Lok Sabha Question No. 4097 (UNSTARRED), answered on 2018-08-10
Subject: Settlement of Insurance Claims
Ministry: FINANCE
Asked by: SANJAY SHAMRAO DHOTRE, RAHUL RAMESH SHEWALE, BHARTRUHARI MAHTAB

Government of India Ministry of Finance Department of Financial Services Lok Sabha Unstarred Question No. 4097

Friday, August 10, 2018/Shravana 19, 1940 (Saka)

## Settlement of Insurance Claims

## 4097. SHRI SANJAY DHOTRE:

## SHRI RAHUL SHEWALE:

## SHRI BHARTRUHARI MAHTAB:

## Will the Minister of FINANCE

be pleased to state:

- (a) the number of claims settled under term insurance policies upon death of the insured person by the Public and Private Insurance Companies across the country during each of the last three years and the current  year, Company-wise including Life Insurance Corporation (LIC) of India and HDFC Life;
- (b)    the  number  of  such  claims  passed/  approved  by  the  said  companies  during  the  said  period, Company-wise, including LIC and HDFC Life;
- (c) the number of complaints received by the Government against the said companies for denial/partial denial of claims under term insurance policies during the said period along with the present status of such complaints, Company-wise; and
- (d)  the steps taken by the Government to ensure smooth and timely payment of sum assured on claims under term insurance policies to their nominees and to curb the clandestine activities of the said companies for denial/partial denial of such claims along with achievements thereof?

## Answer Minister of State in the Ministry of Finance (Shri Shiv Pratap Shukla)

(a) and (b): 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'.

(c):  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'.

(d):  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.

## Number of claims paid upon death of the insured person by the life insurance companies

| Life                                                                 | FY 2015-16   | FY 2015-16   | FY 2016-17   | FY 2016-17   | FY 2017-18   | FY 2017-18   |
|----------------------------------------------------------------------|--------------|--------------|--------------|--------------|--------------|--------------|
| Insurers                                                             | 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)

## Number of complaints for denial/partial denial of claims upon death of insured person by life insurers

|                                                                      | 2015-16   | 2015-16            | 2015-16   | 2015-16   | 2016-17   | 2016-17            | 2016-17   | 2016-17   | 2017-18   | 2017-18            | 2017-18   | 2017-18   |
|----------------------------------------------------------------------|-----------|--------------------|-----------|-----------|-----------|--------------------|-----------|-----------|-----------|--------------------|-----------|-----------|
| Insurer Name                                                         | In favour | Partially infavour | Reject    | Total     | In favour | Partially infavour | Reject    | Total     | In favour | Partially infavour | 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 Company Limited | 1         | 1                  | 2         | 4         |           | 2                  | 1         | 3         | 1         | 1                  | 1         | 3         |
| 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)