General Insurance Claims Handling
This domain tests the claim lifecycle: notification, registration, documentation, survey, decision and payment. Expect questions on surveyor requirements, settlement timelines, interest for delay and the insurer's right to repudiate.
Core rules
- The insured must notify the insurer promptly and submit the claim form with proof of loss, ownership, value and repair estimates.
- A licensed surveyor is appointed where required under the Insurance Act 1938 and IRDAI (Surveyors and Loss Assessors) Regulations 2015. The surveyor assesses the loss; the insurer decides the claim.
- Under IRDAI (Protection of Policyholders' Interests) Regulations 2017, the insurer should settle within 30 days of receiving the last necessary document. Delay attracts interest at 2% above the bank rate.
- The insurer may investigate fraud, apply policy exclusions, excess and average, and seek subrogation before paying a third-party loss.
- A discharge voucher should be obtained on settlement; a repudiation must state the policy reason.
Worked example
A theft claim is notified on 1 March. The last necessary document arrives on 20 March. The 30-day period ends on 19 April. If payment is made on 30 April, the insurer should pay interest at 2% above the bank rate for the delay from 20 April to 30 April, in addition to the admitted claim.
Traps
Do not treat the surveyor's report as the final decision. Do not settle a surveyable loss without a report. Do not ignore the date of the last document. Do not miss the excess, average or salvage. Do not pay a subrogated loss without a letter of subrogation.