The system should be developed in such a manner that whenever a claim is reported by the customer and registered by the insurer, the assignment of surveyor should happen automatically on a random basis by the new digital platform. The system will also seamlessly send a message to the customer on assignment of surveyor to the customer, said IRDAI  

Hyderabad: To revamp the existing retail claim settlement processes, insurance regulator IRDAI has asked General Insurance Council, the official representative body of all domestic general insurers, to develop a technology based solution for automatic allocation of survey work to a surveyor and loss assessor by 31^st Oct,2024.

The system should be developed in such a manner that whenever a claim is reported by the customer and registered by the insurer, the assignment of surveyor should happen automatically by the proposed platform on a random basis. The system will also seamlessly send a message to the customer on assignment of surveyor to the customer, outlined the IRDAI while issuing the Master Circular on General Insurance on Friday last that had come into force with immediate effect. 

Claims for Retail Customer/Policyholder:
-The retail customer/ policyholder will be informed of the timelines/ Turn Around Times for settlement of claim,
-The allocation of surveyors through the General Insurance Council tech-based solution need to happen within 24 hours of report of claim,
-The surveyor has to submit the survey report to the insurer within seven days of allocation. It will be the duty of the insurer to obtain the survey within the specified time limits.

The allocation of work to a surveyor and loss assessor by the proposed digital platform will be based on department, line of business, geography, qualification and any other factor relevant to the exercise and the process to be followed by the policyholder in this regard have also to be displayed by the general insurers, said the IRDAI.

The IRDA elaborated that a tech based approach is the need of the hour in order to bring about transparency in the allotment of survey job to the surveyor and loss assessors.

The  allocation will be done without any bias and in a time bound manner without any human intervention. The system should auto-generate the allocation of survey jobs seamlessly to surveyors. The allocation will  be on a random basis ensuring equitable and fair opportunities to the surveyors and loss assessors.

Also the general insurers will have Board approved criteria for:
-monitoring the performance of surveyors and loss assessors, meeting the Turnaround Time (TAT), accuracy and speed of survey reports, etc. In no case, the remuneration of surveyor and loss assessor shall depend upon the amount of claim amount assessed by the surveyor and loss assessor.
– obtaining feedback from the customers on the survey and loss assessment work undertaken.

Insurers should ensure that the surveyor report is submitted with speed and accuracy and within the time period as laid down in the IRDAI (Protection of Policyholders’ Interests, Operations and Allied Matters of Insurers) Regulations, 2024 and the customer is not put to distress on account of delayed submission of the survey report, said the IRDAI.

This will enable timeliness in survey of the loss, quicker and faster settlement of claims, transparency in allocation, efficient use of technology, faster turnaround times in claim settlement and greater trust in the claims settlement process in general insurance, said the IRDAI.