RMI presentation on IRDA

27-03-2013

Presented by :Aditi Joshi (10044) Neha Joshi (10045) Ambika Kushwah (10055) 1 Tolani Instiute of Management Studies

WHAT is IRDA???
• IRDA-Insurance Regulatory and Development Authority • Its a national agency run by the Government of India based in Hyderabad • Formed by an act of Indian Parliament called as IRDA Act of 1999. • Considering some of the emerging requirements of the Indian insurance industry, IRDA was amended in 27-03-2013 Tolani Instiute of Management Studies

2

IRDA consists of :i.
ii.

A chairman
whole time members

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

27-03-2013

Tolani Instiute of Management Studies

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Contd… • Indian insurance industry is regulated by the terms and conditions of the IRDA.c. IRDA regulates the business of Private Insurance company's like ICICI. the Govt. 4 .of India ruled that ULIPs will be governed by IRDA. AVIVA. Max Newyork e.t. • • In 2010. and not the market regulator SEBI • The Indian banks are under the control of RBI like the corporate insurance companies are under the 27-03-2013 Tolani Instiute of Management Studies reguation of IRDA.

27-03-2013 Tolani Instiute of Management Studies 5 .Private Insurance Companies. Export Credit Guarantee Corporation Ltd. Ltd.IRDA • • • • • • • • Reliance General Insurance Company Limited. Bajaj Allianz General Insurance Company Limited ICICI Lombard General Insurance Company Limited. HDFC-Chubb General Insurance Co. Ltd TATA AIG General Insurance Company Ltd. IFFCO Tokio General Insurance Co. Bharti Axa General Insurance Company Ltd.

financial soundness. To bring about speedy and orderly growth of the insurance industry To set.objectives • • To protect the interest of policyholders. monitor and enforce high standards of integrity. • 27-03-2013 Tolani Instiute of Management Studies 6 . fair dealing and competence of those it regulates. promote.

• To ensure speedy settlement of genuine claims. to prevent insurance frauds and other malpractices. 27-03-2013 Tolani Instiute of Management Studies 7 .Contd… • To ensure the customers receive precise. clear and correct information about products and services.

• To promote fairness. To bring about optimum amount of Self-regulation • • 27-03-2013 Tolani Instiute of Management Studies 8 . transparency and orderly conduct in Financial markets To take action where such standards are inadequate or ineffectively enforced.Contd….

Insureres • Life • General • Reinsurance 27-03-2013 Tolani Instiute of Management Studies 9 .

To specify requisite qualifications code of conduct and training for insurance intermediaries and agents. • To specify code of conduct for Surveyors/ Loss Assessors. To protect the interests of the policyholders. DUTIES & POWER OF IRDA • • • To issue certificate of registration. 27-03-2013 Tolani Instiute of Management Studies 10 .FUNCTIONS.

conduct enquiries and investigations. • To supervise the functioning of Tariff Advisory Committee. • To undertake inspection. • To regulate investment of funds by the insurance companies.Functions Cont. 27-03-2013 Tolani Instiute of Management Studies 11 • . To promote efficiency in the conduct of insurance business...

 To promote and regulate professional organizations connected with the insurance and reinsurance.  To specify the form and manner for maintenance of books of accounts.  To specify the percentage of Life and General Insurance business.. 27-03-2013 Tolani Instiute of Management Studies 12 ..Functions Cont.

• To regulate maintenance of margin of solvency... 27-03-2013 Tolani Instiute of Management Studies 13 . • To prescribe the manner and form in which accounts will be maintained and submitted by insurers and intermediaries.Functions Cont.

• To levy fees & other charges for carrying out the purposes of this act..Functions Cont. 27-03-2013 Tolani Instiute of Management Studies 14 . • To specify the percentage of premium income of the insurer financial schemes for promoting & regulating professional organization. • To adjudication of disputes between insurers & intermediaries or insurance intermediaries..

• Life Insurance Corporation of India (LIC) and General Insurance Corporation of India (GIC). • In last 10 years . & 23 new players • The IRDA also successfully deals with any discrepancy in the insurance sector.Impact of IRDA • The creation of IRDA has brought revolutionary changes in the Insurance sector. 27-03-2013 Tolani Instiute of Management Studies 15 .tremendous growth.

Intermediaries • • • • • Agents Corporate agents Brokers Surveyors TPA Health services 27-03-2013 Tolani Instiute of Management Studies 16 .

OMBUDSMAN 27-03-2013 Tolani Instiute of Management Studies 17 .

1998 • Objectives:Quick disposal of the grievances of the insured customers . • Great importance and relevance for the protection of interests of policy holders . 27-03-2013 Tolani Instiute of Management Studies 18 .Ombudsman • Acts as an intermediary between an organisation • 11th November. • Helped to generate and sustain the faith and confidence amongst the consumers and insurers.

27-03-2013 Tolani Instiute of Management Studies 19 .

GOVERNING BODY OF INSURANCE COUNCIL • Consist of one representative from each of the insurance companies. 27-03-2013 Tolani Instiute of Management Studies 20 . • Representatives shall be Chairman or Managing Director or any one of the Directors of the company • Shall formulate its own procedure for conducting its business including the election of the Chairman.

civil service. judicial service etc.APPOINTMENT OF OMBUDSMAN • The governing body shall appoint one or more persons as ombudsman. administrative service. 27-03-2013 Tolani Instiute of Management Studies 21 . • Two representatives of the Insurance Council. • The Ombudsman selected may be drawn from a wider circle including those who have experience in industry.

27-03-2013 Tolani Instiute of Management Studies 22 . whichever is earlier.Term of Office • An Ombudsman shall be appointed for a term of three years or till the incumbent attains the age of 65 years. Re-appointment is not permitted.

• At present there are 12 centers in India • The Ombudsman may hold sitting at various places within his area of jurisdiction in order to expedite disposal of complaints 27-03-2013 Tolani Instiute of Management Studies 23 .Territorial Jurisdiction • Location specified by the Insurance Council • The Governing Body shall specify the territorial jurisdiction of each Ombudsman.

• Personnel deputed for a term of 2/3 years from Public Sector Life and non-life insurance companies to assist the Ombudsman.Staff • Secretarial staff • Engage the services of professional expert • The salary. allowances and perquisites payable to Ombudsman and staff and all expenses incurred shall be borne by the Insurance Council. 27-03-2013 Tolani Instiute of Management Studies 24 .

27-03-2013 Tolani Instiute of Management Studies 25 .

1998 (RPG RULES) NOTIFICATION DATED 11.REDRESSAL OF PUBLIC GRIEVANCES RULES.1999. 27-03-2013 Tolani Instiute of Management Studies 26 .1998 AND 21.06.1998 AMENDED ON 18.11.12.

Cost effective efficient impartial manner Tolani Instiute of Management Studies 27 27-03-2013 .• These Rules shall apply to all the insurance companies operating in general insurance business and in life insurance business in India •    Objective . efficient and impartial manner .Cost effective.

non-issue of any insurance documents 27-03-2013 Tolani Instiute of Management Studies 28 . any dispute on the legal construction of the policies in so far as such disputes relate to claims d. any partial or total repudiation of claims b. delay in settlement of claims e.ENTERTAINABLE COMPLAINTS  The Ombudsman may receive and consider complaints on a. any dispute in regard to premium paid or payable c.

Tolani Instiute of Management Studies 29 27-03-2013 . Complainant to communicate his acceptance for the recommendation The Insurer to comply with the recommendation within 15 days of the receipt of the consent from the complainant and report to the Ombudsman of the compliance.Recommendations made by the Ombudsman • • • Ombudsman to give recommendation when there is Mutual agreement.

Complainant to give consent on receipt of the award within 1 month to the insurer The Insurer to comply within 15 days 27-03-2013 Tolani Instiute of Management Studies 30 .Award made by the Ombudsman • Where the complaint is not settled by agreement. the Ombudsman shall conduct hearing and pass a speaking award. Power to make ex-gratia payment • • • If the Ombudsman deems fit he may award an ex-gratia payment under Rule 18.

Complainant to give consent on receipt of the award within 1 month to the insurer The Insurer to comply within 15 days Tolani Instiute of Management Studies 31 27-03-2013 .Power to make ex-gratia payment • • • If the Ombudsman deems fit he may award an ex-gratia payment under Rule 18.

Consequences of nonacceptance of award • The award may not be implemented by the insurer if the consent from the complainant is not received within the time frame specified. 27-03-2013 Tolani Instiute of Management Studies 32 . • The complainant has the right to approach other forums.

OMBUDSMAN – REAL TEST WHEN SITS ON JUDGEMENT •Effective listening • Allow steam to let out • Extract more and more data • Counselor / Mediator • Finally to say Yes/No •No pushing paper vertical/horizontal 27-03-2013 Tolani Instiute of Management Studies 33 .

27-03-2013 Tolani Instiute of Management Studies 34 . livestock or tools or instruments or any personal accident contract either individual or group basis as per stated in Schedule –I.Microinsurance • Health insurance contract. any contract covering the belongings such as hut.

Self help group • MFI. 27-03-2013 Tolani Instiute of Management Studies 35 .Non-government organisation • SHG.Micro insurance agents • NGO.Micro finance Insurance spl appointed for microinsurance products.

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