The Insurance Regulatory and Development Authority of India (IRDAI) has released the 2024 Master Circular on Policyholders’ Protection, consolidating policyholder rights into one comprehensive document. It emphasises faster, smoother claims settlements and improved service standards, aiming to enhance trust and transparency in the insurance sector. The circular sets new benchmarks for safeguarding policyholders’ interests, ensuring a more streamlined and hassle-free experience for insurance policyholders.
Insurance policies to be issued in e-format
Insurers are required to issue insurance policies in electronic form. However, policyholders must be given the option to request a physical copy of the policy, and this preference should be given at the time of submission of the proposal form.
Customer CIS is mandatory
As per the circular, IRDAI has made it mandatory for insurers to share a Customer Information Sheet (CIS) along with the insurance policy. The CIS sheet serves as a summary for the policyholder, explaining the features and benefits of the policy.
The CIS should be in a specific format as specified in ‘Schedule D’ of the Insurance Act.
FREE look period of 30 days
A free-look cancellation (FLC) period of 30 days applies to all policies with a term of one year or more. If a policyholder cancels within this period, the applicable refund of the premium must be processed and refunded within 7 days of receiving the FLC cancellation request.
Timeline for life insurance claim settlement
As a policyholder, it is important for you to be aware of the new timelines set by IRDAI for life insurance claim settlement cases.
- Death claims-to be settled within 15 days
- Death claim with investigation-45 days
- Surrender & withdrawals- 7 days
- Maturity & survival benefits- as per the due date
In case of any delay in claim payment, the insurer must pay interest at the bank rate plus an additional 2%, calculated from the date the claim intimation was received.
Utilize Bima Bharosa for unclaimed amount
Claimants and policyholders can check for any unclaimed amounts owed to them by insurers through the Bima Bharosa website, managed by IRDAI. If an unclaimed amount remains unclaimed for 10 years, the insurer transfers it to the Senior Citizens’ Welfare Fund (SCWF). However, claimants or policyholders can still claim these amounts for up to 25 years from the date of transfer by contacting the relevant insurer.
Digilocker integration for hassle-free policy management
Insurers must ensure their IT systems are fully compatible with Digilocker, enabling you to store, retrieve, and manage your policy documents digitally with ease, offering a seamless and secure experience.
Premium payment only after insurer approval
You are only required to pay the insurance premium once the insurer has accepted your proposal. No upfront premium or deposit is necessary when submitting the proposal form, unless the policy’s risk cover begins immediately upon payment.
Health Insurance Claim Settlement TAT
Insurers are required to make a decision on your cashless authorization request within 1 hour. After receiving the hospital’s discharge request, the insurer must issue the final authorization within 3 hours to ensure prompt claim processing.
In conclusion, the IRDAI’s 2024 Master Circular on Policyholders’ Protection marks a significant step forward in ensuring transparency, trust, and better service standards across the insurance sector. With its emphasis on timely claim settlements, digital policy management, and clear guidelines for premium payments and endorsements, the circular aims to create a more streamlined and hassle-free experience for policyholders. These measures not only enhance customer protection but also strengthen the relationship between insurers and policyholders.
