Aegon Religare: ‘Kum insurance dene ki bimari’

Aegon Religare: ‘Kum’ insurance ‘dene ki bimari’

The insurer has been running a high-pitched ad campaign cajoling the ‘masses’ to buy more
insurance. But a look at their official ‘claims settled’ and ‘claims repudiated’ ratios indicate
that the insurer’s policy payouts have a lot of scope for improvement.

Aegon Religare has had a long-running campaign on various media platforms, trying to 'educate' the general public on the need to take sufficient insurance cover. The actual advertisement shows Bollywood star Irrfan Khan highlighting the fact that the Indian masses tend to take less life insurance cover than what is required for them.

According to the insurer's ad, this (not taking sufficient life cover) is a disease in itself. So goes the catch-line in the usual ad voiceover baritone: (Not taking enough life cover) is 'Kum Insurance lene ki bimari' (the disease of taking less life cover).But herein lies the rub…
Aegon Religare can claim that the masses do not take sufficient life cover. But what about the total number of life insurance policy claims that the insurer has actually settled?
Let's keep this shrill campaign aside. According to figures released by insurance regulator IRDA's (the Insurance Regulatory and Development Authority) report for 2009-2010, the 'claims settled ratio' (the number of claims settled with respect to claims received) for Aegon Religare is a measly 48%, and the claims repudiated ratio (the number of claims rejected with respect to claims received) is as high as 44%.

It is clear from these IRDA figures that all Aegon Religare customers coming forward to take
insurance cannot be guaranteed that their claims will be settled. Of course, claims settlement for a life policy depends on the details given in the offer document, like full and complete disclosure of pre-existing ailments, etc. That is because insurance contracts are signed on the condition of utmost good faith, both on part of the insurer and the policyholder.

But even a cursory glance at the figures provided by IRDA for the previous year (2008-09) clearly indicates that Aegon Religare has us wondering whether the insurer itself is suffering from 'kum insurance dene ki bimaari.' For the above year, Aegon Religare had not settled any of the claims that had been submitted to it. On top of that, the insurer repudiated 71% of the claims that had been submitted to it in the above period.

(Max New York Life-Max fall in claims settlement ratio) Moneylife had pointed out how Max New York Life (MYNL) had settled 3,943 claims out of the 6,019 claims it had received in 2009- 10; its claims settlement ratio had fallen from 90% (2008-09) to 65% (2009-10).

Despite the opening up of the insurance sector to private players, government behemoth Life
Insurance Corporation of India (LIC) had a claims settled ratio of 96% and a low claim repudiation figure (just 1%) for 2009-10, according to the insurance regulator.

Among the other players, for the same period, these were the claims repudiation figures (HDFC
Standard Life: 4% and ICICI Prudential: 3%) of total claims submitted. Other insurers, who have high claims repudiation figures include Future Generali (29%); IDBI Federal (23%), and Bharti AXA Life (22%), according to the IRDA report of 2009-10 quoted above. High performers in claims settled include HDFC Standard Life (91%), ICICI Prudential (90%) and ING Vysya (89%), according to IRDA.