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Money & Banking - Insurance
‘Agents must explain policy to the insured’

L.N. Revathy

Coimbatore, June 16 How often does one sign a document – be it an insurance proposal form, a loan application or a legal notice – blindly?

A majority (including professionals and literates) rarely read the fine print before signing.“The intermediaries – be it an insurance agent or the development officer – need to be educated. They have to teach the insured to fill up the proposal form,” says Mr K. Sridhar, Insurance Ombudsman, Chennai.

His contention was based on complaints received from the insured. “The insured approach us, claiming to have no knowledge of the company or about the contract and the procedure. How then did he sign on the dotted line?- the insurer argues. Such issues can be resolved if the intermediary educates the insured in the first place,” Mr Sridhar said, adding that agents, mostly the young ones, were not in the picture when a claim arose. “This could set a bad precedent,” he said.

Ambiguity in products

He further said that linking insurance with other products such as home loan, education or personal loan was turning out to be an issue if the data was not scrutinised at the underwriting stage itself.

“Insurance companies need to improve underwriting skills. There is ambiguity in the product, especially in non-life,” Mr Sridhar said.

He also said publicity material or pamphlet could not be taken as the last word for insurance. This seemed to be happening in bancassurance tie-ups and mostly under group policies.

On complaints received with the ombudsman, he said, “There is a small increase in the number of complaints received in 2007-08. It has risen to 1,255 compared to 1,210 the previous year. Of these, 705 cases pertained to life insurance and the remaining were in the general insurance space. I’ve disposed all but five life insurance complaints. Around 37 non-life complaints were pending as at March-end. The response from non-life companies is tardy. Many private players are yet to set up a grievance cell,” he explained.

On complaints settlement, Mr Sridhar said, “Of the 200 complaints personally heard, 85 pertained to life and most of these were repudiation cases. Sixty three per cent of the cases went in favour of insurance companies.

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