No Insurance Claim To Be Rejected For Lack Of Documents: IRDAI

New Delhi: Insurance Regulatory and Development Authority of India (IRDAI) has released a master circular that shall apply to every single existing general insurance product and every add-on cover.

The IRDAI Circular issued on 11 June added that no claim shall be rejected for want of documents. All the required documents shall be called at the time of underwriting the proposal. The customer may be asked to submit only those documents that are directly related to the claim settlement such as claim form, driving license, permit, fitness, FIR, un-traced report, fire brigade report, post mortem report, books of accounts, stock register, wage register, repair bills (only in cases where cashless is not available), wherever applicable.

The circular on IRDAI (Insurance Products) Regulations 2024 --General Insurance that replaces all earlier Guidelines/circulars of General Insurance Products, is applicable immediately.

Regarding guidelines on Claims for Retail customers and policyholders, IRDAI said that the policyholder will be informed the timelines or turnaround times for settlement of claim. 

The allocation of surveyors through the general insurance council tech-based solution should happen within 24 hours of report of claim. The surveyor shall submit the survey report to the insurer within 15 days of allocation and it shall be the duty of the insurer to obtain the survey within the specified time limits.

The insurer shall decide on the claim within 7 days of receipt of the survey report. This condition will not apply in case of policies issued on the property/building on reinstatement value basis.

IRDAI said that any delay in settlement of the claims beyond the above stipulated timeline is a violation of legislation and regulations. The insurer is liable to be imposed a penalty for such delay.