REPORT ON CLAIM SETTLEMENT.doc

8/14/2019 REPORT ON CLAIM SETTLEMENT.doc

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PREFACE

With the advent of insurance sector, private sector insurance sector has emerged as a

trusted sector. It simplifies customers life by providing them the tailor made product

and quality services, thus helping to take the informed investment decisions.

The emphasis in this study is basically on the procedures followed while settling the

claims of the clients. It is a very detailed and vast area of insurance. So, this report only

consists the process of own damage and third party claims

This report consists of T!"" parts # I, II, III and I$.

%art I& 'escription about the Insurance Sector in India.

%art II& 'escribes the profile of the organi(ation where I have taken my summer

training, to make description of organi(ation brief and effective it is divided into sub

parts such as introduction, profitability, growth report, etc.

%art III& Is about actual pro)ect carried out. It contains overview of claims process,

documents, etc. The ob)ectives, utility and method adopted to carry out the pro)ect

method of data analysis are discussed in this part in detail.

%art I$& Tells about the value addition achieved by the author *myself+. onsidering

this value addition as an effect and its cause has been traced under different heads such

as career path, augmentation of soft skills, acquired knowledge, etc at -S.

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This report contains all the essential details regarding claims settlement in IT0I. It is

the aim of the report to help the reader to develop a skill to understand, analyse and

interpret financial problems and data to make good financial decisions.

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ACKNOWLEDGEMENT

2irst, I thank my advisor 3r.4bhishek Shrivastava, for his continuous support in my

training program. e is responsible for involving me in the pro)ect in the first place.e

showed me different ways to approach the problem and the need to be persistent to

accomplish any goal.

I also thank 3rs hakti, who as my leader 5 advisor guided me in my study of claim

settlement. She taught me how to handle clients as well as their query. She was always

there to meet and talk about my ideas, to proofread and mark up my pro)ect report and

think through my problems.

esides my advisors, I would like to thank 3r ri)esh Tiwari and 3r Suresh

!aghuvanshi, for solving my queries regarding premium and policy creation.

I am also grateful to 3s 6eena and 3s -usrat for her friendly behaviour throughout

my programme. They also e7tended their helping hand whenever I needed.

I would like to e7tend my sincere regards to my 'ean 3r. -ikhil 8ulsheshtra and my

%lacement ell 'irector, 3r. 4lok Satsangi because of whom I am here to pursue my

training.

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6ast, but not least, I thank my family and my parents for giving me life in the first

place, for educating me and for unconditional support and encouragement to pursue

my interests. I am also thankful to my brother who has always supported me and for

listening to all my complaints and frustration and for believing in me.

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TABLE OF CONTENT

PART I

INTRODUCTION TO INSURANCE

PART II

ORGANISATIONAL PROFILE

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& 0!;WT !"%;!T

PART III

REPORT ON PROJECT WORK

CHAPTER 1: CLAIM SETTLEMENT PROCEEDURE

- ;W- '4340" 64I3S

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CHAPTER 2: CLAIM DOCUMENTS

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CHAPTER 3: LOSSES COVERED UNDER CLAIM

SETTLEMENT

& %!;"SS ;2 S"TT6I-0

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PART IV

LEARNING FROM THE SUMMER TRAINING

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ANNEXURES

A


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PART- I

INTRODUCTION TO

INSURANCE

B


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In!"#n$% & M%#n'n() D%*'n'+',n C,n$%.+

Insurance may be considered a G#/% ,* "'0in which individuals andbusinesses protect themselves, their families, and their property from possible losses

resulting from unpredictable events such as storms, fires, accidents, and illnesses. The

first rule of the game, devised centuries ago is Cshare the risk.D To play by this rule,

many people take a small loss in place of one personEs taking a large one.

It is a simple ideaF 4n individual pays a small amount of money called a

premium to an agent who acts on behalf of an insurance company, or underwriter,

which holds the individualEs premium and the premiums paid by thousands of others.

The individual receives an insurance policy, a promise that if there is a loss to the

individual as defined in the policy the insurance company will pay for it. The funds

will come from the individualEs premium, the premiums paid by others who did not

have losses, and money from the companyEs investment of all the premiums. 4n

individual who does not have a loss loses the premium money but purchases what

insurance underwriters callCpeace of mind.D It is a gamble for both the customer and

the underwriter, but it is built on the first rule of riskF that losses are small when shared

by many.

Insurance, in law and business, C,n+"#$+!# #""#n(%/%n+that provides

for compensation by an insurer to an insured party if or when a specified set of

circumstances occurs. Such circumstances may include death or personal in)ury,

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accident, unemployment or old age, loss of or damage to property, or any one of a

number of instances that can be compensated for financially. The insurer conducts its

operations by amassing relatively small contributions from many people who are

e7posed to the risk of occurrence of an unforeseen event in order to create a fund that

is used to reimburse those insured who actually suffer from such an occurrence. The

contributions of the policyholders are called premiums. 4 contract of insurance is

embodied in a policy that specifies the terms under which the insurer agrees to

indemnify the policyholder for loss in consideration of the payment of a stated

premium or premiums. 2or specific details on 6ife Insurance, see that article.

PRINCIPALS OF INSURANCE:

ommercially insurable risks typically share seven common characteristics.

1 A #"(% n!/%" ,* 4,/,(%n%,! %5.,!"% !n'+

The vast ma)ority of insurance policies are provided for individual

members of very large classes. 4utomobile insurance, for e7ample, covered about

/A= million automobiles in the


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Satellite 6aunch insurance covers events that are infrequent. 6arge commercial

property policies may insure e7ceptional properties for which there are no

homogeneous e7posure units. 'espite failing on this criterion, many e7posures

like these are generally considered to be insurable.

2 D%*'n'+% L,

The event that gives rise to the loss that is sub)ect to insurance should,

at least in principle, take place at a known time, in a known place, and from a

known cause. The classic e7ample is death of an insured on a life insurance policy.

2ire, automobile accidents, and worker in)uries may all easily meet this criterion.

;ther types of losses may only be definite in theory. ;ccupational disease, for

instance, may involve prolonged e7posure to in)urious conditions where no specific

time, place or cause is identifiable. Ideally, the time, place and cause of a loss

should be clear enough that a reasonable person, with sufficient information, could

ob)ectively verify all three elements.

3 A$$'6%n+# L,

The event that constitutes the trigger of a claim should be fortuitous, or at

least outside the control of the beneficiary of the insurance. The loss should be

pure, in the sense that it results from an event for which there is only the

opportunity for cost. "vents that contain speculative elements, such as ordinary

business risks, are generally not considered insurable.

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7 L#"(% L,

The si(e of the loss must be meaningful from the perspective of the

insured. Insurance premiums need to cover both the e7pected cost of losses, plus

the cost of issuing and administering the policy, ad)usting losses, and supplying the

capital needed to reasonably assure that the insurer will be able to pay claims. 2or

small losses these latter costs may be several times the si(e of the e7pected cost of

losses. There is little point in paying such costs unless the protection offered has

real value to a buyer.

8 A**,"6#% P"%/'!/

If the likelihood of an insured event is so high, or the cost of the

event so large, that the resulting premium is large relative to the amount of

protection offered, it is not likely that anyone will buy insurance, even if on offer.

2urther, as the accounting profession formally recogni(es in financial accounting

standards, the premium cannot be so large that there is not a reasonable chance of a

significant loss to the insurer. If there is no such chance of loss, the transaction may

have the form of insurance, but not the substance.

9 C#$!#% L,

There are two elements that must be at least estimable, if not formally

calculableF the probability of loss, and the attendant cost. %robability of loss is

generally an empirical e7ercise, while cost has more to do with the ability of a

reasonable person in possession of a copy of the insurance policy and a proof of

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loss associated with a claim presented under that policy to make a reasonably

definite and ob)ective evaluation of the amount of the loss recoverable as a result of

the claim.

L'/'+%6 "'0 ,* $#+#+",.4'$#; #"(% ,%

The essential risk is often aggregation. If the same event can cause

losses to numerous policyholders of the same insurer, the ability of that insurer to

issue policies becomes constrained, not by factors surrounding the individual

characteristics of a given policyholder, but by the factors surrounding the sum of

all policyholders so e7posed. Typically, insurers prefer to limit their e7posure to a

loss from a single event to some small portion of their capital base, on the order of

=percent. Where the loss can be aggregated, or an individual policy could produce

e7ceptionally large claims, the capital constraint will restrict an insurers appetite

for additional policyholders. The classic e7ample is earthquake insurance, where

the ability of an underwriter to issue a new policy depends on the number and si(e

of the policies that it has already underwritten. Wind insurance in hurricane (ones,

particularly along coast lines, is another e7ample of this phenomenon. In e7treme

cases, the aggregation can affect the entire industry, since the combined capital of

insurers and reinsurers can be small compared to the needs of potential

policyholders in areas e7posed to aggregation risk. In commercial fire insurance it

is possible to find single properties whose total e7posed value is well in e7cess of

any individual insurers capital constraint. Such properties are generally shared

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http://en.wikipedia.org/wiki/Percentagehttp://en.wikipedia.org/wiki/Percentage


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among several insurers, or are insured by a single insurer who syndicates the risk

into the reinsurancemarket.

INDEMNIFICATION:

The technical definition of JindemnityJ means to make whole again.

There are two types of insurance contractsK

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insuring party, by means of a contract, called an insurance EpolicyE. 0enerally, an

insurance contract includes, at a minimum, the following elementsF the parties *the

insurer, the insured, the beneficiaries+, the premium, the period of coverage, the

particular loss event covered, the amount of coverage *i.e., the amount to be paid to the

insured or beneficiary in the event of a loss+, and e7clusions *events not covered+. 4n

insured is thus said to be JindemnifiedJ against the loss events covered in the policy.

When insured parties e7perience a loss for a specified peril, the coverage

entitles the policyholder to make a EclaimE against the insurer for the covered amount of

loss as specified by the policy. The fee paid by the insured to the insurer for assuming

the risk is called the EpremiumE. Insurance premiums from many insureds are used to

fund accounts reserved for later payment of claimsMin theory for a relatively few

claimantsMand for overhead costs. So long as an insurer maintains adequate funds set

aside for anticipated losses *i.e., reserves+, the remaining margin is an insurerEsprofit.

/=
http://en.wikipedia.org/wiki/Contracthttp://en.wikipedia.org/wiki/Indemnityhttp://en.wikipedia.org/wiki/Overhead_(business)http://en.wikipedia.org/wiki/Profithttp://en.wikipedia.org/wiki/Contracthttp://en.wikipedia.org/wiki/Indemnityhttp://en.wikipedia.org/wiki/Overhead_(business)http://en.wikipedia.org/wiki/Profit


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TYPES OF INSURANCE:

%erils often covered by insurance include burglary and theft, vehicle

collision, and dishonesty of employees *fidelity insurance+. 2orms of insurance such as

life insurance or maritime insurance are effectively whole subtypes of insurance, with

their own norms. Insurance is also available to cover the e7tension of credit and to

guarantee the title to a property, or as part of a mortgage policy. In addition,

speciali(ed types of insurance cover damage to glass, boilers and machinery, lifts,

animals, and other property, as well as losses to property arising from lightning, wind,

tornadoes, hail, storms, insects, blight, bombardment, e7plosion, and water damage.

3any insurance policies are comprehensive, that is, they cover a group of related

perilsK but most also have e7clusion clauses, detailing what events are not covered by

the policy.

Insurance comes in many varieties. ategories include property, liability,

homeownersE, automobile, medical, life, workersE compensation, and marine.

P",.%"+; In!"#n$%:

%roperty insurance is the modern form of the fire insurance that was sold by

early insurance companies. The name has changed because the coverage has changed.

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-o longer are )ust the losses resulting from fire protected by property insurance. Such

losses as those from windstorm, theft, vandalism, and water damage are also covered.


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attorneysE fees and other losses that occur when another person is in)ured on an

individualEs property and files a lawsuit seeking damages, or payment. usiness

liability insurance is almost always sold separately and comes in manyforms, including

comprehensive general liability, which protects a business from a wide variety of

liability lossesK professional or malpractice liability insurance, which protects

physicians, lawyers, and other professionals from liabilities resulting from professional

mistakesK and product liability insurance, which protects manufacturers from any

liabilities caused by their products.

H,/%,=n%"> In!"#n$%:

omeownersE insurance is a combination offering both property and

liability coverage.


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insurance is not restricted to homeowners but is available in a modified form to people

who rent living quarters.

A!+,/,'% In!"#n$%:

4utomobile insurance is the most complicated kind of insurance

purchased by individuals. It combines several kinds of property and liability coverage.

The standard automobile policy includes collision insurance, covering property

damage to a car when it is struck by another vehicle, and comprehensive insurance,

covering general property damage that occurs when an automobile is damaged by

something other than another vehicle. In other words, a dented fender resulting from

another automobileEs backing into it is insured with collision coverage, while the

windshield broken by a poorly thrown baseball is covered under comprehensive

insurance.

4utomobile insurance also includes a variety of liability coverages,

including general liabilityMcalled bodily in)ury liability coverageMand medical

payment insurance. The automobile policy, however, covers liabilities that occur when

an uninsured motorist is involved in an accident with an insured driver and creates

liabilities for both. %roperty damage liability insurance pays for damage to other

peopleEs property caused by the insured automobile. 2or e7ample, damage caused by

backing a car into a neighborEs garage is paid for by such a policy.

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4utomobile insurance underwriters charge premiums based on classes of

drivers and their safety records. 0enerally drivers who have had accidents pay more

for automobile insurance than do drivers who have had none. harging by classes of

drivers may seem unfair to the individual. 2or e7ample, a young driver, even with a

good safety record, pays a higher premium than a comparable older driver because

younger drivers as a class have poorer safety records. 4ccording to insurance records,

the worst driversMand thus the most e7pensive drivers to insureMare unmarried males

between the ages of /= and 1=. ompanies generally offer premium discounts for good

students, drivers who have more than one car, and drivers who own larger, low&

powered cars, which tend to incur little damage in accidents.

M%6'$# In!"#n$%:

3edical insurance pays the costs of hospitali(ation and physiciansE fees for

insured individuals who are in)ured or become ill. It is unlike medical payment liability

insurance in that the place where an in)ury occurs or an illness begins is not involved.

overage usually includes emergency treatment, surgery, long&term care, and

sometimes dental and vision care.

3edical insurance plays according to share&the&risk rules. The premiums

paid by those people who remain healthy provide the money to treat those who are ill.

The cost of individual health insurance is very high, and many individuals do not

purchase this insurance for themselves. 3ost medical insurance is purchased in group

policies by employers for their employees. "mployees may contribute to the premium,

or they may receive the insurance as an e7tra benefit. 3ost employees are allowed to

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include their marital partners and dependent children by contributing to the additional

cost.

L'*% In!"#n$%:

6ife insurance is designed to insure lives, though it frequently includes

coverage for ma)or disabilities such as the loss of limbs or organs. There are basically

three kinds of life insurance that may be purchased by individuals for themselves or

others or by employers for their employees.

The most common kind is called term insurance, which pays a benefit to the

beneficiary, or previously chosen survivor, if the insured person dies during the period

of time defined in the policy.


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premium. C,/.%n#+',n:

WorkersE compensation is a special state&controlled insurance purchased by

employers for the benefit of their employees. 6ike general liability and medical

payment liability insurance, it pays for medical treatment required by employees of a

company according to a state&regulated schedule of benefits. The ob)ect is to prevent

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employees from the need to sue their employers if they are in)ured and to compensate

workers for losses from accidents on the )ob.

This insurance can be purchased from general insurance underwriters who charge

employers a premium based on their safety records. Insurance companies may not

offer such coverage to employers with poor accident recordsK so state governments

usually maintain a special pool of underwriters for such employers in order to provide

this legally required insurance. Sometimes state governments assign bad&risk

employers to a specific insurance company, which then charges a particularly high

premium.

Some states provide for wage loss workersE compensation, which

eliminates specific benefits but pays workers any salary or wages lost from in)uries.

Such insurance tends to reduce the premium.

M#"'n% In!"#n$%:

The oldest form of insurance that scholars have been able to document,

marine insurance now includes much more than the shared risk of shipsE cargo. It might

best be called transportation insurance because variations of the coverage include

protection for ships, trucks, railroads, and aircraft.


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barratry, an illegal act by captain or crew that does in)ury to the ship&owner or cargo.

4lthough aviation insurance is not considered ocean marine insurance, it is sold almost

the same way and generally protects participants from the same perils to hull and

cargo.

Inland marine insurance has become a catchall for almost any kind of

transportation or storage peril. It is designed to insure cargo carried by trucks and

railcars, but recently inland marine insurance has added protection from losses of data

stored in computers and the temporary storage of customersE valuables by shopkeepers.

D'#''+; In!"#n$%:

'isability insurance policies provide financial support in the event the

policyholder is unable to work because of disabling illness or in)ury. It provides

monthly support to help pay such obligations as mortgages and credit cards.

Total permanent disability insurance insurance provides benefits when a person

is permanently disabled and can no longer work in their profession, often taken

as an ad)unct to life insurance.

'isability overhead insuranceallows business owners to cover the overhead

e7penses of their business while they are unable to work.

WorkersE compensationinsurance replaces all or part of a workerEs wageslost

and accompanying medical e7pense incurred because of a )ob&related in)ury.

1:
http://en.wikipedia.org/wiki/Disability_insurancehttp://en.wikipedia.org/wiki/Total_permanent_disability_insurancehttp://en.wikipedia.org/wiki/Business_overhead_expense_disability_insurancehttp://en.wikipedia.org/wiki/Workers'_compensationhttp://en.wikipedia.org/wiki/Wagehttp://en.wikipedia.org/wiki/Disability_insurancehttp://en.wikipedia.org/wiki/Total_permanent_disability_insurancehttp://en.wikipedia.org/wiki/Business_overhead_expense_disability_insurancehttp://en.wikipedia.org/wiki/Workers'_compensationhttp://en.wikipedia.org/wiki/Wage


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C#!#+; In!"#n$%:

asualty insurance insures against accidents, not necessarily tied to any specific

property.

rime insuranceis a form of casualty insurance that covers the policyholder

against losses arising from the criminal acts of third parties. 2or e7ample, a

company can obtain crime insurance to cover losses arising from theft or

embe((lement.

%olitical risk insuranceis a form of casualty insurance that can be taken out by

businesses with operations in countriesin which there is a risk that revolution

or otherpoliticalconditions will result in a loss.

O+4%" +;.%:

ollateral protection insuranceor %I, insures property *primarily vehicles+

held as collateral for loans made by lending institutions.

'efense ase 4ct WorkersE compensation or '4 Insurance insurance

provides coverage for civilian workers hired by the government to perform

contracts outside the


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related to medical treatment and loss of wages, as well as disability and death

benefits.

"7patriate insuranceprovides individuals and organi(ations operating outside

of their home country with protection for automobiles, property, health,

liability and business pursuits.

2inancial loss insurance protects individuals and companies against various

financial risks. 2or e7ample, abusinessmight purchase cover to protect it from

loss ofsalesif a fire in a factoryprevented it from carrying out its business for

a time. Insurance might also cover the failure of a creditor to pay money it

owes to the insured. This type of insurance is frequently referred to as

Jbusiness interruption insurance.J 2idelity bondsand surety bonds are included

in this category, although these products provide a benefit to a third party *the

JobligeeJ+ in the event the insured party *usually referred to as the JobligorJ+

fails to perform its obligations under a contract with the obligee.

8idnap and ransom insurance

6ocked funds insuranceis a little&known hybrid insurance policy )ointly issued

by governments and banks. It is used to protect public funds from tamper by

unauthori(ed parties. In special cases, a government may authori(e its use in

protecting semi&private funds which are liable to tamper. The terms of this type

of insurance are usually very strict. Therefore it is used only in e7treme cases

where ma7imum security of funds is required.

-uclear incident insurance covers damages resulting from an incident

involving radioactive materials and is generally arranged at the national level.

1?
http://en.wikipedia.org/wiki/Expatriate_insurancehttp://en.wikipedia.org/w/index.php?title=Financial_loss_insurance&action=edit&redlink=1http://en.wikipedia.org/wiki/Businesshttp://en.wikipedia.org/wiki/Saleshttp://en.wikipedia.org/wiki/Factoryhttp://en.wikipedia.org/wiki/Creditorhttp://en.wikipedia.org/wiki/Moneyhttp://en.wikipedia.org/wiki/Fidelity_bondhttp://en.wikipedia.org/wiki/Surety_bondhttp://en.wikipedia.org/wiki/Kidnap_and_ransom_insurancehttp://en.wikipedia.org/wiki/Locked_funds_insurancehttp://en.wikipedia.org/wiki/Expatriate_insurancehttp://en.wikipedia.org/w/index.php?title=Financial_loss_insurance&action=edit&redlink=1http://en.wikipedia.org/wiki/Businesshttp://en.wikipedia.org/wiki/Saleshttp://en.wikipedia.org/wiki/Factoryhttp://en.wikipedia.org/wiki/Creditorhttp://en.wikipedia.org/wiki/Moneyhttp://en.wikipedia.org/wiki/Fidelity_bondhttp://en.wikipedia.org/wiki/Surety_bondhttp://en.wikipedia.org/wiki/Kidnap_and_ransom_insurancehttp://en.wikipedia.org/wiki/Locked_funds_insurance


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*2or the


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TYPES OF INSURERS -

4 variety of organi(ations, chiefly commercial but including some

fraternal or non&profit bodies, underwrites insurance. Insurance companies are owned

by their shareholders, who in return for providing the company with capital by their

share purchases, share in the profits in the form of dividends. 3utual insurance

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companies, however, do not issue shares but operate solely on the money obtained as

premiumsK these organi(ations are owned by the policyholders, who share in the profits

and losses.


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INSURER?S BUSINESS MODEL:

P",*'+ O "arned premium P Investment income & Incurred loss &


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Insurers make money in two waysF

*/+ Through underwriting, the process by which insurers selects the risks to insure and

decide how much in premiums to charge for accepting those risks and

*1+ y investing the premiums they collect from insured.

The most complicated aspect of the insurance business is the

underwriting of policies.


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premium+ is added to the e7pense ratio *underwriting e7penses divided by net premium

written+ to determine the companyEs combined ratio. The combined ratio is a reflection

of the companyEs overall underwritingprofitability. 4 combined ratio of less than /HH

percent indicates underwriting profitability, while anything over /HH indicates an

underwriting loss.

Insurance companies also earn investmentprofits on CfloatD. C2loatD or

available reserve is the amount of money, at hand at any given moment, that an insurer

has collected in insurance premiums but has not been paid out in claims. Insurers start

investing insurance premiums as soon as they are collected and continue to earn

interest on them until claims are paid out.

In the


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%roperty and casualty insurers currently make the most money from their

auto insurance line of business. 0enerally better statistics are available on auto losses

and underwriting on this line of business has benefited greatly from advances in

computing. 4dditionally, property losses in the


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event. 4 policy in which the insured does not have such an interest would be deemed a

gambling contract and therefore voidK an e7ample of such a void policy is one by

which a person insured the house of a stranger against fire.

PROTECTION:

Insurance plays a ma)or role in the modern economy, providing an

orderly means for the replacement of property lost or destroyed and for sustaining

purchasing power adversely affected by illness, in)ury, or death. 3oreover, the huge

reserves accumulated by insurance companies to meet e7pected claims are invested,

thus providing industry with needed funds for capital e7pansion or other investments.

Insurance companies constantly search for additional business by

providing insurance protection against new types of ha(ards. 3ost standard

homeowners policies do not protect against catastrophes, such as earthquakes, nuclear

e7plosion or radiation, war, and certain other perils.

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PART: II

ORGANISATIONAL

PROFILE

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INTRODUCTION

I22;&T;8I; 0eneral Insurance *IT0I+ is Indias trusted insurance company. It

simplifies customers life by providing them tailor made products and quality services,

thus helping them take informed investment decisions.

It is a )oint venture between The Indian 2armers 2ertiliser o&operative *I22;+ and

its associates and Tokio 3arine and -ichido 2ire 0roup, the largest listed insurance

group in Qapan.

IT0I was incorporated on 'ecember :, 1HHH and has its head office in 0urgaon,

aryana.

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74%

26%

0%

0%

IFFCO

TOKIO & NICHIDO

We are among IndiaEs top three private&sector general insurance companies with /HH

offices and a country&wide network of :BH e7clusive point of presence.

In our constant effort to provide our customers with J+4% '*% +4%; 6%%"@%J, we offer a

wide range of over :H uniquely customi(ed policies covering a wide range of

customers, from farmers to some of IndiaEs largest automobile manufacturers.

We are among IndiaEs top three private&sector general insurance companies with /HH

offices and a country&wide network of :BH e7clusive point of presence.

In our constant effort to provide our customers with Jthe life they deserveJ, we offer a

wide range of over :H uniquely customi(ed policies covering a wide range of

customers, from farmers to some of IndiaEs largest automobile manufacturers.

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VISION AND MISSION

VISION:

The vision of IT0I is to be an industry leader by building customer satisfaction

through farmers transparency and quick response.

MISSION:

4s per IT0I the mission is to win the trust of individuals, trade, industry and

commerce and protect citi(ens, corporate, and international investors in India.

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OPERATING ENVIRONMENT OF ITGI

9G


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It mainly focuses on above mentioned areas so that its working is up to date and the

latest one. 2inancial focus is based upon the fund creation and its flows. !5' is done

for renewal strategies and new areas development.

OVERVIEW

ustomerfocus

!enewal5developm&ental focus

%rocessfocus

2inancialfocus

uman2ocus

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PERFORMANCE GROWTH

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#< PROFITABLE GROWTH:

;ur commitment to innovation and customer service has helped us consistently raise

the bar on our performance. We strongly believe in profitable growthF ;ur rapidly

reducing "arned Income 6oss !atio *"I6!+ is testimony to this.

PBT ,* ITGI 4# 'n$"%#%6 *",/ 3 $"; 'n 22-3 +, 7279 $","% 'n 29-

< GROSS WORKING PROFIT:

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IT0IEs sound financial management has been achieved in a period of fast&paced

growth. ;ur 0W% has grown from !s. BG? crores in 1HH=&? to !s. //=1 crores in

1HH?&HA.

IT0I voluntarily maintains strong institutional checks and balances. 4n investment

committee of board members and senior e7ecutives scrutini(es all ma)or investment

decisions. 4n in&house audit committee audits all the branches and suggests ways to

::


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ITGI- PRODUCT OFFERINGS

!isks are inherent in every aspect of life. They are present in whatever we do everyday

and all businesses face the threat of losses that may never occur. Worrying about these

possibilities hardly makes life pleasant. ;f course, it is impossible to eliminate risks &

but they can be controlled, lessened or minimi(ed. That is e7actly what risk

management is a all about.

We at IT0I have established a proficient risk management team to provide customi(ed,

need&based solutions. 4rmed with a high level of domain knowledge in a wide range

of industry verticals, our risk management e7perts identify and evaluate the risk

e7posures of your facility or business to provide a comprehensive risk management

solution based on your special needs. 4s a part of our value&added services, we also

provide recommendations for loss reduction and risk mitigation and continuously

update you about international best practices. IT0I offers various products to its

customers so that it may cover all sorts of risks

:?


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ITGI?S PRODUCT DETAILS

Standard 2ire and Special perils

3arine open over

3achinery reakdown

3otor %vt. ar omprehensive

0roup %ersonal 4ccident

4ll !isk

urglary and ousebreaking

3oney

%rofessional indemnity

Workmens ompensation

"lectronic equipment

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Tractor

Sankat aran ima

Individual %ersonal 4ccident

2idelity 0uarantee

%ublic 6iability

%roduct 6iability

ontractors 4ll !isk

oiler and %ressure plants

ontractors plant and machinery

Industrial 4ll !isk

"rection 4ll !isk

2ire

Special ontingency

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3ega !isk and %ackage %olicies

Weather Insurance

Qewelers lock

3T;

redit Insurance

ankers Indemnity

RURAL CENTRIC INITIATIVES

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IT0I has always engaged itself in rural problem solving and it also take initiatives to

reduce the risk which is open to their crops, land, etc. The latest initiatives taken are as

follows &F

3ausam ima >o)na *3>+

arish ima >o)na *>+

Sankat aran

8isan 8alyan

Qan 8alyan

8isan ima

S#n0#+ H#"#n B'/# Y,n#:It was concluded in ;ctober, 1HH/. 4t that

time a free cover of !s.:HHH per bag *ma7. of !s. / lac+ was granted on the

purchase of fertili(er. It is the largest single policy issued in the world.

B#"'4 B'/# Y,n#:It is a weather insurance product and was introduced

in 4pril, 1HH:. 4s it is an inde7 based product, it covers anticipated

deficiency in crop yield due to deficient rainfall during monsoon. It is sold

as a group policy through co&op societiesNbanksN-0;s etc.

=H


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M#4'# S!"#04# B'/# Y,n#: It was launched on September, 1HH= on

International Womens 'ay. It covers against all accidental occurrences,

including death and in)ury.

G%n4! M#!#/ B'/# Y,n#: It covers frost in)ury and heat stress to

crops as well as cover for low temperature during the flowering stage.

With this it also covers for high temperature during the grain filling stage.

4mong them Sankat aran is the largest single policy of the world.These policies have

been created and modified from time to time as per the needs and requirement of rural

ha(ard.

=/


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ITGI- SERVICE PARAMETERS

IT0I caters to almost all areas of risk management. elow is a list of some of our

mainstream servicesF


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'ocumentation Timeframe commitmentF

Issuance of receipt on the same working day

Issuance of cover note immediately

Issuance of policy ma7imum five working days

laimsF

Surveyor appointment same working day

Surveyor visit ma7imum :B hours of notification

%reliminary report ma7imum = working days of survey

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!esponse to enquiry reply in ma7imum = working days*or

else reasons for the delay+

C!+,/%" S#+'*#$+',n

So how satisfied are customers of the insurance sector ave private sector players

made any difference in the quality of service provided to consumers >"S says

Indias first ever study of customer satisfaction in the insurance sector. %ublic sector

companies need to improve their services and grievance response time, if they wish to

maintain a loyal customer base. -owadays, various companies try to deal mainly with

customer satisfaction and try to follow certain norms such asF

To improve response times

To reduce costs and increase revenues

=:


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TOKIO

HDFC

CHUBB

2 2 1 2 1 2 2

TATA AIG 3 1 2 1 3 3 3

TANGIBILITY T< :%romptness in terms of policy issueK on&time procedures for

policy issue and renewalK depth *network+ of survey team and inspectors *on time

survey+K promptness of reali(ation of the payment after bill submissionK cheque pick up

facilityK cashless transaction facilities.

PROBLEM SOLVING SYSTEM PS


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RESPONSIVENESS R


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GROWTH REPORT

*B;DNA money+

The 0eneral Insurance Industry is beginning to see the benefits of a price& deregulated

regime. 4fter witnessing a =HR decline in growth in 1HHA& HBb, the new financial year

has started off well for them. ;n average, they grew by over /:R.

While private sector players have grown by an average of 1:R in 4pril, the four

nationali(ed companies registered#n (",=+4 'n +4% *'"+ /,n+4 ,* +4% *'$#

=B


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A *#" # +4% (",=+4 'n +4% (", !'n% ."%/'!/ 6!"'n( +4% /,n+4 '

$,n$%"n%6 IFFCO TOKIO) TATA AIG G%n%"# In!"#n$% #n6

CHOLAMANDALAM +,..%6 +4% $4#"+

PART - III

=G


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REPORT ON

PROJECT WORK

CHAPTER: 1

?H


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CLAIM SETTLEMENT

PROCEEDURE

CLAIM SETTLEMENT

?/


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Whenever an insured persons vehicle mets with an accident or his vehicle suffers any

loss or damage then he can file a claim to his insurer. The claim for 3otor Insurance

includes two ma)or categoriesF&

1 O=n D#/#(% C#'/

2 T4'"6 P#"+; L'#''+; C#'/

This can be e7plained in detail with the help of their procedures involved.

1 O=n D#/#(% C#'/

2rom the procedural view point, claims settlement involves three phasesF&

*a+ %reliminary Scrutiny

*b+ 4ssessment of losses

*c+ Settlement

#


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;n the receipt of notice of loss, the policy records are checked to see that the

policy is in force and that it covers the vehicle involved. The loss is entered in the

laims !egister and claim form is issued to the insured for completion and return.

The insured is required to submit a detailed estimate of repairs from any repairer

of his choice. 0enerally, these repairs are acceptable to the insurer but they at

times ask the insured to obtain repair estimate from another repairer, if they have

reason to believe that the competence, moral ha(ard or business integrity of the

repairer first chosen is not satisfactory.

< A%/%n+ ,* ,%

Independent automobile surveyors are assigned the task of assessing the cause and

e7tent of loss. They are supplied with the copy of the policy, the claim form and

the repairers estimate. They inspect the damaged vehicle and discuss the cost of

repair or replacement with the repairer and submit their survey report.

In respect of mirror damage, independent surveyors are not always appointed. The

insurers own in&house surveyors inspect the vehicle and submit the report.

$< S%++%/%n+

?9


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The procedural aspects of third party liability claims may be briefly described as

followsF&

/. ;n the receipt of notice of claim from the insured, from the 3otor accident

laims tribunal, is to make entry in the claims register including date of

intimation, claim no., policy no., period, date of accident, vehicle no., date of

accident, vehicle no., etc. Separate sections are mentioned in the register for

fatal claims and bodily in)ury claims.

1. The matter is entrusted to an advocate. If the company has a legal department

for motor third party claims, then the claim is dealt with that department.

Thais early action is necessary so that the insurers are represented at the very

first hearing.

9. If the claim intimation is received from the 34T, a letter is addressed to the

insured to make certain the following informationF&

The claim no. for own damage if lodged.

The %olice Station where the claim was reported indicating the number

and the date of their station 'iary.

'rivers name and address.

-ame and address of the advocate if the insured has appointed one.

'etails of drivers prosecution.

?=


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:. Simultaneously, a letter is addressed to the police station asking for copies of

police report or panchnama and of the statement made to them relating to the

accident.

=. 4 copy of the claim form is obtained from the insured or if there is an ;wn

'amage claim already lodged, a copy is obtained from the own damage

section and sent to the advocate along with copy of the policy.

?. The following information is needed to determine the question of liability of

the insured and the liability under the policyF

"7istence of insurance and limit of liability under the policy.

'rivers statement and statement of witnesses to the accident.

'etails of drivers prosecution, charges depositions during the proceedings

and the )udgement in the criminal case.

'etails of the accident to decide negligence of parties.

%ost mortem report *fatal accident+.

A. In case of bodily in)ury, medical report is obtained indicatingF

The age of claimant.

is occupation.

The nature and e7tent of in)ury.

??


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'uration of disability, etc.

B. In order to consider the quantum of damages that may be regarded as

reasonable,

the following information is soughtF&

*a+ Status of deceased,

*b+ 3onthly income,

*c+ ontribution to the family,

*d+ !elationship with the claimant,

*e+ Status of the claimant.

*f+ 3edical certificate,

*g+ 3edical e7penditure,

*h+ 3onthly income.

G. ;n the basis of the above information, the advocates opinion is obtained. 6arge

claims are usually referred to solicitors. 4 written statement is then filed by the

advocate depending upon the facts of the case.

?A


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/H. The insured and the driver is required to operate with the insurers advocate.

//. "ventually, the claim is decided upon the 34T where usually, the insurers,

insured, driver, and the third party along with their advocate is present. The

amount awarded is paid to the third party against proper discharge.

C#'/ S%++%/%n+ P",$%6!"% 'n ITGI 'n #

N!+4%

Whenever a request is received for the settlement of claim from the client following

procedure is followed by the companyF&

Surveyor 4ppointment same working day.

4ll related documents of insured is handovered to him.

Surveyor visit ma7imum :B hours of notification.

%reliminary report ma7imum = working days of surveyor.

!esponse to enquiry reply in ma7imum = working days *or else reasons to

delay+.

%art payment processing within 1 working days of receipt of preliminary

survey report and submission of required information or documents from

insured.

?B


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%art payment approval in 1: hours.

2inal survey report within /H days of submission of required information or

document from insured 2inal survey report within /H working days of the

submission of required information or documents from insured.

This is forwarded to IT0I corporate office *3umbai+ and from there cheques

are issued.

2inally, the cheques are given to client.

ITGI C#'/ S%++%/%n+ S+#+'+'$

FY 27-8

'uring 1HH:&H= total nos. of claims reported is ?A,:=B

-o. of claims settled during this period is ?:,9/1

ustomer satisfaction inde7 is over G/R as observed through a market survey

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FY 28-9

IT0Is claims department has processed more than /,9B,HHH claim

Settlement ratioF G1R

This includes ma)or atastrophic 2loods in 0u)arat 5 3umbai

CHAPTER: 2

AH


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DOCUMENTS

C#'/ D,$!/%n+

2ollowing are the document which are required at the time of settlement of claimsF&

I P",.,# F,"/

II C,@%" n,+%

A/


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III In+'/#+',n ,* C#'/

IV C#'/ F,"/

V S!"@%; R%.,"+

VI O+4%" 6,$!/%n+

I P",.,# F,"/

The proposal form is the basis of insurance. It is so desired as to elicit all

information necessary for a proper evaluation of the risk and for rating. The

queries made in the form are the minimum requirement to be furnished by the

proposer. It includesF

%roposer name

4ddress

;ccupation

'etails of $ehicles to be insuredF&

'etails of vehicle, such as !egistration letters and -umbers,

make of the vehicle, "ngine and hassis no., >ear of 3anufacture, Type of

A1


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ody, and Seating apacity for pvt. ars, 'ate of purchase and price paid,

I'$ of the vehicle.

'etails of Insurance history for the purpose of ancellation, 'eclinature.

'etails of other vehicle, if owned by the proposer.

II C,@%" N,+%

A9


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4 cover note is usually issued when the policy and the certificates of insurance

cannot be immediately issued for any reasons. and it is issued only in form =1 in

terms of !ule,/:1, Sub rule*/+ of the entral 3otor $ehicles !ules, /GBG.

4ccording to which it is unstamped document and is valid for a period of si7ty

days from the date of its issue. It containsF

!egistered mark and no.

3ake and cubic capacity

-ame 5 address of insured

"ffective date of commencement of insurance

"7piry date

6imitation to use

4dditional risk

Special conditions.

A:


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9. It enables the Insurer to take preliminary view on whether there is likely any

Third party claim.

:. It enables the Insurer to take a view to the severity of the potential cost of the

claim.

IV C#'/ F,"/

The format and the contents of the claim form differ from ompany to ompany

but the forms contain question relating to the following particularsF&

A T4% In!"%6

The name of insured,

4ddress,

;ccupation,

%olicy no.,

'ate of payment of last premium.

This information leads to identify the policy in the insurers records, and to

supplement the preliminary scrutiny.

A?


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B T4% V%4'$%

3ake and >ear,

orse %ower or ubic apacity,

!egistered letters 5 number

This helps in checking that whether the claimant is the owner of the vehicle or is it

hired to him under a hire purchase agreement.

2or a ommercial vehicle, the additional questions are being asked such asF

!egistered 6aden Weight

-ature of goods carried

C T4% U% ,* V%4'$%

Is it used for social, domestic purposes

Is it used for business purposes

Is it used hire or reward

Were passengers being carried

D T4% D"'@%"

-ame of the driver,

AA


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4ge

4ddress of the driver,

Is driver is paid.

E W'+n%%

-ame and address of all witnesses of 4ccident

i. %assengers in the car

ii. Independent witnesses

iii. If his name not taken then reasons for it

iv. -ame address of police constable witness.

2ull e7tent of personal in)uries or damage to property.

F In!"; +, D"'@%"

The question readsF&

CWas any in)ury sustained by your driver or occupants of your motor vehicle or by any

third party If so, then state full e7tent.

If any in)ured person has been removed to the hospital or medically attended to,

give name and address of the ospital or 'octor.D

AB


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G D#/#(% +, V%4'$%

2ull particulars of damage

"stimated cost of repairs

4ddress where damaged vehicle may be inspected.

4lso, a brief particular about the accident is to be mentioned and it is to be attached

with the signature of insured.

V S!"@%; R%.,"+

The survey report would amplify the information obtained in the claim form and also

incorporate additional information. There is no standardi(ed form for survey report,

but the following information is e7pected in a survey report F&

A A$$'6%n+

AG


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'ate of occurrence

Time

%lace

ause

Special features

%hotographs

B A%/%n+ ,* L,

6abour

%arts less depreciation

'eductible, if any

Salvage.

C N%+ L'#''+; ,* In!"%"

BH


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6abour P %arts *less depreciation+ #'eductibleN salvage !s

D G%n%"# O%"@#+',n

These would relate to compliance with policy conditions, warranties, etc. this

would be followed by surveyors recommendation regarding the payment of the claim.

If adverse features are involved, the surveyor would leave the settlement question to

the insurers, giving the reasons.

VI O+4%" D,$!/%n+

B/


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The other document required for proceeding the claim are F&

/+ 'riving 6icense

1+ !egistration ertificate ook

9+ 2itness ertificate

:+ %ermit

=+ %olice report

?+ 2inal bill from repairer

A+ Satisfaction note from the insured

B+ !eceipted bill from the repairer, if any.

CHAPTER: 3

B1


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Losses Covere

U!er

C"#$% Se&&"e%e!&

B9


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PROCESS OF SETTLING LOSSES

laims under 3otor %olicies can be of three types namelyF C,n+"!$+'@% T,+# ,)

L,% ,n R%.#'" #' #n6 T4'"6 P#"+; C#'/.

LOSSES ON REPAIR BASIS

Whenever a surveyor finds that the vehicle is either beyond repairs or the repairs are

not an economic propositions, he negotiates with the insured to assess the loss on the

total loss basis # for a reasonable sum representing the market value of the vehicle

immediately prior to loss.

If the market value is more than the insured value, the settlement will be brought about

for the settlement value. The insured will be paid in cash and the insurers will take

over the salvage of the damaged vehicle which will thereafter be disposed off for their

own benefit calling tenders through advertisement in the newspaper.

owever, before the actual payment is made to the insured, the insurers will collect

from him the !egistration and Ta7ation books, ignition keys and the bank T.;. and

T.T.;. forms duly signed by the insured, so that the salvage can be transferred in the

name of the salvage buyer.

Total loss can also arise due to the theft of the vehicle and is remaining untraced by the

police authorities till the end. These copies have to be supported by a copy of 2.I.!

lodged with the police immediately after the theft has been detected. %olice authority

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register the complaint allotting in a number of the entry made in the Station diary. This

number which is usually known as S'" or .!. -o. has to be quoted by the insured in

the claim intimation to the insurers.

The police keep the investigation going until the vehicle is traced and delivered to its

owner. owever, if they do not succeed in recovering the vehicle after a period of say,

9&: months, they file away a case is certifying that the case is classified as true but

undetected. This certificate is essential before a total loss following theft is settled by

the insurers.

The document to be submitted by the insured will be the same as those described

above. If the !. book and the ta7ation certificate are also stolen along with the

vehicle, it will be necessary for the insured to obtain duplicate ones from the

!egistering 4uthority and thereafter deposit them with the insurers. The only

additional document will be a letter addressed by the insured to the !.T.; informing

about the loss of the vehicle due to theft and filing of a -on&


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TOTAL LOSS TL< AND CONSTRUCTIVE

TOTAL LOSS CTL< SETTLEMENT

Insureds 'eclared $alue is deemed to be the CS


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2or the purpose of T6N T6 claim settlement this I'$ will not change the during the

currency of the policy period. It is clearly understood that the liability of the insurer

shall in no case e7ceed the I'$ as specified in policy schedule less the value of the

wreck, in as is where is condition.

BB


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CASH LOSS SETTLEMENT


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A..'$#+',n ,* S0' L%#"n+ #+ NSB

3y college -S has taught me various skills likeF

6ife skills

3arketing skills

2inancing skills


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W4#+ I D'6

Inwarding of cover note

Telecalling

illing

heques dispatch

!egistering claim intimation in software *polisy :HH+

Solving clients queries

3aintaining 'atabase


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ack office work

CAREER PATH

4s far as question of career path is concerned now I can say that I am really interested

for making a career in insurance sector. The reason is that this industry offers a great

variety of )obs. 3oreover, I think there is a huge scope for new talent in insurance

research field. In this field one need to keep abreast of new technology, ahead of

general insurance and also it is a booming sector nowadays.

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FUTURE LEARNING

4s far as future learning is concerned this pro)ect has generated sufficient interest

within me to acquire thorough knowledge in insurance sector. 2rom the very first day

of my life at -S, I had planned to take up 2inance as my speciali(ation and I will still

go for that but now I am sure to study insurance as my minor sub)ect. The reason is

very simple I have felt the work very e7citing, dynamic and challenging. In addition to

this I am planning to acquire certifications like 6icentiate, 4ssociate, and 2ellowship

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from Insurance Institute of India. These will boost my learning in insurance domain

and can launch my career in a different orbit.

P"#$+'$# L%#"n'n( In ITGI:

PART & I

P"%/'!/ C#$!#+',n:

!%+',nF $alue of a new two wheeler O !s.9A, HHHN&

0eographical 4rea of ;perationF one

G=


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If the policy is further renewed, so it would be as per the table, for the first renewal

i.e./=R and if there is no claim than bonus is being granted as per the table.

PART & II

T4% C#'/ In+'/#+',n

If a claim arises, than first of all the insured will intimate the Insurer by providing hisN

her policy no. such as 9BG/B:/A. 4t that time the confirmation of policy is being

checked by the Insured in the Software.

GA


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4t that moment the date of loss is also required such as /=N=NHB, and the cause should

be pro7imate.

The claim form is being is submitted by the Insured within seven days and with that

the estimate from !epairers for verification is also being submitted. The receipt of spot

survey is also submitted after assessing the damages, and a 2I! is also being obtained

if in)uries or death is being reported. The claim is not being paid as per the Insured but

it is being assessed by the surveyor. The surveyor maintains a report, under which the

depreciation is being charged as per the consistency and quality of the parts of the

vehicle. Such as forF

/. 2ibreN !ubberF =HR

1. 3etal F/HHR

9. 'entingF 2ull

:. 6abor hargesF full

4fter the completion of repairs, submission of repair bills, checking of bills and

settlement of claim is being done. The data is being stored in the software.

GB


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INTERNET:

www.iifcotokio.co.in

www.google.com

www.wikipedia.com

www.insuranceindia.com

www.encyclopedia.com

4 special thanks to 4bhishek Sir for guiding me in my pro)ect report and for providing

me the relevant data that I required from time to time.

/HH


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P",.,# F,"/

C,@%" n,+%

In+'/#+',n ,* C#'/

C#'/ F,"/

S!"@%; R%.,"+

M,+," T#"'** C4#"+

Documents

REPORT ON CLAIM SETTLEMENT.doc