11/04/2023 Tolani Instiute of Management Studies

RMI presentation

on IRDA

Presented by :-Aditi Joshi (10044)Neha Joshi (10045)Ambika Kushwah (10055)

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WHAT is IRDA???

• IRDA-Insurance Regulatory and Development Authority

• Its a national agency run by the Government of India based in Hyderabad

• Formed by an act of Indian Parliament called as IRDA Act of 1999.

• Considering some of the emerging requirements of the Indian insurance industry, IRDA was amended in 2002.

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i. A chairman

ii. whole time members

iii. Part time members to be appointed by central government.

IRDA consists of :-

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• Indian insurance industry is regulated by the terms and conditions of the IRDA.

• IRDA regulates the business of Private Insurance company's like ICICI, AVIVA, Max Newyork e.t.c.

• In 2010, the Govt.of India ruled that ULIPs will be governed by IRDA, and not the market regulator SEBI

• The Indian banks are under the control of RBI like the corporate insurance companies are under the reguation of IRDA.

Contd…

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Private Insurance Companies- IRDA

• Reliance General Insurance Company Limited.• IFFCO Tokio General Insurance Co. Ltd• TATA AIG General Insurance Company Ltd.• Bajaj Allianz General Insurance Company Limited• ICICI Lombard General Insurance Company Limited.• Export Credit Guarantee Corporation Ltd.• HDFC-Chubb General Insurance Co. Ltd.• Bharti Axa General Insurance Company Ltd.

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objectives

• To protect the interest of policyholders.

• To bring about speedy and orderly growth of the insurance industry

• To set, promote, monitor and enforce high standards of integrity, financial soundness, fair dealing and competence of those it regulates.

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Contd…

• To ensure the customers receive precise, clear and correct information about products and services.

• To ensure speedy settlement of genuine claims, to prevent insurance frauds and other malpractices.

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Contd….

• To promote fairness, transparency and orderly conduct in Financial markets

• To take action where such standards are inadequate or ineffectively enforced.

• To bring about optimum amount of Self-regulation

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Insureres

• Life• General • Reinsurance

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• To issue certificate of registration.

• To protect the interests of the policyholders.

• To specify requisite qualifications code of conduct and training for insurance intermediaries and agents.

• To specify code of conduct for Surveyors/ Loss Assessors.

FUNCTIONS, DUTIES & POWER OF IRDA

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• To promote efficiency in the conduct of insurance business.

• To supervise the functioning of Tariff Advisory Committee.• To regulate investment of funds by the insurance companies.• To undertake inspection, conduct enquiries

and investigations.

Functions Cont...

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To specify the percentage of Life and General Insurance business. To promote and regulate professional organizations connected with the insurance and reinsurance. To specify the form and manner for maintenance of books of accounts.

Functions Cont...

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• To prescribe the manner and form in which accounts will be maintained and submitted by insurers and

intermediaries.

• To regulate maintenance of margin of solvency.

Functions Cont...

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• To levy fees & other charges for carrying out the purposes of this act.

• To adjudication of disputes between insurers & intermediaries or insurance intermediaries.

• To specify the percentage of premium income of the insurer financial schemes for promoting & regulating professional organization.

Functions Cont...

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Impact of IRDA  • The creation of IRDA has brought revolutionary

changes in the Insurance sector.

• In last 10 years ,tremendous growth.

• Life Insurance Corporation of India (LIC) and General Insurance Corporation of India (GIC), & 23 new players

• The IRDA also successfully deals with any discrepancy in the insurance sector.

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Intermediaries

• Agents • Corporate agents• Brokers • Surveyors• TPA Health services

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OMBUDSMAN

Tolani Instiute of Management Studies

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Ombudsman

• Acts as an intermediary between an organisation • 11th November,1998• Objectives:- Quick disposal of the grievances of the insured

customers .• Great importance and relevance for the protection of

interests of policy holders . • Helped to generate and sustain the faith and

confidence amongst the consumers and insurers.

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STRUCTURE OF

INSURANCE OMBUDSMAN

OFFICES

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GOVERNING BODY OF INSURANCE COUNCIL

• Consist of one representative from each of the insurance companies.

• Representatives shall be Chairman or Managing Director or any one of the Directors of the company

• Shall formulate its own procedure for conducting its business including the election of the Chairman.

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APPOINTMENT OF OMBUDSMAN

• The governing body shall appoint one or more persons as ombudsman.

• Two representatives of the Insurance Council.

• The Ombudsman selected may be drawn from a wider circle including those who have experience in industry, civil service, administrative service, judicial service etc.

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Term of Office

• An Ombudsman shall be appointed for a term of three years or till the incumbent attains the age of 65 years, whichever is earlier. Re-appointment is not permitted.

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Territorial Jurisdiction

• Location specified by the Insurance Council

• The Governing Body shall specify the territorial jurisdiction of each Ombudsman.

• At present there are 12 centers in India

• The Ombudsman may hold sitting at various places within his area of jurisdiction in order to expedite disposal of complaints

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Staff

• Secretarial staff

• Engage the services of professional expert

• The salary, allowances and perquisites payable to Ombudsman and staff and all expenses incurred shall be borne by the Insurance Council.

• Personnel deputed for a term of 2/3 years from Public Sector Life and non-life insurance companies to assist the Ombudsman.

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FUNCTIONINGOF

INSURANCE OMBUDSMAN

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REDRESSAL OF PUBLIC GRIEVANCES RULES, 1998(RPG RULES) NOTIFICATION DATED 11.11.1998 AMENDED ON 18.12.1998 AND 21.06.1999.

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• These Rules shall apply to all the insurance companies operating in general insurance business and in life insurance business in India

• Objective - Cost effective, efficient and impartial manner

- Cost effective efficient impartial manner

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ENTERTAINABLE COMPLAINTS

The Ombudsman may receive and consider complaints on

a. any partial or total repudiation of claims

b. any dispute in regard to premium paid or payable

c. any dispute on the legal construction of the policies in so far as such disputes relate to claims

d. delay in settlement of claims

e. non-issue of any insurance documents

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Recommendations made by the Ombudsman

• Ombudsman to give recommendation when there is Mutual agreement.

• Complainant to communicate his acceptance for the recommendation

• The Insurer to comply with the recommendation within 15 days of the receipt of the consent from the complainant and report to the Ombudsman of the compliance.

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Award made by the Ombudsman

• Where the complaint is not settled by agreement, the Ombudsman shall conduct hearing and pass a speaking award.

Power to make ex-gratia payment

• If the Ombudsman deems fit he may award an ex-gratia payment under Rule 18.

• Complainant to give consent on receipt of the award within 1 month to the insurer

• The Insurer to comply within 15 days

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Power to make ex-gratia payment

• If the Ombudsman deems fit he may award an ex-gratia payment under Rule 18.

• Complainant to give consent on receipt of the award within 1 month to the insurer

• The Insurer to comply within 15 days

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Consequences of non-acceptance of award

• The award may not be implemented by the insurer if the consent from the complainant is not received within the time frame specified.

• The complainant has the right to approach other forums.

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OMBUDSMAN – REAL TEST WHEN SITS ON JUDGEMENT•Effective listening• Allow steam to let out• Extract more and more data• Counselor / Mediator• Finally to say Yes/No•No pushing paper vertical/horizontal

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Microinsurance

• Health insurance contract, any contract covering the belongings such as hut, livestock or tools or instruments or any personal accident contract either individual or group basis as per stated in Schedule –I.

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Micro insurance agents

• NGO- Non-government organisation• SHG- Self help group • MFI- Micro finance Insurance spl appointed

for microinsurance products.

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