M' Ramadoss

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NON-PERFORMANCE AN INSURERS RATIONALE

• M. Ramadoss
• Chairman-cum-Managing Director
• mramadoss_at_orientalinsurance.co.in

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IMPORTANCE

• One of the prime causes for the entry of private
  sector in the industry is to throw the industry
  open to competition from several players
• Competition is expected to bring in the best in
  the industry, bring in the best terms for the
  customers
• Remember the Rs.28 per incoming call charged by
  Mobile phone Companies or the Rs.25000 one-way
  airfare to Singapore!!

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WHAT IS CUSTOMER SERVICE?

• A business cannot exist unless it has customers
  to buy the products it wants to sell. Customer
  service is the term used to describe what happens
  at the points at which the customer comes into
  contact with the business.

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CUSTOMER SERVICE CIRCLE
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CUSTOMER EXPECTATIONS

• IN GENERAL INSURANCE,
• CUSTOMER EXPECTATIONS
• ARISE AT TWO STAGES
• POLICY SERVICING STAGE
• CLAIMS SERVICING STAGE

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• POLICY SERVICING

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POLICY SERVICING

• INFORMATION STAGE
• ENLISTMENT STAGE
• POLICY SUPPORT STAGE
• SECONDARY SERVICES

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INFORMATION

• PROSPECTS NEED ADEQUATE INFO ON COVERS, TERMS AND
  RATES TO ENABLE THEM DECIDE THEM THE NEED FOR
  INSURANCE, THE TYPE OF COVER, THE RIGHT AMOUNT
• NEED FOR BROCHURES, PAMPHLETS, KNOWLEDGEABLE
  INTERMEDIARIES
• INSURERS REPUTATION AND IMAGE SHOULD INSPIRE
  CONFIDENCE
• HELP DESK FOR PROVIDING COVER INFORMATION

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ENLISTMENT STAGE

• SEVERAL PROSPECTS REQUIRE ASSISTANCE IN
  DOCUMENTATION LIKE FILLING UP PROPOSAL ETC.
• ENLISTMENT SUPPORT BY INTERMEDIARIES SHOULD BE
  DONE WITH CARE AND ONLY WITH FULL CONCURRENCE OF
  THE INSURED HIMSELF

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POLICY SUPPORT STAGE

• SATISFACTION OF FAIRNESS IN THE DEAL
• SPEED OF DELIVERY OF DOCUMENTS
• CORRECT POLICY DOCUMENT CONSENSUS-AD-IDEM
• EXPLANATION OF THE POLICY DETAILS WHERE REQUESTED
  BY CUSTOMER

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SECONDARY SUPPORT STAGE

• INCLUDES POST POLICY SERVICES SUCH AS
• ENDORSEMENTS
• ALTERATIONS ADDITIONS
• CANCELLATIONS

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INTERMEDIARY ISSUES

• AGENTS/ BROKERS OVER-SELL INSURERS UNABLE TO
  MEET THE CUSTOMER EXPECTATIONS
• INTERMEDIARY PROPROTIES ARE DIFFERENT FROM
  COMPANYS PRIORITIES EXAMPLE MEDICAL POLICIES
  FOR AGED PERSONS

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• CLAIMS SERVICING

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CLAIMS SERVICING

• THE CORE OF CLAIMS SERVICING IS
• HELP DESK FOR IMMEDIATE RESPONSE
• TRANSPARENCY OF ASSESSMENT
• SPEED OF SETTLEMENT OF CLAIMS
• LEAST DISTURBANCE / INCONVENIENCE TO THE CUSTOMER
• FAIR AMOUNT OF SETTLEMENT

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CLAIM ASSISTANCE

• CUSTOMER BE TREATED WITH CARE UNDERSTANDING AND
  NOT WITH SUSPICION DISTRUST
• SURVEYOR COMPETENCY IS VITAL
• ALL REQUIREMENTS TO BE LISTED IN ONE GO
• SYSTEM OF ADMISSION OF LIABILITY

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INTERMEDIARY ISSUES

• SURVEYORS SHOULD SUBMIT REPORTS WITHIN TIME
  FRAMES
• REQUEST FOR DOCUMENTS/ INFORMATION SHOULD BE IN
  WRITING
• ASSESSMENTS SHOULD BE FAIR AND TRANSPARENT
• DISPUTED ISSUES TO BE BROUGHT TO THE URGENT
  KNOWLEDGE OF INSURER

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CLAIM SETTLEMENT

• IF SETTLEMENT AMOUNT IS DIFFERENT FROM THE
  CLAIMED AMOUNT, FULL REASONS FOR DIFFERENCE TO BE
  GIVEN TO INSURED
• IN CASE OF REPUDIATION, CLEAR REASONS FOR
  REJECTION TO BE GIVEN
• INFO ON APPEALS GRIEVANCE REDRESSAL

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• PERFORMANCE APPRAISAL
• OF INSURERS

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HOW HAVE WE PERFORMED?

• CREDIBILITY OF INSURERS A NON-ISSUE
• ALL INSURERS HAVE SOME SYSTEM OF TECHNOLOGY FOR
  QUICK ISSUANCE OF POLICIES, BUT DELIVERY BACKLOG
  STILL PERSISTS DUE TO ADMN ISSUES, POLICY STAMPS
  ETC
• DEFINITE GAPS IN CORRECTNESS OF THE POLICY

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PERFORMANCE IN CLAIMS SERVICING

• LACK OF EMPATHY OR EVEN SYMPATHY
• CUSTOMER IS NOT CLEAR ON ACTION TO BE TAKEN IN
  THE EVENT OF A CLAIM
• DELAYS IN EVERY STAGE EVEN IN APPOINTING SURVEYOR
• SURVEYOR INCOMPETENCIES BARGAINERS AND NOT LOSS
  ASSESSORS
• CLAIM OFFER LETTERS DO NOT DISCLOSE BREAK-UPs

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CUSTOMER SERVICE BALANCE SHEET

• ORIENTAL FOR INSTANCE ISSUED ABOUT 1 CRORE
  POLICIES AND HANDLED 6 LAKH CLAIMS DURING 2005-06
• TOTAL NUMBER OF GRIEVANCES LESS THAN 5000
  WHICH IS 0.04
• EVEN THIS HAS TO BE REDUCED

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NON-PERFORMANCE

• GENERALLY, ONLY MOTOR AND HEALTH GIVE RISE TO
  GRIEVANCES
• MOST GRIEVANCES RELATE TO DELAY IN SETTLEMENT/
  REJECTION
• VERY FEW COMPLAINTS ON RUDE BEHAVIOUR OF
  EMPLOYEES
• UNDERWRITING GRIEVANCES ARE VERY VERY FEW

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NON-PERFORMANCEHEALTH

• PRE-EXISTING CONDITONS
• TPA IS NON-RESPONSIVE TO URGENCY
• BREAK IN INSURANCE
• REQUEST FOR COVER FOR OLDER PEOPLE
• HIGHER PREMIUM CHARGED BASED ON AGE

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NON-PERFORMANCEMOTOR

• ACCEPTANCE OF OLD VEHICLES
• RENEWAL OF COVERS WITH HIGH CLAIMS RATIOS
• DL/RC VERIFICATION INVESTIGATION
• SALVAGE VALUATION IN CASH LOSS
• DEPRECIATION AND DENIAL OF CERTAIN PARTS

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FUTURE EXPECTATIONS

• E-INSURANCE POLICIES ON INTERNET/ ATM
• POLICY/ CLAIMS HISTORY AND STATUS ON INTERNET
• TRANSACT SIMPLE POLICY RENEWALS OVER INTERNET
  WITH CREDIT CARD PAYMENT OPTIONS
• M-INSURANCE TRANSACTIONS THROUGH MOBILE PHONES

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FUTURE EXPECTATIONS

• INTEGRATED HEALTH INSURANCE WITH PREMIUM DEDUCTED
  AT SOURCE- SOCIAL SECURITY CHIP CARD WHICH WILL
  ALSO ASSIST IN CASHLESS CLAIM FACILITY
• HASSLE-FREE MOTOR CLAIM SETTLEMENT AND STANDBY
  VEHICLE DURING REPAIR PERIOD
• ONLINE CLAIM INFO COMPLAINT TO OMBUDAMAN
  CONSUMER FORUM

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SOLUTIONS?

• CUSTOMER EDUCATION BEFORE SALES
• REGULAR CUSTOMER EDUCATION PROGRAMMES TO FEED
  UPDATED INFORMATION PERIODICALLY
• FULL USE OF IT IN UNDERWRITING AND CLAIMS

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SOLUTIONS TO INTERMEDIARY PROBLEMS?

• FULL CONTROL ON APPOINTMENT OF SURVEYORS
• MONITORING SURVEYOR CORRESPONDENCE WITH INSURED
• TPA PERFORMANCE TO BE MORE CLOSELY MONITORED
• RUTHLESS PRUNING OF INTERMEDIARIES

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SOLUTIONS?

• EMPATHY TRAINING FOR EMPLOYEES
• IMMEDIATE DECISION ON ADMISSION OF LIABILITY
• ENCOURAGE PRACTICE OF ON ACCOUNT PAYMENT
• REGULAR REVIEW OF PENDING CLAIMS
• PERIODICAL ENHANCEMENT IN FINANCIAL AUTHORITY FOR
  CLAIMS PAYMENT
• COMPULSORY PAYMENT OF INTEREST ON DELAYED CLAIMS

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CUSTOMER FAULTS

• SOME TIMES CUSTOMERS ALSO ARE AT FAULT
• NOT RESPONDING TO REPEATED REQUESTS
• FRAUDULENT INTENTIONS
• IRRITABILITY why ask all these unnecessary
  questions?
• EXAGGERATED / INFLATED CLAIMS
• LACK OF UNDERSTANDING OF POLCY COVERAGE

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INSURERS RATIONALE

• THERE IS NO EXCUSE FOR
• NON-PERFORMANCE
• EXCELLENT SERVICE IS LIKE HORIZON. THE NEARER YOU
  GO TOWARDS IT, THE FARTHER IT GOES AWAY FROM
  YOU!!!!
• WE ARE FAR AWAY FROM 100 CUSTOMER SATISFACTION
  AND MILES TO GO EVEN BEFORE WE THINK OF SLEEPING

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THANK YOU