T.

Y BANKING & INSURANCE (SEM-VI)

“TO STUDY ABOUT CLAIM MANAGEMENT IN

LIFE INSURANCE”

IN PARTIAL FULLFILLMENT FOR THE AWARD OF

THE DEGREE OF BACHELOR OF BANKING
INSURANCE

PREPARED BY

JEET GANGAR

ROLL NO. 05

T.Y.B&I

MATRUSHRI KASHIBEN MOTILAL PATEL COLLEGE

OF COMMERCE AND SCIENCE
THAKURLI (E) - 421201

GUIDE
Mrs. LEKHA VISARIA.

UNIVERSITY OF MUMBAI,

MUMBAI- 400028

Year 2013- 2014

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T.Y BANKING & INSURANCE (SEM-VI)

ACKNOWLEDGEMENT

In this section, the researcher acknowledges the

assistance and support received from individuals
and organizations in conducting the researcher. It
is thus intended to show his gratitude. Good taste
calls for acknowledgement to be expressed simply
expressed and nicely.

I take this opportunity to thank all of them who

played a major role in completing this project.

I express my deep gratitude towards Prof. MRS.

LEKHA VISARIA course coordinator for
encouraging me to work on this project.

I also thank our in charge Principal Mrs. Lekha

Visaria for her continuous encouragement to our
activities.

I must especially record my sincere thanks to my

family members and all my friends for their constant
support.

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T.Y BANKING & INSURANCE (SEM-VI)

ABSTRACT
.

The field of insurance has taken a giant leap at the

threshold of twentieth century. Insurance have become an
integral part of life of man all over the globe. The proverb
‘Need is the mother of invention’ is proving equally correct
in case of insurance. Insurance have already had a
considerable impact on many aspects of our society.
Claims management is another important aspect on
insurance. It is complex in nature that is true but it is a
driving force to plant confidence in the hearts of people.
Claim management is one of the most challenging
business processes in the insurance industry. With the
number of stakeholders involved, the dependencies and
the logistics, there is a need is to eliminate manual
interventions. For many organizations, claim management
and administration is viewed solely as a service
operation. Claim management is expected to run the
claim process efficiently and keep expenses low, but little
attention is given to leveraging high impact opportunities
afforded through effective data management. In fact, the
data captured in the claim process, which all too often are

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T.Y BANKING & INSURANCE (SEM-VI)

underutilized, are rich in valuable information for those

who know how to extract and analyze it.
Claim management is an expert system which generates
the rules and regulations for the assessment of general
damages using the key information contained in medical
reports, surveyor report, loss assessor’s reports,
claimant’s petition and the procedures or conditions and
warranties contained in the policy document. The claims
management regulates the payment of general damages
and also payment of the loss of future earnings.
This project is just a gist about hoe the insurance
companies settle the claims, the procedure that is
followed, and the intermediaries that are involved in the
process and so on. This project throws light on various
aspects on claims management and the problems faced
by them

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T.Y BANKING & INSURANCE (SEM-VI)

INDEX
SR.NO PARTICULER PAGE.NO
CHAPTER.1 INTRODUCTION 11

1.1 BACKGROUND OF THE 12

TOPIC

1.2 PLACING RESEARCH 18

PROBLEM

1.3 STATING NEEDS FOR 18

SURVEY

1.4 TITLE OF THE STUDY 19

1.5 OBJECTIVES OF THE 19

STUDY
1.6 20
NULL HYPOTHISES
1.7 20
HYPETHOESIS
1.9 20
DEFINITION OF
IMPORATNT TERMS

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T.Y BANKING & INSURANCE (SEM-VI)

1.10 21
ASSUMPTION OF THE
STUDY
1.11 21
REVIEW OF LITERATURE
1.12 23
METHODOLOGY
1.13 24
RESEARCH QUESTION
1.14 24
SIGNIFICANCE OF THE
PRESENT STUDY
1.15 24
SCOPE OF THE PRESENT
STUDY

CHAPTER.2 CASE STUDY 26

CHAPTER.3 RESEARCH 34

METHEDOLOGY

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T.Y BANKING & INSURANCE (SEM-VI)

3.1 RESEARCH METHOD 35

3.2 SOURCE OF DATA 35

3.3 RESEARCH AREA 36

3.4 METHOD USE FOR 36

DECIDING SAMPLE PLAN

3.5 SAMPLING PLAN 36

3.6 VALIDATION OF TOOL 36

3.7 DATA COLLECTION 36

INSRUMENT

3.8 RATING SCALE 37

3.9 RESEARCH PERIOD 37

3.10 DATA PROCESSING AND 37

ANALYSIS PLAN

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T.Y BANKING & INSURANCE (SEM-VI)

CHAPTER.4 DATA ANALYASIS & 38

INTERPRITENTION

CHAPTER 5 SUMMERY OF FINDING 53

& CONCLUSION

CHAPTER 6 SUGGESTION 58

BIBLIOGRAPHY 60

ANNEXURE 61

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T.Y BANKING & INSURANCE (SEM-VI)

Chapter-1

INTRODUCTION

1.1) Background of the study:-

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T.Y BANKING & INSURANCE (SEM-VI)

Insurance is a promise of compensation for specific

potential future losses in exchanges for a periodic
payment. Insurance is designed to protect the financial
well-being of an individual, company or other entity in
case of unexpected loss. Agreeing to the terms of an
insurance policy creates a contract between the insured
and insurer. In exchange for payments from the insured
(called premium), the insurer agrees to pay the policy
holder a sum of money upon the occurrence of a specific
events.

There are two types of insurance. They are- Life

Insurance and General Insurance. General Insurance
comprises of insurance of property against fire, burglary
etc. Personal Insurance such as Accident and Health
Insurance, and Liability Insurance which covers legal
liabilities.

Personal Insurance covers include policies for Accidents,

Health etc. Products offering Personal Accident cover are
benefit policies. A Health Insurance Policy can provide
financial relief to a person undergoing medical treatment
whether due to disease or any injury. Accident and Health
Insurance policies are available for individuals as well as
groups.

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T.Y BANKING & INSURANCE (SEM-VI)

1.1.1) Introduction to Life Insurance:-

Human life is subject to risks of death and disability due to

natural and accidental causes. When human life is lost or
a person is disabled permanently or temporarily, there is
a loss of income to the household. The family is put to
hardship. Sometimes, survival itself is at stake for the
dependants. Risks are unpredictable. Death/disability
may occur when one least expects it. An individual can
protect himself or herself against such contingencies
through life insurance.
Though human life cannot be valued, a monetary sum
could be determined which is based on loss of income in
future years. Hence in life insurance, the sum assured is
by way of a benefit in the case of life insurance.
It is the uncertainty that is risk, which gives rise to the
necessity for some form of protection against the financial
loss arising from death. Insurance substitutes this
uncertainty. The primary purpose of life insurance is the
protection of family. Insurance in its various forms
protects against such misfortunes by having the losses of
the unfortunate few paid by the contribution of the many
that are exposed to the same risk. This is the essence of
insurance- the sharing of losses and substitute of
certainty for uncertainty.
There are a variety of life insurance products to suits to
the needs of various categories of

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T.Y BANKING & INSURANCE (SEM-VI)

People-children, youth, women, middle-aged persons, old

people; and also rural people, etc. life insurance products
could be purchased from registered life insurers notified
by the IRDA. Insurers appoints insurance agents to sell
their products should receive proper advice from
insurance agents/insurers so that a right products could
be chosen to suit particular financial needs.

1.1.2) Claim in Insurance

An insurance claim is the actual application for benefits

provided by an insurance company. Policy holders must
first file an insurance claim before any money can be
disbursed to the hospital or repair shop or other
contracted service. The insurance company may or may
not approve the claim, based on their own assessment of
the circumstances. Individual who take out home, life,
health, or automobile insurance policies must maintain
regular payments called premiums to the insurers. Most
of the times these premiums are used to settle another
person’s insurance claim or o build up the available
assets of the insurance company.
When claims are filed, the insured has to observe the
settled rules and procedures and the insurers has also to
reciprocated in a similar manner by undertaking
appropriated steps for speedy disposal of claims. It is true
that claims settlements is complex in nature, but it is the
driving force to plant confidence in the hearts of people,
in general and beneficiaries in specifies. Insurance claim
is a right of insured under a contract of insurance.

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T.Y BANKING & INSURANCE (SEM-VI)

Insurance contract is a contract by which one party called

the insurer promise to save the other party, the insured on
the payments of consideration known as the premium.
The insurer promises to save the insured are
nominees/assignees of the insured on happening of event
or risk insured. Disputes crop up in the payment of claim
when the insurer and the insured understand the process
of claims payments in a different way. Claims settlement
is an integral part of the insurance business which is a
service industry and its growth is interwoven with the
people, the customers and consumers of service. It is
inevitable for the insurance company to protect and guard
the interest of the policyholders. An insurance claim is the
only way to officially apply for benefits under an insurance
policy, but until insurance company has assessed the
situation it will remain only a claim, not a pay-out.

1.1.3) Claim Management

Many insurers have recognized the need to improve the

efficiency of their claims management process. They
have streamlined processes, eliminated paper-based
forms and redistributed work to match the demands to
skills. The objectives of their efforts are to lower costs,
while also increasing overall throughput. Efficiency
improvements make tasks quicker and less costly
execute. However, to realize even greater improvements
in the claims handling process, insurers must also focus
on the effectiveness of their claims decision.

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T.Y BANKING & INSURANCE (SEM-VI)

Claims handling costs typically represents 10% to 15% of

net earned premium; in contrast, claims represent 40% to
65%. Insurers that expand their focus to include effective
as well as efficient claims processing will find a far longer
poll of saving opportunities. Technology can play a
significant role by providing integrated channels for
communication and collaboration. This would help the
insurance company increase employee productivity by
reducing cycle time and defect rate and also increaser
employee participation and compliance.
Claims Processing sometimes involves collating and
sharing large amounts of information among multiple
parties involved in a claim, from body shops to adjusters
to investigators to lawyers and doctors to claimants and
regulator. And it involves the knowledge of experienced
adjusters to determine be the fair and appropriate
outcome of a claim. In fact, losses and loss expenses
absorb 80% of premium collected by carriers.
Service representatives and claims adjusters need to
access data from multiple sources when processing or
assessing a claim, which delays settlements time and
increases costs. Manual steps reduce transparency of the
claims process and raise the risk of fraud, manipulation or
simply human error. Customer retention is also a
challenge- experts say that 75% of customers leave their
insurer due to claims issues.

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T.Y BANKING & INSURANCE (SEM-VI)

1.1.4) Prodecure of cliam management in

life insurance:-

INSURER INSURED
On Recepit of Claim, Verify Type of Suffering Loss or The
the claim Damage

Understanding and Identyfing

Review the Claim application the Cause of Action

Infoming or Giving Notice of

Respond to Claimant Claim or Loss to Insurer

Providing Sufficient Proof of

Claim Investigation Loss to Insurer

Claim negotiation

Claim settlement

Claim payment

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T.Y BANKING & INSURANCE (SEM-VI)

1.2)Placing the research problem:-

The major role made by insurance programme is

the indemnification of risk averse individual who mightly
adverse affected by natural probablistic phenomenan.
Customer service has great importance in the insurance
company. While the coverage of insurance industry is
expanding day by day. This is because customer
demanding insurance in todays world.

This can be achieved through speed, service quality and

customer satisfaction. These elments are going to be key
differentiators for each insurance company success.

1.3)Stating the need for survey:-

Insurance users pay premium, year after year,

trusting their policies tp protect their lives or business in
the event of a loss. However, there are innumerable
instances where a genuine insurance users with a
genuine loss and a seemingly valid claim, has been
denined his claim amount in full or part. This happen
because the insurance company is not able to estiamte
the total amount of the claims. In life insurance claims the

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T.Y BANKING & INSURANCE (SEM-VI)

insurance company tries to reject the claims without

knowing the causes of death or loss of the person.
1.5) Title of the study: -

To Study about Claim Management in Life Insurance.

1.6) Objective of the study:-

 To study claim management in Life Insurance.

 To find out problem while taking insurance by
people.
 To find out problem arising while claim settlement of
life insurance.
 To find out overall satisfaction about life insurance.

1.7) Null Hypothesis:-

Some people are not aware about claim

management in life insurance & not also avail the claim
management in life insurance.

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T.Y BANKING & INSURANCE (SEM-VI)

1.8) Hypothesis:-

Majority person are aware about claim management in life

insurance facility and they also take benefit of claim
management in life insurance.

Majority person are aware about claim management

in life insurance facility and they also take benefit of claim
management in life insurance.

1.9) Definition of important terms:-

 Definition of life insurance

Life insurance is a contract between two parties
whereby one party agree to pay to the other party, a
certain amount of money is premium to make the good
loss of life arising out of an uncertain event in which
insured has interest.
 Definition of claims
A claim is a right of insured to receive the amount
secured under the policy of insurance contract
promised by insured.

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T.Y BANKING & INSURANCE (SEM-VI)

1.10) Assumption made for present

study:-

 Customer quires are solved by insurance company

personnel immediately.
 All people are engaged in claim management in life
insurance.
 It is assume that majority of customer are aware
about claim management in life insurance.

1.11) Review of Literature:-

According to complaints Sunanda Kanthale, her husband

Manoharrao kanthale who worked as a stores
superintendent with the Amravati policy for Rs 20,000 on
November 28, 1992. The policy which was a non-medical
one was scheduled to mature on November 24, 2004, she
said. Unfortunately Manoharrao passed away on October
22. 1993, 10 months and 25 days from the date of
purchasing the instrument.
Being the nominee in the policy, she asked for her claim
for an account of Rs 40,000 (under double benefit
provision in accident cases) and made an application to
the Akola branch manager of LIC. The senior manager of
LIC (Amravati Division) however refused to settle the
claim vide his letter dated August 4, 1994. As the policy
was a non-medical one, the reason given by the official

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T.Y BANKING & INSURANCE (SEM-VI)

for not settling the claim was also a bogus one, she
alleged. Sunanda then wrote to the area manager of LIC,
Mumbai, justifying her claim. The Mumbai office too (vide
letter dated April 20, 1995) refused to settle the claim,
Kanthale added.
She then lodged a complaint with Akola District
Consumers Grievances redressed forum. In the
complaints, she applied to the forum to issuer the
necessary directives to the LIC for paying Rs 40,000
along with 18% interest, a compensation of Rs 50,000
towards mental tension caused and Rs 1,000 towards
legal expenses.
Defending the stand taken by the company, the LIC
refuted all the allegations made by Sunanda.
Manoharrao, who held the policy, had kept the
information about his health a secret while purchasing the
instrument, the company alleged.
The forum referred to columns 14 and 26 in the
application for where the policy purchaser had made
statements about his health. The form was duly signed by
Dr. B R Jain, the forum said. The LIC officials produced
proofs before the forum regarding heart disorder of the
policy holder and sick leave availed by him after taking
the policy. However, they could not prove that Manohar
was not well on the day of purchasing the policy.
The District Consumer Grievances Redressal Forum has
directed Senior Divisional Manager of Life Insurance
Corporation (LIC) Amravati, Area Manager, Mumbai and
Branch Manager, Akola, to pay Rs 20,000 to Sunanda

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T.Y BANKING & INSURANCE (SEM-VI)

Kanthale towards insurance claim besides interest on the

amount from October 22, 1993, till the date of payments
at a rate of 12%. The forum has also directed LIC to pay
compensation of Rs 10,000 to the woman for causing
mental tension to her during the 4 years, after her
husband’s death, in releasing the insurance amount.
If the insurance company failed to pay the compensation
within two months from the date of receipt of copy of the
judgment, the company will be liable to pay interest at a
rate of 18% on the amount till final payments besides
legal expenses of Rs250, the forum ruled. The forum also
ruled that through the compensation amount, demanded
by the complaints, appeared, considering the troubles she
had to face in the last four years for settlement of claim,
the company should pay her Rs 10,000 towards
compensation.

1.12) Methodology:-

The researcher approaches to 50 respondents in

Dombivli area. All 50 respondents respond to the
questionnaire. The final study of project was done through
based on these 50 respondents. The analysis of data was
done with help of mean percentage and excel sheet.

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T.Y BANKING & INSURANCE (SEM-VI)

1.13) Research Question:-

Which service provide under claim management in life

insurance?

1.14) Significance of the study:-

 The researcher needs to know procedure of claim

management in life insurance.

 The researcher want to know which facilities is avail

by customer of claim management in life insurance.

1.15) Scope of the present study:-

The survey method has been followed for the study well
structure questionnaire to elicit the necessary data and get
filled the details from the respondent. The study will also
help to identify the customer satisfaction toward the claim
management in life insurance.

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T.Y BANKING & INSURANCE (SEM-VI)

Chapter-2
CASE STUDY

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T.Y BANKING & INSURANCE (SEM-VI)

(1)

Life insurance Corporation of India v/s Mrs. Sunanada

kanthale
According to complaints Sunanda Kanthale, her husband
Manoharrao kanthale who worked as a stores
superintendent with the Amravati policy for Rs 20,000 on
November 28, 1992. The policy which was a non-medical
one was scheduled to mature on November 24, 2004, she
said. Unfortunately Manoharrao passed away on October
22. 1993, 10 months and 25 days from the date of
purchasing the instrument.
Being the nominee in the policy, she asked for her claim
for an account of Rs 40,000 (under double benefit
provision in accident cases) and made an application to
the Akola branch manager of LIC. The senior manager of
LIC (Amravati Division) however refused to settle the
claim vide his letter dated August 4, 1994. As the policy
was a non-medical one, the reason given by the official
for not settling the claim was also a bogus one, she
alleged. Sunanda then wrote to the area manager of LIC,

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T.Y BANKING & INSURANCE (SEM-VI)

Mumbai, justifying her claim. The Mumbai office too (vide

letter dated April 20, 1995) refused to settle the claim,
Kanthale added.
She then lodged a complaint with Akola District
Consumers Grievances redressed forum. In the
complaints, she applied to the forum to issuer the
necessary directives to the LIC for paying Rs 40,000
along with 18% interest, a compensation of Rs 50,000
towards mental tension caused and Rs 1,000 towards
legal expenses.
Defending the stand taken by the company, the LIC
refuted all the allegations made by Sunanda.
Manoharrao, who held the policy, had kept the
information about his health a secret while purchasing the
instrument, the company alleged.
The forum referred to columns 14 and 26 in the
application for where the policy purchaser had made
statements about his health. The form was duly signed by
Dr. B R Jain, the forum said. The LIC officials produced
proofs before the forum regarding heart disorder of the
policy holder and sick leave availed by him after taking
the policy. However, they could not prove that Manohar
was not well on the day of purchasing the policy.
The District Consumer Grievances Redressal Forum has
directed Senior Divisional Manager of Life Insurance
Corporation (LIC) Amravati, Area Manager, Mumbai and
Branch Manager, Akola, to pay Rs 20,000 to Sunanda
Kanthale towards insurance claim besides interest on the
amount from October 22, 1993, till the date of payments

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T.Y BANKING & INSURANCE (SEM-VI)

at a rate of 12%. The forum has also directed LIC to pay

compensation of Rs 10,000 to the woman for causing
mental tension to her during the 4 years, after her
husband’s death, in releasing the insurance amount.
If the insurance company failed to pay the compensation
within two months from the date of receipt of copy of the
judgment, the company will be liable to pay interest at a
rate of 18% on the amount till final payments besides
legal expenses of Rs250, the forum ruled. The forum also
ruled that through the compensation amount, demanded
by the complaints, appeared, considering the troubles she
had to face in the last four years for settlement of claim,
the company should pay her Rs 10,000 towards
compensation.

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T.Y BANKING & INSURANCE (SEM-VI)

(2)
Life insurance Corporation of India v/s Neelam Metha
The case arose following the refusal of LIC to pay the
insurance money following the death of her husband
Mahendrabhai Metha. LIC had repudiated the life policy
alleging that he had hid from it that he was suffering from
diabetes at the time of taking the insurance policy in
December 1993. On 6 November 1994 he died following
a heart attack. Neelam told the consumer forum that she
came to know that her husband had a life policy with LIC
3 months after his death, when she started receiving
‘forms one after another to be filled through LIC agent’.
She then filled up all the relevant papers.
She also formally informed LIC about death of her
husband and claimed the insurance money. Thereupon,
LIC intimated her that the claim for her husband’s
insurance policy was repudiated because the life assured
had ‘deliberately’ withheld information regarding his ‘pre-
existing illness which was diabetes’ and which, it said,
had led to his death. It also alleged that because of this

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T.Y BANKING & INSURANCE (SEM-VI)

disease he had been hospitalized before his death and

that he was a insulin-dependent diabetic. Neelam
represented to both the Bhavnagar and Ahmebad office
of LIC and later to its zonal office in Mumbai urging them
to recommend her claim to the review committee.
This request was made in September 1996 till now no
decision had been taken and the ‘matter is still under
consideration’. She also denied that her husband was a
diabetic or that he had been hospitalized for this. He had
not been treated for any ailment during the 5 years
preceding his death, she asserted. The forum comprising
its president, K.D. Desai, members Leena Desai and
Malaybhai Kantharia, found that LIC has failed to prove
that Mr. Metha had made false statement and
misrepresentation about his health.”The burden of proving
that there was a suppression of material fact and that it
was made fraudulently” lied on LIC and it had failed to
prove it, the forum observed. LIC therefore was legally
and morally duty-bound to pay the claim, it said.
Consumer disputes redressal forum, Ahmedabad, has
directed LIC of India to pay up Rs. 50,000 plus 12%
interest for 7 years, as insurance money due to after her
husband’s death. The forum also ordered payment of Rs.
5000 for causing mental agony, hardship and
inconvenience to Neelamben. It granted Rs. 3000 as cost.

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T.Y BANKING & INSURANCE (SEM-VI)

(3)
Life insurance Corporation of India v/s Lily Rani Roy
The petitioner has purchased a life insurance policy from
the appellate and premiums were paid regularly. The
maturity of the said policy was in 1978. Because of some
personal reasons the claim was not filed. The petitioner
had filed the claim after 13 years of its maturity. The LIC
of India rejected the payment on a plea that claim is time
barred claim and as such the claim will not be paid.
The petitioner has filed a complaint with consumer council
with a request to direct the LIC for the payment of the
maturity claim as the policyholder had paid the entire
premium till the date of the maturity and has the right to
receive the claim amount. Assured held LIC guilty under
Consumer Protection Act, 1986 Section (I) (g) for
deficiency in service.
But, the LIC of India pleaded that the Corporation will be
maintaining the records for a period of 5 years only and
the Corporation has received the claim notice from the

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T.Y BANKING & INSURANCE (SEM-VI)

petitioner in 1990 which is far beyond the time. The LIC

also produced a photo copy of the maturity claim payment
register showing the payment of the complainant’s
money.
After examining all the facts, the State forum has declared
that the petitioners cannot claim the payment of policy as
it is already time barred. On the decision of the State
Commission, the petitioners filed a petition with the
National Commission.
The National Commission, after verifying the terms of the
policy, has opined that through the payments of claim is
time barred, the insurance company should have given
notice to that effect or should include a clause in the
policy document stating that the time barred maturity
claims will not be paid. As the Corporation has filed to
bring this information has filed to bring this information to
the notice of the policyholder or failed to create the
awareness among the policyholders, it has failed in its
duties and as such it is liable to pay the claim to the
petitioners. Thus, the National Commission has ordered
the payment of time barred maturity claims.

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T.Y BANKING & INSURANCE (SEM-VI)

Chapter-3

RESEARCH METHOLODOGY

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T.Y BANKING & INSURANCE (SEM-VI)

3.1) Research Method:-

Researcher decides to survey in thane(w) .The

researcher used the survey method for present study.

3.2) Source of Data:-

Primary data and secondary data are collected for

present research study.

a) Primary data-

The researcher collected the primary data personally

through face to face interaction and also with observation
method.

b) Secondary data-

The secondary data was collected through various ways

that is

 Internet- www.investopedia.com
www.wikiipedia.com
 Newspaper-The economics times

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T.Y BANKING & INSURANCE (SEM-VI)

3.3) Research Area:-

The researcher has made research in Thane(w).

3.4) Method Use for Deciding the Sampling Plan:-

The sample constituted of 50 respondents. The sample

size was 50, the elements for samples i.e. the responds
selected through selective sampling method.

3.5) Sampling Plan:-

The approach was made to the respondents twice times.

At the 1 st visit out of 50, 17 respondents responded
perfectly and then 13 responded through telephone 20
responded after approaching twice time through
appointment.

3.6) Validation of Tool:-

The tool was send to professor, insurance official, to

verify their validity & correction where made after
receiving their suggestion the tool was then finalized.

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T.Y BANKING & INSURANCE (SEM-VI)

3.7) Data Collection Instruments:-

The types of instruments used for data collection were

through surveying, internet, approaching to insurance
agents and to customer to know about claim management
in life insurance..

3.8) Rating Scale:-

Liker scale used for quantitive analysis.

3.9) Research Period:-

The research has made during the month of march 2019

3.10) Data processing & Analysis of Plan:-

The data processing & analysis with the help of mean

percentage method and bar diagram.

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T.Y BANKING & INSURANCE (SEM-VI)

Chapter-4
DATA ANALYSIS AND
INTERPRETATION

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T.Y BANKING & INSURANCE (SEM-VI)

Q.1. From which company you have taken life insurance

policy?
TABLE PARTICULAR HDFC ICICI LIC Others
NO
1 RESPONSE 03 13 24 10
RECEIVED
2 TOTAL 50 50 50 50
RESPONDENT

100
90
80
70
60
48%
50
40
30 26%
20%
20
10 06%

0
HDFC ICICI LIC Others

Interpretation:- From the above diagram, we can see that

06% people use HDFC, 26% use ICICI, 48% use LIC, 20%
use others.

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T.Y BANKING & INSURANCE (SEM-VI)

Q.2. Are you aware of claim settlement?

TABLE NO PARTICULAR Yes No
1 REPONCE 50 0
RECEIVED
2 TOTAL 50 50
RESPONDENT

100 100%

90
80
70
60
50
40
30
20
10
0%
0
Yes No

Interpretation:- From the above diagram, we can say that all the
people are aware of claim settlement.

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T.Y BANKING & INSURANCE (SEM-VI)

Q.3. From where did you know about claim settlement?

TABLE NO PARTICULAR While taking policy After maturity
1 RESPONSE 50 0
RECEIVED
2 TOTAL 50 50
RESPONDENT

100 100%
90
80
70
60
50
40
30
20
10
0%
0
While taking After maturity
policy

Interpretation:- From the above diagram, we can say that people

know claim settlement while taking the project.

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T.Y BANKING & INSURANCE (SEM-VI)

Q.4. Have you applied for any claim?

TABLE PARTICULAR Yes No
NO
1 RESPONSE 23 27
RECEIVED
2 TOTAL 50 50
RESPONDENT

100
90
80
70
60 54%
46%
50
40
30
20
10
0
Yes NO

Interpretation:- From the above diagram, we can see that 46% of

people say that have claim while 54% people say isn’t.

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T.Y BANKING & INSURANCE (SEM-VI)

Q.5. How many times you approach in insurance office for

inquiry about claim?
TABLE NO PARTICULAR 1 time 2 times 3 times or
more
1 RESPONSE 10 20 20
RECEIVED

2 TOTAL 50 50 50
RESPONDENT

100
90
80
70
60
50
40% 40%
40
30
10%
20
10
0
1 time 2 times 3 times or more

Interpretation:- From the above diagram, we can say that 10% of

people go 1 time, 40% of people go 2 times, 40% of people go
3 times or more.

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T.Y BANKING & INSURANCE (SEM-VI)

Q.6. Where has your queries solved?

TABLE NO PARTICULAR By insurance Personally
companies
1 RESPONSE 34 16
RECEIVED
2 TOTAL 50 50
RESPONDENT

80
68%
70
60
50
40
32%
30
20
10
0
By insurance Personally
companies

Interpretation: - From the above diagram, we can say that 68%

of people quires solved by insurance companies while 32%
solve their quires personally.

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T.Y BANKING & INSURANCE (SEM-VI)

Q.7 From which company you have settle your claim?

TABLE PARTICULAR HDFC ICICI LIC Others
NO
1 RESPONCES 03 13 24 10
RECEIVED
2 TOTAL 50 50 50 50
RESPONDENT

100
90
80
70
60
48%
50
40
30 26%
20%
20
10 06%

0
HDFC ICICI LIC Others

Interpretation:- From the above diagram, we can say that 3% of

people se HDFC, 26% uses ICICI, 48% uses LIC and 20% uses
others.

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T.Y BANKING & INSURANCE (SEM-VI)

Q.8. How is the procedure for claim settlement?

TABLE PARTICULAR Easy Length
NO
1 RESPONSE 18 32
RECEIVED
2 TOTAL 50 50
RESPONDENT

100
90
80
70 64%
60
50
40 36%

30
20
10
0
Easy Length

Interpretation:- From the above diagram, we can say that 36%

people says that Is easy while 64% don’t.

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T.Y BANKING & INSURANCE (SEM-VI)

Q.9. How much time required for settling the claim?

TABLE PARTICULAR 15 Days 1 Month 2 Months
NO or more
1 RESPONSE 15 21 21
RECEIVED
2 TOTAL 50 50 50
RESPONDENT

100
90
80
70
60
50 42% 42%
40
30
20 16%

10
0
15 Days 1 Month 2 Months or
more

Interpretation:- From the above diagram, we can say that 16% of

people required to settle the claim since 15 days, 42% since 2
months and 42% since 2 months or more.

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T.Y BANKING & INSURANCE (SEM-VI)

Q.10. Do you get any problem while settling the claim?

TABLE PARTICULAR Yes No
NO
1 RESPONSE 30 20
RECEIVED
2 TOTAL 50 50
RESPONDET

100
90
80
70
60%
60
50
40%
40
30
20
10
0
Yes No

Interpretation:- From the above diagram, we can say that 60%

people says yes while 40% don’t .

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T.Y BANKING & INSURANCE (SEM-VI)

Q.11. Are you satisfy with facilities provided by company?

TABLE NO PARTICULAR YES NO
1 RESPONSE 29 21
RECEIVED
2 TOTAL 50 50
RESPONDENT

100
90
80
70
58%
60
50 42%
40
30
20
10
0
Yes No

Interpretation:- From the above diagram, we can say that 58% of

people are satisfy with service while 42% don’t.

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T.Y BANKING & INSURANCE (SEM-VI)

Q.12.Is your claim accepted by company?

TABLE NO PARTICULAR YES NO
1 RESPONSE RECEIVED 40 10

2 TOTAL RESPONDENT 50 50

100
90
80%
80
70
60
50
40
30
20%
20
10
0
Yes No

Interpretation:- From the above diagram, we can say that 80% of

claims were accepted while 20% don’t.

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T.Y BANKING & INSURANCE (SEM-VI)

Q.13. Is your claim rejected by company?

TABLE NO PARTICULAR YES NO
1 RESPONSE ERCEIVED 10 40

2 TOTAL RESPONDENT 50 50

100
90
80%
80
70
60
50
40
30
20%
20
10
0
Yes No

Interpretation:- From the above diagram, we can say that 20% of

claims were rejected while 80% don’t.

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T.Y BANKING & INSURANCE (SEM-VI)

Q.14. Do you have any complain against claim

settlement?
TABLE NO PARTICULAR YES NO
1 RESPONSE RECEIVED 33 17

2 TOTAL RESPONDENT 50 50

100
90
80
70 66%

60
50
40 34%
30
20
10
0
Yes No

Interpretation:- From the above diagram, we can say that 66% of

people having problem while 34% don’t.

49
T.Y BANKING & INSURANCE (SEM-VI)

Chapter-5
SUMMARY OF FINDINGS AND
CONCLUSION

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T.Y BANKING & INSURANCE (SEM-VI)

Summary of Findings:-

1. Majority of people having their life insurance policy

in LIC.
2. Majority of people are aware about claim
settlement.
3. Majority of people know about claim settlement
while taking policy.
4. Majority of people have not applied for claim.
5. Majority of people gone 2 times, 3 times or more
than that for inquiry about claim.
6. Majority of people have solved their queries by
insurance companies.
7. Majority of people have settled their claim through
LIC.
8. Majority of people says that procedure is length for
claim settlement.
9. Majority of people required 1 or 2 month or more
than that for settling the claim.

10. Majority of people gets problem while setting a

claim.

11. Majority of people are satisfy facilities provided by

companies.

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T.Y BANKING & INSURANCE (SEM-VI)

12. Majority of people claim are accepted by

companies.

13. Majority of people claim are not rejected by the

companies.

14. Majority of people have complaints regarding

claim settlement.

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T.Y BANKING & INSURANCE (SEM-VI)

Conclusion:-

The insurance business is major service oriented

business in the world. The service offered by the industry
is well recognized and utilized by the general public and
commercial sector of the world. The life insurance
business has covered nearly 40% of the population of the
world. Global players with strong brand in the insurance
company today set p there back office operation in low
cost country, manage capital on the global basis, make
use of their special skills worldwide and use their superior
managerial ability to secure leadership positions in the
industry.
The claim management in an integral part of insurance. It
involves the strong, processing and transmission of
information relating to settlement of insurance claims. The
use of Information Technology also plays an important
role in claim settlement. In managing the claims handling
the function, insurers seek to balance the elements of
customer satisfaction, administrative handling expenses,
and overpayment leakages. As part of this balance act,
fraudulent insurance practices are a major business risk
that must be managed and overcome. Disputes between
insurers and insured over the validity of claims or claims

53
T.Y BANKING & INSURANCE (SEM-VI)

handling practices occasionally escalate into litigation

which should be solved with due care.
In the fast scenario it will not be enough if companies
have the futuristic strategies. Implementation of the
strategies, effectively adapting them to ongoing changes
can spell success. The success of claim management
depends on the satisfaction of the customer. The
customers are attracted to an insurance company by its
state of art claim service. Therefore, before designing an
IT system for claim management, customer’s
expectations are to be taken into account. The customers,
their needs, knowledge of how the market works, and
what they want, these are the things that are important for
an insurance company for serving the customers in a
better manner through better technology.

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T.Y BANKING & INSURANCE (SEM-VI)

Chapter-6

SUGGESTION

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T.Y BANKING & INSURANCE (SEM-VI)

 Companies should provide better facilities for claim

settlement.
 Company’s procedure regarding claim management
should be easy.
 Companies should take short time while settling the
claim.
 Companies should not rejected the claim without
knowing the reason properly.
 Companies should give better knowledge regarding
claim settlement.
 Companies should solve the queries properly
regarding claim settlement
 Companies should satisfy the consumer needs.

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T.Y BANKING & INSURANCE (SEM-VI)

BIBLIOGRAPHY

 WEBLIOGARPHY:-
www.investopedia.com
www.wikipedia.com

 BIBLIOGARPHY:-
The Times of India
Magazines

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T.Y BANKING & INSURANCE (SEM-VI)

ANNEXURE

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T.Y BANKING & INSURANCE (SEM-VI)

Questionnaire for customer

Name: ______________________________________
Education:____________________________________
Q.1. From which company you have taken life insurance?
 HDFC
 ICICI
 LIC
 Others

Q.2. Are you aware about claim settlement?

 Yes
 No
Q.3. From where did you know about claim settlement?
 While taking policy
 After maturity
Q.4.Have you applied for any claim settlement?
 Yes
 No
Q.5. How many times you approach in insurance office for
inquiry about claim?
 1 time
 2 times
 3 times or more

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T.Y BANKING & INSURANCE (SEM-VI)

Q.6. Where has your quires solved?

 By insurance companies
 Personally
Q.7. From which company you have settle your claim?
 HDFC
 ICICI
 LIC
 Others
Q.8. How is the procedure of claim settlement?
 Easy
 Length
Q.9 How much time required for setting the claim?
 15 Days
 1 Month
 2 Months or more
Q.10. Do you get any problem while setting the claim?
 Yes
 No
Q.11. Are you satisfy with facilities provided by company?
 Yes
 No
Q.12. Is your claim accepted by company?
 Yes
 No

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T.Y BANKING & INSURANCE (SEM-VI)

Q.13. Is your claim rejected by company?

 Yes
 No
Q.14. Do you have any complaint against claim
settlement?
 Yes
 No

Sign:
__________

61