the vehicle was not being driven when stolen or damaged. The Commission observed that in the present case, the claim was repudiated by the Insurance Company on the ground that the vehicle did not have a valid fitness certificate as required under Section 56 of the Motor Vehicle Act, 1988. The Commission highlighted that under Section 56, if a transport vehicle does not have a certificate of fitness, it shall not be deemed validly registered. Hence, this alone becomes valid grounds for the Insurance Company to repudiate the claim. Relied:- 1) United India Insurance Co. vs. Sushii Kumar Godara. 2)Narinder Singh vs. New India Assurance Co. Ltd. 3) Naveen Kumar vs. National Insurance Co. Ltd https://lnkd.in/dJEsjKvm

12

JP Nadda's initiative to include #seniors aged 70+ in health insurance coverage is a thoughtful and commendable move. Read 👇 for more details!! And Follow Aarvi Insurance for more informative posts like this!! #aarviinsurance #insurancecoverage #BJPpresident #jpnadda #healthinsurance #insurancebrokers #informativeposts #greatinitiative #fintech #bfsi #insurtech

2

Thoughts on this? >> Bajaj General Insurance Arm Underwrites Rs 1,365 Crore As Premium, Life Insurer Rs 659 Crore >> Comment below! >>> lqventures.com #industry40 #IoT #mhealth #AI #healthtech

1

The latest guideline of IRDA is actually a fertile ground for disputes. The intention of the regulator seems to be to exclude only fraudulent claims ie claims which are fabricated. Probably, the intent of the regulator is not to exclude claims emanating out of policies which have been obtained through deception. Because, the onus of proof is on the insurer to prove the element of subterfuge and hence it becomes almost impossible for the insurer to prove that the insured had a fraudulent intention and it was not an element of negligence which led to the non-disclosure. So, the intent of the regulator seems to be that all claims have to be paid even if there was deliberate misrepresentation on the part of the insured. I would presume so because there is no cogent effort to address the concerns of the insurers. If the insurer has no access to medical records there is no way he can prove the malafide intent of thre insured. However, the government and IRDAI are creating a nation wide data base of the Health records of individuals. A separate Ayushman Bharat Account Number (acronym ABHA) is going to be given to the voluntary participants. I feel that rhe benefit of moratorium of 5 years should be given only to those who have ABHA

3

Insurer Ki Guarantee: Insurers often keep asking me what kind of additional covers that they should introduce in the market. Now that the tariffs have been dismantled, there is a huge scope for better covers and wordings. I told an insurer who met me this morning that they should think of introducing “guarantees” like “Modi Ki Guarantee” in their policies instead of add-on covers or new wordings. For instance, for claims under property insurance they can give three guarantees. 👉The determination of liability under a fire claim would be done within three months once minimum necessary documents are received from the insured. If not, the claim shall be deemed to be admissible as per terms and conditions of the policy and would be non contestable in future. 👉Once admitted the amount of liability on market value basis should be immediately released to the insured on an on account basis, followed by progress payments as the reinstatement progresses. 👉If the reinstatement is delayed for reasons beyond the control of the insured, the approval for request for extension of reinstatement period of 12 months as per policy would not be unnecessarily denied or delayed. Unlike politicians’ guarantees that are not enforceable, the insurer’s guarantee should be in the policy wording (not in some side letters or service level agreements), giving something for the insured to hold on to. Enforceable guarantees are more valuable than some vague add on cover promising to arrange for Noah's ark when the Biblical flood comes.😊

98

23 Comments