Thursday, December 30, 2010
Mutual Fund Growth Vs Mutual Fund Dividend option
Are you confused while selecting mutual fund dividend or mutual
fund growth option? Are you not clear how your selection will impact your
investment portfolio?
Most of the mutual fund offers two schemes
1) Dividend option – Payout or ReInvest
2) Growth option
What does Mutual fund
scheme mean?
Mutual fund dividend payout option – Declared dividend amount
will be paid back to you and
Saturday, December 18, 2010
Private insurance company claim settlements facts
Did you like life insurance policy of private insurance company? But you do not have details of these insurance company’s claim settlements. Or you do not trust private insurance company’s track records.
It’s best advised to check private insurance company’s track record before taking their policies. I will show you how you can see their claim settlement details on their respective
Mutual Fund dividend declaration facts
When financial year is about to end, Many
mutual funds AMC starts declaring dividends on their tax saving mutual funds or
ELSS funds. It’s purely a marketing trend for their ELSS mutual funds. Many
Investors apply for such funds without looking at past performance records of funds.
Let me explain that you are getting your own money in the name of mutual fund
dividends.
Example: Let's us assume
mutual funds AMC starts declaring dividends on their tax saving mutual funds or
ELSS funds. It’s purely a marketing trend for their ELSS mutual funds. Many
Investors apply for such funds without looking at past performance records of funds.
Let me explain that you are getting your own money in the name of mutual fund
dividends.
Example: Let's us assume
Monday, November 29, 2010
Volumes can result in reduction in health care costs
Fortune India in their October 2010 issue has covered a detailed write up on Medanta Hospital, Gurgaon and it has some interesting facts.
Medanta has ambitious plan to increase the number of beds ultimately to 1800 beds. This will lead to efficiency in use of equipment / resources and this is the reason why Medanta is charging 15% to 60% lower than what other hospitals are charging. These facts support the fact that Large hospitals can be competitive.
Medanta has ambitious plan to increase the number of beds ultimately to 1800 beds. This will lead to efficiency in use of equipment / resources and this is the reason why Medanta is charging 15% to 60% lower than what other hospitals are charging. These facts support the fact that Large hospitals can be competitive.
Tuesday, November 23, 2010
Medical bills contribute towards 62% of bankruptcies among families
Harvard University in USA has collected data for 2007 and has come out with the study that medical bills contribute towards 62% of bankruptcies among families.
We are assuming that this study was focussed on US families.Our estimates are that even in other countries the similar figures are applicable.Recently we have come across a family in Delhi which had to sell their 2 properties to pay for kidney transplant. They had no other alternative as they were not having any health insurance.In the legal terminology this family has not gone in for bankruptcy but selling of 2 properties and moving to a rented house is same thing.
We are assuming that this study was focussed on US families.Our estimates are that even in other countries the similar figures are applicable.Recently we have come across a family in Delhi which had to sell their 2 properties to pay for kidney transplant. They had no other alternative as they were not having any health insurance.In the legal terminology this family has not gone in for bankruptcy but selling of 2 properties and moving to a rented house is same thing.
Thursday, November 11, 2010
Ayurveda, Unani, Siddha , Homeopathy have started getting recognition
Over period of time we have propagated due recognition to be given to Ayurvedic / Homeopathic /Unani/Siddha system of health care,which is used by crores of persons living in different parts of India.In our country we are having over 250 Ayurvedic Medical colleges.It is good to notice that HDFC Ergo Health Suvidha policy pays for medical expenses for inpatient treatment under Ayurveda, Unani, Siddha or Homeopathy. It pays upto 20% of Sum Insured; Maximum Rs. 20,000 (for Policy Sum Insured 2L & 3L) and Rs. 25,000 (for policy Sum Insured Rs. 4L).
This amount is less but we appriciate the beginning.We do hope other Insurance companies will also start coverage under Ayurveda, Unani, Siddha , Homeopathy system of treatment.Why not have a policy which is only for Ayurveda, Unani, Siddha , Homeopathy.Why to charge someone (who beleives in treatment under these syatems) for 100 and give benefit of 6 ( Rs. 25000 against sum assured of Rs 4 lakh)
This amount is less but we appriciate the beginning.We do hope other Insurance companies will also start coverage under Ayurveda, Unani, Siddha , Homeopathy system of treatment.Why not have a policy which is only for Ayurveda, Unani, Siddha , Homeopathy.Why to charge someone (who beleives in treatment under these syatems) for 100 and give benefit of 6 ( Rs. 25000 against sum assured of Rs 4 lakh)
Tuesday, October 26, 2010
Pay higher premium to avail treatment in good /super speciality hospitals
Yes. Paying lower or normal premium and getting treated in good/super speciality hospitals will be a history in 2011.Either you will forget about good/super speciality hospitals
or
you will pay higher premium.
Time has come to relook at your policy - should it be renewed with same PSU or to a different Pvt insurance company or health insurance company
or
you will pay higher premium.
Time has come to relook at your policy - should it be renewed with same PSU or to a different Pvt insurance company or health insurance company
Thursday, October 7, 2010
Heart Diseases are responsible for maximum number of deaths
Civic run Hospitals in Mumbai have compiled data for 2001- mid 2010 period and 97677 persons died during this period due to heart attack/ailments. This is 34% or total deaths across these hospitals over the period.
According to Dr Pavan Kumar Consultant Cardiologist of Lilavati Hospital the reasons for heart attack can be.
• Poor Oral Hygiene
• Malnourishment
• Lack of adequate vitamin B-12/ Folic Acid in the diet
• Social Stress due to work pressure
According to Dr Brian Pinto, another authority and affiliated to Holy Cross Hospital the reasons for heart attack can be
• Not loading much physically active life
• Eating unhealthy foods
Costs related to hospitalization due to heart ailments in good hospitals are high and may be in the range of Rest. 1.50 lakhs to Rs. 5.00 lakhs .This fact should be kept in mind while buying health insurance. Sum assured of Rs. 1.00 lakh may turn out to be too less when the bill comes out to be Rs. 3.50 lakhs or Rs. 5.00 lakhs.
According to Dr Pavan Kumar Consultant Cardiologist of Lilavati Hospital the reasons for heart attack can be.
• Poor Oral Hygiene
• Malnourishment
• Lack of adequate vitamin B-12/ Folic Acid in the diet
• Social Stress due to work pressure
According to Dr Brian Pinto, another authority and affiliated to Holy Cross Hospital the reasons for heart attack can be
• Not loading much physically active life
• Eating unhealthy foods
Costs related to hospitalization due to heart ailments in good hospitals are high and may be in the range of Rest. 1.50 lakhs to Rs. 5.00 lakhs .This fact should be kept in mind while buying health insurance. Sum assured of Rs. 1.00 lakh may turn out to be too less when the bill comes out to be Rs. 3.50 lakhs or Rs. 5.00 lakhs.
Friday, October 1, 2010
Yes medical expenses can be high
According to news paper reports Punjab Chief Minister medical expenses for 2 months were Rs 85 Lakhs.
This proves that medical expenses can be high. It is better to plan by buying health insurance unless you are a Minister/Chief Minister like Punjab Chief Minister as mentioned in this news.
This proves that medical expenses can be high. It is better to plan by buying health insurance unless you are a Minister/Chief Minister like Punjab Chief Minister as mentioned in this news.
Monday, September 27, 2010
Tax Saving Infrastructure bonds 2010 details
Finally the wait is over
to get accurate details of the Tax Saving Infrastructure bonds 2010 where you
can get tax exemptions of amount Rs 20000 in financial year 2010-2011 under
Section 80CCF.It is an additional to 1Lac exemption limit under Section 80C.
IDFC(Infrastructure
Development Finance Company) has announced a public issue of long term
infrastructure bonds to get the capital of up
to get accurate details of the Tax Saving Infrastructure bonds 2010 where you
can get tax exemptions of amount Rs 20000 in financial year 2010-2011 under
Section 80CCF.It is an additional to 1Lac exemption limit under Section 80C.
IDFC(Infrastructure
Development Finance Company) has announced a public issue of long term
infrastructure bonds to get the capital of up
Wednesday, September 22, 2010
We knew it will not happen on Sep 17,2010
In the International Health Insurance Summit ( organised by CII)held on Sep. 9 & 10,2010 in one of the panel discussion attended by high ups of Health care providers /Insurance companies ( mainly PSU) it was agreed that agreement to resolve the PPN issue will be reached by Sep. 17,2010 .This is necessary so that inconvenience is not caused to policy holders ,who are suffering since July1,2010.
We knew this agreement will not be reached because gap in expectation by both parties is too much.Healthcare providers are ready to give a discount of 5 to 7% but this is not at all acceptable to PSU insurance companies.This issue has complication that if the Good/super specilaity hospitals agree to the need of PSU's they may have to give same terms to Private Insurance Companies.That will affect the financial projections of health care providers who have got funding from investors,banks,PE funds and VC funds.This may also bring down price of the share in the stock market and hence the wealth of the promoters.
We knew this agreement will not be reached because gap in expectation by both parties is too much.Healthcare providers are ready to give a discount of 5 to 7% but this is not at all acceptable to PSU insurance companies.This issue has complication that if the Good/super specilaity hospitals agree to the need of PSU's they may have to give same terms to Private Insurance Companies.That will affect the financial projections of health care providers who have got funding from investors,banks,PE funds and VC funds.This may also bring down price of the share in the stock market and hence the wealth of the promoters.
Friday, September 17, 2010
Pvt companies to follow PSU's health insurance PPN package rates
Is it a cartel ?Is is competition?While the Indian customers are confused with what has happened since July 1,2010.We hear Pvt Insurance companies are also going to follow PPN pacage rates finalized by PSU's with hospitals in 4 metros.While customers were thinking of switching over to Pvt companies when the renewal will be due,this news is definitely a disheartening news .
Is it that PSU's acted as the leader and Pvt companies have been following them.
We understand premium products are going to be out -premium is going up.We were always of the view that premium should be always at the right level.Fix it at right level and treat the customer with respect ,which he/she deserves.
Is it that PSU's acted as the leader and Pvt companies have been following them.
We understand premium products are going to be out -premium is going up.We were always of the view that premium should be always at the right level.Fix it at right level and treat the customer with respect ,which he/she deserves.
Direct Tax code bill 2010-2011
The Finance minister
proposed new direct tax code in the parliament in FY 2010.It will be effective from 1st
April 2011.
Theme of the direct tax code bill:
1) Less investment instruments so less confusion for tax payers to invest and get tax exemptions.
2) Invest in long term
investment instruments to get tax exemptions.
3) Opt for term insurance
for higher converge for dependants (More
Wednesday, September 15, 2010
PF interest rate increased to 9.5% for FY 2010-2011
Summary:
The government Employees' Provident Fund Organization (EPFO) has
announced the increase in interest rate of employees’ provident fund from 8.5% to 9.5% for the current financial year 2010-11.
Impact:Every employees of private and public sectors will earn more
interest in their PF contribution for this year.
Why do they increase interest rate for current financial year?
Increasing
The government Employees' Provident Fund Organization (EPFO) has
announced the increase in interest rate of employees’ provident fund from 8.5% to 9.5% for the current financial year 2010-11.
Impact:Every employees of private and public sectors will earn more
interest in their PF contribution for this year.
Why do they increase interest rate for current financial year?
Increasing
Saturday, September 4, 2010
Bajaj Allianz has also increased premium rates for Health Insurance
Bajaj Allianz has also increased premium rates for Health Insurance.
Sometime back Reliance General Insurance Co. Ltd. had increased the premium rates for health insurance.
Bajaj Allianz General Insurance Co. Ltd. has announced increased rates and with this, their rates are 20% higher than that of premium rates of Reliance General.
Let us see comparison of old rates vs. new rates of Bajaj Allianz for a family floater policy where the age of head of the family is 32.
Let us see the comparison of Bajaj Allianz rates with Reliance General/Max Bupa
You may be surprised to see increase of the order of 20% but I was expecting this to happen for quite sometime.
As mentioned earlier in one of my earlier blog no insurance company can go on losing money for a long time as ultimately the shareholders want return on their investment.
As the companies have started getting ready for IPO as well as to release / figures in press (every 6 months) / website (every 3 months) this was expected to happen.
We understand that PSU’s are also going to release new rates where they will call the product as premium product where cashless treatment in good hospitals will be permitted. We expect the rates to be at par with rate of Bajaj Allianz General Insurance Co. Ltd. Let us wait for the announcement.
Sometime back Reliance General Insurance Co. Ltd. had increased the premium rates for health insurance.
Bajaj Allianz General Insurance Co. Ltd. has announced increased rates and with this, their rates are 20% higher than that of premium rates of Reliance General.
Let us see comparison of old rates vs. new rates of Bajaj Allianz for a family floater policy where the age of head of the family is 32.
Let us see the comparison of Bajaj Allianz rates with Reliance General/Max Bupa
You may be surprised to see increase of the order of 20% but I was expecting this to happen for quite sometime.
As mentioned earlier in one of my earlier blog no insurance company can go on losing money for a long time as ultimately the shareholders want return on their investment.
As the companies have started getting ready for IPO as well as to release / figures in press (every 6 months) / website (every 3 months) this was expected to happen.
We understand that PSU’s are also going to release new rates where they will call the product as premium product where cashless treatment in good hospitals will be permitted. We expect the rates to be at par with rate of Bajaj Allianz General Insurance Co. Ltd. Let us wait for the announcement.
Tuesday, August 31, 2010
We are spoiling the image of Health Insurance Industry
Decision of TPA's to go for legal action/Competition Commission /IRDA against 4 PSU's tender for TPA JV is resulting in spoiling the image of Health Insurance Industry.
The newspapers /electronic media are covering it as it is their business to do news coverage.
We are not realising that this is leading to customers losing confidence in the industry.
The newspapers /electronic media are covering it as it is their business to do news coverage.
We are not realising that this is leading to customers losing confidence in the industry.
Friday, August 27, 2010
Cigna USA is ready to come
It is a welcome news that Cigna Health Insurance is ready to enter the Indian market and is having discussions with many banks.
PNB is one of the banks.Can we say that health portfolio will become profitable in near future ?
PNB is one of the banks.Can we say that health portfolio will become profitable in near future ?
Friday, August 20, 2010
Health Care providers bargaining with Insurance companies -Is it affecting the image of Indian Insurance companies
The news papers and TV channels are covering the news of neogotiations going on between healthcare providers/TPA/Insurance Companies (4 PSU's).Waht apperas in the morning newspaper is contradicted during the day on TV.
Is it not bringing down the reputation of healthcare providers/TPA/Insurance Companies?
They are not realizing what the customers are talking about them.Their reputation has come down by 50% since July 1 ,when the controversy started.
Is it not bringing down the reputation of healthcare providers/TPA/Insurance Companies?
They are not realizing what the customers are talking about them.Their reputation has come down by 50% since July 1 ,when the controversy started.
Monday, August 16, 2010
Should PSU's have a common TPA or they should create a subsidiary
Should PSU’s create a common TPA or they should create a stand alone health insurance company?
Creation of a common TPA is not looking at the future. The right thing for the PSU’s will be to set up a JV company (ownership being shared by 4PSU companies, may be 25 % each) and then have in house claim settlement department. If Bajaj Allianz, Star and others are having success in house claim settlement department then this company (let us say for discussion sake GIPSA Health Insurance Company Ltd) can also have in house claim settlement department, strong Business Development Department to negotiate with Health Care Providers, Medical Devices Manufacturers, even Pharma suppliers so that they can have economies of procurement, use of technology to best possible extent. With the first year target of Rs 10,000 crores this company will be strong enough to negotiate and emerge the trend setter for growth of health insurance industry in our country. What NTPC did for power generation and BHEL did for Power Generation Equipment can be expected from this strong health insurance company.
We feel JV TPA with any one who is selected will not work as TPA Company (26%) will be the driving force or 4 companies who will jointly own74% .This option is not going to work.
The only successful model will be a stand alone GIPSA Health insurance Company. This strong company manned by those who specialize in health insurance, who are dedicated to make career in health insurance, who have passion for health insurance will be the solution. In 5 yrs this company can reach level of Rs 25,000 crores, may be Rs 40,000 crores.
Creation of a common TPA is not looking at the future. The right thing for the PSU’s will be to set up a JV company (ownership being shared by 4PSU companies, may be 25 % each) and then have in house claim settlement department. If Bajaj Allianz, Star and others are having success in house claim settlement department then this company (let us say for discussion sake GIPSA Health Insurance Company Ltd) can also have in house claim settlement department, strong Business Development Department to negotiate with Health Care Providers, Medical Devices Manufacturers, even Pharma suppliers so that they can have economies of procurement, use of technology to best possible extent. With the first year target of Rs 10,000 crores this company will be strong enough to negotiate and emerge the trend setter for growth of health insurance industry in our country. What NTPC did for power generation and BHEL did for Power Generation Equipment can be expected from this strong health insurance company.
We feel JV TPA with any one who is selected will not work as TPA Company (26%) will be the driving force or 4 companies who will jointly own74% .This option is not going to work.
The only successful model will be a stand alone GIPSA Health insurance Company. This strong company manned by those who specialize in health insurance, who are dedicated to make career in health insurance, who have passion for health insurance will be the solution. In 5 yrs this company can reach level of Rs 25,000 crores, may be Rs 40,000 crores.
Thursday, August 12, 2010
Premium Health Insurance Product will have the same features which you were getting prior to July 1,2010
Those desirous of availing healthcare facilities of reputed super speciality hospitals may have to buy new products in near future .It is natural that premium rates for these products will be higher.PSU's will be introducing new product in near future.
Saturday, August 7, 2010
Private Business houses owning own Insurance companies bought group health insurance policies from PSU’s
It is interesting to note from Government auditor CAG that public sector insurance companies have incurred huge losses on group mediclaim policies because of
Their lackluster attitude in adopting a standard rate for medical services.
According to the report during the three years (2006-09), the four PSUs suffered a loss of Rest 417 core from individual portfolio and Rest 622.49 core from group policies.
The CAG said that the premium earned by the four insurance companies nearly tripled to Rest 3,696 core in 2008-09, from Rest 1,321 core in 2004-05. It also said that some of the big corporate houses, despite having their own group company in this sector took policies with PSU insurers.
The report said that against Rest 11.74 core premium collected from IT firm TCS; claims paid only for domiciliary hospitalization were Rs 71.64 crore. "Despite its own group company being in the health insurance business, TCS, Tata Motors and Tata Power went for group policies with PSU insurers," it said.
The insures should have increased the premium of the policies when they come up for renewal every year, but "the four insurance companies did not do this in respect of group policies resulting in a loss of premium of Rs 329.68 crore for three years ended March 31, 2009," it said.
The report said the group policy holders were given additional benefits such as maternity, baby day one care, preexisting diseases among others, without charging additional premium. The CAG also pulled up the insurance companies for failing to monitor the quality of services offered by the TPAs to the insured, which in turn impacted customer satisfaction.
Let us see what will be the impact of this report.
Will it result in hardening of premium rates? Yes definitely this is going to happen.
Their lackluster attitude in adopting a standard rate for medical services.
According to the report during the three years (2006-09), the four PSUs suffered a loss of Rest 417 core from individual portfolio and Rest 622.49 core from group policies.
The CAG said that the premium earned by the four insurance companies nearly tripled to Rest 3,696 core in 2008-09, from Rest 1,321 core in 2004-05. It also said that some of the big corporate houses, despite having their own group company in this sector took policies with PSU insurers.
The report said that against Rest 11.74 core premium collected from IT firm TCS; claims paid only for domiciliary hospitalization were Rs 71.64 crore. "Despite its own group company being in the health insurance business, TCS, Tata Motors and Tata Power went for group policies with PSU insurers," it said.
The insures should have increased the premium of the policies when they come up for renewal every year, but "the four insurance companies did not do this in respect of group policies resulting in a loss of premium of Rs 329.68 crore for three years ended March 31, 2009," it said.
The report said the group policy holders were given additional benefits such as maternity, baby day one care, preexisting diseases among others, without charging additional premium. The CAG also pulled up the insurance companies for failing to monitor the quality of services offered by the TPAs to the insured, which in turn impacted customer satisfaction.
Let us see what will be the impact of this report.
Will it result in hardening of premium rates? Yes definitely this is going to happen.
Monday, August 2, 2010
HOW TO ENSURE A SMOOTH CLAIM SETTLEMENT IN CASE OF EMERGENCY HOSPITALISATION
Most of the problems of insurance companies and healthcare providers will be solved by August 10,2010
Every one is talking about the controversy which started on July 1,2010. Yes it started with names of about 800 hospitals being deleted from the list of empanelled
hospitals.
Meetings are going on between insurance companies and health care providers and you can expect solution of the problem by August 10,2010
Let us hope for the best.
hospitals.
Meetings are going on between insurance companies and health care providers and you can expect solution of the problem by August 10,2010
Let us hope for the best.
Thursday, July 29, 2010
Insurance companies to buy medical devices and medicines at wholesale /negotiated rates to save money
It is nice to know that Insurance companies will now be buying devices like stunt/pace maker at whole sale or say negotiated rates from manufacturers with a view to save on their claim costs.
It is also laernt that hospitals have been buying medicines at whole sale rates and were billing to the insurance companies at retail rates.This practice will also stop.
Any steps taken by the insurance industry to reduce the claim cost is welcomed.Let all of us support this initiative.
It is also laernt that hospitals have been buying medicines at whole sale rates and were billing to the insurance companies at retail rates.This practice will also stop.
Any steps taken by the insurance industry to reduce the claim cost is welcomed.Let all of us support this initiative.
Wednesday, July 28, 2010
Where to lodge your insurance related grievances?
Where to lodge your grievances?
Various options available with any consumer in India are to lodge complain
1. Grievance cell of Insurance Company (after pre empting your phone calls/ visits to their branch, which issued you the policy )
2. Insurance Ombudsman
3. Consumer Forum (at District level, State level and National level)
4. IRDA, which is the new addition.
We welcome the service started by IRDA(insurance regulatory and development authority. But the question before us is why we should have too many authorities for grievance resolutions.
Is it not the responsibility of the Insurance Company to provide service as a part of the product? Why they do not show the name of Grievance Officer, phone no/email on their website. Why they do not have online grievance lodging facility?
The consumers will like to have the data- how many cases lodged against the company in Consumer Forums? How many have been decided? How many have gone in favour of the insurance company and how many have gone against them?
Should there be a fee for lodging a complaint so that incomplete complaints are neither lodged nor received.
Various options available with any consumer in India are to lodge complain
1. Grievance cell of Insurance Company (after pre empting your phone calls/ visits to their branch, which issued you the policy )
2. Insurance Ombudsman
3. Consumer Forum (at District level, State level and National level)
4. IRDA, which is the new addition.
We welcome the service started by IRDA(insurance regulatory and development authority. But the question before us is why we should have too many authorities for grievance resolutions.
Is it not the responsibility of the Insurance Company to provide service as a part of the product? Why they do not show the name of Grievance Officer, phone no/email on their website. Why they do not have online grievance lodging facility?
The consumers will like to have the data- how many cases lodged against the company in Consumer Forums? How many have been decided? How many have gone in favour of the insurance company and how many have gone against them?
Should there be a fee for lodging a complaint so that incomplete complaints are neither lodged nor received.
Friday, July 23, 2010
Doctors, not insurance cos & TPA’s will judge urgency of cases
Yes there may be time lag of 10 years in coming of the judgment but it is heartening to note that Maharashtra State Consumer disputes Redressal Commission has agreed that it is the doctor ,who has to decide whether it is emergency or not. It is good that this will not be for TPA’s to decide whether it is emergency or not.
It is interesting to note the observations
“An insurance company’s officials are not experts who can decide whether a particular case is of medical emergency or not, the Maharashtra State Consumer disputes Redressal Commission observed while ordering an insurance company to pay Mediclaim to a Versova resident. It is for the expert doctor in the field to give an opinion if this is case of medical emergency or not, the commission stated in its order. The case dated back to 2000. Shamim Khan was working as a schoolteacher in Jeddah, Saudi Arabia. It was during a visit to India in July 2000 that she suffered unbearable stomach pain that led to severe bleeding.
She also experienced breathing problems and her haemoglobin levels began to drop considerably. Khan was admitted to Bombay Hospital immediately where an emergency surgery was conducted. She was discharged after eight days of stay in the hospital and, after incurring a total expenditure of Rs 41,158, Khan lodged a claim for insurance with the New India Assurance Company Limited from whom she had taken a policy. The policy was in force from April 2000 to March 2001.
Kahn’s claim was, however, rejected on the ground that there was no emergency need to undergo the operation” Aggrieved by the repudiation letter she filed a complaint in a district consumer forum, where the insurance company argued that “she (Khan) knew of the illness even before she came to India and had purchased the policy by suppressing material facts of her illness”, son it had the right to repudiated the in surer pleaded.
Khan had, however, procured a doctor’s certificate to the effect that there was an emergency situation and the doctor was required to operate on her to save her life.
Based on this document, the district forum on July 7, 2007, directed the insurance company to pay the medical claim and also Rs 5000 for causing mental harassment to Khan.
The insurance company then filed an appeal against the order in the state commission. But the state commission agreed with the district forum’s view, saying “doctor’s certificate proved beyond doubt that this was clearly a case of medical emergency”.
The commission, while up holding the order of the district forum, added that the insurance company had wrongly repudiated Khan’s claim.
The order- coming at a time when insurance firms are desperately trying to whittle down expenses on claims –will spread cheer among the insured, feel consumers; organizations.
The name of the insurance company was not mentioned in the news which appeared in a leading newspaper .If you know the name of the insurance company then do let us know.
While we respect and appreciate the judgment –it will be better if the fine imposed on such co is higher, because Rs 5000 is a negligible amount for large insurance companies.
It is interesting to note the observations
“An insurance company’s officials are not experts who can decide whether a particular case is of medical emergency or not, the Maharashtra State Consumer disputes Redressal Commission observed while ordering an insurance company to pay Mediclaim to a Versova resident. It is for the expert doctor in the field to give an opinion if this is case of medical emergency or not, the commission stated in its order. The case dated back to 2000. Shamim Khan was working as a schoolteacher in Jeddah, Saudi Arabia. It was during a visit to India in July 2000 that she suffered unbearable stomach pain that led to severe bleeding.
She also experienced breathing problems and her haemoglobin levels began to drop considerably. Khan was admitted to Bombay Hospital immediately where an emergency surgery was conducted. She was discharged after eight days of stay in the hospital and, after incurring a total expenditure of Rs 41,158, Khan lodged a claim for insurance with the New India Assurance Company Limited from whom she had taken a policy. The policy was in force from April 2000 to March 2001.
Kahn’s claim was, however, rejected on the ground that there was no emergency need to undergo the operation” Aggrieved by the repudiation letter she filed a complaint in a district consumer forum, where the insurance company argued that “she (Khan) knew of the illness even before she came to India and had purchased the policy by suppressing material facts of her illness”, son it had the right to repudiated the in surer pleaded.
Khan had, however, procured a doctor’s certificate to the effect that there was an emergency situation and the doctor was required to operate on her to save her life.
Based on this document, the district forum on July 7, 2007, directed the insurance company to pay the medical claim and also Rs 5000 for causing mental harassment to Khan.
The insurance company then filed an appeal against the order in the state commission. But the state commission agreed with the district forum’s view, saying “doctor’s certificate proved beyond doubt that this was clearly a case of medical emergency”.
The commission, while up holding the order of the district forum, added that the insurance company had wrongly repudiated Khan’s claim.
The order- coming at a time when insurance firms are desperately trying to whittle down expenses on claims –will spread cheer among the insured, feel consumers; organizations.
The name of the insurance company was not mentioned in the news which appeared in a leading newspaper .If you know the name of the insurance company then do let us know.
While we respect and appreciate the judgment –it will be better if the fine imposed on such co is higher, because Rs 5000 is a negligible amount for large insurance companies.
Diabetes and BP can’t be cited to reject claim of health insurance claims
Our health insurance providers have used diabetes and hypertension as 2 holy words to reject the claims of insured persons. It is very interesting to read the following news in The Times of India on July 23, 2010
“In another blow to a medical insurer hell-bent on rejecting a policy holder's claims, a district consumer forum has decreed that a cardiac patient cannot be denied his insurance even if he has not mentioned hypertension and diabetes as pre-existing ailments.
"We have taken the view that, in a large number of cases, diseases like hypertension and diabetes are so common and are always controllable... (so) unless a patient undergoes a long treatment, including hospitalization and undergoes operation in the near proximity of taking the policy (sic), (s/he) cannot be accused of concealment of facts," the forum said, while asking the insurer to honour the policy holder's insurance claims and also pay him Rs. 5,000 as compensation for mental agony.
In 2003, Mulund-based Karunakar Shetty underwent a "coronary arteries bypass grafting" surgery and ran up a bill of Rs 2, 53,553. On July 17, 2003, he intimated Oriental Insurance Company Ltd Co and Raksha TPA. Shetty had taken a policy in 2000 for Rs 3 lakh but, while renewing it in 2002 and 2003, the amount was reduced to Rs 1.5 lakh.
In November 2003, Raksha TPA informed him that his claim was rejected as he was suffering from hypertension even before he took the policy and hid this from the insurance company. Shetty, however, contended that he did not suffer from hypertension before he took the policy and even sent a statement from his family doctor to the insurance company. But they did not reconsider their decision, prompting him to file a complaint in the forum citing deficiency in service.
The insurance company denied the allegations and said that in 2003, while renewing the policy, Shetty mentioned that he did not suffer from any pre-existing disease. It even stated that, when the papers were submitted, the third-party authority got documents from a hospital that said Shetty had told them he was suffering from diabetes for the past four years.
The insurance company alleged that the statement submitted by the family doctor was false and argued that the heart ailment that Shetty suffered from was closely related to diabetes and this was not covered by the policy.
The forum, while passing its order took into account, the hospital discharge card that Shetty had submitted following his treatment in July 2002. From the discharge card and the report submitted by the family doctor it was evident that Shetty was suffering from hypertension and diabetes and he got to know of it only in 2002.
The forum observed that Shetty was unaware of the disease when he took the policy in 2000 and, even if he did not mention it in 2003 while renewing the policy, hypertension and diabetes could not be called ‘pre-existing diseases.’
The forum then directed the insurance company and Raksha TPA to jointly or individually pay Rs 1.5 lakh (the insurance amount) with an interest of 6% from November 2003.”
We would have been happier to know the name of the Insurance company .If you know it then do let us know.
Learning from this case is that client was having complete medical file to fight the case and to prove his point to the consumer forum. We have always suggested to you to maintain your medical file.
Diabetes and BP have been the bottleneck in the growth of health insurance .With a view to follow this judgment in the spirit –why not take a liberal view and increase the number of insured by taking these 2 diseases as a way of life for us.
We honour the judgment and with due respect wish to state that 6 % is too low interest to be paid. This should be 12 % which all of us pay. In fact large insurance companies can pay more than this.
“In another blow to a medical insurer hell-bent on rejecting a policy holder's claims, a district consumer forum has decreed that a cardiac patient cannot be denied his insurance even if he has not mentioned hypertension and diabetes as pre-existing ailments.
"We have taken the view that, in a large number of cases, diseases like hypertension and diabetes are so common and are always controllable... (so) unless a patient undergoes a long treatment, including hospitalization and undergoes operation in the near proximity of taking the policy (sic), (s/he) cannot be accused of concealment of facts," the forum said, while asking the insurer to honour the policy holder's insurance claims and also pay him Rs. 5,000 as compensation for mental agony.
In 2003, Mulund-based Karunakar Shetty underwent a "coronary arteries bypass grafting" surgery and ran up a bill of Rs 2, 53,553. On July 17, 2003, he intimated Oriental Insurance Company Ltd Co and Raksha TPA. Shetty had taken a policy in 2000 for Rs 3 lakh but, while renewing it in 2002 and 2003, the amount was reduced to Rs 1.5 lakh.
In November 2003, Raksha TPA informed him that his claim was rejected as he was suffering from hypertension even before he took the policy and hid this from the insurance company. Shetty, however, contended that he did not suffer from hypertension before he took the policy and even sent a statement from his family doctor to the insurance company. But they did not reconsider their decision, prompting him to file a complaint in the forum citing deficiency in service.
The insurance company denied the allegations and said that in 2003, while renewing the policy, Shetty mentioned that he did not suffer from any pre-existing disease. It even stated that, when the papers were submitted, the third-party authority got documents from a hospital that said Shetty had told them he was suffering from diabetes for the past four years.
The insurance company alleged that the statement submitted by the family doctor was false and argued that the heart ailment that Shetty suffered from was closely related to diabetes and this was not covered by the policy.
The forum, while passing its order took into account, the hospital discharge card that Shetty had submitted following his treatment in July 2002. From the discharge card and the report submitted by the family doctor it was evident that Shetty was suffering from hypertension and diabetes and he got to know of it only in 2002.
The forum observed that Shetty was unaware of the disease when he took the policy in 2000 and, even if he did not mention it in 2003 while renewing the policy, hypertension and diabetes could not be called ‘pre-existing diseases.’
The forum then directed the insurance company and Raksha TPA to jointly or individually pay Rs 1.5 lakh (the insurance amount) with an interest of 6% from November 2003.”
We would have been happier to know the name of the Insurance company .If you know it then do let us know.
Learning from this case is that client was having complete medical file to fight the case and to prove his point to the consumer forum. We have always suggested to you to maintain your medical file.
Diabetes and BP have been the bottleneck in the growth of health insurance .With a view to follow this judgment in the spirit –why not take a liberal view and increase the number of insured by taking these 2 diseases as a way of life for us.
We honour the judgment and with due respect wish to state that 6 % is too low interest to be paid. This should be 12 % which all of us pay. In fact large insurance companies can pay more than this.
Thursday, July 22, 2010
L&T General Insurance will also be dealing in Health Insurance
L&T General Insurance will become operational in Sep/Oct 2010 and will also be handling health insurance. It is good news as the market is growing and naturally we expect more players to come in.
This company is 100% Indian owned company and will be using TPA’s in the beginning.
According to sources this company will also be setting up its in house set up for handling health insurance claims and will ultimately stop use of TPA’s. We support good service to the clients whether it is provided through TPA’s or without TPA’s
This company is 100% Indian owned company and will be using TPA’s in the beginning.
According to sources this company will also be setting up its in house set up for handling health insurance claims and will ultimately stop use of TPA’s. We support good service to the clients whether it is provided through TPA’s or without TPA’s
Sunday, July 11, 2010
You must check whether hospital is still on the list of insurance company for cashless settlement or even reimbursement
Yes our confidence is shaken .Many of you bought the policy after verifying the list of hospitals which were having empanelment with that insurance company.In between that is from July 1 some of these hospitals are removed from the list.
In Delhi /NCR the names are
Apollo,
Fortis,
Ganga Ram,
Max
Medicity
++
Check the list before starting any treatment.It is the best way to avoid surprise.
In Delhi /NCR the names are
Apollo,
Fortis,
Ganga Ram,
Max
Medicity
++
Check the list before starting any treatment.It is the best way to avoid surprise.
All PSU's will be using common TPA
We had covered in the past that KPMG was appointed by 4 PSU's to advise them about a common TPA with a view to protect their interests.
Yes it is going to happen.It may be 1 TPA to be selected by all of them so that they can give good service to them ( 4 PSu's).As it will be a good business therefore naturally all the instructions of PSU's will be followed.
Let us wait for many things to happen.With big hospitals being deleted - Is it going to be market segmentation where HNI's will start moving to private companies like Max Bupa /Apollo Munich .
Yes it is going to happen.It may be 1 TPA to be selected by all of them so that they can give good service to them ( 4 PSu's).As it will be a good business therefore naturally all the instructions of PSU's will be followed.
Let us wait for many things to happen.With big hospitals being deleted - Is it going to be market segmentation where HNI's will start moving to private companies like Max Bupa /Apollo Munich .
Why the newspapers do not reveal the name of the hospital
The Times of India has carried the following news
"Twenty-eight-year-old Javed Akhtar, who was recently admitted to a private hospital, agrees with the TPAs. Last month, Akhtar, who works with a private firm in Noida, met with a minor accident and was admitted at a city hospital. He gave his cashless policy number to the hospital for necessary approval from the TPA. To his horror, he found that the hospital had applied for a spinal surgery and had got Rs 80,000 cleared from the TPA.
"The doctor never got any diagnostic tests like CT scan etc done. I was not even told about the surgery. They took the approval by forging my signature," alleged Akhtar, who later refused to get operated and got a police complaint registered against the hospital. But as he didn't get operated, the TPA refused to clear the bill. '
The question before us is that if the newspaper has carried the news( we appreciate this ) then why not reveal the name of the hospital so that all the insurance companies and TPA's as well as insured can keep the name of the hospital in mind- whether to go there or not.It will be agreat public service.
"Twenty-eight-year-old Javed Akhtar, who was recently admitted to a private hospital, agrees with the TPAs. Last month, Akhtar, who works with a private firm in Noida, met with a minor accident and was admitted at a city hospital. He gave his cashless policy number to the hospital for necessary approval from the TPA. To his horror, he found that the hospital had applied for a spinal surgery and had got Rs 80,000 cleared from the TPA.
"The doctor never got any diagnostic tests like CT scan etc done. I was not even told about the surgery. They took the approval by forging my signature," alleged Akhtar, who later refused to get operated and got a police complaint registered against the hospital. But as he didn't get operated, the TPA refused to clear the bill. '
The question before us is that if the newspaper has carried the news( we appreciate this ) then why not reveal the name of the hospital so that all the insurance companies and TPA's as well as insured can keep the name of the hospital in mind- whether to go there or not.It will be agreat public service.
Friday, July 9, 2010
Should you be treated by the best doctor or a team of good doctors
Harvard Business Review in its April 2010 issue has covered health care in detail.After reading this and thinking over it for sometime we feel that it is better to be treated by a team of good doctors as it is ultimately the team effort in the hospital, which matters.
May be you will consider it while deciding which hospital to go for,when the need arises.
Another good point which emerges is do not waste time and money in going for second opinion as you will ultimately choose the one which suits you.Try to get both the doctors at the same time and let them discuss your case .It is a matter of life and death for you.
May be you will consider it while deciding which hospital to go for,when the need arises.
Another good point which emerges is do not waste time and money in going for second opinion as you will ultimately choose the one which suits you.Try to get both the doctors at the same time and let them discuss your case .It is a matter of life and death for you.
Prestigious hospitals have started moving out of PSU insurance companies approved list
The change is coming and PSU's have deleted some of the prestigious hospitals from the approved list of hospitals.
A question before us is -Is it applicable for group policies also or this is another decision only applicable to retail customers comprising of families.
You must recheck the names of hospitals not on the list of approved hospitals before buying or renewing the policy.
A question before us is -Is it applicable for group policies also or this is another decision only applicable to retail customers comprising of families.
You must recheck the names of hospitals not on the list of approved hospitals before buying or renewing the policy.
Friday, June 11, 2010
Should you buy insurance from a corporate agent?
Should you buy insurance from a corporate agent?
Yes, you can buy but you must check that it is not one of the 4261 corporate agents whose licence has been cancelled by IRDA, the regulator.
The following news item is an eye opener for those who have to buy the insurance.
“The Insurance Regulatory and Development Authority (IRDA) has said that as many as 4,261 corporate agents, out of the total 7,000 in the country, are not authorized to sell policies from March 31, this year.
The IRDA, which displayed the names of corporate agents that were banned, cautioned the insurance companies and general public not to transact any insurance business through them.
The list of banned agents includes HDFC Bank (General Insurance), Oswal Consultancy, India Bulls Insurance Advisors Pvt Ltd in Mumbai; Prosoft Technologies and Tangent in Bangalore; Rishab Investments and Cosmos Financial Services in Chennai; Pact Brokerage and Atluri Travels in Hyderabad.
"These corporate agencies were due for renewal on or before March 31, 2010 but have not been renewed till date. All these agency licences have been withdrawn," IRDA said in a circular on Tuesday.
According to a senior IRDA official, the policies purchased after March 31 and till date could be valid and the full implications are being worked out.
The business is likely to hit as almost all life and general insurers including Life Insurance Corporation of India engaged these agencies.“
Is it that many of the MLM companies are also affected?
Comments are invited.
Yes, you can buy but you must check that it is not one of the 4261 corporate agents whose licence has been cancelled by IRDA, the regulator.
The following news item is an eye opener for those who have to buy the insurance.
“The Insurance Regulatory and Development Authority (IRDA) has said that as many as 4,261 corporate agents, out of the total 7,000 in the country, are not authorized to sell policies from March 31, this year.
The IRDA, which displayed the names of corporate agents that were banned, cautioned the insurance companies and general public not to transact any insurance business through them.
The list of banned agents includes HDFC Bank (General Insurance), Oswal Consultancy, India Bulls Insurance Advisors Pvt Ltd in Mumbai; Prosoft Technologies and Tangent in Bangalore; Rishab Investments and Cosmos Financial Services in Chennai; Pact Brokerage and Atluri Travels in Hyderabad.
"These corporate agencies were due for renewal on or before March 31, 2010 but have not been renewed till date. All these agency licences have been withdrawn," IRDA said in a circular on Tuesday.
According to a senior IRDA official, the policies purchased after March 31 and till date could be valid and the full implications are being worked out.
The business is likely to hit as almost all life and general insurers including Life Insurance Corporation of India engaged these agencies.“
Is it that many of the MLM companies are also affected?
Comments are invited.
Wednesday, June 9, 2010
Rural Insurance:
- Kissan Agricultural Pumpsets Insurance
- Cattle Insurance
- Sheep/ Goat Insurance Honey Bee Insurance
- Dog Insurance
- Janatha Personal Accident
Kissan Agricultural Pumpsets Insurance:
APPLICABILITY:
The policy applies to centrifugal Pumps (Electrical and Diesel) and submersible pumps up to 25 H.P. capacity used for Agricultural purposes only. Pump with higher capacity i.e. more than 25 H.P. should be insured with Engineering Department’s advice.
STANDARD PERILS COVERED:
Sudden physical damage to pumpsets (including starters) caused by
- Fire/ lightning
- Burglary/ theft (due to violent forcible entry provided the pumpset is kept in a locked enclosure).
- Mechanical/ electrical breakdown
- Riots and Strike, malicious damage
- Terrorism
EXCLUSIONS:
- Normal wear and tear gradual deterioration due to atmospheric conditions or otherwise.
- Gross negligence of the insured or his representative
- Faults existing at the time of commencement and known to the insured or his representative.
- Loss or damage for which the manufacturer or supplier of the property is responsible either by law or under contract
- Cost of dismantling, transport to workshop and back as also cost of re-erection.
PREMIUM:
- Standard Cover (Excluding Flood risk) – 1% of S.I.
- Flood Cover (optional) – 0.5% of S.I.
Cattle Insurance:
APPLICABILITY:
Applicable to indigenous cross-breed and Exotic cattle, owned by/ belonging to Private owners, various financial institutions i.e. Bank-financed Military dairy farms, Co-operative/ Corporate dairies etc.
Cattle means include:
- Milch cows and Buffaloes
- Calves/ Heifers
- Stud bulls
- Bullocks/Buffaloes
- Mithuns
AGE GROUP:
- Milch cows: 2 years or age at first calving to 10 years
- Milch Buffaloes: 3 years or age at first calving to 12 years
- Stud Bulls: 3 years or earlier age at sexual maturity to 8 years
- Bullocks/He buffaloes: 3 years to 12 years
- Calves/ Heifers: 4 months up to date of 1st calving.
VALUATION:
Valuation based on market value as on date and place and to be decided on the basis of recommendations of the local veterinary surgeon.
Sum Insured: Not exceeding market value.
SCOPE OF COVER:
The policy shall give indemnity only for death of cattle due to:
- Due to accident (inclusive of fire lightning, Flood/ Inundation, Cyclone, Tornado, Tempest, Storm, Hurricane, Famine) or any other Fortuitous circumstances.
- Disease (inclusive of Rinderpest, BlackQuater Haemorrhegic Septicemia, Foot and mouth disease subject to vaccination against these diseases).
- Surgical operations.
- Strike, Riot and Civil Commotion risk and Terrorism
- Earthquake.
EXCLUSIONS:
- Theft or clandestine sale, missing of insured animal.
- Malicious or willful injury or neglect/ intentional slaughter.
- Transport by air or sea or beyond 80 km by Rail, Road.
- Partial disablement of any type, whether permanent or temporary.
- Accidents happened/ Diseases contracted prior to commencement of risk.
- War and allied perils.
PREMIUM RATE:
- 4% gross p.a.
- 1% gross p.a. for PTD cover
- 2.25% net p.a. for IRDP (Integrated Rural Development Program).
- 2% gross p.a. for exotic animals.
SPECIAL FEATURES:
PTD arising out of accident animal and/ or unable to conceive or yield milk or unable to be used for breeding can be covered by payment of additional premium.
POINTS TO BE NOTED:
- 15 days waiting period: The Company is not liable to pay the claim in the event of death of insured animal due to diseases occurring within 15 days from the commencement of risk.
- No tag- No claim: In the event of death of animals covered under the policy, claims shall not be entertained unless the ear tags are surrendered to the company. In the event of loss of ear tag, it is the responsibility of the insured to give immediate notice to the company and get the animal retagged.
Sheep/ Goat Insurance
APPLICABILITY
The cover is applicable to Indigenous, cross-bred and exotic breeds of sheep and goat, 4 months to 7 years as follows:
- Indigenous animal means whose parents are of Indian breed.
- Exotic animal means whose parents are of foreign breed. This includes animals born in India as well as those born abroad.
- A cross-breed animal for the insurance purpose means one of whose parents is of foreign breed.
SCOPE OF COVER:
Death due to accident, (includes fire, lightning, flood, cyclone, earthquake, famine etc) riot/ strike and diseases contracted or occurring during the period of the policy period.
EXCLUSIONS:
- Theft and /or clandestine sale.
- Malicious or willful injury or neglect/ intentional slaughter
- Transport by air or sea
- Partial disablement of any type, whether permanent or temporary.
- Specified disease such as sheep pox, goat pox, enterotoxaenia, rinderpest, FMD, anthrax, HS and Black Quarter and Tetanus, unless successfully inoculated and necessary certificates produced.
Basic
4% Gross per annum
2.75% net for IRDP
EXTRA RATES:
- For cross bred animals: 1% gross
- For exotic animals: 2% gross
Honey Bee Insurance
APPLICABILITY:
Hive and/ or bee colonies belonging to individual can be insured. Bee colonies of Apis cerena indica and Apis mellifera only shall be covered.
INSURANCE COVERAGE:
- All accidental losses or damage to the hive and/ or bee colony.
- Theft risk can be covered on payment of an additional premium.
- Diseases can also be covered on payment of additional premium.
EXCLUSIONS:
- Loss of production
- Malicious or willful destruction of bee hive
- Theft, clandestine sale or loss of the beehive
- Neglect or improper management and /or rough handling
PREMIUM RATE:
3-5% on total insured value p.a. theft can be covered on payment of an additional premium at 2% Minimum premium Rs. 20 per policy p.a.
SPECIAL FEATURES:
The insurer will bear 80% of the assessed loss amount and the insured will bear the balance 20%.
Dog Insurance
APPLICABILITY
Indigenous, Cross bred or Exotic dogs, which are pets, Watch dogs, Sheep dogs and Hunting dogs.
SCOPE OF COVER:
Death due to accident and /or diseases contracted during the period of insurance.
EXCLUSIONS:
Common: As per the Standard dog insurance policy.
Specific: Partial and permanent Disability of any nature, Rabies, Canine Distemper and Leptospirosis. These diseases are covered if preventive inoculation is done and certificate to that affect is submitted.
AGE GROUP:
8 week to 8 years only.
VALUATION CERTIFICATE:
As certified by the duly qualified Veterinary Doctor at the time of proposing the insurance. Veterinary Certificate from qualified Veterinary Doctor is necessary on the Company’s form.
Note:
- Proposal should be referred, for acceptance.
- Minimum value of dog of any breed should not be less than Rs. 200/- and Maximum value of the dog should not exceed Rs. 10,000/- each.
- Proposals where S.I. exceeds, Rs. 10,000/- have to be referred to H.O. for acceptance.
IDENTIFICATION:
Insured dogs must be suitably identified by one of the following methods:
- Nose Print
- Color photograph
- Normal physical identification marks and breed, sex, age, etc. should be clearly described in the Veterinary Certificate and proposal form.
- In the case of pups, one more color photo may be taken at 6 to 8 months age. Cost of identification is to be borne by the insured only.
PREMIUM:
6% flat on the sum insured
Minimum premium per policy Rs. 20/-
INDEMNITY:
80% Market Value or sum insured whichever is less, 20% of the claim amount to be borne by the insured.
SALVAGE:
In the event of death of insured dog, any amount received or receivable by the proposer from third parties and the value of the salvage recovered, if any would be deducted from the claim amount.
Janatha Personal Accident:
APPLICABILITY
Indigenous, Cross bred or Exotic dogs, which are pets, Watch dogs, Sheep dogs and Hunting dogs.
SCOPE OF COVER:
Death due to accident and /or diseases contracted during the period of insurance.
EXCLUSIONS:
Common: As per the Standard dog insurance policy.
Specific: Partial and permanent Disability of any nature, Rabies, Canine Distemper and Leptospirosis. These diseases are covered if preventive inoculation is done and certificate to that affect is submitted.
AGE GROUP:
8 week to 8 years only.
VALUATION CERTIFICATE:
As certified by the duly qualified Veterinary Doctor at the time of proposing the insurance. Veterinary Certificate from qualified Veterinary Doctor is necessary on the Company’s form.
Note:
- Proposal should be referred, for acceptance.
- Minimum value of dog of any breed should not be less than Rs. 200/- and Maximum value of the dog should not exceed Rs. 10,000/- each.
- Proposals where S.I. exceeds, Rs. 10,000/- have to be referred to H.O. for acceptance.
IDENTIFICATION:
Insured dogs must be suitably identified by one of the following methods:
- Nose Print
- Color photograph
- Normal physical identification marks and breed, sex, age, etc. should be clearly described in the Veterinary Certificate and proposal form.
- In the case of pups, one more color photo may be taken at 6 to 8 months age. Cost of identification is to be borne by the insured only.
PREMIUM:
6% flat on the sum insured
Minimum premium per policy Rs. 20/-
INDEMNITY:
80% Market Value or sum insured whichever is less, 20% of the claim amount to be borne by the insured.
SALVAGE:
In the event of death of insured dog, any amount received or receivable by the proposer from third parties and the value of the salvage recovered, if any would be deducted from the claim amount.
Engineering Insurance:
- Electronic Equipment Insurance
- Machinery Breakdown Insurance
- Erection All Risks Insurance
- Contractor's Risks Insurance
- Contractor's Machinery Insurance
Electronic Equipment Insurance
INTRODUCTION:
The term Electronic Equipment (EE), in the context of this branch of Engineering Insurance, comprises of all electrical system which generally have only a low current. There is a very wide range of such equipments such Computers, Micro Processors, Word Processors, Telecommunication Equipments, Machines meant for Medical and Ophthalmic use, Aviation Equipments, T.V. Studio Equipments, Process Control Equipments, Equipments for Computer/ Numerical control of machine tools and special purpose machines, etc. The electronics first appeared in the industry in the 50’s. Transition from mechanical and electrical monitoring and control to electronics has been accelerating at a breath- taking pace. Now there is hardly any field of technology or industry which is not touched electronics. EE insurance is therefore, of immense importance to the users of electronic equipments, may they be the owners, operators, maintainers.
SCOPE OF COVER:
The E.E. Insurance is a “Comprehensive Accident” Insurance covering unforeseen loses which arise suddenly and cause material damage to the equipment from any of the following perils:-
- Location perils: Fire, Lightning, Explosion, Theft, Burglary and House Breaking.
- Operational Risks: Electrical/ Mechanical Breakdown, Faulty Design, Faulty Material, Faults in manufacturing assembling, erection, Moisture and humidity.
- Risks of Human Element: Faulty/ Careless/ negligent operation, Riot, Strike and Malicious damage.
- Acts of God Risks: Storm, Tempest, Hurricane, Flood, Inundation, Subsidence, Landslide, Rock slide, Earthquake.
EXCLUSION:
The insurance cover is, however, subject to a few exclusions listed in the policy which are applied internationally and are common to the insurance industry.
EXTENSIONS:
Apart from the Material damage to the insured equipment, scope of cover available under an EE policy may be extended to cover the following on specific request:-
Data Media Insurance:
Cover may be obtained for financial loss that may arise from accidental loss of information data stored on the external data media such as diskettes and floppies. Cover is provided on a First Loss basis both for the materials value of the data media and the cost of reprocessing and restoring lost information.
Increased Cost of Working Insurance:
In the event of a breakdown of the insured computer, the required computing capacity may have to be hired from other sources. Cover may be obtained for reimbursement of these additional expenses involved such as hire charges, transportation cost etc.
Machinery Breakdown Insurance
INTRODUCTION:
This Branch of Engineering Insurance has been developed to grant the Industry an effective insurance cover for Plant, Machinery and other mechanical equipment. It is an extremely useful Policy for protecting the Plant and Machinery against operational accidental damages. It even insures the machines against damage while these are idling and/ or under repairs, due to such non-operational causes as external impact, etc. The insured is permitted to select the machinery to be insured under the Policy, but has to offer a complete machine for insurance and not opt only for vulnerable parts. Such items having a short service life listed here under compared to the entire plant are however, normally excluded:-
- All types of interchangeable tools.
- Sieves, engraved, cylinders, stamps, dies, ropes, chains, belts.
- Parts made of glass, ceramic or wood, rubber tyres.
- Operating media of any kind such as fuel, gas, refrigerant, catalysts, lubricant (oil in transformers and circuit breakers is, however, included since it is not only a coolant but also serves as an insulation agent).
It is advisable to make distinction between plant and Machinery and Electronic equipment such as computers, microprocessor based controls and large process control instrumentation and systems which are predominantly electronic in nature. It is more economical and beneficial for the insured to get coverage for such equipment under Electronic Equipment policy instead of insuring it under Machinery Insurance policy. This policy is available only after the newly installed equipment has been successfully commissioned and has proved its operational/ productive worthiness.
SCOPE OF COVER:
Machinery Insurance is an ‘Accident’ cover for machinery supplementing the coverage offered by a Fire Insurance Policy. It basically covers unforeseen and sudden physical loss of or damage to the insured items.\, necessitating their replacement or repair mainly arising from any of the following causes:-
- Faulty design, faulty workmanship, defects in casting and material
- Faulty operation, lack of skill, negligence
- Tearing apart on account of centrifugal forces.
- Short circuit and other electrical causes.
- Damage due to accident to boiler and its allied equipment due to shortage of water/ overheating and collapse of tube/ Flue gas explosion. The insurance cover is, however subject to a few exclusions listed in the policy which are applied internationally and are common to the insurance industry.
EXTENSIONS:
The Scope of cover under a Machinery Insurance Policy may be extended to cover the following on specific request.
ADDITIONAL CUSTOM DUTY COVER:
As custom duty payable on Project Equipment import is less that the duty applicable on replacement equipment/ Spares, it is advisable to have this extension which takes care of additional duty payable for replacement of equipment and/ or spares in the event of loss. The sum insured under the policy should be taken, based on estimated extra custom spares following a serious breakdown. This cover is operated on First Loss basis and actual custom duty is reimbursable subject to limits of amount.
Erection All Risks Insurance
INTRODUCTION:
In the course of execution of a project for erection of machinery, plant and structure of any kind, certain serious mishaps could occur resulting in loss or damage, as well as liabilities could arise in respect of Third Party claims for property damage or bodily injuries. An Erection All Risks(EAR) insurance offers protection to Principals and Contractors and also to manufacturers and Suppliers erecting machinery and plant etc, against financial loss due to any sudden unforeseen causes resulting in loss or damage to the property insured at the project site whilst being stored, erected, rested and maintained. EAR insurance has been designed to meet the tested and maintained. EAR insurance has been designed to meet the needs of the market, which are fast changing with the advancement in technology and the cover is available for structures and projects of all sizes of Macro or Micro levels i.e. large projects such as erection of Thermal Power Stations, Oil Refineries, Fertilizer plants etc, or small projects like installation of Computers or Electrical equipment.
SCOPE OF COVER:
Ear insurance provides a very wide and comprehensive insurance cover to the client in respect of any sort of contingency from the moment the material is unloaded at the site of the project and continues during storage, physical erection and till the test run is over and during maintenance, if covered. It covers all physical losses or damages arising from:-
- Location Risks: Fire, Lightning, Theft, Burglary and House Breaking.
- Handling Risks: Impact from falling objects, Collision, Failure of Cranes, etc.
- Testing and Commissioning Risks: Failure of Safety devices, Leakage of Electricity, Insulation failure, Short Circuit, Explosion.
- Risks of Human Element: Carelessness, Negligence, Fault in Erection, Strike and Riot, Malicious damage.
- Acts of God Risks: Storm, Tempest, Hurricane, Flood, Inundation, Subsidence, Landslide, Rockslide, Earthquake.
The insurance cover is subject to a few exclusions listed in the Policy which are applied internationally and are common to the insurance industry.
EXTENSIONS:
The scope of cover available under a standard EAR policy may be extended to cover the following on specific request:-
Civil Engineering Works:
- Permanent Civil Engineering Works.
- Temporary Civil Engineering Works.
It is preferable to insure the above items under Contractors. All Risks Policy instead of this Policy. However, machinery foundations, specific supports of equipment etc, which must go as part of the machinery and requires to be constructed under supervision and guidance of Engineers of the suppliers of equipments could be insured under the EAR Policy.
Clearance and Removal of Debris:
Major accidents or catastrophes cause devastating damages. The site may become unworkable and warrant clearance of area for restarting the work. This requires considerable expenditure and at times specialized services of experts. Under this cover, the insured is reimbursed the actual amount of expenditure incurred towards debris removal of insured property subject to maximum limit of 50% of the project cost.
Construction Plant and Machinery:
Every project site requires certain material handling and construction equipments like Cranes, Hoists, Air Compressors, Welding Sets, etc. for carrying out various erection activities. The said equipment unless already covered under a separate Contractors Plant and Machinery (CPM) policy, could be covered under this head but it is subject to terms and conditions of the CPM Policy.
Express Freight, (other than Air Freight) Over Time, Sunday and Holiday wages:On account of occurrence of an insured peril, some times it becomes necessary to undertake the repair work on war footing and also to work on holidays. The spare parts may have to be obtained by express freight (excluding air freight). To take care of such expenditure, an estimated amount that would be incurred following a major accident should be taken as sum insured. Factors to be taken into account would be the type of machinery/ plant, distance of the source of procuration, nature of transport available, type of labor and their wage structure.
Air Freight Cover:
Specific coverage should be taken for Air Freight of items. This cover operates on First Loss basis and actual expenses are reimbursable subject to maximum amount chosen under this head.
Surrounding Property:
Under this extension damages caused to the surrounding property, such as property, such as property located on site belonging to or held in trust, care, custody or control of the Insured, on account of accident due to erection work is covered. Insurance of surrounding property becomes relevant when renovation or expansion project is envisaged and the work is carried out in the vicinity of existing assets.
Third Party Liability:
Circumstances may arise when on account of mishaps in the works, loss or damage may be caused to third party property as well as bodily injury in which case a liability will arise on the part of the insured to make good the loss. Such a liability can be covered under the extension of the policy.
Escalation Clause:
It is a known fact that world economy has been experiencing upward inflationary trend in the last four decades. This trend has jumped up considerably during the last decade owing to various known and unknown factors. Our country in particular has faced widespread escalation duri8ng the last twenty years. The prices have shot up more than 3 or 4 times particularly in respect of imported goods. Erection projects are normally for a long period and it is, therefore, advisable to provide for increase in the Prime Cost of the equipment due to escalation to ensure full protection by opting for an Escalation Clause.
In the event of a claim arising, the Escalation Clause under the Policy provides indemnity to the Insured for the actual replacement cost of damaged items subject to the condition that it is equal to but not less than the original Prime Cost plus the selected escalation taken by the Insured under the policy. It should be clearly understood that this extension does not provide automatic coverage for project over-run on account of price variation, modification etc. The maximum escalation permitted under the Policy is 50% of the Prime Cost.
Contractor's Risks Insurance
INTRODUCTION:
During the course of execution of projects relating to construction of buildings and civil engineering works, certain unforeseen accidents could occurs resulting in considerable financial loss to the contractors and /or the principals arising from damage toe the contract works, construction Plant and machinery as well as Third Part Claims. The Contractors All Risks (CAR) Insurance has been designed to protect the interests of the contractors/ principals against such losses.
Although a CAR Policy may be taken by the Principal or by the contractor, but usually, under the terms of the agreement between the contractor and Principal, it is obligatory on the part of the contractor to affect CAR insurance in their joint names before the commencement of the project.
Building works:
- Buildings such as dwelling houses, Schools, Universities, Hospitals, Shopping centers, Hotels, Factories and Workshops.
- Multistoried and high rise buildings.
- Non-conventional buildings or modern designs or where construction is difficult due to large, heavy or cumbersome prefabricated units.
- Alterations and extensions of structural or non-structural buildings.
Civil Engineering Works:
- Earthwork, Sewage, Drainage, Roads, Irrigation system, Flyovers, Canals, Silos, Water Reservoirs and the like.
- Hazardous structures such as Tunnels, Dams, Mines, Bridges and the like.
SCOPE OF COVER:
The Policy covers loss or damage to the subject matter from any sudden unforeseen or accidental cause which is not specifically excluded under the Policy. Therefore it covers all physical losses or damages occurring during the period of insurance arising from:-
- Location Risks: Fire, Lightning, Theft, Burglary and House Breaking.
- Handling Risks: Impact from falling objects, Collision, Failure of material handling equipments.
- Risks of Human Element: Carelessness, Negligence, Faulty material and Construction, Riot, Strike, Malicious damage.
- Act of God Risks: Storm, Tempest, Hurricane, Flood, Inundation, Subsidence, Landslide, Rock slide, Earthquake.
This insurance cover is subject to a few exclusions listed in the Policy which are applied internationally and are common to the insurance industry. The cover attaches as from the commencement of work or after the materials required for the project have been unloaded at the site, and terminates when the completed structure or one completed part thereof is taken over or put into service. The insurer’s liability for construction machinery, plant and equipment commences from their unloading at the site and expires on their removal there form. In addition, on specific request, it is possible to extend the period of cover to include a maintenance period.
EXTENSIONS:
The scope of cover available under a standard CAR Policy may be extended to cover the following on specific request:-
- Clearance and Removal of Debris.
- Construction Plant and Machinery
- Express Freight, Over-time, Sunday and Holiday Wages
- Surrounding Property
- Third Party Liability
- Escalation
- Maintenance Visits Cover
- Extended Maintenance Cover
- Terrorism
The coverage provided under the above extensions are similar to those under EAR insurance.
Contractor's Machinery Insurance
INTRODUCTION:
The execution of almost all projects necessarily requires use of various types of plant and machinery. The nature and the type of equipment may differ according to the nature, type and location of a project and may even differ at different stages of the projects. Such equipment may comprise of Cranes, Compressors, Road-rollers, Vibrators, Welding Sets, Hydraulic Excavators and the like. Whilst it is possible to have the Contractor’s plant and Machinery covered under an EAR or CAR Policy at specific project sites, Contractor’s Plant and Machinery (CPM) Insurance has been designed to provide a cover on annual basis to a contractor who may be using his plant and machinery at different projects during the course of the year. The cover under a CPM Policy is not limited to a specific project site and is operative at all the sites wherever the plant and machinery is in use and even while the same is lying at the contractor’s own premises. The insurers have, however, to be informed of the sites where the insured items are being used.
SCOPE OF COVER:
A CPM Policy covers unforeseen and sudden physical loss of or damage to the insured plant and machinery from any cause whatsoever, occurring at work site or at rest, other than risks specifically excluded under the Policy. The cover is also operative whilst any equipment is being dismantled for the purpose of cleaning or overhauling and also being reassembled thereafter. The Policy, therefore, covers all physical losses or damages arising from:-
- Location Risks: Fire, Lightning, Theft, Burglary and House-breaking.
- Impact from Falling Objects: Collision and the like
- Risks of Human Element: Carelessness, Negligence, Riot, Strike, Malicious Damage.
- Acts of God Risks: Storm, Tempest, Hurricane, Flood, Inundation, Subsidence, Landslide, Rockslide, Earthquake.
EXTENSIONS:
The Scope of cover available under a standard CPM Policy may be extended to cover the following on specific request:-
- Clearance and Removal of Debris
- Surrounding Property
- Their Party Liability
- Terrorism
Motor Vehicle Insurance:
GENERAL REGULATIONS:
Proposal Forms:
A duly completed proposal form is the basis of insurance. For change IDV at each renewal, however, fresh proposal is not necessary. Such changes may be advised by the insured to the insurer by a letter signed by the insured/insured’s authorized signatory (for companies/body corporate) and sent to the insurer by recorded delivery. In case of change of insurer, fresh proposal is required to be submitted to the new insurer. The insurers may include additional questions in the proposal from for their information and use.
TYPES OF POLICIES:
There are two types of policies:
- Liability Only Policy: This covers Third Party Liability for bodily injury and /or death and property damage. Personal Accident for Owner Driver is also included.
- Package Policy: This covers loss or damage to the vehicle insured (O.D) in addition to (1) above.
VALUED POLICIES:
Under an agreed Value Policy a specified sum agreed as the insured value of the vehicle is paid as compensation in case of Total Loss/ constructive Total Loss of the Vehicle without any deduction for depreciation. It is not permitted to issue Agreed Value Policies under this tariff expecting for policies covering vintage cars. For such policies, Endorsement IMT-2 is to be used.
INSURED’S DECLARED VALUE (IDV):
The Insured’s Declared Value (IDV) of the vehicle will be deemed to be the ‘SUM INSURED’ for the purpose of this tariff and it will be fixed at the commencement of each policy period for each insured vehicle. The IDV of the vehicle is to be fixed on the basis of manufacturer’s listed selling price of the brand and model as the vehicle proposed for insurance at the commencement of insurance/renewal and adjusted for depreciation (as per schedule specified below) The IDV of the side car(s) and /or accessories, if any, fitted to the vehicle but not included in the manufacturers ‘s listed selling price of the vehicle is also likewise to be fixed. The schedule of age-wise depreciation as shown below is applicable for the purposed of Total Loss/Constructive Total Loss (TL/CTL)claims only. A vehicle will be considered to be a CTL, where the aggregate cost of retrieval and /or repair of the vehicle subject to terms and conditions of the policy exceed 75% of the IDV.
Schedule of Depreciation for arriving at IDV
AGE OF THE VEHICLE | % OF DEPRECIATION FOR FIXING IDV |
---|---|
Not exceeding 6 months | 5% |
Exceeding 6 months but not exceeding 1year | 15% |
Exceeding 1year but not exceeding 2 years | 20% |
Exceeding 2year but not exceeding 3 years | 30% |
Exceeding 3years but not exceeding 4 years | 40% |
Exceeding 4 years but not exceeding 5 years | 50% |
Note: IDV of vehicles beyond 5 years of age and of obsolete models of the vehicles(i.e models which the manufacturers have discontinued to manufacture) is to be determined on the basis of an understanding between the insurer and the insured.For the purpose TL/CTL claim settlement, this IDV will not change during the currency of the policy period in question. It is clearly understood that the liability of the insurer shall in no case exceed the IDV as specified in the policy schedule less the value of the wreck, in ‘as is where is’ condition.
Depreciation on parts of partial loss claims
The following rates of depreciation shall apply for replacement of parts for partial loss claims in respect of all categories of vehicles/accessories.
- Rate of depreciation for all rubber/nylon/plastic parts, tyres, tubes, batteries and air bags. - 50%
- Rate of depreciation for all fiber glass components - 30%
- Rate of depreciation for all parts made of glass - Nil
Rate of depreciation for all other parts including wooden parts is as per the following schedule
Age of the vehicle | % of Depreciation for fixing IDV |
---|---|
Not exceeding 6 months | Nil |
Exceeding 6 months but not exceeding 1year | 5% |
Exceeding 1 year but not exceeding 2 years | 10% |
Exceeding 2 years but not exceeding 3 years | 15% |
Exceeding 3 years but not exceeding 4 years | 25% |
Exceeding 4 years but not exceeding 5 years | 35% |
Exceeding 5 years but not exceeding 10 years | 40% |
Exceeding 10 years | 50% |
PERIOD OF INSURANCE:
Unless specifically stated otherwise, premiums quoted in the Schedules under various Sections of Motor tariff are the premiums payable on policies issued or renewed for a period of twelve months. No policy is permitted to be issued or renewed for any period of longer than twelve months. It shall, however, be permissible to extend the period of insurance under the policy of any period less than twelve months, for the purpose of arriving at a particular renewal date or for any other reasons convenient to the insured, by payment of extra premium calculated on pro-rate basis provided such policies are renewed with the same insurer immediately after the expiry of such an extension. All such extension will require attachment of the following Warranty to the policy.
In consideration of the premium for this extension being calculated at a pro-rate proportion of the annual premium, it is hereby declared and agreed by the insured that upon expiry of this extension, this policy shall be renewed for a period of twelve months, failing which the difference between the extension premium now paid on pro-rate basis and the premium at short period rate shall become payable by the insured.
Premium Rates for short period cover:
Short period Cover/Renewal may be granted for period less than twelve months at the following short period scale:
Period | % of Annual Premium Rate |
---|---|
Not exceeding 1 month | 20% |
Exceeding 1 month but not exceeding 2 months | 30% |
Exceeding 2 months but not exceeding 3 months | 40% |
Exceeding 3 months but not exceeding 4 months | 50% |
Exceeding 4 months but not exceeding 5 months | 60% |
Exceeding 5 months but not exceeding 6 months | 70% |
Exceeding 6 months but not exceeding 7 months | 80% |
Exceeding 7 months but not exceeding 8 months | 90% |
Exceeding 8 months | Full annual premium/ rate |
Payment of Premium:
The full premium is required to be collected before commencement of cover. It is not permissible to collect premium in installments.
Minimum Premium:
The minimum premium applicable for vehicles specially designed or modified for use of the blind, handicapped and mentally challenged persons will be Rs.25/- per vehicle. For all other vehicles, the applicable minimum premium per vehicle will be Rs.100/-.
Transfers:
On transfer of ownership, the Liability Only cover, under a liability Only policy or under a Package policy, is deemed to have been transferred in favor of the person to whom the motor vehicle is transferred with effect from the date of transfer.
The transferee shall apply within fourteen days from the date of transfer in writing under recorded delivery to the insurer who has insured the vehicle. With the details of the registration of the Vehicle, the date of transfer of the vehicle, the previous owner of the vehicle and the number and date of the insurance policy so that the insurer may make the necessary changes in his record and issues fresh certificate of insurance.
In case of package Policies, transfer of the “Own Damage” section of the policy in favor of the transferee, shall be made by the insurer only on receipt of a specific request from the transferee shall be made by insurer only on receipt of a specific request from the transferee along with consent of the transferror. If the transferee is not entitled to the benefit of the No Claim Bonus (NCB) show on the policy, or is entitled to a lesser percentage of NCB than that existing in the policy, recovery of the difference between the transferee’s entitlement, if any, and that shown on the policy shall be made before effecting the transfer. A fresh proposal From duly completed is to be obtained from the transferee in respect of both Liability only and package Policies.
Transfer of package policy in the name of the transferee can be done only on getting acceptable evidence of sale and a fresh proposal form duly filled and signed. The old certificate of insurance for the vehicle, is required to be surrendered and a fee of Rs.50/- is to be collected for issue of fresh certificate in the name of the transferee. If for any reason the old certificate of insurance cannot be surrendered, a proper declaration to that effect is to be taken from the transferee before a new certificate of insurance is issued.
Double Insurance:
When two policies are in existence on the same vehicle with identical cover, one of the policies may be canceled. Where one of the policies commences a date later than the other policy, the policy commencing later is to be canceled by the insurer concerned. If a vehicle is insured at any time with two different offices of the same insurer, 100% refund of premium of one policy may be allowed by issued by two different insurers, policy commencing later is to be canceled by the insurer concerned and pro-rata refund of premium there on is to be allowed . If however, due to requirements of Banks/Financial Institutions, intimated to the insurer in writing, the earlier dated policy is required to be canceled then refund of premium is to be allowed after retaining premium at short period scale for the period the policy was in force prior to cancellation.
In all such eventualities, the minimum premium as specified in the tariff is to be retained. In either case, no refund of premium can be allowed for such cancellation if any claim has arisen on either of the policies during the period when both the policies were in operation, but prior to cancellation of one of the policies.
No Claim Bonus:
- No claim Bonus (NCB) can be earned only in the own Damages section of policies covering all classes of vehicles but not on Motor trade Policy (road Transit Risk/Road Risk/ Internal Risks) and policies which cover only Fire and/ or Theft Risks. For policies covering Liability with fire and only fire and /or theft Risks, the NCB will be applicable only on the Fire and /or Theft components of the premium. An insured becomes entitled to NCB only at the renewal of a policy after the expiry of the full duration of 12 months.
- No claim Bonus wherever applicable, will be as per the following table:
All types of Vehicles % of Discount on
Own Damage PremiumNo claim made or pending during the
Preceding full year of insurance20% No claim made or pending during the
preceding 2 consecutive years of insurance25% No claim made or pending during the
preceding 3 consecutive years of insurance35% No claim made or pending during the
preceding 4 consecutive years of insurance45% No claim made or pending during the
preceding 5 consecutive years of insurance50%
Sunset clause:
If at the renewal falling due any time between 1st July 2002 and 30th June 2003, both day inclusive (after completion of the full policy period of 12 months) an insured becomes entitled to an NCB of 55%^ or 65% in terms of the tariff prevailing prior to 1st July 2002, the entitlement of such higher percentage of NCB will remain protected for all subsequent renewals till a claim arises under the policy, in which case of the NCB will revert to ‘Nil’ at the renewal. Thereafter, NCB if any earned, will be in terms of the above table.
Compulsory PA Cover for Owner-Driver:
Compulsory Personal Accident cover shall be applicable under both Liability only and package policies. The owner of insured vehicle holding an effective driving license is termed as Owner Driver for the purposes of this section Cover is provided to the Owner- Driver whilst driving the vehicle including mounting into / dismounting from or traveling in the insured vehicle as a co-driver.
N.B: this provision deals with personal Accident cover and only registered owner in person is entitled to the compulsory cover where he /she holds an effective driving license. Hence compulsory PA cover cannot be granted where a vehicle is owned by a company a partnership firm or a similar body corporate or where he owner-driver does not hold an effective driving license. In all such cases, compulsory PA cover cannot be granted, the additional premium for the compulsory, PA cover for the owner-driver should not be charged and the compulsory PA cover provision in the policy should also be deleted . Where the owner-driver own more than one vehicle compulsory PA cover can be granted for only one vehicle as opted by him/her.
Scope of P.A. cover
Sl.No | Types of vehicle | Capital Sum Assured | Premium |
---|---|---|---|
1. | Two-wheeler | Rs.1Lakh | Rs. 50-00 |
2. | Private Cars | Rs.2Lakhs | Rs.100-00 |
3. | Commercial Vehicles | Rs.2Lakhs | Rs.100-00 |
Benefits:
Death 100% CSI, Loss of two limbs or Sights of both eyes or one limb and one eye- 100% Loss of one limb or one eye -50% Permanent total disablement 100%.
Use of CNG/LPG fuel:
- In case of vehicle fitted with bi-fuel system such as petrol /Diesel and CNG/LPG permitted by the concerned RTA , the CNG/LPG kit fitted to the vehicle is to insured separately at an additional premium @ 4% on the value of such kit to be specific ally declared by the insured in the proposal form and or in a letter forming part of the proposal form. Endorsement IMT-25 is to be used.
- Where the vehicle is fitted with only CNG/LPG engine or where the vehicle is fitted with bi-fuel system referred above but the value of CNG/ LPG Kit is not separately available. 5% extra on OD premium to be charged.
Liability Insurance:
- Professional Indemnity Policy for Doctors
- Medical Establishments Errors
Professional Indemnity Policy For Doctors & Medical Practitioners:
APPLICABILITY:
The policy will indemnity any act committed by the insured who shall be Registered Medical Practitioner, giving rise to any legal liability to the third party due to professional negligence. The insured includes the policy holder and his qualified assistants or employees named in the proposal .
The act has to be committed during the period of insurance commencing from the retroactive date. Jurisdiction applicable will be Indian Courts. Registered Medical Practitioners shall be classified as:
- Physicians
- Pathologists
- Oncologists
- Cardiologists
- Psychiatrists
- Radiologists or Reontgenologists
- General surgeons
- Plastic Surgeons
- Orthopaedic Surgeons
- Urologist
- Abdominal Surgeons
- Thoracic Surgeons
- Neuro Surgeons
- Cardio-vascular Surgeons
- Otolaryngologists
- Prootologists
- Opthalmologic surgeon
- Opthalmologic physician(excl. surgery)
- Obstertrician and Gynaecologists
- Physician & Non-specialist Surgeon
- Other Practitioner describe fully.
- Whenever doctors wish to cover unqualified staff working with then the same may be allowed by collecting additional premium of 7.5% of the indemnity premium.
- Whenever multiple professional specialization are involved, then the rate applicable will be that of the specialization which attracts the higher premium rates.
- Minimum Premium Rs. 100/-
- No compulsory or Voluntary Deductibles are applicable.
Medical Establishments:
ERRORS & OMISSIONS INSURANCE POLICY:
APPLICABILITY:
The policy will indemnify the insured in respect of any act committed by the professionals or qualified assistants named in the proposal engaged by the medical establishments which gives rise to any third party legal liability. Such activities will be apart of the declared medical activities of the establishment.Such an act should have taken place during the period of Insurance commencing from the retroactive date.
REGISTRATION OF THE ESTABLISHMENTS:
Medical establishment shall be registered with competent authorities as per the local regulations.
Explanations:
For this purpose whenever necessary, applications have been made such registrations and the same have not been rejected then this requirement shall be deemed to have been complied with.
In territories, where no registration facilities exist, the following minimum norms need to be complied with for considering the proposal.The establishment should have:
- At least 10 in-patient bed facility.
- A fully equipped operation theater of its own.
- Fully qualified nursing staff in its employment round the clock unless indicated to the contrary and additional premium paid.
- Fully qualified doctor/doctors should be in-charge round the clock.
Subject to the condition that as and when additional regulations are introduced in the concerned territory the insured shall comply with registration formalities for continuation of the policy or renewal.
LIST OF ELIGIBLE MEDICAL ESTABLISHMENT:
- Hospitals
- Nursing homes
EXCESS:
0.25% of the A.O.Y. limit subject minimum of Rs. 1,000/- and a maximum of Rs. 1Lac.
Miscellaneous Insurance:
The various Policies under it are as follows:
SUBJECT MATTER COVERED:
The policy is specially suitable for covering Jewellery, Valuables, Curios, Antiques and other Works of Art, Paintings, Watches, Cameras and other similar articles.
PROPERTY NOT COVERED:
Fountain pens, Spectacles, Musical Instruments, Cufflinks, Clothing, Cigarette Cases, Silver Utensils, Money, Securities, Manuscripts, Deeds, Bonds, Traveller’s Cheques, Books of Accounts etc.
INSURED PERILS:
EXCLUSIONS UNDER THE POLICIES:
Although these policies are known as All Risk Insurance Policies there are certain exclusions such as
IMPORTANT CONSIDERATION:
Moral Hazard is a very pertinent factor and policies are issued only to known and valued clients. A moral hazard report should be obtained from the marketing official or the concerned u/w officer about his her personal knowledge of the client for a minimum period of three years.
RATING:
APPLICABILITY OF INSURANCE:
The policy is available to Commercial Establishments. Factories, Godowns, shops etc. Burglary Policy can be issued only where a fire policy is also availed.
PROPERTY COVERED UNDER THE POLICY:
EXCLUDED PROPERTIES:
The property excluded under the policy include deeds, bonds, bills of exchange, promissory notes, cash treasury and bank notes, cheques, security for money, stamps, stamp collections, books of account, documents of any kinds, manuscripts, medals and coins, motor vehicles and accessories or livestock unless specifically insured.
INSURED PERILS:
EXCLUSIONS UNDER THE POLICY:
Loss or Damage
TYPES OF POLICIES:
SCOPE OF COVER:
DEFINITION OF MONEY:
It shall include cash, bank draft, currency notes, treasury notes, cheques, postal orders and current postage stamps.
IMPORTANT CONSIDERATION:
The insured should indicate the address of the premises where cash is kept and also the Limits under each or the following situations.
Section 1:
Section II:
Money kept in premises during business hours and whilst kept in licked safe or strong room after business hours against burglary, house breaking or hold up.
MAJOR EXCLUSIONS:
The Company shall not be liable in respect of:
RATING:
Section-I
Normally 0.35 per mile may be charged on ordinary risk in good locality. In case of remote, isolated places the rate may be charged upto 0-.50 per mile.
Section-II
0.25% to 0.50% depending upon risk perception.
APPLICABILITY OF INSURANCE:
This insurance indemnifies the employers against
the financial loss suffered by them due to fraud, dishonesty during the course of employment of an employee or employees subject to the following conditions:
THE PERIOD OF DISCOVERY:
EXCLUSIONS:
This insurance policy does not cover any loss:
IMPORTANT CONSIDERATION:
The following particulars regarding the person to be guaranteed should be satisfactory:
TYPES OF POLICIES:
COMMERCIAL FIDELITY GUARANTEE:
Individual Policy: Only one named individual is covered.
Collective policy: List of employees may be furnished. Each individual may have his respective guarantee amount shown against his/ her name. Advantage of this policy is that any change can be incorporated by just putting an endorsement.
Floater policy: Here list of employees may be furnished by individual guarantee amount is not mentioned. The guarantee amount is floated and can be pegged to any individual in the list upto the maximum limit mentioned in the policy. The policy is helpful for those employers who because of the functional intricacies may not be able to quantify loss in respect of each act of fraud or dishonesty by individual employees.
NOTE:
Floater cover should not be granted for persons numbering less than 5 in case of cover for unnamed persons, all persons without exception should be included. Sub-limits may be stipulated for each category of employees taking into account their functions and maximum amount handled by them.
Position policy: Guarantee amount shown against each position and no name is mentioned.
Blanket policy: Given to establishment with a wide network of staff. Just, a blanket amount for the total number of employees.
PROPOSAL FORM:
Normally for commercial fidelity guarantee policy there are two proposal forms viz., one given by the3 employer and another given by the employee.
HAZARDOUS RISK:
The collection agents whose cash limits are higher than his salary, such as jewelery and traveling salesman, cashiers in hotels, cinema halls, estate agents, treasurer in socio-cultural organization and employees of billion merchants are treated as hazardous risks under these policies.
APPLICABILITY:
This is a comprehensive package insurance scheme, meant for house holders, by combining a number of contingencies under single policy.
This policy comprises of 10 sections. They are as follows.
APPLICABILITY:
This is a comprehensive package insurance scheme meant for small shopkeepers whose property is valued at less than Rs. 10,00,000/-. It contains eleven sections. Maximum four sections will have to be taken in which section 1 and 2 are compulsory.
COVERAGE UNDER POLICY:
The Television insurance policy is designed to indemnify the insured against:
IMPORTANT EXCLUSIONS:
"PACKAGE INSURANCE COVER FOR DOMESTIC TRAVELERS"
SCOPE OF COVER:
The object of this insurance is to provide relief in case of accidental death and loss and/ or damage to accompanied baggage during traveling within the country as follows:
SPECIAL PROVISION:
SCOPE OF COVER:
This policy provides cover against loss/ damage to accompanied personal baggage of the insured due to FIRE, THEFT OR ACCIDENT during the course of the journey.
IMPORTANT EXCLUSIONS:
SPECIAL CONDITIONS:
UNDERWRITING GUIDELINES:
SCOPE OF COVER:
The policy covers loss/ damage to fixed glass (Display windows, show cases etc) by breakage due to accidental causes.
IMPORTANT EXCLUSIONS:
DECLINED RISKS:
RATE:
Rate is to the fixed depending on the merit of each individual proposal taking into consideration localities, risk involved, precautionary measures and previous claims experience etc.
SUGGESTED RATE: Between 4% and 6%.
SECTION 1:
Loss/ damage to property (Gold, Silver items, Pearl, Precious stones etc.) insured whilst contained in the premises or deposited with a bank:-
Perils Covered: Fire, Explosion, Lightning, Riot and Strike, Malicious Damage, Burglary, House Breaking, Theft, Robbery and Hold-up risk only.
SECTION 2: ALL RISKS COVER
SECTION 3: TRANSIT COVER ALL RISKS
Property excluding cash and currency notes whilst in transit within India by
SECTION 4:
Office furniture and fittings against the perils mentioned in Section 1.Damage done by burglars and/ or thieves to the premises and/ or landlord’s fixtures and fitting for which insured is legally responsible as tenant upto 1% of SI under this section.
IMPORTANT EXCLUSIONS:
Loss or damage to the property insured due to:
- All Risk Insurance
- Burglary Insurance Policy
- Cash in Transit Insurance
- Fidelity Guarantee Insurance Policy
- Householder's Insurance
- Shopkeeper's Insurance
- Television Insurance
- Special Contigency Insurance
- Suhana Safar Insurance
- Baggage Insurance
- Plate Glass Insurance
- Jeweller's Block Insurance
All Risk Insurance:
SUBJECT MATTER COVERED:
The policy is specially suitable for covering Jewellery, Valuables, Curios, Antiques and other Works of Art, Paintings, Watches, Cameras and other similar articles.
PROPERTY NOT COVERED:
Fountain pens, Spectacles, Musical Instruments, Cufflinks, Clothing, Cigarette Cases, Silver Utensils, Money, Securities, Manuscripts, Deeds, Bonds, Traveller’s Cheques, Books of Accounts etc.
INSURED PERILS:
- Fire, Riot and Strike
- Burglary, House Breaking, Larceny or Theft
- Accidental Loss or Damage
EXCLUSIONS UNDER THE POLICIES:
Although these policies are known as All Risk Insurance Policies there are certain exclusions such as
- Loss arising from Wear and Tear
- Damages caused by the process of repairing renovation etc.
- Breakage of Lens and Cameras unless caused by fire/ accident to the means of conveyance
- Mechanical/ Electrical Breakdown
IMPORTANT CONSIDERATION:
Moral Hazard is a very pertinent factor and policies are issued only to known and valued clients. A moral hazard report should be obtained from the marketing official or the concerned u/w officer about his her personal knowledge of the client for a minimum period of three years.
RATING:
- Non Tariff
- The normal lowest rate for First Class Proposal is 1.50%.
- If in special cases the geographical limits are to be extended world wide the rate should be atleast 2%.
- The above rate includes Riot and Strike.
Burglary Insurance(Business Premises):
APPLICABILITY OF INSURANCE:
The policy is available to Commercial Establishments. Factories, Godowns, shops etc. Burglary Policy can be issued only where a fire policy is also availed.
PROPERTY COVERED UNDER THE POLICY:
- Stock in trade
- Goods held in trust or on commission for which the insured is responsible.
- Fixtures, Fittings and Utensils in Trade.
- Cash and Currency notes secured in locked safe.
EXCLUDED PROPERTIES:
The property excluded under the policy include deeds, bonds, bills of exchange, promissory notes, cash treasury and bank notes, cheques, security for money, stamps, stamp collections, books of account, documents of any kinds, manuscripts, medals and coins, motor vehicles and accessories or livestock unless specifically insured.
INSURED PERILS:
- Burglary or Housebreaking of property, by actual forcible and violent entry.
- Theft by a person in the premises who subsequently breaks out by a violent and forcible means.
- Damage to the premises by the burglars to be made good by the insured.
EXCLUSIONS UNDER THE POLICY:
Loss or Damage
- Where insured’s family member or business staff is involved as principal or accessory.
- By act of persons lawfully on the premises(larceny)
- Consequent upon fire or explosion.
- Perils insurable under a fire or Plate glass insurance policy.
- Loss of cash from the safe following the use of key or duplicate thereof unless such key is obtained by violence or threats of violence.
- Earthquake and other natural perils.
- Riot, Strike and civil commotion.
- War and Nuclear Risks.
TYPES OF POLICIES:
- Declaration policy may be issued as in Fire Department
- Floater policy on the basis of provision of the fire tariff may be issued.
- First Loss policy may be issued for property except cash and/ or valuables where total loss is impossible.
- Full value policy is the most common type of policy issued.
Cash In Transit Policy:
SCOPE OF COVER:
- Loss of Money in Transit by the insured or insured’s authorized employees occasioned by Robbery. Theft or any other fortitude cause.
- Loss of Money by Burglary, House-breaking, Robbery or Hold up whilst money is retained at insured’s premises in safe or strong room.
DEFINITION OF MONEY:
It shall include cash, bank draft, currency notes, treasury notes, cheques, postal orders and current postage stamps.
IMPORTANT CONSIDERATION:
The insured should indicate the address of the premises where cash is kept and also the Limits under each or the following situations.
Section 1:
- Money for payment of wages or petty cash in transit from bank to office premises and cheques drawn by the insured for the above purposes from premises to bank.
- Money for other purposes in transit between premises and bank.
- Money other than above collected and in personal custody of the insured/ his employees in transit to the premises or bank within 48 hours time.
Section II:
Money kept in premises during business hours and whilst kept in licked safe or strong room after business hours against burglary, house breaking or hold up.
MAJOR EXCLUSIONS:
The Company shall not be liable in respect of:
- Shortage due to error or omission.
- Loss of money entrusted to any person other than the insured or an authorized employee of the insured.
- Loss of money where the insured or his employee is involved as Principal accessory, except loss due to fraud or dishonesty of the cash carrying employee of the insured occurring whilst in transit and discovered within 48 hours.
- Loss occurring on the premises, after business hours, unless the money is in a locked safe or strong room.
- Loss occasioned by Riot and Strike and Terrorism (can be covered on payment of additional premium).
- Money carried under contract of affrightment and theft of money from unattended vehicle.
- Loss of money from safe or strong room following use of the key to the safe or strong room or any duplicate thereof belonging to the insured. Unless this has been obtained by threat or by violence.
RATING:
Section-I
Normally 0.35 per mile may be charged on ordinary risk in good locality. In case of remote, isolated places the rate may be charged upto 0-.50 per mile.
Section-II
0.25% to 0.50% depending upon risk perception.
Fidelity Guarantee Insurance Policy:
APPLICABILITY OF INSURANCE:
This insurance indemnifies the employers against
the financial loss suffered by them due to fraud, dishonesty during the course of employment of an employee or employees subject to the following conditions:
- The cover granted is against the direct pecuniary loss and not a consequential one.
- The loss should be in respect of monies or goods of the insured.
- The act should be committed in the course of the duties specified.
- If the employee guaranteed under the policy had left the services of the employer and was re-engaged by him, no liability attaches to the policy unless the consent of the insurers was obtained.
THE PERIOD OF DISCOVERY:
- If the policy is not renewed or if the policy is canceled, losses must be discovered within 12 months from the date of expiry or cancellation of the policy.
- Company is not liable for losses not sustained within a retroactive period not exceeding 2 years from the date of discovery.
EXCLUSIONS:
This insurance policy does not cover any loss:
- Discovered more than 12 months after the death/ dismissal/ retirement of the employee concerned.
- When there has been any change in the agreed system of check or accounting precautions, without the insurer’s prior consent.
- Caused by an employee after discovery of his previous fraud or dishonesty.
- Such as stock taking shortages, trading losses, not caused by fraud or dishonesty.
IMPORTANT CONSIDERATION:
The following particulars regarding the person to be guaranteed should be satisfactory:
- Character
- Financial position
- Domestic Responsibility.
- Previous experience
- Previous record or service
- Amount guaranteed in relation to remuneration
TYPES OF POLICIES:
COMMERCIAL FIDELITY GUARANTEE:
Individual Policy: Only one named individual is covered.
Collective policy: List of employees may be furnished. Each individual may have his respective guarantee amount shown against his/ her name. Advantage of this policy is that any change can be incorporated by just putting an endorsement.
Floater policy: Here list of employees may be furnished by individual guarantee amount is not mentioned. The guarantee amount is floated and can be pegged to any individual in the list upto the maximum limit mentioned in the policy. The policy is helpful for those employers who because of the functional intricacies may not be able to quantify loss in respect of each act of fraud or dishonesty by individual employees.
NOTE:
Floater cover should not be granted for persons numbering less than 5 in case of cover for unnamed persons, all persons without exception should be included. Sub-limits may be stipulated for each category of employees taking into account their functions and maximum amount handled by them.
Position policy: Guarantee amount shown against each position and no name is mentioned.
Blanket policy: Given to establishment with a wide network of staff. Just, a blanket amount for the total number of employees.
PROPOSAL FORM:
Normally for commercial fidelity guarantee policy there are two proposal forms viz., one given by the3 employer and another given by the employee.
HAZARDOUS RISK:
The collection agents whose cash limits are higher than his salary, such as jewelery and traveling salesman, cashiers in hotels, cinema halls, estate agents, treasurer in socio-cultural organization and employees of billion merchants are treated as hazardous risks under these policies.
House Holder’s Insurance:
APPLICABILITY:
This is a comprehensive package insurance scheme, meant for house holders, by combining a number of contingencies under single policy.
This policy comprises of 10 sections. They are as follows.
- Fire and Allied perils (including earthquake, loss of or damage to building/ contents excluding money and valuables).
- Burglary/ Housebreaking including larceny or theft: Loss of or damage to contents excluding money and valuables.
- All risks: Loss of damage to jewelery or valuables caused by accident or misfortune whilst any where in India.
- Plate Glass: Loss of or damage to fixed plate glass by accidental means.
- Breakdown of domestic appliances: Unforeseen and sudden physical damage caused by mechanical or electrical breakdown of domestic, electrical, electronic or mechanical appliances specified in the policy and whilst contained in the insured premises.
- Television Set: Loss of or damage to television apparatus including V.C.R/ V.C.P whilst contained in the insured’s premises.
- Pedal Cycles: Loss of or damage to pedal cycles, and legal liability to third parties.
- Baggage Insurance: Loss of or damage to personal baggage dud to accident or misfortune whilst traveling any where in India.
- Personal Accident: Personal Accident Insurance for insured, his spouse and children as per personal accident insurance guidelines.
- Public Liability: Legal liability of the insured in respect of accidental death or bodily injury to third party through fault or negligence of the insured/ family members. Legal liability as per W.C. Act/ Common Law towards employees.
ShopKeeper’s Insurance:
APPLICABILITY:
This is a comprehensive package insurance scheme meant for small shopkeepers whose property is valued at less than Rs. 10,00,000/-. It contains eleven sections. Maximum four sections will have to be taken in which section 1 and 2 are compulsory.
COVERAGE UNDER POLICY:
- Fire and Allied perils: Loss of or damage to building/ contents (excluding money and valuables) Whilst contained in the insured’s premises.
- Building
- Contents
- Burglary/ Housebreaking: Loss of or damage to contents (excluding money and valuables) whilst contained in the premises.
- Money Insurance:
- Loss of money in transit due to accident/ misfortune (Not exceeding Rs. 50,000/- per any one carrying).
- Loss of or damage to money, valuables whilst contained in a burglar-proof safe (2% of the sum insured under Section or Rs. 10,000/- whichever is less)
- Loss of money whilst lying in cashiers till and counter (1% of the sum insured under Section 1 or Rs. 5,000/- whichever is less).
- Pedal cycles: Loss of or damage to pedal cycles and legal liability to third parties.
- Plate Glass: Loss of or damage to fixed plate glass by accidental means.
- Neon and Glow sign: Loss of or damage to Non Sign or Glow Sign by accidental external means/ Fire, lightning or external explosion/ Theft/ Riot, Strike, malicious Act.
- Baggage Insurance: Loss of or damage to personal baggage of insured or baggage in connection with trade anywhere in India.
- Personal Accident: Personal Accident insurance for insured/ his employees as per PA Policy
- Fidelity guarantee: Direct pecuniary loss suffered by the insured due to fraud or dishonesty committed by any salaried employee excluding sales man and commission agents.
- Public Liability: Legal liability in respect of accidental death or bodily injury to a third party or accidental damage to their property during performance of business.
- Business Interruption: Due to operation of perils covered under Section I and subject to claim payable there under.
Television Insurance:
The Television insurance policy is designed to indemnify the insured against:
- Loss of or damage to the Television apparatus by
- Accidental external means
- Fire. Lighting
- Short circuiting
- Flood and Storm
- Bursting and overflowing of water tanks
- Theft
- Riot and Strike
- Earthquake, fire and shock
- Legal Liability to third party for accidental bodily injury/ damage to property arising out of the use of TV installation. Rs. 25,000/- for all claims out of one event.
IMPORTANT EXCLUSIONS:
- The company will not pay first Rs. 150/- of any claim due to electrical causes or self-heating.
- Damage to cathode ray tubes.
- Burning out of valves or coils.
- Theft of parts unless the apparatus is also stolen at the same time.
Special Contingency Insurance:
APPLICABILITY:
This policy covers loss against accidental external means, fire, external explosions, self ignition, lightning, burglary, housebreaking, theft and malicious act whilst the property is situated at a designated place.
EXCLUSIONS:
Mechanical or electrical breakdown
SPECIAL FEATURES:
INSURANCE FOR LAP-TOP COMPUTERS:
Laptop computers can be covered under special contingency policy on the lines of electronic equipments policy which also covers electrical or mechanical breakdown. However the rate charged for Lap-Top computers would be between Rs. 1.25% to 1.50%.
This policy covers loss against accidental external means, fire, external explosions, self ignition, lightning, burglary, housebreaking, theft and malicious act whilst the property is situated at a designated place.
EXCLUSIONS:
Mechanical or electrical breakdown
SPECIAL FEATURES:
- Suggested rate is 2.5%
- Whenever items are governed by tariff rates but covered under special contingency policy, it is to be ensured that tariff rates and excess are applied in respect of such items and no violations made in this regard.
INSURANCE FOR LAP-TOP COMPUTERS:
Laptop computers can be covered under special contingency policy on the lines of electronic equipments policy which also covers electrical or mechanical breakdown. However the rate charged for Lap-Top computers would be between Rs. 1.25% to 1.50%.
Suhana Sufur Insurance:
"PACKAGE INSURANCE COVER FOR DOMESTIC TRAVELERS"
SCOPE OF COVER:
The object of this insurance is to provide relief in case of accidental death and loss and/ or damage to accompanied baggage during traveling within the country as follows:
- Rs. 1 lac per head irrespective of age and income, under Table I and Table II of PA policy.
- Reasonable and actual emergency incidental expenses upto Rs. 1000/- per head arising out of an accident resulting in a valid claim under PA section.
- Loss or damage to accompanied baggage arising out of fire, storm, tempest, hurricane, flood, inundation, riot, strike, malicious damage, accident, theft or burglary.
No. of persons | 1 | 2 | 3 | 4 and above |
Sum Insured (Rs.) | 5000 | 10,000 | 12,500 | 15,000 |
SPECIAL PROVISION:
- Cover is available to travelers by all modes. Road/ Rail/ Water and Air including those who travel by their own mode of transport.
- Cover is valid for transit period subject to maximum of 60 days. The cover includes incidental local travel also.
Baggage Insurance:
SCOPE OF COVER:
This policy provides cover against loss/ damage to accompanied personal baggage of the insured due to FIRE, THEFT OR ACCIDENT during the course of the journey.
IMPORTANT EXCLUSIONS:
- LOSS/ damage by wear and tear, moth, mildew, vermin.
- Any process of cleaning, repairing etc.
- Breakage of glass articles, china clay and articles of brittle nature.
- Theft from unattended vehicles
- Electrical and Mechanical breakdown
- Loss or damage to articles while being worn or in actual use
- Terrorism
SPECIAL CONDITIONS:
- Articles in Pairs or Sets.
- Single Article limit.
UNDERWRITING GUIDELINES:
- The geographical limit to the above policy is ‘worldwide’.
- The items covered to be specified with individual values. Valuation report shall be obtained for valuables like Diamond/ precious stones etc.
- Non –Tariff business.
- Guideline rate 0.75% - 5% based on clientele relationship/ other premium income etc.
Plate Glass Insurance:
SCOPE OF COVER:
The policy covers loss/ damage to fixed glass (Display windows, show cases etc) by breakage due to accidental causes.
IMPORTANT EXCLUSIONS:
- Fire/ Explosion, Riot and Strike, terrorism.
- Typhoon, Flood, Hurricane, Volcanic eruption, Earthquake and other convulsions of nature.
- Damage to frame/ framework or any description.
- Cost of lettering or painting.
DECLINED RISKS:
- Bad localities, Empty shops, green house conservatories, unprotected glass at high levels.
- Broken or cracked glass, movable mirrors.
RATE:
Rate is to the fixed depending on the merit of each individual proposal taking into consideration localities, risk involved, precautionary measures and previous claims experience etc.
SUGGESTED RATE: Between 4% and 6%.
Jeweler’s Block Insurance:
SECTION 1:
Loss/ damage to property (Gold, Silver items, Pearl, Precious stones etc.) insured whilst contained in the premises or deposited with a bank:-
- Property insured on the premises
- Property insured in display windows.
- Cash and Currency notes.
- Property Insured in Bank Lockers subject to the insured maintaining a separate register to record all deposits/ withdrawals in such lockers.
Perils Covered: Fire, Explosion, Lightning, Riot and Strike, Malicious Damage, Burglary, House Breaking, Theft, Robbery and Hold-up risk only.
SECTION 2: ALL RISKS COVER
- Property insured excluding Cash and Currency Notes whilst in the custody of the Insured, his partners, Directors duly constituted Attorneys, his employees or sorters of diamonds.
- Property Insured excluding Cash and currency Notes whilst in the custody of persons not in regular employment of the insured such as brokers or agents or cutters or goldsmiths.
SECTION 3: TRANSIT COVER ALL RISKS
Property excluding cash and currency notes whilst in transit within India by
- Registered insured Parcel Post.
- AIR Freight (Minimum 20% of value to be declared to the Airlines).
- Angadias.
SECTION 4:
Office furniture and fittings against the perils mentioned in Section 1.Damage done by burglars and/ or thieves to the premises and/ or landlord’s fixtures and fitting for which insured is legally responsible as tenant upto 1% of SI under this section.
IMPORTANT EXCLUSIONS:
Loss or damage to the property insured due to:
- Whilst it is being worked upon or during cleaning, repairing etc.
- Inventory losses.
- Whilst at any Public Exhibition.
- Theft or dishonesty of the insured’s family members, servants employees, customer, broker, angadias, cutters, goldsmiths in respect of the property entrusted to them by insured.
- Whilst in window display at night or whilst kept out of safes after business hours.
- Any loss following use of key of duplicate key belonging to the insured unless it has been obtained by threat or violence.
- EQ, Volcanic eruptions, flood, storm etc.
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