Indian general insurers usually send a complaint about a claim back to the department that decided it. A grievance function without authority to revise decisions measures dissatisfaction instead of correcting it, and leaves the Insurance Ombudsman to do the insurer's work.
Indian general insurers usually send a complaint about a claim back to the department that decided it. A grievance function without authority to revise decisions measures dissatisfaction instead of correcting it, and leaves the Insurance Ombudsman to do the insurer's work.
When a cyclone or flood produces months of claims in a few days, insisting on a physical survey before every payment turns a natural disaster into a slow administrative one. Insurers should settle routine losses on remote assessment and control the risk with a well-designed audit after payment.
Indian general insurers have relied on third-party administrators for health claims for a quarter of a century. Administrators can do much of the work well, but the decision to refuse or reduce a claim should stay with the insurer's own people, because that is where a policyholder's trust is won or lost.