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Surveyor assessment waived in some cases

In case normal commercial claims below a certain claim amount, we do not do an assessment.

Chennai: In case of certain claims, insurance companies can now entrust loss assessment to people other than licensed surveyors or not make any loss assessment at all. This can make processing of claims faster, especially during times of calamities.

Insurance Regulatory and Development Authority of India (Irdai) has exempted claims which have documentary evidence of the value of loss in the form of police reports, short-landing or non-delivery certificates issued by port trusts, Railways or other public or semi-government authorities and those which have certificate for dutiable items from excise authorities and sling loss claims certified by harbour authorities from customary assessment by licensed surveyor.

Motor claim on account of theft or injury/death to third parties and claims under health insurance policies including travel and personal accident covers are also exempted. Claims under Workmen’s Compensation/ Benefit policies under the Employees Compensation (Amendment) Act, 2009 and claims under public liability policies, including third party liability, professional indemnity, products liability and personal liability except where liability arising out of property damage or defect to physical property/goods are involved too come under the category.

“In case of retail health claims, the assessments are based on the submitted documents. For motor claims we have in-house surveyors. However, decision by Irdai will benefit the customers and companies during times of calamities like floods and cyclones and speed up the processing of claims,” said an industry expert.

Claims of General Average under marine policies and total loss or constructive total loss under agreed value insurance policies or valued policies as defined by Marine Insurance Act also do not need separate assessment, finds Irdai.

Aviation Hull insurance claims and cyber Insurance claims , those under money insurance including cash in transit policies, all risks and burglary insurance policies on personal effects and jewellery and those under Race Horses insurance policies and Live-stock insurance policies too are exempted by the regulator.

Further, claims with respect to loss or damage to crop, trees, plantations and forests which are covered by government-sponsored schemes, loss or damage to tea in transit from gardens in India also do not need assessment.

Claims under policies of the nature of Bonds and Guarantees including fidelity guarantees, Bankers’ Blanket policies, credit insurance, and those insuring contractual liability, claims in which the amount of claim is determined by recognized and well-established conventions or under agreements as well as claims in which the amount of which has been adjudicated upon or decreed by courts too come under exemption category.

“In case normal commercial claims below a certain claim amount, we do not do an assessment. But, some claims do need to be assessed properly. Irdai has not barred companies from doing so. But this decision has provided more clarity and will make claims processing faster,” he said.

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