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Insurance claim process made easier by IRDAI

Priyadarshini Maji
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The Insurance Regulatory and Development Authority of India (IRDAI) has notified that for settling any claim in the line of business (LoB), licensed surveyors will no longer be mandatory. This includes claims under personal accident, motor, health, cyber insurance and travel policies.

The regulator said claims under policies of motor vehicle insurance where the claim is on account of theft or injury or death to third parties, and in respect of loss or damage to crop, trees, plantations, and forests which are covered by the government-sponsored schemes can now be settled without the mandator assessment of a certified surveyor.

Earlier, after a claim was filed, the insurer normally used to send a surveyor to analyze the situation and determine the damage of the claim that is lodged. The damages for the claim were observed by the surveyor and they used to submit their report about it.

The regulator further stated claims will also not involve a surveyor on behalf of the insurer when documentary evidence under a policy stating the value of the loss is available. The documentary evidence can be in the form of police reports, railways or similar public or semi-government authorities, port trust issued short-landing or non-delivery certificates, claims in respect of which excise authorities give a certificate for dutiable items and sling loss claims certified by harbour authorities.

Here are some of the cases when a surveyor will not be involved to assess a claim;

  • Exempted claims of general average under marine policies. Claims of total loss or constructive total loss under agreed value insurance policies or valued policies as defined in Section 29 of the Marine Insurance Act, 1963.
  • Claims filed under motor insurance policy wherein the claim is on account of theft or injury or death to third parties, is also exempted.
  • Under Health Insurance Policies claims including travel and personal accident, covers are also exempted.
  • Claims that include third party liability, products liability and personal liability except where liability arising out of property damage or defect to physical property or goods are involved, should also not include a surveyor.
  • Claims made under all risks and burglary insurance policies on personal effects and jewelry.
  • Claims In case of loss or damage to the crop, trees, plantations, and forests that are covered by Government-sponsored Schemes, claims shall be exempted from the assessment of a surveyor.
  • Claims will also be exempted under cyber insurance policies, under policies of the nature of Bonds and Guarantees including fidelity guarantees, Bankers' Blanket policies, aviation hull insurance policies, credit insurance, and under policies insuring the contractual liability.
  • Additionally, when a claim amount is determined by a recognized and well-established conventions or under agreements, it will be exempted.