Thursday, November 10, 2011

If you are persistent you will win

If you are persistent you will win

The health insurance claim of Sanjay (name changed) was rejected by the insurance company. Repeated attempts by the insured with insurance company at various levels were not successful. We as Insurance Brokerage Firm advised him to take up the matter with Insurance Ombudsman. The matter took some time as the office of Insurance Ombudsman is having large number of complaints or cases coming up every day. After processing the date were fixed, the case was taken up and finally the insurance company was ordered to pay the claim. We appreciate the persistence effort put in by the insured, which has brought success to him.

Outlook magazine of November 3, 2011 has carried the case of Dr Kunal Saha, a medical doctor working and residing in USA. His wife had died in Kolkatta in 1998 while undergoing treatment. Kunal was convinced that Dr. Sukumar Mukherjee, the top Kolkatta physician who first treated Anuradha, had inflicted on her a massive overdose of Depomedrol, a long acting corticosteroids that went on to play havoc with her immune system; and that the treatment that followed, involving other doctors and the Advanced Medicare Research Institute (AMRI) a reputed private hospital, had been appallingly negligent .Armed with both certainty and rage, Saha, himself, a Kolkatta trained doctor put his peers in the dock.

Saha had too traveled 50 times over 13 years to India to fight the legal battle. I admire this gentleman.

The claim of Saha was for Rs 77 crores but Supreme Court of India delivered a ruling in 2009 which vindicated his struggle. By finding the Kolkatta doctors negligent, it opened the door for compensation order to be passed.

In October 2011, National Consumer Redressal commission has ordered that three Kolkatta doctors who treated Anuradha and AMFI will have to pay Rs 1.73 crores. Net payment after deductions to Saha will be Rs 1.34 crores. According to Dr Kunal Saha the amount spent by him on legal battle has been of the order of Rs 5 crores.

The points coming up before us are;

1. We should be persistent in follow up of our case whether it is Health insurance claim against an Insurance Company or liability claim against someone, who has not performed his duty.

2. Were 3 doctors or AMFI having professional liability cover in 1998 from Insurance Company? If yes will the Insurance Company pay it?

Let us wait and watch.

Wednesday, November 9, 2011

4 PSU General Insurance Companies to come out with IPO

New India, National, Oriental & United all the 4 PSU General Insurance Companies will be coming out with IPO. Even though some newspapers have written that this is because Government of India is facing financial deficit.

Let us look at the positive aspects of this move of the government;

1. IPO by these strong Insurance Companies will set a healthy record for listing of Insurance Companies in India. It means putting the insurance companies shares on right path i.e. growth 2 or 3 IPO's by Private companies at high premium and then going down on listing or within 2 months of listing would have been disaster.

2. Independent Directors are a requirement of SEBI for listing on Stock Exchange. It means that all the insurance Companies will now become broad based and will start following the rules /concepts of Corporate Governance. It is good for all of us, who are the customers of these Insurance Companies.If you feel that you should be considered for appointment of Independent Director ,this is the time to lobby for it.

3. Listing on Stock Exchange means that name of the company is covered many a times in press/TV so insurance Companies will not have too waste their money on advertising as brand is coming in front of customers on regular basis.

But here is a word of caution. The shares of these companies should not go into the hands of foreign companies because these companies (4 PSU’s) are very valuable because of

1 Real Estate assets( offices/Mumbai Flats owned by New India -thees are worth many many thousands of crores) owned by them. Pvt. Companies are generally operating out of rented buildings.

2. They own valuable investments in stock, accumulated over 40 years.

These shares should go to Indian Citizens who have been the customers of these companies. Therefore I feel;

'Let us write to Finance Minister that 10 % of the equity is reserved for policy holders of the company. We who have been loyal to these 4 companies can get the benefit of appreciation in share price. If you agree make it a point to send a letter to Finance Minister. Let us have this as a campaign.

Sunday, November 6, 2011

List of Insurance Repositories selected for maintaining the Insurance data in de mat form.

Recently when the claim was lodged for health insurance with a general insurance company then the delay in clearing /payment of the claim was that they had called for original proposal form , which was submitted when the insured had purchased the policy for the firs time i.e. 3 years back . What can be the situation if insured had purchased the policy 15 years back ?

We always advise the clients that they should keep all the old policies of health insurance in a file ,as it may be needed in future ,when the claim is lodged.

May be Repositories which will start operations in near future will simplify the whole thing as these will maintain data in de mat form. All of us are hopeful that this will help the insured as well as insurers.

5 companies which  have been selected by IRDA for the work of Insurance Repository  are;

1. National Securities Depository
2. Central Securities Depository
3.Stock Holding India
5 Karvy

It is understood that" In principle" approval has been given to them.
Karvy, which is also in the business of insurance distribution, has been asked to keep arms length distance between Insurance Repository and  its insurance distribution firm . It is a difficult task but we are sure that IRDA, the regulator will take sufficient precautions so that de mat data is not misused.

Saturday, November 5, 2011

Yellow markings in the skin around the eyelids are a warning to you as well as insurer

Researchers in Denmark have come out with a study after compiling data of 13000 persons and that too over 30 years . According to this those who were having patches, known as xanthelasmata were more likely to have heart attack or even die with it within 10 years.

These spots are deposits of Cholesterol which are soft and painless. They do not interfere with eyesight /vision. People generally go to dermatologists or skin specialists and get these treated.

In this Danish study started in 1970’s 12745 people were in the control group Out of this 4.4% were having xanthelasmata.Over 33 years 1872 had heart attack ,3699 developed heart disease and 8507 had died. The study shows that those with markings were 48% more likely to have heart attack,39% more likely to have heart disease and 14% more likely to die. The heart disease link is more acute for men in 70 to 79 years age group.

May be insurance companies issuing health insurance policies/life insurance policies  will start compiling data on xanthelasmata,come out with corrective steps (medical advice or loading of premium ) and save on costs associated with claims.

Apollo Munich / L & T / Max Bupa- which one is better and why?

Apollo Munich / L & T / Max Bupa- which one is better and why?

These 3 private sector companies are competing for business from premium customers or HNI’s, (high net worth individuals) who are looking for better health insurance products with good and attractive features.

Let us see the comparison ;

L & T is charging premium 72% higher than premium of Apollo Munich or 25% higher than premium of Max Bupa. The additional benefits offered are:

Hospital Cash Benefit – Rs. 6000 (max)
Recovery Benefits – Rs. 10000 (max)
Attendant person payment- Rs. 1000

provided the insured remains in hospital for 10 days or more than that.

At the same time L&T  product is losing on the following point;
No Claim Bonus is 5% vs. 10% being offered by Apollo Munich or Max Bupa.

When I checked up with few customers about their reaction on L& T product then the feedback was “no one is wishing to earn Rs. 17000 by getting hospitalized for 10 days. A person who is well off and can pay higher premium of L&T  is not the one who is looking for payment of Rs. 17000.

Let us see how L&T product will perform in the months to come.