Professional Documents
Culture Documents
General insurance means managing risk against financial loss arising due to fire,
marine or miscellaneous events as a result of contingencies, which may or may not
occur. General Insurance means to “Cover the risk of the financial loss from any
natural calamities viz. Flood, Fire, Earthquake, Burglary, etc.. i.e. the events which are
beyond the control of the owner of the goods for the things having insurable interest
with the utmost good faith by declaring the facts about the circumstances and the
products by paying the stipulated sum , a premium and not having a motive of making
profit from the insurance contract.”
Premiums are collected on a regular basis and invested in Government Bonds, Gift
stocks, mutual funds, real estates and other conservative avenues. However,
investment income depends on market conditions, interest rates, economy etc and
varies from year to year. Because of the uncertainty associated with the investment
income, insurance companies must generate enough income from the premiums to
cover the bulk of their expenses.
Insurance is a contract whereby, in return for the payment of premium by the insured,
the insurers pay the financial losses suffered by the insured as a result of the
occurrence of unforeseen events. The term "risk" is used to describe all the accidental
happenings, which produce a monetary loss.
d) The insurer should have sufficient knowledge about the risks he accepts.
1. INSURANCE:
Insurance is the means of managing risk and protection against financial loss arising
as a result of contingencies, which may or may not occur.
In other words, insurance is the act of providing assurance, against a possible loss, by
entering into a contract, with one who is willing to give assurance. Through this
contract the person willing to give assurance binds himself to make good such loss, if
it occurs.
2. GENERAL INSURANCE:
General insurance means managing risk against financial loss arising due to fire,
marine or miscellaneous events as a result of contingencies, which may or may not
occur.
General Insurance means to “Cover the risk of the financial loss from any natural
calamities viz. Flood, Fire, Earthquake, Burglary, etc.. i.e. the events which are beyond
the control of the owner of the goods for the things having insurable interest with the
utmost good faith by declaring the facts about the circumstances and the products by
paying the stipulated sum , a premium and not having a motive of making profit from
the insurance contract.”
The 4 I’s refers to the different dimensions/ characteristics of any service. Unlike pure
product, services have its own characteristics and its related problems. So the service
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provider needs to deal with these problems accordingly. The service provider has to
design different strategies according the varying feature of the service. These 4 I’s not
only represent the characteristics of different services but also the problems and
advantages attached to it.
•Inconsistency
• Inseparability
• Inventory
• Intangibility:
Insurance is a guarantee against risk and neither the risk nor the guarantee is tangible.
Hence, insurance rightly come under services, which are intangible. Efforts have been
made by the insurance companies to make insurance tangible to some extent by
including letters and form
• Inconsistency
Service quality is often inconsistent. This is because service personnel have different
capabilities, which vary in performance from day to day. This problem of
inconsistency in service quality can be reduced through standardization, training and
mechanization.
• Inseparability
Services are produced and consumed simultaneously. Consumers cannot and do not
separate the deliverer of the service from the service itself. Interaction between
consumer and the service provider varies based on whether consumer must be
physically present to receive the service.
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• Inventory
No inventory can be maintained for services. Inventory carrying costs are more
subjective and lead to idle production capacity. When the service is available but there
is no demand, cost rises as, cost of paying the people and overhead remains constant
even though the people are not required to provide services due to lack of demand.
In the insurance sector however, commission is paid to the agents on each policy that
they sell. Hence, not much inventory cost is wasted on idle inventory. As the cost of
agents is directly proportionate to the policy sold.
The insurance policy shall be void and all the premiums paid by insured may be
forfeited by the insurance company in the event of mis-presentation or mis-
declaration and/or non-disclosure of any material facts.
2. Reasonable care :
The insured shall take all reasonable steps to safeguard the property insured against
any loss or damage. Insured shall exercise reasonable care that only competent
employees are employed and shall take all reasonable precautions to prevent all
accidents and shall comply with all statuary or other regulations
3. Fraud :
If any claim under the policy may be in any respect fraudulent or if any fraudulent
means or device are used by the insured or any one acting on the insured’s behalf to
obtain any benefit under the insurance policy, all the benefits under the insurance
policy may be forfeited.
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4. Few basic principles of general insurance are :
Insurable interest
Today the technology is boosting in each and every field. Insurance is not an
exception. Companies have started providing customers facility of online payment of
premium through their websites. They also provide online assistant to the customer the
policy status and how to calculate the premium. To calculate the premium they just
need the present age, the type of police, sum assured, and accident covered if any. By
filling in this information you can calculate the amount of premium you have to pay.
The customer can pay their premiums by means of credit cards or can also give
standing instruction to the bank in order to pay their monthly premiums.
The insurance companies also provide loan facilities against their policies. At present
loans are granted on unencumbered polices as follows:
• Up to 90% of the Surrender Value for policies, where the premium due is fully paid-
up, and
• Up to 85% of the Surrender Value for policies where the premium due is partly paid-
up.
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The minimum amount for which a loan can be granted under a policy is Rs150. The
rate of interest charged is 10.5% p.a., payable half-yearly. Loans are not granted for a
period shorter than six months, or on the security of lost policies (the assured must
have the duplicate policies) or on policies issued under certain plans. Certain types of
policies are, however, without loan facility.
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COMPANY PROFILE
Reliance General Life Insurance Company is a Reliance Capital Ltd. product. Under
the guidance of Anil Dhirubhai Ambani Group, reliance insurance company has
secured the position of the top insurers in India. Reliance General insurance is one of
the first non-life companies to get the license from the IRDA.
The risks covered under general insurance include property, marine, casualty and
liability. Wide ranges of products are available at Reliance Standard Insurance for
both group and individual customers. Each insurance policy is customized so as the
customers feel as if it was made for their needs. The distribution channels include
branch network, individual and specially trained insurance agents and insurance
brokers and online purchases of the insurance policies.
A completely customer centric company, Reliance Insurance Co Ltd aims at making
insurance affordable and accessible to all. The interests of the policyholders are
protected to the best of their capabilities and complete cooperation is provided in
insurance claims. a pan India presence of Reliance Standard Insurance brings the
insurance policy best suited to your requirements right to a branch near you.
RCL has a net worth of over Rs '3,300 crore and over 165,000' shareholders. On
conversion of outstanding equity instruments, the net worth of the company will
increase to about Rs 4,100 crore. It is headed by Anil Ambani and is a part of the
Reliance ADA Group. Reliance Capital ranks among the top 3 private sector financial
services and banking companies, in terms of net worth.
Reliance Capital has interests in : Asset management, Mutual funds. Life and general
insurance. Private equity and proprietary investments. Stock broking. Reliance PMS.
Depository services and financial products. Consumer finance and other activities in
financial services
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2.b) Nature of the business carried
Reliance General Insurance is one of India’s leading private general insurance
companies with over 94 customized insurance products catering to the corporate, SME
and individual customers. The Company has launched innovative products like India’s
first Over-The-Counter health & home insurance policies. Reliance General Insurance
has an extended network of over 200 offices spread across 173 cities in 22 states, a
wide distribution channel network, 24x7 customer service assistance and a full fledged
website. It is also India’s first insurance company to be awarded the ISO 9001:2000
certification across all functions, processes, products and locations pan-India.
Mission
The Mission is to keep the customer satisfaction as focal point of all our operations,
adopt the best international practices in underwriting, claims and customer service, be
the most innovative in product development, establish presence all over India, ensure
sustained value addition to all stake holders and to uphold Corporate Value &
Corporate Governance.
Objectives
1. Make affordable insurance accessible to all
2. Keep customer as focal point for all operations
3. Protect policy holders interests
4. Adopt best international practices in claims, underwriting and policy servicing
5. Be the most innovative in product development
6. Establish Pan India presence
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Quality Policy
At Reliance General Insurance, one can identify Quality and Customer-focus as the
key strategic initiatives. The Quality roadmap, strictly aligned with the business
priorities, is benchmarked to the best contemporary global practices, and is designed
to support single-minded objectives of maintaining world-class quality standards.
The quality system deployment, defined from the point of the view of the customers,
is to enhance customer experience at all the touch points. As part of this initiative,
every business process in the organization is identified, documented, automated and
deployed. These processes are further monitored continuously through their
compliance scores and dashboard measures and reviewed by the Senior Management
team within the organization.
In fact this passion has taken us one step ahead. The company is pleased to share the
recognition of the Quality Management System by reputed global quality standards
auditing organization – Det Norske Veritas (DNV), which has awarded us the ISO
9001:2000 certification. The certification conforms our adherence to design,
development & sale of General Insurance product offerings to meet customer needs
and in line with 'IRDA regulations'
Reliance General Insurance has established well-defined and documented process and
to help understand our Customer’s requirements and address them to their satisfaction.
Reliance General Insurance currently offers over 80 customized insurance products for
the retail and corporate sector. All these products are sold through its various offices in
different places.
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Personal accident
I. For Individuals
II. Group Personal Accident
Fire
Engineering
Group products
Marine
Motor insurance
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Liability
Other policies
I. Industry Care
II. Commercial Care
III. Office Package
IV. Fidelity Guarantee
V. Burglary and housebreaking
VI. Money insurance
VII. Householder's Package
VIII. Shopkeeper's package
IX. Reinsurance
X. Dental Insurance
XI. Disability Insurance
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Health insurance
I. Individual Mediclaim
II. Group Mediclaim
III. Reliance Healthwise Policy
Travel insurance
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2.e) Area Of Operation
National and Regional
To be successful at doing this, we need to nurture both parts of the solution equation,
that is, creation of solution-oriented strategy and deployment of solution-based
scalable technology that enables meeting of strategic goals laid out as part of the
enterprise strategy. In the current scenario many insurers either rely on manual
methods or custom coded solutions that lack strategic approach to address their
business needs. Manual execution of their crucial operations leads to many errors that
occur in documents passed from insurers to brokers or ceding companies to
reinsurers, which results in lengthy settlement cycles. While custom coded interfaces
are developed to meet a certain set of needs only. They are not scalable so cannot
meet changing needs and require recurring IT investment to keep them in use
.
Reliance General Insurance Co. Ltd is in the process of rolling out a 'Centrally
controlled, Decentralized delivery' operations structure to ensure speedy processing
and service while maintaining predictable and strict quality control. A solution is also
being developed to offer strategic value through systematic design and deployment of
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BPM and integration technologies. The solution will address volatile situations, and
shall be a scalable and reusable solution. It would help meet the challenge of
operational costs saving while enabling the company to exploit business expansion
opportunities .
Global
Reliance Capital Limited intends to be a well-respected global player in the
international financial services sector. It is present in Singapore, Malaysia, United
Kingdom and United Arab Emirates.
Singapore
Malaysia
Reliance Asset Management Malaysia Sdn Bhd (RAMMy) has been incorporated to
undertake Islamic Asset Management under the license of The Securities Commission
of Malaysia. RAMMy aims to become the provider of choice within Islamic Asset
Management by launching unique Shariah-compliant investment strategies to
complement investor’s portfolios with the ultimate focus on wealth creation.
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Reliance Capital Asset Management (UK) plc also established a branch in Dubai
International Financial Centre in 2009. It has commenced operations after receiving a
license from Dubai Financial Service Authority. The DIFC based entity provides a
full range of Wealth and Investment Advisory Services to professional investors and
institutional clients in the region. By establishing this branch RCAM (UK) plc intends
to expand its operations throughout the UK, GCC and Africa.
The ownership pattern of reliance general insurance company limited is shown with a
table below:
Promoters
• Holding Company - Indian 110,929,269 96.27% 108,786,412 96.20%
• Holding Company – Foreign - -
Others
• Reliance General Insurance 4,294,672 3.73% 4,294,672 3.80%
Employees Benefit Trust
TOTAL 115,223,941 100% 113,081,084
For the period ended 30/09/2010 total number of shares of the company are 115,223,941.
Out of which 96.27% of the shares are held by Indian holding company and no shares are
held by foreign holding company. And shares held by Reliance General Insurance
Employee Benefit Trust 3.73%. Number of shares held by Promoters are increased when
compared to last year.
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2.g) Competitors information
For any industries there are number of competitors who themselves try to emerge with
innovative products and services, to compete with other industries. They provide
products and services in order to satisfy the customers, which are economy to their
purchasing habits. Likewise RGICL is also having its competitors.
Royal Sundaram: Royal Sundaram Alliance Insurance Company Limited has been at
the forefront of providing innovative insurance solutions for its customers. It became
the first private insurer in the country to be licensed post privatization in 2001. Since
then the company have been innovating constantly for its customers. Its business in
over 150 cities through a combination of own branches and those of our partners. Total
market share is 2.46%
Star Health and Allied Insurance: Another major competitor for Reliance General
Insurance company Ltd is Star health And Allied Insurance. It spreads its business
over 100 cities, through its branches. The Total market share of the company is 2.63%.
Tata AIG: Tata AIG General Insurance Company Limited is a joint venture company
between the Tata Group and American International Group, Inc. (AIG). The Tata
Group holds 74 per cent stake in the insurance venture with AIG holding the balance
26 percent. It commenced its operations on January 22, 2001, by providing insurance
solutions to individuals and corporate. It offers complete range of general insurance
products that includes insurance for automobile, home, personal accident, travel,
energy, marine, property and casualty as well as several specialized financial lines.
Total market share is 2.64%
ICICI Lombard: ICICI Lombard GIC Ltd. is a 74:26 joint venture between ICICI
Bank Limited, India’s second largest bank with consolidated total assets of over USD
100 billion at March 31, 2010 and Fairfax Financial Holdings Limited, a Canada based
USD 30 billion diversified financial services company engaged in general insurance,
reinsurance, insurance claims management and investment management.
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ICICI Lombard GIC Ltd. is the largest private sector general insurance company in
India with a Gross Written Premium (GWP) of 36,948 million for the year ended
March 31, 2010. The company issued over 44 Lakh policies and settled over 62 Lakh
claims and has a claim disposal ratio of 96% (percentage of claims settled against
claims reported) as on March 31, 2010. The company has 4,634 employees and 350
branches as on March 31, 2010. Total market share 9.38%
Bajaj Allianz: Bajaj Allianz General Insurance received the Insurance Regulatory
and Development Authority (IRDA) certificate of Registration on 2nd May, 2001 to
conduct General Insurance business (including Health Insurance business) in India.
The Company has an authorized and paid up capital of Rs 110 crores. Bajaj Finserv
Limited holds 74% and the remaining 26% is held by Allianz, SE.
As on 31st March 2010, Bajaj Allianz General Insurance maintained its premier
position in the industry by achieving growth as well as profitability. Bajaj Allianz has
made a profit before tax of Rs. 180 crores and has become the only private insurer to
cross the Rs.100 crore mark in profit before tax in the last four years. The profit after
tax was Rs. 121 crores, 27% higher than the previous year. Total market share is
6.22%.
Bharthi Axa General: Bharti AXA General Insurance is a joint venture between
Bharti, one of India’s leading business groups with interests in Telecom, Agri
Business and Retail; and AXA, world leader in Financial Protection and Wealth
Management. Bharti Group holds 74% of equity and AXA holds 26% of the equity.
The total market share of the company is 1.13%.
RGICL has good infrastructural facilities. All the employees are provided with the
facilities such as telephone, computer with internet access. All the branches are fully
computerized and all branches are well equipped . Employees in the office are
provided with their own software for calculating the claims and for other operations.
The ambience within the office is what can make the customer feel comfortable. The
cordial and friendly atmosphere at office is like a full time motivation for the
employees.
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2.i) Achievements and Awards
The RGICL has not received any specific awards for the business carried out.
Customer
Branch Office
Surveyor
Customer
Claims Manager
Company
customer
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2.k)Future growth and prospects
We can clearly get the idea about the future growth and prospects of the company by
looking at the following figure. It clears tells that, in the earlier years the company’s
growth was stagnant. And the profit was also low because of its stagnant growth. But
from the year 2006-07 the RGICL is having very high growth every year. The gross
premium and the number of policies of the company are increasing at a very high rate.
As there is high increase in the number of vehicles ,there is a high need of insurance
for it, not only for vehicles but also for other services like marine cargo, employee
liability, travel, personal accident etc there is a lot of need for insurance in order to
protect them from loss. So for Reliance General Insurance there is a opportunity of
better growth in the upcoming years
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Mckensey’s 7S frame work with special reference to RGICL
The 7-S Framework was first mentioned in "The Art Of Japanese Management" by
Richard Pascale and Anthony Athos in 1981. They had been investigating how
Japanese industry had been so successful. At around the same time that Tom Peters
and Robert Waterman were exploring what made a company excellent. The Seven S
model was born at a meeting of these four authors in 1978. It appeared also in "In
Search of Excellence" by Peters and Waterman, and was taken up as a basic tool by
the global management consultancy company McKinsey. Since then it is known as
their 7-S model.
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Shared Values (also called Super ordinate Goals).
The interconnecting center of McKinsey's model is: Shared Values. What does the
organization stands for and what it believes in. Central beliefs and attitudes. These are
the core values of the company that are evidenced in the corporate culture and the
general work ethic. Super ordinate goals are the fundamental ideas around which a
business is built. They are of main values. What does the organization stands for and
what it believes in. Central beliefs and attitudes. They are the broad notions of future
direction. According to Mckensey super ordinate goals refers to: a set of values and
aspirations that goes beyond the conventional formal statement of corporate
objectives. All targets and attention of all activities and exercises of the six levers of
any organization should be directed towards accomplishment of the best possible
goals. This is the ultimate and terminal point where the organization will have to
reach.
RGICL believes in total quality at all levels of the organization. It aims at total value
packages for all its needs. The shared values or goals of the RGICL are contained in
the banks mission and vision statement. All the employees are work together to
achieve the objectives of the company. The company try to know the customer needs,
wants and based on that it launches the new product and services. It guides to the
employees in order to provide a better service to customers
Strategy
Plans for the allocation of a firms scarce resources, over time, to reach identified goals.
The plan devised to maintain and build competitive advantage over the competition
.The concept of strategy includes purposes, mission's objectives, goals and major
action plans and policies. The 7s model emphasizes that in practice, the development
of strategies poses less of a problem than their execution. It also includes Plans for the
allocation of firm’s scarce resources, over time, to reach identified goals, environment,
competition, customers.
The company strongly believes that customer satisfaction is indispensable for the
business growth. Customer relation manager and facilitator at the strategic location
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and field units, periodic customer services audit and senior level officer are appointed
as nodal officer monitoring the prompt redressed of customer grievances.
Structure
The way in which the organization's units relate to each other: centralized, functional
divisions (top-down); decentralized; a matrix, a network, a holding, etc. : The way the
organization is structured and who reports to whom .The way the organization's units
relate to each other: centralized, functional divisions (top-down); decentralized (the
trend in larger organizations); matrix, network, holding, etc.
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Figure 5. Organization chart
Central manager
MKT manager
Jr.fin/operation
manger.
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Systems
The procedures, processes and routines that characterize how the work should be done:
financial systems; recruiting, promotion and performance appraisal systems;
information systems. The daily activities and procedures that staff members engage in
to get the job done. Systems include all those procedures and methodologies, which
are framed by the organization and followed by the operating personnel in the
respective functional areas. Example, financial accounting system, materials planning
and inventory control system, quality management computerization, etc all these
functional areas some traditional system may be in existence which needs to be
reviewed and changed, as per requirements, in view of advanced technology and
process developed.
System in relation to RGICL : The system and procedure as well defined and are
available with all the hierarchy as on need to know basis. The well structure process
manuals are available for all the functional areas, be it business or administration
Staff
Numbers and types of personnel within the organization. The employees and their
general capabilities. Staffing is the process of acquiring human resources for the
organization and assuring that they have the potential to contribute to the achievement
of organizational goals.
RGICL recruits those persons who are perfect for the job. Since the job profile can
change so that it requires training and updating knowledge. The company provides
required training for the personnel which will results in increased productivity and
efficiency
Style
The Mckensy’s framework considers the style as more than the style of top
management. Aspects of organizational culture also seen to be encompass by the term
style. It includes Cultural style of the organization and how key managers behave in
achieving the organization’s goals. Management Styles.
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Organizational Culture: the dominant values and beliefs, and norms, which develop
over time and become relatively enduring features of organizational life.
The style of the RGICL in business or in administration has a unique niche in the
industry.
i .Top Down: The RGICL has been following Top Down style of leadership. The
employee in the organization has well defined roles duties and responsibilities. The
managers get guidelines from the top management regarding interest rate, products
and services to the customers.
ii Authoritarian: The managers in the organization has their own style of functioning
and collectively works as a team. Most of the managers use Authoritative style of
functioning to control their executives.
Skills
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Swot Analysis
Strengths
Weakness
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Opportunities
1. De-tariff
o –IRDA removed controls on pricing in General Insurance
business with effect from 1st January 2008
2. The industry is going to be freed from product \wordings and policy wordings
3. Can become market leader as presently it is no. 2 position
4. General insurance industry in India has grown at 15% CAGR in terms of gross
premium collection
Threats
1. New Entrants
– Future General India Life Insurance Company Limited
– IDBI Fortis Life Insurance Company Ltd
– Bharti Axa General Insurance Company Ltd
2. Many foreign bank giants are going to enter Indian market. They have very
large portfolio of various verticals and products with them.
3. New tie-ups by the competitors viz.
o -Online travel portal clear trip ties up with TATA AIG to offer
travel insurance
o -ICICI Prudential inks pact with suvidha Info Serve.
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Analysis of Financial Statement
Financial analysis of the company with the help of ratio analysis:
I. Current Ratio:
Current ratio is a measure of liquidity calculated dividing the current assets by the
current Liabilities
31/03/2009 31/03/2010
The current ratio in the year 2010 is very high this is because of less current
liabilities. Company has repaid the liabilities in the year 2010.
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Table 3. Quick Ratio
31/03/2009 31/03/2010
The quick ratio and current ratio is same for both the years because there is no
inventory.
31/03/2009 31/3/2010
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Learning experience
As a student of Business Administration the learning experience gained in Reliance
General Insurance Co Ltd was one of the important part of my life before entering
into the corporate world. This work provided strong base to get first hand knowledge
of the corporate world which proved very helpful. It not only provided knowledge of
the corporate world but also taught to tackle each and every tremendous situation with
ease.
RGICL is one of the leading companies in India. The study gave me very fruitful
knowledge experience. It provided the solid foundation to study and learn the tactics
of facing the world.
The study on the industry profile, informed on ever expanding view of business in
India with its fascinating history of Insurance sector and its growth and development
in the recent times. This gave a clear idea of the scope of the general insurance in
future, its vastness and ever expanding coverage which the company will cover in the
coming year. The insurance industry has a tremendous potential in the coming years
worldwide and can boom the economy of any given nation.
The history of this company and its origin gave me knowledge to have a great vision
and move strongly withstanding and difficulty which we face and be strong in our
goals. Practically speaking, RGICL is providing vast variety of services to its
customers, that being a customer it’s rather difficult to have knowledge of all the
services. .
To conclude, the whole study in RGICL was a never ending process to learn more,
experience more and get maximum exposure towards the corporate world. In total the
overall experience was excellent and knowledgeable, experience gained was a never
ending quest for knowledge
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General Introduction
The study is conducted in order to know, whether the claims are managed properly in
the Reliance General Insurance Company Ltd. The study was conducted on the twelve
months data from 1st January 2010 to 31st December 2010. The data considered for the
study are claims paid, claims recovered, gross incurred claims and net incurred claims
of the year 2010.
1.d) Methodology:
The research carried out a descriptive type of research. The study is mainly based on
the secondary data at appropriate places. Thus the data collected by secondary source
have been tabulated and analyzed making use of appropriate statistical tools and
results, such as correlation. and chi-square tests
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1.e) Limitations of the study:
No single work is exception to the limitations, every work has got its own limitations,
following are some of the limitations of my study
The study is mainly based on secondary data and no field work is done because
of time constraint.
The study is limited to the data of the previous year 2009- 10 only.
Difficulties are faced while accumulating important data.
It is not an exact science, so we cannot expect 100% result, so only justified
solutions are given.
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2.a) Creating Claims
When the variance is detected from the project plan, claim can be created using an
Internet application. This means variances can be documented either at work station,
or at any computer that has Internet access. This makes claim entry easy and
convenient. And claims can be entered at a construction site, when traveling, and so
on. The flexible user interface makes things even easier. Details of the claim can be
entered using long texts. In addition to the notification header long text, four other
long text categories are available. That can be used to structure the information on the
claims.
Processing Claims
As claims usually cause additional costs, costs can be entered which expect to arise
either when claim is created, or later, when more precise information is available. The
following options are available:
-Entering the estimated costs manually.
-Creating a unit costing from the claim or link it to an existing unit costing.
Enter the costs demanded and accepted manually. Status management and workflow
are two more high-performance tools you can use to process claims in the R/3 System.
The link between claim management and status management means that processing of
a claim dependent on its status, that a claim cannot. The system documents all changes
to the claim in the action log. Once the claims processed and closed ,it can be
archived. A deletion program deletes the database records for claims successfully
archived.
Evaluating Claims
The work lists for notifications and tasks include an overview of the claims to be
processed and the tasks associated with them. For detailed evaluations of claims,
information system and access the overview reports for the claims are useful. As the
claim is assigned to a project or WBS element either when creating the claim or later,
all the claims created for a project/WBS element in the information system can be
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displayed. An evaluation program can be used to display the data for claims already
archived.
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Ageing of claims means, claims paid after a certain number of days. In the above
graph, X axis represents various products of the company and Y axis represents total
amount of claims paid. Motor OD( Own Damage) is having highest number of claims
paid for ageing i.e. Rs.16,490.6 lacs. Motor TP( Third Party), Health and
Miscellaneous are the other 3 products which have more than Rs.2000 lacs. All other
products have total claims paid less Rs.2000 lacs
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Table 7 Details regarding claims
Incase of Fire related claims, the claims outstanding at the beginning of the quarter,
i.e. on 1st october 2010 is 35%. Total claims paid is 18% and claims recovered is 13%.
Claims outstanding at the quarter end 31st december 2010 is 34%. There is a slight
change in the outstanding claims at the end of the quarter when compared to claims
outstanding at the beginning of the quarter
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Figure 9 Claims Details for Marine Insurance
Incase of marine related claims, the claims outstanding at the beginning of the period
is 36%, total claims paid is 15%. Here recovered claims are very less in number i.e.
only 8% and claims outstanding at the end of the quarter is 41%. In case of marine
related claims, outstanding claims are increased from 36% to 41%.
Incase of motor related claims, 43% of claims are outstanding at the beginning of the
quarter. Total claims paid are 14% and recovered claims are only 4%. Very less
amount of claims are recovered in case of mator policies. And claims outstanding at
the end of the quarter is 39% this shows that nimber of claims outstanding are
decreased at the end of the quarter.
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Figure 11. Claims Details for Miscellaneous Insurance policies
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Contact Person Address, for the contact person at the customer
Notification Address: for example, the customer's lawyer
_ For vendors:
Vendor Address, where a vendor can enter who already exists in the system
Manufacturer Address
Notification Address: for example, sales and distribution at the vendor
Contact person can be entered in the notification address.
If you change the partner the partner type is changed, for example, from customer to
vendor, the system adopts all the partners and displays them in the partner overview.
In the standard claim configuration, the contact person is always the customer contact
person.
Allowed reference documents
For vendors, the purchasing document
For customers, the sales order, delivery, and purchase order number
For "internal", the sales order, delivery, purchase order number, and purchasing
document
Features
Following default values and settings can be defined:
General data
- Notification type
- WBS element
- Partner type
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- Whether the system shows a status line/pushbutton when you enter or display
long texts
Appearance of the action box: The system represents the action box as a table
or an overview tree. If the table is chosen, the system displays only the follow-
up activities that can be carried out. If the overview tree is chosen, the system
displays all the available follow-up activities.
Use
A task allows to plan the cooperation of various persons during the claim process and
assures that the activities connected to the task are completed within a given
timeframe. The task receives a status depending on its degree of completion.
Data for a task is entered on two different screens with varying degrees of detail.
Overview screen
Detail screen
The following entries are possible for each task:
A table key for the tasks to be executed and a brief instruction describing what
is to be done
The task's planned start and end
The task's status
Responsible partner for carrying out the task
The documentation for processing tasks contains a note explaining how to create a
task for a notification item. This is not possible in claim management because a claim
does not recognize items. In claim management a task refers to the entire claim.
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Claim Overview
The system displays all the data entered for the claim selected, except for tasks and
actions. If this is all the data you need, we recommend you use this report, for
performance reasons.
Claim Hierarchy
The system displays all the data entered for the claim selected, including tasks and
actions.
Archiving Claims.
Procedure
Claim archiving using transaction SARA involves the following steps:
1. Preparation
The preparation program assigns status MARC to the claims selected, thereby flagging
them as ready for archiving and deletion. This also blocks the claims so flagged
against further online changes.
2. Archiving Run
The archiving program writes the database tables for the claim to the archive. If the
process was successful, the program deletes the data from the system immediately
after it has been archived.
3. Delete
A deletion program deletes the database records for claims successfully archived. If
the deletion program is not accessed automatically when the archiving action has been
completed successfully, you must wait until archiving is complete altogether.
4. Evaluation
Evaluation can be used to display the data for claims already archived.
Claims Analysis
The following are the tables regarding claims paid from direct business written,
claims paid on re-insurance accepted, claims recovered on re-insurance accepted,
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net claims paid, outstanding claims at the quarter end, outstanding claims at the quarter
beginning.net claims incurred. The data is for the period ended 31st December 2010
Public Liability - - 54
43
Motor TP 10,86,099 58,43,173 63,73,686 5,55,586
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Correlation between Claims Paid and Claims Recovered = 0.985024
Therefore, claims paid and claims recovered are positively correlated as the
calculated value is more than 0. And they are highly significant at 5% level of
significance.
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Table 13
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Table 14
Correlation between gross incurred claim and net incurred claim is 0.93
The relationship between gross incurred claims and net incurred claims is positively
correlated. And they are highly significant at 5% level of significance.
Table 17.1 Quarterly claims data for the period ended 31/12/2010
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Table 17.2 Quarterly claims data
The above tables shows the quarterly claims data, regarding claims outstanding at the
beginning of the period, claims settled during the period, claims reported and claims
repudiated during the period, claims closed during the period and claims outstanding at
the end of the period. And it also gives details of claims paid within different periods
of time, i.e. less than 3 months, 3 months to 6 months, 6 months to 1 year, 1 year and
above. These tables gives complete information of the claims for the different
products offered by the company.
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Table 18 The following table shows the data regarding Ageing Of
Claims
(Rs in Lacs)
Sl no
no of claims paid
1 Fire 99 1,511.41
138 80 36 28 381
2 Marine 84 424.64
cargo 255 45 32 14 430
9 Liability 4 1 1 21.18
11 3 20
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Ageing of claims means claims paid within a specific number of days, as in the above
table, claims are paid within 1 month or between 1 to 3 months, 3 to 6 months, 6
months to 1 year and above 1 year. In most of the policies customers want their claims
to be paid as early as possible. So claims most of the claims are paid within 1 month or
1 to 3 months.
In the below graphs ‘X’ axis represents different periods of time and ‘Y’ axis
represents total amount of claims paid.
1- 1 month
2- 1-3 months
3- 3-6 months
4- 6 months to 1 year
5- > 1 year
Figure 13. showing number of claims paid for different periods for Fire
In the above figure claims paid within 1 month is more than all other periods. Out of
381 claims, 138 claims are paid within a period of 1 months. As the period goes on
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changing the number of claims paid also goes on decreasing. This means that if the
period for paying claims is less people will be more interested in such policies. As
they can get the claim immedietly.
Figure 14.
Out of 430 total claims related to Marine Cargo, 255 claims are paid within 1 month.
Here also most of the people prefer to go for the policies where the claims are paid as
early as possible, i.e. within 1 month. Number of claims paid decreases as the period
changes. At period 5, i.e. when claims are paid after 1 year the total amount of claims
paid is 14 out of 430, which is the least among all.
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Figure 15.
Number of claims paid for different periods for Motor Own Damage
In the above figure claims paid within 1 month is more than all other periods. Out of
60,506 claims, 33,102 claims are paid within a period of 1 months. More than 50% of
the total claims are paid during period 1. As the period goes on changing the number
of claims paid also goes on decreasing. This means that if the period for paying claims
is less people will be more interested in such policies. As they can get the claim
immedietly.
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Figure 16
Out of 18,580 claims 12,447 claims are paid within a period of 1 month. i.e morethan
66% of claims are paid in the period 1. In this case also as the period for payment of
claim increases, number of claims paid decreases. People are more interested to get
claims as early as possible. So they prefer the periods in which they will get claims
quicky.
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Figure 17
In case of personal accidents people need money as early as possible, to meet their
medical and other expenses. So usually, people will go for the period 1 where they get
the claim within 1 month. Here more than 50% of the total claims are paid within 1
month. Very few people go for the period 5 where the claims are paid after 1 year.
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Figure 18
Incase of oversease travel most of the people go for the 2nd and 3rd period where the claims
are paid either between 1 to 3 months or between 3 to 6 months. Nearly 40% of the claims are
paid in period 2. i.e. between 1 to 3 months. And 27% of the claims are paid in period 3. i.e.
between 3 to 6 months. Only 5% of claims are paid in the period 5 where the claims are paid
after 1 year.
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In case of employee liability more than 50% of the claims are paid in the period 3
where the claims are paid between 3 to 6 months.
-Complete cover
Reliance two wheeler insurance policy give s complete cover on the road and off it.
It will also gives you personal accident insurance cover and third party liability cover.
-Convenience designed
Towing service owned and operated to cut down on inefficiencies. It also provide an
allowance of Rs. 300 towards towing charges if required
A net work of 1700m garages in over 231 cities to provide you with cashless repairs
It values time and responds immediately. There are 24/7 helpline for emergency
services also.
It also make sure that a survey of the vehicle is arranged within 8 working hours
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Discounts
If the claim is made in the previous year, one can get a ‘No Claim Bonus’ reward
while renewing the policy.
-Voluntary excess
There are special discounts for physically challenged car owners and vintage vehicles.
The policy coverage is wide and encompasses many aspects, from the vehicle to the
owner to any third party involved in a liability concerning the vehicle that is insured.
Vehicle
The Reliance Two Wheeler Insurance Policy covers loss or damage to vehicle due to:
Accident, fire, lightening, self-ignition, explosion, burglary, house break-in or
theft.
Riot and strike, malicious act, terrorism, earthquake, flood, cyclone and
inundation.
Transit by rail, road, air, elevator and lift.
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Third Party Liability
As per the Motor Vehicle Act, third part liability cover is a compulsory cover to be
taken by all vehicles. This cover provides against the liability for third party
injury/death, third party property damage and liability to paid driver.
Add on covers
Electrical/Electronic Accessories
Non electrical accessories
Rally Extension
Racing, speed tests, dexterity trials, Hill Climb extensions
Legal Liability to employees, paid drivers
Exclusions
At Reliance General Insurance, the policies are as transparent as possible. To ensure,
not face any unpleasant surprises when making a claim, some of the major exclusions
under the policy :
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Following information needs to be furnished while intimating a claim:
Contact Numbers
Policy Number
Name of Insured person,
Date & Time of accident,
Vehicle number
Make and Model,
Location of Loss,
Garage Name with contact details
Brief description on how the accident took place,
Extent of loss
Place & contact details of the Insured Person if the person intimating the claim
is not insured.
key benefits
Specially designed plan that covers the business premises against burglary and
housebreaking.
Cover available on a first loss basis by way of judicious management of
probable maximum loss assessment.
Host of extensions such as coverage for riot, strike, malicious damage and
theft.
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Multiple options for variations in sum insured such as floater policy,
declaration policy, floater declaration policy
Policy coverage
The policy offers coverage against
Property contained in business premises (such as stocks, furniture etc) owned
by the Insured
Stocks held in trust / commission and for which the Insured is responsible, if
specifically covered
Damage to premises resulting from burglary and/or housebreaking or any
attempt at burglary
Cash, valuables and securities kept in a locked safe or cash box in locked steel
cupboard if specifically covered
Policy feature
The following variations with regard to sum insured can be opted for:
Floater policy: Issued for stocks at various locations under one sum insured
Declaration policy: Takes care of frequent fluctuations in stocks / stock values
Floater declaration policy: Comprises of features of both floater and the
declaration policies
Exclusions
Eligibility
The Reliance Burglary & Housebreaking insurance Policy can be bought by any one
who has property and valuables that are exposed to the risk of burglary and
housebreaking.
Key Benefits
Exhaustive coverage against loss or damage to cargo in connection with its
carriage by land, waterways, air or postal services
Policy extendable to cover War and Strikes perils
Flexible coverage options (Specific Policy, Open Policy and Open Cover)
available for the Insured
Policy coverage
Specific Policy – This policy provides cover against specified perils under
marine cargo sent/received during the Policy period.
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Open Policy – Typically opted by commercial firms and industrial
establishments with substantial volume of trade and a number of transactions, an
Open Policy is issued for ensuring automatic & continuous insurance protection.
This policy is issued to cover all shipments sent/received during the Policy period.
Open Cover – This is an arrangement similar to Open Policy to cover loss or
damage to cargo where specific stamped certificate is issued for declaration made.
The Marine Cargo Policy covers loss or damage to cargo in relation to and in
connection with its carriage by:
-land (whether by motor vehicle or by railway),
-waterways (that is to say by ship which includes every description of vessel used in
navigation);
-air (that is to say, by aircraft used for the transport of cargo, among others); and
-government or private postal services
The Policy provides cover against loss or damage to cargo during transit from one
place to another by any one or more of the modes of transport.
Coverage provided under Marine Cargo policies range from a restricted form of cover
e.g. Fire and Lightning perils only to the widest available form of cover, namely, All
Risks, at the option of the insured.
Special features
Worldwide Claims Survey and Settlement Assistance.
Network of Surveyors all over the country.
Customized and Innovative covers based on your needs.
Extensions for multi transit, incidental storage, FOB, riot and strikes perils etc
Discounts for Voluntary Higher excess, lesser distance etc.
Exclusions
The Policy does not cover loss or damage to cargo insured due to:
willful misconduct of the Insured;
insufficiency or unsuitability of packing or preparation of the cargo insured;
ordinary leakage, ordinary loss in weight or volume, ordinary wear and tear
and inherent flaws in the cargo insured;
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delay,
insolvency and financial distress of the carriers;
unseaworthiness of vessel;
Key Benefits
Reliance Individual Personal Accident Policy covers against risks of accidents.
It not only provides compensation to the family in case of the accidental death
of the insured but also takes on the onus of providing the insured
with compensation in case of injury, whether temporary or permanent.
The sum insured increases by 5% for each completed claim-free year of
insurance, subject to a maximum of a 50% increase.
This policy can also be expanded to cover actual medical expenses arising out
of the accident
Policy coverage.
Accidental Death – On the accidental death of the insured person, we will pay
the family the capital sum insured.
Permanent Total Disability – In the event of permanent total disability due to
an accident, we will also pay the capital sum insured.
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Permanent Partial Disability – In case of a partial disability due to an
accident, a specified percentage of the sum insured will be paid. To know the
specific percentage of the sum assured that will be paid,
Temporary Total Disability – If one is totally disabled by an accident for a
limited period of time, the policy will pay you 1% of the capital sum insured per
week, not exceeding Rs 5,000 per week.
Exclusions
The policy excludes cover for death or disablement due to:
Eligibility
This policy can be issued to persons in the age group of 5 years to 70 years. It can be
extended to cover persons beyond the age of 70 years and up to 80 years on payment of
suitable additional premiums.
Features
a. End-to-end claims cycle management:
The system covers the claims management process right from the moment a case is
registered in the front desk to its closure. Workflow provides corresponding task
allocations to task owners.
b. Role based management:
Profiles that are part of the claims process provided with relevant access to the system.
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c. Document management:
Case related documents, can be uploaded in the system and managed effectively. This
enables easy access to them by the claims owner.
d. Collaboration through web and mobile solutions:
For stakeholders like surveyors, claims advisors web/mobile solutions speed up their
data collection and uploading tasks.
e. Efficient claims Case and Task tracking:
The manager through operational reports can handle claims tracking and resource
assignments efficiently
.
Solution review.
An application that would help the Insurance Company manage their claims
processing from claims Initiation to closure with automated process flows,
collaboration, document management and reporting features.
a. End-to-end claims cycle management: The system covers the claims
management process right from the moment a case is registered in the front
desk to its closure. Workflow provides corresponding task allocations to task
owners.
b. Role based management: Profiles that are part of the claims process provided
with relevant access to the system.
c. Document management: Case related documents, can be uploaded in the
system and managed effectively. This enables easy access to them by the
claims owner.
d. Collaboration through web and mobile solutions: For stakeholders like
surveyors, claims advisors web/mobile solutions speed up their data collection
and uploading tasks.
e. Efficient claims Case and Task tracking: The manager through operational
reports can handle claims tracking and resource assignments efficiently.
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Figure 20. claims management system solution review
68
Figure 21. claims management system process review
69
Call Center/ Front Claims Manager Claims Advisor Claims Owner
Desk
Start
Verifies the
Agent initiates a Collects the
case and assigns
case after receiving necessary
a claims advisor
details from details about
to the case
customer the case
Stop
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FINDINGS
• Claims paid and Claims recovered are compared here using correlation
technique and it shows that they are positively correlated as the computed
value is more than 0
• Claims paid and Claims recovered are highly significant at 5% level of
significance, as the table value is less than the calculated value.
• Net claims incurred and Gross claims incurred are compared and it is found
that they are also positively correlated as the computed value is more than 0.
And are highly significant at 5% level of significance.
• Claims Management System can play a very significant role. This would help
the company in increasing employee productivity by reducing cycle time and
defect rate. It also increases employee participation and compliance.
• The good practices for claims management mentioned here can be effectively
used by the company to settle claims in an efficient way. If the company uses
these practices it would result in ‘timely claim processing’ ‘effective handling
of complaints and disputes’ ‘ fraud detection and prevention’ ‘better claims
procedure’.
RECOMMENDATIONS
1: Claims reporting
The insurance company writes insurance policies in easily understandable language.
Policies spell out what is covered and what is not covered. If necessary, plain language
explanations could be an addendum to the legal language. The insurance company
draws the attention of the policyholder/claimant/beneficiary1 both when he/she signs a
policy (for policyholders only) and when he/she reports a loss on his/her duties related
to claim reporting which include:
Try to minimize losses;
To report claims in a timely fashion;
To co-operate in the investigation by providing the company with all relevant
information and, in particular, copies of official documents regarding the
damage (accident, loss, etc.);
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To authorize the company to handle necessary inspections and assess the extent
of the damage prior to any repairs or replacement; To ensure that the claims
reporting phase proceeds as smoothly as possible, the insurance company sends
to the policyholder/claimant/beneficiary within a reasonable period of time
(beginning from when the loss is reported):
An appropriate claim form (when the loss reporting is made in writing) for
the type of policy - prepared either by an individual insurance company or at
the national level by companies or the supervisory authorities together with
instructions and useful information on how to comply with the terms of the
policy and the legitimate requirements of the company;
7: Market practices
The public authorities promote the implementation of a benchmark exercise regarding
the claims process or a specific part of this process (i.e. handling of complaints). The
terms of remuneration of insurance company employees or other services in charge of
claim management do not give incentives to disadvantageous treatment of
policyholders/claimants/beneficiaries, as regards the handling or the outcome of
claims.
CONCLUSION
After making the study on ‘Claims Management’ with the help of various statistical
tools, I would like to conclude that claims paid and claims recovered are positively
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correlated and highly significant. The Claims Management System explained above is
very helpful to the company. As the technology plays an important role in the Claims
management System, it will result in less manual errors, time taken to process claims
will be less . claims procedure becomes fully automated. Managing claims becomes
easy for the company it would further results in customer satisfaction. The good
practices on claim management are neither binding nor exhaustive, but meant as a
“checklist” to assist insurance companies in handling claims.
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ANNEXURE
TOTAL 11,506,183
Applications of funds
Investments 19,618,135
Loans 300,627
Fixed assets 376,664
Deferred tax asset 409,735
Current assets
Cash and bank balances 440,527
Advances and other assets 3,921,946
Sub-total(A) 4,362,473
Current liabilities 10,129,089
Provisions 6,258,561
Sub-total(B) 16,387,650
Net current assets(C)=(A-B) (12,025,177)
Debit balance in profit and loss account 2,826,199
TOTAL 11,506,183
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Balance sheet as at 30th September 2009
TOTAL 7,812,807
Applications of funds
Investments 14,592,775
Loans 300,627
Fixed assets 595,688
Deferred tax asset 8,535
Current assets
Cash and bank balances 956,365
Advances and other assets 5,055,035
Sub-total(A) 6,011,401
Current liabilities 8,085,675
Provisions 7,253,307
Sub-total(B) 15,339,982
Net current assets(C)=(A-B) (9,328,581)
Debit balance in profit and loss account 1,643,763
TOTAL 7,812,807
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BIBLIOGRAPHY
www.reliancegeneral.co.in
www.niapune.com/Research/Claims%20Management.
http://help.sap.com/printdocu/core/print46c/en/data/pdf/PSCLM/PSCLM.
www.oecd.org/dataoecd/43/44/33964905
www.polaris.co.in/practices/technology/.../Claims-Management
http://en.wikipedia.org/wiki/Claims_management_company
www.polaris.co.in/media/media-release/2010-jan-claim-mgmt-solution
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7,934,162 629,085 3,037,659 5,525,588
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